Undocumented Issues Research Articles

Growing up on the Street: Barriers to Educational Services Among Street Children in Malaysia

Educational services are part of the child welfare system and part of social services that are required for street-connected children to enhance their well-being. Negative street life and homelessness influence street-connected children to access educational services. This paper discusses the barriers to educational services encountered by street-connected children in Kuala Lumpur, Malaysia. Understanding barriers to educational services is crucial to inform policymakers, child welfare providers, and the government to formulate relatable educational services for street-connected children. The researcher employed a quantitative research design to conduct the study. A total of 303 took part in this study. The influence factors of barriers to educational services were determined using multiple regression analysis. The findings revealed that undocumented issues, poverty issues, personality issues, involvement in antisocial behavior, behavior in school, and school social environment are among the barriers to educational services faced by street-connected children in Kuala Lumpur. Inputs provided in this study can be instrumental in improving the child welfare system related to educational needs and addressing the psycho-educational needs of street-connected children. Implementing and recommendations proposed in this study can make a positive impact to improve the overall well-being of street-connected children.

ЗМІНА МОДЕЛІ РОБОТИ ЧАТ-БОТІВ У СФЕРІ ОБСЛУГОВУВАННЯ КЛІЄНТІВ

In modern business, customer support stands as a pivotal element for successful client servicing. The operation of customer support involves providing assistance and resolving client issues regarding company products or services. In the current simplified model, the efficacy of technical support agent searches generally surpasses that of chatbots or human assistance. Filtering internal staff-only articles from those intended for clients poses a challenge, necessitating complex implementations that not all companies may afford. Previous-generation chatbots have shown limited effectiveness in replacing humans due to varying client articulations, necessitating human intervention. Conventional chatbots offer limited options: information retrieval based on client queries, problem narrowing through additional inquiries, and sending tailored instructions. However, maintaining and updating knowledge for both internal staff and clients poses resource-intensive challenges for large companies. An alternative emerges with LLM-based chatbots, automating communication with users via chat interfaces. LLM chatbots enhance speed and efficiency, reduce personnel costs, and ensure 24/7 client service. Yet, they require con- stant knowledge updating and careful handling to address a spectrum of issues effectively. Notably, LLM chatbots can handle complex articles, gathering step-by-step instructions from various sources. Still, undocumented issues or incorrect solutions may necessitate human assistance. The primary functional difference between LLM chatbots and conventional ones lies in their contextual and linguistic processing capabilities, making communication with LLM chatbots akin to human interaction. Despite advancements, the nuances of context and language remain pivotal for effective client servicing, particularly in technical support scenarios. Future exploration in this direction should focus on optimizing knowledge management and enhancing LLM chatbot capabilities for improved client satisfac- tion and operational efficiency."

Etiologies and Outcomes Associated With Tacrolimus Levels Out of a Typical Range That Lead to High Variability in Kidney Transplant Recipients.

High tacrolimus intrapatient variability (tac IPV) is associated with poor outcomes in kidney transplantation, including rejection, donor-specific antibodies, and graft loss. A common cause of high tac IPV is related to patient nonadherence, but this is yet to be conclusively demonstrated. This was a longitudinal cohort study comprising adult kidney recipients, who received transplants between 2015 and 2017, with follow-ups through February 2020. The goal of this study was to identify the most common etiologies of tac levels outside the typical range, which lead to high tac IPV, and assess the etiology-specific associations between high tac IPV and graft outcomes. Multivariate Cox regression was used to assess time-to-event analyses. In total, 537 adult kidney recipients were included; 145 (27%) were identified as having a high tac IPV (>40%) 3-102 months post-transplant. Common etiologies of tac levels significantly outside the standard goal range (6-12 ng/mL) leading to high tac IPV included patient nonadherence (20%), infections (19%), tac-related toxicities (17%), and undocumented issues (27%). In multivariable Cox modeling, those with high tac IPV because of nonadherence had a 3.5 times higher risk of late acute rejection (P = 0.019) and 2.2 times higher risk of late graft loss (P = 0.044). No other etiologies in the typical tac level range were significantly associated with either acute rejection or graft loss. Although high tac IPV has many causes, only high tac IPV caused by nonadherence is consistently associated with poor allograft outcomes.

Foreign Institutional Investors: Fair-Weather Friends or Smart Traders?

We examine a theoretically robust but previously undocumented issue of what drives foreign portfolio investments into emerging markets. Foreign institutional investors (FIIs) are often blamed as fair-weather friends who pull out their investment at the first sign of trouble. Using a bottom-up approach, we explore this possibility. We demonstrate the influence of the firm-specific factors such as size, book to market ratio, the riskiness of the stocks, stock prices, dividend yield, liquidity, leverage, and earnings on the FII ownership. We find no evidence to show foreign investors as fair-weather friends. Instead, they are smart traders who follow a diligent investment strategy. We suggest reforms in corporate governance and improvement in financial fundamentals of the companies to attract FII ownership.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40953-021-00233-3.

Preliminary Assessment of Plastic Litter and Microplastic Contamination in Freshwater Depositional Areas: The Case Study of Puerto Misahualli, Ecuadorian Amazonia.

We quantify plastic litter (PL, > 2cm) and microplastics (MP, < 5mm) from the sediments of a beach formed at a riverine depositional area, at the upper Amazon River basin, Ecuador. In the collection area (4400 m2), the PL density was 0.045 items m-2, where low-density polyethylene bags were the prevalent PL. The beach was classified as "very clean" (Clean Coast Index (CCI) of 1.3 items m-2). Regarding MP, in 55 sampling stations, average MP concentrations ranged from 0 to 2200 items kg-1 of dry sediment (0.5-2mm), and 0-4200 items kg-1 of dry sediment (2-5mm). Blue fibers were the prevalent MP. Our results represent the first report to show the ubiquitous presence of PL and MP for the area. The monitoring and management of plastic disposal in freshwater beaches are necessary, as here we report a small part of an undocumented issue.

The curious reaction to an auditor’s adverse opinion: a case study from 1976

Purpose The purpose of this paper is to identify the circumstances that gave rise to an adverse audit opinion by a New Zealand (Christchurch) accounting firm, Hicks and Ainger, on the annual financial report of the local firm, T.J. Edmonds Ltd, in 1976. In so doing, this study revealed not only previously undocumented issues surrounding major asset purchases but also the impact of key personalities before and after the adverse opinion decision. Design/methodology/approach The study is located within the Cultural Theory of History, to theorize the narratives within the wider contextual perspective. The issues surrounding the use of memory from such interviews are also considered. The key material offered in this study is sourced from a 2015 interview with the two key audit partners in this audit engagement. Findings The accounting standard on depreciation at that time, SSAP 3, had not been applied properly to the accounting treatment of four helicopters for wild deer operations, purchased a week before balance date. Neither the artificial suppression of profits by this purchase decision and accounting choice nor the fall in profits nor the adverse opinion, influenced share prices or shareholder perceptions long term. Originality/value The significance of this project is that it informs the appreciation of the importance of contextual understanding of a singular adverse audit opinion.

Obesity in Inflammatory Bowel Disease: Gains in Adiposity despite High Prevalence of Myopenia and Osteopenia.

Background: Rising rates of obesity have been reported in patients with inflammatory bowel disease (IBD); however, prospective data is lacking. The aim of this study is to prospectively evaluate body composition in adults with IBD over 24 months. Methods: Whole body dual energy X-ray absorptiometry (DXA) data was performed at 0 months, 12 months, and 24 months. Bone mineral density (BMD), fat mass index (FMI (kg)/height (m2)), appendicular skeletal muscle index (ASMI (kg)/height (m2)), visceral adipose tissue and the visceral adipose height index (VHI, VAT area (cm3)/height (m2)), and clinical and anthropometric assessments were performed at each time point. Multivariable linear mixed effects regression analyses were performed. Results: Initially, 154 participants were assessed at baseline (70% Crohn’s disease, 55% male, median age 31 years), of whom 129 underwent repeated DXA at 12 months, and 110 underwent repeated DXA at 24 months. Amongst those undergoing repeated DXA, their body mass index (BMI) significantly increased over time, such that by 24 months, 62% of patients were overweight or obese (annual change BMI β = 0.43, 95%CI = [0.18, 0.67], p = 0.0006). Gains in BMI related to increases in both FMI and VHI (β = 0.33, 95%CI = [0.14, 0.53], p = 0.0007; β = 0.08, 95%CI = [0.02, 0.13], p = 0.001; respectively), whereas ASMI decreased (β = −0.07, 95%CI = [−0.12, −0.01], p = 0.01) with a concordant rise in rates of myopenia (OR = 3.1 95%CI = [1.2, 7.7]; p = 0.01). Rates of osteopenia and osteoporosis were high (37%), but remained unchanged over time (p = 0.23). Conclusion: Increasing rates of obesity in patients with IBD coincide with decreases in lean muscle mass over time, while high rates of osteopenia remain stable. These previously undocumented issues warrant attention in routine care to prevent avoidable morbidity.

Therapist perceptions of best practice as ordered by referral source: An exploratory survey

IntroductionProductive outcomes for the hand therapy patient involve many components. Understanding whether therapists agree with the recommendations they receive, or find these informative, is a first step into understanding how shared decision-making on a treatment plan can be optimized. Purpose of the StudyThe purposes of this study include (1) the extent which therapists see variable presentations of primary surgical/management in some indicator exemplars where practices vary from accepted/evidence-based practice; (2) hand therapists' level of agreement with the interventions prescribed on referrals, (3) describe the undocumented complications observed by hand therapists, and (4) report the therapists' perceptions as to the reasons for these complications MethodsA survey was designed and pilot tested. Multiple-choice questions and free text allowed further explanation. The survey was administered through an electronic mailing to all American Society of Hand Therapy members with available e-mail addresses. Raw survey data were extracted and processed. Descriptive statistics were used to analyze therapists' demographic information. Frequencies of therapists' responses were calculated. ResultsNinety percent of all who responded have been in practice 10 years or more. The mean of the “often and always” ordered interventions was 20%. The mean of therapist perceptions as to whether these ordered interventions are best practice was 14%. Sixty percent reported that they had found an undocumented condition, and 60% reported to have found a postoperative complication. Perceived reasons for complications included the lack of communication and therapy intervention. DiscussionHand therapists can play an important role in improving patient outcomes. Therapists can provide the health care team information regarding best practice. Additionally, the hand therapist may be who first identifies a postsurgical complication or an undocumented issue. Communication between the hand therapist and referral source is vital in optimizing patient outcomes. ConclusionHand therapists can play an important role in improving overall outcomes for patients. The inter-professional working relationship between the referral source, hand therapist, and the patient is a complex phenomenon and communication between the hand therapist and referral source is vital.

Biodiversity changes along the Algerian coast (Southwest Mediterranean basin): from 1834 to 2017: A first assessment of introduced species

“Introduced” species of the Algerian coast remains the most undocumented issue in the Mediterranean Sea. Only few studies were dedicated to Introduced species due to the lack of taxonomists. In-depth research on Introduced species along the Algerian coast should provide new data that could explain the spreading mechanisms in the southwestern part of the Mediterranean basin particularly near the Alboran Sea. Introduced species among other related research; of which the outcome is expected in the next few years, is in progress in the southwest Mediterranean basin. The aim of this work is to provide an inventory of available data pertaining to marine species “introduced” in Algerian waters, whether these species were introduced intentionally or accidentally. This large number of Introduced species records covers the period from 1834 to December 2017. Seventy “Introduced” species have been recorded along the Algerian coast, composed by 55.7% true aliens25.7 % range expanding species, 15.7% cryptogenic species and 2,9% vagrant species, with a clear domination of fish (38.57%) and macroalgae (30%). Approximately 348 introduction events have been reported; 64,9 % of them belong to macroalgae and one sighting out of two is done in the central region. The distribution and the status of introduced species in Algeria were evaluated. In total, 20% of the Introduced species can be considered as established along the Algerian coast, in particular the macrophyta, Codium fragile and Ulva lactuca as well as the cryptogenic species, Oculina patagonica, while Asparagopsis armata, A. taxiformis and Caulerpa cylindracea are considered as invasive.

Nos cenários da urgência e emergência: ideação suicida dos profissionais de enfermagem

Um convite à reflexão sobre as evidências, a efetividade das intervenções e expectativas que cercam os profissionais de saúde no contexto hospitalar, principalmente os da enfermagem, em relação aos cenários da urgência e emergência. O texto não trata especificamente de um único tema, problema, mas de uma complexa, subliminar e imbrincada problemática não-dita no cotidano da atuação dos profissionais de enfermagem. Chama-se a atenção para a saúde mental, particularmente sobre a ideação suicida, considerada o mais expressivo fator de risco decorrente da depressão e do ambiente de trabalho.

Postpartum depression among mothers as seen in hospitals in Enugu, South-East Nigeria: an undocumented issue

Introduction: postpartum depression is an uncommon and frequently undocumented issue that impacts negatively on maternal and child health.

Improvements in the data quality of the Interferometric Monitor for Greenhouse Gases

The Interferometric Monitor for Greenhouse Gases (IMG) operated aboard the polar-orbiting Advanced Earth Observing Satellite from October 1996 through June 1997. The IMG measured upwelling infrared radiance at fine spectral resolution. This paper identifies previously undocumented issues with IMG interferograms and describes procedures for correcting the majority of the affected data. In particular, single-sided interferograms should be used to avoid large noise bursts, and phase ambiguities must be resolved in uncalibrated spectra before radiometric calibration. The corrections are essential for studies that require accurately calibrated radiance spectra, including those that track atmospheric changes globally on decadal time scales.