Assessment Process Research Articles

Explainable machine learning models for predicting the acute toxicity of pesticides to sheepshead minnow (Cyprinodon variegatus)

A quantitative structure–activity relationship (QSAR) study was conducted on 313 pesticides to predict their acute toxicity to Sheepshead minnow (Cyprinodon variegatus) by using DRAGON descriptors. Essentials accounting for a reliable model were all considered carefully, giving full consideration to the OECD (Organization for Economic Co-operation and Development) principles for QSAR acceptability in regulation during the model construction and assessment process. Nine variables were selected through the forward stepwise regression method and used as inputs to construct both linear and nonlinear models. The obtained models were validated internally and externally. Generally, machine learning-based methods, namely support vector machine (SVM), random forest (RF), and projection pursuit regression (PPR), perform better than the multiple linear regression (MLR) model. The statistical results (R2 = 0.682–0.933, Q2LOO = 0.604–0.659, Q2F1 = 0.740–0.796, CCC = 0.861–0.882) of the developed models show that they are robust, reliable, reproducible, accurate and predictive. Comparatively, the RF model performs best, giving predictive correlation coefficient Q2 of 0.814, root mean squared error (RMSE) of 0.658 and mean absolute error (MAE) of 0.534 for the test set, respectively. The RF model (as well as SVM and PPR models) was visualized and explained by using the SHapley Additive explanation (SHAP) analysis to enhance its transparency and credibility. In addition, the applicability domain (AD) range of the RF model was characterized by the Williams plot and the tree manifold approximation and projection (TMAP) technology was utilized to illustrate similarity and diversity of the entire data space, to assist in the analysis of the outliers. Activity cliff detection was investigated by using Arithmetic Residuals in K-groups Analysis (ARKA) descriptors. It was found that none of the pesticides was identified as an activity cliff in the training set or a potential prediction cliff in the test set. Therefore, the RF model fulfills each OECD principle in regulation for QSAR models. The research in this work will aid in the in silico QSAR prediction of the acute toxicity to Sheepshead minnow (Cyprinodon variegatus) for untested and new toxic pesticides and can also be extended to other studies.

The impact of peer assessment design on interpersonal processes: A systematic review

Peer assessment can have a very positive impact on students’ learning. However, it also poses some challenges such as trust issues, concerns about its fairness, feelings of discomfort, etc. It is known that the interpersonal processes of peer assessment can affect its outcomes. However, it is less clear how peer assessment should be implemented to prevent this. In this article, we reviewed 27 studies that have investigated how the instructional design elements of peer assessment influence interpersonal processes. A literature search was carried out on Scopus, PsycINFO, and Eric with a search string composed of three parts with keywords linked to (1) peer assessment, (2) educational contexts, and (3) interpersonal processes. The 14,552 retrieved records were screened in terms of the inclusion criteria, which resulted in 27 studies being included and analysed through a narrative synthesis. The results revealed that the three most commonly-investigated design elements were privacy, format, and training. Privacy seems to have a positive impact on some interpersonal processes, but a detrimental effect on others. Concerning format, studies suggest that increased amounts of guidance are associated with a positive impact on interpersonal processes, but this result must be interpreted with caution due to the limitations of the studies’ research designs. The use of training seems to be beneficial in minimising the negative effects of interpersonal processes. Finally, no conclusion could be drawn on three other design elements that were only investigated in one study each, and with weak research designs. These results allowed us to draw important recommendations for practitioners implementing peer assessment and to identify gaps and needs that could inform future research.

The importance of needs satisfaction, teacher support, and L2 learning experience in Intelligent Computer-Assisted Language Assessment (ICALA): a probe into the state of willingness to communicate as well as academic motivation in EFL settings

In recent years, Intelligent Computer-Assisted Language Assessment (ICALA) has emerged as a transformative approach in language education, leveraging technology to enhance student assessment and learning processes. Despite its growing importance, there is a scarcity of research investigating the connections among needs satisfaction, teacher support, L2 learning experience, willingness to communicate, and academic motivation—factors that play a crucial role in students’ academic performance in this context. This study addressed the lack of knowledge by examining the impact of needs satisfaction and teacher support among Omani students enrolled in English as a foreign language (EFL) classes. The structural equation modeling data via SMART PLS revealed a positive correlation between needs satisfaction, L2 learning experience, increased willingness to communicate, and academic motivation in ICALA. Furthermore, teacher support positively impacted willingness to communicate, academic motivation, and L2 learning experience. The results facilitate fostering needs satisfaction and teacher support in ICALA and contribute to our understanding of the connections between these variables. A more in-depth discussion is held regarding the significance of the study for educational practices.

Harnessing the Power of AI-Instructor Collaborative Grading Approach: Topic-Based Effective Grading for Semi Open-Ended Multipart Questions

Semi open-ended multipart questions consist of multiple sub questions within a single question, requiring students to provide certain factual information while allowing them to express their opinion within a defined context. Human grading of such questions can be tedious, constrained by the marking scheme and susceptible to the subjective judgement of instructors. The emergence of large language models (LLMs) such as ChatGPT has significantly advanced the prospect of automatic grading in educational settings. This paper introduces a topic-based grading approach that harnesses LLM capabilities alongside a refined marking scheme to ensure fair and explainable assessment processes. The proposed approach involves segmenting student responses according to sub questions, extracting topics utilizing LLM, and refining the marking scheme in consultation with instructors. The refined marking scheme is derived from LLM-extracted topics, validated by instructors to augment the original grading criteria. Leveraging LLM, we match student responses with refined marking scheme topics and employ a Python program to assign marks based on the matches. Various prompt versions are compared using relevant metrics to determine the most effective prompts. We evaluate LLM's grading proficiency through three approaches: zero-shot prompting, few-shot prompting, and our proposed method. Results indicate that while zero-shot and few-shot prompting methods fall short compared to human grading, the proposed approach achieves the best performance (highest percentage of exact match marks, lowest mean absolute error, highest Spearman correlation, highest Cohen’s weighted kappa) and closely mirrors the distribution observed in human grading. Specifically, the collaborative approach enhances the grading process by refining the marking scheme to student responses, improving transparency and explainability through topic-based matching, and significantly increasing the effectiveness of LLMs when combined with instructor input, rather than as standalone automated grading systems.

Setting of residue definitions and toxicological reference values for ethiprole.

In accordance with Article 6 of Regulation (EC) No 396/2005, the original evaluating Member State (EMS), the United Kingdom, received an application from Bayer CropScience to set an import tolerance for the non-approved active substance ethiprole in rice. In the framework of the assessment process, the application was re-allocated to the Netherlands and the purpose of the application was changed to only set European residue definitions and toxicological reference values for the active substance ethiprole. Based on the assessment of the available toxicological data, an acceptable daily intake of 0.002 mg/kg bw per day and an acute reference dose of 0.005 mg/kg bw were derived. The data submitted in support of the request were found to be sufficient to derive residue definitions in primary crops and in processed commodities. The residue definition for enforcement was derived as 'ethiprole'. Adequate analytical methods for enforcement are available to control the residues of ethiprole in dry commodities at the validated LOQ of 0.002 mg/kg. A residue definition for risk assessment was derived as the 'sum of ethiprole, ethiprole-sulfone (RPA097973) and ethiprole-amide (RPA112916), expressed as ethiprole'. This residue definition is applicable for foliar treatment in all primary crops, for both foliar and soil treatments in cereals crops, and is also valid for processed commodities.

Advanced Assessment Dynamics Neglected Age: Barriers and Skills Communication Worker Social in Bandung City Social Services

Study This aiming For analyze dynamics in the assessment process of carry on elderly neglected in Bandung City Social Service, with focus on the barriers faced by workers social as well as skills necessary communication For overcome challenge The research method used is approach qualitative with technique data collection in the form of interview in-depth, observation, and study documentation. Research results show that Assessment is step important in practice worker social For understand problem client and determine appropriate interventions, especially for elderly displaced with dementia. However, this process face various obstacles, such as limitations cognitive, difficulties communication, change emotions, limitations physical, as well as obstacle culture and language. Elderly with dementia often difficulty give information accurate Because disturbance Power remember or difficulty speaking. In addition, workers social often faced with a lack of tool help communication and training special. Therefore that, skill communication become very important For overcome obstacle this, like ability do interview effective, listening active, and understanding non-verbal communication. Mastery technology supporter, understanding culture, as well as supervision and feedback return is also required For increase effectiveness assessment and support welfare elderly.

Challenges affecting public participation in environmental impact assessment in Sri Lanka

Environmental impact assessment (EIA), as a policy procedure, proved capable of promoting sustainable development by reducing or eliminating the adverse effects of development projects. Encouraging public involvement in the Environmental Impact Assessment (EIA) process is crucial for promoting sustainable development, which is arguably the main purpose of the EIA. There are a number of challenges that prevent the public from participating meaningfully in the EIA process. The primary objective of this study is to identify the challenges when they come within the domain of public participation in Environmental Impact Assessment. The paper focuses on identifying the most severe challenges experienced in Sri Lanka. The study is conducted by employing a mixed-method approach. After in-depth interviews with selected key informants and a sample survey of 240 participants representing all 9 provinces of Sri Lanka. This sample is selected using a purposive sampling process. The study revealed a number of challenges, like limited access to information and language barriers, education level, cultural norms and gender roles, institutional support and transparency, lack of awareness and knowledge, and trust among community members in the community. Identified all 6 key challenges that have a significant impact and positive correlation towards public participation in Sri Lanka

Resettlement, Employment, and Mental Health Among Syrian Refugee Men in Canada: An Intersectional Study Using Photovoice

Context: The impact of forced migration on the mental health of refugee men is far-reaching and compounded by gendered masculinity, which shapes men’s access to employment and other resources. A gap in knowledge exists on the broader determinants of refugee men’s mental health. Methodology: Using community-based participatory action research and the arts-based method of photovoice, this study advances knowledge about the gendered impacts of forced migration from the perspective of (n = 11) Syrian refugee men in the Canadian context. Theoretical approaches of intersectionality and masculinity were applied to understand how power relations shape Syrian men’s identities, their access to employment, and impacts on their mental health. Analysis and Results: Syrian men’s identities were marginalized by working in low-wage jobs because of inequitable policies that favored Canadian experience and credentialing assessment processes that devalued their knowledge. Multiple and overlapping factors shaped Syrian men’s mental health including language and literacy barriers, time and stage of life, isolation and loneliness, belonging and identity, and gender-based stress. Caring masculinities performed through fathering, cultural connection, and service-based work promoted agency, hope, and resilience. Conclusions: Public health and community-based pathways must adopt gender-responsive and intersectional approaches to policy and practice. Peer-based programs may mitigate harmful forms of masculinity and promote transformative change to support refugee men’s mental health.

Diversity of Medicinal Plants in Nubamado Village, Lembata District to Cure Livestock Diseases

People in Indonesia who still use plants to cure livestock diseases are the people of Nubamado village. Knowledge about traditional medicines is very little known and is usually only passed on from generation to generation. The purpose of the study was to describe the types of plants or record the types of local medicinal herbs used by the community in curing animal diseases. The method used in this research is descriptive survey method, namely direct observation method and Participatory Rural Appraisal method, which is an assessment process oriented towards the involvement and active role of the community in research. The sampling technique on medicinal plants was carried out by means of researchers directly documenting it, while the informant technique was carried out by means of, Determination of the initial sample was carried out using Purposive Sampling. After the initial observation, the next informant selection was carried out using the Snowball Sampling method, which is an informant selection technique based on key informant recommendations. Based on the results of the study, there are 25 types of plants that are used by the people of Nubamado village as medicine, the part of the plant that is most often used by the community is the leaves. Family Zingiberaceae, Poaceae, Arecaceae, is the most widely used family as medicinal plants in Nubamado village, the second largest family is Solanaceae, Piperaceae and Fabaceae. The least family is Malvaceae, Euphorbiaceae, Piperaceae, Mimosaceae, Meliaceae, Rubiaceae, Musaceae, Alliaceae, Rutaceae, Myrtaceae, Caricaceae.

The Financial Performance of Ligao Association of City Employees Multi-Purpose Cooperative (LACE-MPC) Credit Business for Calendar Years 2017-2021

This study assessed the financial performance of the Ligao Association of City Employees Multi-Purpose Cooperative (LACE-MPC) credit business from 2017 to 2021, addressing a significant gap in the literature regarding the operational dynamics of multi-purpose cooperatives in the Bicol region. Utilizing a descriptive research design, the study conducted interviews and employed survey questionnaires and documentary analysis to gather data from 113 regular and 85 associate members. The results revealed a commendable financial standing characterized by a low non-performing loan ratio and improved operational efficiency, as indicated by key financial indicators such as portfolio quality and efficiency ratios. However, the study also identified significant policy issues , including unclear loan terms and challenges in credit assessment, which hindered member satisfaction and operational effectiveness.The implications of these findings extend beyond LACE-MPC, highlighting the need for enhanced governance and operational transparency within cooperatives to foster member trust and engagement. The study underscores the importance of clear communication regarding loan terms and the necessity of robust credit assessment processes to improve member experiences. Furthermore, the research opens avenues for future studies focused on enhancing financial literacy among cooperative members and exploring the potential for establishing educational initiatives, such as a review center for civil service examinations. Overall, this research contributes to the understanding of cooperative financial management and offers insights that can enhance the sustainability of LACE-MPC's credit services, ultimately improving the socio-economic status of its members and reinforcing the role of cooperatives in community development.

Exploring translanguaging in academic discourse through an ecological analytic lens

ABSTRACT This study investigates the manifestation of translanguaging in joint academic courses for Jewish and Arab students studying in a binational Israeli teacher education college. The study focuses on the lectures’ and students’ perspectives. Sources of data included in-depth personal and focus-group interviews with the lecturers and students. Qualitative analyses through an ecological lens revealed a number of interrelated themes suggesting that these courses create academic spaces whereby translanguaging involves the intersection of multilayered pedagogical, psychological, sociocultural and, particularly, political dimensions. The unique data, revealed in this study, demonstrate that ecological dimensions are particularly useful for capturing the nature of translanguaging in complex academic settings. The findings suggest a number of important educational implications for bilingual societies. In particular, our data highlight the necessity to adopt an inclusive language policy in multilingual higher education contexts to secure the status of minoritized languages, encouraging translanguaging in the instructional and assessment processes. Moreover, within the Israeli geopolitical context and other educational settings involving conflicts, teachers and teacher educators should acquire skills and strategies to implement translanguaging effectively as a means to realize shared societies.

Peningkatan Pemanfaatan Teknologi Informasi Dalam Jumpa Bakti Gembira Se-Kabupaten Jombang

PMI Kabupaten Jombang organized the Jumpa Bakti Gembira Palang Merah Remaja (Jumbara PMR) competition across Jombang Regency, involving 543 participants from elementary, middle, and high school levels. The main problem was how to publish the results of 21 competition categories on the same day with accuracy and timeliness. To facilitate the organizing committee and participants in utilizing technology to speed up and enhance the accuracy of the competition results assessment. The research and development (R&D) method was used in the development of an information system that automatically processes the assessment and recapitulation of competition results, along with implementation support, ranging from system testing to training and score monitoring. The development of the information system successfully improved the efficiency of the competition assessment and recapitulation process. This system facilitated participants, the organizing committee, and judges in managing data, reducing the time required for data collection, and enhancing the accuracy and integrity of the results. The developed information system provided an effective solution to the problem of publishing competition results. The use of information technology has proven to increase the transparency and professionalism of PMI Kabupaten Jombang.

Time-Varying Spillover Effects of Carbon Prices on China’s Financial Risks

As China’s financial markets become increasingly integrated and the carbon market undergoes financialization, the impact of carbon emission price fluctuations on financial markets has emerged as a key area of systemic risk research. This study employs the Generalized AutoRegressive Conditional Heteroskedasticity (GARCH) model and the optimal Copula function to investigate the dynamic correlation between carbon prices and China’s financial markets. Building on this, the Monte Carlo simulation and Copula CoVaR models are used to explore the spillover effects of carbon price volatility on China’s financial markets. The findings reveal the following: (1) Carbon price fluctuations generate spillover effects on all financial markets, but the intensity varies across different markets. The foreign exchange market experiences the strongest spillover effect, followed by the bond market, while the stock and money markets are relatively less affected. (2) The optimal Copula functions differ between the carbon market and China’s financial markets, indicating heterogeneous characteristics across regional markets. (3) There is a degree of interdependence between the carbon market and various sub-markets in China’s financial system. The carbon market has the strongest positive correlation with the commodity market and a relatively high negative correlation with the real estate market. These findings underscore the importance of integrating carbon price volatility into financial risk management frameworks. For policymakers, it highlights the need to consider market stability measures when crafting carbon emission regulations. Market managers can leverage these insights to develop strategies that mitigate risk spillover effects, while investors can use this analysis to inform their portfolio diversification and risk assessment processes.

Improving Access to Dementia Care in the Era of Monoclonal Antibody Treatments for Alzheimer's Disease: a Pilot Clinical Protocol Using Abbreviated Neuropsychological Assessment.

To meet the growing demand for timely diagnosis in the new era of disease-modifying medications for Alzheimer's disease (AD), the present study aimed to reduce clinic wait times by developing and refining an abbreviated neuropsychological battery to assess individuals with a suspected amnestic process (i.e., Early-Stage AD Pathway). Early-Stage AD Pathway patients were referred by an internal neurology provider who determined that the patient had: (1) an amnestic clinical presentation, (2) a normal neurological examination, and (3) a Montreal Cognitive Assessment total score between 18 and 25. These patients were scheduled for a 2-h neuropsychological evaluation, including a brief clinical interview and an abbreviated testing battery. We evaluated n = 19 patients in the Early-Stage AD Pathway and compared them to 114 older adults referred via traditional clinic procedures (i.e., General Clinic). Most individuals evaluated via the Early-Stage AD Pathway were diagnosed with mild cognitive impairment (MCI; 68.4%) or mild dementia (21.1%) through the neuropsychological evaluation. Rate of diagnosis of MCI/dementia was comparable between groups. The average number of days between initial referral and completion of the neuropsychological evaluation was significantly lower (Mdiff = 145.8days, U = 1867.500, p < 0.001) for the Early-Stage AD Pathway group than for the General Clinic group, as the former could be scheduled more flexibly. Implementing an abbreviated neuropsychological assessment process significantly reduced the time between referral and evaluation to identify individuals who may be eligible for emerging pharmacological treatments for AD and/or non-pharmacological interventions in a timely manner.

A comprehensive multi-stage decision-making model for supplier selection and order allocation approach in the digital economy

The increasingly serious environmental issues and fierce competition caused by globalization have brought pressure on supply chain managers who seek to allocate multiple purchase demands comprehensively, highlighting the significance of supplier assessment considering sustainability and technique. Moreover, many multi-criteria decision-making (MCDM) methods fail to quantify the risk preference of decision-makers (DMs) when conducting the supplier assessment process. Indeed, a hybrid supplier selection and order allocation model that integrates such requirements is yet to be proposed. Thus, this work develops a comprehensive decision-making model that constructs a deep learning model to forecast the potential demand and addresses the sustainable supplier selection based on cumulative prospect theory (CPT) and multi-material order allocation problem simultaneously. The proposed order allocation model is solved by the second generation of adaptive geometry estimation based many-objective evolutionary algorithm, with the technique of order preference similarity to the ideal solution used to filter out the best Pareto solution for DMs as the reference. Through implementing an illustrative case study of a leading Chinese engineering machinery manufacturer followed by a sensitivity analysis, the relatively strong applicability and scalability of the proposed model and methods are demonstrated. The results show that introducing Weibull distribution to estimate the theoretical obsolescence rate of historically sold accessories can result in higher demand prediction accuracy for consumable mechanical accessories. Integrating CPT into the MCDM framework allows us to evaluate suppliers more comprehensively by capturing the effect of DMs’ risk preferences and gain or loss sensitivity.

A New Interpretable State‐of‐Health Assessment Model for Lithium‐Ion Batteries With Multidimensional Adaptability Optimization

ABSTRACTThe state‐of‐health (SOH) assessment of lithium‐ion batteries is critical to the development and optimization of maintenance strategies. To ensure the accuracy of the assessment results, it must not only address a variety of uncertainties but also rationalize and transparently conduct the assessment process, as well as make the results interpretable and traceable. These requirements are necessary to ensure that the battery operates safely and steadily. As an interpretable modeling method, belief rule base (BRB) has been widely used in lithium‐ion battery SOH assessment. However, current BRB‐based models face two problems: (1) The initial reference values provided by experts often have limited accuracy due to complex internal chemistry. (2) The multidimensionality of the parameters in the interpretable optimization process and the differences in their properties should be fully considered. Therefore, this paper proposes a new SOH assessment model for lithium‐ion batteries based on an interpretable BRB with multidimensional adaptability optimization (IBRB‐mao). First, an interpretable knowledge and data dual‐driven reference value generation method is proposed to address the issue of imprecise reference values. Expert knowledge is maintained when generating reference values using this method. Second, two interpretable multidimensional constraint strategies are proposed to ensure interpretability in the optimization process. Finally, the NASA lithium‐ion battery data set is taken as a case study to validate the effectiveness of the proposed method.

Exploring the impact of computerized dynamic assessment on the explicit and implicit knowledge of reflexive pronouns: The mediating role of brain dominance

Dissatisfaction with product-oriented and static forms of assessment led to the emergence of process-oriented testing or dynamic assessment. Learners' involvement in the assessment process can enhance their learning autonomy and help them process linguistic features more deeply. In this regard, this study explored the impacts of computerized dynamic assessment on the explicit and implicit knowledge of reflexive pronouns and the moderating impact of brain dominance among university-level English language learners in Iran. Drawing on Vygotsky's sociocultural theory and employing a quantitative quasi-experimental pretest posttest control group design with two intact classes (N = 62) randomly assigned to experimental and control groups, the rigorous statistical analyses using ANOVAs and t-tests revealed the superior performance of the learners in the experimental group over the control group in both explicit and implicit knowledge on the posttest. As a support for the interface position, our findings highlighted a strong interface between explicit and implicit knowledge. In addition, the study findings indicated that learners with different hemispheric preferences benefitted from computerized dynamic assessment in similar fashions. Practical implications of the study signify how flexible computerized dynamic assessment is to fit different hemispheric tendencies and its affordances and possibilities for inclusive language instruction and the development of both the explicit and implicit knowledge of reflexive pronouns.

Serious Game for the Nursing Assessment of Home-Dwelling Older Adults: Development and Validation Study.

The use of serious games (SGs) in nursing education is increasing, with the COVID-19 pandemic significantly accelerating their development. A key feature of SGs is their flexibility, allowing students to train at any place and time as needed. Recently, there has been a shift from developing disease-specific SGs to games focused on broader health issues. However, there has been a lack of proposals to enhance nursing interventions in home and frail care settings. The REACtion project developed a SG to improve students' understanding and clinical reasoning in caring for home-dwelling older adults. This study aims to describe the development of "REACtion Game" (RG) and explore its validity as an educational tool. A multidisciplinary team created a SG that simulates the assessment process of older adults in home settings by nurses. It features web-based scenarios, clickable objects, and a menu with tools, and medical records to enhance nursing students' knowledge and clinical reasoning skills. A prospective, observational study was conducted using the Dutch Society for Simulation in Healthcare's framework to validate the game. Further, 5 experts in home health care nursing evaluated content validity, while 30 students assessed construct validity, face validity, concurrent validity (by comparing game scores with those from the Nursing Clinical Reasoning Scale), game quality, and usability. Data were collected through self-administered web-based questionnaires and the debriefings of each match played. The students were enrolled in 2 postgraduate nursing programs: a master of science in nursing degree and a first-level continuing education in family and community nursing. Experts rated the content validity highly after revisions (universal agreement calculation method of scale-level content validity index=0.97). The sample consisted of 30 students, predominantly women (n=20, 67%) and aged younger than 45 years (n=23, 77%) with no prior experience in SG. Almost all students had a positive impression of RG as an attractive and useful method for learning new knowledge. Participants found the cases, scenarios, and dialogues realistic (face validity) and of high quality, though usability aspects such as instructions clarity and intelligibility of game progression were less favored. Construct validity showed general agreement on the game's educational value, with family and community nursing students reporting more consistent alignment with educational goals. Overall, RG scores correlated positively with time spent playing but showed limited correlation with Nursing Clinical Reasoning Scale scores. This study developed and validated a nursing education game, especially valuable as simulation is underused in some curricula. Created during the pandemic, it offered a digital learning environment. Although the game shows potential, further testing is needed for usability, concurrent validity, and functional improvements. Future research should involve larger samples to fully validate the game and assess its impact on academic achievement.

Frailty Screening in Primary Care-Based Memory Clinics: Feasibility, Acceptability, and Preliminary Findings.

We evaluated the feasibility and acceptability of frailty screening using handgrip strength with gait speed measures within four primary care-based memory clinics in Ontario. This mixed methods quality improvement initiative examined the reach, effectiveness, adoption, implementation, and maintenance of frailty screening from the perspective of patients (N = 216), care partners (N = 142), and healthcare providers (N = 9). Frailty screening was well-received by patients and care partners and perceived as quick and easy to administer and integrate into assessment processes by healthcare providers at all four memory clinics. The ease of integrating frailty screening into clinic processes was a key factor facilitating implementation; few challenges or suggestions for improvement were identified. All four clinics plan to continue frailty screening, three using the methods adopted in this study. Integrating frailty screening into memory assessments is feasible and acceptable and, given the interactional relationship between frailty and dementia, provides a significant opportunity to improve health outcomes for older adults.

Impact of indication changes on scoping for European Union Joint Clinical Assessment: scale of the problem and how to address it.

The European Union Joint Clinical Assessment (JCA) process aligns with the regulatory process to promote faster patient access. The PICO (population, intervention, comparator, and outcome) scoping for the JCA must occur before the regulatory process concludes. The risk of indication change during this period is one of the concerns for the success of the JCA process. We investigated the frequency and type of changes that are made to proposed indications and examined how such changes could impact the PICO scoping for JCA. Twenty-seven recently approved oncology and 15 Advanced Therapy Medicinal Products (ATMP) products were included. Observed indication changes were categorized into editorial or population changes population changes were graded based on the anticipated impact on JCA scope depending on their nature. The majority of products had only editorial changes between proposed and approved indications (67 percent). Once amended, it was common for the indicated population to be narrowed, and rare for it to be broadened. The most common change observed was the shift to a later treatment line. The greatest risk for PICO rescoping would be when new populations would have been added, or new subpopulations or subgroups would have been omitted from the initial scope. The impact on JCA scope depends on the proposed indication wording and how the PICO scoping would have been conducted. Rescoping warrants a considered decision, and to mitigate the risk of delays, dialogue between the assessors and the developer is recommended for informed decision-making.