Ongoing Improvement Research Articles

Impact of En Route Critical Care Provider Experience on Lung Protective Ventilation Compliance During Air Transport of Combat Wounded.

The primary objective of this study was to evaluate the association between the U.S. Air Force Critical Care Air Transport (CCAT) provider operational experience with compliance for lung protective ventilation (LPV) volumes recommended by Acute Respiratory Distress Syndrome Clinical Network guidelines. We performed a retrospective cohort study of CCAT providers transporting combat casualties requiring mechanical ventilation from the Middle East to Germany from 2007 to 2012. We reviewed CCAT medical records from 2007 to 2012 for the total number of patient transports by CCAT physicians and respiratory care practitioners (RCPs). Center for Sustainment of Trauma and Readiness Skills Cincinnati process improvement questionnaire data described provider demographics and clinical backgrounds. We linked these data to patient demographics and in-flight ventilation management from a prior CCAT cohort study. Patient inclusion criteria included transport by CCAT from the Middle East to Germany for traumatic injury requiring mechanical ventilation between 2007 and 2012. We excluded patients with no documented height or tidal volume. LPV compliance was defined as tidal volumes ≤8 mL/kg of predicted body weight during en route critical care transport. We performed a logistic regression analysis. This study was reviewed and approved by the 59th Medical Wing institutional review board (IRB). We analyzed 491 patient transports conducted by 71 (RCPs and 84 physicians. Patients had a median age of 25 years (IQR 22-30), 98% were male, median injury severity score was 24 (IQR 17-34), and median preflight PaO2/FiO2 was 285 (IQR 220-365). Median experience was 26 missions (IQR 13-40) for RCPs and 23 missions (IQR 12-38) for physicians. All in-flight tidal volumes were LPV compliant in 58.3% of missions. Unadjusted analysis showed higher LPV compliance for RCPs with in-garrison critical care experience. Multivariate models did not find an association between missions flown and LPV compliance but did demonstrate a positive association with physician specialty of medical intensivist (OR 3.0, 95% CI 1.6-5.7) and a negative association with flights in 2008 (OR 0.4, 95% CI 0.2-0.7) for LPV compliance. No association was found between number of missions flown by CCAT providers and lung protective tidal volume compliance. Linkage of multiple data sources enabled investigation of clinical and operational currency associations with a care quality metric compliance in the combat en route care environment. Future studies should evaluate the impact of ongoing CCAT training and quality improvement interventions on LPV compliance.

Educational materials as collaborative design space?

The study presented constitutes the first step in a research project aiming at gaining more insight into the processes of creating educational materials through a collaborative design space. Additionally, it focuses on the possibilities of and challenges involved in creating valuable and meaningful educational materials drawing on teachers’ remix practices. The purpose of the study is to investigate how teachers' collaborative interaction with educational tools may influence ongoing improvement of the courses and materials included in design of contextualized learning paths. By taking our point of departure in existing theories and knowledge, we designed a triangulated methodology using a combination of questionnaires, interviews and user behaviour data focusing on the use of the CourseBuilder as a collaborative space. The article focuses on the possibilities and barriers of developing a collaborative design space that enables a (re)design of digital educational materials which looks at teachers’ interest in: 1) designing their own teaching materials, 2) working professionally with the redesign and remixing of materials from many different sources, and 3) adapting them to the many contexts in which materials of this type are included. This article should be seen as a step towards a deeper understanding of opportunities and challenges within teachers' cooperation on designing, sharing, redesigning and resharing teaching materials. It shows that there is a high degree of acceptance of digital teaching materials among teachers of upper secondary schools in Denmark. Furthermore, there seems to be a collaborative culture, where the majority of teachers indicate that they already collaborate professionally regarding course planning and they see advantages connected with these practises. In prior research, factors promoting the adaptation of virtual collaboration are mentioned. These include teachers’ digital skills, professional development through courses, allocated time and integration of tools that allow teachers to enter into re-design networks with colleagues. All the institutions participating in our study show a supportive environment regarding the use of CourseBuilder. However, several factors were identified indicating that CourseBuilder is not the ideal version of a design collaborator. Although the necessary factors for a successful collaborative environment are present, somehow there seems to be a missing link in the fulfilment of CourseBuilder as collaborative design space. Put differently, there are collaborative supportive environments at the specific institutions - but the productive remix practices are not facilitated by CourseBuilder, despite the design intentions and layout.

Examining the perception of undergraduate health professional students of their learning environment, learning experience and professional identity development: a mixed-methods study

BackgroundThe quality of the learning environment significantly impacts student engagement and professional identity formation in health professions education. Despite global recognition of its importance, research on student perceptions of learning environments across different health education programs is scarce. This study aimed to explore how health professional students perceive their learning environment and its influence on their professional identity development.MethodsAn explanatory mixed-methods approach was employed. In the quantitative phase, the Dundee Ready Education Environment Measure [Minimum–Maximum possible scores = 0–200] and Macleod Clark Professional Identity Scale [Minimum–Maximum possible scores = 1–45] were administered to Qatar University-Health students (N = 908), with a minimum required sample size of 271 students. Data were analyzed using SPSS, including descriptive statistics and inferential analysis. In the qualitative phase, seven focus groups (FGs) were conducted online via Microsoft Teams. FGs were guided by a topic guide developed from the quantitative results and the framework proposed by Gruppen et al. (Acad Med 94:969-74, 2019), transcribed verbatim, and thematically analyzed using NVIVO®.ResultsThe questionnaire response rate was 57.8% (525 responses out of 908), with a usability rate of 74.3% (390 responses out of 525) after excluding students who only completed the demographic section. The study indicated a “more positive than negative” perception of the learning environment (Median [IQR] = 132 [116–174], Minimum–Maximum obtained scores = 43–185), and a “good” perception of their professional identity (Median [IQR] = 24 [22–27], Minimum–Maximum obtained scores = 3–36). Qualitative data confirmed that the learning environment was supportive in developing competence, interpersonal skills, and professional identity, though opinions on emotional support adequacy were mixed. Key attributes of an ideal learning environment included mentorship programs, a reward system, and measures to address fatigue and boredom.ConclusionsThe learning environment at QU-Health was effective in developing competence and interpersonal skills. Students' perceptions of their learning environment positively correlated with their professional identity. Ideal environments should include mentorship programs, a reward system, and strategies to address fatigue and boredom, emphasizing the need for ongoing improvements in learning environments to enhance student satisfaction, professional identity development, and high-quality patient care.

Earlier Decision on Detection of Ransomware Identification: A Comprehensive Systematic Literature Review

Cybersecurity is normally defined as protecting systems against all kinds of cyberattacks; however, due to the rapid and permanent expansion of technology and digital transformation, the threats are also increasing. One of those new threats is ransomware, which is a form of malware that aims to steal user’s money. Ransomware is a form of malware that encrypts a victim’s files. The attacker then demands a ransom from the victim to restore access to the data upon a large payment. Ransomware is a way of stealing money in which a user’s files are encrypted and the decrypted key is held by the attacker until a ransom amount is paid by the victim. This systematic literature review (SLR) highlights recent papers published between 2020 and 2024. This paper examines existing research on early ransomware detection methods, focusing on the signs, frameworks, and techniques used to identify and detect ransomware before it causes harm. By analyzing a wide range of academic papers, industry reports, and case studies, this review categorizes and assesses the effectiveness of different detection methods, including those based on signatures, behavior patterns, and machine learning (ML). It also looks at new trends and innovative strategies in ransomware detection, offering a classification of detection techniques and pointing out the gaps in current research. The findings provide useful insights for cybersecurity professionals and researchers, helping guide future efforts to develop strong and proactive ransomware detection systems. This review emphasizes the need for ongoing improvements in detection technologies to keep up with the constantly changing ransomware threat landscape.

Cross-Site Evaluation of Alcohol Screening and Brief Intervention Implementation Programs in Healthcare Systems Serving Individuals of Reproductive Age.

With US Centers for Disease Control and Prevention funding, from 2018 to 2022, 4 large healthcare systems (n = 53 health centers across 7 states) serving people of reproductive age trained staff and provided implementation support for alcohol screening and brief intervention (SBI). This cross-site evaluation explores each healthcare system's implementation approach to implement SBI, reduce excessive alcohol use, and prevent prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorders. The SBIRT (Screening, Brief Intervention, and Referral to Treatment) Program Matrix framed the multilevel strategies to implement alcohol SBI programs from 2018 to 2022. Qualitative and quantitative data sources examined outcomes, guided by one logic model, through systems-level process data and provider-level performance metrics. Data analyses utilized frequencies and means for quantitative data and themes for qualitative data according to an established framework. Successful approaches within systems included using electronic health records, flexible implementation and workflow protocols, customized training and technical assistance programs, quality assurance feedback loops, and stakeholder buy-in. Centralized management structures were efficient in standardizing implementation across health centers. Decentralized management structures used tailored approaches, enhancing provider/staff SBI acceptance. Across systems, 1259 staff (eg, clinicians, medical assistants) were trained to provide alcohol SBI services and reported pre-post training increases in self-efficacy in performing brief intervention; skills in PAE counseling; and confidence in screening. Fifty-three (48 providing data) health centers implemented alcohol SBI, screening 106 826 patients over the study period with most of the 10 087 patients who screened positive for excessive alcohol use receiving a BI. Maximizing the use of technology, employing flexibility in program delivery, and institutionalizing processes and protocols improved workflow, efficiency, and program reach. Ongoing partnership and stakeholder communication identify areas for ongoing improvement, engagement, and best practices for sustainability around substance use screening, which are essential with increases in substance use since the pandemic.

A Review on in-vivo and in-vitro Models of Obesity and Obesity-Associated Co-Morbidities.

Obesity is becoming a global pandemic with pandemic proportions. According to the WHO estimates, there were over 1.9 billion overweight individuals and over 650 million obese adults in the globe in 2016. In recent years, scientists have encountered difficulties in choosing acceptable animal models, leading to a multitude of contradicting aspects and incorrect outcomes. This review comprehensively evaluates different screening models of obesity and obesity-associated comorbidities to reveal the advantages and disadvantages/limitations of each model while also mentioning the time duration each model requires to induce obesity. For this review, the authors have gone through a vast number of article sources from different scientific databases, such as Google Scholar, Web of Science, Medline, and PubMed. In-vivo models used to represent a variety of obesity-inducing processes, such as diet-induced, drug-induced, surgical, chemical, stress-induced, and genetic models, are discussed. Animal cell models are examined with an emphasis on their use in understanding the molecular causes of obesity, for which we discussed in depth the important cell lines, including 3T3-L1, OP9, 3T3-F442A, and C3H10T1/2. Screening models of obesity-associated co-morbidities like diabetes, asthma, cardiovascular disorders, cancer, and polycystic ovarian syndrome (PCOS) were discussed, which provided light on the complex interactions between obesity and numerous health problems. Mimicking obesity in an animal model reflects multifactorial aspects is a matter of challenge. Future studies could address the ethical issues surrounding the use of animals in obesity research as well as investigate newly developed models, such as non-mammalian models. In conclusion, improving our knowledge and management of obesity and related health problems will require ongoing assessment and improvement of study models.

Enhancing efficiency and quality control: Implementing TQM in Pakistani construction

In recent years, construction technology and production have heavily relied on Total Quality Management (TQM) systems to oversee processes and prevent errors before they arise. TQM prioritizes ongoing improvement across all aspects of an organization rather than just measuring performance. It places a strong emphasis on the quality of management systems and is essentially about changing the culture within an organization. This research aims to shed light on the importance of TQM in the construction industry, as there hasn't been an extensive study on its impact in this sector before.

Leadership's Role in Facilitating Faculty Professional Development for Technology Integration

This study explores the function of leadership in supporting faculty professional development for technology integration in educational institutions. Key themes about the role of leadership in fostering successful technology integration were identified through qualitative analysis of semi-structured interviews with 125 participants, including administrators and instructors from 10 educational institutions in Uganda. Establishing the vision and strategic direction, allocating resources and building infrastructure, professional development programs initiative and support mechanisms, recognizing and rewarding technology integration, fostering an innovative and collaborative culture, assessment, and ongoing improvement are some of these themes. The results draw attention to the various roles that leadership plays in fostering an atmosphere that supports technology-enhanced teaching and learning. In addition to providing useful advice for practitioners, policymakers, and educational leaders looking to foster innovation and quality in learning environments, this study advances our understanding of leadership in educational technology.

Development and psychometric evaluation of the Implementation Support Competencies Assessment

BackgroundImplementation support practitioners (ISPs) are professionals that support others to implement evidence-informed practices, programs, and policies in various service delivery settings to achieve population outcomes. Measuring the use of competencies by ISPs provides a unique opportunity to assess an understudied facet of implementation science—how knowledge, attitudes, and skills used by ISPs affects sustainable change in complicated and complex service systems. This study describes the development and validation of a measure—the Implementation Support Competencies Assessment (ISCA)—that assesses implementation support competencies, with versatile applications across service contexts.MethodsRecently developed practice guide materials included operationalizations of core competencies for ISPs across three domains: co-creation and engagement, ongoing improvement, and sustaining change. These operationalizations, in combination with recent empirical and conceptual work, provided an initial item pool and foundation on which to advance measurement development, largely from a confirmatory perspective (as opposed to exploratory). The measure was further refined through modified cognitive interviewing with three highly experienced ISPs and pilot-testing with 39 individuals enrolled in a university-based certificate program in implementation practice. To recruit a sample for validation analyses, we leveraged a listserv of nearly 4,000 individuals who have registered for or expressed interest in various events and trainings focused on implementation practice offered by an implementation science collaborative housed within a research-intensive university in the Southeast region of the United States. Our final analytic sample included 357 participants who self-identified as ISPs.ResultsAssessments of internal consistency reliability for each competency-specific item set yielded evidence of strong reliability. Results from confirmatory factor analyses provided evidence for the factorial and construct validity of all three domains and associated competencies in the ISCA.ConclusionsThe findings suggest that one’s possession of high levels of competence across each of the three competency domains is strongly associated with theorized outcomes that can promote successful and sustainable implementation efforts among those who receive implementation support from an ISP. The ISCA serves as a foundational tool for workforce development to formally measure and assess improvement in the skills that are required to tailor a package of implementation strategies situated in context.

Is It the Best Option? Robotic Surgery for Endometriosis.

Endometriosis is a chronic condition affecting approximately 10% of women of reproductive age, leading to significant physical and emotional stress. Treatments include medical management and surgical interventions, with laparoscopic surgery being the gold standard for removing endometrial tissue. The advent of robotic-assisted laparoscopic surgery (RALS) has enabled more complex procedures to be performed minimally invasively, increasing its use in high-difficulty surgeries. Developed in the late 20th century, systems like the Da Vinci Surgical System have revolutionized surgery by enhancing precision, dexterity, and visualization. The latest models, including the Da Vinci Xi and SP, offer advanced features such as enhanced arm mobility, fluorescence imaging, and single-port capabilities. Comparative studies of RALS and conventional laparoscopy (LPS) for endometriosis show mixed results. While some studies indicate no significant differences in complications or recovery outcomes, others highlight longer operative times and hospital stays for RALS. Despite these drawbacks, RALS is not inferior to LPS overall. The clinical benefits of RALS include greater precision and accuracy, reduced surgeon fatigue, and a faster learning curve, facilitated by advanced ergonomic and control systems. However, the high costs and extensive infrastructure requirements limit the accessibility and availability of robotic surgery, particularly in smaller or rural hospitals. The absence of tactile feedback remains a challenge, though upcoming advancements aim to address this. Continued research and development are essential to make robotic surgery more cost-effective and broadly accessible, ensuring its benefits can reach a wider patient population. This abstract encapsulates the key aspects of robotic surgery's development, comparative studies with conventional methods, and its clinical benefits and limitations, highlighting the need for ongoing improvements and research.

Application of image recognition-based tracker-less augmented reality navigation system in a series of sawbone trials

BackgroundThis study introduced an Augmented Reality (AR) navigation system to address limitations in conventional high tibial osteotomy (HTO). The objective was to enhance precision and efficiency in HTO procedures, overcoming challenges such as inconsistent postoperative alignment and potential neurovascular damage.MethodsThe AR-MR (Mixed Reality) navigation system, comprising HoloLens, Unity Engine, and Vuforia software, was employed for pre-clinical trials using tibial sawbone models. CT images generated 3D anatomical models, projected via HoloLens, allowing surgeons to interact through intuitive hand gestures. The critical procedure of target tracking, essential for aligning virtual and real objects, was facilitated by Vuforia’s feature detection algorithm.ResultsIn trials, the AR-MR system demonstrated significant reductions in both preoperative planning and intraoperative times compared to conventional navigation and metal 3D-printed surgical guides. The AR system, while exhibiting lower accuracy, exhibited efficiency, making it a promising option for HTO procedures. The preoperative planning time for the AR system was notably shorter (4 min) compared to conventional navigation (30.5 min) and metal guides (75.5 min). Intraoperative time for AR lasted 8.5 min, considerably faster than that of conventional navigation (31.5 min) and metal guides (10.5 min).ConclusionsThe AR navigation system presents a transformative approach to HTO, offering a trade-off between accuracy and efficiency. Ongoing improvements, such as the incorporation of two-stage registration and pointing devices, could further enhance precision. While the system may be less accurate, its efficiency renders it a potential breakthrough in orthopedic surgery, particularly for reducing unnecessary harm and streamlining surgical procedures.

Assessing and Enhancing the Adequacy of Radiology Request Forms at a Tertiary Care Hospital in Sudan: A Clinical Audit.

Clinical auditing is one method of improving the quality of patient care. Radiology request forms (RRFs) are crucial for the purpose of facilitating communication between the radiologist or radiographer and the referring clinician. A two-cycle clinical audit was conducted at the Radiology Department of Atbara Police Hospital in Khartoum, Sudan. A total of 100 forms were collected, with 50 forms from each cycle. As an intervention, the existing blank paper format for radiology requests was replaced with a structured form based on the standards of the Royal College of Radiologists (RCR). This new form was distributed hospital-wide, and doctors were educated on its use through presentations and briefings. The collected forms were then compared against the RCR standards for completeness and accuracy. Data were entered into Microsoft Excel 2016 for analysis. The interventions led to notable improvements in several areas. Accuracy in recording the patient's address, phone number, and location increased from 0 (0%) in the first cycle to 50 (100%) in the second cycle, marking a 100% improvement. In addition, referencing the patient's age improved from 15 (30%) in the first cycle to 50 (100%) in the second cycle, indicating a 70% increase. The mean score for RRF documentation was 25.33% in the first cycle and significantly increased to 97.77% in the second cycle. The audit shows significant improvement in RRFs post-intervention, highlighting the importance of standardization. However, deficiencies point to the need for orientation and follow-up training for physicians to ensure accurate form completion. Integrating quality assurance, including periodic audits and real-time feedback, can help sustain these gains. Collaboration between radiologists and referring physicians is also essential for ongoing improvement.

Evaluation of the Muara Satu Community Health Center in Lhokseumawe City's outpatient services' quality utilizing the importance-performance analysis approach and possible increase in customer value

A dynamic state of people, processes, environments, goods, and services that either meet or beyond expectations is known as service quality. It is vital to improve services to compete and provide higher-quality services at the Muara Satu Community Health Center through initiatives to enhance human resources and ongoing performance improvement. The Muara Satu Community Health Center has received major accreditation for its services; however, as of yet, no reassessment has been conducted. The management of Puskesmas wishes to refine the accreditation to become plenary so that patient satisfaction can serve as a gauge of the success of the center's health services provided to the community. This study aims to evaluate the degree of agreement between patient interests and satisfaction and the Muara Satu Community Health Center's service quality performance. Additionally, it seeks to identify the attributes that should be given priority for service improvement through the application of the Potential Gain in Customer Value (PGCV) method. Patients' complaints regarding services, such as uncomfortable waiting rooms and a lack of information about the ailments they were suffering from, posed a challenge for this study. Five categories were created based on 17 characteristics of the patient requests made at the health center and were given to 58 pre-selected samples. This category includes Assurance, Empathy, Tangible, Reliability, and Responsive. The Muara Satu Health Center is required to implement seven priority orders for quality improvement based on the IPA and PGCV methods, based on data processing findings. These orders include requiring the Community Health Center staff to inform patients before providing services, having a comfortable waiting area, and having officers act quickly and appropriately when necessary. Facilities in Puskesmas are fully equipped. The types of ailments, their treatments, and how to take medication are all thoroughly explained by the doctor. Furthermore, physicians allot enough time for patient examinations

Exploring university students’ preferences and satisfaction in utilizing digital tools for foreign language learning

This article investigates the utilization of digital resources, including applications like Duolingo, ChatGPT, and Google Translate, in the language learning practices of English as a Foreign Language (EFL) college students from the Czech Republic, Taiwan, and Iraq. Through a questionnaire-based approach, the study explores the digital tools employed, activities conducted, satisfaction levels, and the impact on language skills. Findings reveal diverse usage patterns and positive perceptions, highlighting the multifaceted role of digital resources in vocabulary acquisition, skill development, and language exploration. While participants express overall satisfaction, challenges such as connectivity issues and content variety are identified. The study’s most important finding is that digital resources like Duolingo, ChatGPT, and Google Translate significantly enhance EFL students’ language learning experiences through increased engagement and skill development, despite challenges such as connectivity issues and content diversity. The study underscores the need for ongoing improvement in digital language learning tools and suggests avenues for future research, emphasizing long-term impact, personalized learning paths, emerging technologies, and socio-emotional aspects. Despite limitations, the research provides valuable insights into the dynamic interplay between technology and language education in diverse cultural contexts.

The pressures within a changing landscape: How indigenous joint management is changing conservation management practices in Western Australia

In 2011, Western Australia introduced the requirement of “protecting and conserving the value of the land to the culture and heritage of Aboriginal persons” into the state’s Conservation and Land Management Act. While bringing little change to the Indigenous Traditional Owners’ perspectives on land management, this became a powerful driver of change within the Western Australian government since it mandates ongoing collaboration between the staff of a government department and diverse groups of Aboriginal people who have different priorities, understandings of land management and decision-making structures to those of the state. These differences between Traditional Owners and conservation managers have both demanded changes to conservation management practices and procedures and generated a source of tension that portends further changes in the state’s conservation management practices. Based on 17 interviews with Traditional Owners, state-employed conservation managers and non-Indigenous land managers working in Aboriginal organisations, we consider how joint management practices are changing the nature of official conservation management. We document the progress and achievements of joint management to date, notably in the mutual appreciation of cultural and ontological differences and identify the lack of congruence between Indigenous and non-Indigenous boundaries and timeframes as sources of tension and issues requiring ongoing improvements in joint management collaborations.

Mixed methods evaluation of a specialty-specific system to promote physician engagement in safety and quality reporting in a large academic health system

BackgroundIncident reporting systems (IRS) can improve care quality and patient safety, yet their impact is limited by clinician engagement. Our objective was to assess barriers to reporting in a hospital-wide...

A capability assessment model for implementing digital technologies in Nigerian heavy construction firms

PurposeDue to the critical importance of digital transformation in enhancing industrial growth and competitiveness, especially in heavy construction, this study introduces a tailored capability assessment model and self-appraisal tool for firms in this sector. These resources enable them to gauge their readiness for adopting digital technology effectively.Design/methodology/approachUtilizing the Technology—Organization—Environment (TOE) and Natural Resource Dependence Theory (NRDT) frameworks, 22 markers were identified to structure a questionnaire distributed to construction professionals. Descriptive analysis and fuzzy synthetic evaluation (FSE) were used to develop the capability assessment model. A validation survey assessed the validity of both the model and the self-appraisal instrument.FindingsThe study identified the top five significant markers: (1) leadership commitment to digital transformation, (2) workforce readiness for technology integration, (3) potential ROI through efficiency gains, (4) technology maturity for construction applications and (5) complexity of integrating new technologies with existing workflows. Through FSE, the most critical factors were technology-related, organizational and resource optimization markers.Originality/valueBy employing the TOE and NRDT frameworks, the study identifies the most critical factors influencing digital adoption in heavy construction. Also, the user-friendly self-appraisal instrument developed in this study can be considered a valuable contribution, as it provides heavy construction firms with a practical tool for ongoing monitoring and improvement of their digital transformation efforts.

An experiential account with recommendations for the design, installation, operation and maintenance of a farm-scale soil moisture sensing and mapping system

Context The research explores the benefits of real time tracking of soil moisture for various land management contexts and the importance of spatio-temporal modelling and mapping to gain clear and visual understanding of soil moisture fluxes across a farm. Aims This research aims to outline the key processes required for building an operational on-farm soil moisture monitoring system where the product is highly granular daily soil moisture maps depicting variations temporally, spatially and vertically. Methods We describe processes of capacitance soil moisture probe installation, data collection infrastructure, sensor calibration, spatio-temporal modelling, and mapping. Key results An out-of-bag soil moisture evaluation modelling system was tested for nearly 2 years. We found a model accuracy (RMSE) estimate of 0.002 cm−3 cm−3 and concordance of 0.96 were found. This result is averaged over this period but fluctuated daily, and related to rainfall patterns across the target farm, which were not directly incorporated into the modelling framework. As expected, incorporating prior estimates of soil moisture into the modelling framework contributed to very accurate estimates of real time available soil moisture. Conclusions This research promotes the importance of iterative improvements to the soil moisture monitoring system, particularly in areas of sensor recalibration and spatio-temporal modelling. We stress the need for a longer-term view and plan for ongoing maintenance and improvement of such systems in the emerging digital farming ecosystem. Implications The results of this research will be useful for researchers and practitioners involved in the design and implementation of on-farm soil monitoring systems.

Cultural Historical Activity Theory: A Conceptual Framework for Analysing Post- Method Pedagogy

Cultural Historical Activity Theory (CHAT) serves as an effective theoretical framework for analysing post-method pedagogy, providing valuable insights into the complexities of educational practices. This framework integrates social, cultural, and historical contexts, allowing for a comprehensive perspective that examines patterns influencing educational processes, cognitive development, and equitable education. At the heart of CHAT is the concept of expansive learning, which emphasises the continuous improvement and evolution of teaching methods over time. This approach advocates for adaptive and innovative practices that respond to the dynamic needs of learners and the ever-changing educational environment. By incorporating CHAT into post-method pedagogy, educators can significantly enhance their teaching practices, fostering more democratic, versatile, and effective methods that engage all students. This paper delves into the impact of CHAT on education, tracing the foundational narrative of its development through the contributions of three generations of influential scholars, from Lev Vygotsky to Yrjö Engeström. CHAT distinguishes itself by moving beyond mere rote cognitive accumulation, offering a conceptual toolkit for refining, and leveling pedagogical practices. Key elements of CHAT include the division of labour, which defines roles within the teaching and learning process, and mediating means, which involves the tools and resources utilised in learning. The central theme of expansive learning underscores the ongoing improvement of teaching methods, illustrating CHAT's practical application in English language instruction. By fostering inclusive learning environments, CHAT effectively addresses real challenges faced today in education. For educators seeking to strengthen their teaching methods, adopting CHAT offers a transformative pathway which is accessible to everyday teachers striving for positive change in their instructional practices. Integrating CHAT dynamics into teaching holds significant promise for those committed to continuous improvement in the field of education.

Child sexual abuse in Vietnam: A review of prevalence, risk factors, and prevention strategies

Child sexual abuse (CSA) is a severe global problem that has long-term psychological, physical, and societal effects for victims. This review looks at the prevalence, risk factors, and effects of CSA, with a specific emphasis on Vietnam. The frequency of CSA varies worldwide, with notable regional variations. In Vietnam, approximately 2,000 children are sexually abused each year, with females being disproportionately affected. Risk variables include age, gender, family dynamics, social level, and cultural norms. The review investigates the short- and long-term effects of CSA, which include mental health illnesses, physical health issues, and social difficulties. Prevention and intervention efforts, including as school-based education programs and parental involvement, show promise, but they encounter obstacles owing to cultural stigma and limited resources. The Vietnamese government has developed a variety of policies and legal frameworks to combat CSA, however gaps persist. This research emphasizes the importance of a multidimensional approach that involves broad education, substantial support services, and ongoing legislative improvements to effectively prevent and respond to CSA. Future study should focus on improving preventative strategies and assuring their long-term efficacy.