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Previous research on ISO 9001 certification maintenance, decertification and recertification is fragmented and lacks an integrated theoretical framework. Thus, the aims of this study are to provide an overview of current research, develop an integrated framework and identify research gaps. The research methodology consists of a systematic literature review (SLR) which starts with the definition of a research protocol, proceeds with searches in Web of Science and Scopus, and selects a final sample of 32 articles for analysis. Results show that the research interest in certification maintenance, decertification and recertification is growing, but is still scarce. Extant research focuses on certification maintenance factors, benefits and frameworks; decertification reasons and consequences, and recertification impact on efficiency. There is a lack of consensus on these topics, but the data extracted from the literature is used to develop a theoretical framework of what companies do in the post-certification period. The framework identifies the main variables involved in certification maintenance, decertification and recertification, and establishes the main relationships between them. This is the first SLR conducted on these topics, which provides the first integrated framework of the research phenomena, a comprehensive list of research gaps to guide future studies, and relevant management recommendations. info:eu-repo/semantics/publishedVersion

The food industry has been widely regarded as an effective sector due to its contribution to the national economy, job creation, and people's welfare. Malaysia as one effective country in the food industry and leading country in Halal food brand emphasized the importance of food quality in both operation and supply chain. Despite the importance of the Halal food industry to countries' economy including Malaysia, this industry is facing multiple challenges. In addition, halal food literature still in the infant stage despite the rapid growth of this important industry. Therefore, this review study aims to identify the challenges that surrounded the Halal industry worldwide generally and Malaysian firms particularly. This study also aims to identify the potential solution to overcome Halal food challenges. The finding of this study uncovers multiple challenges surrounded the Halal food industry in operation, marketing, and certification processes. This study also suggests that the application of the manufacturing execution system can bring a new insight to overcome Halal food challenges. This study contributes to the body of knowledge by providing a clear understanding of Halal food industry operation and certification and their challenges and explains how MES can improve the efficiency of this industry.

ObjectiveThe certified transport registered nurse (CTRN) credential independently validates a registered nurse's advanced knowledge, skills, and abilities in critical care ground transport nursing. After multiple years of mostly modest growth, the number of CTRNs surged in 2020 and 2021 and continues to post strong growth into 2022. The aim of the 2022 Certified Transport Registered Nurse Pulse Survey was to better understand the ways in which CTRN-certified registered nurses value this national ground transport specialty credential and gain insight into factors that may have contributed to the recent surge in CTRN certification.MethodsThe Board of Certification for Emergency Nursing e-mailed individuals in its database of CTRN credential holders and invited them to complete an 11-question online survey between March 15 and March 28, 2022. Participation in the survey was voluntary. Sixty-three of 297 verified CTRN holders who received the survey responded for a response rate of 21.2%. The survey instrument included discrete field and open-ended questions. Data were deidentified for analysis, and institutional review board exemption was received. Descriptive statistics were used, and counts and percentages are reported.ResultsThe highest percentage of respondents (42.9%) have 10 or more years of experience in ground transport nursing, and nearly half (46%) are employed by a stand-alone transport program. Forty-three percent of all respondents reported that ground transport makes up at least 50% of their current role, whereas one third (33.3%) indicated they do ground transport 100% of the time. Critical thinking (87.5%) in the ground transport environment, confidence as a ground transport nurse (87.5%), and a sense of accomplishment and pride (94.6%) were the top 3 perceived benefits of being a CTRN-certified nurse.ConclusionThe 2022 CTRN pulse survey identified current CTRN demographics, practice environments, and perceived benefits of the CTRN credential. The findings suggest CTRNs are highly experienced and perceive multiple intrinsic and extrinsic benefits of CTRN certification, many of which are essential to safe, evidence-based nursing practice in the autonomous, complex, and dynamic ground transport environment.

This article uses the agency theory perspective to analyze governance, composed of a set of dimensions and measured by governance factors that influence donations to Brazilian environmental Nonprofit Organizations (NPOs). Data were collected predominantly from the documents available on the Internet, and the random sample consisted of 108 observations. We identified governance dimensions through Multiple Correspondence Analysis. From these dimensions, we verified, through Partial Least Squares Structural Equation Modeling, if governance affected donations. It was observed that governance positively affected donations and that public certifications provided to NPOs in Brazil did not moderate the relationship between governance and donations. These results showing that governance helps NPOs to have easier access to the donations market and that public certifications provided to NPOs do not contribute to increasing donations. These findings are important for practitioners and also to enrich the debate about public policies for the third sector in environments of low regulation. Resumo Este artigo analisa a governança composta como um conjunto de dimensões medidas por fatores de governança que influenciam as doações com restrições de doadores recebidas por Organizações Sem Fins Lucrativos (ONG) ambientais no Brasil, sob a perspectiva da teoria da agência. Os dados foram coletados predominantemente em documentos disponíveis na internet, e a amostra aleatória foi composta por 108 observações. Identificamos as dimensões de governança por meio da Análise de Correspondência Múltipla. A partir dessas dimensões, verificou-se, por meio de Partial Least Squares Structural Equation Modeling, se a governança afetou as doações. Observou-se que a governança afetou positivamente as doações e que as certificações públicas fornecidas às ONGs no Brasil não moderaram a relação entre governança e doações. Esses resultados mostram que a governança ajuda a ONG a ter acesso mais fácil ao mercado de doações e que as certificações públicas fornecidas à ONG não contribuem para o aumento das doações. Esses achados são importantes para os profissionais e também para enriquecer o debate sobre políticas públicas para o terceiro setor em ambientes pouco regulamentados.

This survey aimed to evaluate contemporary pediatric nurse practitioner (PNP) practice as it relates to the competencies of both the primary and acute care population focus and settings of practice to guide curriculum revisions. The design of the study was a cross-sectional survey of PNPs certified by the Pediatric Nursing Certification Board. There were 2,265 surveys completed. Regardless of the certification type, PNPs report providing care across settings and integrating the competencies of both the primary and acute care PNP into practice. This warrants further consideration by programs to prepare future PNPs for dual primary and acute care certification.

ImportanceMedical second opinions are common, although little is known about the best processes for obtaining them. This study assesses whether knowledge of a prior physician’s diagnosis influences consulting physicians’ diagnoses.ObjectiveTo measure the extent to which dermatopathologists’ diagnoses are influenced by prior diagnostic information from another dermatopathologist.Design, Setting, and ParticipantsDermatopathologists were randomly assigned to interpret 1 slide set of 18 melanocytic skin biopsy specimens in 2 phases (5 slide sets totaling 90 cases). Phase 1 interpretations were conducted without prior diagnostic information. After a washout period of 12 or more months, dermatopathologists’ phase 2 interpretations were conducted with their identical slide set; for a random subset of cases in phase 2, participants were shown prior diagnoses by other dermatopathologists that were either more or less severe than their own phase 1 diagnosis of the case. Using the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis tool, cases ranged from class I (benign) to class V (≥pT1b invasive melanoma). Data collection took place from August 2018 to March 2021, and data analysis was performed from March to December 2021.InterventionPrior diagnoses were actual diagnoses from board-certified and/or fellowship-trained dermatopathologists. A prior diagnosis was always in a more severe or less severe diagnostic class than the participant’s phase 1 interpretation; more or less severe was determined by the randomization scheme. In the control condition of no prior diagnostic information, the participants were told that a prior diagnosis was not available.Main Outcomes and MeasuresWhen exposure was to a prior diagnosis in a higher diagnostic class, the primary study outcome was whether a participant’s diagnosis in phase 2 was in a higher diagnostic class than the participant’s diagnosis in phase 1. When exposure was to a prior diagnosis in a lower diagnostic class, the primary study outcome was whether a participant’s diagnosis in phase 2 was in a lower diagnostic class than the participant’s diagnosis in phase 1. The effect of prior diagnostic information was measured using the relative risk (RR) of each outcome relative to the control condition of no prior diagnostic information, adjusted for the diagnostic class of the phase 1 diagnosis. Prior to data collection, it was hypothesized that participants would be swayed in the direction of prior diagnostic information.ResultsA total of 149 dermatopathologists (median [range] age, 47 years [34-76] years; 101 [68%] were male) provided 5322 interpretations of study cases. Participants were more likely to increase the severity of their diagnosis when the prior diagnosis was of greater severity compared with when no prior diagnosis was provided (RR, 1.52; 95% CI, 1.34-1.73); likewise, participants gave less severe diagnoses when prior diagnoses were of lesser severity (RR, 1.38; 95% CI, 1.19-1.59). Trends were similar among dermatopathologists who had previously stated they were “not at all influenced” by prior diagnoses. Prior diagnoses also swayed dermatopathologists away from correct diagnoses.Conclusions and RelevanceIn this randomized controlled trial, despite the preference of most dermatopathologists to receive prior diagnoses when providing second opinions, this information swayed them away from a correct diagnosis to an incorrect diagnosis.

ObjectiveThe Certified Flight Registered Nurse (CFRN) credential independently validates a registered nurse's advanced knowledge, skills, and abilities in the unique specialty of flight nursing. Introduced in 1993 and celebrating its 30th anniversary in July 2023, the CFRN is held by over 5,500 registered nurses. The purpose of the 2022 CFRN pulse survey was to better understand the waysCFRN-certified registered nurses value this national flight nursing specialty credential. The CFRN survey is a companion to the 2022 Certified Transport Registered Nurse pulse survey, which focused on the Certified Transport Registered Nurse critical care ground transport nursing credential.MethodsThe Board of Certification for Emergency Nursing e-mailed individuals in its database of CFRN credential holders and asked them to respond to a 14-question online survey between October 17, 2022, and November 8, 2022. Participation in the survey was voluntary. Of the 5,275 verified CFRN holders who received the survey, 992 responded, for a response rate of 18.8%. The survey instrument included discrete field and open-ended questions. Data were deidentified for analysis, and institutional review board exemption was received. Counts and percentages were reported, and descriptive statistics were used.ResultsThe highest percentage of flight nurses who responded have more than 10 years of experience in flight nursing (35.3%) and are employed by a stand-alone transport program (42.7%). Flight nurses reported they spent a mean of 70% of their work hours transporting via rotor wing aircraft, with a predominantly adult patient population. The top perceived benefits of being a CFRN-certified nurse were a sense of accomplishment and pride (90.7%) followed by flight physiology knowledge (85.4%), flight nursing clinical knowledge (83.4%), and confidence as a flight nurse (80.6%).ConclusionThe 2022 CFRN pulse survey identified current CFRN demographics, practice environments including transport percentage by mode and patient population types, and perceived benefits of the CFRN credential. The findings suggest CFRNs are very experienced, provide care for patients across the age continuum, and perceive multiple intrinsic and extrinsic benefits of CFRN certification, all of which are essential to safe, evidence-based advanced nursing practice in the unique, complex, autonomous, and dynamic flight environment.

Participation of women and early-career faculty in hematology and medical oncology board review lecture series has not been studied previously. We aimed to evaluate gender and early-career faculty disparities in hematology and medical oncology board review lecture series. Speakers at major hematology and/or oncology board review lecture series meetings in the United States were analyzed in this cross-sectional study during a 5-year period from the years 2017 through 2021. Data about the lecture topic, field, speaker’s gender, years of experience, and the frequency at which the lecture was given by the speaker were collected. Of 386 speakers participating, 315 (81.6%) were ABIM (American Board of Internal Medicine)-certified. A total of 1,224 board review lectures were given in the studied period, of which 1,016 (83%) were given by an ABIM-certified speaker. Women constituted 37.7% of all speakers, with less than 50% representation in five out of six courses. Lectures discussing malignant hematology topics had the lowest proportion of women presenters (24.8%), followed by solid tumors (38.9%) and benign hematology lectures (44.1%). Faculty with more than 15 years since initial certification presented more than 50% of lectures. The median time from initial hematology or medical oncology certification to lecture presentation was 12.5 years and 14 years, respectively. A positive trend in the participation of women was found at all board review conferences across the studied period. Our data suggest that women and early-career faculty participation in hematology and oncology board review series is inadequate.

Violation of the interconnected system of institutions for assessing the qualifications of medical specialists can be associated with two main circumstances. The first circumstance is the emergence of new institutions with duplicate tasks and organizational forms, and the second is the withdrawal from the system of an institution that performs the necessary system function. Two relatively new institutions, namely the independent assessment of qualifications (IAQ) and certification for the title of «Moscow Doctor», are considered from the point of view of these circumstances. The paper reveals that there is a convergence of the rules of the Institute of accreditation with the Institution of IAQ of qualifications, which can result in significant duplication of their activities. Therefore, it is necessary to resolve the issue of its possible unification with the Institution of accreditation while the IAQ is at the experimental stage and has not been put into practice. A certain similarity of the principles of activity can be traced in such institutions as certification for the qualification category and certification for the title of «Moscow doctor». Both of these institutions identify and rank the qualifications of specialists exceeding the basic level. The fundamental innovation of certification for the status of «Moscow Doctor» is that this institution actually introduces a qualification category that is higher than the current highest category. At the same time, this institution shows the importance of the institution of certification for a category whose existence is being questioned.Нарушение системности институтов оценки квалификации медицинских специалистов может быть связано с двумя основными обстоятельствами: появление новых институтов с дублирующими задачами и организационными формами, вывод из системы института, выполняющего необходимую системную функцию. Два сравнительно новых института - независимой оценки квалификации (НОК) и аттестации на звание «Московский врач» - рассмотрены в свете этих обстоятельств. Выявлено сближение правил работы института аккредитации с институтом НОК, что может обернуться значительным дублированием их деятельности. Поэтому, пока НОК находится на стадии экспериментов и не внедрён в практику, следует решить вопрос о возможном его объединении с институтом аккредитации. Определённая схожесть принципов деятельности прослеживается и по таким институтам, как аттестация на квалификационную категорию и на звание «Московский врач». Оба эти института идентифицируют и ранжируют квалификацию специалистов, превышающую базовый уровень. Принципиальное новаторство аттестации на статус «Московский врач» состоит в том, что данный институт фактически вводит квалификационную категорию, которая выше действующей высшей категории. Вместе с тем этот институт показывает важность института аттестации на категорию, существование которого подвергается сомнению.

AORN conducted its 20th annual compensation survey for perioperative nurses in June of 2022. A multiple regression model was used to examine how several variables, including job title, education level, certification, experience, and geographic region, affect perioperative nurse compensation. Comparisons between the 2022 data and data from previous years are presented. The effects of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differentials, benefits) on total compensation are also examined. Additional analyses explore the current state of the nursing shortage and the sources of job satisfaction and dissatisfaction.

OBJECTIVE: To evaluate the use of point-of-care ultrasound (POCUS) for the assessment of patients experiencing first-trimester bleeding or abdominal pain by family physicians working in family medicine clinics following first-trimester POCUS training and certification. DESIGN: Multisite, retrospective chart review. SETTING: Two hospital-affiliated academic family medicine clinics in Toronto, Ont. PARTICIPANTS: Twelve family physicians who completed a first-trimester POCUS training and certification course. MAIN OUTCOME MEASURES: The primary outcome was the proportion of family physicians using POCUS during their evaluations of patients in the first trimester of pregnancy in the 6 months following the FPs’ successful completion of the Family Medicine Obstetrical Ultrasound (FaMOUS) course. Secondary outcomes included indications for POCUS use, diagnostic accuracy of POCUS compared with radiologist-interpreted ultrasound, pregnancy outcomes, and emergency department visits within 10 days of the index family medicine clinic visit. RESULTS: Of the 12 certified family physicians, 7 (58.3%) used POCUS during their assessments of first-trimester patients during the study period. The FPs used POCUS with 56 patients for the following indications: 11 (19.6%) had only vaginal bleeding, 5 (8.9%) had only abdominal pain, and 8 (14.3%) had both vaginal bleeding and abdominal pain; the indication for 32 patients (57.1%) was unclear. Forty-six patients (82.1%) underwent a subsequent radiologist-interpreted ultrasound within 10 days of the index POCUS test. Compared with radiologist-interpreted ultrasound, POCUS had a sensitivity of 91.3% (95% CI 79.2% to 97.6%) for documenting intrauterine pregnancy and a sensitivity of 81.4% (95% CI 66.6% to 91.6%) for documenting the presence of fetal cardiac activity. CONCLUSION: Following a first-trimester POCUS certification course, family physicians used POCUS for the assessment of first-trimester patients with varying frequency and for indications other than vaginal bleeding or abdominal pain. Further study is needed to assess the clinical impact of office-based POCUS, unforeseen barriers and facilitators to its use, and patient and provider preferences.

A 3-year study explores employment outcomes of certified peer specialists (CPSs). Analyses reported here identified relationships between demographic, clinical, work history, and geographic characteristics and employment status and current employment in peer services jobs versus other jobs.The study recruited adults who recently became a CPS, regardless of current employment status, in four states. Online survey data were collected from March to October 2020 and included demographic information, health status and diagnoses, mental health service use, motivations for becoming certified, employment history, and job characteristics, including job satisfaction. Descriptive statistics and logistic regression models were used to compare groups.Of 681 respondents, 591 provided data on current employment and were included. Participants who received Social Security Disability Insurance or Supplemental Security Income, veterans, those who used outpatient counseling or therapy, and those who did not disclose their mental health status in the workplace were less likely to report current employment. Lack of disclosure and higher local unemployment rates contributed to a lower likelihood of working in peer services jobs, whereas individuals reporting depressive disorders were more likely to hold such jobs. Compared with those in other jobs, those in peer services jobs reported longer job tenure, and a larger proportion received employee benefits. Job satisfaction was significantly higher among those with peer services jobs.Workers with a CPS credential had higher employment rates, compared with adults with psychiatric disabilities, and the quality of peer specialist jobs was equal to or higher than the quality of other jobs held by study participants.

Depuis une dizaine d’années le fait religieux semble de plus en plus interférer avec la vie professionnelle et impacter le monde du travail. Quels sont les implications de l’entrée du fait religieux en entreprise et les changements que cela entraîne ? Quel est le rôle de la spiritualité dans le management des quinze dernières années ? C’est autour de cette problématique que les seize contributions de ce volume essaient de réfléchir, dans une dimension interdisciplinaire entre approches théologiques et approches anthropologiques, philosophiques, sociologiques, historiques relevant des sciences humaines et des sciences des religions., For the past ten years or so, religious issues seem to increasingly interfere with the professional life, and that has an impact on the workplace. What are the implications of religion’s entry into the workplace and the changes it brings? What is the place of spirituality in management over the last fifteen years? It is around this question that the sixteen contributions in this volume attempt to reflect, in an interdisciplinary dimension between theological approaches and anthropological, philosophical, sociological, historical approaches drawn from humanities and religious sciences.

Background In 2019, the Hand Therapy Certification Commission (HTCC), in consultation with Scantron Corporation, performed a practice analysis study of hand therapy, the sixth in a series of similar studies performed byHTCC over a 35-year period. Purpose The primary goal of this study was to update and validate the definition and delineation of hand therapy and to ensure that the test content outline for the Hand Therapy Certification Examination (HTCE) reflects the critical tasks, knowledge, and skills required in the practice of hand therapy. Additionally, HTCC explored specific trends in hand therapy practice, compared findings with previous studies, and gathered data about the frequency, criticality, and performance expectations for the use and fabrication of orthoses by hand therapists. Study Design Quantitative Descriptive. Methods More than 40 subject matter experts from the United States and Canada, representing a broad range of experiences and perspectives, developed an updated delineation of the domains, tasks, knowledge, and techniques and tools used in hand therapy practice. A large-scale online survey of all certified hand therapists from the United States, Canada, and other countries was completed to test the profile within the practice of hand therapy. Results This large-scale online survey overwhelmingly validated the profile of hand therapy. The results affirmed the test specifications for the Hand Therapy Certification Examination; affirmed the definition of hand therapy; and refined the scope of hand therapy practice. New data was gathered regarding the use of orthotics in hand therapy. Conclusions This study establishes content validity for the HTCE. It highlights that the specialty of hand therapy is a mature and stable specialty field of occupational therapy and physical therapy. Certified Hand Therapists frequently issue pre-fabricated and fabricate custom orthoses in the course of rehabilitation for clients with hand and arm injuries, and overall consider this a highly critical task in hand therapy practice. Level of Evidence N/A

Nurses working on progressive care units (PCUs) use specialized knowledge and skills to provide care to acutely ill patients. The literature suggests that specialty certification may have a positive impact on patient and nurse outcomes alike, although results are mixed. A project team set out to create a culture that encouraged nurses to pursue progressive care certified nurse (PCCN) certification on three cardiac medical PCUs at a large academic health center by implementing a Pathway to PCCN program, which is a structured, cohort-based approach to certification preparation.The primary aim of the intervention was to achieve a 10% PCCN certification rate within one year. Additionally, the project team evaluated whether participating in the Pathway to PCCN program affected staff nurses' self-reported confidence in their clinical judgment in 10 patient care domains: cardiac, pulmonary, behavioral, neurological, musculoskeletal, hematological, endocrine, gastrointestinal, renal, and multisystem.Project methods included structured strategies within a "4R" framework developed by the project team: recruitment, obtaining resources, providing reassurance, and celebrating certification through recognition. Project methods were evaluated using anonymous electronic surveys and staff interviews.The percentage of staff with PCCN certification increased from 0% to 15.2%. The average confidence levels reported by nurses who participated in the project (N = 64) increased in eight out of nine (89%) of the clinical judgment domains tested on the PCCN examination in Cohort 2, and in nine of the clinical judgment domains in Cohorts 1 and 3. Implementing a structured cohort pathway for specialty certification using the 4R framework is a strategy that can increase rates of specialty certification among eligible nurses.

Objectives. To evaluate the effects of state community health worker (CHW) certification programs and Medicaid reimbursement for CHW services on wages and turnover. Methods. A staggered difference-in-differences design was used to compare CHWs in states with and without CHW certification or CHW Medicaid reimbursement policies. Data were derived from the 2010 to 2021 Current Population Survey in the United States. Results. CHW wages increased by $2.42 more per hour in states with certification programs than in states without programs (P = .04). Also, hourly wages increased more among White workers, men, and part-time workers (P = .04). Wages increased by $14.46 in the state with the earliest CHW certification program adoption (P Conclusions. CHW wages are higher in states with certification programs. However, wage gaps exist between Whites and non-Whites and between men and women. Public Health Implications. Federal, state, and employer-based strategies are needed to establish and sustain effective CHW programs to meet the needs of communities experiencing health and access disparities. (Am J Public Health. 2022;112(10):1480–1488. https://doi.org/10.2105/AJPH.2022.306965 )

el actual mercado globalizado de la educación superior propicia nuevos marcos regulatorios para las instituciones que generan la necesidad de sistemas de gestión para el seguimiento y control de objetivos y metas. El aseguramiento de la calidad implica la obtención de acreditaciones y certificaciones por entidades externas basadas en la norma ISO 9001 y la nueva norma ISO 21001. La presente investigación analiza el impacto de las variables de gestión por procesos y de planeación estratégica en la calidad educativa en una muestra de 48 Instituciones Públicas de Educación Superior (IES) de México, pertenecientes a una asociación nacional que cuentan con un sistema de gestión de calidad certificado de acuerdo con la norma ISO 9001:2015. El objetivo del estudio es determinar la incidencia de la gestión por procesos y de la planeación estratégica en la calidad educativa en las IES públicas de México. Mediante el uso de ecuaciones estructurales ajustadas por mínimos cuadrados parciales, los resultados señalan que la gestión por procesos tiene un impacto positivo en la calidad educativa; mientras que la planeación estratégica no presenta impacto en la variable dependiente. Estos hallazgos son consistentes con la literatura, incluyendo la no significancia de la planeación estratégica con la calidad educativa debido a la naturaleza de instituciones públicas con fondos no vinculados al desempeño o la matrícula.//at current global competitive markets characterized with new regulations, higher education institutions require management systems to assure the achievement of goals and objectives. Thus, quality in processes and work routines imply systems certified in ISO 9001 or 21001 from external parties. This study analyzes the impact of process management and strategic planning on educational quality of 48 public universities in Mexico that belong to a national association and hold ISO 9001:2015 certifications. The objective is centered in determining the effect of process management and strategic planning on educational quality. By using partial least squares structural equation modelling through Smart PLS, results indicate that process management has a positive impact on educational quality; while strategic planning has no impact on the dependent variable. In one hand, the significant result of process management on educational quality is consistent with literature about quality management systems at higher education institutions. In the other hand, the non-significant impact of strategic planning on educational quality is consistent with studies including public institutions with budgets not dependent on institutional performance or student admissions.

Purpose To track and analyze the growth of 12 Board of Pharmacy Specialties (BPS) specialties from 2008 to 2020 and, subject to criteria, to project specialty numbers through 2025. The analysis considered residency data and Bureau of Labor Statistics projections. Methods BPS data were used to determine numeric growth, growth rates, and trends for 12 BPS specialties from 2008 to 2020. Specialties begun after 2008 were analyzed from their start date. For specialties with more than 2 data points and coefficients of determination greater than 0.80, we calculated projections through 2025. We also estimated the percentage of BPS-certified pharmacists with postgraduate year 1 training. Results BPS-certified pharmacists grew in number from 3,004 (2008) to 41,802 (2020), an over 13-fold increase. Currently, 4 of the 5 largest specialties (pharmacotherapy, ambulatory care, oncology, and critical care) continue to grow at a fast rate. Pharmacotherapy experienced the largest numeric growth (20,624) despite the ongoing introduction of new specialties. Critical care and infectious diseases had the highest growth rates (both 32%). We were able to make projections for 10 of 12 specialties, with greater than 62,000 certifications projected by 2025. Growth to these projected levels will require more residencies and more certification preparation opportunities. Residency-trained BPS specialists currently constitute slightly less than 50% of the BPS-certified population. Conclusion Specialization in the pharmacy profession is growing at a rapid pace. As more clinical privileges are approved, the demand for more specialized pharmacists will likely continue to increase. Data from this study document the growth of the pharmacy specialty workforce. The data and analysis can be used to estimate potential pharmacist contributions across the healthcare spectrum in clinical areas where BPS-certified pharmacists practice.

Patient safety is a priority in health care systems. Nurses' safety competence along with environmental and personal factors plays a role in patient safety.The purpose of this study was to explore the relationships among safety competency, structural empowerment, systems thinking, level of education, and certification.A cross-sectional exploratory design was used to collect data from nurses (n = 163) practicing in a large Midwestern hospital system.There were significant positive correlations between safety competency and ( a ) structural empowerment, ( b ) systems thinking, and ( c ) certification. Systems thinking explained 12.9% of the variance in the knowledge component of safety competency and 6.8% of the variance in the skill component of safety competency. Certification explained 2.4% of the variance in the skill component of safety competency.Understanding factors that affect safety competency supports the development of effective interventions that may improve safety.

Background and Objectives: Board certification is acknowledged as the mainstay for ensuring quality physician-delivered health care within medical specialties. The American College of Osteopathic Family Physicians (ACOFP) administers the American Osteopathic Board of Family Physicians’ (AOBFP) In-Service Examination (ISE) to provide residents and program directors with a formative examination to assess competency and preparation for successful completion of the AOBFP certifying examination (CE). Unique assessment processes are integral to monitoring development of the osteopathic family physician throughout training and into practice, and to verify their competency for the safety and protection of the public. This study sought to investigate whether performance on the AOBFP ISE predicted performance on the AOBFP CE, and thereby successfully equipped residents to safely enter medical practice. Methods: In 2020, data from 1,893 PGY-1 through PGY-3 residents (2016-2018), whose ISE scores could be matched with scores on the AOBFP initial board CE, were analyzed for this study. Results: Correlations among ISE administrations across 3 years of postgraduate medical education were in the mid-to-high .6 range; the ISE scores correlated with CE scores in the mid .4 to high .5 range. Less reliable measures of positive predictive value were 0.99, and sensitivity was 0.91. Conclusions: Results suggest that ISE administrations during residency training are effective in developing remediation strategies for subsequent successful CE performance. The inclusion of osteopathic principles in the AOBFP CE necessitates inclusion of osteopathic content in resident training exams like ISE.

Le phénomène de valorisation des produits de terroirs a, depuis les dix dernières années, suscité l’intérêt des producteurs, des agriculteurs, des groupements professionnels et des institutions publiques, mais l’essor attendu pour le développement rural et la compétitivité des territoires n’a pas été atteint pour autant.La labellisation et la protection des produits de terroirs se font très lentement à travers une poignée d’acteurs actifs, cherchant à tirer rapidement profit des produits déjà très spéciaux par rapport aux produits conventionnels, du fait de leurs valeurs culturelles et historiques et leur relation avec la terre qui les produit.La coexistence d’un Système Qualité défaillant avec une réglementation complexe et incomplète sous une responsabilité institutionnelle désynchronisée rend également difficile la généralisation d’une production massive pour la commercialisation à grande échelle et l’exportation.L’identification des blocages techniques, réglementaires et organisationnels a permis de cibler des pistes possibles d’intervention pour permettre l’émergence des produits de terroirs, dans un objectif de diversification des produits agricoles, de développement rural, de valorisation de la biodiversité, de création de revenus, dans des chaînes de valeurs de proximité et bien évidemment, pour une production durable et inclusive.L’équation reste encore difficile à résoudre, car il n’est pas facile qu’un produit de terroir soit labélisé sans un Système Qualité conforme, efficace et opérationnel, qui devra permettre de connaitre les caractéristiques intrinsèques aux produits mais aussi, de garantir leur salubrité selon les normes internationales. Dans cet article, un aperçu du Système Qualité de deux pays européens, leaders dans les produits labélisés, permettra de situer le Système Qualité algérien et de mettre en évidence les voies possibles d’amélioration pour permettre l’émergence des produits de terroirs en Algérie, dans un objectif de sécurité alimentaire.

As yet, the benefit of the Fit Note has not been convincingly demonstrated, although a limited body of research suggests that provision of fitness for work advice and sickness absence certification may be improved with training and case-specific direction. The role of certifying sickness absence in the UK has traditionally been conducted by General Practitioners, but this role has now been extended to First Contact Practitioner (FCP) Physiotherapists in primary care. Therefore, FCPs may offer an ideal solution to the current challenges faced within primary care for those with a musculoskeletal (MSK) condition at risk of sickness absence from their work environment.The main aim of this study was to identify the challenges and key learning and development needs of FCPs in response to providing Occupational Health (OH) information in the form of fitness for work advice and sickness certification for patients with MSK conditions within primary care.Consensus was generated using an online modified version of the Nominal Group Technique (NGT) method. A priori consensus threshold of 60% was used in the voting stage.NGT participants included clinicians with experience in managing MSK conditions in primary care within the FCP model of care. All participants generated, voted, and ranked the items using an online platform.This research adds new evidence regarding the challenges and learning and development needs identified by a group of FCPs working within primary care in consideration of sickness absence certification and fitness for work advice. The items highlighted provide evidence to complement Health Education England's FCP A Roadmap to Practice educational pathway and informs on professional development needs in this area.

PURPOSE: Medical oncologists have a variety of options for demonstrating proficiency in providing high-quality patient care. Perhaps, the best-known opportunity for demonstrating individual expertise and lifelong learning is the American Board of Internal Medicine (ABIM) maintenance of certification (MOC) program. At the practice level, ASCO has offered the Quality Oncology Practice Initiative (QOPI) as a means of optimizing cancer care delivery. In this study, we assess the association between active involvement in MOC on an individual basis and whether that individual’s practice is involved with the QOPI program. METHODS: We evaluated 13,600 US medical oncologists initially certified by the ABIM and divided them into those initially certified before 1990 (the year in which ABIM started to require periodic recertification), those from 1990 to 2007, and those from 2008 to 2016. It was then determined which of these had let their certificates expire by 2020. These data were then compared with practices that participated in QOPI from 2017 to 2019, resulting in the matching of 97% of physicians RESULTS: Of individuals initially certified before 1990 (and technically with lifelong certification), 22% were in QOPI practices. Among those who did not have lifelong certification, there was an association between QOPI participation and maintenance of ABIM certification. For those initially certified between 1990 and 2007, 35% of oncologists with up-to-date ABIM certification were in QOPI practices, whereas only 11% with expired ABIM certification were QOPI participants ( P < .0001). For those in the 2008-2016 category, the numbers were 36% v 16%, respectively ( P < .0001). CONCLUSION: Our analysis identifies a relationship between participation in these ABIM and ASCO proficiency programs. The reasons for this are likely complex and based on a variety of institutional, professional, monetary, and personal factors.

A vehicle simulation model, CO2MPAS supports the introduction of the new WLTP-based certification system for CO2 emissions in Europe. This paper investigates the possibility to use the underlying simulation methodology to accurately calculate CO2 emissions over real-world trips, thus to extend the use of the methodology beyond vehicle certification. As a reference, the analysis used measurement data obtained from four vehicles over two different routes under real-world driving conditions. The CO2 emissions were measured using portable emissions measurement systems. The formal CO2MPAS methodology and two modified versions of it that require a reduced number of input data were assessed about their capacity to predict the measured CO2 emissions. The analysis focused on the accuracy and uncertainty of the three different methodology configurations. As an additional benchmark, the analysis considered the CO2 emissions estimates obtained from the EMEP/EEA Guidebook methodology used for emissions inventorying in Europe. Results show that the basic CO2MPAS configuration demonstrates good performance in predicting CO2 emissions over on-road tests, reaching a prediction accuracy over an entire test trip of −0,3% and a standard deviation of 3,1%. The modified versions showed slightly higher biases up to 3% and uncertainties (5–7%), but remaining within reasonable limits considering the reduced number of inputs used in each case. Given its ability to predict CO2 emissions accurately on a local base, CO2MPAS could be used for the prediction of instantaneous CO2 emissions in traffic micro-simulation exercises.

Outreach to people with serious mental illness who are disengaged from treatment can facilitate return to care. However, little is known regarding what outreach strategies are effective. This mixed-methods evaluation assessed best practices for conducting outreach to Veterans with serious mental illness via the national Veterans Health Administration Re-Engaging Veterans with Serious Mental Illness program by comparing the strategies used by high-performing sites and low-performing sites. Quantitative data included the types and number of contact attempts used to reach Veterans. Qualitative data included interviews with clinicians from high- and low-performing sites. Results indicated making at least four contact attempts using methods of phone, certified letter, and next of kin differentiated high from low-performing facilities. Clinicians from high-performing sites also differed from low-performing sites in their expressed philosophy about outreach, demonstrated a broader array of strategies in attempting to contact Veterans, and described greater connections with others at their site, with clinicians around the country, and with national program resources. Implications of evaluation findings for outreach programs and research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Voluntary environmental certification programs have been a popular tool used by governments, industry groups, and nonprofit organizations alike. A central question in the design of such programs is who should pay for them. In a context where firms respond strategically to a certification, the answer to this question is a priori ambiguous and, ultimately, empirical. This paper provides important insights on this question using ENERGY STAR, a voluntary certification program for energy-efficient products, as a case study. I show that firms are highly strategic with respect to this certification and extract consumer surplus associated with certified products via three mechanisms. They offer products that bunch at the certification requirement, differentiate certified products in the energy and nonenergy dimensions, and charge a price premium on certified products. I use these findings to motivate a structural econometric model with firms’ strategic behaviors with respect to product line and pricing decisions and to investigate the incidence of a certification licensing fee to fund the certification program. This paper was accepted by Juanjuan Zhang, marketing.

Survey psychology postdoctoral training programs involving patients with disability receiving rehabilitation services, and compare with similar data from 2007.Public data sources identified 297 potential postdoctoral training programs. Of these, 100 programs (34%) provided services for patients with disability in rehabilitation settings, and 92% returned a survey (Programs reported having a primary rehabilitation involvement (42%), a secondary involvement (26%), or an optional involvement (23%). Programs were based in university settings (27%), VA/DoD settings (35%), or private/public health care settings (38%). A total of 433 faculty and 308 residents were involved in these programs. Fifty percent (50%) of programs had faculty with American Board of Rehabilitation Psychology (ABRP) certification, while 62% of programs had faculty with American Board of Clinical Neuropsychology (ABCN) certification. On average, programs formally taught 58% of the ABRP competencies.Compared to 2007, there has been a 200% increase in the number of training programs with rehabilitation involvement. However, there has been an overall decrease in the variety of populations with which residents work, and an overall decrease in the number of ABRP competencies that are formally taught, so that training has become more focused on specific populations and specific competencies to the exclusion of others. Many rehabilitation patients and teams receive services from psychologists whose professional concentration is not primarily in rehabilitation psychology, and many psychology residents involved with rehabilitation populations do not receive comprehensive training in rehabilitation psychology. There is an opportunity for rehabilitation psychologists to collaborate with these programs to enhance competent services to persons with disability. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

INTRODUCTION: In 2019, the Federal Aviation Administration (FAA) announced a protocol to evaluate pilots with insulin treated diabetes mellitus (ITDM) for special issuance (SI) medical certification for first-/second-class pilots. The protocol’s aim is improved assessment of ITDM control/hypoglycemia risk and relies on continuous glucose monitoring (CGM) data. This study compares the characteristics of first-/second-class pilots with ITDM and certification outcome.METHODS: Data was collected retrospectively from the FAA Document Imaging Workflow System (DIWS) for pilots considered for a first-/second-class SI under the ITDM program between November 2019 and October 2021. Inclusion criteria required submission of information required for certification decision (SI vs. denial). We extracted data on demographics and CGM parameters including mean glucose, standard deviation, coefficient of variance, time in range (%), time > 250 mg · dl−1 (%), and time < 70–80 mg · dl−1 (%). We compared these parameters between pilots issued an SI vs. denial with Mann-Whitney U-tests and Fisher exact tests using R.RESULTS: Of 200 pilots with ITDM identified, 77 met inclusion criteria. Of those, 55 received SIs and 22 were denied. Pilots issued SI were statistically significantly older (46 vs. 27 yr), had a lower hemoglobin A1c (6.50% vs. 7.10%), lower average glucose (139 mg · dl−1 vs. 156 mg · dl−1), and spent less time with low glucose levels (0.95% vs. 2.0%).DISCUSSION: The FAA program has successfully medically certificated pilots with ITDM for first-/second-class. Pilots granted an ITDM SI reflect significantly better diabetes control, including less potential for hypoglycemia. As this program continues, it will potentially allow previously disqualified pilots to fly safely.Stanwyck LK, DeVoll JR, Pastore J, Gamble Z, Poe A, Gui GV. Medical certification of pilots through the insulin-treated diabetes mellitus protocol at the FAA. Aerosp Med Hum Perform. 2022; 93(8):627–632.

Residency program directors' careers follow several trajectories. For many, the role is relatively short term, lasting 3 to 5 years, during which time the program director may gain educational and administrative experience. However, a sizeable cohort of program directors have remained as program directors for a decade or more, and some have filled the role for the majority of their careers. Over the years, the role of the academic residency program director has become increasingly affected by administrative responsibilities, including scheduling, documentation, and reporting requirements, along with increasing clinical demands that may conflict with ensuring resident wellness and lead to insufficient time to do the job. Burnout in this role is understandable. Given these obstacles, why should any young faculty member choose to become a training director? The authors of this commentary have each served as a residency program director for decades, aggregating approximately 150 years of program director experiences. Based on their collective reflections, the authors describe social and interpersonal aspects of the program director role that have enhanced their professional satisfaction and well-being. These include overseeing residency cycle events from initial interviews through graduation and certification; assuming leadership and social roles in academic departments; counseling, mentoring, and assisting residents with work-personal life difficulties; and helping trainees and programs weather a variety of traumatic circumstances. These life-enriching experiences can compensate for the challenging aspects of these roles and sustain program directors through exceptionally rewarding careers.

A testing program's decision making on retake policy considers a number of factors, including fairness to examinees, examination security, examination purpose, and classification accuracy. For high-stakes licensure and certification examinations charged with protection of the public, this includes balancing fairness issues inherent in the potential for false negatives with the public protection need to minimize false positives. Since 2012, the United States Medical Licensing Examination (USMLE) has maintained a policy of ≤ 6 attempts on any examination component. The purpose of this study was to empirically examine the appropriateness of existing USMLE retake policy.A sample of over 300,000 examinees who were administered each Step examination between 2008 and 2018 was examined to address how pass rates (per attempt and cumulatively) differed for examinees and examinee subgroups via graphic depictions of pass rates, the impact of restricting the number of attempts on examinees and examinee subgroups via logistic regression analyses, and the impact of restricting the number of attempts on classification error via classification error analyses.Repeaters displayed consistently lower pass rates on subsequent attempts. Regardless of Step, most passing examinees did so by their fourth attempt. Models predicting the log odds of examinees taking ≥ 5 attempts showed a significant effect of gender, race, and medical school status, although the associated sample sizes are small. Misclassification analyses showed that, as attempts increased, the percentage of false passers increased and percentage of false failers decreased.These considerations led to the USMLE's decision to reduce its attempt limit from 6 to 4 on any Step or Step component effective July 2021. This change balances the competing interests of fairness and examination access to the examinee population, while simultaneously maintaining a minimum standard consistent with the mission of the USMLE program to protect the public.

To achieve the measurement reliability of amino acids used as diagnostic markers in clinical fields, establishing a reference measurement system is required, in which certified reference materials (CRMs) are an essential step in the hierarchy of measurement traceability. This study describes the development of dried blood spot (DBS) CRMs for amino acid analysis with complete measurement traceability to the International System of Units (SI). Six essential amino acids─proline, valine, isoleucine, leucine, phenylalanine, and tyrosine─were analyzed using isotope-dilution liquid chromatography-mass spectrometry (ID-MS). For minimizing measurement bias and uncertainty overestimation, whole spots with 50 μL of whole blood were adopted in the certification. The between-spot homogeneities by whole spot sampling were lower than 2.1%. The relative expanded uncertainties of the six amino acids in the developed DBS CRMs were lower than 5.7% at 95% confidence. The certified values are traceable to SI through both gravimetric preparation and the primary method in certification, ID-MS. Comparison among DBS testing laboratories revealed discrepancies between the whole spot and disc sampling methods. The actual sampling volume was accurately estimated by weighing, which revealed the possibility of underestimation in routine DBS testing. The candidate CRMs can support the standardization of DBS testing for amino acids through the qualification and validation of many kinds of measurement procedures to compensate the measurement bias caused by matrix-specific sampling error.

To measure associations between surgeons' examination performance and obtaining American Board of Surgery certification with the likelihood of having medical malpractice payments.Further research is needed to establish a broader understanding of the association of board certification and patient and practice outcomes.Retrospective analysis using propensity score-matched surgeons who attempted to obtain American Board of Surgery certification. Surgeons who completed residency between 2000 and 2019 (n=910) and attempted to become certified were categorized as certified or failing to obtain certification. In addition, groups were categorized as either passing or failing their first attempt on the qualifying and certifying examinations. Malpractice payment reports were dichotomized for surgeons who either had a payment report or not.The hazard rate (HR) of malpractice payment reports was significantly greater for surgeons who attempted and failed to obtain certification [HR=1.87; 95% confidence interval (CI), 1.28-2.74] than for surgeons who were certified. Moreover, surgeons who failed either the qualifying (HR=1.64; 95% CI, 1.14-2.37) or certifying examination (HR=1.72; 95% CI, 1.14-2.60) had significantly higher malpractice payment HRs than those who passed the examinations on their first attempt.Failing to obtain board certification was associated with a higher rate of medical malpractice payments. In addition, failing examinations in the certification examination process on the first attempt was also associated with higher rates of medical malpractice payments. This study provides further evidence that board certification is linked to potential indicators for patient outcomes and practice quality.

Our goals were to estimate how many physicians who were enrolled in a physical medicine and rehabilitation residency program are licensed to practice medicine without American Board of Physical Medicine and Rehabilitation board certification and to compare risk of state medical board disciplinary action with those who are board certified.We matched physicians who completed training in physical medicine and rehabilitation before 2019 with the Federation of State Medical Boards database. We compared certified versus noncertified physicians registered with Federation of State Medical Boards and frequencies of disciplinary action.There were 14,729 physicians with matched American Board of Physical Medicine and Rehabilitation and Federation of State Medical Boards data. Of these, 13,707 (93.1%) had attained initial American Board of Physical Medicine and Rehabilitation certification and 1022 (6.9%) had not. Certification status predicted a disciplinary action (odds ratio = 2.76; 95% confidence interval = 2.202-3.463; P0.001). Compared with the board-certified physicians, those who never passed part I (attempted once or more) were 4.68 times more likely to have a disciplinary action (P0.001), and those who passed part I with multiple attempts but failed part II (1 or more times) were 3.26 times more likely to have a disciplinary action (P = 0.013).Absence of American Board of Physical Medicine and Rehabilitation certification is noted in approximately 7% of physicians who undertook physical medicine and rehabilitation residency training and obtained medical licensure. These individuals are at higher risk for state medical board disciplinary action.

Este artículo forma parte del monográfico Turismo, peregrinación y comunidades, coordinado por Carlos Pazos-Justo, Beatriz Busto y Susana Sotelo [Resumo] Este texto tem como ponto de partida a análise de documentos jurídicos que estiveram na base da aprovação pelo Governo de Portugal do Decreto-Lei nº 51/2019, de 17 de abril, - e do próprio- cujo âmbito é definir o “itinerário do Caminho de Santiago”, tendo por objeto a “salvaguardar, valorização e promoção do Caminho de Santiago” em território português. Trata-se do primeiro diploma legal cujo corpo normativo visa regular o procedimento de “certificação” com vista ao reconhecimento do interesse público dos itinerários e a consequente utilização da Marca “Caminho de Santiago Certificado”. Nesta análise procura-se aferir de que modo a “repartição de responsabilidades com os cidadãos e com outros órgãos da administração pública de forma que, em matéria de património cultural, passe a evidenciar-se uma visão integrada e participada (...)” -preconizado no Programa do XXII Governo Constitucional- e se a mesma se encontra espelhado naquele diploma legal. Por fim, pretende-se extrair algumas reflexões no domínio da instrumentalização do Direito na determinação das “alianças” e quais as possíveis “ameaças” dessa instrumentalização. [Abstract] The study is based on an analysis of the legal documents behind Decree-Law nº 51/2019 (17 April), and the text of the legislation itself, whose purpose is to define the Portuguese Way of St James route in order to ‘safeguard, enhance and promote’ the pilgrimage in Portugal. This is the first piece of legislation designed to regulate the Way of St James certification procedure, prompted by public interest in the route and increased use of the ‘Caminho de Santiago Certified’ brand. The analysis assesses how the sharing of responsibilities with citizens and other public administration bodies to ensure an integrated, participatory view of heritage (as recommended in the Portuguese Programme for Government, 2019-2023) is reflected in Decree-Law 51/2019. The article concludes with a series of reflections on the instrumentalisation of law in the creation of these ‘alliances’ and the possible dangers of such a strategy.

There is limited literature examining the reasons physical medicine and rehabilitation residents take an extended leave of absence during residency and the impact of leave on board examination performance. Such information could better inform leave policies, help guide residency program directors, and potentially destigmatize taking leave. Study objectives were to describe the characteristics of physical medicine and rehabilitation residents who take leave during residency, compare differences in part I (written) and part II (oral) certification examination performance, and determine the prevalence of delays in taking board examinations. Study methodology was a retrospective analysis of deidentified information from the American Board of Physical Medicine and Rehabilitation database between 2008 and 2020. Results indicated four reasons for extended leave of absence: medical, parental, academic/remediation, and unspecified personal reasons. Residents who took an extended leave of absence for medical or parental reasons had similar or better odds of passing their part I and part II examinations compared with those without leave. Residents who took leave for academic/remediation concerns or unspecified personal reasons had lower odds of passing their board examinations. Examination delays for those taking parental or personal health leaves did not affect board pass rates. Further investigation is needed to identify how to support residents on academic/remediation and unspecified leaves during training.

We assess the effects of land markets on misallocation and productivity both empirically and quantitatively. Exploiting variation from a land certification reform across time and space in Ethiopia, we find that certification facilitates rentals and improves agricultural productivity. We calibrate a quantitative macroeconomic model with heterogeneous household farms facing institutional costs to land markets using the micro panel data. The effect of a counterfactual reallocation from no rentals to efficient rentals increases zone-level agricultural productivity by 43 percent on average. While our estimated institutional costs are strongly associated with land certification across zones, there are nontrivial residual frictions to rental market activity, implying that land certification only partially captures the overall effects of rentals. A full certification reform accounts for about one-fourth of the overall productivity gains from land rentals. This result highlights the importance of comprehensive reforms alleviating frictions to land transactions beyond the granting of certificates.

International audience; This paper addresses the observability analysis and the optimal design of observation parameters in the presence of noisy measurements and parametric uncertainties. The notion of almost !-observability is introduced and a systematic procedure to assess its satisfaction for a given system with a priori known measurement noise statistics and parameter discrepancy is sketched. Moreover, the concept of observation-target quantities is introduced in order to analyze the precision with which specific chosen expressions of the state and the parameters can be reconstructed. The overall framework is exposed and validated through an illustrative example.

In the medication management process, storage methods constitute a step at risk of errors that needs to be secured. As part of an institutional project, computerized medicine cabinets (CMC) have been deployed in our hospital’s emergency and intensive care units. In order to meet the requirements of the certification, the deployment of CMC in all care units has been decided. Each deployment includes many steps and involves several trades that must be coordinated. We decided to formalize these steps in the form of a checklist. Two pharmacists listed all the tasks required to install a CMC. They were ordered chronologically, and a person responsible for each step is proposed. All those involved in the installation of CMC in the care units validated the checklist. The checklist is broken down into 13 major steps, from the assessment of the need to the installation of CMC in the care units. Before installation, several months are required, particularly in terms of the delivery time of the CMC. Support and training for the pharmacy technicians and caregivers are essential to ensure the teams enrolment. The checklist provides to boost CMC installations by involving and empowering more accountable all participants, coordinated by the pharmacist. Moreover, it contributes to save time and to improve the management of every ongoing deployments.

This article was migrated. The article was marked as recommended. Background: Interpreters may offer valuable perspectives on ways clinicians could improve communication skills. Relationship-centered communication (RCC) curricula are based on a framework for promoting effective communication both with patients and within health care teams. Methods: We conducted a 90-minute workshop with certified interpreters at an academically-affiliated safety-net system to solicit feedback to optimize RCC skills trainings for clinicians at a U.S. academically-affiliated safety-net system. We applied an editing analysis style to transcribed quotes to reveal opportunities to optimize RCC skills trainings to improve safety-net care for diverse populations. Results: Twenty-two Spanish-, Cantonese-, Mandarin-, Vietnamese-, and Russian-speaking interpreters participated. Overall, interpreters emphasized the importance of creating a supportive environment for safety-net patients. One Spanish-speaking interpreter added: "When they get up in the morning and go to work, they may get deported. So, that's important to create an atmosphere to help them open up. And they may tell you stuff that's directly pertinent to patient care." Thematic analysis revealed opportunities to tailor and reinforce each RCC stage. On agenda-setting and rapport-building: "We need a little background on the phone, and we don't know how many people are in the room ... Sometimes you're talking to the mom, but the doctor didn't even bother to say it.. [If] we're lost, we're bound to make mistakes." On eliciting the patient's perspective: "Start with this information so they know you're still going to give them your advice: "I'm going to let you know what I think is going on, but what do you think is going on?" On negotiating a shared plan: "[Teachback] is really important. Otherwise it puts an incredible burden on the interpreter ... I'm not sure that the patient really understood." Conclusions: Teaching RCC in partnership with medical interpreters could provide opportunities to deepen clinician RCC skills for more effective patient-interpreter-clinician interactions.

This is Apollo's CoreTrustSeal certification full application document. It is also publicly available via the "CoreTrustSeal Certified Repositories" page, https://amt.coretrustseal.org/certificates

The purpose of this mixed-methods study is to analyze the U.S. equine industry’s availability of riding instruction certification options, describe the relationship between professional certification and the self-efficacy of horseback riding instructors in the U.S., and explore the expectations that consumers have of instructors and instructor selection criteria. Two surveys were developed and sent out to instructors and consumers aligned with the research objectives designed to collect information on instructors’ self- perception of self-efficacy after certifying their perceived barriers to receiving certification, and consumers’ selection criteria for instructors. The average certified instructor was extremely satisfied with their decision to pursue certification and achieve certification, and the perception of improvement of self-efficacy for the average certified instructor showed that the respondent believed very strongly that the process of receiving a certification improved their self-efficacy. The top three barriers perceived by instructors to obtaining certification were the expense, time, and geographic inaccessibility to workshops. Consumers seek instructors with high levels of horsemanship skills and soft skills, as well as competition experience in specific disciplines, with certification being the fifth most important out of seven characteristics. The results of this study will help professional organizations, third-party stakeholders, and post-secondary education in the development of programming aimed toward certification acquisition for professional riding instruction.

The year 2020 has witnessed the emergence of coronavirus disease (COVID-19) that has rapidly spread and adversely affected the global economy, health, and human lives. The COVID-19 pandemic has exposed the limitations of existing healthcare systems regarding its inadequacy to timely and efficiently handle public health emergencies. A large portion of today's healthcare systems are centralized and fall short in providing necessary information security and privacy, data immutability, transparency, and traceability features to detect frauds related to COVID-19 vaccination certification, anti-body testing, and medical supplies. Blockchain technology can assist to combat the COVID-19 pandemic by assuring safe and reliable medical supplies, accurate identification of virus hot spots, and establishing data provenance to verify the genuine personal protective equipment that is decentralized, trustworthy, traceable, and transparent. In this paper, we discuss the potential blockchain applications for the COVID-19 pandemic. We present the high-level design of three blockchain-based systems to enable the governments and medical professionals to efficiently handle health emergencies caused by COVID-19. We discuss the important ongoing blockchain-based research projects to demonstrate the adoption of blockchain technology for the COVID-19. Finally, we identify and discuss future research challenges along with their key causes and guidelines.

Indonesia has been known to have abundant natural resources and culture-based creative industries. The country is therefore vulnerable to the practice of fraud of origin. One of many industrial sectors susceptible to that particular crime is the wooden furniture businesses. In many cases, it is apparent that natural products and raw materials of Indonesia are being exported without listing the country as the place of origin. The most common Indonesian material falls within this illegal practice are timber products. In the province of Central Java, Jepara has been a prominent center of timber industry producing high quality timber products and wooden raw materials. From a unique standpoint, the timber industry in Jepara is deeply rooted to the culture and identity of the natives, making the attempt to separate the discussion between timber industry and the people of Jepara not only imprudent but virtually impossible. By looking at the statistic in which Jepara’s public education level is assessed to be still below the national standard, and as well bearing to the general fact that the timber actors in Jepara are more focused on product sales rather than important technical aspects such as certification of origin, it should be projected that crimes such as fraud of origin could be easily committed in Jepara. This study is using a comparative advantage theory and theories or models of H-O to investigate how the practice of fraud of origin in Jepara occurs and how to resolve such problem.

Based on the interpretation of regulatory requirements to describe the approach to risk-oriented medical devices design and development strategy and approaches to their certification in Ukraine market. The approach to the medical devices design and development strategy is described taking into account the classification by level of risk; a tree of decisions on determining the risk class and certification of medical devices according to the requirements of the Technical Regulation № 753 is presented.

Care of the critically injured burn patient presents unique challenges to the intensivist. Certified burn centers are rare and geographically sparse, necessitating that much of the initial management of patients with severe burn injuries must happen in the pre-burn center setting. Severe burn injuries often lead to a wide range of complications that extend beyond the loss of skin integrity and require specialized care. As such, medical intensivists are often called on to stabilize these critically injured patients. This focused review outlines the clinical care of these medically complex patients, including airway management, postburn complications, volume resuscitation, nutrition, and end-of-life care.