Search Results (251)

Background and Objectives: During pandemics, emergency departments face the challenge of managing critically ill patients with limited resources. Point-of-Care Ultrasound (POCUS) has emerged as a crucial diagnostic tool in such scenarios. This study aimed to develop a standardized POCUS protocol using expert consensus via a modified Delphi survey to guide physicians in managing these patients more effectively. Materials and Methods: A committee of emergency imaging experts and board-certified emergency physicians identified essential elements of POCUS in the treatment of patients under investigation (PUI) with shock, sepsis, or other life-threatening diseases. A modified Delphi survey was conducted among 39 emergency imaging experts who were members of the Korean Society of Emergency Medicine. The survey included three rounds of expert feedback and revisions, leading to the development of a POCUS protocol for critically ill patients during a pandemic. Results: The developed POCUS protocol emphasizes the use of POCUS-echocardiography and POCUS-lung ultrasound for the evaluation of cardiac and respiratory function, respectively. The protocol also provides guidance on when to consider additional tests or imaging based on POCUS findings. The Delphi survey results indicated general consensus on the inclusion of POCUS-echocardiography and POCUS-lung ultrasound within the protocol, although there were some disagreements regarding specific elements. Conclusions: Effective clinical practice aids emergency physicians in determining appropriate POCUS strategies for differential diagnosis between life-threatening diseases. Future studies should investigate the effectiveness and feasibility of the protocol in actual clinical scenarios, including its impact on patient outcomes, resource utilization, and workflow efficiency in emergency departments. Full article

In this research, we have compiled and analysed the organisations and studies that jointly address the issue of land administration, fundamentally in the cartographic aspects related to the cadastre and land registry, in the international environment, and at the Ibero-American level. Through qualitative social research, interviews were conducted with internationally recognised experts on issues of general cartography, cartography and legal security, and related to cadastral valuation, obtaining conclusions that allow a general diagnosis of the situation of the Land Administration System in Ibero-America. In this environment, problems such as the heterogeneity of systems, overlapping of competencies, instability, lack of sustainability, need for standards, lack of transparency, etc., should be highlighted, among others. Finally, based on the compilation of existing data from the Cadastre Data survey conducted in 2011 by the Permanent Committee of Cadastre in Ibero-America, and with information from its members and member organisations of the Pan-American Association of Professional Surveyors, the geoportal Diagnosis of the Situation of the Land Administration System in Ibero-America has been created. This geoportal allows the initial identification of the different organisations and general regional data. Full article

The purpose of this research is to examine how relationships between corporate control environments and stakeholders mediate the different dimensions of pressure on auditor independence. In France, two (joint) auditors are required by law for listed companies. In this context, we analyze the experiences of higher-echelon professionals of audit firms, controllers, and managers who could elucidate the essence of pressure on auditor independence in their lived environment. An interpretative approach and empirical analysis were adopted for this study to expand on the literature and proffer an answer to the following research question: How does the relationship between a control environment and a stakeholder mediate the pressures on auditor independence? Interviews involved seven participants, mainly higher-echelon professionals of Big Four firms, as well as two members of auditee organizations, and a member of an audit committee. In addition, the narratives from the documents gathered from the EU audit legislation implementation database constitute our data corpus. Thematic coding was used to organize the results. The findings reveal that control environment best practices and down-to-earth corporate governance policies, participated in by both auditors and audited organizations, cushion the pressures on auditors. This, in turn, presents a positive and significant impact on auditor independence. Overall, the dimensions that mediate the pressures on auditors are as follows: the consciousness of pressure in itself; the reputation and experience of the audit firm; and the interactions between the auditors and corporate governance. Other factors include the cordiality of the relationship between the auditor and corporate management and the resulting healthy end of the negotiation between auditors and auditees. This study contributes to the theory and practical discussion of the relationships between the corporate control environment, corporate governance, auditing, and pressure on auditor independence. Full article

Bridges are assets in every society, and their deterioration can have severe economic, social, and environmental consequences. Therefore, implementing effective asset management strategies is crucial to ensure bridge infrastructure’s long-term performance and safety. Roadmaps can serve as valuable tools for bridge asset managers, helping bridge engineers make informed decisions that enhance bridge safety while maintaining controlled life cycle costs. Although some bridge asset management roadmaps exist, such as the one published by the United States Federal Highway Administration (FHWA), there is a lack of structured research roadmaps that are both region-specific and adaptable as guiding frameworks for similar studies. For instance, the FHWA roadmap cannot be universally applied across diverse regional contexts. This study addresses this critical gap by developing a research roadmap tailored to Idaho, USA. The roadmap was developed using a three-phase methodological approach: (1) a comprehensive analysis of past and ongoing Department of Transportation (DOT)-funded research projects over the last five years, (2) a nationwide survey of DOT funding and research practices, and (3) a detailed assessment of Idaho Transportation Department (ITD) deficiently rated bridge inventory, including individual element condition states. In the first phase, three filtering stages were implemented to identify the top 25 state projects. A literature review was conducted for each project to provide ITD’s Technical Advisory Committee (TAC) members with insights into research undertaken by various state DOTs. Moreover, in the second phase, approximately six questionnaires were designed and distributed to other state DOTs. These questionnaires primarily covered topics related to bridge research priorities and funding allocation. In the final phase, a condition state analysis was conducted using data-driven methods. Key findings from this three-phase methodological approach highlight that ultra-high-performance concrete (UHPC), bridge deck preservation, and maintenance strategies are high-priority research areas across many DOTs. Furthermore, according to the DOT responses, funding is most commonly allocated to projects related to superstructure and deck elements. Finally, ITD found that the most deficient elements in Idaho bridges are reinforced concrete abutments, reinforced concrete pile caps and footings, reinforced concrete pier walls, and movable bearing systems. These findings were integrated with insights from ITD’s TAC to generate a prioritized list of 23 high-impact research topics aligned with Idaho’s specific needs and priorities. From this list, the top six topics were selected for further investigation. By adopting this strategic approach, ITD aims to enhance the efficiency and effectiveness of its bridge-related research efforts, ultimately contributing to safer and more resilient transportation infrastructure. This paper could be a helpful resource for other DOTs seeking a systematic approach to addressing their bridge research needs. Full article

Integrated Reporting (IR) has gained prominence as a comprehensive approach to corporate disclosure, yet theoretical clarity is still developing regarding how governance mechanisms shape IR quality and its relation to ESG risk ratings. Addressing this gap, this study explores the influence of board and audit committee characteristics on IR quality and whether an improved IR quality is associated with a lower ESG risk. Drawing on different theories, this research examines how governance structures enhance transparency and accountability in line with societal expectations. Based on panel data from 158 firms across four years (2019–2022), a random effects Panel EGLS regression model is employed along with an endogeneity check. Findings show that board independence and the presence of women members significantly enhance the IR quality, while board size is not a determining factor. Similarly, audit committee independence and meeting frequency positively influence the IR quality, whereas committee size does not. Furthermore, firms with a higher IR quality demonstrate significantly lower ESG risk scores. These results underscore the theoretical proposition that effective governance improves disclosure credibility and reduces information asymmetry. This study suggests that reinforcing board independence and diversity can enhance reporting quality and stakeholder trust, offering a strategic path toward more sustainable and transparent corporate behavior. Full article

This study explores the key factors driving corporate social responsibility disclosure (CSR_DISC) by Takaful insurance companies (TKIs) in Saudi Arabia during and after the COVID-19 pandemic. We use content analysis and follow an unweighted scoring method to score the CSR_DISC index. Based on a sample of 26 Saudi-listed TKIs, for the period 2020–2024, we employ Poisson panel and negative binomial panel models to examine the interdependent relationships between CSR_DISCs and a set of corporate governance factors. We find that Saudi TKIs increased their CSR_DISCs in their financial reporting during and after the COVID-19 crisis. These findings confirm that board and firm size have a significant and negative effect on corporate CSR_DISC. However, the number of independent board members and female directors positively affect the extent of CSR_DISCs. Finally, the size of the audit committee and the Shariah supervisory board, frequency of board meetings, and profitability do not affect CSR_DISCs. Full article

Background/Objectives: Heart failure (HF) poses a significant global health burden. In Spain, its prevalence rises annually, contributing significantly to cardiovascular-related hospitalizations and deaths. Through a broad and integrative perspective, the CARABELA-HF initiative seeks to improve the organization and delivery of HF care in Spain, addressing the key challenges identified across the care continuum. Methods: CARABELA-HF involved four phases: characterization of HF care models, validation of improvement areas, potential solutions and healthcare quality indicators, refinement of results from a regional perspective, and local dissemination and implementation. Ten pilot centers participated, and nine variables were identified to characterize operating HF care models. Results: Four HF care models were identified based on the degree of coordination between departments and resource availability. Structure, quality of care, and transformation indicators were used to evaluate these models, revealing improvement areas. Overall, this process identified solutions for generating a comprehensive and integrated HF care model, highlighting enhanced coordination, digital transformation, enhanced nursing roles, professional training and patients’ education, accredited HF care models, resource accessibility, and data-based evaluation. Conclusions: CARABELA-HF provides insights into current HF care models in Spain and identifies healthcare quality indicators for future improvement efforts. It strives to enhance patient outcomes, raise healthcare standards, and improve overall system efficiency through the promotion of a comprehensive and integrated HF care pathway. Full article

This research examines how corporate governance (CG) affects corporate social responsibility (CSR) disclosure with government ownership as a moderation factor by analyzing panel data from 30 industrial firms listed on the Amman Stock Exchange during 2018–2022. The study employed board of directors and audit committee characteristics as independent variables to represent CG while developing a CSR disclosure index. The research controlled for company size and financial leverage in its model. The findings demonstrate that corporate governance dimensions affect CSR disclosure, while government ownership significantly enhances this relationship in a positive direction. Government ownership increases R² values, which shows that corporate governance merged with government ownership modifies the corporate governance and CSR disclosure relationship by strengthening the impact when government stakes rise. Statistical analysis revealed that board independence, board duality, audit committee size and independence, along with audit committee meeting frequency, all had positive effects on CSR disclosure. The study found no statistically significant effect of board size, frequency of board meetings, or the financial expertise of audit committee members on CSR disclosure. Based on the findings, this study outlines recommendations to strengthen governance practices that support social disclosure. Full article

The existence of a natural hybridization zone of members of the Triatoma brasiliensis complex in Pernambuco, a Brazilian state with areas highly infested by Trypanosoma cruzi vectors, raised questions to be studied about the vectorial capacity of these hybrids. Recently, it was demonstrated that experimental hybrids of T. brasiliensis brasiliensis and Triatoma juazeirensis present vectorial competence superior to that of the parental species. The objective of the present study was to compare bionomic aspects related to the vectorial capacity of T. b. brasiliensis, T. juazeirensis, and their experimental hybrids. Feeding and defecation behavior patterns in fifth instar nymphs were comparatively analyzed between four groups, two parental and two hybrids, respectively: T. b. brasiliensis, T. juazeirensis, Hjb (♀ T. juazeirensis × ♂ T. b. brasiliensis), and Hbj (♀ T. b. brasiliensis × ♂ T. juazeirensis). Fifteen newly molted fifth instar nymphs from each of the mentioned groups were previously subjected to a period of fasting for 10 days and individually kept in identified bottles. In the experiment, the insects were placed in a jar containing a mouse immobilized in nylon mesh, in accordance with the guidelines of the animal ethics committee. The following variables were observed: 1-total number of feedings carried out; 2-time to start feeding; 3-duration of feeding and weight acquired; 4-defecations during feeding; 5-defecation within one minute after cessation of feeding; 6-defecation within ten minutes after cessation of feeding; 7-defecation behavior. Specimens from all groups demonstrated voracity, starting their meal immediately after contact with the mouse, and most of the insects defecated immediately after feeding, with 78% of the insects defecating within 30 s. The results obtained suggest that T. brasiliensis, T. juazeirensis, and their experimental hybrids presented bionomic characteristics compatible with the species considered good vectors in the literature. However, T. b. brasiliensis and T. juazeirensis demonstrated even more effective characteristics for T. cruzi transmission regarding their feeding and defecation patterns when compared to their hybrids. Full article

Confronted with the climate emergency, reducing CO₂ emissions has become a priority for all nations of the world because the follow-up of humanity depends on it. Most European Union (EU) member states have pledged to cut their net greenhouse gas emissions by at least 55% by 2030 and reach full carbon neutrality by 2050, using 1990 as the baseline year. Despite this common effort, there is still a lack of effective decision-making on carbon neutrality strategies applied throughout the life cycle of a building in all EU countries. A common strategy is proposed in this study to fill this gap in the literature. The building sector is a real lever for reducing the carbon footprint and saving energy. Currently, the methodology for achieving large-scale carbon neutrality is well established. However, there is only a limited number of experts worldwide who have mastered this technology, making it challenging to develop a standardized approach for all nations. The absence of extensive, regular, and consistent data on carbon emissions has considerably hindered the understanding of the root causes of climate change at both the building and neighborhood levels. Is it not it time to break this barrier? With this in mind, this study was carried out with the intention of proposing a common method to achieve carbon neutrality at the neighborhood scale in European Union countries. The most significant parameters having a direct impact on carbon emissions have facilitated the adaptation of the three types of neighborhood in the different capitals of the EU countries, in particular, local building materials, microclimate, the energy mix of each country, and the mode of daily transport. The life cycle assessment of the three districts was conducted using the Plaides LCAv6.25.3 tool in combination with Meteonorm software version 8.2.0, considering a 100-year lifespan for the buildings. In addition, the cost of the various environmental impacts is assessed based on the monetary indicators for European Committee for Standardization indicators method. The main results showed that the distribution of carbon dioxide is 73.3% higher in urban areas than in sustainable neighborhoods and 39.0% higher in urban districts than in rural districts. Nearly zero emissions in the next decade are again possible by applying the scenario involves global warming combined with the complete (100%) renovation of all buildings and the transition to 100% electric vehicles along with the use of solar panels. This strategy makes it possible to reduce between 90.1% and 99.9% of the emission rate in residential districts regarding EU countries. Full article

Background and purpose: When a family becomes aware of family symptoms, family resilience is defined as its power to autonomously and actively improve its own family functions. A quantitative assessment of family resilience is essential in the practice of family nursing. The purpose of this study was to develop a self-assessment scale for family resilience based on the theoretical foundation of the Concentric Sphere Family Environment Theory (CSFET), and to examine the scale’s reliability and validity. Methods: Based on 23 categories obtained from previous studies clarifying family conditions demonstrating family resilience, the Assessment Scale for Insufficiencies in Family Resilience (IFR), consisting of 21 items, was developed through content validity examinations by an expert committee and through face validity examinations for family members. The reliability and validity of the IFR were examined for families with children or with family members requiring care. Results: Temporal stability over a 2-week interval, which was assessed in 26 subjects, was supported by a high and significant correlation coefficient. The following statistical analysis was performed based on the responses of 206 subjects. The Cronbach’s alpha coefficient showed high internal consistency reliability. The total IFR score showed a moderately significant correlation with the family function score and the family support demands score, demonstrating acceptable criterion-related validity. Exploratory factor analysis confirmed the fit of a five-factor model based on the five systems of CSFET, and construct validity was supported. Conclusions: The reliability and validity of the IFR, which is composed of five factors and 21 items based on the CSFET, were confirmed, making the IFR a viable self-assessment scale for determining the level of family resilience. Full article

PK-12 Equity Directors (EDs) are tasked with addressing systemic inequities. The scope of their responsibilities is influenced by role configuration or placement within the organizational structure and the authority they are granted. Limited research has explored how role stress stemming from ambiguous or conflicting directives linked to role configuration affects EDs’ capacity to address systemic inequities. This organizational autoethnographic study examines how role stress because of my role configuration influenced my ability to address systemic inequities over 26 months, using reflective journal entries triangulated with artifacts and documents. The findings demonstrate that I experienced role ambiguity as my position had substantive unstructured time that sometimes made me feel I was not contributing to district goals of addressing systemic inequities. However, after recognizing my authority in different ways, this unstructured time allowed me to pursue projects aligned with my expertise and interests. I also encountered role conflict when leading employee teams who volunteered outside their contracted hours. The voluntary nature of their involvement limited consistent collaboration and forced me to be strategic about employee involvement in equity initiatives. The implications of this study suggest that supervisors should carefully balance EDs’ autonomy with structured support to foster sustainable equity efforts. Furthermore, district leaders must align volunteer committee members’ time commitments and expectations with the scope and demands of equity initiatives to ensure effective collaboration. Full article

Recently, studies have highlighted the impact of factors such as environmental, corporate governance, and social performances on companies’ sustainability activities. Therefore, the current study focuses on the impact of environmental and social activities of manufacturing and service enterprises operating in the transportation sector, which is at the forefront of pollutant component production, on sustainability disclosures. For this purpose, how the size of the board of directors in the transportation sector affects environmental sustainability disclosures and the mediating effect of the existence of a sustainability committee (SC) on ecological sustainability disclosures are discussed. For this, panel data analysis was carried out with the data of 47 companies operating in the transportation sector of European Union member countries between 2005 and 2020. The paper’s conclusions demonstrate that increasing board size and adding an SC to the board of directors will improve a company’s environmental performance. They also shows that the relationship between board size and environmental sustainability performance will be improved by the presence of an SC. The paper demonstrates that incorporating environmental sustainability initiatives into the strategic decision-making procedures of manufacturing and service firms in the transportation sector can offer another perspective to its stakeholders, policymakers, and sector organizations. Full article

Background: Workers in healthcare facilities can encourage and serve as role models for the general population regarding vaccination. The information source preferences of employees in healthcare facilities can play an important role in their decisions to receive COVID-19 and seasonal influenza vaccinations (SIVs). A study of specific channels of information and their impact on vaccine acceptance could provide valuable insights. Methods: A cross-sectional questionnaire-based survey was conducted during the first semester of 2021 among 2592 staff members in healthcare facilities (primary, secondary and tertiary). Results: Higher odds of seasonal influenza vaccination (SIV) acceptance were found among staff who were informed by the National Public Health Organization (NPHO) (adjusted Odds Ratio (aOR): 1.47, 95% confidence intervals (CI): 1.13–1.90), the Hellenic Ministry of Health (HMH) (aOR: 1.50, 95% CI: 1.16–1.94) and the Healthcare Facilities Infection Control Committees (ICC) (aOR: 1.35, 95% CI: 1.06–1.73). Professionals who were more willing to accept a COVID-19 vaccine were more likely to obtain information from television (aOR: 1.43, 95% CI: 1.08–1.92), the ICC (aOR: 1.36, 95% CI: 1.03–1.81), the NPHO (aOR: 1.71, 95% CI: 1.28–2.28) and the HMH (aOR: 1.68, 95% CI: 1.26–2.26). Social media presented no statistically significant association with either COVID-19 vaccine acceptance or SIV. Conclusions: Workers in healthcare facilities who received information from highly credible organizations were more likely to accept vaccines. Television was effective in disseminating COVID-19 vaccine campaigns. Full article

The rapid proliferation of the Internet of Things (IoT) poses significant challenges for utility optimization in sharding blockchain systems. In this paper, we propose a Committee Scheduling Algorithm (CSA), which employs an iterative optimization framework based on the Markov chain to balance transaction throughput, cumulative latency, and transaction fees. CSA dynamically adjusts the committee members to achieve near-optimal solutions while addressing operational constraints. Theoretical analysis demonstrates the convergence bounds of the algorithm and its robustness against Sybil and eclipse attacks, ensuring high entropy for committee selection. Experimental results show that CSA outperforms Stochastic-Exploration (SE), Simulated Annealing (SA), and Policy Gradient-Based Computing Task Scheduling (PG-CTS) in terms of utility, convergence speed, and adaptability to dynamic events, with the committee scheduling utility improving by about 30%. Furthermore, CSA demonstrates stable performance in large-scale IoT environments characterized by dynamic node additions and failures. This paper offers a robust and adaptive solution for utility optimization in sharding blockchains, thereby improving the scalability, security, and efficiency of IoT applications. Full article