Multi-professional collaboration is being promoted worldwide as a response to the need for sophisticated medical care and for catering to patients’ diverse needs. Patients in Intensive Care Units (ICUs) are seriously...Multi-professional collaboration is being promoted worldwide as a response to the need for sophisticated medical care and for catering to patients’ diverse needs. Patients in Intensive Care Units (ICUs) are seriously ill, and their families may be at risk depending on the patient’s situation. Considering these characteristics of patients and families, there is a strong need for multi-professional collaboration within ICUs. The purpose of this descriptive study was to examine recognition and other factors related to collaboration and satisfaction involving care decisions in Japanese ICUs. A mail survey about collaboration of activities and systems was sent to physicians, clinical engineers, and nurses working in ICUs in Japan, 387 consented to participate in this study. Results showed that satisfaction scores were generally high among the three aforementioned professions, but collaboration scores on deciding care for patients showed significant differences (p < 0.05). The total collaboration score was the highest among physicians (36.7 ± 6.7 points), followed by nurses (32.8 ± 7.4 points), and CEs (32.8 ± 7.4 points). The factors that commonly affected collaboration scores were the satisfaction score and the ability to collaborate with other professionals and set team medical care as a goal. Moreover, it is worth noting that the degree of difficulty in collaboration negatively affected this factor. On the other hand, other factors differed among the three professions, suggesting that the purpose and need for collaboration differ depending on the profession.展开更多
I the context of the Corporate Governance Code enactment in Japan, we examine how newly introduced outside directors in Japanese boards obtain information to take part in the decision-making process. We conducted a sy...I the context of the Corporate Governance Code enactment in Japan, we examine how newly introduced outside directors in Japanese boards obtain information to take part in the decision-making process. We conducted a systematic review of the literature and found 18 peer-reviewed publications in a time span between 2000 and 2016 that described the asymmetry of information between the insider group of board directors （including the CEO） and the outside board members. Our fmdings show that for the course of more than a decade, despite all changes and reforms, the role of board directors, whether insiders or outsiders, is still supplementary. They are treated more as advisors than active part in the decision-making process. We reveal different insider sources of information as forming social ties with the CEO and/or inside board directors and collaboration with Audit ＆ Supervisory Board （Kansayaku）, which can help reduce this asymmetry and improve the decision-making process. We assume that it will be easier for the outsiders to establish contacts and form social ties with the Audit ＆ Supervisory Board members because of their unspoken lower status and thus to obtain more information about the company internal affairs and discussions that take place during the informal meetings, where only insiders （including the CEO） are present.展开更多
Several models of multi-criteria decision-making(MCDM)have identified the optimal alternative electrical energy sources to supply certain load in an isolated region in Al-Minya City,Egypt.The load demand consists of w...Several models of multi-criteria decision-making(MCDM)have identified the optimal alternative electrical energy sources to supply certain load in an isolated region in Al-Minya City,Egypt.The load demand consists of water pumping system with a water desalination unit.Various options containing three different power sources:only DG,PV-B system,and hybrid PV-DG-B,two different sizes of reverse osmosis(RO)units;RO-250 and RO-500,two strategies of energy management;load following(LF)and cycle charging(CC),and two sizes of DG;5 and 10 kW were taken into account.Eight attributes,including operating cost,renewable fraction,initial cost,the cost of energy,excess energy,unmet load,breakeven grid extension distance,and the amount of CO_(2),were used during the evaluation process.To estimate these parameters,HOMER®software was employed to perform both the simulation and optimization process.Four different weight estimation methods were considered;no priority of criteria,based on a pairwise comparisons matrix of the criteria,CRITIC-method,and entropy-based method.The main findings(output results)confirmed that the optimal option for the case study was hybrid PV-DG-B with the following specification:5 kW DG,RO-500,and load following control strategy.Under this condition,the annual operating cost and initial costs were$5546 and$161022,respectively,whereas the cost of energy was 0.077$/kWh.The excess energy and unmet loads were 40998 and 2371 kWh,respectively.The breakeven grid extension distance and the amount of CO_(2) were 3.31 km and 5171 kg per year,respectively.Compared with DG only,the amount of CO_(2) has been sharply reduced by 113939 kg per year.展开更多
The COVID-19 pandemic has a significant impact on the global economy and health.While the pandemic continues to cause casualties in millions,many countries have gone under lockdown.During this period,people have to st...The COVID-19 pandemic has a significant impact on the global economy and health.While the pandemic continues to cause casualties in millions,many countries have gone under lockdown.During this period,people have to stay within walls and become more addicted towards social networks.They express their emotions and sympathy via these online platforms.Thus,popular social media(Twitter and Facebook)have become rich sources of information for Opinion Mining and Sentiment Analysis on COVID-19-related issues.We have used Aspect Based Sentiment Analysis to anticipate the polarity of public opinion underlying different aspects from Twitter during lockdown and stepwise unlock phases.The goal of this study is to find the feelings of Indians about the lockdown initiative taken by the Government of India to stop the spread of Coronavirus.India-specific COVID-19 tweets have been annotated,for analysing the sentiment of common public.To classify the Twitter data set a deep learning model has been proposed which has achieved accuracies of 82.35%for Lockdown and 83.33%for Unlock data set.The suggested method outperforms many of the contemporary approaches(long shortterm memory,Bi-directional long short-term memory,Gated Recurrent Unit etc.).This study highlights the public sentiment on lockdown and stepwise unlocks,imposed by the Indian Government on various aspects during the Corona outburst.展开更多
On account of the lack of monetary unit sampling( MUS), an extended audit game model based on uncertainty information,which centers on audit risk and combines audit game with statistical sampling,is established to imp...On account of the lack of monetary unit sampling( MUS), an extended audit game model based on uncertainty information,which centers on audit risk and combines audit game with statistical sampling,is established to improve the effectiveness of audit risks analysis and sampling errors control. In this paper,an example concerning practical problems is given to demonstrate the process of extended audit game and confirm the truth of the effectiveness of the method. Not only does this method enhance the role of audit technology and the extension of audit procedures in deterring material irregularities,but also helps the auditors measure and control audit risk and sample sizes under uncertainty,conducive to improving the effect of cost control,risk evaluation,and decisionmaking optimization in audit sampling.展开更多
Physical restraint is a common nursing intervention in intensive care units and nurses often use it to ensure patients'safety and to prevent unexpected accidents.However,existing literature indicated that the use ...Physical restraint is a common nursing intervention in intensive care units and nurses often use it to ensure patients'safety and to prevent unexpected accidents.However,existing literature indicated that the use of physical restraint is a complex one because of inadequate rationales,the negative physical and emotional effects on patients,but the lack of perceived alternatives.This paper is aimed to interpret the clinical decision-making theories related to the use of physical restraint in intensive care units in order to facilitate our understanding on the use of physical restraint and to evaluate the quality of decisions made by nurses.By reviewing the literature,intuition and heuristics are the main decision-making strategies related to the use of physical restraint in intensive care units because the rapid and reflexive nature of intuition and heuristics allow nurses to have a rapid response to urgent and emergent cases.However,it is problematic if nurses simply count their decision-making on experience rather than incorporate research evidence into clinical practice because of inadequate evidence to support the use of physical restraint.Besides that,such a rapid response may lead nurses to make decisions without adequate assessment and thinking and therefore biases and errors may be generated.Therefore,despite the importance of intuition and heuristics in decision-making in acute settings on the use of physical restraint,it is recommended that nurses should incorporate research evidence with their experience to make decisions and adequate assessment before implementing physical restraint is also necessary.展开更多
The efforts by the Financial Reporting Council （FRC） in the United Kingdom （UK） to stimulate audit firms to improve audit quality manifest in its Discussion Paper： Promoting Audit Quality warrant further analysis...The efforts by the Financial Reporting Council （FRC） in the United Kingdom （UK） to stimulate audit firms to improve audit quality manifest in its Discussion Paper： Promoting Audit Quality warrant further analysis. The discussion paper identified factors such as audit firm culture, the quality of people, the effectiveness of audit process, and outside factors such as management and audit committee （AC） which can affect level of audit quality in practice. Reporting upon the analysis of responses to the discussion paper, the objective of this study is to analyze views from the respondents about various issues related to audit quality. This study composes of how subject of audit quality is seen in practice, which contributes to our understanding of conditions, events, or processes that can affect audit quality in practice.展开更多
<strong>Background and Aim: </strong>Vigilance is an essential element in intensive care nursing. This study was conducted to determine nursing vigilance in nurses working in the intensive care units of ed...<strong>Background and Aim: </strong>Vigilance is an essential element in intensive care nursing. This study was conducted to determine nursing vigilance in nurses working in the intensive care units of educational and medical centers in Ardabil, Iran. <strong>Methods: </strong>This was a cross-sectional descriptive-analytical study with 192 ICU nurses as the participants. The data were obtained through questionnaires regarding demographic characteristics and nursing vigilance. SPSS software version 24 was used for the statistical analysis. <strong>Results: </strong>The mean total vigilance score was 3.86 ± 0.23 of 5. The mean scores of the timely diagnosis of changes, pattern recognition, and clinical decision-making subscales were 4.07 ± 0.26, 04.04 ± 0.41, and 3.44 ± 0.25, respectively. No significant relationships were observed between the total or subscale vigilance scores and other demographic characteristics. <strong>Conclusion: </strong>We assessed ICU nurses’ vigilance behaviors and found that their mean vigilance score was higher than the expected average, indicating our participants had a high level of clinical vigilance. These results suggest a need for effective educational interventions to boost clinical decision-making skills in ICU nurses, especially younger nurses.展开更多
Objectives Renal replacement therapy(RRT)is increasingly adopted for critically ill patients diagnosed with acute kidney injury,but the optimal time for initiation remains unclear and prognosis is uncertain,leading to...Objectives Renal replacement therapy(RRT)is increasingly adopted for critically ill patients diagnosed with acute kidney injury,but the optimal time for initiation remains unclear and prognosis is uncertain,leading to medical complexity,ethical conflicts,and decision dilemmas in intensive care unit(ICU)settings.This study aimed to develop a decision aid(DA)for the family surrogate of critically ill patients to support their engagement in shared decision-making process with clinicians.Methods Development of DA employed a systematic process with user-centered design(UCD)principle,which included:(i)competitive analysis:searched,screened,and assessed the existing DAs to gather insights for design strategies,developmental techniques,and functionalities;(ii)user needs assessment:interviewed family surrogates in our hospital to explore target user group's decision-making experience and identify their unmet needs;(iii)evidence syntheses:integrate latest clinical evidence and pertinent information to inform the content development of DA.Results The competitive analysis included 16 relevant DAs,from which we derived valuable insights using existing resources.User decision needs were explored among a cohort of 15 family surrogates,revealing four thematic issues in decision-making,including stuck into dilemmas,sense of uncertainty,limited capacity,and delayed decision confirmation.A total of 27 articles were included for evidence syntheses.Relevant decision making knowledge on disease and treatment,as delineated in the literature sourced from decision support system or clinical guidelines,were formatted as the foundational knowledge base.Twenty-one items of evidence were extracted and integrated into the content panels of benefits and risks of RRT,possible outcomes,and reasons to choose.The DA was drafted into a web-based phototype using the elements of UCD.This platform could guide users in their preparation of decision-making through a sequential four-step process:identifying treatment options,weighing the benefits and risks,clarifying personal preferences and values,and formulating a schedule for formal shared decision-making with clinicians.Conclusions We developed a rapid prototype of DA tailored for family surrogate decision makers of critically ill patients in need of RRT in ICU setting.Future studies are needed to evaluate its usability,feasibility,and clinical effects of this intervention.展开更多
文摘Multi-professional collaboration is being promoted worldwide as a response to the need for sophisticated medical care and for catering to patients’ diverse needs. Patients in Intensive Care Units (ICUs) are seriously ill, and their families may be at risk depending on the patient’s situation. Considering these characteristics of patients and families, there is a strong need for multi-professional collaboration within ICUs. The purpose of this descriptive study was to examine recognition and other factors related to collaboration and satisfaction involving care decisions in Japanese ICUs. A mail survey about collaboration of activities and systems was sent to physicians, clinical engineers, and nurses working in ICUs in Japan, 387 consented to participate in this study. Results showed that satisfaction scores were generally high among the three aforementioned professions, but collaboration scores on deciding care for patients showed significant differences (p < 0.05). The total collaboration score was the highest among physicians (36.7 ± 6.7 points), followed by nurses (32.8 ± 7.4 points), and CEs (32.8 ± 7.4 points). The factors that commonly affected collaboration scores were the satisfaction score and the ability to collaborate with other professionals and set team medical care as a goal. Moreover, it is worth noting that the degree of difficulty in collaboration negatively affected this factor. On the other hand, other factors differed among the three professions, suggesting that the purpose and need for collaboration differ depending on the profession.
文摘I the context of the Corporate Governance Code enactment in Japan, we examine how newly introduced outside directors in Japanese boards obtain information to take part in the decision-making process. We conducted a systematic review of the literature and found 18 peer-reviewed publications in a time span between 2000 and 2016 that described the asymmetry of information between the insider group of board directors （including the CEO） and the outside board members. Our fmdings show that for the course of more than a decade, despite all changes and reforms, the role of board directors, whether insiders or outsiders, is still supplementary. They are treated more as advisors than active part in the decision-making process. We reveal different insider sources of information as forming social ties with the CEO and/or inside board directors and collaboration with Audit ＆ Supervisory Board （Kansayaku）, which can help reduce this asymmetry and improve the decision-making process. We assume that it will be easier for the outsiders to establish contacts and form social ties with the Audit ＆ Supervisory Board members because of their unspoken lower status and thus to obtain more information about the company internal affairs and discussions that take place during the informal meetings, where only insiders （including the CEO） are present.
文摘Several models of multi-criteria decision-making(MCDM)have identified the optimal alternative electrical energy sources to supply certain load in an isolated region in Al-Minya City,Egypt.The load demand consists of water pumping system with a water desalination unit.Various options containing three different power sources:only DG,PV-B system,and hybrid PV-DG-B,two different sizes of reverse osmosis(RO)units;RO-250 and RO-500,two strategies of energy management;load following(LF)and cycle charging(CC),and two sizes of DG;5 and 10 kW were taken into account.Eight attributes,including operating cost,renewable fraction,initial cost,the cost of energy,excess energy,unmet load,breakeven grid extension distance,and the amount of CO_(2),were used during the evaluation process.To estimate these parameters,HOMER®software was employed to perform both the simulation and optimization process.Four different weight estimation methods were considered;no priority of criteria,based on a pairwise comparisons matrix of the criteria,CRITIC-method,and entropy-based method.The main findings(output results)confirmed that the optimal option for the case study was hybrid PV-DG-B with the following specification:5 kW DG,RO-500,and load following control strategy.Under this condition,the annual operating cost and initial costs were$5546 and$161022,respectively,whereas the cost of energy was 0.077$/kWh.The excess energy and unmet loads were 40998 and 2371 kWh,respectively.The breakeven grid extension distance and the amount of CO_(2) were 3.31 km and 5171 kg per year,respectively.Compared with DG only,the amount of CO_(2) has been sharply reduced by 113939 kg per year.
文摘The COVID-19 pandemic has a significant impact on the global economy and health.While the pandemic continues to cause casualties in millions,many countries have gone under lockdown.During this period,people have to stay within walls and become more addicted towards social networks.They express their emotions and sympathy via these online platforms.Thus,popular social media(Twitter and Facebook)have become rich sources of information for Opinion Mining and Sentiment Analysis on COVID-19-related issues.We have used Aspect Based Sentiment Analysis to anticipate the polarity of public opinion underlying different aspects from Twitter during lockdown and stepwise unlock phases.The goal of this study is to find the feelings of Indians about the lockdown initiative taken by the Government of India to stop the spread of Coronavirus.India-specific COVID-19 tweets have been annotated,for analysing the sentiment of common public.To classify the Twitter data set a deep learning model has been proposed which has achieved accuracies of 82.35%for Lockdown and 83.33%for Unlock data set.The suggested method outperforms many of the contemporary approaches(long shortterm memory,Bi-directional long short-term memory,Gated Recurrent Unit etc.).This study highlights the public sentiment on lockdown and stepwise unlocks,imposed by the Indian Government on various aspects during the Corona outburst.
基金Fundamental Research Funds for the Central Universities,China(No.JUSRP1071)National Social Science Foundation of China(No.11CGL086)
文摘On account of the lack of monetary unit sampling( MUS), an extended audit game model based on uncertainty information,which centers on audit risk and combines audit game with statistical sampling,is established to improve the effectiveness of audit risks analysis and sampling errors control. In this paper,an example concerning practical problems is given to demonstrate the process of extended audit game and confirm the truth of the effectiveness of the method. Not only does this method enhance the role of audit technology and the extension of audit procedures in deterring material irregularities,but also helps the auditors measure and control audit risk and sample sizes under uncertainty,conducive to improving the effect of cost control,risk evaluation,and decisionmaking optimization in audit sampling.
文摘Physical restraint is a common nursing intervention in intensive care units and nurses often use it to ensure patients'safety and to prevent unexpected accidents.However,existing literature indicated that the use of physical restraint is a complex one because of inadequate rationales,the negative physical and emotional effects on patients,but the lack of perceived alternatives.This paper is aimed to interpret the clinical decision-making theories related to the use of physical restraint in intensive care units in order to facilitate our understanding on the use of physical restraint and to evaluate the quality of decisions made by nurses.By reviewing the literature,intuition and heuristics are the main decision-making strategies related to the use of physical restraint in intensive care units because the rapid and reflexive nature of intuition and heuristics allow nurses to have a rapid response to urgent and emergent cases.However,it is problematic if nurses simply count their decision-making on experience rather than incorporate research evidence into clinical practice because of inadequate evidence to support the use of physical restraint.Besides that,such a rapid response may lead nurses to make decisions without adequate assessment and thinking and therefore biases and errors may be generated.Therefore,despite the importance of intuition and heuristics in decision-making in acute settings on the use of physical restraint,it is recommended that nurses should incorporate research evidence with their experience to make decisions and adequate assessment before implementing physical restraint is also necessary.
文摘The efforts by the Financial Reporting Council （FRC） in the United Kingdom （UK） to stimulate audit firms to improve audit quality manifest in its Discussion Paper： Promoting Audit Quality warrant further analysis. The discussion paper identified factors such as audit firm culture, the quality of people, the effectiveness of audit process, and outside factors such as management and audit committee （AC） which can affect level of audit quality in practice. Reporting upon the analysis of responses to the discussion paper, the objective of this study is to analyze views from the respondents about various issues related to audit quality. This study composes of how subject of audit quality is seen in practice, which contributes to our understanding of conditions, events, or processes that can affect audit quality in practice.
文摘<strong>Background and Aim: </strong>Vigilance is an essential element in intensive care nursing. This study was conducted to determine nursing vigilance in nurses working in the intensive care units of educational and medical centers in Ardabil, Iran. <strong>Methods: </strong>This was a cross-sectional descriptive-analytical study with 192 ICU nurses as the participants. The data were obtained through questionnaires regarding demographic characteristics and nursing vigilance. SPSS software version 24 was used for the statistical analysis. <strong>Results: </strong>The mean total vigilance score was 3.86 ± 0.23 of 5. The mean scores of the timely diagnosis of changes, pattern recognition, and clinical decision-making subscales were 4.07 ± 0.26, 04.04 ± 0.41, and 3.44 ± 0.25, respectively. No significant relationships were observed between the total or subscale vigilance scores and other demographic characteristics. <strong>Conclusion: </strong>We assessed ICU nurses’ vigilance behaviors and found that their mean vigilance score was higher than the expected average, indicating our participants had a high level of clinical vigilance. These results suggest a need for effective educational interventions to boost clinical decision-making skills in ICU nurses, especially younger nurses.
文摘Objectives Renal replacement therapy(RRT)is increasingly adopted for critically ill patients diagnosed with acute kidney injury,but the optimal time for initiation remains unclear and prognosis is uncertain,leading to medical complexity,ethical conflicts,and decision dilemmas in intensive care unit(ICU)settings.This study aimed to develop a decision aid(DA)for the family surrogate of critically ill patients to support their engagement in shared decision-making process with clinicians.Methods Development of DA employed a systematic process with user-centered design(UCD)principle,which included:(i)competitive analysis:searched,screened,and assessed the existing DAs to gather insights for design strategies,developmental techniques,and functionalities;(ii)user needs assessment:interviewed family surrogates in our hospital to explore target user group's decision-making experience and identify their unmet needs;(iii)evidence syntheses:integrate latest clinical evidence and pertinent information to inform the content development of DA.Results The competitive analysis included 16 relevant DAs,from which we derived valuable insights using existing resources.User decision needs were explored among a cohort of 15 family surrogates,revealing four thematic issues in decision-making,including stuck into dilemmas,sense of uncertainty,limited capacity,and delayed decision confirmation.A total of 27 articles were included for evidence syntheses.Relevant decision making knowledge on disease and treatment,as delineated in the literature sourced from decision support system or clinical guidelines,were formatted as the foundational knowledge base.Twenty-one items of evidence were extracted and integrated into the content panels of benefits and risks of RRT,possible outcomes,and reasons to choose.The DA was drafted into a web-based phototype using the elements of UCD.This platform could guide users in their preparation of decision-making through a sequential four-step process:identifying treatment options,weighing the benefits and risks,clarifying personal preferences and values,and formulating a schedule for formal shared decision-making with clinicians.Conclusions We developed a rapid prototype of DA tailored for family surrogate decision makers of critically ill patients in need of RRT in ICU setting.Future studies are needed to evaluate its usability,feasibility,and clinical effects of this intervention.
