Management Program Research Articles

Personalized care in dilated cardiomyopathy: Rationale and study design of the activeDCM trial.

Dilated cardiomyopathy (DCM) is a leading cause of heart failure, particularly in younger individuals. Low physical strength is a global risk factor for cardiovascular mortality, and physical activity and a healthy lifestyle have been shown to improve outcomes in patients with heart failure. However, inappropriate exercise may increase the risk of arrhythmias in certain individuals with DCM. The determinants for predicting individual risks in this setting are poorly understood, and clinicians are hesitant to recommend sports for cardiomyopathy patients. The activeDCM trial aims to assess the safety and efficacy of a personalized exercise and activity programme for individuals with DCM. The activeDCM trial is a prospective, randomized, interventional trial with a 12month follow-up. Three hundred patients, aged 18-75years with DCM, left ventricular ejection fraction (LVEF)≤50% and New York Heart Association (NYHA) classes I-III, will be enrolled. The intervention includes a personalized exercise and activity programme. The primary outcome is the increase in peak oxygen uptake (VO2max, mL/kg/min) from baseline to 12months. Secondary endpoints include adherence to personalized activity programmes, freedom from clinically relevant arrhythmia, unplanned hospitalization for heart failure and changes in NYHA class, quality of life scores, 6min walk distance, muscular strength, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hsTnT) levels and cardiac function. Advanced research questions include high-density phenome and omics analysis combined with digital biomarkers derived from Apple Watch devices. The activeDCM trial will provide valuable insights into the safety and efficacy of personalized exercise training in DCM patients, inform clinical practice and contribute to the development of heart failure management programmes. The study will generate data on the impact of exercise on various aspects of cardiovascular disease, including genetic, metabolic, phenotypic and longitudinal aspects, facilitating the development of future digital tools and strategies, including the incorporation of smart wearable devices.

A Prototype Decision Support System for Tree Selection and Plantation with a Focus on Agroforestry and Ecosystem Services

This study presents the development and application of a prototype decision support system (DSS) for tree selection specifically for Punjab, India, a region facing challenges of low forest cover and an increasing demand for sustainable land use practices. The DSS developed using the R Shiny framework integrates ecological, social, and agro-commercial criteria to facilitate scientific knowledge decision making in tree plantation. The modules in this DSS include a tree selection tool based on comprehensive species attributes, a GIS-based tree suitability map module utilizing an Analytical Hierarchical Process (AHP), and a silviculture practice information module sourced from authoritative databases. Combining sophisticated statistical and spatial analysis, such as NMDS and AHP-GIS, this DSS mitigates data redundancy in SDM while incorporating extensive bibliographic research in dataset processing. The study highlights the necessity of fundamental niche-based suitability in comparison to realized niche suitability. It emphasizes on the importance of addressing ecosystem services, agro-commercial aspects, and enhancing silvicultural knowledge. Additionally, the study underscores the significance of local stakeholder engagement in tree selection, particularly involving farmers and other growers, to ensure community involvement and support. The DSS supports agroforestry initiatives and finds applications in urban tree management and governmental programs, emphasizing the use of scientific literature at each step, in contrast to relying solely on local knowledge.

Realized heritability and fitness costs of flupyradifurone resistance in the cowpea aphid, Aphis craccivora Koch

The cowpea aphid, Aphis craccivora Koch (Homoptera: Aphididae) is a serious insect pest that infests legume crops. Flupyradifurone (FPF) is a butenolide insecticide that selectively targets sucking insects including aphids and whiteflies. However, the realized heritability (h2) and fitness costs associated with resistance to FPF have not yet been assessed with A. craccivora. In this study, A. craccivora showed the potential to develop resistance to FPF under continuous selection, with an overall mean estimated h2 of resistance of 0.21. Results of fitness costs showed no differences in the developmental time (except for N2 and N3), longevity, fecundity, adult pre-reproductive period (APRP), total pre-reproductive period (TPRP), and oviposition days (Od) of the FPF-R strain compared to the S-strain. In contrast, all population growth parameters, including the growth reproductive rate (GRR), net reproductive rate (R0), intrinsic rate of increase (r), finite rate of increase (λ), mean generation time (T), and doubling time (DT), were significantly lower in the FPF-R strain than in the S-strain. Fitness cost studies revealed that resistance to FPF decreased the relative fitness of the FPF-R strain to 0.76 compared with that of the S-strain. The estimation of realized heritable h2 and identification of resistance fitness costs provide a basis for designing insecticide resistance management (IRM) programs to sustain susceptibility in insect populations.

The moderating role of sex in the relationship between cannabis use treatment admission profile and treatment processes and outcomes: A gender perspective

BackgroundGender-specific interventions are crucial in addressing substance use disorders —particularly cannabis use disorder — as they allow for tailored therapeutic approaches and increase the likelihood of successful outcomes. However, differences in therapeutic processes and outcomes between males and females are often not observed, making the prognosis and development of such interventions more difficult. ObjectiveThis study aimed to examine the moderating role of sex in the relationship between treatment admission profile characterized by indicators of cannabis use and sociodemographic sources of gender inequality (e.g., employment status) and adherence and outcome at discharge. MethodA multicentric retrospective observational study was conducted with a sample of 3,814 outpatients diagnosed with cannabis use disorder. Electronic health records were used for data analysis. ResultsThe interaction between sex and the number of children, as well as pre-treatment cannabis use, predicted lower treatment adherence, particularly among females. Additionally, the interaction between sex and the number of children predicted outcomes at discharge, with females showing a higher likelihood of dropout compared to males. Discussion and conclusionEnhanced comprehensive treatment with intensified contingency management programs should be prioritized for females (especially those with children) who have consumed cannabis in the month before treatment. Adopting a treatment policy framework incorporating sex/gender-sensitive therapist training and evaluative measures is essential for optimizing treatment outcomes for all patients.

Diabetes Mellitus Inequality in South Korean Adults by Region: The Influence of Obesity and Depression.

Diabetes mellitus (DM) has different prevalence by region. This study aimed to identify the differences in the effects of obesity and depression on DM in South Korean adults by region. The participants were 14,343 adults (≥30 yr) from Ulsan (regions with the lowest prevalence of DM) and Jeonbuk (regions with the highest prevalence of DM), and data were extracted from the Community Health Survey 2019. We applied a complex sampling design analysis to reflect the stratified, clustering and weights. The data were analyzed using the unweighted frequencies, weighted percentage, mean, standard error, Chi-Square test and multiple logistic regression analysis (SPSS 25.0). Regarding the main result for Ulsan, the odds ratio of DM increased by 1.94, 2.52,1.57, and 4.87 times for obesity(25-29.9kg/m2), high obesity(≥30kg/m2), depression, and receipt of psychological counseling for depression, respectively. In Jeonbuk, the odds ratio of DM increased by 1.79, 2.84, and 3.59 times for obesity, high obesity, and unmet medical experience, respectively. On the other hand, depression-related variables were found to not influence DM. We provided the rationale for conducting a health project that interventions for obesity and depression should be included in DM management programs differently in Ulsan and Jeonbuk regions.

Non-emergency department (ED) interventions to reduce ED utilization: a scoping review

BackgroundEmergency department (ED) crowding is a global burden. Interventions to reduce ED utilization have been widely discussed in the literature, but previous reviews have mainly focused on specific interventions or patient groups within the EDs. The purpose of this scoping review was to identify, summarize, and categorize the various types of non-ED-based interventions designed to reduce unnecessary visits to EDs.MethodsThis scoping review followed the JBI Manual for Evidence Synthesis and the PRISMA-SCR checklist. A comprehensive structured literature search was performed in the databases MEDLINE and Embase from 2008 to March 2024. The inclusion criteria covered studies reporting on interventions outside the ED that aimed to reduce ED visits. Two reviewers independently screened the records and categorized the included articles by intervention type, location, and population.ResultsAmong the 15,324 screened records, we included 210 studies, comprising 183 intervention studies and 27 systematic reviews. In the primary studies, care coordination/case management or other care programs were the most commonly examined out of 15 different intervention categories. The majority of interventions took place in clinics or medical centers, in patients’ homes, followed by hospitals and primary care settings - and targeted patients with specific medical conditions.ConclusionA large number of studies have been published investigating interventions to mitigate the influx of patients to EDs. Many of these targeted patients with specific medical conditions, frequent users and high-risk patients. Further research is needed to address other high prevalent groups in the ED - including older adults and mental health patients (who are ill but may not need the ED). There is also room for further research on new interventions to reduce ED utilization in low-acuity patients and in the general patient population.

Molecular detection of sub-microscopic infections and Plasmodium falciparum histidine-rich protein-2 and 3 gene deletions in pre-elimination settings of South Africa

South Africa’s efforts toward eliminating malaria have positioned the country in the pre-elimination stage. Imported and sub-microscopic cases still contribute to the persistence of malaria in regions of low transmission as identified in this study where diagnostics is built largely on the use of Rapid Diagnostic Test (RDT). However, the presence of Pfhrp2/3 gene deletion is known to interfere with the accuracy of diagnosis with the use of RDT. Malaria elimination and detection of Pfhrp2/3 gene deletion in the pre-elimination setting requires accurate molecular surveillance. With the core objective of this study being the determination of the presence sub-microscopic malaria cases and deleted Pfhrp2/3 gene markers, a total of 354 samples were collected from five districts of KwaZulu Natal, South Africa. These samples were prepared for molecular analysis using primers and PCR conditions specific for amplification of 18S rRNA and msp-1gene. Positive amplicons were analysed for the presence of Pfhrp2/3 and flanking genes, along with Sanger sequencing and phylogenetic studies. Out of 354 samples collected 339 were tested negative with PfHRP2 based RDTs. Of these Pfhrp2 and Pfhrp3 gene deletions were confirmed in 94.7% (18/19) and 100% (19/19) respectively. High migration rate (75%) among the study participants was noted and phylogenetic analysis of sequenced isolates showed close evolutionary relatedness with India, United Kingdom, Iran, and Myanmar and China isolates. Molecular-based test is recommended as an essential surveillance tool for malaria management programs as the target focuses on elimination.

The Impact of Remote Work Policies, Employee Mental Health Support, and Agile Project Management on Organizational Resilience

This study examines the impact of remote work policies, employee mental health support, and agile project management on organizational resilience. The primary objective is to qualitatively analyze the literature to understand how these practices contribute to building and sustaining resilience within organizations. The research employs a qualitative literature review methodology, synthesizing findings from academic articles, industry reports, case studies, and empirical studies to provide a comprehensive understanding of the relationship between these factors and organizational resilience. The literature review methodology involves systematically collecting and analyzing scholarly sources that explore various aspects of remote work policies, employee mental health support, and agile project management. The study categorizes the literature into key themes, such as the benefits and challenges of remote work, the importance of mental health initiatives for employee well-being, and the effectiveness of agile methodologies in project management. Thematic analysis is used to identify patterns and trends in how these practices interact to enhance organizational resilience. The findings reveal that remote work policies, when effectively implemented, offer flexibility, improve work-life balance, and maintain productivity during disruptions. Employee mental health support, including counseling services, stress management programs, and fostering a supportive workplace culture, significantly enhances employee well-being and reduces burnout, contributing to overall organizational stability. Agile project management, characterized by its flexibility, iterative approach, and emphasis on collaboration, enables organizations to quickly adapt to changes and efficiently manage projects under varying conditions.

Development and Effectiveness of a Pattern Management Educational Program Using Continuous Glucose Monitoring for Type 2 Diabetic Patients in Korea: A Quasi-Experimental Study.

The prevalence of diabetes has increased worldwide. Therefore, interest in improving glycemic control for diabetes has grown, and continuous glucose monitoring (CGM) has recently received attention as an effective glycemic control method. This study developed and evaluated the effectiveness of an education program for pattern management using CGM based on Whittemore and Roy's middle-range theory of adapting to diabetes mellitus. A quasi-experimental study was conducted on 50 adult patients with type 2 diabetes who visited the outpatient clinic of a university hospital. The experimental group was treated with a pattern management program using CGM for 12 weeks and six personalized education sessions were provided to the patients through face-to-face education and phone monitoring. The frequency of diabetes-related symptoms in the experimental group decreased, and social support (t = 2.95, p = 0.005), perceived benefits (t = 3.72, p < 0.001) and self-care significantly increased (t = 6.09, p < 0.001). Additionally, the program was found to be effective in improving HbA1c (t = -3.83, p < 0.001), FBS (t = -2.14, p = 0.038), and HDL-C (t = 2.39, p = 0.021). The educational program developed through this study can be implemented as a self-management approach for individuals with type 2 diabetes using CGM, aimed at enhancing glycemic control and preventing complications.

Toxicity of cockroach gel baits to the oothecal parasitoid Aprostocetus hagenowii (Hymenoptera: Eulophidae) and implications for cockroach integrated pest management.

Aprostocetus hagenowii (Ratzeburg) is a parasitoid wasp that parasitizes the oothecae of peridomestic pest cockroaches. A. hagenowii has been used in integrated pest management (IPM) programs for cockroach control but little is known about how this parasitoid responds to the insecticides commonly used for cockroach management. Five insecticidal gel bait products containing indoxacarb, clothianidin, fipronil, dinotefuran, or abamectin B1 were tested for their toxicity towards A. hagenowii and the American cockroach, Periplaneta americana (L.; Blattodea: Blattidae), a host of A. hagenowii and a common pest. All baits were tested as fresh and 1-d aged deposits. Indoxacarb was the only active ingredient that did not cause significant (P < 0.05) A. hagenowii mortality compared to the control in both the fresh and aged gel experiments (Median survival time [MST]s: 168h fresh, 72h aged). Clothianidin caused the lowest A. hagenowii MSTs across experiments (24h, fresh and aged). All baits caused significant P. americana mortality as fresh and 1-d aged deposits (P < 0.05). Indoxacarb appears most compatible with A. hagenowii in cockroach IPM.

Effectiveness of Aging Impact Management Program for Nurses with Phenomenological Approach

Effectiveness of Aging Impact Management Program for Nurses with Phenomenological Approach

Systematic approach of measuring program outcomes of management postgraduate program

This study aimed to develop a simplified approach for measuring the outcomes of academic programs. To achieve this, postgraduate management programs offered by various Indian institutions have been selected. Program outcomes (POs) and course outcomes (COs) are key measurement constructs. The course assessment strategy is tailored to the nature of each course, which is categorized into four distinct groups. Course outcomes (COs) of continual evaluation courses are measured through developed rubrics. This study concludes that a systematic assessment process and well-designed measurement tools are important for measuring program outcomes (POs) of academic programs such as management postgraduate programs. We recommend our model of measuring learning outcomes for all institutions, where the management postgraduate programs offered courses are evaluated on three components: faculty assessment, mid-semester assessment, and end-semester assessment. This process ensures a comprehensive and accurate measurement of program outcomes.

Heavy rainfall and moisture susceptibility of pavement foundation: A case study coupling finite element method and MnROAD moisture monitoring data

The Midwest region, including Minnesota, has been experiencing increased heavy precipitation events due to climate change, and the Minnesota Department of Transportation (MnDOT) is currently investigating the effect of climate change on pavement foundation and other transportation assets. As part of this effort, a study was conducted to investigate the impact of heavy rainfall on pavement foundation performance by focusing on moisture dynamics and resilient modulus changes in the pavement base layer. This study is aimed at understanding the adverse effects of heavy rainfall on moisture fluxes within pavement foundation and corresponding stiffness of the base aggregate layer. A two-step approach was adopted for predicting changes in saturation when estimating corresponding resilient modulus values using the resilient modulus prediction equation employed in AASHTOWare Pavement Mechanistic-Empirical (ME) Design. PLAXIS 3D, a finite-element analysis tool, was utilized to simulate the movement of moisture within the pavement layers under varying heavy rainfall scenarios. By incorporating predicted saturation from PLAXIS 3D simulations into the Pavement ME equation, corresponding resilient modulus values were estimated for the base layer. To ensure its accuracy and reliability, the model was validated using field sensor data from the MnROAD facility. Multiple linear regression models were developed to provide a means for estimating resilient modulus changes due to heavy rainfall. This study highlights the importance of considering moisture effects in pavement design and maintenance in regions prone to heavy rainfall events, and findings can be used by transportation agencies as part of their transportation/geotechnical asset management programs.

Stroke Survivors' Dependency Level and Informal Caregivers' Quality of Life in Kelantan, Malaysia: Examining the Mediating Role of Psychological Distress.

Caring for stroke survivors can affect the caregiver's life, especially with the increment of patients' dependency level. This led to depression, anxiety, and stress in the caregiver, impacting their quality of life (QoL). This study aims to model relationships between caregivers' factors and stroke survivors' factors with caregivers' QoLand to estimate the mediation effects of caregivers' depression, anxiety, and stress in the relationships between stroke survivors' dependency level and caregivers' QoL. Methods: Data from a cross-sectional study with a sample size of 250 subjects was analyzed. Linear regression was done to model the relationship between stroke survivors' factors and caregivers' factors with caregivers' QoL. Hayes's PROCESS macro model 4 for bootstrapping indirect effects was used to estimate the mediation effects of depression, anxiety, and stress in the relationship between stroke survivors' dependency level and caregivers' QoL. Stroke survivors' dependency levels that were measured by the Modified Barthel Index score (b=0.14; 95% CI: 0.07, 0.20), caregivers' depression score (b=-0.81; 95% CI: -1.44, -0.20), and caregivers' anxiety score (b=-0.73; 95% CI: -1.34, -0.12) were found to be associated with caregivers' QoL. Caregivers' depression score (effect=0.02; 95% CI for bootstrapping: 0.01, 0.04) and caregivers' anxiety score (effect=0.01; 95% CI for bootstrapping: 0.01, 0.04) were found as partial mediators in the relationship between stroke survivors' dependency level and caregivers' QoL. Stroke survivors' dependency level and caregivers' depression and anxiety significantly impact caregivers' QoL, with the latter factors partially mediating this relationship. Interventions such as providing caregivers with psychological support, stress management programs, and training in caregiving skills could help mitigate these impacts and improve caregivers' QoL.

Effects of Physiological Status and Environmental Factors on the Lure Responses of Three Pest Fruit Fly Species (Diptera: Tephritidae).

Biotic and abiotic factors influence how insects respond to stimuli. This can make it challenging to interpret captures in traps used to monitor pest abundance in management programmes. To address this, the lure response of three pest fruit flies (Diptera: Tephritidae) was evaluated in a semi-field setting with respect to several physiological and environmental factors. Using standardised methods with known fly numbers in field cages, the response to Biolure (food-based lure) was evaluated for Ceratitis capitata, Ceratitis cosyra and Bactrocera dorsalis. Response to the male lures was tested: E.G.O PheroLure for C. capitata and C. cosyra, Trimedlure for C. capitata, and methyl eugenol for B. dorsalis. The physiological variables evaluated were fly age, sex, weight, and total body nutritional composition. The environmental effects of temperature, relative humidity and light intensity were also assessed. Protein-deprived adults responded more strongly to Biolure. The response to Biolure was not sex-specific. Fly age influenced the response of all species to all tested lures. However, this effect was species and lure specific. Temperature was the most influential environmental factor, with response generally increasing with temperature. Lower thresholds for lure response, despite the proximity of responsive flies, range from 12.21 to 22.95°C depending on the species and lure tested. These results indicate that trapping systems and management activity thresholds must take physiological and environmental variation into account to increase their accuracy.

Psoas muscle index and psoas muscle density are associated with functional status in patients with degenerative lumbar spinal stenosis.

The factors affecting lumbar spinal function in patients with degenerative lumbar spinal stenosis (DLSS) are still unclear. This study explored psoas major muscle morphology in patients with DLSS and its association with their functional status. A retrospective study was conducted on 288patients with DLSS and 260control subjects. Psoas major muscle evaluation included three morphometric parameters at the L3/4disc level: psoas major index (PMI), muscle attenuation, and psoas major morphological changes (MPM). The association between psoas major morphology and functional status was assessed using the Oswestry disability index (ODI). Both female and male patients with DLSS had a higher PMI and lower muscle attenuation. PMI and muscle attenuation were inversely correlated with age in the DLSS group. After multivariable analyses, the PMI and psoas major muscle attenuation were positively correlated with patients' functional status. The PMI and muscle attenuation were positively correlated with functional status in patients with DLSS. These findings have important implications for physiotherapy programs of postoperative rehabilitation and conservative management of DLSS.

Impact of community-driven biogas initiatives on waste vegetable reduction for energy sustainability in developing countries

This research investigates the management of waste vegetables in Lagos, Nigeria, aiming to enhance sustainability and reduce environmental impact. This study explores existing waste management practices and assesses their effectiveness through a mixed-method approach combining quantitative data collection on waste volumes and qualitative interviews with stakeholders. Significant findings indicate a steady increase in waste vegetable generation in Lagos, from 120,000 tons in 2016 to 140,000 tons in 2020. Current management practices primarily involve landfilling, with minimal recycling. However, pilot projects on composting and biogas production show promising results in reducing landfill use and providing renewable energy. For instance, composting initiatives have successfully decreased landfill usage from 100% in 2019 to 60% in 2024, and community participation in waste management programs has grown from 10% to 85% over the same period. The study concludes that while Lagos faces significant waste management challenges, sustainable practices like composting and biogas production can effectively address these issues. The research underscores the need for policy support and increased community engagement to expand these initiatives, suggesting a potential model for other developing cities with similar challenges.

Self-Reported Mental Health and Addiction Outcomes of a Novel Community-Based Case Management Program for Frequent Emergency Department Users

Frequent emergency department users with mental illness or addiction often struggle to find the services they need. A pre-test/post-test design assessed outcomes for these individuals after participating in a novel community-based stepped-care program delivering individualized intensive case management services. Results indicated improvement in overall functioning and severity of anxious and depressive symptoms.

Do we get what we expect? A qualitative study of preschool teachers’ experiences with the Incredible Years® Teacher Classroom Management program

The Incredible Years® Teacher Classroom Management program (IY-TCM) is an evidence-based program with documented effectiveness and positive outcomes for teachers, children and parents. However, most of the research relies on quantitative approaches, with fewer qualitative studies exploring teachers’ personal perspectives. The aim of this study is to explore the teachers’ experiences when they got training on the IY-TCM. This study was a qualitative study and involved 11 preschool teachers who participated in two focus groups. The first focus group was conducted before the teachers started the IY-TCM training and aimed to assess the challenges they were facing in their classrooms and their expectations for the training. The second focus group took place two weeks after the teachers had completed the training and aimed to evaluate their perception of the training’s impact on children, parents, and themselves. Results indicated that, before the training, the teachers reported several behavioral challenges in their classrooms, felt exhausted and were concerned about the lack of parental involvement in the educational process. They were also enthusiastic about the training. After the training, they identified several changes: children had become more empathetic and self-regulated, and parents were more engaged in the educational process. Furthermore, teachers felt more self-confident/controlled, valued the management tools they had acquired during the training, and appreciated the sharing and support. Effective improvements were evidenced in children, parents, and teachers, underscoring the recognized effectiveness of the IY-TCM program.

Preparing future nonprofit social enterprise leaders: a research-based instructional needs analysis

ABSTRACT Nonprofit social enterprises (NSEs) have the potential to alleviate social issues significantly through entrepreneurial means. However, their unique mission and challenges require a distinct type of leadership compared to traditional nonprofit organizations. This leadership model must integrate social work and business management competencies. Unfortunately, research suggests that finding leaders with this combination of competencies can be challenging for NSEs. This raises the question of whether master’s degree programs in public administration (MPA) and nonprofit management (MNM) adequately equip students with the necessary competencies to lead NSEs. In response to this question, researchers surveyed MPA and MNM faculty using a 14-item online questionnaire. The results indicate that there are significant gaps in the current curriculum, with neither program placing strong emphasis on NSE leadership competencies. However, MNM programs cover some of these competencies more extensively than MPA programs. The findings suggest curricular and pedagogical improvement opportunities in public and private universities’ MPA and MNM programs.