A case study of performance-based pavement maintenance and rehabilitation needs assessment in Pennsylvania

This paper presents the theory,method,and application of performance-based pavement needs assessment at a state level,using the Pennsylvania Interstate System as an example.First,a general framework is presented for the pavement asset management and a general optimization model is established for the pavement maintenance and rehabilitation needs assessment.Also,the bundling of pavement segments for the project implementation is discussed.Using the examples of Statewide Transportation Improvement Plan and Long Range Transportation Plan for Pennsylvania Interstate System,the application of performance-based pavement needs assessment is demonstrated.It is shown that unconstrained analysis can help decision-makers investigate the real maintenance and rehabilitation needs;financially-constrained analysis can help decision-makers select projects for implementation and examine the corresponding future pavement conditions.Trade-off analysis can help decision-makers investigate the outcomes of different investment levels on pavement maintenance and rehabilitation and make the final decision on the investment level.The proposed case study provides a good example of performance-based pavement needs assessment for developing countries.

What do coaches want to know about sports-related concussion?A needs assessment study

Purpose: This study aims to identify the concussion-related training and education needs of Gaelic Athletic Association(GAA) coaches in Ireland,as well as the preferred method of concussion education delivery.Methods: We used a self-report questionnaire to collect data from a convenience sample of 108 GAA coaches in Ireland. Data were captured on(1) informational needs and desires,(2) preferred methods of delivery, and(3) concussion practices and procedures. Questionnaires were completed electronically from June 3 rd–September 29 th, 2015.Results: Coaches indicated that they were most interested in receiving information about the(1) signs and symptoms of concussion,(2) assessment of concussion, and(3) return-to-play guidelines. Over two-thirds of participants indicated that in-person training would be the most effective mode of delivery of concussion education for this population. Additionally, only 10% coaches reported that before the start of the season they talked to their athletes about concussion management and safety, and this was more common among coaches who reported being formally educated about concussion.Conclusion: Our findings reveal a disconnect between the concussion education needs and the education that is currently provided to GAA coaches, in terms of content and delivery modality. Our results suggest a need for a multifaceted approach to concussion education, tailored to the needs and learning preferences of the target population.

Community Needs Assessment in Relation to Urban Heat Effects: A Study in Greater Kuala Lumpur, Malaysia

Urban areas usually experience higher temperatures compared with their rural surroundings; this is characterized as urban heat islands （UHIs）, which are the result of environmental overheating due to anthropic activities. Urban areas,which are characterised by massive construction that reduce local vegetation coverage, are subject to the absorption of a large amount of solar radiation,which is only partially released into the atmosphere by radiation in the thermal infrared.

Are High School Students Ready to Stop the Bleed from Injuries? Needs Assessment in a Low Resource Country

Background: Life-threatening bleeding is a major cause of trauma-related deaths. Stop the Bleed—Active bleeding control (ABC) program in Hyderabad recently showed that lay first responders can be effectively trained. However, the willingness of high school students to train in bleeding control is unknown. We report Stop the Bleed training needs assessment from high schools in India and estimate the potential multiplier effect. Methods: A cross-sectional survey was conducted from 12 randomly selected schools in Hyderabad. The study was to understand current knowledge, skills and willingness to get trained and respond to life-threatening bleeding from injuries. 107 Participants (35 Teachers and 72 students) were purposively selected for telephonic interviews with a structured questionnaire. Results: Response rate was 93% overall. 80% of participants have never been trained in bleeding control. 84% reported willingness to be trained, train others and help bleeding victims. All the teachers reported that stop the bleed training would be useful in high schools. 70.6% of teachers recommended that training could start from middle school (10 to 15 years), 47% preferred the online training mode. Only 20% of participants had prior training in lifesaving first aid and 32% did not know the number of emergency medical services (EMS). Each trained participant has the potential to train 3 to 4 people at the household level and perhaps more at the community level. Conclusion: The surveyed schools in Hyderabad do not have the knowledge, skills, or training curriculum in Stop the Bleed. Students and teachers are willing to be trained and train others, with great potential for a “multiplier-effect” in the community.

Assessment of community health needs of Chongqing residents: a qualitative study

Objective: The aim of this preliminary qualitative study was to gain insight into community health needs in order to develop health program for community in Chongqing. Methods: Totally 40 participants were assigned into 6 focus group discussions. All groups were led by local language speakers, and their talking was recorded after gaining informed consent. Transcribed data were coded and subjected to thematic analysis. Results: The main obtained themes were that community health problems were chronic noncommunicable disease, main health service needs included regularly free check-up and health education, and perceived health risk factors were unhealthy lifestyle and behavior as well as environment problems. Conclusion: Our community health needs assessment (CHNA) with FGDs indicate that residents realize the importance of prevention of disease. Our study identifies that primarily community health promotion is one of the priorities of community health service needs, including reorienting health service, health education, guiding behavior or lifestyle, and creating healthy environments. The findings of this study can provide guidance to the development of more effective and pertinent health program in this community.

Research-training needs of clinical nurses: A nationwide study among tertiary hospitals in China

Objective: This study aimed to evaluate Chinese tertiary hospital nurses' research output,research ability,and their related training needs regarding scientific research methodology and analyze the relations among them.Methods: A nationwide survey was conducted in China on a large sample of tertiary hospital nurses (n =27,335) recruited from 22 provinces,autonomous regions,and municipalities.A validated,self-designed questionnaire,consisted of a common questionnaire,the Science Research Skills Self-Rating Questionnaire (SRSQ) and the Scientific Research Training Needs Questionnaire (SRTNQ) were used to assess nurses' research output,self-rated research skills and research-training needs.Results: The nurses' scientific research participation rates (with 4.13%,7.85%,5.35%,and 2.04% in research projects,research attendance,papers published,and patent,respectively) and their self-rated research skills 25.00 (12.50,37.50) were very low.However,the research training needs were relatively high 53.12(37.50,75.00).Significant differences in research participation rates (research projects,research attendance,papers published,and patent),scientific research skills,and research-training needs were determined by age,highest education level,nursing experience,employment,technical title,administrative post,and clinical tutoring experience (P< 0.05).Female and male nurses had different research participation rates (only research projects and studies published) and scientific research skills (P < 0.05).Positive correlations were observed among research output,scientific research skills,and researchtraining needs (P < 0.01).Conclusions: Nurses' scientific research participation and self-rated research ability were below the optimal despite that they had relatively high research-training needs.Nurses should be provided further research training with tailored content to their characteristics and capacity.

Palliative care needs and symptom burden in younger and older patients with end-stage renal disease undergoing maintenance hemodialysis:A cross-sectional study

Objectives:To investigate the current situation of palliative care needs and the symptom burden in patients with end-stage renal disease(ESRD)undergoing maintenance hemodialysis(MHD),and to explore whether there are differences between younger and older patients.Methods:This cross-sectional study was conducted in the hemodialysis centers of two tertiary hospitals from November 2021 to June 2022.Participants were selected by convenience sampling.Sociodemographics,clinical characteristics,the Palliative Care Outcome Scale(POS),the Dialysis Symptom Index(DSI),and health-related quality of life(EQ-5D-3L)were used for evaluation.Descriptive statistics,between-group comparisons,and correlation analysis were used to analyze the data.Results:A total of 236 patients were enrolled,including 118 younger and 118 older patients.The total median(P25,P75)POS score was 16.0(12.0,23.0),and the score was higher in older patients(P<0.01).The mean total number of symptoms in MHD patients was 15.04±5.06,and the overall median symptom severity score was 59.0(52.0,71.0);these scores were higher in the older group(P<0.01).The most common symptom was dry mouth(91.5%),followed by itching(83.1%),and dry skin(82.2%).Additionally,palliative care needs were significantly associated with symptom burden and health-related quality of life(HRQOL).Conclusions:The results showed that patients with ESRD undergoing MHD have a significant symptom burden and moderate palliative care needs,which are more severe in older patients.Therefore,interdisciplinary teams should be formed to actively manage patients’symptoms and meet the physical,psychological,social,and spiritual needs related to palliative care to improve patients’HRQOL.

Myocardial infarction patients' learning needs: Perceptions of patients, family members and nurses

Purpose: This descriptive study aimed to identify and compare patient with myocardial infarction,their family member,and cardiac nurse perceptions on the learning needs of patients with myocardial infarction in the acute,sub-acute,and post-acute phases.Methods: A total of 288 patients with myocardial infarction,145 family members,and 40 cardiac unit nurses were enrolled in this study.Data were collected by survey method using the Cardiac Patient Learning Need Inventory (CPLNI).Data analysis was done using descriptive statistical analysis and analysis of variance.Results: The results showed that the learning needs of patients with myocardial infarction were high according to the perceptions of patients,patients' family members,and nurses.There were differences in the priority of learning that the patient need in relation to the disease and healing process.Conclusion: Patients,family members,and nurses have different perceptions regarding the learning needs of patients with myocardial infarction.To create adequate intervention to meet patient's learning needs,there should be an accurate assessment.The results of this study support the importance of patient-centered,individualized education and attention to learning priorities.

Reliability and validity of the Chinese version of spiritual needs questionnaire with 27 items (SpNQ-Ch-27) in cancer patients

Objective: To evaluate the reliability and validity of the Chinese version of the Spiritual Needs Questionnaire with 27 items (SpNQ-Ch-27) for cancer patients.Methods: A total of 457 cancer patients in a tertiary hospital in Xinjiang from March to July in 2017 were investigated by using the SpNQ-Ch-27 and convenient sampling method.They were recruited to validate the discrimination,reliability,and validity of the scale.According to the odd and even questionnaire numbers,data were divided into two groups to do exploratory factor analysis group and confirmatory factor analysis,respectively.Results: SpNQ-Ch-27 included 27 items and six factors,which were extracted by using factor analysis.It could explain 63.08% of the total variance.The total scores of each dimension and the SpNQ-Ch-27 were highly correlated,and the correlation coefficient was from 0.58 to 0.78.For the CFA,the overall fitting ideal was x2/df=2.00,RMSEA =0.07,IFI =0.93,NFI =0.86,CFI =0.92,TLI =0.90;Cronbach's α =0.90;the dimensions of Cronbach's α =0.63-0.95;split-half reliability was 0.82,dimensions were 0.68-0.95.Conclusion: SpNQ-Ch-27 is applicable for Chinese cancer patients with better validity and higher internal consistency,and it can be used as a tool to assess the spiritual needs of cancer patients.

Reliability and validity of the Chinese version of the Head and Neck Information Needs Questionnaire for patients with head and neck cancer and their caregivers

Objectives:This study aimed to assess the reliability and validity of the Chinese version of the Head and Neck Information Needs Questionnaire(HaNiQ).Methods:The HaNiQ was translated into a Chinese version using internationally recognized forwardand back-translation procedures.The reliability and validity of the HaNiQ were measured using Cronbach’s a coefficient,split-half reliability,exploratory factor analysis,and Pearson correlation analysis.Results:A total of 207 patients in different head and neck cancer(HNC)stages and 174 caregivers completed the Chinese version of the HaNiQ.Internal consistencies varied between good and very well(Cronbach’s α coefficient 0.74-0.90);the split-half coefficient and the content validity index(CVI)of the questionnaire were 83.5%and 83.33%,respectively.The cumulative contribution rates of the 5 subscales in patients with HNCand their caregivers were 62.41%and 61.19%,respectively.However,there are some differences between the Chinese questionnaire for caregiver and the original questionnaire regarding the attribution of items.Items 22,23,and 27 in the Psychosocial subscale of the English version were assigned to the Survivorship subscale in the Chinese version for caregivers.Conclusions:The results demonstrated that the Chinese version of the HaNiQ is a reliable and valid instrument for measuring the information needs of patients with HNC and that of their caregivers.Though the structure of the Chinese versionwas different from the English version for caregivers of HNC patients,the Chinese version of the HaNiQ appears to be reliable and would benefit from further testing.

Outpatient Experience of Human Caring Scale （OEHC-Scale）： Improvement by Delphi Method

Based on the outpatient interview and literature review, the initial framework of the outpatient experience of human caring scale was formed with 9 dimensions of outpatient process. The research aim was to improve the scale by Delphi method. Sixteen experts in medical management, human caring or medical education were invited to evaluate the importance of the dimensions and items of the scale and provided some expertise via filling out the DeLphi consultation questionnaires twice in the consulting round. In the first round, the recovery rate showing the experts＇ positivity was 80%; the coefficient of reliability （Cr） ascertaining the authority of the evaluation was 0.92; the mean and full mark ratios responding the concentration of the evaluation were 2.88-4.94 and 6.25%-93.75% respectively; the coefficients of variation （CV） and the Kendall＇s W determining the concordance of the evaluation were 5.06%-52.15% and 0.21-0.24 respectively. In the second round, the recovery rate was 93.75%; the Cr was 0.93; the mean was 3.93-4.93; the full mark ratios were 26.67%-93.33%; the Kendall＇s W was 0.14- 0.31, the CV was 5.25%-23.61%. Via the two-round Delphi study, the scale that included 10 dimensions and 61 items has been improved. Ten dimensions are pre-hospital medical service, guidance, registration, waiting, diagnosis ＆ treatment, paying, inspection ＆ assay, medicine receiving, therapy/injection/transfusion and global evaluation. It was concluded that Chinese scholars have paid high attention to human caring and outpatient experience. The experts have given high agreements about the dimensions which were established with Chinese outpatient process. The dimensions are different from the similar researches about outpatient experience study. In the future, it is necessary to survey the outpatients to test the construct validity, internal consistency reliability and others of the scale to improve the scale.

Demand analysis of an intelligent medication administration system for older adults with chronic diseases based on the Kano model

Objectives Gerontechnology has great potential in promoting older adults’well-being.With the accelerated aging process,gerontechnology has a promising market prospect.However,most technological developers and healthcare professionals attached importance to products’effectiveness,and ignored older adults’demands and user experience,which reduced older adults'adoption intention of gerontechnology use.The inclusion of older adults in the design process of technologies is essential to maximize the effect.This study explored older adults’demands for a self-developed intelligent medication administration system and proposed optimization schemes,thus providing reference to developing geriatric-friendly technologies and products.Methods A cross-sectional survey was conducted to explore older adults’technological demands for the self-developed intelligent medication administration system,and data were analyzed based on the Kano model.A self-made questionnaire was administered from July 2020 to October 2020 after participants used this system for two weeks.The study was registered with the Chinese Clinical Trial Registry(ChiCTR2000040644).Results A total of 354 older adults participated in the survey.Four items,namely larger font size,simpler operation process,scheduled medication reminders and reliable hardware,were classified as must-be attributes;three items,namely searching drug instructions through WeChat,more sensitive system and longer battery life,as attractive attributes;one item,viewing disease-related information through WeChat,as the one-dimensional attribute;and the rest were indifferent attributes,including simple and beautiful displays,blocking advertisements automatically,providing user privacy protection protocol,viewing personal medical information only by logged-in users,recording all the medications,ordering medications through WeChat.The satisfaction values were between 0.24 and 0.69,and dissatisfaction values were between 0.06 and 0.94.Conclusion This study suggested that older adults had personalized technology demands.Including their technological demands and desire may assist in decreasing the digital divide and promoting the satisfaction of e-health and/or m-health.Based on older adults’demands,our study proposed optimization schemes of the intelligent medication administration system,which may help developers design geriatric-friendly intelligent products and nurses to perform older adults-centered and efficient medication management.

Truck Cab Design： Perceptions of Women Truck Drivers

The trucking industry is a major force behind the United States （US） economy with approximately 750,000 interstate motor carriers. Trucks deliver 70% of all freight tonnage while 80% of U.S. communities receive goods exclusively by truck. The motor carrier industry provides jobs, generating significant income and tax revenue, representing approximately 5% of U.S. GDP （gross domestic product）. Despite one of every 13 people employed in a trucking-related job, there is a significant driver shortage. The ATA （American Trucking Associations） currently projects a shortage of 20,000 to 25,000 drivers in the for-hire truckload market. Women are well positioned to address this shortage. In 2011, women represented 7% of total employment in the U.S. trucking industry. The purpose of this study was to identify truck design needs for women truck drivers. This research is significant due to limited data sources about truck design needs for women drivers. This study also contributes to the body of knowledge about women in the trucking industry. In response, a 33-question survey was developed using QualtricsTM survey software. In April, 2012, an electronic survey was distributed to 663 Women in Trucking Association members over a two-week period with a response rate of 18%. Results were separated into quantitative and qualitative data and analyzed accordingly. Adjustability was a central issue facing women truck drivers. Recommendations for seat design, side mirrors, steps, handrails, hydraulic hood lifters, and steering consoles will be presented. Limitations of the study and recommendations for future research will be discussed.

Motivations and Training Needs of General Practitioner Preceptors

Background：General practitioner （GP） preceptors play an important role in the cultivation of GPs.Many problems exist in the training of GP preceptors.This study aimed to explore the willingness and training needs of GP preceptors and compare the differences between preceptors from general practice and other specialties.Methods：A total of 375 questionnaire forms were sent to 375 GP preceptors from 11 different provinces,and 344 completed forms were returned.The main outcome included general information,teaching motivations,and training needs of GP preceptors.Results：The study showed that about 89.2% of GP preceptors were willing to be teachers.The majority of respondents strongly agreed that the motivation for becoming a GP supervisor was to learn from teaching.The most important capability they should master was clinical teaching （92.2%）,followed by lecture （83.1%） and doctor-patient communication （83.1%）.The top three preferred methods of GP preceptors training were case discussion （78.8%）,workshop （57.6%）,and classroom teaching （56.4%）.The domains in which most GP preceptors wanted to acquire knowledge and skill were mental health （59.3%）,rehabilitation （47.1%）,pediatrics （41.0%）,and obstetrics （37.5%）.No significant differences were found in the willingness to train GPs （x2 =3.34,P 〉 0.05） and whether they would become or continue to become a GP supervisor after the training （x2 =l.106,P 〉 0.05）.Conclusions：Although most preceptors were under on-the-job training,they were glad to train GPs.To be qualified,preceptors should be trained according to the actual needs of GP preceptors.