Management Questions Research Articles

The effectiveness of enhanced reality simulation on postmastectomy patient care management provided by nursing students: a quasi-experimental study

AimThe aim of this study was to evaluate the effect of enhanced reality simulation on nursing students' learning satisfaction and self-confidence and patient care management knowledge and skills regarding postmastectomy care. BackgroundBreast cancer is a common disease with increasing incidence and mastectomy is the treatment of choice. Postmastectomy patient care is a multidimensional and complex process. For various reasons, nursing students today graduate with inadequate clinical skills and do not have experience with many cases. DesignThis quasi-experimental study was conducted using a pretest–posttest design with a nonequivalent control group. MethodsThis study was conducted with fourth-year nursing students (78 students). Students were allocated to each group through a simple random allocation using IBM SPSS Statistics version 24. Research data were collected at the Clinical Simulation Training Center of the university in 2020–2021 academic year. The study group (n=39) learned using a scenario-based learning approach with moulage in a real clinical setting using enhanced reality simulation, while the control group (n=39) learned using the same scenario-based approach with the routine practice adult standard patient care model. The data were collected through the “Student Sociodemographic and Descriptive Characteristics Data Collection Form”, the “Student Satisfaction and Self-Confidence in Learning Scale”, the “Postmastectomy Patient Care Skills Checklist” and the “Pre–Post Knowledge Test on Postmastectomy Patient Care Management”. ResultsAll 78 participants completed the training course. The training significantly increased the Student Satisfaction and Self-Confidence in Learning Scale subdimension scores of both groups (p<0.05). The Postmastectomy Patient Care Management scores of the study group students who received enhanced reality simulation training significantly increased (p<0.05), while there was no significant effect on the scores of the control group students (p>0.05). While most the students in the study group increased their rates of correct answers to Postmastectomy Patient Care Management questions significantly (p<0.05) after the enhanced reality simulation training, the students in the control group showed no significant improvement (p>0.05). The training significantly (p<0.001) increased the mean postmastectomy patient care skills control scores. This increase had a high effect size on the study group. ConclusionEnhanced reality simulation is a learning method that increases nursing students' learning satisfaction and self-confidence and patient care management knowledge and skills regarding postmastectomy care. Learning with enhanced reality simulation is an effective approach for nursing education that improves nursing students' learning satisfaction and self-confidence and patient care management knowledge and skills regarding postmastectomy care.

Surgical Management of Pediatric Dog Bites: A Systematic Review and Treatment Guideline

IntroductionDog bites are a unique and unusual injury in children, associated with atypical bacterial species, high infection rates, and controversial surgical treatment. Expert recommendations currently guide management and no surgical evidence-based guidelines exist. We conducted a systematic review to answer three management questions: (1) What are the best practices for wound management? (2) In what circumstances should prophylactic antibiotics be administered? (3) In what circumstances should rabies prophylaxis be given? MethodsA structured review was performed using a keyword search querying “pediatric” “dog bite” “management”. Results were reported according to the PRISMA methodology. The quality of nonrandomized studies was evaluated according to Methodological Index for Non-Randomized Studies (MINORS). Qualitative analysis was performed. ResultsA total of 803 studies were identified and 53 studies were included in the final analysis. Current literature suggests that primary closure of bites which are well irrigated and sharply debrided within 8 h of injury, is not associated with increased infection. While dog bites are associated with an overall high rate of infection (6–25 %), routine antibiotic prophylaxis in low-risk wounds does not lower that risk. Postexposure prophylaxis for rabies is indicated for all dog bites where the rabies status of the dog cannot be determined, or the animal cannot be quarantined for 10 days. ConclusionHigh-quality evidence regarding the surgical management of pediatric dog bites is limited. Trial data have demonstrated improved outcomes in wound healing and infection rates with a focus on copious irrigation and diligent wound debridement, although independent validation is needed. Level of EvidenceLevel II – systematic review.

The association between public managers' type of education and prioritizing core service provision and communication

AbstractAn important question in public management is whether public organizations should prefer or avoid specialist managers (i.e., managers whose professional backgrounds match the work they oversee). Research has shown that specialist managers are associated with better field‐specific performance in public organizations, and theory suggests that they lead differently than nonspecialist managers. However, there is no empirical evidence to support this latter claim. To remedy this, we investigate whether specialist managers prioritize core service provision more and communicate better than nonspecialist managers. Through multilevel regressions of employee reports of leaders' behaviors in the contexts of schools, eldercare, daycare, and employment, we find that specialist managers prioritize core service provision more in all contexts but schools and communicate better in eldercare and employment but not elsewhere. These findings are consistent with the theoretical expectations and thus emphasize the importance of educational background in shaping managerial behavior.

От погрома до обретения советской «земли Обетованной»: дисперсность, миграции и кон-солидация джегонасских горских евреев на Северном Кавказе (1917 г. – начало 1930-х гг.)

The article devotes itself to establishing and describing the key events in the “migration history” of the Dzhegonassko-Evreyskoe Mountain Jews. The problem is discussed in the context of this group’s post-revolutionary history, up until the beginning of the 1930s. The article analyzes the debatable issues of the fate of the devastated settlement of the Dzhegonas Jews in 1918 and in the subsequent period, their further dispersion on the North Caucasus territory. Additional evidence has been uncovered that confirms the residency of a large portion of this group of Mountain Jews in the village of Nevinnomysskaya, as well as their links to other groups of Mountain Jews. Addi-tional facts about the attempts of the Dzhegonas Jews to return to the lands of their old village in Karachay-Cherkessia in the first half of the 1920s have been revealed. It is shown how the ques-tion of land management of the Dzhegonas Jews turned out to be connected with the regular col-lection by the Soviet, Communist Party and other structures of a variety of accounting, statistical and other information about them (as well as about the Mozdok and Grozny mountain Jews). The forms and methods of consolidation of Dzhegonas Jews in the Soviet policy of indigenization of national minorities and the settlement of Terek District by mountain Jews organized by the au-thorities are studied.

Asymptomatic pediatric presentation of S‐adenosylhomocysteine hydrolase deficiency

AbstractS‐adenosylhomocysteine hydrolase deficiency is an autosomal recessive inborn error of metabolism affecting methylation by disrupting the methionine cycle. Its clinical spectrum spans from severe perinatal encephalomyopathy and liver failure to asymptomatic course in patients with isolated hypermethioninemia. We present two new cases of S‐adenosylhomocysteine hydrolase deficiency from Pakistani origin clinically asymptomatic at presentation. Both siblings showed mild chronic liver failure and elevation of creatine kinase. The older patient presented at 6 years of age with isolated verbal processing difficulty and mild diffuse leukodystrophy, reversible 12 months after introduction of methionine dietary restriction. The patient showed subtle atrophy in the muscle MRI at the age of 7 years. S‐adenosylhomocysteine hydrolase deficiency was confirmed with homozygous missense variant c.146G&gt;A (p.Arg49His) in the AHCY gene, a genotype previously reported in Pakistani patients with mild presentation. Dietary methionine restriction decreased plasma methionine but not plasma S‐adenosylhomocysteine and S‐adenosylmethionine. This work expands the mild spectrum of S‐adenosylhomocysteine hydrolase deficiency with no noticeable clinical symptoms in children, highlighting a specific hotspot variant from South Asia. This mild form of the disease is likely underdiagnosed and raises the question of therapeutic management to prevent long‐term complications documented in the literature, such as hepatocellular carcinoma and myopathy in early adulthood.

Performance of generative pre-trained transformer-4 on the certification test for mental health management: A factorial design

This study aimed to investigate the performance of generative pre-trained transformer-4 (GPT-4) on the Certification Test for Mental Health Management and whether tuned prompts could improve its performance. This study used a 3 × 2 factorial design to examine the performance according to test difficulty (courses) and prompt conditions. We prepared 200 multiple-choice questions (600 questions overall) for each course using the Certification Test for Mental Health Management (levels I-III) and essay questions from the level I test for the previous four examinations. Two conditions were used: a simple prompt condition using the questions as prompts and tuned prompt condition using techniques to obtain better answers. GPT-4 (gpt-4-0613) was adopted and implemented using the OpenAI API. The simple prompt condition scores were 74.5, 71.5, and 64.0 for levels III, II, and I, respectively. The tuned and simple prompt condition scores had no significant differences (OR = 1.03, 95% CI; 0.65-1.62, p = 0.908). Incorrect answers were observed in the simple prompt condition because of the inability to make choices, whereas no incorrect answers were observed in the tuned prompt condition. The average score for the essay questions under the simple prompt condition was 22.5 out of 50 points (45.0%). GPT-4 had a sufficient knowledge network for occupational mental health, surpassing the criteria for levels II and III tests. For the level I test, which required the ability to describe more advanced knowledge accurately, GPT-4 did not meet the criteria. External information may be needed when using GPT-4 at this level. Although the tuned prompts did not significantly improve the performance, they were promising in avoiding unintended outputs and organizing output formats. UMIN trial registration: UMIN-CTR ID = UMIN000053582.

To the ER? Can Patients Treat Their Anaphylaxis at Home?

To discuss if all patients who use self-injectable epinephrine outside the hospital setting require immediate emergency care. Prior to 2023, anaphylaxis management guidance universally recommended that patients who use self-injectable epinephrine outside of the hospital or clinic setting immediately activate emergency medical services and seek further care. Additional food-induced anaphylaxis management recommendations specified that all patients always carry 2 auto-injector devices and give a second dose of epinephrine if there was not immediate response within 5min of injection. Patients presenting for emergency care after epinephrine are often observed for up to 4-6h afterwards, even when completely asymptomatic. These management steps have lacked evidence for improving outcomes, and universal implementation of these approaches is not cost-effective as guidance for food allergic patients. Epinephrine pharmacokinetics and pharmacodynamics suggest that peak physiologic response is more likely to occur closer to 15min than before 5min, that few patients require a second dose of epinephrine as most stabilize within 15min of use, that 60min of observation after a patient stabilizes after epinephrine use may be adequate as patients infrequently have further sequelae, and that not everyone needs to carry 2 epinephrine auto-injectors on their person at all times. The most recent anaphylaxis practice parameter promotes a contextualized approach to these management questions, outlining the option for watchful waiting to gauge response to epinephrine before seeking emergency care, which has been proven as a more cost-effective management strategy. The recent updated anaphylaxis care guidelines support the evolution of anaphylaxis care, in that universal, immediate activation of emergency services is not required for using self-injectable epinephrine outside the hospital setting.

Diagnosis and management of pediatric acute liver failure: consensus recommendations of the Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ISPGHAN).

Timely diagnosis and management of pediatric acute liver failure (PALF) is of paramount importance to improve survival. The Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition invited national and international experts to identify and review important management and research questions. These covered the definition, age appropriate stepwise workup for the etiology, non-invasive diagnosis and management of cerebral edema, prognostic scores, criteria for listing for liver transplantation (LT) and bridging therapies in PALF. Statements and recommendations based on evidences assessed using the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were developed, deliberated and critically reappraised by circulation. The final consensus recommendations along with relevant published background information are presented here. We expect that these recommendations would be followed by the pediatric and adult medical fraternity to improve the outcomes of PALF patients.

The analysis of the stock of the Republican scientific-technical library

Nowadays, the investigation of the questions of the scientific management of library stocks has gained great urgency (increased in importance). The tasks of increasing the efficiency of the formation and usage of library stocks highlight the necessity for systematic research into their peculiarities and tendencies of development. This article analyzes the peculiarities and tendencies of the development of the stocks of the Republican Scientific-Technical Library of Lithuania's Scientific-Research Institute of Scientific-Technical Information and Technical-Economic Research. The multifaceted research of the stocks should enable the improvement of library processes and information-bibliography services. The research carried out allows for the following conclusions: The Republican Scientific-Technical Library, by volume of stocks, is the largest library among scientific libraries of the republic. Its stocks total 40.4 percent of the whole stock of the United Republican Information Stock (URIS). The library is the main library in URIS, which organizes the stocks of special documentation and literature. A peculiarity of the stock is that special technical documentation and literature have predominated in the stock since 1970, totaling approximately 90.1 percent of the entire stock. The basic stocks are in the Republican Scientific-Technical Library in Vilnius, which total 87.6 percent of the entire stock. The superextensive growth of the special technical documentation and literature during 1967-1970 is accounted for by the organization of the departments of patents and technical documentation (as per the decision of the Council of Ministers of Lithuania). At present, the growth of the stock has stabilized. Every year during 1975-1982, the library received an average of 850.2 thousand documents. The growth of the quantity of the stocks, completion on the whole, and the growth of the stocks of special kinds of scientific-technical literature and documentation may be defined by a mathematical curve, which shows that from a certain moment, the speed of the growth of the volume of the stocks slows down due to limited resources.

Marketing Outcomes and Shareholder Value: A Review and Research Agenda

One of the most fundamental management questions is how market-based assets affect shareholder value. To provide an answer, we review the extensive literature on marketing outcomes and shareholder value using the Theory, Context, Characteristics, and Methodology (TCCM) framework. The analysis reveals that researchers mainly rely on the efficient market hypothesis, signaling theory, and market-based arguments to theorize the relationship between customer-based market assets and shareholder value. Researchers predominantly collect secondary data and employ event study, persistence methods, and instrumental variables approach to show that marketing actions (such as advertising and brand building) and customer-based market assets (such as customer satisfaction, customer loyalty, and brand equity) positively influence shareholder value. After outlining the findings, future research directions on the relationship between market assets and shareholder value are explored.

Machine learning for environmental justice: Dissecting an algorithmic approach to predict drinking water quality in California

The potential for machine learning to answer questions of environmental science, monitoring, and regulatory enforcement is evident, but there is cause for concern regarding potential embedded bias: algorithms can codify discrimination and exacerbate systematic gaps. This paper, organized into two halves, underscores the importance of vetting algorithms for bias when used for questions of environmental science and justice. In the first half, we present a case study of using machine learning for environmental justice-motivated research: prediction of drinking water quality. While performance varied across models and contaminants, some performed well. Multiple models had overall accuracy rates at or above 90 % and F2 scores above 0.60 on their respective test sets. In the second half, we dissect this algorithmic approach to examine how modeling decisions affect modeling outcomes – and not only how these decisions change whether the model is correct or incorrect, but for whom. We find that multiple decision points in the modeling process can lead to different predictive outcomes. More importantly, we find that these choices can result in significant differences in demographic characteristics of false negatives. We conclude by proposing a set of practices for researchers and policy makers to follow (and improve upon) when applying machine learning to questions of environmental science, management, and justice.

Large Language Model Influence on Management Reasoning: A Randomized Controlled Trial.

Large language model (LLM) artificial intelligence (AI) systems have shown promise in diagnostic reasoning, but their utility in management reasoning with no clear right answers is unknown. To determine whether LLM assistance improves physician performance on open-ended management reasoning tasks compared to conventional resources. Prospective, randomized controlled trial conducted from 30 November 2023 to 21 April 2024. Multi-institutional study from Stanford University, Beth Israel Deaconess Medical Center, and the University of Virginia involving physicians from across the United States. 92 practicing attending physicians and residents with training in internal medicine, family medicine, or emergency medicine. Five expert-developed clinical case vignettes were presented with multiple open-ended management questions and scoring rubrics created through a Delphi process. Physicians were randomized to use either GPT-4 via ChatGPT Plus in addition to conventional resources (e.g., UpToDate, Google), or conventional resources alone. The primary outcome was difference in total score between groups on expert-developed scoring rubrics. Secondary outcomes included domain-specific scores and time spent per case. Physicians using the LLM scored higher compared to those using conventional resources (mean difference 6.5 %, 95% CI 2.7-10.2, p<0.001). Significant improvements were seen in management decisions (6.1%, 95% CI 2.5-9.7, p=0.001), diagnostic decisions (12.1%, 95% CI 3.1-21.0, p=0.009), and case-specific (6.2%, 95% CI 2.4-9.9, p=0.002) domains. GPT-4 users spent more time per case (mean difference 119.3 seconds, 95% CI 17.4-221.2, p=0.02). There was no significant difference between GPT-4-augmented physicians and GPT-4 alone (-0.9%, 95% CI -9.0 to 7.2, p=0.8). LLM assistance improved physician management reasoning compared to conventional resources, with particular gains in contextual and patient-specific decision-making. These findings indicate that LLMs can augment management decision-making in complex cases. ClinicalTrials.gov Identifier: NCT06208423; https://classic.clinicaltrials.gov/ct2/show/NCT06208423.

Performance of ChatGPT on basic healthcare leadership and management questions

PurposeChatGPT is an LLM-based chatbot introduced in 2022. This study investigates the performance of ChatGPT-3.5 and ChatGPT-4 on basic healthcare leadership and management questions.MethodsChatGPT-3.5 and -4 (OpenAI, San Francisco, CA, USA) generated answers to 24 pre-selected questions on three different areas of management and leadership in medical practice: group 1) accessing management/leadership training, group 2) management/leadership basics, group 3) department management/leadership. Three readers independently evaluated the answers provided by the two versions of ChatGPT. Three 4-digit scores were developed to assess the quality of the responses: 1) overall quality score (OQS), 2) understandibility score (US), and 3) implementability score (IS). The mean quality score (MQS) was calculated from these three scores.ResultsThe interrater agreement was good for ChatGPT-4 (72%) and moderate for ChatGPT-3.5 (56%). The MQS of all questions reached a mean score of 3,42 (SD: 0,64) using ChatGPT-3.5 and 3,75 (SD: 0,47) using ChatGPT-4. ChatGPT-4 showed significantly higher MQS scores in group 2 and 3 questions than ChatGPT-3.5 (p = 0.039 and p < 0.001, respectively). Also, significant differences between ChatGPT-3.5 and ChatGPT-4 regarding OQS, US, and IS in group 3 questions were seen with significances reaching p < 0.001. Significant differences between the two chatbot versions were also present regarding OQS in question groups 1 and 2 (p = 0.035 each). 87.5% of the answers provided by ChatGPT-4 (21 of 24 answers) were considered superior to the answers provided by ChatGPT-3.5 for the same questions. Neither ChatGPT-3.5 nor ChatGPT-4 offered any inaccurate answers.ConclusionChatGPT-3.5 and ChatGPT-4 performed well on basic healthcare leadership and management questions, while ChatGPT-4 was superior.

Large language models' responses to liver cancer surveillance, diagnosis, and management questions: accuracy, reliability, readability.

To assess the accuracy, reliability, and readability of publicly available large language models in answering fundamental questions on hepatocellular carcinoma diagnosis and management. Twenty questions on liver cancer diagnosis and management were asked in triplicate to ChatGPT-3.5 (OpenAI), Gemini (Google), and Bing (Microsoft). Responses were assessed by six fellowship-trained physicians from three academic liver transplant centers who actively diagnose and/or treat liver cancer. Responses were categorized as accurate (score 1; all information is true and relevant), inadequate (score 0; all information is true, but does not fully answer the question or provides irrelevant information), or inaccurate (score - 1; any information is false). Means with standard deviations were recorded. Responses were considered as a whole accurate if mean score was > 0 and reliable if mean score was > 0 across all responses for the single question. Responses were also quantified for readability using the Flesch Reading Ease Score and Flesch-Kincaid Grade Level. Readability and accuracy across 60 responses were compared using one-way ANOVAs with Tukey's multiple comparison tests. Of the twenty questions, ChatGPT answered nine (45%), Gemini answered 12 (60%), and Bing answered six (30%) questions accurately; however, only six (30%), eight (40%), and three (15%), respectively, were both accurate and reliable. There were no significant differences in accuracy between any chatbot. ChatGPT responses were the least readable (mean Flesch Reading Ease Score 29; college graduate), followed by Gemini (30; college) and Bing (40; college; p < 0.001). Large language models provide complex responses to basic questions on hepatocellular carcinoma diagnosis and management that are seldomly accurate, reliable, or readable.

Brief Teaching Intervention Improves Medical Students' Dermatology Diagnostic Skills and Comfort in Performing Dermatology Exams.

Skin disease is a significant contributor to the global disease burden, with dermatologic health disparities adding to this burden. Internists, general practitioners, and other medical professionals often manage skin disease with limited exposure to dermatologic education in medical school. This study evaluated a brief educational intervention for medical students to improve dermatologic knowledge, diagnostic and communication skills, and comfort in performing dermatology-focused physical exams. A secondary focus of the intervention was to promote awareness of skin disease, detection, and prevention for patients with a variety of skin tones. Sixty-five first through fourth-year students at Rutgers RWJMS participated in a pre-test-post-test within-subject study. Students described images using open-ended responses followed by multiple-choice identification questions. Students watched a one-hour self-paced module created by a licensed dermatologist and completed a follow-up assessment. At pre-test, descriptions were brief and often inaccurate but significantly improved post-intervention to include descriptors such as primary morphology and demarcation. Accuracy on diagnostic and management questions significantly improved and comfort in advising patients and performing dermatologic exams significantly increased. A low-cost, brief, self-paced module can augment dermatologic education for medical students while increasing exposure to multiple skin tone presentations of lesions.

WILDPOP: AN INTERACTIVE TOOL FOR ESTIMATING OCCUPANCY AND ABUNDANCE OF WILDLIFE POPULATIONS

Species abundance or population size is an ecological parameter of critical importance for wildlife management and conservation decisions. Widely used data collection methods, such as sign surveys and remote cameras, often count non-identifiable individuals or individuals prone to misidentification. In ecological modeling, these individuals are considered unmarked, and a state-of-the-art modeling approach for such data is occupancy-type modeling for unmarked individuals, which explicitly incorporates imperfect detection. Hierarchical modeling of this kind requires advanced statistical analyses, typically conducted using the R software platform and the “unmarked” package. However, these models can be explored only by researchers with programming skills and a thorough understanding of hierarchical analysis of wildlife population data. To help researchers and practitioners implement these models, we have developed a Shiny web-based interactive tool for wildlife population assessment, which works with data collected by scientists and wildlife managers. This app facilitates the use of occupancy-type modeling for unmarked individuals (single-season single species occupancy and N-mixture models) for non-coder users. The app performs simulations for single-season single species occupancy and N-mixture models with or without covariates, and estimates occupancy and abundance employing users provided data. The results are displayed as text, tables, and graphs, helping users understand hierarchical modeling and answering real-life wildlife management questions.

Confidence as a Buffer Against Covid-19 Stigma: Enhancing Employee Engagement Among Recovered Individuals

Quality of work life (QWL) is important for individual and organizational success. Post-pandemic times have brought the challenge of declined, yet continued Covid-19 cases among the working Pakistani population. Stigma due to Covid-19 and thus deteriorated QWL in such individuals is plausible. Hence, elucidating factors that enhance the possible damaged quality of work life among Covid-19 stigmatized individuals remains an essential question for managers and practitioners. Drawing on the Social Identity theory, we hypothesize that QWL is damaged in Covid-19 recovered, stigmatized working individuals through deterioration in self-esteem as such individuals are prone to influences from the societal groups that they psychologically identify with. We also argue that self-efficacy buffers this negative effect. Albeit several researches have probed into relations of QWL with stigma-related antecedents and moderation and mediation mechanisms that underlie these effect, but this study investigates self-esteem and self-efficacy as mediator and moderator, respectively, of the Covid-19 related stigma and quality of work life relationship through the lens of the Social Identity Theory. Employing a correlational framework using purposive sampling, we obtained data from 133 working individuals who had been tested positive with Covid-19 in public and private hospitals and health centers of Pakistan during November 2022 – November 2023, had completely recovered and joined their professional lives. Results confirmed study hypotheses, suggesting that stigma related to Covid-19 damages QWL, this relationship is mediated by self-esteem, while self-efficacy buffers the relationship between Covid-19 related stigma and self-esteem. Such individuals and their managers need to collaboratively work in order to reduce effects of this stigma, and undo its damaging effects on self-esteem and QWL. In this regard, boosting self-efficacy plays a supporting role as it acts as a coping mechanism in the inter-play between Covid-19 stigma, self-esteem, and QWL.

Evaluasi Tim Renang Kota Mojokerto Dalam Mengikuti Kejuaraan Daerah Renang Jawa Timur Tahun 2023

Sport is a physical activity needed by humans which has many purposes, such as maintaining body health, maintaining mental health (refreshing), achieving achievements, building character and other people (Wijaya, 2018). According to Kurt et al., (2023) swimming is a sport that can be used as a means of talent search, achievement, recreation, education, rehabilitation and self-preservation. Coaches, facilities and infrastructure, training programs, athlete development, government support and parents are some of the components that contribute to good performance. Sports achievements can be achieved through professional and quality sports training. In the sport of swimming, there are several events, namely events representing clubs, events representing regions at the provincial level, events representing regions at the national level, and events representing international national levels. The process of improving actions or techniques that have been carried out is known as evaluation. This research is motivated by the fact that there is still no research on the Mojokerto City swimming team in participating in the 2023 East Java Regional Swimming Championship. This research aims to cycle the Mojokerto City swimming team in participating in the 2023 East Java Regional Swimming Championship. The use of the SWOT method is important in analyzing and determining points earned. This method focuses on evaluating the Mojokerto City swimming team in participating in the 2023 Regional Swimming Championships which is expected to contribute to achievements for the City of Mojokerto in the future. To explain the evaluation results, the methodology used is qualitative descriptive research. The source of information comes from licensed swimming coaches. Data collection methods include interviews and documentation. Research findings include, (1) strengths include: the Mojokerto City swimming team is in young athletes and young coaches. If young athletes are coached properly, they will develop, while young coaches who are full of ideas, if given space or a platform, can express their aspirations. (2) Weaknesses include: no management questions, no atlhletes selection, no impressive Training Center (TC), no space or forum for young coaches to express their aspirations. (3) Opportunities include: the Mojokerto City swimming team has good opportunities for the future because this team is dominated by young athletes and young coaches. (4) Threats include: if the existing management is not immediately improved, the young athletes and young coaches, the Mojokerto City swimming team is threatened with not being able to get maximum results in future events.

Priorities for Clinical Research in Pediatric Extracorporeal Membrane Oxygenation Anticoagulation From the Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference.

To identify and prioritize research questions for anticoagulation and hemostasis management of neonates and children supported with extracorporeal membrane oxygenation (ECMO) from the Pediatric ECMO Anticoagulation CollaborativE (PEACE) consensus. Systematic review was performed using PubMed, EMBASE, and Cochrane Library (CENTRAL) databases from January 1988 to May 2021, followed by serial consensus conferences of international, interprofessional experts in the management of ECMO for critically ill neonates and children. The management of ECMO anticoagulation for critically ill neonates and children. Within each of the eight subgroups, two authors reviewed all citations independently, with a third independent reviewer resolving any conflicts. Following the systematic review of MEDLINE, EMBASE, and Cochrane Library databases from January 1988 to May 2021, and the consensus process for clinical recommendations and consensus statements, PEACE panel experts constructed research priorities using the Child Health and Nutrition Research Initiative methodology. Twenty research topics were prioritized, falling within five domains (definitions and outcomes, therapeutics, anticoagulant monitoring, protocolized management, and impact of the ECMO circuit and its components on hemostasis). We present the research priorities identified by the PEACE expert panel after a systematic review of existing evidence informing clinical care of neonates and children managed with ECMO. More research is required within the five identified domains to ultimately inform and improve the care of this vulnerable population.

The production, distribution and attribution of risk: a conceptual framework to climate-related risk management from the perspective of Arraigo in Bogotá, Colombia

ABSTRACT This article offers a critical perspective on disaster risk management, arguing that the mainstream approaches are based on reductive epistemologies that constrain access to a dimension of knowledge, that not only fails to mitigate risk, it actually increases it. Re-examining the notion of underlying risk drivers, the study investigates risk through ontological and sociological approaches to define three different operations or risk dynamics: the production, distribution and attribution of risk. The framework outlined is based on a case study of Bogotá, Colombia, where the notion of «arraigo» has served to anchor the popular resistance to risk-related relocation policies, revealing historical constructions (risk production), preferences and exclusions embedded within knowledge systems (risk attribution), and spatial patterns of permissiveness, control and regulations, or asymmetries across the geographical space (risk distribution). This three-branched conceptual framework has practical implications, serving to integrate the underlying risk drivers into the knowledge and stewardship frames of action to respond to the political questions in disaster risk management and leverage their transformative potential as climate adaptation measures.