Questionable Validity Research Articles

You say potato, I say vegetable; you say tomato, I say fruit: Cognitive validity of food group-based dietary recall questions

BackgroundThere is a need for valid, standardized approach for list-based questionnaires to measure food group consumption for indicators of diet quality including dietary diversity. ObjectiveA common method for collecting dietary diversity data consists of open-ended food group questions, e.g. Yesterday, did you eat any vegetables, such as cucumber, cabbage, or celery? We sought to examine the cognitive validity of open-ended questions that require respondents to categorize foods, and closed-ended alternatives using sentinel foods. MethodsPretesting and 83 cognitive interviews were conducted in five languages in São Paulo and New York City in 2018. In structured interviews, respondents were asked to describe their thought processes in answering each question. Their feedback and responses to closed-ended and open-ended food group questions were compared. The Gallup World Poll then piloted two versions of the questionnaire in a nationally representative sample of 1,000 in Brazil in 2018. ResultsRespondents in all settings miscategorized foods when asked open-ended food group questions (0-82%, depending on the food group), respondents varied in their ability to think of other foods that belonged to specified food groups (35-50% could think of any items), and open-ended questions presented an additional cognitive burden. There were no significant differences between the results from closed-ended and open-ended questions in the national pilot test. In the context of a multi-topic survey, the finalized questionnaire took 3-5 minutes, had no additional training requirements, and enumerators reported similar ease in administration as other survey modules. ConclusionsFor data collection on food group consumption, open-ended questions requiring respondents to categorize foods present cognitive validity problems. Closed-ended questions using sentinel foods reduce or eliminate ambiguity, presenting lower cognitive burden and greater comprehension. Based on these results, the closed-ended method has been adopted in international survey platforms for measuring dietary diversity and other aspects of diet quality.

Adaptation of the Diet Quality Questionnaire as a global public good for use in 140 countries

BackgroundFood group consumption data is useful for measuring and monitoring diet quality. To collect valid data across contexts, consistent and rigorous adaptation of survey questions is needed. ObjectivesThe objective of this research is to adapt food group consumption survey questions for 140 countries, by identifying the most common (sentinel) food items in each food group using a structured, participatory process and global standards for classification. MethodsSurvey questions were adapted for 29 food groups of the Diet Quality Questionnaire (DQQ) and for additional questions for infant and young child feeding (IYCF) indicators. For each country, adaptation comprised: (1) review of existing questionnaires, dietary intake data, and other information to draft food lists; (2) key informant (KI) interviews with 5-12 experts to identify and prioritize sentinel items including terminology; (3) comparison of items across countries within the same region to identify discrepancies, and follow-up with KIs to resolve them. Results1,016 KIs contributed to the adapted DQQs for 140 countries and IYCF DQQs for 96 countries, amounting to approximately 9,550 hours of collective effort (68 person-hours/country on average) from 2020-2024. The process revealed numerous challenges and decisions to ensure consistent classification of items and valid question formulation. ConclusionCountry-specific questions adhering to global standards, and adapted through cumulative and iterative input of local experts, enable the collection of food group consumption data that is valid and comparable across time and geographies. The adapted survey questions have been implemented in the Demographic and Health Surveys (DHS) and Gallup World Poll in 94 countries, generating the first cross-country data on minimum dietary diversity (MDD) and other diet quality indicators. The finalized country-adapted DQQs and IYCF DQQs were translated to 143 national languages and are published online as a global public good for population-level diet quality measurement.

Response patterns in self-reported medical conditions: insights from the National Health and Nutrition Examination Survey (NHANES)

Abstract Background In the era of large-scale experiments, self-reported information has become a useful approach for gathering information longitudinally. The extent of subjectivity in self-reported medical conditions can vary considerably and can subject to a large degree of individual interpretation. Purpose To assess potential clustering among non-related self-reported conditions in the National Health and Nutrition Examination Survey (NHANES) over a period of 20 years (1999-2018). Methods We considered adult individuals (older than 20 years old) at the time of recruitment in all 10 cycles of the NHANES spanning from 1999 to 2018. For each individual, we gathered information on demographics, socioeconomic, examination data, laboratory variables and self-reported conditions included in the questionnaire instruments being available for all cycles. We focused only on questionnaire variables that are valid questions for both men and women. We examined potential patterns in clustering of responses among individuals in the same survey cycle and subsequently among individuals of different survey cycles. Results The study sample consisted of 55081 adult individuals. Female and male participants were equally represented in the study sample (52% and 48% respectively). The mean age of individuals at screening was 50 years (standard deviation 18). Participants were mostly non-Hispanic white (44%), followed by non-Hispanic black (21%) and Mexican American (17%). 41 self-reported medical conditions were available across the 10 cycles of NHANES and were considered in this analysis. The percentage of affirmative answers and missing information in the level of self-reported medical condition did not differ considerably across the 10 cycles for the vast majority of the medical conditions; but the percentage of missing information differed considerably across the different self-reported conditions and cycles ranging between 0% to 97% (Figure). Conclusions Surveys based on self-reported medical conditions may suffer from clusters and secular trends in provided responses or missing information among non-related conditions. Potential clustering may bias the data analysis and interpretation of the findings. The risk of clustering in individuals responses should be taken into account in analysis of self-reported conditions.Figure

Utilization of Computer-Based Testing Technology to Optimize Cognitive-Based Assessment Literacy in the Learning of Islamic Elementary School Students

The focus of 21st-century learning is on developing students' critical thinking, real-world application of knowledge, mastery of information technology, communication, and collaboration skills. Therefore, it is important to integrate information technology into the learning process and assessment of learning outcomes. This research aims to explore how Computer-Based Testing (CBT) can enhance the quality of cognitive assessment procedures based on literacy and improve learning evaluations for students at Islamic Elementary School. This study adopted a qualitative case study design and was conducted at Islamic Elementary School Al Wathoniyah 10 East Jakarta in the second semester of the 2023/2024 academic year. The researcher used interviews, observations, and documentation as data collection methods. The findings of this research show that literacy-based cognitive assessment using CBT can optimize the quality of learning evaluation. Teachers and students are accustomed to using information and communication technology devices in learning activities. There are five stages of the procedure in literacy-based cognitive assessment using CBT to optimize the quality of learning evaluation, including the planning stage, item question development stage, validation stage, implementation stage, and evaluation stage. The investigative conducting procedure truly optimizes the quality of learning evaluation. Islamic Elementary School Al Wathoniyah 10 utilizes CBT, which has literacy-based characteristics. CBT used in learning evaluation is equipped with meaningful stimuli and various forms of questions. The questions in CBT are made as similar as possible to the national assessment questions. The educational report results in the 2023 national assessment, especially in the cognitive domain, have shown improvement. The literacy and numeracy skills of students at Islamic Elementary School Al Wathoniyah 10 have achieved good and moderate results. Both have obtained top rankings nationally.

Empirical Analysis of Physics Test Instruments to Measure Graphical Representation Abilities in “Temperature and Heat” Topics

This study focused on developing physics test instruments for senior high school students on the topics of temperature and heat. The study aimed to determine (i) the quality of the test instrument content, (ii) the feasibility of the test instrument, and (iii) students’ graphic representation abilities on “Temperature and Heat” topics. The test instrument development went through three stages, namely test design, testing, and test assembly. The test instrument was tested in the Science Class XII of the Public Senior High School 5 Yogyakarta with a total of 195 students as research subjects. The item analyzes in this study included analysis of model validity, reliability, level of difficulty, and level of students’ ability. The research results showed that the test instrument for the graphical representation of “Temperature and Heat” topics had good content quality but still needed to be improved. The feasibility of the graphic representation test instrument showed that there were seven items that were declared valid and reliable even though the items tested did not conform to the Raschmodel. However, these seven items were still suitable for use on a wide scale to measure graphical representations of “Temperature and Heat” topics. Finally, in the analysis of students’ abilities regarding graphical representation individually, the largest percentage was in the low category, while, overall, the students’ abilities level was classified as medium. Thus, it was necessary to improve question items that involve graphical representation that meet the criteria for good, valid, and reliable question items, and can improve students’ graphic representation abilities.

Effect of Implementing the Balanced Scorecard on the Management Performance of PT YKK AP Indonesia

This study aims to determine the effect of a balanced scorecard on the management performance of PT. YKK AP Indonesia. This study used 40 employees of PT. YKK AP Indonesia, who met the criteria to be respondents. This study was conducted using the conventional sampling method on PT employees. YKK AP Indonesia and analyzed using multiple linear regression. The first stage tested the validity and reliability of questions for each variable. The second stage conducted a classical test, and the third stage conducted an F test, t-test, and determination coefficient test. The results of the t-test study showed that the variables of financial perspective, customer perspective, internal business process perspective, and growth and learning perspective had a partial effect on management performance. In the F test, all independent variables simultaneously affected the dependent variable. Meanwhile, the determination coefficient value shows that the independent variables of financial perspective, customer perspective, internal business process perspective, and growth and learning perspective contributed to the dependent variable, namely management performance, by 49%, while other factors outside the model influenced the remaining 51%.

GPT-4o vs. Human Candidates: Performance Analysis in the Polish Final Dentistry Examination.

Background This study aims to evaluate the performance of OpenAI's GPT-4o in the Polish Final Dentistry Examination (LDEK) and compare it with human candidates' results. The LDEK is a standardized test essential for dental graduates in Poland to obtain their professional license. With artificial intelligence (AI) becoming increasingly integrated into medical and dental education, it is important to assess AI's capabilities in such high-stakes examinations. Materials and methods The study was conducted from August 1 to August 15, 2024, using the Spring 2023 LDEK exam. The exam comprised 200 multiple-choice questions, each with one correct answer among five options. Questions spanned various dental disciplines, including Conservative Dentistry with Endodontics, Pediatric Dentistry, Dental Surgery, Prosthetic Dentistry, Periodontology, Orthodontics, Emergency Medicine, Bioethics and Medical Law, Medical Certification, and Public Health. The exam organizers withdrew one question. GPT-4o was tested on these questions without access to the publicly available question bank. The AI model's responses were recorded, and each answer's confidence level was assessed. Correct answers were determined based on the official key provided by the Center for Medical Education (CEM) in Łódź, Poland. Statistical analyses, including Pearson's chi-square test and the Mann-Whitney U test, were performed to evaluate the accuracy and confidence of ChatGPT's answers across different dental fields. Results GPT-4o correctly answered 141 out of 199 valid questions (70.85%) and incorrectly answered 58 (29.15%). The AI performed better in fields like Conservative Dentistry with Endodontics (71.74%) and Prosthetic Dentistry (80%) but showed lower accuracy in Pediatric Dentistry (62.07%) and Orthodontics (52.63%). A statistically significant difference was observed between ChatGPT's performance on clinical case-based questions (36.36% accuracy) and other factual questions (72.87% accuracy), with a p-value of 0.025. Confidence levels also varied significantly between correct and incorrect answers, with a p-value of 0.0208. Conclusions GPT-4o's performance in the LDEK suggests it has potential as a supplementary educational tool in dentistry. However, the AI's limited clinical reasoning abilities, especially in complex scenarios, reveal a substantial gap between AI and human expertise. While ChatGPT demonstrates strong performance in factual recall, it cannot yet match the critical thinking and clinical judgment exhibited by human candidates.

Evaluation of Information Technology Governance Maturity Using COBIT 2019: A Case Study on the IT Security Industry

This study aims to evaluate the maturity of IT governance in the IT security industry using COBIT 2019. The assessment covered 13 COBIT 2019 domains, namely APO03—Managed Enterprise Architecture, APO07—Managed Human Resources, APO12—Managed Risk, APO13—Managed Security, APO14—Managed Data, BAI02—Managed Requirements Definition, BAI03—Managed Solutions Identification & Build, BAI05—Managed Organizational Change, BAI06—Managed IT Changes, BAI07—Managed IT Change Acceptance and Transitioning, BAI09—Managed Assets, BAI10—Managed Configuration, and BAI11—Managed Projects. The research methodology included observation, domain-based question formulation, RACI interviews, data collection, and question validation testing, with maturity calculation performed using appropriate formulas. Results indicate that most domains are at Level 2 (Managed), with significant contributions to maturity at Levels 3 and 4. Significant gaps were found between the current state and the desired maturity targets for many domains, such as APO03 and BAI03. The percentage contribution from Level 2 is the highest, while contributions from Levels 3 and 4 vary, with very low contributions from Level 5. The total maturity score is 2.49, with percentage contributions from Levels 2, 3, 4, and 5 being 74%, 26%, 11%, and 3%, respectively. Recommendations include improving processes to achieve Levels 3 and 4 across more domains and investing in training and development for relevant teams.

Designing Patient-Reported Measures of Fertility: Cognitive Interview Findings from Adolescents and Young Adults with Cancer.

Purpose: Fertility concerns (FC) are central to the well-being of many adolescent and young adult (AYA) cancer survivors. Clinical conversations about FC and fertility preservation are suboptimal, increasing patient distress. The goal of this project was to establish content validity and comprehensibility of self-report questions on FCs for AYAs with cancer. Methods: Following best practices, we conducted: (1) item identification, refinement, and generation; (2) translatability and reading level review; and (3) cognitive interviews. Items were reviewed by five AYAs in each round of cognitive interviews. Results: A systematic search yielded 63 measures and 873 items. Fifty items were subsequently modified to enhance clarity and relevance, representing subdomains of psychological and social/relational FC. Flesch-Kincaid analysis found 31 items written above the 6th grade level, which were subsequently revised. Translatability review resulted in the modification of 3 items. During cognitive interviews, 76% of AYAs found items easy to answer with 52% describing them as "very easy" and 24% as "somewhat easy." Sixty percent of participants indicated the items captured their experiences. The majority of those who reported items only somewhat reflected or did not reflect their experiences suggested items were simply not applicable for their particular case. Conclusion: This study is a critical step toward the foundation for an FC measurement system that is reliable, flexible, developmentally appropriate, comprehensible, translatable, and interpretable. Subsequent steps include psychometric testing to examine the construct validity and reliability of the FC items and calibration to enable the application of computer-adaptive testing and short form development. The evaluation will include potential item response bias by age range, gender identity, and race/ethnicity.

Psychometrics of an Eight-Item Pulmonary Artery Catheter Safe-Care Assessment Tool for Critical Care Nurses.

Background and Purpose: The ability to safely care for patients with pulmonary artery catheters (PACs) is an essential skill for critical care nurses, yet no valid and reliable test exists to assess this knowledge. The purpose of this study was to assess the psychometrics of a test created to assess nurses' knowledge of PAC safe-care. Methods: Reliability was assessed using Kuder-Richardson-20, and validity was assessed using item difficulty, discrimination, and known-groups comparison. Results: The sample (N = 95) consisted of new graduates and experienced nurses. Reliability was less than desired (.657) but expected due to the small number of test items. Validity was supported by item difficulty, discrimination indices, and known-groups comparison. Conclusion: Assessing the reliability and validity of test questions is a crucial step for creating accurate instruments to assess safe-care practices, which can be used to improve course content and evaluation methods.

Cross-National Study on the Convergent, Discriminant, and Concurrent Validity of the “Body Size Perception” Item in the Health Behaviour in School-aged Children Survey

BackgroundDespite its significant usefulness in adolescent health studies, the single-item “body size perception” question, developed within the Health Behaviour in School-aged Children (HBSC) survey, has yet to undergo multidimensional validation. ObjectivesTo assess the convergent, divergent and concurrent validity of the HBSC body size perception question among adolescents. MethodsThe single-item HBSC body size perception question is as follows: “Do you think your body is…?,” with answers ranging from “much too thin” to “much too fat.” Fifteen-year-old participants included in the analysis were 72,086 from 45 HBSC countries in 2017/18 (concurrent validity), and 595, 127, and 615 in 2021/22 in French-speaking Belgium, Ireland, and Poland, respectively. The convergent, divergent, and concurrent validity was assessed with body dissatisfaction, social desirability, and selfesteem, respectively. The concurrent validity was also examined with body mass index (BMI) from the 2017/18 HBSC data. All analyses were sex-stratified. ResultsCohen’s Kappa values were 0.67 [confidence interval (CI): 95%: 0.62, 0.72] and 0.64 (0.59, 0.69) for boys and girls, respectively, in all 3 countries together. Body size perception was associated with social desirability, selfesteem, and BMI, with a stronger association in girls than that in boys. For instance, girls with higher social desirability were less likely to perceive themselves as “too thin” [Relative Risk Ratio (RRR) = 0.78 (0.69, 0.89)] rather than as the “right size.” Boys with higher selfesteem were less likely to perceive themselves as “too fat” [0.93 (0.90, 0.97)] rather than the “right size.” Girls with underweight were less likely to perceive themselves as “too fat” [0.38 (0.34, 043)] rather than “right size” and girls with overweight/obesity were more likely to perceive themselves as such [8.19 (7.49, 8.95)]. ConclusionsThe single-item HBSC body size perception question demonstrated good convergent, divergent, and concurrent validity. It reflects adolescents’ own perception of body size, possibly influenced by societal norms and ideals.

The Relationship Between Self-Efficacy and Peer Association with Mathematics Learning Outcomes of Grade X Students of SMAN 4 Palangka Raya

This study aims to find out: (1) The relationship between self-efficacy and mathematics learning outcomes of grade X students of SMAN 4 Palangka Raya, (2) The relationship of peer association with mathematics learning outcomes of grade X students of SMAN 4 Palangka Raya, (3) The relationship of self-efficacy and peer association with the mathematics learning outcomes of grade X students of SMAN 4 Palangka Raya. This research was carried out in the even semester of the 2023/2024 academic year. The study population was 515 students with a sample of 221 students. Based on the results of the trial, the self-efficacy questionnaire obtained 36 valid statements with , the peer association questionnaire obtained 28 valid statements with , and the mathematics learning outcomes test obtained 21 valid questions with . Based on the results of the prerequisite analysis test, namely the normality test, obtained for self-efficacy data , peer association data , and mathematics learning outcome test data , while the value , because the three data are not normally distributed, so the test used is nonparametric statistical analysis, namely Spearman rank correlation. The results of this study can be concluded: (1) There is a positive relationship between self-efficacy and mathematics learning outcomes of grade X students of SMAN 4 Palangka Raya; (2) There is a positive relationship between peer association and mathematics learning outcomes of grade X students of SMAN 4 Palangka Raya; (3) There is a positive relationship between self-efficacy and peer association with mathematics learning outcomes of grade X students of SMAN 4 Palangka Raya

A Comparison of Measurement of Stability and Predictors of Special Education Burnout and Work Engagement

Special education teacher (SET) stress and burnout is a significant problem. A total of 490 special education teachers were surveyed across the United States. The purpose of this study was to (a) assess and compare three measures of burnout/work engagement, the Maslach Burnout Inventory (MBI), the Oldenburg Burnout Inventory (OLBI), and the Utrecht Work Engagement Scale (UWES) and (b) examine change over the course of a school year that coincided with the COVID-19 pandemic. Significant measurement quality issues were observed for the MBI and OLBI, including questionable convergent validity. Burnout of SETs was found to be highly stable for the MBI and OLBI. Teachers experienced little mean change in burnout over the school year, and perceptions of the effects of COVID and demographic and school variables were generally not predictive of change in burnout for any measure. Implications are discussed.

Urdu-Language Translation and Validation of the Ask Suicide-Screening Questions (ASQ) Tool: A Focus on Connotation and Context.

Background Suicide is a significant cause of death in the world, and Pakistan, a low- and middle-income country, is no exception. Despite the increasing number of suicides, Pakistan does not have a validated suicide risk screening tool to identify suicide risk in the national language, Urdu, accurately. This study aims to translate and validate the Ask Suicide-Screening Questions (ASQ) tool into Urdu for suicide risk screening in Pakistan. Methodology We conducted this study at the Services Institute of Medical Sciences (SIMS), a large teaching hospital in Lahore, Pakistan, after receiving the approval of the SIMS Institutional Review Board. The study used a cross-sectional instrument validation study design. The inclusion criteria were youth and adults of both sexes aged 15-45 years, with an ability to understand, speak, read, and write in the Urdu language, who had no cognitive or intellectual limitation to consenting, and who were medically stable to participate. Exclusion criteria included any medical, physical, or cognitive unstable condition to consent or participate. We enrolled 300 participants in our convenience sample from the emergency department (ED), inpatient, and outpatient settings. The ASQ and the ASQ Brief Suicide Safety Assessment (BSSA) were translated and back-translated by Urdu language experts and modified to accommodate cultural and linguistic nuances. The clinician-administered BSSA Urdu version was used as a standard criterion to validate the ASQ by comparing the ASQ-Urdu responses vs. BSSA-Urdu responses. RStudio (version 2023.09.1+494) was used for statistical analyses Results The sample had an enrollment rate of 99.7% (300/301). The sample was 52% female (158/300); the mean age was 27.1 years (SD = 9.4), the overall screen-positive rate was 41.7% (125/300), and 9.3% (28/300) of the participants endorsed a past suicide attempt. In our sample, 35.9% (33/92) of outpatients, 32.2% (19/59) of inpatients, and 49.0% (73/149) of ED patients screened positive on the Urdu ASQ. The screen-positive rate was 16.9% (10/59) for participants aged 17 years and younger, 40.7% (35/86) for participants aged 18 to 25 years, and 51.6% (80/155) for participants aged 26 years and older. Compared to the criterion standard clinician-administered assessment, the Urdu ASQ had a sensitivity of 94.2% (95% confidence interval (CI) = 85.8%-98.4%), a specificity of 73.9% (95% CI = 67.7%-79.5%), a negative predictive value of 97.7% (95% CI = 94.2%-99.1%), and a positive predictive value of 52.0% (95% CI = 46.4%-57.6%). Conclusions The Urdu ASQ has strong psychometric properties, allowing healthcare professionals in Pakistan and worldwide with Urdu-speaking diaspora to identify individuals at risk for suicide efficiently. Utilizing cultural contexts in adapted screening tools improves the accuracy of suicide detection by ensuring that the tools are relevant, sensitive, and respectful to the cultural context of the individuals being assessed. High screen-positive rates in our pilot study underscore the need for early detection and intervention of suicide as a major global public health problem.

من المكاتب إلى الفضائات السيبرانية: فعالية برنامج الإرشاد ما قبل الزواج عبر منصات التواصل الاجتماعية

The progress of communication technologies, especially post-Covid-19, has changed general behavior patterns and premarital rehabilitation programs. Traditionally held at religious affairs offices (KUA), these programs are now frequently found on social media platforms like Instagram, YouTube, and Facebook with various type. This research was presented to answer a valid question about premarital guidance program chapters via social media, how they were applied and whether they demonstrated good effectiveness. By employing qualitative study, the research found that the premarital guidance program through the social network provide sufficient and innovative materials for their followers and conducting in an appropriate manner and advanced way. As for the effectiveness of the pre-marriage guidance program classes through social media platforms, the result showed that they have good effectiveness, either in terms of the participants’ assimilation of the materials, or in terms of organizing the programs, both in terms of the method of delivering and developing affection and the experience of the mentors. However, there is still a weakness in terms of the lack of dialogue between the counsellors and the participants, the lack of discussion of experiences and facts about family life, and case studies.

A study to determine if the fluid heart tracker app supports patient decision-making at the onset of worsening heart failure

Abstract Background Delay in seeking early intervention for worsening heart failure (HF) can result in poorer patient outcomes, hospital admission and increased risk of mortality (Andersen 2017, Matsue et al. 2017, Mikami et al. 2021). Despite the availability of health-related mobile apps for HF self-care, no study has focused on whether apps designed for HF weight monitoring make a meaningful contribution to the decision-making process of HF self-care. The Fluid Heart Tracker App was developed as a simple app to support the patient in the identification of significant weight gain as a result of worsening HF. An Advanced Nurse Practitioner in HF proposed the concept of the app, and it was developed by an Open-Source Volunteer team. It has one feature which is weight monitoring. It does not require interpretation of symptoms. The app has CE approval. It does not have a backend. The Irish Heart Foundation (IHF) has championed the app and the National Heart Programme listed it as a patient resource in the National Model of Care for Heart Failure in Ireland. The app is free to download from play store and the app-store in Ireland and the UK. Pilot study An evaluative, cross-sectional pilot study was initially carried out in potential users from three acute general hospitals. to determine the acceptability and usefulness of the Fluid Heart Tracker-App for patients with HF. This to garner feedback to use to develop, alter or refine the app. Methods Participants downloaded the app and used it to monitor their daily weight for two weeks. A short bespoke questionnaire was developed for the survey. It comprised five valid questions with dichotomous answers and an option at the end for participants to add any additional six comments. Results 31 participations- 13 female. The average age was 72. All participants (N=31, 100%) used the app, found it useful and found it easy to use and all participants would recommend the app to other patients with heart failure. 30 participants used the app daily, while one used it on alternate days. Participants stated that it was easy or very easy to use. Based on these positive results a before and after, quasi-experimental study is currently being undertaken. Aim of current study The aim of this current study is to determine the impact, use and the effect of the Fluid Heart Tracker App on patient decision making in HF. Primary Outcomes 1) Compare if using the app improved previous engagement patterns for weight monitoring. 2) Determine which factors influence engagement with the app. 3) Determine the impact of an app alert to the patient on seeking medical attention for worsening heart failure. Progress to date 179 participants were recruited from 12 HF sites in Ireland. Data collection was completed November 2nd, 2023. Currently the data set is being cleaned prior to statistical analysis. This investigation has been undertaken as part of a PhD study.

The Influence of the Work Environment and Work Stress on Employee Performance Case Study at STIE IBMT Surabaya

This study aims to determine the effect of work environment and stress on performance for operational employees at STIE IBMT Surabaya. Where the proposed two independent variables and one dependent variable, namely the working environment and job stress acting as independent variables and employee performance served as dependent variables. This research was conducted using a survey of operational employees in the import and export service company was analyzed by regression. The first phase of testing the validity and reliability of questions of each variable. The second phase, making the regression variable work environment and work stress on employee performance. The results showed that the variable has a significant positive work environment on the performance of employees in decline. And work stress variables significant negative effect on employee performance in decline. However, work stress are at low to moderate level will create a good employee performance and will worsen if the employee within a very long time and excessive.

Determinants of parental demand of human papillomavirus vaccination for adolescent daughters in China: Contingent valuation survey.

Several types of human papillomavirus (HPV) vaccines have been approved for use in adolescent girls in China. These vaccines are regulated as non-National Immunisation Program vaccines and are optional and generally fully self-paid by vaccinees. To assess parents' demand for HPV vaccination by eliciting their willingness-to-pay for their adolescent daughters to be vaccinated against HPV and to examine the determinants of demand for HPV vaccination in China. A contingent valuation survey was conducted across three cities in Shandong Province in eastern China. We selected 11 junior middle schools with different socioeconomic features and randomly selected 6 classes in each school, and questionnaires were distributed to all girls aged 12-16 in the 66 classes for their parents to complete. A payment card approach was used to elicit parental willingness-to-pay for HPV vaccination for their daughters. We also collected a wide array of socioeconomic and psychological variables and interval regressions were applied to examine the determinants of parental willingness-to-pay. A total of 1074 eligible parents who completed valid questions were included in analyses. Over 85% of parents believed HPV vaccines were, in general, necessary and beneficiary. However, only around 10% believed that their daughters would be infected by HPV. About 8% of parents would not accept HPV vaccine even if the vaccine were free mainly due to concerns about the potential side effects and vaccine safety and quality issues, and 27.37% would only accept the vaccine if it were free. The median willingness-to-pay was 300 CNY (42 USD). Several factors were positively correlated with higher willingness-to-pay: income, urban residence (relative to rural residence), mothers (relative to fathers), parents' beliefs about vaccine benefits, whether they should make decisions for their daughters, and whether their daughters would be susceptible to HPV. Though education-level was not significantly correlated with willingness-to-pay in the main regressions, a subgroup analysis revealed interesting dynamics in the relation between education and willingness-to-pay across different income-levels. There is a large gap between parents' willingness-to-pay and the market price of HPV vaccine for girls in China. Parents generally believed the HPV vaccines were beneficial and necessary but when asked for their daughters, most parents did not believe their daughters would be infected by HPV despite the high prevalence in China. Future focus should be on ensuring the provision of accurate health information about HPV prevalence, vaccine quality, and safety to promote vaccine uptake, and promotional efforts tailored to different income groups might yield better effects. Government involvement in negotiating more widely acceptable and affordable prices or subsidising may be necessary for protecting high-risk population groups.

Study Examines Limitations of CCS and Their Effect on Oil and Gas Production

_ This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper SPE 214950, “Limitations and Fallacies of Carbon Capture and Storage and Impact on Oil and Gas Production,” by S.M. Farouq Ali, SPE, and Mohamed Y. Soliman, SPE, University of Houston. The paper has not been peer reviewed. _ In the complete paper, the authors write that, while carbon capture and storage (CCS) initiatives are affecting oil and gas operations profoundly, such efforts have had little perceptible effect on atmospheric CO2, which continues to increase. The paper aims to show that current CCS regimens have serious technical and fiscal constraints and questionable validity, stating that, globally, CCS has not increased beyond approximately 0.1% of global CO2 emissions in the past 20 years. The paper offers partial solutions and concludes that, while oil and gas will continue to be important energy sources beyond the foreseeable future, oil companies will accomplish the needed CCS. Introduction The authors write that, while CCS efforts have been pursued for 4 decades, little has been achieved. For the past 20 years, the percentage of CO2 captured and stored is less than 0.1% of the CO2 emitted worldwide, if one considers CO2 enhanced oil recovery (EOR) projects to be CSS—which, the authors write, is a fallacy. They emphasize that CCS means injection with no production. The key to CCS success, they write, is major governmental subsidization, by whatever terminology it is known, and that means taxpayer money. Sweeping decisions that have a profound effect on oil and gas production and petroleum engineering education are being made based on predictions of an increase in CO2 concentration in the atmosphere in various time frames. Magnitude of the Problem The problem of world CO2 emissions capture is gigantic. To appreciate the magnitude of the problem, imagine that 1 year’s CO2 emissions (40 billion tonnes) are captured, compressed and liquified, and injected into a reservoir the size of the Ghawar oil field, the largest reservoir in the world, with the entire pore space (approximately 0.5 Tcf) available for storage. In this hypothetical, nine such reservoirs would be required every year. Presumably, such storage space can be found, but collecting the CO2 and bringing it to a storage site is a highly complex task. For example, in a sequestration effort in a building complex in New York, the CO2 is separated, liquified, and trucked to a storage site to be injected underground, which is impractical. Often, the example of the Nordic countries (mainly Denmark, Sweden, and Norway) is cited as evidence of successful emissions reduction. But the total population of these countries is approximately the same as that of metropolitan Mumbai in India. Definitions Carbon capture use and storage (CCUS) implies that the CO2 produced by various processes is captured and used for EOR. This accounts for approximately 30% of the 230 mtpa of CO2 captured globally. CCS means that any CO2 produced by the process is captured and injected into a suitable geological formation for storage for thousands of years. Net-zero emissions (NZE) implies that all the CO2 produced is captured and stored. In Canada, “absolute zero emissions” is discussed, meaning that no CO2 is produced in the first place, pointing to total fossil-fuel phaseout.

Does Serum Estradiol Prior to Progesterone Administration in Programmed Frozen Embryo Transfer Cycle Impacts Live Birth Rate: A Prospective Cohort Study

Background: There is a paucity of data on the optimal threshold of oestradiol (E2) levels required for successful implantation as this is a valid question to be answered, considering that significant number of in vitro fertilisation cycles are deferred for FET cycles. Aim: The aim of this study is to investigate the serum E2 levels before starting exogenous progesterone in artificial autologous frozen thawed embryo transfers on pregnancy outcomes. Settings and Design: This was a cohort study wherein clinical data of 213 artificial autologous programmed hormone-regulated frozen embryo transfer (HR-FET) cycles were collected. Materials and Methods: The HR-FET cycles were divided into three groups based on the E2 levels before starting progesterone: Group A: E2 ≤300 pg/mL, Group B: E2 301–500 pg/mL and Group C: E2 >500 pg/mL. After adequate endometrial stripe was appreciated by transvaginal ultrasonography, single blastocyst transfer was performed in all the cycles. Statistical Analysis Used and Results: The clinical pregnancy rate (CPR) in Groups A, B and C were 41.8%, 73.5% and 0.95%, respectively (P = 0.0001). The live birth rate (LBR) in Groups A, B and C was 18.1%, 62.2% and 0%, respectively (P = 0.0001). The miscarriage rate (MR) was significantly lower (15.3%) when E2 was between 301 and 500 pg/mL (P = 0.001). At both the extremes of serum E2 values, the rate of miscarriage increased. If serum E2 levels were ≤300 pg/mL or >500 pg/mL, the rate of miscarriage was 56.5% and 100%, respectively. Conclusion: Serum E2 levels in the range of 301–500 pg/mL before starting progesterone in programmed FET cycle are associated with an improved CPR and LBR and also decreased MR as compared to the extreme values of E2 ≤300 pg/mL or >500 pg/mL.