Evaluation Process Research Articles

Teaching Reform and Practice Based on Four Dimensions and One Penetration for Sensing and Detection Technology

Sensing and Detection Technology is a core course in engineering specialties. Traditional sensor teaching methods have obvious deficiencies in cultivating students’ ability. To better foster students’ comprehensive qualities, this study explored a 4D1P (Four Dimensions and One Penetration) teaching mode. We independently developed an industrial sensor teaching platform with intellectual property rights, integrating classroom and sensor experiments to address the disconnection between traditional sensor teaching and practical application. This mode combined the teaching platform with SPOC (small private online courses) and Rain Classroom teaching software, enriching classroom teaching and stimulating students’ interest. By applying industry-academia-research integration to sensor teaching, students’ horizons were broadened and their creative thinking enriched. The mode set up discussion-based learning in the classroom, making the class atmosphere lively. Throughout the teaching process, data-driven learning and teaching evaluation were consistently applied, allowing teachers to promptly understand students’ learning situations. Data shows that under the backdrop of the COVID-19 pandemic, students’ grades improved and they were satisfied with this teaching mode. This mode solves most current problems in university classroom teaching and significantly enhances students’ practical abilities. It also has certain significance for education in other disciplines.

Implementing a chronic disease self-management program in Moldova: a roadmap for sustainability

Abstract Chronic disease self-management programs are evidence-based interventions but achieving their sustainability can be challenging. We propose a roadmap to sustainability that examines the transferability of intervention components and fosters multi-level and multisectoral partnerships. Since 2019, the Swiss Agency for Development and Cooperation’s Healthy Life project, in cooperation with the Ministry of Health of Moldova, has implemented a self-management program in rural communities. At pilot stage, we achieved a 53% increase in participants’ self-efficacy (Palmeirim et al, 2024). To date, the program has reached 1432 beneficiaries in 70 communities. The intervention cost per participant was approximately 74 Euros. Our evidence supported the inclusion of self-management in the national non-communicable disease program 2023-2027. We designed a roadmap to hand over this innovation to Moldovan public health institutions. Firstly, we unpacked the intervention into transferable resources, processes and roles. These included human resources (a network of 140 facilitators), pedagogical resources (culturally adapted facilitator training and self-management workshop content) and key operational processes (coordination, resource management, partnership building, monitoring and evaluation). Then, we convened a national workshop to discuss the transfer of these components to relevant institutions. We emphasized working in a coordinated partnership across institutions for intervention delivery. Finally, we launched a national working group that will work on the operational modalities of this multi-stakeholder partnership. Achieving an enabling policy environment for self-management created favorable conditions and accountability for institutional partnership building. A strategic reflection on our partner ecosystem was key to leverage local and national interests in continuing self-management approaches. Key messages • We have established priorities among transferable intervention components to match country stakeholders’ ability and readiness to sustain innovative approaches. • We are building an institutional partnership across sectors based on complementarity of experience to sustain the delivery of a self-management intervention.

Medical students attitudes towards patients with disability: a scale validation study

BackgroundDisparities in health outcomes among persons with disabilities (PWD) are influenced by preventable factors including negative attitudes and discriminatory practices of healthcare professionals and the limited training of medical students in working with PWD.ObjectiveThe purpose of this study was to validate the “Medical Students’ Attitudes Towards Patients with Disabilities” (MSA-PWD) scale among Lebanese medical students and identify associated factors.MethodA scale validation study was conducted as part of the standard internal evaluation process at the medical school, using a cross-sectional design based on a qualitative content validity process, involving students from years 1 to 4. The study included questions from previous tools, and others encouraging students to reflect on their encounters with PWD and share their insights. Statistical procedures were applied to assess the reliability and validity of the tool, including construct validity, convergent validity, known-group validity, and trend analysis.ResultsAfter a careful selection of the related items, the MSA-PWD scale demonstrated high construct validity and internal consistency, along with good convergent validity and known-group validity. Factor 1 of the scale was able to differentiate between different enrollment years of medical students, correlating with the self-assessment tool for confidence in dealing with PWD and clinical experience scenarios.ConclusionThe “Medical Students’ Attitudes Towards Patients with Disabilities” scale validated in this study is a comprehensive instrument that can distinguish between different medical school enrollment classes. The newly developed scale was valid, and reliable.

Innovative approaches to measuring and promoting employee vitality and sustainable employability

Abstract Background Employers find it difficult to develop interventions for vitality and sustainable employability (SE), particularly for employees in low-skilled jobs. Measures based on the employee perspective on SE that would give direction to interventions fall short, and effective programs to improve vitality and SE in this group are lacking. This study aims (1) to get insight into the effect and implementation of an innovative organizational, dialogue-based approach ‘Healthy HR’ (HHR)* to promote job control and SE, and (2) to refine and further validate the Maastricht Instrument for SE (MAISE)-Easy (an HHR tool for needs assessment). Methods (1) An effect evaluation with a pretest-posttest design with a 1 year follow up (N = 71), and a mixed-methods process evaluation were conducted. Data were collected using questionnaires, interviews with employees and employers (N = 26), focus groups (N = 4) and logbooks. (2) A questionnaire containing the MAISE-Easy-items, proxy variables (health and vitality) and demographics was answered by 1223 employees from 7 organizations. Construct validity, reliability and criterion validity were tested through PCA, CFA, Cronbach’s alpha and correlations. Results (1) A higher dose of HHR resulted in better job control and SE (n.s.). HHR had a positive impact on the awareness level of vitality and healthy workplaces of all stakeholders. (2) Reliability, construct and criterion validity of the MAISE-Easy were good, and MAISE-Easy 2.0 was constructed. This tool consists of 8 scales and 20 items divided over 4 areas: (1) Level of SE; (2) Factors affecting my SE; (3) Overall responsibility for SE; and (4) Responsibility for factors affecting my SE. Conclusions MAISE-Easy 2.0 is a valuable, valid and reliable tool in HHR which serves as a needs assessment for SE interventions. The innovative participatory approach HHR can improve job control and SE of employees in low-skilled jobs by giving them an active voice. *doi.org/10.1186/s12889-021-11278-7 Key messages • Healthy HR (HHR) is an effective, organisational dialogue-based approach (online toolkit) to promote job control, vitality and sustainable employability (SE) of employees in low-skilled jobs. • MAISE-Easy-2.0 (Maastricht Instrument for SE) is a new and thoroughly validated HHR tool for needs assessment, which measures SE and the responsibility for SE from the employee perspective.

Evaluation of a public health workplace staff psychosocial risk assessment and wellbeing initiative

Abstract Adverse psychosocial work environments can have a detrimental effect on staff wellbeing causing chronic stress leading to burnout. Despite legislation mandating regular risk assessments, only one third of workplaces assess psychosocial risks. A 2020 European report identified one of the main barriers being a reluctance to talk openly about psychosocial issues. This paper describes an evaluation of a staff psychosocial risk assessment and wellbeing initiative in a Public Health Department in Ireland. The initiative commenced in October 2022 during a period of major health service organisational change. Informed by positive organisational psychology conceptual frameworks, guided by the European Psychosocial risk assessment framework (PRIMA-EF) and utilising the HSE Work Positive (CI) survey tool it was possible to constructively identify and categorise psychosocial risks across the Public Health team. In the evaluation, a mixed methods approach was used based on Donabedian’s structures, processes and outcomes overarching framework and Nielsen’s Model of Process Evaluation Framework. The first three iterative quality improvement cycles of the intervention were reviewed. The evaluation demonstrated that all of Nielson’s three indicators for a successful organisational level staff wellbeing intervention had been met: there was evidence of improvement in both working conditions and staff wellbeing; iterative quality improvement cycles including appreciative inquiry staff collaborative engagement ensured staff views and key learning was captured; new organisational structures within the Department enabled the sustainability of this process. The evaluation indicates that the staff psychosocial risk assessment process is beneficial for staff wellbeing and that the methods used are appropriate. The resources used in this process continue to be readily available within the health service organisation. The evaluation supports continuation of this process in its present form. Key messages • This evaluation supports staff psychosocial risk assessment and mitigation processes and provides a framework for healthcare managers to implement such processes and comply with legislation. • This evaluation indicates that effective and sustainable collaborative staff engagement can be achieved using a positive focus which builds on team strengths and harnesses collective wisdom.

England RCT of air filtration to prevent respiratory infections (including covid-19) in care homes

Abstract Context There is evidence that portable high-efficiency-particulate-air (HEPA) filtration units remove microbial particles from the air, but it is unclear whether this is sufficient to reduce infections in care home residents. Objectives To investigate the effectiveness of portable HEPA filtration units for winter respiratory infection episode reduction in care home residents. Study design and analysis: Cluster controlled trial with intention-to-treat analysis. Setting: 90 residential care homes for older adults in England. Population: Residents expected to reside in the care home for ≥1 month. Intervention care homes: Five HEPA filtration units in communal rooms and one HEPA filtration unit in 10 to 16 bedrooms. Control care homes: Usual care. Outcome measures: The primary outcome is the number of symptomatic winter respiratory infection episodes recorded by care home staff. Secondary outcomes: other infection measures; falls /near falls; laboratory confirmed infections; hospitalisations; and staff sickness. Process evaluation to assess intervention acceptability and implementation. Results Care homes were randomised between January 2022 and February 2024, 43 to intervention and 47 to usual care. Respectively, in intervention and control group care homes: 43% and 45% provided nursing care; 87% and 87% dementia care; and median (IQR) number of communal rooms were 4 (3-5) in both groups. 1126 residents were consented, of whom 31 (3%) moved away; 151 (13%) died; and 5 stopped participating. Primary outcome data is 98% complete with 175,318 'resident days' symptom data collected. Comparing intervention and control group residents: median (IQR) age was 88 (81-92) and 88 (82-92) years; 33% and 43% were receiving nursing care; 58% and 57% had dementia; frailty scores were 6 (4-7) and 6 (5-7); 94% and 94% received influenza; and 97% and 95% COVID vaccines. Conclusions Final analytic results of this world-first RCT will be available for the conference. Key messages • This world-first RCT using HEPA filters in care homes will report the evidence of effectiveness of respiratory infection episode reduction in care home residents. • The trial will inform policy makers about the effectiveness, acceptability and implementation of HEPA filters in care homes.

Process evaluation of a randomised controlled trial - prevention of sickness absence through early identification and rehabilitation of at-risk patients with musculoskeletal disorders (PREVSAM)

BackgroundMusculoskeletal disorders are commonly treated in primary healthcare and may, if not treated adequately, entail a risk for long-term disability and sickness absence. A team-based rehabilitation intervention (PREVention of Sickness Absence for Musculoskeletal disorders, PREVSAM) was evaluated in a randomised controlled trial. The purpose of this study was to evaluate the process of implementing the PREVSAM model in primary care rehabilitation.MethodsThis process evaluation was conducted alongside the trial, collecting quantitative and qualitative data to evaluate how the PREVSAM model was implemented, mechanisms of impact, and contextual factors. Acceptability, feasibility, appropriateness, adaptations, training and support, resources, recruitment, reach, retention, dose, fidelity, and readiness for change were investigated. Qualitative data were collected from healthcare professionals and patients.ResultsEight of 22 invited rehabilitation clinics (36%) and 28 of 54 healthcare professionals (52%) were included in the PREVSAM trial and this process evaluation. Of 507 eligible patients, 261 (51%) were included. Of those, 134 were randomised to the intervention and 129 (96%) were retained. Twelve healthcare professionals and 15 patients participated in the qualitative evaluations. The model’s essential components; individual assessments and structured, team-based rehabilitation with clear division of responsibilities agreed in a joint health plan; were generally delivered according to protocol. The optional components early access to psychological treatment and workplace contact were delivered to a lesser extent. Perceived acceptability, feasibility, and appropriateness of the PREVSAM model were moderate to high. Several contextual barriers, in the form of missing prerequisites, affected the implementation. Qualitative data showed that the model, with its holistic view, was appreciated by both healthcare professionals and patients.ConclusionsThis process evaluation suggests that PREVSAM is acceptable, feasible and appropriate for patients with MSDs reporting psychological risk factors associated with increased risk for sickness absence. While essential components were implemented with fidelity for most patients, optional components were not. This variability reflects the complexity of the model, its mandatory and optional components, contextual barriers, and the person-centred approach meeting individual patient needs. As all model components were not delivered to all patients, the intervention may have been too similar to treatment as usual to detect differences on a group level. A limitation of the study is that half of the participating rehabilitation clinics withdrew prematurely.

Corn biomass as a feedstock for biorefinery: a bibliometric analysis of research on bioenergy, biofuel and value‐added products

AbstractLimited research has been dedicated to exploring the potential reuse and creation of value‐added products from corn stover. Existing gaps in current research underscore the need for waste biorefineries that adhere to the principles of a circular bioeconomy to maximize the value of corn stover. This review uses bibliometric analysis from the past decade to examine the potential and pathways for converting corn stover into energy and value‐added products within the biorefinery framework. The data were processed using the Web of Science® database and analyzed with the VosViewer® bibliometric software's, Bibliometrix package in R and Gephi, generating keyword‐based maps. A total of 2557 experimental articles and 30 reviews on corn stover research were analyzed. The bibliometric study revealed that the primary research focuses on pretreatment technologies for converting corn stover into value‐added products, bioenergy and biofuels. The main technologies employed include acid, alkaline and enzymatic hydrolysis, as well as torrefaction anaerobic digestion and steam explosion. The pretreatment processes yield sugars, xylooligosaccharides and organic acids. Additionally, the studies explored the use of corn stover biochar for soil remediation and adsorption processes. This review aims to enhance the understanding of technological pathways explored in previous research, contributing to the evaluation of sustainable processes for utilizing corn stover byproducts. Ultimately, it promotes environmentally conscious agroindustry practices that align with circular economy principles and sustainable development.

Comparative Diagnostic Value of 18F-FDG–PET–CT and Intraoperative Examination in Cervical Cancer Staging

Background and Objectives: The primary objective of this study is to assess the effectiveness of 18F-FDG–PET–CT in preoperative staging of cervical cancer, focusing on determining surgical operability and exploring the correlation between its quantitative parameters and clinicopathological characteristics. Materials and Methods: This retrospective study included 62 cervical cancer patients treated at the Department of Gynecology, Clinic for Operative Oncology at the Institute of Oncology Vojvodina between January 2016 and January 2020, where preoperative clinical examinations and 18F-FDG–PET–CT were performed to assess the extent of cancer, followed by intraoperative and pathohistological examinations of surgically removed specimens to provide a comprehensive evaluation. Results: The mean tumor size measured by 18F-FDG–PET–CT was slightly greater than that obtained through clinical examination (26.4 mm vs. 26.0 mm), with a strong linear correlation (r = 0.678, p < 0.001) observed between the two measurement methods. The overall prediction accuracy of 18F-FDG–PET–CT for primary tumors is 88.7% (55/62) [sensitivity 86.8%, specificity 100.0%, PPV 100.0%, NPV 56.2%] and for intraoperative examination is 88.7% (55/62) [sensitivity 98.1%, specificity 33.3%, PPV 89.7%, NPV 75.0%]. The agreement with histopathological examination was good for 18F-FDG–PET–CT and moderate for intraoperative examination for primary tumors. Regarding lymph nodes, the overall prediction accuracy of 18F-FDG–PET–CT is 82.2% (51/62) [sensitivity 53.8%, specificity 89.8%, PPV 58.3%, NPV 88.8%] and for intraoperative examination 66.1% (41/62) [sensitivity 76.9%, specificity 63.3%, PPV 35.7%, NPV 91.2%]. The agreement with histopathological examination was moderate for 18F-FDG–PET–CT and poor for intraoperative examination for lymph node metastasis, highlighting that the overall accuracy of 18F-FDG–PET–CT (82.1%) was significantly higher than that of intraoperative examination (66.1%) (p = 0.002). Conclusions: In conclusion, 18F-FDG–PET–CT provides high accuracy in detecting primary tumors and superior predictive value for lymph node metastases compared to intraoperative examination, highlighting the importance of incorporating this imaging modality into the preoperative evaluation process to enhance diagnostic precision and inform treatment decisions.

The NEW Soul Study: Implementation and Evaluation Impact From the Secular Trend of the COVID-19 Pandemic.

In process evaluation research, secular trends refer to external factors unrelated to an intervention that impact implementation. The COVID-19 pandemic was a secular trend that affected the implementation of the Nutritious Eating with Soul (NEW Soul) study. This paper describes steps taken in modifying intervention delivery due to the secular trend of the pandemic. This paper also addresses process evaluation measures of dose delivered, dose received, and satisfaction. This study is a longitudinal study. The study took place in Columbia, SC, from 2018 to 2021. African American adults between 18 and 65years old. The NEW Soul study, a dietary lifestyle intervention, lasted 24months. Process evaluation variables of dose delivered, dose received, and satisfaction. The study team shifted intervention delivery and maintained the timeline of classes for participants and intervention activities. Dose delivered was higher in-person (7.0 out of 8) compared to online (6.4 out of 8; t =-3.92, P =.002). Attendance was higher in-person compared to online (t =2.80, P =.006). Overall, satisfaction of the intervention was favorable in-person and online. Helpfulness of nutrition information in the class was rated lower online compared to in-person (t =2.05, P =.04). Even though the study team successfully shifted intervention delivery online, dose delivered was higher in-person. Evaluations of classes remained high across cohorts and for in-person and online classes. Future lifestyle interventions working with African American adults requires consistent flexibility in intervention delivery.

Unlocking the Anion Effect on Steerable Production of 5-Hydroxymethylfurfural.

Homogeneous metal salt catalysts play a pivotal role in industrial production of 5-hydroxymethylfurfural (HMF). Herein, we first proposed the anion effect on steerable production of HMF using metal salts with different anions as catalyst in a biphasic system of tetrahydrofuran (THF)/NaCl aqueous solution (NaCl aq). Notably, the anions affected the catalytic activity of the metal salts, leading to an order of magnitude difference in the HMF yields, i.e., AlBr3 (74.0 mol %)>AlCl3 (60.8 mol %)>Al2(SO4)3 (35.2 mol %)>Al(NO3)3 (14.9 mol %). The anion effect on steerable production of HMF could be attributed to the proximity effect and electron tension. Anions form close-range interactions with glucose molecules by proximity effect to promote electron transfer, facilitating the isomerization of glucose to fructose. Besides, anions induce a reduction of the electron cloud density of glucose carbon atoms, generating electron tension that rapidly transforms glucose from the ground state to the transition state, thereby increasing the HMF yield. Based on the revelation of anions effect and evaluation of techno-economic process, we expect to provides theoretical guidance for high-throughput screening of metal salt catalysts in industrial biorefinery.

Deep learning-based automatic contour quality assurance for auto-segmented abdominal MR-Linac contours

Objective.Deep-learning auto-segmentation (DLAS) aims to streamline contouring in clinical settings. Nevertheless, achieving clinical acceptance of DLAS remains a hurdle in abdominal MRI, hindering the implementation of efficient clinical workflows for MR-guided online adaptive radiotherapy (MRgOART). Integrating automated contour quality assurance (ACQA) with automatic contour correction (ACC) techniques could optimize the performance of ACC by concentrating on inaccurate contours. Furthermore, ACQA can facilitate the contour selection process from various DLAS tools and/or deformable contour propagation from a prior treatment session. Here, we present the performance of novel DL-based 3D ACQA models for evaluating DLAS contours acquired during MRgOART.Approach.The ACQA model, based on a 3D convolutional neural network (CNN), was trained using pancreas and duodenum contours obtained from a research DLAS tool on abdominal MRIs acquired from a 1.5 T MR-Linac. The training dataset contained abdominal MR images, DL contours, and their corresponding quality ratings, from 103 datasets. The quality of DLAS contours was determined using an in-house contour classification tool, which categorizes contours as acceptable or edit-required based on the expected editing effort. The performance of the 3D ACQA model was evaluated using an independent dataset of 34 abdominal MRIs, utilizing confusion matrices for true and predicted classes.Main results.The ACQA predicted 'acceptable' and 'edit-required' contours at 72.2% (91/126) and 83.6% (726/868) accuracy for pancreas, and at 71.2% (79/111) and 89.6% (772/862) for duodenum contours, respectively. The model successfully identified false positive (extra) and false negative (missing) DLAS contours at 93.75% (15/16) and %99.7 (438/439) accuracy for pancreas, and at 95% (57/60) and 98.9% (91/99) for duodenum, respectively.Significance.We developed 3D-ACQA models capable of quickly evaluating the quality of DLAS pancreas and duodenum contours on abdominal MRI. These models can be integrated into clinical workflow, facilitating efficient and consistent contour evaluation process in MRgOART for abdominal malignancies.

Development, Implementation, and Formative Evaluation of a Social Needs Screening Tool.

We aim to develop and formatively evaluate a brief social needs screening tool that adheres to Massachusetts Department of Public Health (MDPH) clinical service standards for sexual and reproductive health (SRH) agencies and is acceptable and feasible for use by staff during a clinical encounter. Through a multi-stage literature and expert review process, we developed an evidence-informed, two-page social needs screening tool, scoring form, and implementation guide. We piloted this tool at three SRH agencies in Massachusetts and recruited staff to provide quantitative and qualitative feedback through post-pilot test self-reported surveys and semi-structured interviews. Participants (n = 13) felt the social needs screening tool was easy to integrate into their clinical workflow and were comfortable using it with patients. All participants reported feeling comfortable administering the tool, scoring it, and referring patients to appropriate resources, if applicable. Most reported they would like to continue using the tool after the pilot implementation period, either with or without modifications. Our multi-stage tool development and formative evaluation process involving literature review, expert review, and pilot-testing in clinical settings enabled our team to create a brief, evidence-informed social needs screening tool that is acceptable to staff and feasible for use during a short clinic visit at SRH agencies in Massachusetts. Staff felt that there is value in using this tool, are comfortable using it, and are able to integrate it into their existing clinical workflows.

A comparative analysis of the evaluation system for comprehensive reform of agricultural water prices in China

Water is a fundamental natural resource that affects human and social development, and also plays an important role in modern agricultural production and food security. In China, agricultural water consumption accounts for the majority of the total water consumption. For a long time, China has not fully implemented water pricing and payment for agricultural water, and the lower agricultural water cost have led to the waste of water resource and the rapid conversion of agricultural water to other industries. In order to avoid agricultural water waste and achieve the goal of agricultural sustainable development, the Chinese government has launched a comprehensive reform of agricultural water prices nationwide since 2016. According to the plan, nowadays, the reform will faces overall evaluation and acceptance in 2024 and 2025. However, there is a lack of a relatively unified and flexible nationwide evaluation index system and acceptance measures. In this study, a comparative research of the evaluation system for comprehensive reform of agricultural water prices was developed. Based on existing evaluation and acceptance measures issued by four typical provincial regions, this study compared and analyzed the compliance and similarities and differences of these acceptance measures with national reform policies and requirements. From the aspects of evaluation procedure and index system, a systematic comparative analysis was conducted on the integrity and differences in the four regions. At the same time, suggestions were given for policy-making of national evaluation process and standard. The comparative analysis results showed that the evaluation indices in the four provincial regions have met all the key points of national reform policies and have a complete system, but there were significant differences in the structure of the evaluation index system in different provincial regions. It is recommended to establish a simple, relatively unified and practical national evaluation and acceptance system as soon as possible. In addition, evaluation criteria for individual specific indices should be determined by region based on the differences in economic capacity and agricultural water conservancy facilities conditions.

Test-retest reliability and construct validity of Inosen’s Silat Momentum Test

Problem Statements: The kick in Pencak Silat has a magnitude called momentum, which requires a tool capable of measuring several variables based on the International System of Units (SI) in real-time. Nowadays, there are affordable and reliable sensor technologies to meet these needs. Purpose: The research aimed to design a test instrument that utilizes sensor technology to measure kick momentum in the sparring category of Pencak Silat following the applicable SI, and to test its reliability and validity. The resulting instrument is named Inosen’s Silat Momentum Test. Approach: This study followed Johnson and Nelson’s seven-test construction process. Twenty-four Pencak Silat athletes, consisting of 12 elite and 12 non-elite participants, were involved in the evaluation process. The test’s reliability was assessed by examining the correlation between the test and retest results. The construct validity test was conducted by comparing the results of the front kick tests of elite and non-elite Pencak Silat athletes. Data analysis was performed using Pearson correlation and independent t-tests using Minitab 21.4.1 software. Results: The results of the test and retest indicate a very high correlation (r = 0.923), demonstrating the consistent ability of Inosen’s Silat Momentum Test to measure kick momentum. The study found a statistically significant difference in the Inosen’s Silat Momentum Test scores (p < 0.05) between the elite fighter group (average score of 463.3 kg.m/s) and the non-elite fighter group (average score of 375 kg.m/s). The results indicate that Inosen’s Silat Momentum Test is an effective instrument for differentiating kick momentum based on fighter performance. Conclusions: Based on the findings, it is inferred that Inosen’s Silat Momentum Test is a reliable and valid instrument for measuring Pencak Silat kick momentum according to SI standards. Keywords: biomechanics, kick momentum, pencak silat, performance test, sensor technology.

Effectiveness of a Bullying Intervention (Be-Prox) in Norwegian Early Childhood and Education Care Centers: Protocol for a Cluster Randomized Controlled Trial.

A new and growing body of research has studied bullying among children in early childhood education and care centers (ECECs). The Bernese Program (Be-Prox) is designed to systematically prevent and handle bullying between children in Swiss ECECs. However, the effectiveness of the Be-Prox intervention has not yet been explored in a Norwegian ECEC setting. This study aims to evaluate the effectiveness of Be-Prox in preventing and handling bullying among peers in Norwegian ECECs. ECECs from 2 Norwegian municipalities were invited to participate in a cluster randomized controlled trial (RCT) to evaluate the effectiveness of the Be-Prox intervention on peer bullying in Norwegian ECECs. After baseline measures were taken, project ECECs were randomized to either an intervention or a control arm. The Be-Prox intervention was introduced to ECECs in the intervention arm through 6 modules over a 9-month period immediately after the randomization. ECECs in the control arm participated in the data collection and were offered the Be-Prox intervention the following year. The primary outcome of the effect evaluation is the mean sum of negative behavior between peers after the Be-Prox training is completed in the intervention arm. Secondary outcomes include child bystander behavior, teacher self-efficacy, and ECEC's authoritative climate. An extensive implementation and process evaluation, as well as cost-effectiveness analyses, will be conducted alongside the RCT. Baseline data collection was conducted in September 2023, and the postintervention data collection started in May 2024. At baseline, we collected data on 708 children and 413 personnel from 38 project ECECs in the 2 Norwegian municipalities. The results from the study will be available in late 2024 at the earliest. The proposed project includes a comprehensive evaluation of the effectiveness of Be-Prox in Norwegian ECECs directly targeting the prevention and handling of bullying, including implementation and cost-effectiveness evaluations. The results from the project have the potential to fill in identified knowledge gaps in the understanding of negative behavior and bullying between peers in ECECs, and how these may be prevented. If proven efficient, our ambition is to offer Be-Prox to Norwegian ECECs as an evidence-based practice to prevent and handle bullying among preschool children. ClinicalTrials.gov NCT06040437; https://clinicaltrials.gov/study/NCT06040437. DERR1-10.2196/60626.

Program evaluation and healthcare process improvement focused on complex wheelchair procurement

ABSTRACT The operations of a specialty wheelchair (WC) seating center can influence the evaluation to delivery timeframe in days for a complex rehab technology (CRT) WC. Operations at one facility improved due to departmental process improvement (PI) project with evaluation of the delivery workflow and implementation of changes. A retrospective chart audit gathered baseline data on the evaluation to delivery timeframe in days of a CRT WC for 50 individuals prior to PI changes. Standard departmental workflow collected 745 individuals’ post-PI changes. The interventions took place from March 25, 2017, to April 5, 2018, and included defining and educating stakeholders on their roles and expectations, revisions of the electronic medical record, weekly and quarterly meetings with supplier leadership, paperwork completion goals, and follow-up paperwork centralization. Mean pre- and post-intervention evaluation to delivery timeframes in days was significantly different (162.2 versus 127.4 days, p < 0.0001). Overall, a reduction in the mean evaluation to delivery timeframe in days of CRT WC by 21.5% or 34.8 days occurred. Systematic change takes time as well as the commitment of all key players. PI changes resulted in evaluation to delivery timeframe reduction for patients to receive their CRT WCs.

Rationale and design of Healthy Kids Beyond the Bell: a 2x2 full factorial study evaluating the impact of summer and after-school programming on children’s body mass index and health behaviors

BackgroundThe Structured Days Hypothesis posits that structure protects children against obesogenic behaviors (e.g., physical inactivity, unhealthy dietary intake) and, ultimately, prevents the occurrence of excessive weight gain. The hours following school (i.e., 3–6 pm school days) and summer vacation are two “windows of vulnerability” when children may experience less structure. Programs that provide a healthy structured environment and may prevent BMI gain exist for both time periods (i.e., after-school programs and summer day camps). Unfortunately, these programs are cost prohibitive for children from low-income families to attend. This study will test the impact of providing vouchers to access existing, community-operated after-school and summer programs on BMI z-score, body composition, and obesogenic behaviors (i.e., physical activity, screen use, diet, and sleep) of children (5–12 years) from schools that primarily serve families with low income.MethodsThe study will employ a 2x2 factorial design. Participants (N = 480) attending 4 elementary schools in one school district will be randomly assigned to a no treatment control, after-school program voucher only, summer day camp voucher only, or after-school and summer day camp vouchers. Vouchers will cover the full cost of attending a pre-existing community-based after-school or summer camp program. The primary outcome (BMI z-score) will be measured at baseline (before end of school year, ~ May), 3-month follow-up (after summer, ~ August), and 12-month follow-up (end the following school year, ~ May). Secondary outcomes include body composition (i.e., whole-body fat mass, fat free mass, and percent body fat) and obesogenic behaviors (i.e., physical activity, sedentary time, sleep, screen-time, and diet). The study will also employ a rigorous process evaluation which will consider after-school and summer camp program attendance and content. Analyses will examine differences between the four groups in BMI z-score, body composition, and obesogenic behaviors. Incremental cost effectiveness ratios will determine the cost effectiveness of the intervention.DiscussionThe current study will provide critical information for researchers, practitioners, and policy makers seeking to combat the childhood obesity epidemic in children from families with low-income during the school year and summer.Trial registrationNCT05880901. Registered 27 May 2023.

A novel multi-criteria decision making method to evaluate green innovation ecosystem resilience

Green innovation ecosystem resilience evaluation is crucial for ensuring sustainable development in dynamic environments. By comprehensively assessing resilience, it helps identify risks and facilitate effective responses, thus promoting sustainable development. To effectively evaluate the resilience of green innovation ecosystems, this paper proposes a model based on the interval-valued intuitionistic fuzzy multi-criteria decision-making (MCDM) method, designed to support decision-makers (DMs) in resilience evaluation. In this model, we improve the Criteria Importance Through Intercriteria Correlation (CRITIC) method by introducing Spearman's correlation coefficient to more accurately determine the objective weights of various indicators based on their interrelationships. Furthermore, we propose an Interval-Valued Intuitionistic Fuzzy Hybrid Average Aggregation (IVIFHAA) operator, which considers both the subjective and objective weight order for aggregating expert evaluation results. Additionally, a scoring function is introduced to generate ranked evaluation results. We also establish a resilience evaluation criteria system covering interconnectivity, sustainability, and diversity within green innovation ecosystems to assist DMs in resilience evaluation. Finally, to validate this method, we apply it to assess the resilience of regional green innovation ecosystems and compare it with other methods. The results demonstrate that the improved operator effectively reduces information loss and improves evaluation efficiency, while the improved CRITIC method handles outliers during the evaluation process.

Strategies for effective high pressure germination or inactivation of Bacillus spores involving nisin.

Extremely resistant spore-forming bacteria are widely distributed in nature. They infiltrate the food chain and processing environments, posing risks of spoilage and food safety. Traditional heat-intensive inactivation methods often negatively affect the product quality. HP germination-inactivation offers a potential solution for better preserving sensitive ingredients while inactivating spores. However, the presence of ungerminated (superdormant) spores hampers the strategy's success and safety. Knowledge of strategies to overcome resistance to HP germination is vital to progress mild spore control technologies. Our study contributes to the evaluation and development of mild preservation processes by evaluating strategies to enhance the HP germination-inactivation efficacy. Mild preservation processes can fulfill the consumers' demand for safe and minimally processed food.