Professional Activities Research Articles

Co-designing Entrustable Professional Activities in General Practitioner's training: a participatory research study.

In medical education, Entrustable Professional Activities (EPAs) have been gaining momentum for the last decade. Such novel educational interventions necessitate accommodating competing needs, those of curriculum designers, and those of users in practice, in order to be successfully implemented. We employed a participatory research design, engaging diverse stakeholders in designing an EPA framework. This iterative approach allowed for continuous refinement, shaping a comprehensive blueprintcomprising 60 EPAs. Our approach involved two iterative cycles. In the first cycle, we utilized a modified-Delphi methodology with clinical competence committee (CCC) members, asking them whether each EPA should be included. In the second cycle, we used semi-structured interviews with General Practitioner (GP) trainers and trainees to explore their perceptions about the framework and refine it accordingly. During the first cycle, 14 CCC members agreed that all the 60 EPAs should be included in the framework. Regarding the formulation of each EPAs, 20 comments were given and 16 adaptations were made to enhance clarity. In the second cycle, the semi-structured interviews with trainers and trainees echoed the same findings, emphasizing the need of the EPA framework for improving workplace-based assessment, and its relevance to real-world clinical scenarios. However, trainees and trainers expressed concerns regarding implementation challenges, such as the large number of EPAs to be assessed, and perception of EPAs as potentially high-stakes. Accommodating competing stakeholders' needs during the design process can significantly enhance the EPA implementation. Recognizing users as experts in their own experiences empowers them, enabling a priori identification of implementation barriers and potential pitfalls. By embracing a collaborative approach, wherein diverse stakeholders contribute their unique viewpoints, we can only create effective educational interventions to complex assessment challenges.

Implementing Entrustable Professional Activities in Pediatric Fellowships: Facilitating the Process.

Entrustable professional activities (EPAs) will be used for initial certification by the American Board of Pediatrics by 2028. Less than half of pediatric fellowships currently use EPAs for assessment, yetall will need to adopt them. Our objectives were to identify facilitators and barriers to the implementation of EPAs to assess pediatric fellows and to determine fellowship program directors' (FPD) perceptions of EPAs and Milestones. We conducted a survey of FPDs from 15 pediatric subspecialties. EPA users were asked about their implementation of EPAs, barriers encountered, and perceptions of EPAs. Nonusers were queried about deterrents to using EPAs. Both groups were asked about potential facilitators of implementation and their perceptions of Milestones. The response rate was 65% (575/883). Of these, 344 (59.8%) were EPA users and 231 (40.2%) were nonusers. Both groups indicated work burden as a barrier to implementation. Nonusers reported more barriers than users (mean [SD]: 7 [3.8] vs 5.8 [3.4], P < .001). Both groups identified training materials and premade assessment forms as facilitators to implementation. Users felt that EPAs were easier to understand than Milestones (89%) and better reflected what it meant to be a practicing subspecialty physician (90%). In contrast, nonusers felt that Milestones were easy to understand (57%) and reflected what it meant to be a practicing subspecialist (58%). Implementing EPA-based assessment will require a substantial investment by FPDs, facilitated by guidance and easily accessible resources provided by multiple organizations. Perceived barriers to be addressed include FPD time constraints, a need for additional assessment tools, and outcomes data.

Action research and professional development in schools

This article examines practitioner action research in schools and how action research can enhance practice and generate knowledge through partnerships between academia and the education sector. In 2020, revisions to the Norwegian curriculum for primary and secondary education introduced guidelines for professional work. The changes in the curriculum framework entail teachers’ collaboration in knowledge production - utilizing research and their own experiences in the process. This changed the formal role of teachers from transmitting established knowledge to producing knowledge in professional development and research activities. The new regulations can be related to traditions within practitioner action research. The article explores how action research can be used as a methodological framework in the professional work of schools. The starting point for the article is a thematic analysis of reflections from an action research project named Deeper Learning – How?, in which six schools participate in developing a model for unit planning. Structured interviews were conducted with members of school development groups in the schools every six months over 3.5 years, totaling seven interviews per school. The participants' reflections on their professional work serve as the empirical basis for the article. Results from the thematic analysis demonstrate that participants employed the action research process as a methodological tool to cultivate new insights and enhance practice. These reflections enrich the schools' comprehension of their educational practices and lead to measures for improvements, actions, and change. The results also highlight that proactive leadership, agreed-upon measures, teamwork, and a consistent rhythm in professional work are vital for educational practice development and knowledge production.

Morton's Metatarsalgia: The Current State of the Issue

A typical complaint with Morton's neuroma is a burning paroxysmal pain in the area of the plantar surface of the metatarsal bones with irradiation into the III interdigital space, which forces the patient to take off his shoes and massage the foot in the most inappropriate situations. Given that women are mostly ill, clinical manifestations reduce the quality of life of patients, limit their daily professional and work activities. The paper presents the etiology, pathogenesis and clinical picture of this disease, diagnostic features. A radical method of treatment is surgery, which is relatively simple in technique and consists in dissecting the tissues that compress the nerve and creating optimal conditions for the nerve trunk, preventing its subsequent traumatization.

Private practice dietetics: A scoping review of the literature.

Private practice is one of the most rapidly growing, but under-researched employment sectors for graduate dietitians in Australia, limiting evidence-based workforce development. This scoping review examines existing international literature to gain an understanding of the current private practice workforce size, distribution, demography and workforce development considerations, including competencies, supply and demand, remuneration and professional development activities. The databases MEDLINE, EMBASE, CINAHL, EMCARE, PsycInfo (Ovid) and grey literature were systematically searched in August 2023 using key search terms to identify studies for inclusion. Articles were included if they related to private practice dietetics and described an aspect of workforce. Original research, government and organisational reports,statements of practice and websites providing governmental or organisational statistics were included. A directed content analysis and qualitative constant comparison technique were used to deductively map intelligence sources against a workforce development framework. A gap analysis was also conducted to provide a focus for future workforce development research. A total of 72 peer-reviewed and grey literature sources were included, with 65% of the studies being Australian-based publications. Private practice dietetics research interest has increased in the last decade. Despite a breadth of published sources, this review found little published data on workforce size, distribution, demography, supply, demand, continued professional development and remuneration, indicating a significant gap in the evidence base. Existing literature focuses on workforce challenges and barriers, the work of private practice dietitians, with limited exploration of competency requirements for graduate private practitioners. The literature on the private practice dietetics workforce is lacking worldwide, which constrains evidenced-based workforce development initiatives. Workforce development research across all workforce aspects is warranted to address current evidence gaps.

Enhancing Workplace Safety through Personalized Environmental Risk Assessment: An AI-Driven Approach in Industry 5.0

This paper describes an integrated monitoring system designed for individualized environmental risk assessment and management in the workplace. The system incorporates monitoring devices that measure dust, noise, ultraviolet radiation, illuminance, temperature, humidity, and flammable gases. Comprising monitoring devices, a server-based web application for employers, and a mobile application for workers, the system integrates the registration of workers’ health histories, such as common diseases and symptoms related to the monitored agents, and a web-based recommendation system. The recommendation system application uses classifiers to decide the risk/no risk per sensor and crosses this information with fixed rules to define recommendations. The system generates actionable alerts for companies to improve decision-making regarding professional activities and long-term safety planning by analyzing health information through fixed rules and exposure data through machine learning algorithms. As the system must handle sensitive data, data privacy is addressed in communication and data storage. The study provides test results that evaluate the performance of different machine learning models in building an effective recommendation system. Since it was not possible to find public datasets with all the sensor data needed to train artificial intelligence models, it was necessary to build a data generator for this work. By proposing an approach that focuses on individualized environmental risk assessment and management, considering workers’ health histories, this work is expected to contribute to enhancing occupational safety through computational technologies in the Industry 5.0 approach.

USAGE OF DIGITAL SERVICES IN FOREIGN LANGUAGE LEARNING BY STUDENTS MAJORING IN APPLIED LINGUISTICS

The purpose of the article: to consider aspects of the use of digital resources in the process of learning a foreign language by students of «Applied Linguistics» specialty. Research methods: analysis and generalization of pedagogical literature; theoretical generalization. The objective processes of the formation of Ukrainian society determine the search for effective ways to improve the quality of the educational process. In addition to professional competencies, which include a certain set of abilities and skills, a modern specialist by the state educational standards is to master one of the foreign languages and properly apply it in professional activities. The level of students` mastery of a foreign language directly depends on effective teaching methods and the use of information technologies. The use of information and digital technologies increases students` interest in learning and contributes to the growth of their motivation to learn a foreign language. We consider various aspects of the use of digital resources, such as mobile applications, virtual platforms, and online resources, as well as evaluate their impact on learning and the development of students' communication skills. The analysis is focused on revealing the advantages and possible challenges that accompany the use of digital tools in the study of foreign languages in this specialty. We explore how these tools can support and facilitate learning, looking in particular at their potential for interactive learning, self-directed learning, and student engagement. At the same time, we analyze possible challenges, such as the availability of technology, the need to train educators, and possible limitations associated with the use of digital tools in the educational process.

Professional learning activity in and of teacher teams: multilevel assessment of how transformational leadership, goal interdependence, and collective efficacy affect information sharing

Engaging in learning with colleagues is paramount for teachers to enhance students’ learning. To be effective and sustainable, it requires engagement both by individual teachers as well as whole teams. Surprisingly however, research examining learning activity as a characteristic of individuals in teams and a property of teams, as well as their antecedents on both levels, is still scarce. This study examined how perceptions of transformational leadership, as mediated by goal interdependence and collective-efficacy, facilitate teachers’ engagement in information sharing, and whether effects are similar for individuals and teams. Questionnaire data were analyzed using multilevel structural equation modelling. Results showed that individual engagement in information sharing and individuals’ perceptions of goal interdependence were directly impacted by transformational leadership practices. Information sharing of teams, and collective efficacy, were impacted by consistent perceptions of goal interdependence. Teachers shape their learning amongst themselves in teams, with individual support from their leader.

INTEGRATION OF EDUCATIONAL AND SCIENTIFIC RESEARCH ACTIVITIES IN THE PROCESS OF FORMING THE COMPETITIVENESS OF FUTURE TEACHERS

INTEGRATION OF EDUCATIONAL AND SCIENTIFIC RESEARCH ACTIVITIES IN THE PROCESS OF FORMING THE COMPETITIVENESS OF FUTURE TEACHERS

DEVELOPMENT OF DESIGN COMPETENCIES OF FUTURE CIVIL ENGINEERS AS A SUBJECT OF PSYCHOLOGICAL AND PEDAGOGICAL RESEARCH

DEVELOPMENT OF DESIGN COMPETENCIES OF FUTURE CIVIL ENGINEERS AS A SUBJECT OF PSYCHOLOGICAL AND PEDAGOGICAL RESEARCH

THE CONCEPT OF SUSTAINABLE DEVELOPMENT AS THE BASIS OF CONTINUOUS ECOLOGICAL TRAINING OF FUTURE TEACHERS

Increasing attention to the ecological training of young people in the system of modern education is one of the important problems nowadays. Guarantees of environmental protection are presented in ecological knowledge, abilities and skills, as well as in the socio-cultural behavior and worldview of the population. Therefore, one of the priority tasks of the educational system is the formation of the ecological culture of the younger generation through the implementation of a system of continuous environmental education based on the principles of sustainable development. The purpose of the article is to investigate the problem of continuous ecological training of future teachers based on sustainable development. Research methods: analysis and synthesis of scientific literature (to clarify key research concepts), systematization, and generalization (for the purpose of forming the author's conclusions). It is established that ensuring the sustainable development of society involves positive life activities of people through the creation of conditions that contribute to the harmonization of their relationships, development, and satisfaction of their needs in the socio-natural environment, providing opportunities for the formation of ecological culture in the educational sphere. The peculiarities of continuous ecological training of future teachers based on the concept of sustainable development are studied, and the content and results of this process are highlighted. The goal of continuous ecological training for sustainable development is to teach people to manage the quality of life; the formation of an ecological culture in the young generation, which involves the ecological orientation of the individual, the ability to increase their ecological education and literacy, to carry out social-ecological and ecological-project activities for the benefit of sustainable development. The main tasks of continuous ecological training are the formation of scientific knowledge and ecologically oriented knowledge, the development of environmental protection skills and abilities aimed at improving the state of the environment and improving the quality of life of people, and the upbringing of a highly educated and ecologically cultural personality. Continuous ecological education for the benefit of sustainable development originates in preschool education institutions, where for the first time children master the basics of environmental education and culture, and form an idea of their unity with nature. The next stage is general secondary education, where students form environmental competence and develop an environmental outlook. The next level of the continuous ecological education system is the higher school, where the professional ecological training of the future teacher is carried out, the value-meaning sphere of the individual is formed, social-ecological norms of professional activity are mastered.

FORMATION OF PROFESSIONAL ORIENTATION OF FUTURE SPECIALISTS OF THE SOCIO-ECONOMIC SPHERE

The article is devoted to the analysis of the problem of forming the professional orientation of future specialists in the socionomic sphere. The purpose of the study is to reveal the essence of personality orientation and the peculiarities of the formation of professional orientation among specialists in socionomic professions. Research methods applied: theoretical ‒ study of scientific literature, analysis, systematization, comparison, generalization of the obtained information. It was established that in the most general sense, the orientation of the individual is understood as a set of stable motives that orient the activity of the individual and determine its selectivity and activity. The orientation of a person is characterized by his beliefs, ideals, interests, inclinations, which express the individualʼs worldview. In their structure, these types of orientation contain needs, attitudes, and relationships. If we are talking about the orientation of an individual when performing a specific activity, then the concept of «professional orientation» is used. Being an important aspect of the general orientation of the individual, the professional orientation represents a set of needs, attitudes, interests, ideals, beliefs and determines the choice of life goals. To form a professional orientation in future specialists means to strengthen in them a positive attitude towards the future profession, interest, inclination and ability to it, the desire to improve their qualifications after graduating from an educational institution, to develop ideals, views, beliefs, the prestige of the profession in the eyes of the future specialist. In the multi-functional activity of a specialist in the socio-economic sphere, professional training, his ability to design his activity, effectively solve complex professional tasks, and creatively approach the matter are priorities. The personality of the future specialist is formed and developed simultaneously with his professional qualities, readiness to fulfill future obligations. We consider the category «readiness» as two interdependent components: the individualʼs readiness for activity and the individualʼs readiness for professional self-development. The readiness of the future specialist in the socio-economic sphere for professional activity is determined by: psychological readiness, scientific-professional, practical, psychophysiological, physical.

Educators' invisible labour: A systematic review

AbstractThe hidden or overlooked nature of many of educators' professional activities complicates the already difficult task of supporting educators' labour—in both K‐12 and higher education settings. These efforts can be understood as types of invisible labour. Following PRISMA standards, we conducted a systematic literature review to answer a single research question: How have scholars framed educators' professional activities in terms of invisible labour? This systematic review searched 10 educational databases and identified 16 peer‐reviewed journal articles spanning 2011–2021. From thematic analysis of these studies, we developed a model of five types of invisibility that intersect and mask educators' professional efforts: background, care, precarious, identity and remote labour. The review also showed several overall themes related to educators' invisible labour, which we discuss in connection to the literature: effort is often semivisible, invisibility is subjective, effort by marginalised educators is often overlooked, labour in unexpected places often means effort is overlooked, and there are layers of factors masking effort. We then discuss implications for practice, starting with five invisible labour questions to prompt reflection, then how to apply invisible labour as an improvement lens for identifying needs, allocating resources, analysing jobs and tasks, and evaluating performance.

Наставничество в профессиональном образовании

The article analyzes the problem of mentoring in the framework of vocational education, examines the degree of personal relationships between mentor and mentee. It provides an opportunity to understand the importance and relevance of one of the forms of systematic transfer of knowledge and skills by a professional to a young specialist, which is mentoring. Representing the process of introducing a young specialist into professional activity. The author formulates the provisions that make it possible to comprehend the features of mentoring activities carried out by teachers of secondary vocational education in order to form an environment of qualitative formation and intensive development of the process of professional adaptation of a young specialist through mentoring in educational institutions of the Novosibirsk region.

NEUROPERSONALITY APPROACH TO THE ISSUE OF COGNITIVE SECURITY AS A NECESSARY CONDITION FOR WORK-RELATED SOCIALIZATION OF IT-SPECIALISTS

The post-classical paradigm of understanding the system of personality potentials due to virtualization and informatization of most spheres of natural life emphasizes the need to rethink the many positions of determining personal development and resourcefulness of specialists. The conceptual principles of cognitive security research of specialists in the field of IT technologies, whose professional activity is directly related to information culture, information, and cognitive security of others, need to be clarified. Methodology. An empirical study was conducted on two randomized groups of IT specialists. The groups are differentiated according to the criterion of professional experience. Accordingly, two groups were formed: EG1 (n 76) - IT specialists with experience of up to five years and group EG2 (n 83) - IT specialists with experience of more than five years (6-10 years). To generalize the structure of the relationship of categories that reveal the range of factors of cognitive-stylistic determination and neurodynamic conditionality of cognitive security of IT specialists, an expert evaluation was conducted. Research technology involved the assessment of IT experts (22 specialists with 15-22 years of experience) the importance of parameters that identified three main strategies for cognitive security of IT specialists Results. Sixteen neuropersonality types of solving professional problems and ensuring cognitive security of IT specialists differentiated by professional experience were identified. Three strategies of cognitive security of IT specialists: "Life-sustainability-strategicity", "Metacognitive knowledge - control over action" and "Positive refocusing - Metacognitive activity" are specified.

Problematic aspects of the implementation of artificial intelligence in the field of jurisprudence

The article is devoted to highlighting problematic aspects of the implementation of artificial intelligence in the field of jurisprudence, in particular, in certain branches of law. Due to the rapid development of neural network capabilities, artificial intelligence is a tool for quickly completing tasks and processing information in various spheres of society, including in jurisprudence. Therefore, for a comprehensive analysis, it is necessary to identify problem areas for the implementation of such a phenomenon. It is noted that today there is no unified approach to defining the concept of artificial intelligence. The authors provide several definitions of this concept for the most complete understanding of the essence of artificial intelligence. The legislation does not contain a normative legal act dedicated to the issue of the essence and procedure for using artificial intelligence, which gives rise to such dilemmas. Despite the widespread use of artificial intelligence capabilities among citizens, there is a lack of interest, funding and development of educational methods for the effective use of artificial intelligence in professional activities on the part of government authorities. It is also stated that the introduction of artificial intelligence into professional activities requires staffing with specialists who can service the software. The problems of introducing artificial intelligence in the field of legal proceedings are analyzed. The use of artificial intelligence by courts risks undermining the autonomy of courts and the independence of judges. Artificial intelligence is not able to comprehensively evaluate evidence and make decisions based on moral standards. The issues of transparency of courts, guaranteeing fundamental human rights and freedoms, and software reliability remain open. The legal status of artificial intelligence in civil law is considered. Since artificial intelligence is capable of creating a work, questions remain regarding the protection of copyrights using artificial intelligence and legal liability in case of copyright infringement. A debatable and controversial topic is the definition of artificial intelligence as a subject or object in a civil legal relationship. It has been determined that the introduction of artificial intelligence in criminal proceedings can become a factor in increasing cyber attacks on the neural network with the aim of stealing, destroying, and making data public.

The stress level of future teachers depending on the direction of professional subject training

The article describes the influence of university educational environment on the formation of resistance to stress in future teachers. A theoretical analysis of the phenomenon of psychological stress as a state of mental tension manifested in emotional, behavioural and somatic sensations is presented. The results of testing 529 students, who were examined in April 2022, using the PSN-25 methodology were analysed. The features of the stress level of future teachers are formulated and statistically substantiated, depending on the direction of professional subject training (foreign language, music, physical education), course of study, gender. It was found that more than half of all respondents do not experience excessive mental stress. The number of students with a low level of stress increases from the first year to the third one, regardless of the direction of professional subject training. Among future foreign language teachers, a relatively higher level of mental stress prevails. This trend is statistically significant for the first-year students of the sample. Future of physical education and music teachers are more normalised in terms of mental stress which may be due to the peculiarities of educational environment of these faculties and due to the nature of educational and professional activities. Significant gender differences in the prevalence of higher stress levels in young ladies compared to young men were revealed in a sample of these two directions of training.

The Role of Value Orientations of High School Students in the Process of Choosing a Professional Activity

This article delves into the intricate details of research that focuses on analyzing specific aspects of value orientation in the process of high school students determining their future professional paths. The study delves into the essence of self-determination in the professional realm, identifies the problem, offers solutions, and pinpoints factors for successful implementation. It underscores the crucial role of a complex value orientation in personality development and individuality formation. An individual's attitude towards themselves, the world, and the future, including their career, is reflected through priorities and values. These value orientations can serve as a dependable guide for high school students when making successful professional choices. The conducted research supports the hypothesis that value orientation is an essential factor in shaping a mature personality. Value orientation plays a pivotal role in making informed decisions about future careers. Labor value orientations are particularly important and can serve as a solid foundation for high school students as they navigate their professional paths.The purpose of this study is to study the influence of Labor value orientation on the process of professional self-determination of modern high school students.To achieve the purpose of the research, various methodological approaches are used, including systemic, socio-psychological and axiological approaches oriented on the humanist principle. Various methods have been used to conduct research, including theoretical analysis of scientific research, organizational approaches, and empirical methods such as observation, questionnaires, and psychodiagnostic methods.This article conducted a bibliometric analysis of the problem, as well as empirical research. Thanks to the experiment carried out, it turned out that most of the high school students surveyed suffer from a certain anxiety that prevents them from choosing professional preferences that correspond to their abilities, desires and needs.

The Career of Scribes of the Grand Duchy of Lithuania and the Factors That influenced It according to the 1566–1623 Lithuanian Metrics Data

The article examines what influence the number of signed documents had on the careers of GDL scribes. In order to do this, a statistical method is used in this article. The statistical data (see appendices no. 2 and 3) lead to the conclusion that persons who were active in their daily work were more successful in climbing the career ladder. These are Leonas Sapiega, Gabrielius Vaina, Eustachijus Valavičius (the future bishop of Vilnius) and Aleksandras Gosievskis. These individuals have one thing in common – they all started working in the office at a relatively young age. The conducted research allows to see a connection between a person’s education, his professional activity and a more successful career. However, it is important not to forget the informavo influence as well. For example, M. Vaina was one of the most active scribes of the LDK office, but he did not have an impressive career. The importance and influence of education on the career of a scribe is also illustrated by the case of Valavičius brothers. E. Valavičius surpassed his older brother Jeronimas with having a better education, being more active in the chancellery which allowed him to reach the post of chancellor sooner. This case shows that it didn’t matter how long a person had worked in the office before moving up the career ladder. Consequently, education, activity and the ability to maintain good relations with the social environment were more important for the career of a scribe than the work experience.

THE IMPACT OF STRESS-ASSOCIATED DISEASES OF THE DIGESTIVE ORGANS ON THE PSYCHOPHYSIOLOGICAL STATE OF OPERATORS OF UNMANNED AIRCRAFT SYSTEMS

Introduction. In the conditions of martial law, an important role belongs to modern military equipment, which includes unmanned aircraft systems (UAS). Оperators of UAS in the course of combat missions are significantly affected by the stress factor. It provokes the occurrence of stress-associated diseases in them, therefore, studying the specifics of the impact of stress-associated diseases on the psychophysiological state of operators determines the relevance of this study. The purpose of the study. To establish the patterns of influence of stress-associated diseases of the digestive organs on the psychophysiological state of the operators of unmanned aircraft systems. Materials and methods. In the course of the research, 94 operators of UAS under the age of 40 were examined, who were then divided into groups based on their health status. The examination was carried out using modern modified methods implemented on the basis of the software and hardware complex for psychophysiological research «PFI-2». The results. It has been proven that stress-associated diseases of the digestive organs significantly worsen (p&lt;0,05) the psychophysiological state of operators of UAS in a sufficiently large number of professionally important psychophysiological qualities. The reliable influence of the «state of health» factor on the indicators of simple and complex visual-motor reaction of operators of UAS is shown. The analysis of correlation constellations according to cognitive parameters showed that 6 of them are observed in healthy operators, 2 in mildly ill patients, and 1 in severely ill patients, that is, the system of connections between cognitive functions breaks down quite strongly with the development of stress-associated diseases of the digestive organs. There is a natural decrease in the number of connections in the series «healthy (13) – mildly ill (10) – severely ill (5)». It is shown that the stress that causes the disease fundamentally destroys the system of ensuring professional activity. Conclusions. It was established that stress-associated diseases of the digestive organs negatively affect the psychophysiological state of operators. The degree of degradation of the structure of correlation relations (р=0,0491) as a result of the influence of the stress factor on the operators was revealed. A hypothesis regarding the destruction of the system of connections between cognitive psychophysiological parameters depending on the «severity of the disease» is proposed. The need to develop a set of measures to prevent the development of stress-related diseases among operators of UAS has been established.