Search

Health care providers are increasingly using clinical measures derived from electronic health records (EHRs) for risk stratification and predictive modeling. EHR-specific data elements such as prescriptions, laboratory results, and vital signs have been shown to improve risk prediction models. In this study, the value of EHR-based blood pressure (BP) values was assessed in predicting health care costs (ie, total, medical, and pharmacy) and key utilization end points (ie, hospitalization, emergency department use, and being among the highest utilizers). The study population included 37,451 patients of a large integrated delivery system in the mid-western United States with complete EHR data files, who were 18-64 years old, had continuous insurance at an affiliated health plan, and had eligible BP records. Both EHRs and insurance claims of the study population were used to extract the predictors (ie, demographics, diagnosis, and BP values) and outcomes (ie, costs and utilizations). Predictors were extracted from 2012 data, whereas concurrent and prospective outcomes were extracted from 2012 to 2013 data. Three base models (BMs) were constructed to predict each of the outcomes. The first BM no. 1 used demographics. The second BM no. 2 added the Charlson comorbidity index to BM no. 1, whereas the third BM no. 3 added the Adjusted Clinical Group Dx-PM case-mix score to BM no. 1. BP was specified as means, ranges, and classes. Adding BP ranges to BM no. 1 and BM no. 2 showed the greatest improvements when predicting costs and utilization. More specifically, adjusted R2 and area under the curve of BM no. 2 improved by 32.9% and 14.1% when BP ranges were added to predict concurrent total cost and hospitalization, respectively. The effect of BP measures on improving the risk stratification models was diminished when predicting prospective outcomes after adding the measures to BM no. 3 (ie, the more comprehensive diagnostic model), specifically when represented as BP means. Given the increasing availability of BP information, this research suggests that these data should be integrated into provider-based population health analytic activities. Future research should focus on subpopulations that benefit the most from incorporating vital signs such as BP measures in risk stratification models.

BackgroundGPs are well placed to enhance shared decision making (SDM) about treatment for patients with advanced cancer. However, to date, little is known about GPs’ views about their contribution to SDM.AimTo explore GPs’ perspectives on their role in SDM about palliative cancer treatment and the requirements they report to fulfil this role.Design and settingQualitative interview study among Dutch GPs.MethodGPs were sampled purposefully and conveniently. In-depth, semi-structured interviews were conducted, recorded, and transcribed verbatim. Transcripts were analysed by thematic analysis.ResultsFifteen GPs took part in this study. Most of them reported practices that potentially support SDM: checking the quality of a decision, complementing SDM, and enabling SDM. Even though most of the GPs believed that decision making about systemic cancer treatment is primarily the oncologist’s responsibility, they did recognise their added value in the SDM process because of their gatekeeper position, the additional opportunity they offer patients to discuss treatment decisions, and their knowledge and experience as primary healthcare providers at the end of life. Requirements for them to support the SDM process were described as: good collaboration with oncologists; sufficient information about the disease and its treatment; time to engage in conversations about treatment; a trusting relationship with patients; and patient-centred communication.ConclusionGPs may support SDM by checking the quality of a decision and by complementing and enabling the SDM process to reach high-quality decisions. This conceptualisation of the GP’s supporting role in SDM may help us to understand how SDM is carried out through interprofessional collaboration and provide tools for how to adopt a role in the interprofessional SDM process.

Background: The coronavirus disease 2019 (COVID-19) pandemic led to the suspension or postponement of care for non-urgent conditions worldwide. Regula Mais Brasil is an initiative of the Unified Health System (SUS) in Brazil to optimize the management of referrals to specialized care by using telehealth. Objectives: To report the expansion of telehealth activities of Regula Mais Brasil in response to COVID-19 and to assess qualification of referrals in primary health care (PHC) units as well as the added value of teleconsultation in qualifying referral cases. Methods: Descriptive study of the teleconsultations carried out as an additional strategy to the remotely operated referral management system, responsible for navigating cases from PHC units to specialized care in Recife, Brazil, between May 6, 2020 and September 30, 2020. Teleconsultation was implemented as a tool for reducing delays in the access to health care due to COVID-19 and ultimately allowed for reclassification of the referral adequacy and priority. Changes in referral priority ratings and referral decisions after teleconsultation were analyzed. Results: A total of 622 referral cases were analyzed. Approved referrals represented 51.9% of cases. The main reason for approved referrals was the need for diagnostic resources. There was a reduction in priority ratings in 449 cases (72.2%) after teleconsultation. There was a statistically significant association between the change of priority ratings and the decision on referral (Pearson's χ2, p-value

Advance warning of seasonal conditions has the potential to assist water management in planning and risk mitigation, with large potential social, economic, and ecological benefits. In this study, we explore the value of seasonal forecasting for decision-making at five case study sites located in extratropical regions. The forecasting tools used integrate seasonal climate model forecasts with freshwater impact models of catchment hydrology, lake conditions (temperature, water level, chemistry, and ecology), and fish migration timing and were co-developed together with water managers. To explore the decision-making value of forecasts, we carried out a qualitative assessment of (1) how useful forecasts would have been for a problematic past season and (2) the relevance of any windows of opportunity (seasons and variables where forecasts are thought to perform well) for management. Overall, water managers were optimistic about the potential for improved decision-making and identified actions that could be taken based on forecasts. However, there was often a mismatch between those variables that could best be predicted and those which would be most useful for management. Reductions in forecast uncertainty and a need to develop practical, hands-on experience were identified as key requirements before forecasts would be used in operational decision-making. Seasonal climate forecasts provided little added value to freshwater forecasts in these extratropical study sites, and we discuss the conditions under which seasonal climate forecasts with only limited skill are most likely to be worth incorporating into freshwater forecasting workflows. MINECO-AEI [PCIN-2017062, PCIN-2017-092]; FORMAS; BMBF; EPA; RCN [274208]; IFD; European Union [690462] Published version This work was carried out as part of the WATExR project, part of ERA4CS, an ERA-NET initiated by JPI Climate and funded by MINECO-AEI (ES; grant nos. PCIN-2017062 and PCIN-2017-092), FORMAS (SE), BMBF (DE), EPA (IE), RCN (NO; grant no. 274208), and IFD (DK), with co-funding by the European Union (grant no. 690462).

The affordances of technology-based assessments, like the Objectively Structured Practical Examination, have become an integral part of gross anatomy courses. The Department of Anatomy Faculty of Medicine at the University of Warmia and Mazury developed and introduced an application for tablet devices which has been implemented in student examinations and assessments, called the tablet-assisted objective structured spotter practical examination (TOSSPE). It was created to simplify the educational process and to build a rich learning environment, facilitating deep learning for students through examination and feedback data. The method consists of cadaver stations with traditional corresponding pin spotters in an expanded tablet application. It not only provides instant feedback on various observations of teaching-learning skills but has also positively affected the entire process of education. The method provides an unbiased evaluation of knowledge and understanding of the anatomy course, ensuring objectivity and standardization. The current study was performed on a total of 608 first year medical students in Polish and English divisions and focused on the observed advantages since the new method was introduced. Outcomes indicate that after the implementation of the method for both the Polish and English divisions' first-year medical students, the mean score of examinations significantly increased compared to other teaching-learning methods. The study highlights that students were excited about the implementation of the new method and identified its many benefits. It is recognized that technological development and the digital environment offer a range of opportunities and added value versus traditional assessment activities, methods, and processes.

Identifying the inter-sectoral relationships between the construction sector and other related sectors is crucial to reducing carbon emissions and promoting economic development. Non-competitive input–output models at comparable prices in 1992, 1997, 2002, 2007, 2012, and 2017 were used to conduct this study. The structural production layer difference (SPLD) method was employed in this study and complemented with the results of structural decomposition analysis to identify significant sectors affecting economic growth and carbon emissions in the construction sector. Overall, the carbon emissions and economic growth of China's construction sector in 2017 increased by 2.4 billion tonnes and 10512.4 billion yuan, respectively, compared to 1992 at the 2000 price level. Important sectors influencing economic growth and carbon emissions in the construction sector are identified. Wholesale and retail trade sector (s31) and finance sector (s33) increased the economic growth of the construction sector without the additional emission of CO2, which is economically and environmentally sustainable. Smelting and processing of the metals (s15) and transport and storage (s29) sectors simultaneously restrained economic growth and inhibited carbon emissions in the construction sector. The production and distribution of the electric and heat power sector (s25) stimulates the growth of carbon emissions in the sector of smelting and processing of the metals (s15), reducing the carbon reduction effect of smelting and processing of the metals (s15) on the construction sector. The SPLD results revealed that the direct impact of other services sector (s35) and transport and storage (s29) on carbon emissions in the construction sector has not been highlighted by the structural decomposition analysis (SDA). In terms of economic added value, processing of petroleum coking and the nuclear fuel sector (s12) is a pivotal sector in the supply chain influencing the added value from the extraction of petroleum and natural gas sector (s3) to the construction sector according to the results of SPLD.

Supplemental Digital Content is available in the text., Background and Purpose: Blinded outcome assessment in trials with prospective randomized open blinded end point design is challenging. Unblinding can result in misclassified outcomes and biased treatment effect estimates. An outcome adjudication committee assures blinded outcome assessment, but the added value for trials with prospective randomized open blinded end point design and subjective outcomes is unknown. We aimed to assess the degree of misclassification of modified Rankin Scale (mRS) scores by a central assessor and its impact on treatment effect estimates in a stroke trial with prospective randomized open blinded end point design. Methods: We used data from the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands). The primary outcome was the mRS at 90 days. Standardized, algorithm-based telephone interviews to assess the mRS were conducted from a central location by an experienced research nurse, unaware but not formally blinded to treatment allocation (central assessor). Masked reports of these interviews were adjudicated by a blinded outcome committee. Misclassification was defined as an incorrect classification of the mRS by the central assessor. The effect of endovascular treatment on the mRS was assessed with multivariable ordinal logistic regression. Results: In MR CLEAN, 53/500 (10.6%) of the mRS scores were misclassified. The degree and direction of misclassification did not differ between treatment arms (P=0.59). Benefit of endovascular treatment was shown on the mRS when scored by the central assessor (adjusted common odds ratio, 1.60 [95% CI, 1.16–2.21]) and the outcome adjudication committee (adjusted common odds ratio, 1.67 [95% CI, 1.21–2.20]). Conclusions: Misclassification by the central assessor was small, randomly distributed over treatment arms, and did not affect treatment effect estimates. This study suggests that the added value of a blinded outcome adjudication committee is limited in a stroke trial with prospective randomized open blinded end point design applying standardized, algorithm-based outcome assessment by a central assessor, who is unaware but not formally blinded to treatment allocation. Registration: URL: https://www.isrctn.com; Unique identifier: ISRCTN10888758.

Competitive performance is one of the important means in companies, as most companies suffer from the problem of misuse of economic resources in an optimal manner, which affects their ability to create added value and consequently the decline of the company’s contribution to raise the gross domestic product. To reach to final results of the company, we have to identify its strengths and weaknesses and choose the appropriate strategy to improve the reality of the facility and work on increasing productivity and reducing losses to the least possible. The aim of the research is to develop solutions to correct the company's performance competitive in line with the company's objectives. The research is divided into two sections, the first section deals with the concept of competitive performance, its elements and indicators, and the analysis of the internal and external competitive environment. The second section deals with the analysis of the internal and external environment within the Porter model of Iraqi Company for Seed Production (ICSP) and improving competitive performance and rehabilitating it. The research concluded with a number of conclusions and recommendations.

Food insecurity, defined as the lack of physical or economic access to safe, nutritious and sufficient food, remains one of the main challenges included in the 2030 Agenda for Sustainable Development. Near real-time data on the food insecurity situation collected by international organizations such as the World Food Programme can be crucial to monitor and forecast time trends of insufficient food consumption levels in countries at risk. Here, using food consumption observations in combination with secondary data on conflict, extreme weather events and economic shocks, we build a forecasting model based on gradient boosted regression trees to create predictions on the evolution of insufficient food consumption trends up to 30 days in to the future in 6 countries (Burkina Faso, Cameroon, Mali, Nigeria, Syria and Yemen). Results show that the number of available historical observations is a key element for the forecasting model performance. Among the 6 countries studied in this work, for those with the longest food insecurity time series, that is Syria and Yemen, the proposed forecasting model allows to forecast the prevalence of people with insufficient food consumption up to 30 days into the future with higher accuracy than a naive approach based on the last measured prevalence only. The framework developed in this work could provide decision makers with a tool to assess how the food insecurity situation will evolve in the near future in countries at risk. Results clearly point to the added value of continuous near real-time data collection at sub-national level.

Higher education institutions annually produce hundreds to thousands of graduates with the same or similar education. The new graduates only with academic background compete with the graduates from previous years who have acquired some practical experience. The individual will only assert themselves through the complex of superstructure competencies and the ability to apply them effectively and practically for the benefit of the employer. The paper aims to present research focused on the analysis of soft skills and summarising the requirements for the soft skills competencies of the graduates from the Technical University in Zvolen in terms of employers’ expectations in the Slovak republic. The research was carried out in the form of a questionnaire survey, and the results of the questionnaire survey were evaluated by the method of mathematical-statistical analysis by non-parametric testing of significance. On the basis of the testing of significance, the hypothesis for specific areas of soft skills competencies was confirmed, suggesting that students’ competencies in these areas do not reach the level demanded by enterprises, and therefore, it is necessary to improve the quality of education in that area to match students’ real knowledge with business requirements. Implications for Central European audience: The global labour market requires the introduction of new competencies so that university graduates can work in a domestic or transnational context. An advantage is the added value showed by various interpersonal skills represented by soft skills. In the research, we focused on the analysis and summarising the requirements for the soft skills. Based on the testing of significance, the hypothesis of the statistical significance of the difference for specific areas of soft skills competencies was confirmed, suggesting that students’ competencies in these areas do not reach the level demanded by enterprises. Soft skills and emotional behaviours deficits could affect business outcomes.

Wastewater from the food industry is increasingly recognized as a valuable source of energy and as a resource for new products and not as waste. The reutilization and valorization of wastewater contributes to combating water scarcity and to improve the energetic efficiency of treatment facilities. Moreover, it has the added benefit of reducing environmental impact and providing economically interesting added value products. This review discusses the most recent approaches for the valorization of food industry wastewaters of different origins (dairy, brewery, oil mill, fish, meat, among others) and the products obtained, from energetic resources such as biogas and biofuel to the recovery of biopolymers, pigments, phenolic compounds, and other added value products. A critical overview regarding the bottlenecks of large-scale implementation of resource recovery strategies, including up-scaling, quality and quantity of the effluent, legislation, and economic, environmental, and social issues related to the use of products derived from waste, is herein presented.

PurposeThis research aims to identify how important it is that brands incorporate relevant-added value into their esports sponsorships.Design/methodology/approachThis exploratory research applied a convergent-parallel mixed method with equal status. Data were collected by interviewing 22 experts in esports sponsorships and having 5,638 esports fans fill out an online survey. SPSS 25 was used to analyze quantitative data and NVIVO 10 to process qualitative data. Each dataset was analyzed separately and then compared with both having the same level of importance.FindingsThe results revealed that all experts considered the creation of relevant-added value as an essential strategy for successful esports sponsorships and the large majority of fans want sponsors to apply this tactic. Interestingly, while the experts mostly emphasized ways to directly benefit the fan-base, the fans prefer that sponsors focus on directly supporting the esports industry.Practical implicationsBrands should incorporate relevant-added value into their esports sponsorships as it greatly decreases fan resistance to the promotional message, catches the fans' attention and engagement much more easily, has a much higher probability of leading to high positive return on investments (ROIs) and makes for a much more cost-effective investment.Originality/valueThe field of esports sponsorships has received little academic attention and the results are highly significant and relevant for all current and potential esports sponsors looking to increase the effectiveness of their esports sponsorships.

The performance audit is an effective instrument in the process of managing public money by analyzing a border range of matters, conducting an objective and independent evaluation of the extent to which public funding is used using the principles of economy, efficiency, effectiveness. The progress of performance audit in the Republic of Moldova is as well a priority because the allocation of public resources takes place to achieve social and economic objectives, but having regard to that resources are limited and allocated as a result of setting priorities and needs, they are managed based on the principles of "3E". In this regard, the auditors, at the performance audit planning stage, exclude the risk that the audit activities will not be proficient or efficacious, and the results of the audit will not add value to the public entity in managing public financial resources and public heritage. The author, in this study, examines the quality assurance of the processes performed during the performance audit planning stage and proposes to the auditors the use of other tools practiced in developed countries in selecting entities/programs or activities for auditing with the implementation of professional judgment.

This is the first article of a series, devoted to a comprehensive problem of economic and geopolitical rivalry of the leading global powers in energy sector. It is dedicated to a number of topical issues of world economy and Russian economic environment. A systematic analysis of long-term world energy economy development trends is performed. For this purpose, a cause-and-effect relationship between international supply chains and energy procurement, on one hand, and revolutionary changes of international economic relations, caused by USA - China and Russia - USA, EU sanctions exchange, on the other, is derived. It is concluded that a developed gas industry is to play a decisive role in insuring global energy leadership of the major global powers on a mid- and long-term basis. A scenario analysis of further European gas market developments is provided. The external effects of developing gas industry are contemplated for Russian economic environment. In this framework most efficient options of action by Russian state are observed.

Purpose of review The development and progression of chronic respiratory diseases are impacted by a complex interplay between genetic, microbial, and environmental factors. Here we specifically summarize the effects of environmental exposure on asthma, allergic rhinitis, and chronic rhinosinusitis. We furthermore discuss how digital health technology may aid in the assessment of the environmental exposure of patients and how it may be of added value for them. Recent findings It is well established that one gets allergic symptoms if sensitized and exposed to the same allergen. Viruses, bacteria, pollutants, irritants, and lifestyle-related factors modify the risk of getting sensitized and develop symptoms or may induce symptoms themselves. Understanding these processes and how the various factors interact with each other and the human body require big data and advanced statistics. Mobile health technology enables integration of multiple sources of data of the patients' exposome and link these to patient outcomes. Such technologies may contribute to the increased understanding of the development of chronic respiratory disease. Summary Implementation of digital technologies in clinical practice may in future guide the development of preventive strategies to tackle chronic respiratory diseases and eventually improve outcomes of the patient.

Digitalization of the economy is fundamentally changing the professional environment. Artificial intelligence is becoming a full-fledged participant in professional activity along with humans. The creation of a product with in-demand properties is ensured by the interaction of a changing environment, natural and artificial intelligence. It is important to train a specialist-actor who is able to create technical systems with artificial intelligence and build productive relationships with such systems in real time. The new reality has exacerbated the problem of the intensification of the increase in the value of higher education. The article argues that the added value of higher education is realized in the transition of a university graduate from a passive and reactive acquirer of knowledge to an active specialist-actor, creator of a qualitatively new product in almost any area of interest due to holistically presentation of productive activity and a conscious choice of the type of relationship with participants in professional activity including artificial intelligence. The necessity and possibility of transition to the strategy of organizing the structure and content of higher education based on the transfer of the ontological status of both subjects and the environment on the relations between them, providing the effect of interaction of heterogeneous participants in a distributed network of relations and mediating the interobjectivity (integrity of activity) of the impact on the object of all participants in the creation is proved.

Purpose This paper aims to explore the added value of healthy workplaces for employees and organizations, in particular regarding employee satisfaction, labour productivity and facility cost. Design/methodology/approach The paper is based on a narrative review of journal papers and other sources covering the fields of building research, corporate real estate management, facilities management, environmental psychology and ergonomics. Findings The review supports the assumption of positive impacts of appropriate building characteristics on health, satisfaction and productivity. Correlations between these impacts are still underexposed. Data on cost and economic benefits of healthy workplace characteristics is limited, and mainly regard reduced sickness absence. The discussed papers indicate that investing in healthy work environments is cost-effective. Originality/value The findings contribute to a better understanding of the complex relationships between physical characteristics of the environment and health, satisfaction, productivity and costs. These insights can be used to assess work environments on these topics, and to identify appropriate interventions in value-adding management of buildings and facilities.

Theoretical background: The present article focuses on the assessment of the readiness of representatives of science, business and local administration in Poland to establish mutual cooperation in the areas of leadership, management style, competences and technologies. Subject literature refers to the cooperation of these three spheres as the triple helix. The literature, however, still lacks an assessment of readiness to cooperate from the perspective of science, business and administration. This article belongs to the area of institutional economics. Purpose of the article: The main purpose of this article was to present the functioning of cooperation between representatives of science, business and administration in Lublin and Warsaw. The methodological purpose was to develop the proprietary methodology of readiness to function according to the Triple Helix Readiness concept as a tool for assessing the level of readiness of the scientific, business and administration environment for mutual cooperation in Polish cities. The empirical purpose was to evaluate Polish cities in terms of their preparation for cooperation, as well as to formulate recommendations for the science, business and administration environment focused on increasing the effectiveness of mutual cooperation. Research methods: Qualitative and quantitative research methods were selected. Among the qualitative methods, a diagnostic survey was used. The Computer-Assisted Self Interviewing (CASI) online survey technique was also used, which is in line with the quantitative methodology of market and opinion research. The tool used to conduct the research was an Internet questionnaire addressed to stakeholders. For the present article we adopted the assumption that the adaptation of the modified Net Readiness methodology will enable us to assess the level of readiness of the science, business and administration environments in Poland to establish mutual cooperation. The author modified the original Net Readiness methodology for the purposes of conducting the research. Main findings: The adopted research hypothesis: cooperation between science, business and administration is determined by various factors. Diversifiation of the level of cooperation depends on the management style, leadership, level of competence and technology advancement used. The results of our research indicate that the readiness to cooperate with external entities depends on many factors. From the perspective of enterprises, these include the level of advancement of information systems, modern tools supporting knowledge management, their research and development activities, registered and transferred patents, trademarks and training expenditure. On the other hand, universities pay attention to the possibility of commercializing their solutions and later marketing them. Still other factors determine the readiness to undertake such cooperation on the part of cities and towns. The main added value of this article is that it adds to the scientific output an assessment of the readiness of the scientific, business and administration communities to cooperate under the triple helix model and recommendations focusing on increasing the effectiveness of their mutual cooperation.

Ecological civilization is an advanced form after industrial civilization. Improving China's ecological civilization system will provide developing countries with experience and guidance. The study is dedicated to determining the path dependence characteristics of ecological civilization construction to promote regional sustainable development. This paper estimates the path dependence pattern and evolution of ecological civilization construction in 13 cities in Jiangsu Province and uses entropy method, Pearson correlation coefficient, regression model and other methods to determine the interaction of the "social-economic-natural" system in the construction of ecological civilization relationship. All in all, the path dependence phenomenon gradually appeared in the construction of ecological civilization, and the regional heterogeneity was obvious. The characteristic of path dependence in the southern region is the most significant, and there is a strong dependence on economic development. In particular, reducing pollution emissions, improving resource utilization, alleviating employment and population pressure and improving residents' living standards play an important role in breaking through regional path dependence. From the perspective of the social-economic-natural system, the systemic benign interaction situation required for the construction of a new ecological civilization has not yet appeared. The interaction of natural systems is significantly insufficient. It is recommended that the government guide funds to invest in green industries and develop central cities to promote the development of ecological civilization in the surrounding areas. Financial institutions support green enterprises and provide financial support for polluting enterprises to complete industrial upgrading. Enterprises take the initiative to eliminate outdated production capacity, promote cleaner production models and increase the added value of products.

Purpose The purpose of this paper is to investigate how an Urban Facilities Management (Urban FM) focused summer school in Norway in 2019 impacted knowledge creation, as well as the host and foreign educators, along with the international student participants. Design/methodology/approach This paper’s data collection is formed as a “post-event study” using interviews and a quantitative survey from both the students and educators to look at the impact of the summer school on the student and the associated educational programs. Findings The outcomes of this study indicate that the impact on educators and their educational programs was substantial with regard to their teaching experiences. The study confirmed that foreign experience allowed not just for greater potential for cross institution cooperation for the future but also allowed for the usage of the summer school case studies in host and guest educational programs. For the students, the added value was in the international experience primarily and a chance to study on a case study project. The study was also successful in the dissemination of Urban FM knowledge. Originality/value This paper also offers added theoretical value in the development of a model in future projects on how to capitalize on the potential impact of the summer school on educators and students. The possibilities for increased dissemination and knowledge creation in Urban FM is also significant.

Objective The transferability of the EU joint clinical assessment (JCA) reports for pharmaceuticals for the German benefit assessment was evaluated by systematically comparing EU JCA and German clinical assessments (CA) based on established assessment elements for HTA and assessing the potential impact of differences on Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA) ability to derive the therapeutic added value. Methods Identification of all pharmaceuticals undergoing both, EU JCA and German CA between January 2016–June 2020. Qualitative review and data extraction from the assessments, assessment of methodological differences using a hierarchical model. Recommendations for harmonisation were developed and consented with pharmaceutical industry stakeholders. Results Differences with potentially major impact: (1) View on differing treatment algorithms and definition of corresponding subpopulations/respective comparators. (2) Clinical relevance of surrogate/intermediate endpoints. Inclusion of different/surrogate morbidity endpoints resulting in different relative effectiveness conclusions. (3) Tolerance of study interventions not used according to marketing authorisation. (4) Different operationalisation and/or weighting of individual safety endpoints leading to differing relative safety conclusions. Differences with potentially minor impact: (1) Disagreement in risk of bias assessment for overall survival and its robustness against study limitations. (2) Use of patient-reported outcome symptom scales as measurements for health-related quality of life instruments. Conclusion While many synergies between EU JCA and German CA exist, we identified several aspects in HTA methodology that would benefit of harmonisation and ensure the transferability of future EU JCA to the German HTA process without duplicated evaluation requirements. For those, a set of recommendations was developed.

Mitra Promas adalah kelompok wanita tani sayur yang hanya bekerja sebagai ibu rumah tangga dan terkadang sebagai buruh musiman. Kegiatan PKM ini dilakukan di desa Suralaga Kecamatan Suralaga Kabupaten Lombok Timur NTB pada bula April sampai Desember dengan tujuan membangkitkan jiwa wirausaha para ibu-ibu rumah tangga di desa ini dengan berbahan baku sayuran yang mudah, murah dan selalu ditanam. Kesuburan tanah di desa ini sangat berpotensi untuk menenam berbagai macam jenis sayuran karena system perairan yang lancar sehingga tidak membutuhkan air hujan atau tidak bersifat musiman. Petani di desa Suralaga cendrung memilih tanaman sayuran daripada menanam padi karena umur tanam yang singkat. Metode yang digunakan dalam kegiatan ini berupa pendampingan dan pelatihan. Produk yang akan diperkenalkan dalam kegiatan PKM ini adalah dari jenis Sawi putih (Brassica Rappa) yang merupakan jenis tanaman hortikultura yang memiliki nilai gizi tinggi apabila dimanfaatkan secara baik dan dengan sentuhan teknologi sehingga dapat memberikan nilai tambah secara ekonomis untuk meningkatkan pendapatan masyarakat dan terbukanya lapangan kerja. Tujuan kegiatan PKM ini adalah untuk melatih ibu- ibu rumah tangga untuk untuk mengembangkan jiwa wirausaha yang sudah lama vakum karena pada dasarnya kelompok usaha yang akan dibina merupakan kelompok usaha yang pernah ada yaitu KUB WATISA (Kelompok Usaha Bersama Wanita Tani Sayur Suralaga tapi tidak berjalan dengan baik.

The German industry originates and uses the concept of industry 4.0 for the effective production. In today’s scenario, the technologies like the Internet of Things (IoT), cyber-physical systems and the emergence of industries have negative impact on environmental sustainability. While continuing to further economic growth, China provokes the dual experiment of reducing utilization of energy. The types of technological and financial opportunities are affected by the improvement in economic growth. In order to deal with the increasingly prominent energy constraints and increasingly serious problems in the economic and social development, this paper uses the grey theory which can contract with the little information and uncertainty in the system, and establishes the GM (1, 1) prediction model for carbon emissions prediction and the added value of various industries in China. All the experiments are done by using MATLAB. It is observed from the results that the carbon emissions under LC and ELC scenarios will decrease by 18.87% and 36.82% respectively as compared with Bau scenario. The conclusion confirmations that the carbon emissions of various industries in China are on the rise, and the carbon emissions will be greatly reduced by 2030.

Purpose: This article is centered on the Mixed Methods Research (MMR) used by the “Sports Life” research team to analyze the conditions under which social interactions are developed in the physical...

Purpose Health problems among employees with a lower socioeconomic position (SEP) often result from an interplay of problems on multiple life domains. Contextual factors greatly affect implementation of interventions that aim to solve these type of problems. The aim of this study was to gain insight into the organizational and socio-political context for implementation of preventive interventions that consider multiple life domains among employees with a lower SEP. Methods In total 16 semi-structured interviews were conducted with stakeholders at organizational level, occupational health service (OHS) level, and at socio-political macro level. Thematic analysis was performed to identify themes that describe the perceptions of stakeholders about the impact of contextual factors on implementation. Results The following themes were identified: (1) the importance of addressing problems on multiple life domains among employees with a lower SEP, (2) unclarity of responsibilities for solving problems on multiple life domains, (3) necessity of better collaboration between occupational and curative healthcare, (4) insufficient investments in prevention by employers, (5) difficulties in early identification of employees at risk for health problems, and (6) risk of conflicting role for supervisors in addressing problems on multiple life domains. Conclusions Implementation of preventive interventions considering multiple life domains among lower SEP employees is challenging, due to various contextual factors. To improve the feasibility, many different stakeholders both in- and outside occupational health practice need to be involved, collaborate, and need to be convinced of the added value to prevent problems on multiple life domains among employees with a lower SEP.

International audience; This paper aims to identify drivers and barriers to the achievement of EU water policy objectives in the agricultural sector by adopting an institutional perspective on water quality management at the landscape level. We apply a conceptual framework combining Integrated Landscape Management (ILM) and Institutional Design Principles (IDP) perspectives to analyze cooperation initiatives involving water suppliers and agricultural stakeholders to protect drinking water catchments from agricultural diffuse pollution. Three cases representing different forms of cooperation in rural landscapes in France were investigated on the basis of primary data collected at the local, water-basin and national levels. The results show that the success of multi-stakeholder collective action depends on both local factors such as characteristics of the water resource and stakeholders (knowledge, resources, trust and social capital) and on factors linked to the EU and national water and agricultural policy frameworks. In addition to the identification of drivers of and constraints on the implementation of EU water policy in agricultural landscapes, the analysis highlights the conceptual added value in combining the IDP and ILM approaches to understand policy implementation processes at the landscape level.

Valuations of real estate are widely used for various purposes and it relied always upon the financial and other markets. Valuation methodology is based on the operation of the free market economy and the real estate properties. The issue of certified properties is relatively new in the field of real estate valuation and is not sufficiently explored. Certified buildings are preferred by major corporate tenants with international field of activity who often have ethical rules for sustainable development. Therefore, certified properties are attractive to international commercial real estate investors who have higher purchasing power and are willing to pay a higher purchase price. Sustainable property certification is an element affecting the market value of the property. The purpose of this presented research is to quantify the impact of property certification on the value of office properties in Prague and subsequently to determine the impact of sustainability certificates on the market value of the land by using basic valuation techniques. The outcome of the project could be used by real estate valuation experts as a guideline to consider the future project certification and its impact on the land market value.

BACKGROUND: The concept of real option value (ROV) suggests there is added value in treatments that extend life because they enable a patient to live long enough to benefit from future innovative t...

The purpose of this study is to identify and analyze the drivers and restraining factors of the development of local economic resources. This study uses force field analysis to analyze the various forces / factors that affect a change, determine the source of its strength, and develop strategies to strengthen the drivers and weaken the inhibitors. The results showed that there were a number of driving factors, namely: 1) superior commodities; 2) Rules / policies; 3) Budget allocation; 4) Human resources availability; 5) Leadership. The restraining factors are: 1) Lack of coordination and collaboration of stakeholders involved; 2) The quality of human resources of farmers is still low; 3) community participation is still low; 4) Availability of infrastructure; 5) Commitment of stakeholders involved. This research is expected to be a material consideration for developing strategies to achieve success in developing local economic resources and providing recommendations to local governments to implement planned changes to be able to increase the added value and welfare of local communities.

In response to the Covid-19 pandemic imposed by the Indonesian government has impacted supply chains of various important commodities, including fish products. Lockdowns and mobility restrictions forced market players to limit their activities, change strategies or even close their businesses. This research, conducted in June 2020 - February 2021 in West Java Province, aimed to analyze patterns of adaptation taken by business players of the fisheries industry in facing the pandemic. The research methodological approach was the Supply Chain Operations Reference (SCOR) framework, which relied on data collected from 80 respondents proportionally representing impacted groups of fisheries business players in the West Java Province. The results showed that fisheries business players and the government had exercised some supply chain innovative adaptations, some of which can be considered potential adaptation strategies that will improve resilience and ensure the industry’s sustainability when similar pandemic crises occur in the future. These are (i) ensuring access to domestic and international supply chains, (ii) connecting fishery production centers with processors to reduce damage to fresh fish, (iii) creating added value using optimizing existing temporary fish storages, and (iv) promoting and delivering products through digital platform or e-commerce.

OPLC (optical fiber composite low-voltage cable) technology is a common field of communication and power electronics technology, and it is an important means to realizing the energy Internet and the integration of four networks. As an infrastructure sharing technology, OPLC technology will fundamentally and substantially promote the sustainable development of China’s economy and environment. Taking typical OPLC projects in China as an example, the direct energy consumption of these projects is calculated by the life-cycle cost (LCC) analysis method and then compared with traditional projects that use only power technology or optical fiber. Based on the direct consumption of the project, the interaction between the intermediate sector and the total output variable under the traditional technology and OPLC technology was explored and compared by using the input-output (I-O) model and the structural decomposition model (SDA). The results showed that in 2015, technology substitution weakened the influence of 86% of industries on the upstream industry and weakened the demand sensitivity of 90% of industries to the downstream industry. In 2017, technology substitution reduced the industry’s influence over 86% of upstream industries. Short-term technology replacement will not increase the positive influence of each industry on the upstream industry, thus resulting in a negative impact of technology substitution cost. However, that negative impact will gradually weaken over time. After technology replacement, the total added value of 20 industries increased from 2015 to 2017.

To enable patients with rheumatoid arthritis (RA) and their healthcare professionals to choose the optimal treatment, it is crucial to accurately assess the current state of inflammatory activity. The objectives of this study were to (1) investigate the perspective of RA patients on their insight into the current status of their disease, and to (2) investigate the patients’ perspective on the possible added value of a monitoring device based on optical spectral transmission—called the HandScan—that measures the location and severity of joint inflammation. A survey was distributed online among patients with RA in the Netherlands. Four-hundred and eight patients with RA completed the survey. Of these, 298 (73%) felt they have sufficient insight into their current disease status. Most respondents perceived either a large (n = 242; 59%) or small (n = 148; 36%) added value of the HandScan in their monitoring process, mostly because the device provides additional knowledge on the presence of inflammation. This perceived added value was higher for respondents experienced with the device (n = 46; p = .04). Respondents preferred monitoring with the device on every (n = 192; 47%) or most (n = 171; 42%) visits to the outpatient clinic, or even more often than on every visit (n = 17; 4%). Monitoring RA using an optical spectral transmission device is seen by patients as a possibly valuable addition to the monitoring process of inflammatory activity during visits to an outpatient clinic. Their main reason was that the device can increase insight into their current disease status. More insight may support patients in discussing treatment options with their rheumatologist.

The aim of the research was to investigate the organisational functioning of primary schools in the context of the development of extra-curricular learning work arrangements, based on information on the decision-making of heads of institutions. In May 2020, semi-structured telephone interviews were conducted with heads of 34 primary schools. The institutions are implementers of the Complex Basic Programme and were selected on the basis of the type of municipality, size of the institution and pedagogical added value. Based on the research, a general model of managerial tasks for the development of an extracurricular learning work system was established: (1) opportunity analysis, (2) capacity building, (3) choice of online media, (4) setting expectations for learning, (5) feedback-based management and (6) dealing with the problem of inaccessible learners. The coherence of the use of the digital platform has proved to be indicative of the organisational performance of the institution. However, the way in which the organisation operates is not linked to the success of the institution: heads of institutions that made decisions on the basis of discussion could be as capable as those that relied on authority - hierarchical decision-making. Informed decision-making was of crucial importance. This raises the question of whether ideal-typical organisational models, such as the learning organisation model, can be generalised in terms of leadership style.