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Knowledge management tools and mechanisms for evidence-informed decision-making in the WHO European Region: a scoping review
No full textBackground: Knowledge management (KM) emerged as a strategy to promote evidence-informed decision-making. This scoping review aims to map existing KM tools and mechanisms used to promote evidence-informed health decision-making in the WHO European Region and identify knowledge gaps. Methods: Following the Joanna Briggs Institute (JBI) guidance for conducting scoping reviews, we searched Medline, PubMed, EMBASE, the Cochrane library, and Open Grey. We conducted a descriptive analysis of the general characteristics of the included papers and conducted narrative analysis of the included studies and categorized studies according to KM type and phase. Results: Out of 9541 citations identified, we included 141 studies. The KM tools mostly assessed are evidence networks, surveillance tools, observatories, data platforms and registries, with most examining KM tools in high-income countries of the WHO European region. Findings suggest that KM tools can identify health problems, inform health planning and resource allocation, increase the use of evidence by policymakers and stimulate policy discussion. Conclusion: Policymakers and funding agencies are called to support capacity-building activities, and future studies to strengthen KM in the WHO European region particularly in Eastern Europe and Central Asia. An updated over-arching strategy to coordinate KM activities in the WHO European region will be useful in these efforts. © 2023, The Author(s)
Insights on Female Sex Offenders from the Missouri Registry
Get PDFThere is limited research on female sex offenders and their offending characteristics. The sociocul-tural description of women as being nurturing, nonaggressive and, more significantly, nonsexual has diverted the attention from female sexual offending. Although reports have shown that female sex offenders make up two percent of the whole sex offender population, the true rate is remarkably higher because the caretaking behavior of women masks their sexual offenses. The purpose of our study is to explore the characteristics of female sex offenders. We analyzed the publicly available Missouri sex offender registry database and selected all female sex offenders (n = 532) of any age who committed their crimes in Missouri and were convicted in Missouri. We found that the 532 female offenders had a mean age of 29.8 years at the time of their first offense and were convicted for a total of 992 offenses. The calculated recidivism rate was close to 0.6 percent. Moreover, 89.5 percent of offenders had strictly contact offenses, whereas five percent had strictly pornography offenses. Implications for risk assessment are discussed. © 2023, American Academy of Psychiatry and the Law. All rights reserved
Exact Time Discounting and Heuristics for the EOQ Model with Random Yield
No full textIn inventory management, the warehousing cost, in addition to the financial cost, which reflects the economic cost of money tied up in the inventory, make up the inventory holding cost. Accurate estimation for this holding cost is important, especially in non-conventional settings, such as systems with random yield, where the uncertainty in the supply process complicates the analysis. In this research, we develop an exact time discounting formulation for the Economic Order Quantity (EOQ) model with many random yield variants, such as the “stochastically proportional” and the binomial processes. We also propose heuristics, based on the undiscounted cost framework, aimed at obtaining near-optimal ordering policies with simple closed-form variations of the base EOQ. Our numerical results indicate significant cost reduction from using exact time discounting over the classical undiscounted cost approach, which bases the financing cost solely on the amount of received inventory in an order. However, some of our heuristics, especially one based on an “average cost” that inflates the unit cost to account for the wasted supply, perform very well, albeit with a little added complexity with respect to the classical approach
A thermal sensation model for elderly under steady and transient uniform conditions
Get PDFSub-optimal thermal conditions influence the health and well-being of elderly people and deteriorate their cognitive functions due to age-induced changes in thermoregulatory mechanisms. Addressing the thermal comfort needs of elderly is better aided when a robust predictive thermal sensation (TS) model exists. However, available TS models in the literature are based on physiological and subjective data collected from young subjects, and their use to assess elderly TS is inappropriate. In this work, a model for predicting elderly TS under steady and transient states was developed from published experimental data under controlled environment. The model predicts the mean TS of elderly people in terms of their average skin temperature, rate of change of skin temperature and core temperature. The model was coupled with a robust elderly bioheat model, enabling the prediction of elderly TS from environmental conditions. The TS model was further extended with a correlation that links the required physiological data for sensation prediction with few segmental skin temperatures that can be measured to enable the development of TS monitoring devices for the elderly. The model and the approach of using segmental temperatures in TS prediction were validated using different experimental measurements and subjective data than those used in the model development. Good agreement between experimental and predicted TS was achieved under varying steady and transient environments. The model predicts the elderly TS in ambient temperatures ranging from 13 °C to 43 °C and in transient settings with up to a 10 °C step rise or drop in ambient temperature. © 2022 Elsevier Lt
Microendoscopic Ultrasound-Guided Percutaneous Tracheostomy (MUGPT): A Case Series Describing a Novel Technique for Performing Percutaneous Tracheostomy
Get PDFA percutaneous tracheostomy is a common surgical procedure done in intensive care. Several different techniques have been described. Recently, the addition of bronchoscopy or ultrasound has been advocated to decrease the risks and complications associated with the procedure; however, both aids used alone, bronchoscopy or ultrasound, have some drawbacks and pitfalls. In this manuscript, we describe a new technique implementing a new technology, Microendoscopy coupled with ultrasound to perform percutaneous dilation tracheostomy MUGPT. MUGPT relies on dual real-time feedback microendoscopy and ultrasound to perform percutaneous dilation tracheostomy. This technique helps reduce the risk of bleeding, airway loss, tracheal wall injury, tracheal ring fracture, damage to adjacent structures, pneumothorax, pneumomediastinum, subcutaneous emphysema, false placement, hypoxia, carbon dioxide retention bronchospasm, cardiac dysrhythmias, and cost reduction. Methods. This is a case series of 6 patients who underwent single-step percutaneous dilation tracheostomy using the MUGPT technique. All the patients were in ICU and were candidates for tracheostomy. Intraoperative data collection, vital signs, oxygen saturation, and end-tidal CO2 were measured. No postoperative or intraoperative complications were documented. Conclusion. Microendoscopic ultrasound-guided percutaneous tracheostomy (MUGPT) is a promising technique with minimal complications. It is a procedure that can be performed and taught easily to Junior physicians and is a lifesaver in difficult cases. © 2023 Mayyas M. Msheik et al
Mental Health of LGBTQ Individuals Who are Arab or of an Arab Descent: A Systematic Review
Get PDFLesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at a higher risk of mental illness when compared to their heterosexual and cisgender counterparts. Most research emanates from Western countries, with a paucity of studies in the Arab world. We systematically reviewed studies assessing the mental health of LGBTQ individuals who live in the Arab world or are of Arab descent. Of 261 articles, seven were eligible for analysis. Depression was the most common psychiatric disorder. Suicidal ideations and attempts were frequent in trans women. Post-traumatic stress disorder was also common, with the majority of precipitating traumatic events being related to sexual orientation and/or gender identity. Societal and familial stressors in the Arab culture are major contributors to the increased vulnerability of the LGBTQ community to mental health challenges. Further research is of utmost need while taking into consideration the Arab socio-cultural context. © 2022 Taylor & Francis Group, LLC
Infant and young child feeding practices in Lebanon: a cross-sectional national study
Get PDFObjective: To assess infant and young child feeding (IYCF) practices in Lebanon and investigate their associations with socio-demographic and lifestyle factors. Design: A cross-sectional national survey was conducted in 2012-2013. In addition to a socio-demographic and lifestyle questionnaire, a 24-h dietary recall for the children was collected, with mothers as proxies. IYCF practices were assessed based on the 2021 indicators of the WHO. Setting: Lebanon. Participants: Children aged 0-23 months and their mothers (n 469). Results: While the majority of infants were ever breastfed (87·6 %), the prevalence of exclusive breast-feeding (BF) in those under 6 months of age was 11·0 %. Early initiation of BF was 28 %. A greater child's birth order, partner's support for BF, higher parental education, maternal BF knowledge and non-smoking were associated with higher odds of meeting BF recommendations. As for complementary feeding, 92·8 % of children (6-23 months) met the minimum meal frequency indicator, 37·5 % met the minimum dietary diversity (MDD) and 34·4 % met the minimum adequate diet (MAD). The consumption of unhealthy food was observed amongst 48·9 % of children, with nearly 37 % consuming sweet beverages. Older maternal age and maternal overweight/obesity were associated with lower odds of meeting MDD and MAD, while child's age and partner's support for BF were associated with higher odds. Conclusions: The results documented suboptimal IYCF practices amongst Lebanese children and identified a number of factors associated with these practices. Findings from this study will help guide the development of culture-specific programmes aimed at improving IYCF practices in Lebanon. © The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society
Perceptions of ophthalmologists on the impact of trachoma in Egypt: a mixed-methods, nationwide survey
Get PDFPurpose: Understanding the perception and practices of ophthalmologists for trachoma is important to develop interventions aimed at disease elimination in Egypt. The survey investigated: (1) the views and practice patterns of Egyptian ophthalmologists for trachoma and (2) the influence of geographic location, setting, and years of practice on ophthalmologists’ perceptions. Methods: A questionnaire sent to ophthalmologists currently working in Egypt collected information on: (1) demographics, (2) caseload and practice patterns for trachoma, (3) 13 Likert scale questions regarding the current state of trachoma, and (4) two open-ended written response questions. Results: Of the 500 recipients, 194 ophthalmologists participated. 98% of the respondents reported seeing trachoma patients in their practice. 28.8% agreed that trachoma is currently an active health problem in Egypt, with ophthalmologists in public practice having significantly higher agreement scores compared to private practitioners (p = 0.030). Rural ophthalmologists were significantly more likely to agree that a targeted trachoma control program is needed in their location of practice compared to their urban counterparts (p < 0.001). Open-ended questions revealed recurrent themes, including the rural distribution of trachoma patients and the high volume of patients with corneal opacity. Conclusion: Ophthalmologists’ experiences with trachoma in Egypt differed based on practice setting, years in practice, and location, and the overall perception of the impact of the disease remains low. However, there was widespread agreement that trachoma is present in communities across the country. Practitioners in rural areas and in the public sector shared a disproportionate burden of the trachoma caseload. The perspectives of such ophthalmologists must be emphasized in decision-making related to trachoma interventions. © 2023, The Author(s)
Towards a Contextual Understanding of the Influence of Critical Incidents on Teacher Agency: a Case of the Lebanese Private Schools
No full textLiterature considers teacher agency as an essential condition for teachers to be able to play an effective and influential role in the field of education (Everitt, 2019; Jenkins, 2019; Lasky, 2015). Teacher agency is affected by many conditions such as context (Alvunger, 2018; Biesta et al., 2015; Buchanan, 2015; Eteläpelto, et al., 2015) and professional identity (Buchanan, 2015; Kontovourki et al. 2018; Lasky, 2015; Stillman and Anderson, 2015; Tan, 2016) which is in turn influenced by lived experiences Novak and Knowels, 1992; Drake, 2006; Avraamidou; 2016; Howell and Allen, 2016). According to literature, teacher agency remains to be studied in educational research (Akar, 2020; Hilal, 2021). The relationship between agency and past experiences and incidents in particular is an area that presents a major gap in literature. This fact evidently applies when focusing on education field of Lebanese private schools. Understanding this relationship could present a ground for understanding why different teachers manifest different levels of agency in similar contexts.
The purpose of this study is to understand the impact of past experiences, particularly critical incidents, on the level of teacher agency in the private school context. This will be done by adopting Bourdieu’s theory of practice as a guiding conceptual understanding of the relationship between personal dispositions and their effect on the habitus in relation to the person’s position in the field of education. Under the critical research paradigm semi-structured interviews were conducted with five private school teachers where the data was analyzed through the method of analysis of narratives and the findings were presented through the formation of three personas that saw light based on what the participants shared. The date showed that there is a clear influence of critical incidents on how private school teachers’ agency manifests. The study also found that the time in terms of human development that the critical incidents being critically reflected on occurred and teachers chose to focus on and discuss could play a role in how agency manifests. The study recommends further research, longitudinal in nature, to study the influence of this critical agency on how agency continued to manifest. It also recommends considering those findings in preservice and in-service contex
The General Contractor - Subcontractor Relationship: towards Building a Balanced Approach
No full textSubcontracting is a common practice in the construction industry. It offers several
benefits to the project itself as well as the project parties.
Despite its advantages, the subcontracting practices have also negatively affected the
working relationship between the main contractor and the subcontractor. Such practices
are well addressed in the literature review which also described the nature of the
relationship between the two parties and paved the road for an unbalanced and onesided type relation.
This research aims at validating this hypothesis through offering a critical analysis of
the literature to highlight the instances where an unbalanced relationship exists. The
study will also investigate whether disputes related to subcontract emanate as a result of
this relationship. To further support this argument, extensive examination of case law
reviews involving main contractor – subcontractor related disputes is conducted to filter
out those where an unbalanced relation depicts itself.
To this end, the subcontracting practices that should be revisited are highlighted, and
better practices are proposed to improve this relationship, and ultimately mitigate
disputes