Unit Selection Research Articles

Surfactants Used in Colloidal Synthesis Modulate Ni Nanoparticle Surface Evolution for Selective CO2 Hydrogenation.

Colloidal chemistry holds promise to prepare uniform and size-controllable pre-catalysts; however, it remains a challenge to unveil the atomic-level transition from pre-catalysts to active catalytic surfaces under the reaction conditions to enable the mechanistic design of catalysts. Here, we report an ambient-pressure X-ray photoelectron spectroscopy study, coupled with in situ environmental transmission electron microscopy, infrared spectroscopy, and theoretical calculations, to elucidate the surface catalytic sites of colloidal Ni nanoparticles for CO2 hydrogenation. We show that Ni nanoparticles with phosphine ligands exhibit a distinct surface evolution compared with amine-capped ones, owing to the diffusion of P under oxidative (air) or reductive (CO2 + H2) gaseous environments at elevated temperatures. The resulting NiPx surface leads to a substantially improved selectivity for CO production, in contrast to the metallic Ni, which favors CH4. The further elimination of surface metallic Ni sites by designing multi-step P incorporation achieves unit selectivity of CO in high-rate CO2 hydrogenation.

Sequential adaptive strategies for sampling rare clustered populations

A new class of sampling strategies is proposed that can be applied to population-based surveys targeting a rare trait that is unevenly spread over an area of interest. Our proposal is characterised by the ability to tailor the data collection to specific features and challenges of the survey at hand. It is based on integrating an adaptive component into a sequential selection, which aims both to intensify the detection of positive cases, upon exploiting the spatial clustering, and to provide a flexible framework to manage logistics and budget constraints. A class of estimators is also proposed to account for the selection bias, that are proved unbiased for the population mean (prevalence) as well as consistent and asymptotically Normal distributed. Unbiased variance estimation is also provided. A ready-to-implement weighting system is developed for estimation purposes. Two special strategies included in the proposed class are presented, that are based on the Poisson sampling and proved more efficient. The selection of primary sampling units is also illustrated for tuberculosis prevalence surveys, which are recommended in many countries and supported by the World Health Organisation as an emblematic example of the need for an improved sampling design. Simulation results are given in the tuberculosis application to illustrate the strengths and weaknesses of the proposed sequential adaptive sampling strategies with respect to traditional cross-sectional non-informative sampling as currently suggested by World Health Organisation guidelines.

EPIC-26 urinary incontinence score results and pad use 12 months after radical prostatectomy for localized or (locally) advanced prostate cancer: Results of a cohort of 14,920 patients from 118 certified centers in Germany, Switzerland, and Austria.

e17102 Background: Besides erectile dysfunction, urinary incontinence is the most common functional impairment after radical prostatectomy (RP) for localized and (locally) advanced prostate cancer (PCa). Clinical guidelines recommend informing patients about incontinence and other functional impairment of the different therapy options. Yet, real-world data on incontinence following RP is sparse in most countries, impeding the information of patients. This work aims to present data on urinary incontinence after RP from routine care in Germany, Switzerland and Austria using the EPIC-26 urinary incontinence score and the single item on pad use. Methods: We analyzed data from the prospective cohort study PCO (Prostate Cancer Outcomes Study), partly funded by the Movember Foundation. The data presented was based on patients treated with RP for localized and (locally) advanced PCa in one of 118 Certified Prostate Cancer Centers between 2016 and 2021. The Berlin Medical Association's ethics board and local ethics boards approved the study. Each patient gave informed written consent. Patients included in the analytic sample had to complete a baseline questionnaire (EPIC-26) before (T0) and a follow-up questionnaire 12 months after RP (T1). Questionnaire data were linked to clinical data and analyzed descriptively: We report changes in the urinary incontinence score between T0 and T1 and the proportion of patients using pads ("pad use") stratified by age and risk group according to the German clinical guideline (based on the d’Amico risk groups). Results: 14,920 patients from 118 centers were included in the analysis. The median age was 66 (interquartile range 61-70). The average urinary incontinence score (value range: 0 - worst possible to 100 - best possible) was 93 points at T0 and 73 points 12 months later. 97% of the patients did not use pads at T0, compared to 57% using at least one pad per day at T1. Among patients who did not use pads at T0, 42% used at least one pad a day 12 months later, and 12% used two or more pads per day. The proportion of patients using pads differs meaningfully according to age and risk group and across centers. Conclusions: The data presented gives insight into real-world functional outcomes after RP. These results may help inform providers and patients when discussing treatment options in an easy-to-understand way. Availability of comparable data from other countries is limited, with Australian registry data suggesting slightly better outcomes at 12 months. Results are limited to Prostate Cancer Centers certified according to the requirements of the German Cancer Society. They are thus a selection of units with at least 50 RPs per year and many other quality standards met.

The use of semantic transparency and L1-L2 congruency as multi-word units selection criteria

Multi-word units (MWUs) are defined as two or more words that commonly co-occur. There is evidence that knowledge of high-frequency MWUs is essential to language fluency, leading to growing research identifying valuable MWUs to learn and the impact of L1-L2 congruency and semantic transparency on the learning burden of MWUs. Therefore, there needs to be more research on which MWUs should be selected with these criteria. This article highlights an investigation of the role of congruency and semantic transparency using a corpus-based list that offers a sizable sample of MWUs that appear in general English. In this study, we analysed a list of 11,212 high-frequency MWUs created using a lemmatised concgramming approach to examine the role of semantic transparency and L1-L2 congruency. The list was translated into Persian, and L1-L2 congruency ratings were given to each item. The list was also classified based on Grant and Bauer’s (2004) taxonomy to explore the role of semantic transparency to determine the extent to which these two factors play a role in the learning burden of the MWUs. The results showed that 85% of items were literal, and a low number of opaque items were found in the high L1-L2 congruency rating, suggesting a positive relationship between congruency and transparency. The current research then discusses the implications of these two criteria for teaching English as a second language and considers their importance in designing teaching materials.

The properties of machine-tractor unit (MTU) regarding soil preparation with bed ridging

BACKGROUND:One of the main criteria for assessment of work performance is productivity. It depends on a number of indicators: towing resistance, optimal use of energy, used technical equipment, the adaptability of the equipment to the operation conditions, etc. Experimental studies are required in order to establish the patterns of influence of these indicators on work efficiency.
 AIMS:Carrying out theoretical calculations and practical observations on the process of bed ridging for potatoes, assessment of the unit assembly for the technological process performing and the using of the unit.
 METHODS:Field tests of a machine-tractor unit with subsequent result processing using the Microsoft Office applications.
 RESULTS:Recommendations are given for practical use in the unit formation depending on velocity and operation width of the unit for various values of specific resistance.
 CONCLUSIONS:The practical value of the study lies in the opportunity of using the proposed patterns for optimization the machine-tractor unit assembly according to operation conditions, selection of power unit, development of combined machines and units.

Designing a Fuzzy Adaptive Neural Network Leveraging a Feature Self-Enhancement Unit and Statistical Selection Methods

In this study, we propose an advanced category of a fuzzy adaptive neural network (FANN) based on a feature self-enhancement unit (FSU) and statistical selection methods (SSMs). Undoubtedly, the raw data contain a large amount of information with varying importance. One of the most important tasks for regression model design is to avoid losing these important details. However, the raw data cannot participate in the whole training process due to the data fuzzification unit in the structure of conventional fuzzy neural networks (FNNs). Meanwhile, the polynomial-based neuron also has its limitations as a common node in FNNs. For example, in the polynomial neuron, the complexity of the neurons increases exponentially with the increase in network size. Consequently, overfitting and insufficient raw data information are two primary drawbacks in the structure of conventional FNNs. To address these limitations, we designed the FSU and the SSM as effective vehicles to reduce data dimensionality and select significant raw information. The proposed FANN also demonstrates the capability to improve modeling accuracy in neural networks. Moreover, this is the first instance of integrating statistical methods and feature self-enhancement techniques into a fuzzy model. To validate and showcase the superiority of the proposed FANN, the model is applied to 16 machine learning datasets, outperforming other comparative models in 81.25% of the datasets utilized. Additionally, the proposed FANN model outperformed the latest FNN models, achieving an average 5.1% increase in modeling accuracy. The comparison experiment section not only includes classical machine learning models but also references the experimental results from two recent related studies.

Features of the first-year students’ lifestyle at the faculty of medicine: an observational study

Introduction. Our analysis of studies of the lifestyle of medical students has shown that the students keep an unhealthy lifestyle with some differences in their lifestyle components, regions, and course of university study. Therefore, it is of scientific and practical interest to identify and analyze some factors which influence the formation of a healthy lifestyle for future medical doctors. The aim of the study is to investigate the lifestyle characteristics of the first-year students at the Faculty of Medicine and identify some key predictors of an unhealthy lifestyle. Methods. An observational cross-sectional study of the first-year students of the Medical Faculty at the Kabardino-Balkarian State University named after I.I. HM. Berbekov was conducted. The selection of units of the observation was carried out by the nesting method while maintaining the proportion characteristic of the general population. The sample set reflected the properties of the general population both quantitatively and qualitatively. The study included an anonymous survey using a specially designed questionnaire containing 80 questions to study socio-demographic characteristics that make up lifestyle (physical activity, daily routine, diet schedule and diet composition, the presence of bad habits), well-being, attention to one’s own health, using online Google Forms Designer. Results. More than half of the students surveyed (51.6%) consider their lifestyle not fully consistent with the principles of a healthy lifestyle. Herewith, 75.4% of the students did not adhere to the proper diet, 72.1% of them did not follow the daily scheduled routine, 24.9% of them slept less than 6 hours at night, 20.4% of the students did not engage in any type of physical activity. The number of smoking students was 8.9%, those drinking alcohol was recorded to reach 9.7%. Using the method of multiple logistic regression analysis for predicting lifestyle changes, the key predictors of an unhealthy lifestyle were identified as follows: the presence of bad habits, the number of cigarettes smoked and an unhealthy diet. Conclusion. The completed study made it possible to reveal the characteristics of the lifestyle of the first-year students of the Faculty of Medicine, identify significant predictors of an unhealthy lifestyle, and produce a social profile of a first-year student at the Faculty of Medicine. The results obtained by us can be used to adapt the curricula of the Medical Faculty for the formation of a healthy lifestyle among the students.

Simple Additive Weighting (SAW) Method to Provide Recommendations for Selection of Graphic Processing Unit (GPU)

CV. Venes Jaya is a company that operates in the field of technological equipment such as computer hardware, monitors, recording equipment, communications equipment, networks, and many more. With the complete range of products sold and reliable teams, this company still has problems in providing recommendations for GPU selection to customers. This process is still carried out manually, namely by providing recommendations according to the funds owned by the customer. If there is more than one alternative that suits the funds owned by the customer, employees will have difficulty choosing them. Such a manual process is likely to be wrong or mistaken. Therefore, there is a need for innovation that can help and make it easier for employees to provide recommendations for GPU selection to customers, namely by implementing a Decision Support System (SPK) that uses the Simple Additive Weighting (SAW) method built with the VB programming language, and a MySQL database. in determining GPU recommendations that will be given to customers. This system is expected to help CV. Venes Jaya in providing GPU recommendations quickly, precisely and accurately. The results obtained from this research are that Alternative 5, namely the Gigabyte RTX 3080 Ti Gaming OC, was selected as the best alternative with a total value of 1. These results are the results obtained from the Decision Support System created by the author, where these results will be used as recommendations to customers in choosing Graphics . Processing Unit (GPU). This system can help CV. Venes Jaya in providing GPU recommendations to customers quickly, precisely and accurately

Reflexive Possibilities of a Language During the Selection of the Word of the Year

“Word of the Year” as a linguistic and sociological research is carried out in many countries of the world and has been very popular for many years, moreover, it attracts more and more attention every year. This partly explains the relevance of this study. The “Word of the Year” campaign is usually attended by professional philologists, who can involve the general public in the discussion, but the final choice is made by experts. Yet, the average native speaker gets a chance to evaluate the result. The aim of the article is to describe the reflexive possibilities of “Words of the Year” as seen by a Russian-speaking observer, who carries out linguistic reflection. The material for analysis includes lists of “Words of the Year” for different years in different countries; sources of material are Internet publications, designed for a wide range of Russian-speaking readers; the main methods encompass observation, description, component and conceptual analysis. The article formulates the definition of “Word of the Year” as a linguistic unit that due to its significance and frequency of use, has become a nominal linguistic marker of one calendar year. “Word of the Year” helps to trace current social sentiments, problematic topics and topical issues of concern to the social majority. “Word of the Year” allows us to summarize a brief verbal summary of the period and consolidate these generalisations for the next generations. The analysis of the material led to conclusions that the reflexive possibilities of the “Word of the Year” can comprise frequency as an indicator of a surge of attention to the word; selection of a language unit from a number of words that are to some extent related to the current and significant “key situation”; and competition between several lists of “Words of the Year” compiled by different expert groups, whose existence allows a native speaker, first, to compare different approaches to the choice made and to juxtapose them to their own linguistic instinct.

Refining eligibility criteria of unit selection for myeloablative cord blood transplantation in acute leukemia: Real-world experience of a referral center.

The algorithm for cord blood (CB) unit selection is still somewhat ambiguous. We retrospectively analyzed 620 cases of acute leukemia between 2015 and 2020, who were treated with myeloablative single-unit umbilical CB transplantation (UCBT). We found that, when human leukocyte antigen (HLA) mismatch was ≤3/10, CD34+ cell dosage<0.83 × 105/kg-considerably lower than prevalent guidelines-was permissible without affecting survival. Moreover, synergy between donor killer-cell immunoglobulin-like receptors (KIR) haplotypes-B and donor-recipient HLA-C mismatch protected against relapse-related mortality. We submit that minimum required CD34+ cell dosage can possibly be relaxed to broaden access to UCBT, and donor KIR genotyping should be considered during unit selection.

Preemptive Epidemic Information Transmission Model Using Nonreplication Edge Node Connectivity in Health Care Networks.

The reliability in medical data organization and transmission is eased with the inheritance of information and communication technologies in recent years. The growth of digital communication and sharing medium imposes the necessity for optimizing the accessibility and transmission of sensitive medical data to the end-users. In this article, the Preemptive Information Transmission Model (PITM) is introduced for improving the promptness in medical data delivery. This transmission model is designed to acquire the least communication in an epidemic region for seamless information availability. The proposed model makes use of a noncyclic connection procedure and preemptive forwarding inside and outside the epidemic region. The first is responsible for replication-less connection maximization ensuring better availability of the edge nodes. The connection replications are reduced using the pruning tree classifiers based on the communication time and delivery balancing factor. The later process is responsible for the reliable forwarding of the acquired data using a conditional selection of the infrastructure units. Both the processes of PITM are accountable for improving the delivery of observed medical data, over better transmissions, communication time, and achieving fewer delays.

Factors Associated with Peer Victimization Among Brazilian Low-Income Adolescents

ABSTRACT Exposure to peer aggression and bullying victimization are both expressions of peer victimization but distinct constructs among adolescents. This study examined the potential associations between peer victimization and individual/family/peer factors and assessed whether the factors associated with peer aggression differed from those related to bullying victimization. This cross-sectional study, conducted in a low-income Brazilian city characterized by poverty, inequality, and violence, involved a three-stage probabilistic sampling plan that included a random selection of census units, eligible households, and the target child. Data collected from face-to-face confidential home interviews with 669 in-school adolescents (11 to 15 years, 51.7% girls) were analyzed. The level of exposure to peer aggression was determined by the sum of the presence of 15 events (within the categories of physical aggression, verbal harassment, and social manipulation) occurring at different frequencies in the previous six months. Bullying victimization occurring more than once a week or most days in the previous six months was investigated after presenting a bullying victimization definition to participants which required them to have felt harmed by their victimization experiences. Path analysis identified factors associated with peer aggression and bullying victimization. Suicide ideation or attempt was associated with bullying victimization, while being overweight, using alcohol (previous 12 months) and having no social support from a friend were associated with exposure to peer aggression. Community violence exposure was associated with both study outcomes. In conclusion, the fact that suicidality was associated with bullying victimization but not with peer aggression suggests that when adolescents recognize that peer victimization hurts their feelings, their mental health appears to be negatively affected.

Implementasi Algoritma Naïve Bayes untuk Sistem Rekomendasi Pemilihan Fakultas di Universitas Amikom Yogyakarta

When someone experiences obstacles in making decisions that must be done, they will usually ask for recommendations from those around them. Similarly, when a prospective student has difficulty determining the faculty when they want to continue their education to the higher education level, they will ask for recommendations from those closest to them who have not provided objective recommendations in accordance with their potential, even though a person's potential is very instrumental in making faculty selection decisions so that they can achieve learning success which can be seen from the achievement index. The same happened to prospective students of Amikom University Yogyakarta. It is necessary to build a system of recommendations for faculty selection. The potential of prospective students explored in this study includes school origin, personality expression, and the values of several subjects that have been obtained in high school. Cluster sampling was chosen to determine respondents where the Faculty as a cluster, respondents were selected from the student population who had taken at least 4 semesters with a grade point average of at least 3.00. The application of the Naïve Bayes algorithm in this study shows good accuracy results so that it can be used on research objects, but it would be more perfect if this system is later developed again into a recommendation for the selection of smaller educational units, namely study programs.

Models for cluster randomized designs using ranked set sampling.

Cluster randomized designs (CRD) provide a rigorous development for randomization principles for studies where treatments are allocated to cluster units rather than the individual subjects within clusters. It is known that CRDs are less efficient than completely randomized designs since the randomization of treatment allocation is applied to the cluster units. To mitigate this problem, we embed a ranked set sampling design from survey sampling studies into CRD for the selection of both cluster and subsampling units. We show that ranking groups in ranked set sampling act like a covariate, reduce the expected mean squared cluster error, and increase the precision of the sampling design. We provide an optimality result to determine the sample sizes at cluster and sub-sample level. We apply the proposed sampling design to a dental study on human tooth size, and to a longitudinal study from an education intervention program.

EFFICIENCY OF THE RENEWABLE ENERGY SOURCES APPLICATION FOR AN AUTONOMOUS HEAT SUPPLY SYSTEM

Description of the developed software and information complex for modeling autonomous heat supply systems provided, which allows optimizing the selection of units and their operation modes and ensuring the production and redistribution of thermal energy in accordance with the schedule of consumers. Optimized modes simulation operation of the autonomous heat supply system for a cottage village based on local energy resources with minimal use of external energy sources performed. The use of software and information complex made it possible to calculate the parameters that provide optimal coverage of the heat load schedule of a cottage settlement based on local energy resources. For the calculation, the predicted values of the installed thermal power of the units and the heat load graph which was obtained by adapting the real annual graph of the external temperature of Stockholm to the geographical location of the Kyiv region were used. The developed new software and information complex provide an opportunity for hourly modeling, research into the optimal modes of operation of heat units, and evaluation of the effectiveness of the use of renewable energy sources in autonomous heat supply systems. In the developed software and information complex, the model of optimization of operating modes is applied, which belongs to the class of problems of optimal loading of generating capacities of power systems with the criterion of minimizing costs for production, accumulation, and consumption of thermal energy. An example of simulation results using a heat load schedule for a selected typical day is presented. The obtained results indicate a decrease in the specific cost of hourly heat supply with an increase in the part of thermal energy supplied at the expense of renewable energy sources. This is due to a decrease in the share of gas, and in general, any other generation based on fossil fuel technologies, in the total volume of heat supply. Thus, the effectiveness of the use of renewable energy sources based on local energy resources as part of the heat supply system of the cottage village was confirmed. Keywords: autonomous heat supply, the efficiency of renewable energy sources based on local energy resources.

The effect of nettle vaginal cream on subjective symptoms of vaginal atrophy in postmenopausal women

Background and objectiveVaginal atrophy is a condition where the vaginal epithelium gets thinner and includes symptoms, such as vaginal dryness, abnormal vaginal discharge, vaginal bleeding, dyspareunia, and sexual problems. Hormone therapy is associated with some problems and some women prefer herbal medicine to reduce vaginal atrophy. Considering the phytoestrogenic compounds present in the nettle, this study aimed to investigate the effect of the nettle vaginal cream on subjective symptoms of vaginal atrophy in postmenopausal women. Materials and methodsThis triple-blind randomized placebo-controlled clinical trial study was conducted on 84 eligible postmenopausal women aged 45–60 years, who referred to comprehensive health service centers in Aliabad Katul in 2021–2022. Women eligible for the study received 5% nettle vaginal cream and placebo for 8 weeks. Subjective symptoms of vaginal atrophy were assessed before, four and eight weeks after the intervention. Data collection tools included a checklist for research unit selection, individual and midwifery characteristics questionnaire, vaginal assessment scale (VAS), vaginal pH, laboratory results of the vaginal maturation value (VMV). Data analysis was performed using SPSS software (version 21) and independent t-test, Mann-Whitney, chi-square, Two-way analysis of variance and analysis of covariance. P value less than 0.05 was considered significant. ResultsSubjective symptoms of vaginal atrophy decreased significantly after the intervention compared to before the intervention in both the nettle and placebo groups (p < 0.001), but in the comparison between groups four weeks and eight weeks after the intervention, the subjective symptoms of vaginal atrophy in nettle group decreased significantly (p < 0.001). In the nettle group, the scores of vaginal burning, vaginal dryness, vaginal itching and dyspareunia significantly improved after the intervention compared to before the intervention (p < 0.001). Also, in the nettle group compared to the placebo group, after the intervention, vaginal burning and vaginal dryness score (p < 0.001) and vaginal itching score (0.004) improved significantly. ConclusionBased on the results of the present study, Nettle vaginal cream reduced subjective symptoms of vaginal atrophy, including vaginal burning, vaginal dryness, vaginal itching, and dyspareunia in postmenopausal women, so it is a cost-effective, available and do not have the side effects product that can be useful for menopausal women.

Software Development Effort Estimation Using Relational Database and Optimized Learning Mechanism

Accurately estimating the cost of software development is crucial for effective project planning and resource allocation. However, traditional cost estimation methods rely heavily on expert judgment and historical data, which can be time consuming and prone to errors. This study suggests a learning-based cost estimation model that leverages relational databases to improve accuracy. The proposed approach estimates project cost based on the effort required to complete software development, which is a key driver of the project cost. The proposed model is designed to address the challenges posed by the variability in open-source development, including variable team sizes, working hours, and expertise. The study collects and pre-processes data from open-source platforms and selects cost drivers and metrics based on logical rules and SQL queries. Moreover, we propose an optimized Artificial Neural Network (ANN) with augmented topology to automate the selection of neuron units, layers, and adjustment of learnable parameters according to the input variables. The proposed model is evaluated on a 100 open-source software repositories dataset and demonstrates its effectiveness in accurately estimating development cost. The system is implemented using Python and evaluated using performance parameters such as MSE, RMSE, MAE, and MMRE. Results indicate that our proposed model offers a more accurate and efficient approach to software cost estimation, especially for freelancers and outsourcing firms. The proposed model has the potential to save time and resources and improve the reliability and accuracy of software cost estimation.

Modelling of Post-COVID-19 Food Production Index in Nigeria using Box-Jenkins Methodology

Before the COVID-19 pandemic, global food security has been known to be a major threat for developed and developing countries of the world. However, during the COVID-19 pandemic, global food security was expected to be at a very high risk due to lockdown across the globe. Consequently, the developing countries, most especially, were expected to experience food shortage challenges. One important way to measure the amount of food production of any country in the world is through the use of a macroeconomic variable known as Food Production Index (FPI). Therefore, this study seeks to examine the post-COVID-19 behaviorof the Nigeria’s FPI using the Box-Jenkins methodology for modelingunivariate time series. A low-frequency time series datasets over 56 years spanning from 1961 to 2016 on Nigerian FPI was extracted from World Bank repository. Pre-tests results from the unit root analyses, correlogram and selection criteria techniques showed that the FPI is a differenced stationary series of order one {I(1)}and that ARIMA (2, 1, 2) model best fitted the series. Besides, diagnostic checking of the fitted model confirmed that the error was white noise and forecast of 8 years (2017 to 2024) was made. Findings from the study revealed that the future values of the FPI are erratic and expected to fluctuate (i.e.,rise and fall) within the predicted periods. Conclusively, the fourteen years out sample forecast of FPI for the periods 2017 to 2030 indicates that the gains of FPI in recent years is currently being affected bythe current COVID-19 pandemic. The study recommends that concerted efforts to achieve optimal FPI must be focused on the improvement of inter-regional trade which will result in shorter food chains, and thereby creating more market for farmers and enhancing accessibility to both inputs and outputs

Safer Care for Older Persons in (residential) Environments (SCOPE): a pragmatic controlled trial of a care aide-led quality improvement intervention

BackgroundThe increased complexity of residents and increased needs for care in long-term care (LTC) have not been met with increased staffing. There remains a need to improve the quality of care for residents. Care aides, providers of the bulk of direct care, are well placed to contribute to quality improvement efforts but are often excluded from so doing. This study examined the effect of a facilitation intervention enabling care aides to lead quality improvement efforts and improve the use of evidence-informed best practices. The eventual goal was to improve both the quality of care for older residents in LTC homes and the engagement and empowerment of care aides in leading quality improvement efforts.MethodsIntervention teams participated in a year-long facilitative intervention which supported care aide-led teams to test changes in care provision to residents using a combination of networking and QI education meetings, and quality advisor and senior leader support.This was a controlled trial with random selection of intervention clinical care units matched 1:1 post hoc with control units. The primary outcome, between group change in conceptual research use (CRU), was supplemented by secondary staff- and resident-level outcome measures. A power calculation based upon pilot data effect sizes resulted in a sample size of 25 intervention sites.ResultsThe final sample included 32 intervention care units matched to 32 units in the control group. In an adjusted model, there was no statistically significant difference between intervention and control units for CRU or in secondary staff outcomes. Compared to baseline, resident-adjusted pain scores were statistically significantly reduced (less pain) in the intervention group (p=0.02). The level of resident dependency significantly decreased statistically for residents whose teams addressed mobility (p<0.0001) compared to baseline.ConclusionsThe Safer Care for Older Persons in (residential) Environments (SCOPE) intervention resulted in a smaller change in its primary outcome than initially expected resulting in a study underpowered to detect a difference. These findings should inform sample size calculations of future studies of this nature if using similar outcome measures. This study highlights the problem with measures drawn from current LTC databases to capture change in this population. Importantly, findings from the trial’s concurrent process evaluation provide important insights into interpretation of main trial data, highlight the need for such evaluations of complex trials, and suggest the need to consider more broadly what constitutes “success” in complex interventions.Trial registrationClinicalTrials.gov, NCT03426072, registered August 02, 2018, first participant site April, 05, 2018.

Uptake and Adherence to National Guidelines on Postpartum Haemorrhage in Italy: The MOVIE before-after Observational Study.

Translating evidence-based guidelines into clinical practice is a complex challenge. This observational study aimed to assess the adherence to the Italian national guidelines on postpartum haemorrhage (PPH) and describe the clinical management of haemorrhagic events in a selection of maternity units (MUs) in six Italian regions, between January 2019 and October 2020. A twofold study design was adopted: (i) a before-after observational study was used to assess the adherence to national clinical and organisational key recommendations on PPH management, and (ii) a cross-sectional study enrolling prospectively 1100 women with PPH ≥ 1000 mL was used to verify the results of the before-after study. The post-test detected an improved adherence to 16/17 key recommendations of the guidelines, with clinical governance and communication with family members emerging as critical areas. Overall, PPH management emerged as appropriate except for three recommended procedures that emphasise different results between the practices adopted and the difference between what is considered acquired and what is actually practised in daily care. The methodology adopted by the MOVIE project and the adopted training materials and tools have proved effective in improving adherence to the recommended procedures for appropriate PPH management and could be adopted in similar care settings in order to move evidence into practice.