Substantive Improvements Research Articles

The impact of social and institutional trust on South Korean perceptions of North Korean arrivals

AbstractHow do forms of trust influence South Korean views of North Korean arrivals? While a broad literature addresses the institutional and generalized social trust impacting a range of public perceptions, this has not been extended to views on North Korean arrivals. Meanwhile, research on views of arrivals often relies on only one measure for what are likely complex concerns. Through the use of a 2021 Korean Social Integration Survey, we find evidence of institutional and social trust positively influencing overall views of arrivals, with mixed results on the impact on proximal tolerance of arrivals, suggesting that policy efforts to enhance trust as a means to improve integration efforts may fail to produce substantive improvements for arrivals.

Determinants of acute psychiatric inpatient length of stay in Ireland.

Ireland has had an historic over-reliance on inpatient mental health care accompanied by poorly resourced community provision. There has been an increasing policy focus on provision of mental health care in the community to facilitate diversion from, or shorten stays in, inpatient care. However, little is known about the determinants of psychiatric inpatient length of stay (LOS) to allow for the targeting of community services. To use a large cross-sectional national dataset to examine the determinants of psychiatric inpatient LOS in the Irish context. Using information on 60,607 discharges from adult acute psychiatric units in Ireland between 2015 and 2019, the study employs both descriptive and regression analysis. Using negative binomial regression models, we control for patient demographic, socioeconomic, and clinical characteristics. In addition, as LOS may be related to provision of non-acute services in the patient area of residence, the analysis also controls for aspects of community service provision. The study finds that longer LOS is associated with older age, being female, and having an involuntary admission. Clinical diagnosis significantly impacts LOS, with diagnoses such as schizophrenia being associated with longer LOS. There is also significant variation in LOS across region of residence, with discharges from some regions staying up to 5days longer. The regional variation observed in inpatient LOS supports the assumption that increased provision of community services diverts or reduces the quantum of care required in inpatient settings. However, without substantive improvement in the community data collected and reported, future planning of mental health services, both community and inpatient, will be substantially curtailed.

The Use of Bronchial Rheoplasty in Emphysema Patients Previously Treated with Endoscopic Lung Volume Reduction: A Case Series.

Endoscopic lung volume reduction (ELVR) is an established treatment option for patients with severe emphysema. Not all patients are candidates for this type of intervention, and in the context of significant airway secretions, they may be excluded from treatment. Bronchial Rheoplasty (BR) was developed to treat mucus hypersecretion by delivering nonthermal pulsed electric fields to the airway epithelium and submucosa. The literature to date demonstrates that patients treated with BR in clinical studies have a reduction in airway goblet cell hyperplasia as well as substantive clinical improvement in the setting of chronic bronchitis (CB). In this case series, we present four patients treated at three different institutions who had previously undergone ELVR with beneficial outcome. However, over time, these patients subsequently developed worsening clinical issues, including complaints of increased and thickened mucus, along with exacerbations in the setting of a loss of some ELVR-associated benefits. These patients then underwent exploratory treatment with BR with the intent of reducing their secretion burden and potentially restoring the efficacy associated with the initial placement of the airway valves. All BR procedures were well tolerated, and three of the four patients showed substantial improvement in their symptom burden. Airway examinations during the second of the two BR procedures also revealed what appeared to be less airway mucosal inflammation and a decrease in the quantity of airway secretions. Therefore, treatment with BR may have the potential to improve and restore the initial benefits associated with ELVR, thus enhancing long-term outcomes. Further clinical studies with sufficient follow-up are warranted to assess this in a larger cohort of patients, and to determine whether treatment with BR prior to ELVR may make more patients eligible for this treatment through reduction in their secretions and/or symptoms.

The same only different: precarious workers’ perceptions of their treatment in COVID-19 times

PurposeOur core aim was to explore the perceptions of precarious workers on the ways in which the pandemic impacted their relationships with their employing organizations and to explore the ways in which they viewed the pandemic as (re)shaping the dynamics of precarious work and the extent to which they saw the pandemic as contributing to substantive improvement in their working lives or whether the pandemic is exacerbating their marginalisation.Design/methodology/approachWe adopted an approach akin to grounded theory in an exploratory research design and utilized in-depth, semi-structured interviews as the most apposite method of data collection. Our research design centred on a two-phase data collection approach, which were intended to gather data at two points. First, during the most difficult part of the pandemic, which we describe as the “Lockdown phase” and second, during the period wherein the pandemic rules were eased but elements of the risks remained; the “New Normal phase”.FindingsThis article reports the findings of a longitudinal study of the reflections and interpretations of precarious workers on the impacts of the pandemic on their relationships with their employing organizations. We supply findings across three periods – pre-the COVID-19 pandemic, during the pandemic lockdown phase and post-lockdowns in the “new normal phase”.Research limitations/implicationsThe first contribution of the study is the importance of “voice” and giving voice to workers in nontraditional, fragmented and marginalised employment. Our study builds on these contributions by exploring the journeys of precarious workers and is particularly valuable in that we explore the perceptions of these workers across the societal, organizational and employment/working turbulence of the pandemic. The second contribution arises from the insights developed through studying the working lives and experiences of precarious workers longitudinally rather than in a single, snapshot fashion. A third contribution centres on how precarious workers felt they were treated by others during both the two phases of the study. The insights here are complex and, in parts, contradictory – reflecting the interpretations and conflicted opinions/deeds of those connected with precarious workers.Originality/valueIt is particularly important for scholars to understand the ways in which the pandemic shaped (or reshaped) the dynamics of precarious work and to understand whether the evolving conceptions of the centrality of such workers as “essential” during the pandemic (Crane and Matten, 2021) contributed to substantive or merely illusory, improvements in their working lives. Thus, we analyse the reflections of precarious workers on changes to their working lives that are linked to the pandemic.

Transformative Pathways: Implementing Intercultural Competence Development in Higher Education Using Kotter’s Change Model

This study explores the efficacy of Kotter’s eight-step change model in fostering intercultural competence among faculty and staff within a large Midwestern public university. Recognizing the need for intercultural development in higher education, this research applies a structured change framework coupled with the Intercultural Development Inventory (IDI) assessment tool to guide the change process. The development of intercultural competence among faculty and staff is crucial for creating inclusive learning environments, as they play a pivotal role in modeling intercultural competence and fostering students’ skills necessary to navigate an increasingly diverse and interconnected world. This study employs an instrumental case study design, utilizing interviews, document analysis, and Intercultural Development Inventory (IDI) assessments to examine the change process over a three-year period. The findings demonstrate how each step of Kotter’s model was successfully adapted to drive organizational change and enhance intercultural competence among 639 faculty and staff members across 11 departments in the College of Agriculture. This study highlights the importance of creating a shared vision, empowering stakeholders, and anchoring changes in the institution’s culture and emphasizes the pivotal role of structured change management in achieving substantive improvements in intercultural learning environments. The insights and strategies presented can serve as a foundation for other higher education institutions seeking to implement similar initiatives and foster inclusive learning environments.

Cross-cultural adaptation and validation of the Spanish sensory processing sensitivity questionnaire (S-SPSQ).

Sensory Processing Sensitivity (SPS) is a temperament trait rooted in biology, and is distinguished by heightened awareness, emotional responsiveness, and sensitivity to environmental stimuli. In this study, we aimed to enable the assessment of SPS within Spanish-speaking populations. To achieve this, we translated, adapted, and validated the Sensory Processing Sensitivity Questionnaire (SPSQ), which offers a comprehensive evaluation of SPS, encompassing both positive and negative aspects of the trait. Participants were 1,004 (844 females, mean age 37) mainly from Chile (964), and 40 were from other Spanish-speaking regions. Confirmatory factor analysis, utilizing the diagonally weighted least squares method, was applied to validate the internal structure of the Spanish version of the SPSQ (S-SPSQ). Fit indices such as GFI, CFI, TLI, RMSEA, and SRMR were scrutinized. Reliability assessment utilized Cronbach's alpha and McDonald's Omega. Three models were examined: Model I (six factors) displayed robustness, Model II (six factors plus a general factor) did not show substantive improvement, and Model III (Higher Order and Bifactor) excelled in fit while balancing complexity and representation, thus validating the findings of the original SPSQ and indicating similar reliability coefficients. The study offers a balanced perspective on SPS and contributes to cross-cultural validation of an SPS instrument which may facilitate research and guide personalized therapeutic interventions, thus enhancing outcomes for highly sensitive persons.

Theoretical impact of chromatic aberration correction on visual acuity

It has been known for more than 220 years that the image quality of the human eye is significantly degraded by chromatic aberrations. Recently, it was shown experimentally that correcting chromatic aberrations results in a 0.2- to 0.8-line improvement in visual acuity. Here we ask, is this expected? We developed tools that enable simulations of the optical impact of physiologically relevant amounts of chromatic aberration in real human eyes and combined these with tools that compute the visual acuity of an ideal observer. This allows us to characterize the theoretical impact of chromatic aberration correction on visual acuity. Results indicate a substantive improvement of 0.4- to 2-lines in ideal observer visual acuity with chromatic aberration correction. Ideal observer thresholds benefit significantly more from correction of longitudinal than correction of transverse chromatic aberration. Finally, improvements in ideal observer visual acuity are greater for subjects with less monochromatic aberration, such that subjects with better baseline optical quality benefit most from correction of chromatic aberrations.

The Jordan Compact, Refugee Labour and the Limits of Indicator‐oriented Formalization

ABSTRACTThis article explores the significance of initiatives to formalize the labour market participation of refugees. Many practitioners believe that formalization is a panacea for improving the lives of marginalized workers, including refugees. This article argues, however, that in practice it easily becomes an indicator‐oriented exercise, where readily quantifiable targets are prioritized over substantive improvements. To this end, the article analyses the trajectory of the Jordan Compact, a flagship initiative that brought together humanitarian, development and labour actors to create ‘win‐win’ solutions for Syrians and Jordanians. Drawing on years of qualitative fieldwork in Jordan, the article traces how the Jordan Compact has made formalization an end in itself, with little regard for how much it actually benefits workers. It examines three central areas of programming: work permits, home‐based businesses and working conditions. In each area, the article demonstrates how the chosen indicators have shaped initiatives while undermining meaningful reform. Bringing together insights from humanitarianism, development and critical labour studies, the analysis shows that indicator‐oriented formalization, a form of measurement‐driven governance, ostensibly produces impressive results, yet it can simultaneously undermine longer‐term, multidimensional processes that would benefit workers more. The article advocates shifting the focus onto the individual and collective power of workers so that they can better realize the potential benefits of formalization.

A generalized phase 1-2-3 design integrating dose optimization with confirmatory treatment comparison.

A generalized phase 1-2-3 design, Gen 1-2-3, that includes all phases of clinical treatment evaluation is proposed. The design extends and modifies the design of Chapple and Thall (2019), denoted by CT. Both designs begin with a phase 1-2 trial including dose acceptability and optimality criteria, and both select an optimal dose for phase 3. The Gen 1-2-3 design has the following key differences. In stage 1, it uses phase 1-2 criteria to identify a set of candidate doses rather than 1 dose. In stage 2, which is intermediate between phase 1-2 and phase 3, it randomizes additional patients fairly among the candidate doses and an active control treatment arm and uses survival time data from both stage 1 and stage 2 patients to select an optimal dose. It then makes a Go/No Go decision of whether or not to conduct phase 3 based on the predictive probability that the selected optimal dose will provide a specified substantive improvement in survival time over the control. A simulation study shows that the Gen 1-2-3 design has desirable operating characteristics compared to the CT design and 2 conventional designs.

Risk prediction of diabetic retinopathy based on visit-to-visit fasting blood glucose indices.

The long-term glucose monitoring is essential to the risk assessment of diabetic retinopathy (DR), the aim of this study was to investigate the predictive ability of visit-to-visit fasting blood glucose (FBG) indices on the risk of DR. This was a community-based, cohort study conducted from 2013 to 2021. DR was diagnosed by digital fundus photography. The FPG indices included FBG, var. Associations of each FBG indices and DR were estimated using multinomial logistic regression models adjusting for confounders, and discrimination was determined by area under the curve (AUC). Predictive utility of different models was compared by changes in AUC, integrated discrimination improvement (IDI), and net reclassification index (NRI). This study analyzed 5054 participants, the mean age was 46.26 ± 11.44 years, and 2620 (51.84%) were women. After adjustment for confounders, the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for FBG, SD, CV, VIM, ARV, M-FBG, and cumulative FBG load were 1.62 (1.52-1.73), 2.74 (2.38-3.16), 1.78 (1.62-1.95), 1.11 (0.95-1.29), 1.72 (1.56-1.91), 2.15 (1.96-2.36), and 2.57 (2.31-2.85), respectively. The AUC of the model with separate cumulative FBG load and classical risk factors was 0.9135 (95%CI 0.8890-0.9380), and no substantive improvement in discrimination was achieved with the addition of other FBG indices once cumulative FBG load was in the model. Cumulative FBG load is adequate for capturing the glucose-related DR risk, and the predictive utility of cumulative FBG load is not significantly improved by adding or replacing other FBG indices in the assessment of DR risk.

A pilot randomised controlled trial exploring the feasibility and efficacy of a human-AI sleep coaching model for improving sleep among university students.

Sleep quality is a crucial concern, particularly among youth. The integration of health coaching with question-answering (QA) systems presents the potential to foster behavioural changes and enhance health outcomes. This study proposes a novel human-AI sleep coaching model, combining health coaching by peers and a QA system, and assesses its feasibility and efficacy in improving university students' sleep quality. In a four-week unblinded pilot randomised controlled trial, 59 university students (mean age: 21.9; 64% males) were randomly assigned to the intervention (health coaching and QA system; n = 30) or the control conditions (QA system; n = 29). Outcomes included efficacy of the intervention on sleep quality (Pittsburgh Sleep Quality Index; PSQI), objective and self-reported sleep measures (obtained from Fitbit and sleep diaries) and feasibility of the study procedures and the intervention. Analysis revealed no significant differences in sleep quality (PSQI) between intervention and control groups (adjusted mean difference = -0.51, 95% CI: [-1.55-0.77], p = 0.40). The intervention group demonstrated significant improvements in Fitbit measures of total sleep time (adjusted mean difference = 32.5, 95% CI: [5.9-59.1], p = 0.02) and time in bed (adjusted mean difference = 32.3, 95% CI: [2.7-61.9], p = 0.03) compared to the control group, although other sleep measures were insignificant. Adherence was high, with the majority of the intervention group attending all health coaching sessions. Most participants completed baseline and post-intervention self-report measures, all diary entries, and consistently wore Fitbits during sleep. The proposed model showed improvements in specific sleep measures for university students and the feasibility of the study procedures and intervention. Future research may extend the intervention period to see substantive sleep quality improvements.

The miss of the framework.

The authors rightly critique existing social sciences approaches. However, they are too quick to dismiss the criticism that their proposed paradigm is atheoretical. Social and cognitive theories are indeed incommensurate, often due to the lack of a unifying framework. Without proper integration with theoretical frameworks, their proposal may merely produce a resource-intensive veneer of thoroughness without substantive improvements to understanding.

Addiction Treatment Outcomes: Examining the Impact of an Inpatient Program for Substance Use Disorders and Concurrent Mental Distress

ABSTRACT Substance use disorders (SUDs) affect over 35 million individuals worldwide and are associated with significant harms. Residential treatment is an essential component of Canada’s approach to combating SUDs, offering highly intensive and specialized acute services. Historically, residential treatment facilities have quantified the success of their program(s) solely based on program completion. However, there has been a recent movement toward empirically evaluating programs using standardized measures of distress. The purpose of this study was to evaluate whether the inpatient residential program for SUDs at Edgewood Treatment Centre is effective in providing substantive improvement of a range of addiction and mental health symptoms. The current study assessed both addiction related and psychological outcomes. Specifically, we examined whether patients improved on various measures of functional impairment, addiction-related symptoms, traumatic stress, and psychological distress, following completion of the 7-week inpatient addiction program. Findings suggested that there were significant improvements in emotion regulation, and decreases in substance dependence, substance cravings, anxiety, depressive symptoms, and traumatic stress between admission and discharge.

Forecasting extremely high ischemic stroke incidence using meteorological time serie.

The association between weather conditions and stroke incidence has been a subject of interest for several years, yet the findings from various studies remain inconsistent. Additionally, predictive modelling in this context has been infrequent. This study explores the relationship of extremely high ischaemic stroke incidence and meteorological factors within the Slovak population. Furthermore, it aims to construct forecasting models of extremely high number of strokes. Over a five-year period, a total of 52,036 cases of ischemic stroke were documented. Days exhibiting a notable surge in ischemic stroke occurrences (surpassing the 90th percentile of historical records) were identified as extreme cases. These cases were then scrutinized alongside daily meteorological parameters spanning from 2015 to 2019. To create forecasts for the occurrence of these extreme cases one day in advance, three distinct methods were employed: Logistic regression, Random Forest for Time Series, and Croston's method. For each of the analyzed stroke centers, the cross-correlations between instances of extremely high stroke numbers and meteorological factors yielded negligible results. Predictive performance achieved by forecasts generated through multivariate logistic regression and Random Forest for time series analysis, which incorporated meteorological data, was on par with that of Croston's method. Notably, Croston's method relies solely on the stroke time series data. All three forecasting methods exhibited limited predictive accuracy. The task of predicting days characterized by an exceptionally high number of strokes proved to be challenging across all three explored methods. The inclusion of meteorological parameters did not yield substantive improvements in forecasting accuracy.

Enhancing Anomaly Detection Models for Industrial Applications through SVM-Based False Positive Classification

Unsupervised anomaly detection models are crucial for the efficiency of industrial applications. However, frequent false alarms hinder the widespread adoption of unsupervised anomaly detection, especially in fault detection tasks. To this end, our research delves into the dependence of false alarms on the baseline anomaly detector by analyzing the high-response regions in anomaly maps. We introduce an SVM-based false positive classifier as a post-processing module, which identifies false alarms from positive predictions at the object level. Moreover, we devise a sample synthesis strategy that generates synthetic false positives from the trained baseline detector while producing synthetic defect patch features from fuzzy domain knowledge. Following comprehensive evaluations, we showcase substantial performance enhancements in two advanced out-of-distribution anomaly detection models, Cflow and Fastflow, across image and pixel-level anomaly detection performance metrics. Substantive improvements are observed in two distinct industrial applications, with notable instances of elevating the image-level F1-score from 46.15% to 78.26% in optimal scenarios and boosting pixel-level AUROC from 72.36% to 94.74%.

Whistling in the Dark? Is the Protected Disclosures Act 2022 a form of placebo policy?

This article examines the development of the Protected Disclosures Act 2022, and evaluates the changes that it has made to previous legislation. It argues that it provides relatively few substantive improvements in the legal protections for disclosers and that even these are clouded by ambiguity. The article outlines alternative suggestions that were made throughout the passage of the Act and explores the extent to which it might be read as a placebo policy. It closes by looking at similar patterns of punch-pulling in other recent integrity initiatives.

Effect of Instructional Supervision on Utilization of Teaching and Learning Resources for Implementation of CBC in Pre-Primary Classrooms in Webuye East Sub-County, Bungoma County, Kenya

The competency-based curriculum was first offered to Kenyan schools in 2017 as a pilot program, and it was adopted in January 2019. As a drastic departure from the 8-4-4 education system, a new 2-6-3-3-3 system was established in 2017. This new system would require two years in preprimary, six in primary, three in junior secondary, three in senior secondary, and three in university. In the majority of English-speaking countries, competency-based curriculum (CBC) as an approach has resulted in substantive improvements to curriculum in a particular sector of the educational system. This study therefore set out to establish the influence of instruction supervision (InS) and utilisation of teaching and learning resources on the implementation of CBC in preprimary schools in Webuye East Sub-county, Kenya. The study was anchored on the Systems Theory of Educational Management by Kaufaman. The population of this study consisted of 316 respondents from Ndivisi, Mihuu, and Maraka wards in Webuye East sub-county, sampled purposefully and stratified by random sampling. They include the 157 head teachers who are charged with the role of supervision, 1 curriculum support officer who coordinates pre-school programmes at ward level, 157 pre-primary teachers, 1 CSO, and 1 QASO officer. A descriptive survey research design was used in the study. Data collection was conducted through questionnaires and interview schedules as well as classroom observation. Pearson product moment correlation was used to determine reliability. The quantitative evidence was presented using descriptive statistics such as frequency distribution tables and pie chart figures that displayed the results of the analysis. The study revealed that the teaching and learning resources are adequate. An observation confirmed that some subjects had so many books as compared to others. This, therefore, meant the suppliers of the books relied on non-existing statistics to supply the books. This study recommends that suppliers of the books be in constant touch with the head teachers so that the right and adequate resources are supplied in schools.

Exploring Sustainable Operations Management in Major Infrastructure Projects: The Case of the Hong Kong-Zhuhai-Macao Bridge

This study systematically analyzes sustainable operations management (SOM) in major infrastructure projects (MIPs). The study proposes systematic definitions of MIP-SOM and studies sustainability improvement in MIP operations management from complex systems thinking. Based on literature review and deconstructive analysis, a conceptual model of the MIP-SOM system and an integrated framework for MIP-SOM practices were constructed. Additionally, per an in-depth case analysis of the Hong Kong-Zhuhai-Macao Bridge (HZMB), a progressive roadmap for the MIP-SOM was developed. These results offer a systematic theoretical framework to guide MIP-SOM implementation and provide a solution for the substantive improvement of MIP sustainability.

Experiencing and treating ‘madness’ in the United States circa 1967–2022: Critical counter-histories

Over the past 55 years, in the United States, we have witnessed shifts and changes in mental health treatment practice and policy focused on ‘psychosis.’ Alarmingly, in this same period, neither in its social location nor its clinical outcomes, has psychosis, particularly multi-episode psychosis, shown much substantive improvement (Hansen et al., 2022; Huxley et al., 2021). Epidemiological studies of stigma have documented the worsening of perceived dangerousness and desired social distance (Pescosolido et al., 2010, 2019), while long-term trajectories include extraordinarily high rates of incarceration, homelessness, and unemployment (Lin et al., 2022; Ramsay et al., 2012; Wildeman and Wang, 2017). Disengagement from “services” viewed by users as unresponsive to the user's actual needs and values is thought to be part of the problem, although it is not clear that those who do engage do better (Hansen et al., 2022). Written from the first-person perspectives of current/former “users”—people who have experienced psychosis and “used” services—this paper leverages critical counter-history, conceptual analysis, and autoethnography to ask how and why treatment policies and practices continue to fail so many persons labelled with psychosis in the United States. Outcome, we argue, hangs on much more than clinical effort. We thus explain widespread “treatment failure” as a consequence of interpersonal misunderstanding and misrecognition as well as entrenched structural and institutional ableism, racism, and classism—factors to which clinical services and individualizing narratives alike consistently fail to adequately respond. On a more hopeful note, we trace histories of activist (user/survivor) resistance. This includes efforts that may appear fledgling or transient, but that have nevertheless sustained a distinctly different vision of what might be possible.

Does Open Innovation Open Doors for Underrepresented Groups to Contribute to Technology Innovation?: Evidence from a Space Robotics Challenge

Diversity, equity, and inclusion (DEI) are increasingly being recognized as important policy goals for organizations across government and the industry. Improved DEI has been linked to both substantive improvement in innovation performance and societal good. However, despite a stated emphasis on DEI, progress has not kept up with aspirations. One indirect policy approach that holds promise is wider adoption of Open Innovation (OI) as part of an innovation toolkit. Proponents contend that OI reduces barriers to entry and garners productive contributions from diverse contributors. While there is anecdotal support for the diversifying potential of OI, so far, there is a dearth of empirical evidence connecting OI to DEI with consideration of performance outcomes, beyond `winners´. To study this link directly, this article leverages data from a previously conducted unique field experiment that explicitly tracked the population of potential solvers and their performance on a National Aeronautics and Space Administration (NASA) space robotics problem. We found that while OI attracted different solvers than the reference internal workforce, there was important variation in both the extent and direction of the observed differences, with respect to attributes of DEI. For instance, OI attracted proportionally fewer female solvers than the already male-dominated space workforce; and that proportion decreased further among solvers providing quality solutions. On the other hand, OI proved effective at granting access to an international pool of young professionals with potentially novel perspectives. Overall, our findings suggest OI can be an effective tool for achieving some diversity policy goals, but it is not well-suited for achieving all stated aspects of diversity. Therefore, we suggest a more targeted approach to matching the opportunities for OI to achieve specific policy objectives.