Quality Of Practice Research Articles

International medical graduates and PAs: A history and update.

During the 1980s and 1990s, international medical graduates (IMGs) sought legal and educational measures aimed at obtaining licensure as physician associates/assistants (PAs). Proponents of IMGs asserted that their ethnic backgrounds and identification with their respective communities could increase access to care for some segments of the population and therefore should be permitted pathways to qualify as PAs. A variety of legal measures were introduced into state legislatures in at least five states and were firmly opposed and defeated by the PA profession. Recent attempts by IMGs to obtain licensure as PAs have occurred in Puerto Rico and Arizona. In their haste to address healthcare access and satisfy various constituencies, state legislators and regulatory boards fail to recognize established professional norms. This is occurring as medical organizations are examining alternative pathways for state licensure of physicians who have completed training and/or practiced outside of the United States. PA organizations, particularly state chapters, must be vigilant in upholding qualifications for practice and licensure standards, and state PA organizations must work to convince legislators to avoid using PA professional regulations to solve a workforce issue that is essentially an issue of physician medical education remediation.

Current Evidence of the Application of Music in Tai Chi Exercise: Scoping Review.

Music has frequently been used in movement exercises to enhance health benefits. However, scientific evidence regarding the application of music to Tai Chi practice is limited. This scoping review aims to understand how music has been used in Tai Chi practice and whether music could be applied to Tai Chi practice to help optimize its benefits. PubMed, CINAHL, CNKI, and Weipu databases were searched. We included studies that compare Tai Chi practice experience or health outcomes between individuals practicing Tai Chi with music and those practicing Tai Chi without music. Studies published through September 2022 were identified. Two researchers (YD and YH) independently performed study selection and data extraction. Thematic analysis was used to summarize and categorize the findings of the included studies. Seven studies were included in this review. All 7 included studies are experimental studies. Practicing Tai Chi with music might lead to positive perceptions of Tai Chi practice (eg, motivation, concentration, enjoyment, compliance, and performance) and higher evaluations of Tai Chi instructional quality, especially for Tai Chi beginners. The effects of incorporating music into Tai Chi practice on health outcomes are inconclusive due to the heterogeneities of the sample size, and the intervention components, lengths, and frequencies of the included studies. Applying music to Tai Chi practice may result in positive Tai Chi practice experience and adherence, particularly for beginners, which could help improve the dissemination and implementation of Tai Chi interventions for public health. However, whether applying music to Tai Chi practice leads to synergetic effects on health outcomes needs further investigation.

Emerging Trends in Pre-Anesthetic Assessment: A Systematic Review of Novel Approaches and Technologies

In order to understand the current evolution, this systematic review examines the advances in preanesthetic assessment. Although the paper demonstrates the potential to revolutionize patient care, it also recognizes its limitations. These include publication bias and search limitations. At the same time, the general exposure to advances in preoperative care, including but not limited to technology and patient-centered approaches, may be valuable to the research. The nature of survey research is complicated because studies vary in quality and are prone to bias. Nevertheless, studies should be conducted on a regular basis, and techniques for assessing preanesthetic should be improved. Furthermore, this improvement should take into account patient outcomes and their subsequent need for surgical safety. Although achievements in assessment systems have limitations, prospective developments aim to fill gaps, including deficiencies in current approaches. This fact is beneficial for both patients and healthcare providers, and underscores the importance of innovation and EBP practices for preanesthetic assessment and overall quality of perioperative care.

Investigating the Benefits of Imaginative Teaching Practices in Enhancing Educational Quality

The study examines the benefits of imaginative teaching practices in enhancing educational quality by focusing on innovative pedagogical approaches. It aims to evaluate the influence of these performances on key variables, including Student Engagement (SE), Academic Performance (AP), Educational Satisfaction (ES), Creativity Development (CD), and Critical Thinking Skills (CTS). Using SPSS software, various statistical methods, such as x2 tests, ANOVA (Analysis of Variance), T-tests, and descriptive statistics, were employed to analyze data collected from educators. The findings reveal significant improvements across all measured variables, indicating that imaginative teaching practices effectively enhance student engagement, academic performance, critical thinking skills, creativity, and overall satisfaction with the educational experience. These results suggest that incorporating creative methods in teaching can create a more dynamic, engaging, and effective learning environment, ultimately leading to improved educational outcomes.

A Financial Analysis and Valuation of Starbucks

Upon reviewing Starbucks' financial analysis, it can be seen a company poised for enduring growth, underpinned by a strategy that harmonizes customer engagement with market innovation. Starbucks leverages its market strength as a leading global coffeehouse chain despite challenges inherent in the coffee industry. As a result of the company's commitment to expansion, digital innovation, and sustainability, it is demonstrating a foresight aligned with consumer trends and market demands. With a diversified business model and a reputation for quality and ethical practices, Starbucks remains resilient to market competition. Strategic initiatives like the "Triple Shot Reinvention with Two Pumps" demonstrate the company's forward-looking approach. The company prioritizes customer satisfaction and innovation as it navigates the complexities of global expansion. As a result of this approach, as well as its prudent risk management strategy, Starbucks is well positioned to maintain its industry dominance and deliver shareholder value for many years to come.

Five problems plaguing publishing in the life sciences-and one common cause.

Although publication in scholarly peer-reviewed journals remains the gold standard for communication of findings in the life sciences, the gold has been debased in the digital age by various impurities, including (a) reviewer fatigue, (b) fraud, paper mills, and the perils of artificial intelligence, (c) predatory journals, (d) the ongoing use of journal impact factor as a proxy for individual article quality, and (e) salami-slicing and other unethical practices. In this article, I present a detailed overview of these problems, as well as solutions proposed and implemented to counter them. Finally, I suggest that these are all symptomatic of a wider problem, namely the culture of 'publish or perish' and ongoing issues with how researcher performance is evaluated for grant, hiring, and promotion decisions. Only by working towards a global shift in the way scientists view the purpose of publication can we finally remove the impurities and refine the gold.

Electrospinning-based sensing technologies: Opportunities for food applications.

The article explores the science and practice of electrospinning, tracing its history and examining the factors that influence fiber morphology, including the solution composition, processing conditions, and environmental conditions. It offers a thorough examination of electrospinning fundamentals geared toward generating an appropriate platform for creating tailored nanofibers for sensing applications in the food industry. These nanofibers play a critical role in food analysis, sensing, and traceability, and we highlight their effectiveness in identifying pesticide residues, food components, antibiotics, heavy metals, and foodborne pathogens as well as in monitoring the freshness and spoilage of food. The use of electrospinning technology is poised to make sensing platforms more accessible, affordable, and widespread, thereby significantly contributing to the improvement of food quality and safety monitoring practices.

Air Quality Awareness—Empirical Evidence from a Comparative Perspective between Two European Cities

This research, conducted as part of the European project PA-MAP (Participatory Approach to Monitoring Air Quality in Urban Environments), investigates citizens’ perceptions of air pollution in two European cities: Turin (Italy) and Dublin (Ireland). We systematically collected social data through semi-structured surveys distributed via online platforms. Our aim was to gather comprehensive information on the perception of pollution sources and the effectiveness of control systems. We examined citizens’ habits and their suggestions to improve air quality. The results revealed the following: (1) In Turin, the perception of air pollution significantly influences individuals’ self-assessments of health. Consequently, increased vigilance is required to mitigate environmental health risks and to disseminate information on air quality and effective practices for reducing air pollution. (2) The use of sustainable transportation in Turin is hindered due to the inadequate maintenance of cycling infrastructure. Citizens prefer to use cars or trains, which facilitate rapid travel. (3) In Dublin, greater sensitivity to the problem of air pollution has emerged, and the use of sustainable means of transport is facilitated via ad hoc infrastructure. These results provide empirical evidence to policymakers to support the promotion of concrete local actions through which to improve air quality.

Quality risk management and data integrity in R&D laboratories supporting CMC lifecycle of biological products

The development of pharmaceutical products is the critical bridge that moves a potential new medicine from academic discovery to applied treatment of patients. It translates an idea for a new drug to bench-level research on how it can be manufactured, formulated, characterized and controlled for use in non-clinical and early clinical trials.From pre-clinical R&D discovery work through the commercial launch, substantial R&D CMC data is generated to develop and optimize cGMP manufacturing and testing operations, while also supporting product comparability, elucidating product / impurity structures, assessing critical quality attributes, developing the drug delivery mode, and developing the product formulation for long-term stability. Significant R&D CMC work continues post-approval to support continuous improvement and market expansion of the commercial product. These activities are crucial elements of Product Lifecycle Management, and taken together, they comprise Pharmaceutical Quality or Chemistry, Manufacturing and Controls (CMC). The objective of this paper is to mitigate the regulatory ambiguity of R&D quality systems with practical, risk-based examples and recommendations when conducting supportive CMC studies for biological products.Making sound strategic CMC decisions under any circumstances assumes data from R&D studies are reliable, traceable, and complete. While there are specific regulatory guidelines on phase-appropriate cGMP activities, none exist for quality practices in R&D CMC laboratories conducting non-cGMP studies. Hindsight is not the time to discover that R&D studies lack key elements that would otherwise have allowed the data to be directly presented to regulators, if needed. There is a strong prospective business interest in protecting considerable investments made for CMC R&D studies. Therefore, establishment of a robust and stage-appropriate R&D laboratory quality system is essential for companies seeking to capitalize on prior knowledge, protect investments, and be prepared for accelerated approval pathways.

Introduction to Special Issue: How Research Reform in Psychology Can Influence Professional School Psychology

This special issue features essays by prominent scholars in school psychology discussing how shifts in research can reshape the future training and practice of the field. A profession that evolves and adapts indicates a robust and dynamic discipline. However, staying current with these changes poses a significant challenge. Given the pivotal role of evidence-based practices in school psychology, the type and quality of research directly influence how psychological services are delivered and practiced. Reforming research practices in psychology can serve as a catalyst for enhancing our field. This issue presents a variety of viewpoints on how research and clinical practice intersect in a rapidly changing landscape.

Stuart Murray: Glasgow GP whose drive to raise standards saw him design the first national mandatory qualification for general practice

Stuart Murray: Glasgow GP whose drive to raise standards saw him design the first national mandatory qualification for general practice

Негосударственная система бесплатной юридической помощи в Российской Федерации: основные проблемы и перспективы

Purpose. Identification of problems that impede the progressive development of the legal education system in the Russian Federation, reflection of the role and importance of legal advice in the field of strengthening and developing practical skills. Identification of the degree of influence on the existing system of legal education in the Russian Federation of state policy in the field of regulation and formation of a system of free legal assistance. Methodology: dialectics, analysis and synthesis, formal legal, comparative legal, logical, method of interpreting legal norms, philosophical conceptology. Conclusions. Today, the development of the free legal aid system leads to the fact that in the absence of funding, many legal advice centers created at universities risk not being in demand. In modern conditions, many legal consultations created at universities may be abolished. In the future, the management of individual universities may relieve themselves of the obligation to provide legal consultations or relevant educational programs. The main reasons for abolition may also be the student’s lack of real opportunity to obtain practical skills in government bodies and the judicial system (impossibility of practical participation in judicial proceedings). Scientific and practical relevance. The article is aimed at identifying existing problems in the legal education system in the Russian Federation, which have a negative impact on the effectiveness of the education system in the field of development and strengthening the final level of practical qualifications of a graduate of a legal educational institution. In addition, the article substantiates the need to eliminate the identified problems.

A Taxonomy for Supporting Industry- Academia Communication in Software Quality

Software quality is one of the most important components of software development. Software quality attracts the user's attention and produces reliable and error-free software. Poor approach strategies lead to less effective outcomes and a higher likelihood of failure. The gap between software quality research and practice is one of the main problems with software quality. The difference between the way software quality research is communicated and the way industry concerns related to software quality is the actual gap.software industries are unaware about rapid technological change, complexities of Modern software systems, security concerns, skill shortage impact on software quality, to overcome theses problems and gaps. Taxonomy is proposed to enhance industry-academia collaboration by facilitating better communication between software quality research and practice. Some of the best quality standards are outlined and authorized in this paper that yields the greatest out-comes. A methodical and goal-oriented strategy is used to develop the proposed taxonomy, with the help of literature review, blogs, articles, and interviews with researchers and practitioners. Twenty distinct questions regarding team co-ordination, dispersion, culture, behaviors and attitudes, experience, and other topics are included in the questionnaire. The taxonomy is evaluated through online survey by implementing it in an industry-academia collaboration project. Researchers and practitioners could use the proposed taxonomy to classify and identify quality concerns or obstacles.

Lost in transition: A protocol for a retrospective, longitudinal cohort study for addressing challenges in opioid treatment for transition-age adults.

In the United States, there has been a concerning rise in the prevalence of opioid use disorders (OUD) among transition-age (TA) adults, 18 to 25-years old, with a disproportionate impact on individuals and families covered by Medicaid. Of equal concern, the treatment system continues to underperform for many young people, emphasizing the need to address the treatment challenges faced by this vulnerable population at a pivotal juncture in their life course. Pharmacotherapy is the most effective treatment for OUD, yet notably, observational studies reveal gaps in the receipt of and retention in medications for opioid use disorder (MOUD), resulting in poor outcomes for many TA adults in treatment. Few current studies on OUD treatment quality explicitly consider the influence of individual, organizational, and contextual factors, especially for young people whose social roles and institutional ties remain in flux. We introduce a retrospective, longitudinal cohort design to study treatment quality practices and outcomes among approximately 65,000 TA adults entering treatment for OUD between 2012 and 2025 in New York. We propose to combine data from multiple sources, including Medicaid claims and encounter data and a state registry of substance use disorder (SUD) treatment episodes, to examine three aspects of OUD treatment quality: 1) MOUD use, including MOUD option (e.g., buprenorphine, methadone, or extended-release [XR] naltrexone); 2) adherence to pharmacotherapy and retention in treatment; and 3) adverse events (e.g., overdoses). Using rigorous analytical methods, we will provide insights into how variation in treatment practices and outcomes are structured more broadly by multilevel processes related to communities, treatment programs, and characteristics of the patient, as well as their complex interplay. Our findings will inform clinical decision making by patients and providers as well as public health responses to the rising number of young adults seeking treatment for OUD amidst the opioid and polysubstance overdose crisis in the U.S.

Breast Malignancy: Evaluating Perception and Adoption of Methods of Screening among Women in Urban Areas of Ondo State Nigeria

Background: Mortality from breast malignancy (cancer) is assuming a worldwide epidemic among women in recent times. The increasing mortality rate is partly due to poor level of adoption of early detection methods. The purpose of this study was to evaluate the perception and adoption of methods of screening for breast malignancy among women in Ondo State, Nigeria.  Methods: A cross sectional design was employed to carry out this research while 427 respondents were randomly selected through multistage sampling technique. The data instrument was piloted for accuracy and reliability. Statistical analysis was done using SPSS Version 25. Findings: This study indicated that most respondents (63.9%) were young adults >35years while the mean age was 38.0 years. There was a positive perception (90.2%) about breast malignancy screening among respondents. Notably, majority (82.2%) of respondents utilized Breast Self-Examination (BSE) screening method while only (14.1%) utilized mammography. Findings also revealed obesity and age as predictors of breast malignancy while family/friends remain the potent source of awareness of breast malignancy screening. Chi- square test revealed an association between occupation and practice of breast malignancy screening (P-value = 0.04*; X2 = 8.02) and educational qualification (P-value = 0.000*; X2 = 31.9). Findings also showed a correlation between perception and breast malignancy screening method (r = 0.218**; p-value = 0.00) and reasons for breast malignancy screening (r = 0.250**; p-value = 0.00).  Conclusion: Government should prioritize compulsory free screening initiatives for early detection of breast malignancy in women to avert the mental agony of loss of lives.

Lessons from enriching Tanzania’s clinical research ethics clinical trials oversight and pharmacovigilance through the ASCEND project

Engaging in clinical trials in Africa not only enhances researchers' comprehension of local health concerns but also plays a crucial role in tackling global health challenges. In Tanzania, there has been a surge of clinical research for the past 10 years indicating a need to improve ethical and clinical trial regulatory capacity. Several initiatives to address the clinical trial regulatory and ethics challenges have been done. Lessons from such initiatives are important to inform evidence-based decision-making for sustainability. The ASCEND project with the theme of “Moving Tanzania’s Clinical Research Ethics and Medicines Regulatory Capacity to the Next Level: Fostering Medicine Quality, Safety and Good Clinical Practice (GCP) on Clinical Trials” was implemented in Tanzania Mainland and Zanzibar from November 2020 to December 2023. A thorough review of the project implementation reports and on deliverables was conducted to identify the lessons learned. Inductive content analysis was used to analyze the information. A total of seven lessons were deduced from the reviewed documents. These include capacity building through training on clinical trials review and approval process, research ethics and GCP inspection which cannot be overlooked; engaging the community in reporting adverse drug events is worth considering; digitalization of electronic systems enhances clinical trial control and creates a dynamic regulatory ecosystem; compliance to requirements for clinical trials conduct is enhanced by training of early and mid-career researchers; networking and broad stakeholders’ engagement and participation in ethics and regulations governing clinical trials is a cornerstone for strengthening collaboration between researchers and regulators; the need for electronic systems for monitoring and evaluation of the project is inevitable and the need for adhering to project timelines is crucial for successful implementation of the project. Sustainability is the take-home message from the ASCEND project and should inform stakeholders for future improvement. Continuous investment and advancement in research ethics and regulatory oversight across Africa should be prioritized.

Quality Indicators of Colonoscopy: Are we meeting the standards in Nepal?

BACKGROUND Colonoscopy is an important tool for management of colorectal disorders. Performance of quality colonoscopy requires a trained endoscopist, adequate resources, preparation and evaluation parameters for good outcomes. We conducted this study to emphasize the importance of quality practice in colonoscopy in our country as there is lack of standardization. METHODS This is a retrospective observational study done at a referral center in Western Nepal. All the colonoscopies were done without sedation with two sachets of peglec powder 137.15 grams, each containing polyethylene glycol (118grams) dissolved in 2 liters of clean water each. Data of 1052 colonoscopies done during three years were retrieved from colonoscopy record section and analysed for important quality measures in use. Data entry and analysis was done in Microsoft Excel. RESULTS A total of 1052 colonoscopies were included in this study. Pain abdomen (70.6%) was the commonest indication for colonoscopy and majority were male patients (53.4%). Good bowel preparation was achieved by split dosing of commercially available polyethylene glycol. Cecal and ileal intubation was achieved in 98% and 96% colonoscopies respectively, meeting the current recommendations set by the gastroenterology societies. No major complications occurred during the procedure. CONCLUSION Important quality indicators could be achieved with colonoscopy done without sedation in resource limited settings also. Screening colonoscopy should be promoted for early detection and management of colorectal cancers in low-income countries like Nepal. Quality should be standardized and practiced in routine colonoscopy examination taking into consideration of patient comfort.

Tri Hita Karana Based Yoga Model Instrument for Independent Student Exchange Students

Implementing the Tri Hita Karana concept in character and spiritual values education in higher education significantly impacts students' holistic well-being. However, developing assessment instruments for implementing this concept is still lacking. This research aims to develop a Tri Hita Karana-based yoga model instrument for Merdeka exchange students. This type of research is development research using the ADDIE method. The subjects of this research were 2 learning content experts, 2 language experts, and 2 learning design experts. The trial subjects were 30 independent exchange students (3 in individual trials and 27 in small group trials). Data collection methods used include observation, interviews, and questionnaires. The instrument used in this research was a questionnaire sheet. The techniques used to analyze data are qualitative descriptive analysis and quantitative and inferential statistics. The research results, namely the assessments given by learning content experts, obtained an average score of 94.5%, resulting in very good qualifications. The assessment results given by language experts were 93% (very good qualifications). The assessment results given by learning design experts were 96.5% (very good qualifications). The results of the practicality test given by the lecturer received an average score of 96% (very practical). The results of the individual trial assessment were 92% and small group trials 95%, so getting a very practical qualification. The t-test results show a difference in the average value of holistic well-being among students after using the Tri Hita Karana Based Yoga Model Instrument. It was concluded that the Tri Hita Karana Based Yoga Model Instrument is feasible and effective to use to improve the holistic well-being of independent exchange students.

The factors driving industrial integration: A fuzzy set qualitative comparative analysis

The integration of modern service and advanced manufacturing industries represents deep industrial reform and profound change in quality concepts, mechanisms, and practices. Integrating these two industries is important for achieving high-quality development and is an area of interest for policymakers and academia. This study analyzes the data of 11 regions in 2021 in the Guangdong–Hong Kong–Macao Greater Bay Area using the fuzzy set qualitative comparative analysis method from the configuration perspective. This study explores the effects of multiple factors, such as economic efficiency, technological innovation, and the policy environment, on improving the coupling coordination level of the modern service and advanced manufacturing industries, and analyzes the path selection of industrial integration development. Overall, economic efficiency, technological innovation, and policy environment factors are not necessary conditions for the integration development of the modern service and advanced manufacturing industries. The multiple impacts of economic efficiency, technological innovation, and policy environment form a multi-restructuring path that drives the integration of the two industries. Owing to the economic development level and resource endowment of different regions, the path dictating the degree of integration between the two industries varies by region. From a holistic perspective, all regions should strive to coordinate the multiple conditions of economic efficiency, technological innovation, and policy environment to break through objective constraints such as the government's conditions and external environment based on their own organizational conditions and resource endowments. Additionally, all regions should strengthen exchanges, cooperation, and integration mechanisms and implement complementary development and distinctive development in core cities in the Greater Bay Area. The results clarify the factors affecting industrial convergence in the Greater Bay Area, enriching existing research methods and laying a foundation for a decision-making theory of industrial integration development.

Quality Assurance of Higher Education at the University Level in Division Bahawalpur

This informative study aims to clarify the quality assurance in higher education at the university level in the Division of Bahawalpur. The objectives of this study are: to find out the difference in quality assurance among students of different universities (public and private), to compare learning and teaching strategies, to identify reasons for quality assurance failure, to analyze physical infrastructure and academic facilities, and to compare the administrative facilities between these institutions. A descriptive quantitative survey design was selected for this study. The population of this study is all universities (Government and Private) located in the Division Bahawalpur and 07 universities were chosen as a sample. Of these 07 universities, 514 students (boys and girls) and 48 teachers (males and females) participated in this study as a sample. The simple random sampling technique is used. For data collection, two self-structured questionnaires were employed; one for students and one for teachers, each consisting of 40 items. After data collection, it was analyzed with the help of SPSS. The findings revealed that public universities have difficulty keeping up-to-date infrastructure and attempting to adapt contemporary teaching tactics, whereas private institutions often have superior administrative resources and more sophisticated teaching methodologies. It is suggested that to guarantee uniformity in educational quality, all universities should use a common quality assurance system and provide a favorable learning environment, increase spending on academic facilities, and encourage cooperation between public and private institutions to exchange best practices in quality and learning for progress.