Pre-defined Indicators Research Articles

Distribution of Airway Findings in ANCA-Associated Vasculitis: A 20-Year Observational Analysis.

Objective: Pulmonary involvement is commonly observed in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), presenting with manifestations such as diffuse alveolar hemorrhage, inflammatory infiltrates, pulmonary nodules, and tracheobronchial disease. We aimed to identify distinct subgroups of tracheobronchial disease patterns in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) using latent class analysis (LCA), and to evaluate their clinical characteristics and outcomes. Methods: We conducted a retrospective cohort study using electronic medical records of patients aged >18 years diagnosed with AAV and tracheobronchial disease between 1 January 2002 and 6 September 2022. Patients with follow-up <6 months were excluded. LCA was employed to identify disease subtypes based on 10 pre-defined indicators. Maximum likelihood estimation with 10 repetitions per model ensured robustness in model selection, guided by the Akaike information criterion (AIC). Patient and disease characteristics were summarized and compared across predicted classes. Statistical analyses included Kruskal-Wallis and Fisher's exact tests for continuous and categorical variables, respectively. The primary outcome was time to relapse of the tracheobronchial inflammation after starting immunosuppressive medication, analyzed using the Kaplan-Meier method and log-rank tests. Secondary outcomes included severity of pulmonary disease on pulmonary function tests, endoscopic interventions, tracheostomy, or mortality during follow-up. Results: Among 136 identified AAV patients assessed for tracheobronchial involvement, 111 (81.6%) were included after excluding 25 without tracheal or bronchial disease. Predominant findings included subglottic stenosis (91.0%), lower tracheal stenosis (16.2%), and bronchial stenosis (17.1%). LCA identified a three-class model as optimal: tracheal predominant (n = 94), tracheobronchial (n = 12), and bronchial predominant (n = 5). Tracheal predominant patients showed reduced risk of ear, eye, and lower respiratory manifestations, with milder obstruction on pulmonary function testing (PFT). Tracheobronchial-class patients were prone to saddle nose deformity (50%), extensive lower respiratory involvement (91.7%), and renal disease (66.7%). Bronchial predominant patients exhibited severe obstructive disease (median forced expiratory volume in 1 s (FEV1)% predicted: 58, IQR 34-66; FEV1/forced vital capacity (FVC) ratio: 56.9, interquartile range (IQR) 43-63.3) but lacked systemic AAV manifestations. LCA classes did not predict outcomes such as endoscopic intervention, tracheostomy, recurrent tracheobronchial narrowing, or mortality. Conclusion: LCA shows promise in subtype stratification of AAV patients, yet its utility in predicting outcomes and guiding treatment remains limited based on our analysis. Future studies with enhanced phenotypic data and larger cohorts are warranted to improve predictive accuracy.

Argumentasi Analogis Siswa SMA pada Masalah Analogi Tipe Prediktif

Analogy helps students find solutions to problems that involve new knowledge by referring to previously learned knowledge. Analogical argumentation plays a crucial role in supporting solutions to interconnected problems. Analogical argumentation itself is defined as the process of analyzing information from two similar and interconnected problems to provide logical reasons to justify conclusions. This research aims to describe the analogical argumentation of high school students on predictive analogy problems. This study uses a descriptive qualitative approach. The research subjects are three 10th-grade students from a public high school in Bojonegoro, selected based on the criteria of the source problem 1) claim being supported by grounds and warrant, 2) claim being supported by grounds, warrants focusing on congruence, and backing, 3) claim being supported by grounds, warrants focusing on square rotation, and backing. The data from the analogical argumentaion task and interviews were analyzed using predefined indicators by the researcher. The research findings indicate that students' analogical argumentation begins with identifying information, questions, and identical concepts between the two problems. Then, students make assumptions about the structure of the target problem in relation to the source problem, search for similarities in geometric properties, and discover relationships between the questions in both problems. Students engage in appropriate argumentation based on the source problem to predict conclusions for the target problem. They construct grounds and warrants based on the structure of analogical argumentation. Students tend not to double-check their answers because they are already confident with their stated conclusions.

Constructing an emergency preparedness evaluation index system for public use during major emerging infectious disease outbreaks: a Delphi study

BackgroundThe major emerging infectious diseases (MEIDs) have occurred frequently and become increasingly serious in the world. Sufficient personal emergency preparedness is critical for the general people in efficiently responding to and recovering from MEIDs. Nevertheless, few specific indicators are available for assessing the individual emergency preparedness of the general public during these periods. Therefore, the aim of this study was to construct an index system for comprehensively evaluating the personal emergency preparedness of the public regarding MEIDs.MethodsBased on the global national-level emergency preparedness index framework and a literature review, a preliminary index system was constructed. From June 2022 to September 2022, a panel of 20 experts from nine provinces and municipalities across multiple research areas participated in this Delphi study. They rated the importance of pre-defined indicators using a five-point Likert scale and provided their qualitative comments. According to the feedback of each round of experts, the indicators of the evaluation index system were revised.ResultsAfter two rounds of expert consultation the evaluation index system reached a consensus, containing five first-level indicators, cooperating with prevention and control work, improving emergency response capacity, securing supplies and equipment, preparing economic resources, maintaining physical and mental health with affiliated 20 s-level indicators and 53 third-level indicators. The expert authority coefficient of consultation was 0.88 and 0.90. The Kendall’s coefficient of concordance of expert consultations was 0.294 and 0.322, respectively. The differences were statistically significant (P < 0.05).ConclusionA valid, reliable and scientific evaluation index system was established. This personal emergency preparedness index system, as a precursor form, will further lay the foundation for the formation of an assessment instrument. At the same time, it could provide a reference for future education and training of emergency preparedness for the general public.

Committed collaboration to address homelessness in the Netherlands

Context: In the Netherlands, the number of homeless people increased from 17.800 in 2009 to 39.300 in 2018. Due to the COVID-19 pandemic and its socioeconomic consequences, the needs of marginalized people have increased worldwide in terms of access to services and relevant information. In the Netherlands, along with the Red Cross, other humanitarian organizations such as the Salvation Army, the Rainbow Foundation, and the Foundation for the Homeless are already providing people in need with primary needs such as food and housing, but also with healthcare and legal support. Cooperation between services for the homeless is also gaining attention. However, collaboration between relevant stakeholders is still insufficient and urges to be expanded. Moreover, centralized monitoring is challenging as different services are provided (shelters, assisted housing) by different stakeholders and there is no central data collection system or pre-defined indicators. Recent, comprehensive data on homelessness figures are needed to understand the needs and how these may have changed, given the exacerbated consequences of COVID-19 pandemic on those in socioeconomic vulnerability, in order safeguard the health, safety and dignity of homeless people.

Predicting catchment suitability for biodiversity at national scales

Biomonitoring of water quality and catchment management are often disconnected, due to mismatching scales. Considerable effort and money are spent each year on routine reach-scale surveying across many sites, particularly in countries like the UK, where nationwide sampling has been conducted using standardised techniques for many decades. Most of these traditional freshwater biomonitoring schemes focus on pre-defined indicators of organic pollution to compare observed vs expected subsets of common macroinvertebrate indicator species. Other taxa, including many threatened species, are often ignored due to their rarity, as are many invasive species, which are seen as undesirable despite becoming increasingly common and widespread in freshwaters, especially in urban ecosystems. Both these types of taxa are often monitored separately for reasons related to biodiversity concerns rather than for gauging water quality. Repurposing such data could therefore provide important new biomonitoring tools that can help catchment managers to directly link the water quality they aim to control with the biodiversity they are trying to protect. Here we used extensive data held in the England Non-Native and Rare/Protected species records that track these two groups of species as a proof-of-concept for linking catchment scale management of freshwater ecosystems and biodiversity to a range of potential drivers across England. We used national land use (Centre for Ecology and Hydrology land cover map) and water quality indicator (Environment Agency water quality data archive) datasets to predict, at the catchment scale, the presence or absence of 48 focal threatened or invasive species of concern routinely sampled by the English Environment Agency, with a median accuracy of 0.81 area under the receiver operating characteristic curve. A variety of water quality indicators and land-use types were useful in predictions, highlighting that future biomonitoring schemes could use such complementary measures to capture a wider spectrum of drivers and responses. In particular, the percentage of a catchment covered by freshwater was the single most important metric, reinforcing the need for space/habitat to support biodiversity, but we were also able to resolve a range of key environmental drivers for particular focal species. We show how our method could inform new catchment management approaches, by highlighting how key relationships can be identified and how to understand, visualise and prioritise catchments that are most suitable for restoration or water quality interventions. The scale of this work, in terms of number of species, drivers and locations, represents a significant step towards forging a new approach to catchment management that enables managers to link drivers they can control (water quality and land use) to the biota they are trying to protect (biodiversity).

Increasing the Prediction Power of Moodle Machine Learning Models with Self-defined Indicators

Starting with version 3.4 of Moodle, it has been possible to build educational ML models using predefined indicators in the Analytics API. These models can be used primarily to identify students at risk of failure. Our research shows that the goodness and predictability of models built using predefined core indicators in the API lags far behind the generally acceptable level. Moodle is an open-source system, which on the one hand allows the analysis of algorithms, and on the oth-er hand its modification and further development. Utilizing the openness of the system, we examined the calculation algorithm of the core indicators, and then, based on the experience, we built new models with our own indicators. Our re-sults show that the goodness of models built on a given course can be significant-ly improved. In the article, we discuss the development process in detail and pre-sent the results achieved.

Committed collaboration to address homelessness in the netherlands

Context: In the Netherlands, the number of homeless people increased from 17.800 in 2009 to 39.300 in 2018. Due to the COVID-19 pandemic and its socioeconomic consequences, the needs of marginalized people have increased worldwide in terms of access to services and relevant information. In the Netherlands, along with the Red Cross, other humanitarian organizations such as the Salvation Army, the Rainbow Foundation, and the Foundation for the Homeless are already providing people in need with primary needs such as food and housing, but also with healthcare and legal support. Cooperation between services for the homeless is also gaining attention. However, collaboration between relevant stakeholders is still insufficient and urges to be expanded. Moreover, centralized monitoring is challenging as different services are provided (shelters, assisted housing) by different stakeholders and there is no central data collection system or pre-defined indicators. Recent, comprehensive data on homelessness figures are needed to understand the needs and how these may have changed, given the exacerbated consequences of COVID-19 pandemic on those in socioeconomic vulnerability, in order safeguard the health, safety and dignity of homeless people. Policy Options: To address the needs of homeless people, innovation is needed to overcome sectoral boundaries and to work collaboratively. At the level of service provision, as shown by some successful global experiences (e.g. Homeless Individuals and Families Information System (HIFIS), Housing First, Les Infirmieres de la Rue), new partnerships and collaborations are a central dimension of many effective innovative initiatives relating to homelessness. The target of collaboration is to improve health and social outcomes in the most appropriate and efficient manner. To improve case management at the local level, in Canada, the Homeless Individuals and Families Information System (HIFIS) provides a single platform for homogeneous data collection on clients among service providers that facilitates referrals between services. Recommendations: Approaches to improve cross-sectoral collaboration and communication at two levels should be identified. Firstly, establishing a coordinated and comprehensive cross-sectoral network among organizations in the field and secondly, improving data collection. Acknowledgments: The authors would like to express their sincere thanks to J. Neicun and K. Czabanowska for their support in preparing and revising the policy brief. Authors’ contributions: All authors contributed equally to this work. Conflicts of interest: None declared Funding: None declared

Resilience capacities as perceived by European farmers

CONTEXTThe ability of a farm to cope with challenges is often conceptualised as resilience. Although improving resilience of farms is a major policy goal in the European Union, the current state of resilience is often unknown. Previous resilience assessments have been based either on pre-defined indicators or on perceptions. In particular, empirical research of perceived resilience is still limited and usually restricted to one specific resilience capacity, one challenge, or one function. OBJECTIVEWe investigate how European farmers perceive resilience capacities of their farms. Extending beyond previous research, we cover all three resilience capacities (robustness, adaptability, and transformability), consider a broad range of short-term shocks and long-term stresses, and include multiple functions. Furthermore, we analyse farms from diverse farming systems across Europe and investigate whether farms and farmers with similar perceived resilience capacities share characteristics. METHODSWe address the complex nature of resilience capacities by accounting for multiple scales formulated as analytical steps of a resilience assessment framework. More specifically, these are ‘resilience of what’ (farms and farming systems), ‘resilience to what’ (challenges), ‘resilience for what purpose’ (functions), and ‘what enhances resilience’ (resilience attributes). These steps guided the development of a survey with farmers across eleven European farming systems. Based on three indices for each farmer indicating perceived robustness, adaptability, and transformability of their farms, we identified two classes of farmers with particularly strong and weak resilience profiles respectively. Using nonparametric Mann-Whitney U tests, we furthermore compared other parameters collected via the survey across the identified classes. RESULTS AND CONCLUSIONSOur data sample outputs two classes of similar size characterised by all three perceived resilience capacities being above (below) regional average. This finding suggests that the perceptions of robustness, adaptability, and transformability are mutually dependent. Furthermore, we found that farmers who perceive their resilience above the regional averages are characterised by lower risk aversion, greater focus on providing public goods, a higher number of implemented risk management strategies, more active involvement in networks, and greater openness to innovation. SIGNIFICANCEThe revealed links between particular characteristics of farms and farmers and different levels of perceived resilience capacities can support policy-makers in developing more targeted resilience-enhancing strategies, as well as in understanding farmers' responses to challenges. Finally, our results can serve as a basis for further research, e.g., for formulating and testing hypotheses on causal effects between perceived resilience and its components, and on links between perception- and indicator-based resilience assessments.

Selecting a Contextualized Set of Urban Quality of Life Indicators: Results of a Delphi Consensus Procedure

Although indicators are commonly used to measure/assess urban quality of life (QOL), there is no consensus in the literature on the core indicators of urban QOL. This paper aims to identify a set of key indicators that will be used to assess/measure urban QOL in the Saudi Arabia (SA) context. For this purpose, a three-round online Delphi procedure is used. A group of 92 local experts were asked to rate the importance of a set of pre-defined indicators in assessing/measuring urban QOL. The results reveal that the panel of experts reached consensus and agreed on the high importance of 53 indicators for assessing/measuring urban QOL. These indicators provide appropriate coverage of the three core dimensions of urban QOL: environmental, social and economic. However, the results also show that the social indicators are perceived as more essential than economic and environmental indicators. This finding has practical implications for designing and developing QOL assessment tools to better capture and measure urban QOL in the SA context. Furthermore, research findings also identified some methodological limitations associated with using the Delphi approach, which need to be addressed to ensure the development of comprehensive QOL assessment tools.

Equity as a consideration in National Cancer Control Plans from the American continent: a comparative content analysis

Equity as a consideration in National Cancer Control Plans from the American continent: a comparative content analysis

PDB61 IMPACT of a Diabetes Disease Management Program on Quality of Care and Costs: Propensity Score-Matched Real-World DATA from Switzerland

PDB61 IMPACT of a Diabetes Disease Management Program on Quality of Care and Costs: Propensity Score-Matched Real-World DATA from Switzerland

Role of sustainability in global seaports

Seaports are integral hubs of maritime supply chains and contribute to socio-economic development for communities. However, seaports can create negative impacts on host communities. Adopting sustainability initiatives within seaport operations is growing rapidly, and while many seaports claim to operate green or sustainably, sustainable port initiatives and approaches are poorly described in the academic literature. This research explores relationships between existing seaport sustainability and the current narrative that exists related to sustainability improvements. Thirty-six seaports were selected from North America (NA), Europe (EU) and Asia Pacific (AP) for analysis. Twenty-five (25) pre-defined indicators were used to identify operational trends linked to sustainability claimed by seaports. Each operation was assessed using publicly available data; using a mixed methods approach, descriptive statistical analysis for sustainability initiatives was performed to assess seaport sustainability efforts. Results show that EU seaports have made more progress in adopting various sustainability initiatives compared to NA and AP seaports, despite the public narrative of most seaport executives about their commitment to manage environmental impacts, and being good corporate citizens. Initiative most widely adopted include: greater emphasis on internal environmental policy and management – including third-party certification; investment in proactive environmental solutions; and enhanced stakeholder engagement.

Peningkatan Kemampuan Motorik Kasar Anak Usia Dini Melalui Bermain Lempar Tangkap Bola

This study aimed to find out the implementation of a throw-and-catch ball game on young learners aged 5-6 years old in PAUD Nurul Fadillah and discovered young learners’ hard motoric skill improvement through the game.Conducted as a Class Action Research, this study involved 11 young learners as the subject as well as object of the study. The study process was carried on by applying two cycles, 1 and 2, which was initiated by a pre-cycle activity. There were four steps taken in each cycle which included planning, doing, observing, and reflecting. The data collection was obtained by observation, interview, and documentation study.The result of the study showed that: 1) The implementation of a throw-and-catch ball game had resulted in the improvement of hard motoric skill on young learners aged 5-6 years old in PAUD Nurul Fadillah on these categories: 82% on balancing, 91% on power and flexibility; 2) The implementation of playing a throw-and-catch ball game was able to improve hard motoric skill on young learners aged 5-6 years old in PAUD Nurul Fadillah Depok, since they have succeeded in achieving the predefined success indicators on balance, power and flexibility.

Predictors of persistent disease activity following anti-VEGF loading dose for nAMD patients in Singapore: the DIALS study

BackgroundTo determine the frequency of persistent disease activity following 3 loading doses of anti- vascular endothelial growth factor (VEGF) agents, and the anatomic and demographic predictors of early persistent disease activity among patients with neovascular age-related macular degeneration (nAMD).MethodsIn a retrospective real-world cohort study, 281 consecutive patients with nAMD were reviewed at baseline and after 3 anti-VEGF injections for pre-defined indicators of disease activity. Optical coherence tomography (OCT) features such as subretinal fluid, intraretinal cysts and intraretinal fluid were assessed by reading-center certified graders. Multiple logistic regression was performed on demographic and anatomic factors.ResultsAt month 3, 66.1% of patients had persistent disease activity. The best-corrected visual acuity (BCVA) improvement was 0.16 LogMAR for those with no disease activity compared to 0 for patients with persistent activity (p < 0.001). The significant risk factors for persistent activity at 3 months were male gender (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.32–0.93, p = 0.025), intraretinal cysts at baseline (OR 2.95, 95% CI 1.67–5.20, p < 0.001) and subretinal fluid at baseline (OR 3.17, 95% CI 1.62–6.18, p = 0.002). At 3 months, 58% of patients had features of activity on OCT. Patients with intraretinal cysts and intraretinal fluid at baseline had worse BCVA at month 3 compared to patients without these OCT features (0.69 vs. 0.43, p < 0.001, and 0.62 vs. 0.43, p < 0.001, respectively).ConclusionsIn a real-world study, 66.1% of nAMD patients have persistent disease activity after the initial loading dose, with poorer BCVA compared to those without. Baseline OCT features (intraretinal cysts and subretinal fluid) are useful predictors of persistent disease activity at month 3.

Development of a systematic mapping review protocol for the most recent evidence on ruminant infectious disease frequency and disease-associated mortality: Ethiopia as a case study.

Almost 19% of the GDP of Ethiopia results from livestock production. Ruminants, in particular, form the majority of the national herd and are a critical source of income for smallholder farmers. Infectious diseases have been identified as a major cause of reduced livestock productivity in low- and middle-income countries (LMICs); therefore, a sound and comprehensive understanding of the relevant evidence would be beneficial in order to enable decision making on disease control policies. However, livestock disease data from sub-Saharan Africa is variable and disparate, which poses a challenge for evidence synthesis. This paper describes a protocol for a systematic mapping review of the recent available evidence on ruminant disease prevalence and associated mortality in Ethiopia. Literature sources will be identified using database search strategies. The titles, abstracts and, subsequently, full texts will be screened for inclusion based on predefined eligibility criteria. Specific data will be extracted and a preliminary qualitative assessment of the evidence will be performed using predefined indicators. The planned systematic map will be the first to provide a large-scale overview of the available ruminant disease evidence in Ethiopia; the final output will be an interactive dashboard tool to inform critical stakeholders in policy and research.

Implementing Package of Essential Non-communicable Disease Interventionsin the Republic of Moldova-a feasibility study.

The aim of this study is to determine the feasibility of implementing and evaluating the World Health Organization Package of Essential Non-communicable Disease Interventions (WHO PEN) approach in primary healthcare in the Republic of Moldova. According to our published a priori methods, 20 primary care clinics were randomized to 10 intervention and 10 control clinics. The intervention consisted of implementation of adapted WHO PEN guidelines and structured training for health workers; the control clinics continued with usual care. Data were gathered from paper-based patient records in July 2017 and August 2018 resulting in a total of 1174 and 995 patients in intervention and control clinics at baseline and 1329 and 1256 at follow-up. Pre-defined indicators describing assessment of risk factors and total cardiovascular risk, prescribing medications and treatment outcomes were calculated. Differences between baseline and follow-up as well as between intervention and control clinics were calculated using logistic and linear regression models and by assessing interaction effects. Improvements were seen in recording smoking status, activity to measure HbA1c among diabetes patients and achieving control in hypertension treatment. Improvement was also seen in identification of patients with hypertension or diabetes. Less improvement or even deterioration was seen in assessing total risk or prescribing statins for high-risk patients. It is feasible to evaluate the quality and management of patients with non-communicable diseases in low-resource settings from routine data. Modest improvements in risk factor identification and management can be achieved in a relatively short period of time.

Retrospective Comparative Study of the Influence on Quality of Primary Total Hip Arthroplasty by the EndoCert-Certification System in a Communal Hospital.

The EndoCert®-Initiative system sets specific requirements for the structural, process and result quality in certified Arthroplasty Centers in Germany. However, it remains unclear to what extent the certification process can increase the quality in total hip and knee arthroplasty. Aim of the comparative retrospective study is to analyse the change in quality of total hip arthroplasty in a communal hospital before and after the certification process. All primary total hip arthroplasties (n = 366) between 2013 and 2016 were included in the study retrospectively and grouped by treatment period. Treatment was performed in group 1 without clinical pathways, in group 2 pathway-controlled without a valid certificate and in group 3 pathway-controlled after final completion of the certification process. Outcome quality was analysed using quality indicators defined by the EndoCert-Initiative and further predefined indicators. Results show quality improvement under certified pathway-controlled treatment, e.g. time of surgery, cup and stem positioning, blood transfusion rate, periprosthetic fractures. However, improvements were not significantly in all cases and limitations must be recognized. Positive effects of the certification process legitimate capital investment and efforts. Further quality indicators may be implemented in the certification process to improve quality of treatment in arthroplasty.

An evaluation of the Zambia influenza sentinel surveillance system, 2011\u20132017

BackgroundOver the past decade, influenza surveillance has been established in several African countries including Zambia. However, information on the on data quality and reliability of established influenza surveillance systems in Africa are limited. Such information would enable countries to assess the performance of their surveillance systems, identify shortfalls for improvement and provide evidence of data reliability for policy making and public health interventions.MethodsWe used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza surveillance system (ISS) in Zambia during 2011–2017 using 9 attributes: (i) data quality and completeness, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability, (viii) utility, and (ix) sustainability. Each attribute was evaluated using pre-defined indicators. For each indicator we obtained the proportion (expressed as percentage) of the outcome of interest over the total. A scale from 1 to 3 was used to provide a score for each attribute as follows: < 60% (as obtained in the calculation above) scored 1 (weak performance); 60–79% scored 2 (moderate performance); ≥80% scored 3 (good performance). An overall score for each attribute and the ISS was obtained by averaging the scores of all evaluated attributes.ResultsThe overall mean score for the ISS in Zambia was 2.6. Key strengths of the system were the quality of data generated (score: 2.9), its flexibility (score: 3.0) especially to monitor viral pathogens other than influenza viruses, its simplicity (score: 2.8), acceptability (score: 3.0) and stability (score: 2.6) over the review period and its relatively low cost ($310,000 per annum). Identified weaknesses related mainly to geographic representativeness (score: 2.0), timeliness (score: 2.5), especially in shipment of samples from remote sites, and sustainability (score: 1.0) in the absence of external funds.ConclusionsThe system performed moderately well in our evaluation. Key improvements would include improvements in the timeliness of samples shipments and geographical coverage. However, these improvements would result in increased cost and logistical complexity. The ISSS in Zambia is largely reliant on external funds and the acceptability of maintaining the surveillance system through national funds would require evaluation.

Research of 3-Tier Mobility Stations System with bike and car sharing— Case study of small–scale city in Germany

This paper proposed an innovative strategy for planning multimodal, integrated, intelligent, and sustainable mobility by applying 3-tiers mobility stations system combine with car sharing and bike sharing, which aims to promoting the accessibility with available transportation systems and enhance the intramodality and utilization of non-motorized transportation modes. Through the case study of the Fürstenfeldbruck city region in Germany, the 3-tiers mobility stations system concept and its planning criteria and indicators were proposed. And mobility service offerings and location selection of stations were analyzed by considering demand and coverage. Subsequently, evaluation methods based on the pre-defined indicators were implemented to the case study. The planning process is target-oriented and based on relevant structural data analysis.

Supportive supervision to improve the quality and outcome of outpatient care among malnourished children: a cluster randomised trial in Arua district, Uganda

IntroductionSuboptimal quality of paediatric care has been reported in resource-limited settings, but little evidence exists on interventions to improve it in such settings. This study aimed at testing supportive supervision...