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Purpose: To establish a consensus on the complexity of 16 fundamental movement skills (FMS). Initially, complexity was defined as how difficult it would be to teach FMS to children and for the children to learn them. Method: The study was conducted using a modified Delphi method and a mobile application called Move Improve® to showcase video demonstrations of 16 FMS. Six experts discussed and rated the complexity of each FMS using a 5-point Likert scale until a 75% consensus was obtained during three rounds. Result: Dribble was rated as the most complex (average five) and run as the least (average one). The highest percentage of consensus at 100% was obtained for dribble, overhead throw, run, and skip during Round 3. Conclusion: Eye–hand or eye–foot coordination, laterality, and the environment were deemed as the most influential factors when rating the complexity of FMS. [ABSTRACT FROM AUTHOR]

Many methods exist for engaging experts in interactive groups to explore, clarify, and/or decide on various issues. In an investigation of four possible future scenarios concerning transportation and land use in California, we developed a novel “hybrid policy Delphi” method for use with a panel of 18 experts. We applied it to explore the policies and practices that would likely lead to each of the four scenarios and the consequences that would result from them. Through our process, panel members discussed and reflected on the scenarios in multiple ways. The scenario they considered most desirable they also deemed least likely to occur, and they foresaw the likely trajectory of California transportation and land use leading to less desirable scenarios. Our mix of discussion and questionnaires traded the benefit of anonymity for the benefit of exploratory, interactive discussion. In addition, our use of surveys before and after meetings allowed us to track changes in panel opinion on a central question and discuss the survey results at meetings, at the cost of greater administrative effort. We discuss the results of this hybrid policy Delphi approach, reflect on how it worked, and conclude with a discussion of limitations and future directions.

Purpose: Utilizing teacher socialization in physical education theory, the aim of this study was to develop a survey to measure physical education teachers' socialization experiences and comprehensive school physical activity program involvement. Method: Instrument development included a review of existing comprehensive school physical activity program and socialization instruments, Delphi method to evaluate face and content validity through expert feedback, and a pilot test to examine the instrument's psychometric properties. Results: Upon completion of expert feedback, three items were removed, four items were revised, and open-ended questions were added to each survey construct. The pilot test yielded 28 completed surveys (40% response rate). Bayesian exploratory factor analytic procedures showed that items had statistically significant loadings and were quality measures of the corresponding constructs. Survey subscales had acceptable and high internal consistency coefficients. Discussion/Conclusion: Results suggest that this instrument is a trustworthy tool for continued research examining physical education teachers' socialization and comprehensive school physical activity program involvement. [ABSTRACT FROM AUTHOR]

Background: Traditionally, poverty assessment has relied on a single income criterion, which is inadequate in contexts where absolute poverty has been mitigated. This study developed a weighting scheme for the Multidimensional Health Poverty Index (MHPI) based on sustainable livelihood framework (SLF), aimed at enhancing the accuracy of poverty identification in China. Methods: A two-round Delphi process was used to determine the indicators of the index system. The weight of each indicator was calculated using the analytic hierarchy process (AHP) method. The multidimensional poverty index incorporates SLF's five dimensions: financial, natural, physical, social, and human capital. Results: The initial 46 indicators formed an indicator pool for the Delphi questionnaire. Based on the final consensus of the expert panel, the Delphi consultation resulted in an index system comprising six first-level and 23 second-level indicators. The weight values of the first-level indicators (economic security, health status, education, social capital, healthcare utilisation, and living conditions) were 0.2715, 0.2593, 0.0855, 0.0657, 0.1812, and 0.1363, respectively. Conclusion: This study established a scientific and effective index to evaluate generate weight for estimating multidimensional health poverty in China. Economic security, health status, and healthcare utilisation are the most crucial aspects of multidimensional health poverty. Moreover, the results indicated that vocational training and social capital should be emphasised. [ABSTRACT FROM AUTHOR]

Community-acquired pneumonia (CAP) is an acute infection of the lung parenchyma acquired outside the hospital or other healthcare settings, typically affecting previously healthy individuals. This intersociety consensus aims to provide evidence-based recommendations for the antibiotic treatment of mild to moderate CAP in previously healthy children in Italy. A systematic review was conducted to identify the most recent and relevant evidence. Embase, Scopus, PubMed, and Cochrane databases were systematically screened, with a date restriction from 2012 to April 2024, but without language limitations. The review included studies conducted in high-income countries on antibiotic therapy in children over 3 months of age diagnosed with mild-moderate CAP. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methods. The final recommendations were obtained through a Delphi consensus of an expert panel. Amoxicillin is the first-line treatment if the child is at least immunized against Haemophilus influenzae type b (low/very low quality of evidence, strong recommendations), while amoxicillin-clavulanate or second- or third-generation cephalosporins should be prescribed for those unimmunized or with incomplete immunization coverage for both H. influenzae type b and Streptococcus pneumoniae (low/very low quality of evidence, strong recommendations). Macrolides should be considered in addition to amoxicillin in children over 5 years old, if symptoms persist and the clinical condition remains good after 48 h of therapy (low/very low quality of evidence, strong recommendations). The dosage of amoxicillin is 90 mg/kg/day divided in three doses, although two doses could be considered to improve compliance (moderate quality of evidence, weak recommendations). A five-day duration of therapy is recommended, with clinical monitoring and re-assessment approximately 72 h after the start of antibiotic treatment to evaluate symptom resolution (moderate quality of evidence, strong recommendations). To improve the management of CAP in pediatric patients, we have developed this consensus based on a thorough review of the best available evidence and extensive discussions with an expert panel. However, further efforts are needed. Future research should focus on enhancing diagnostic accuracy, optimizing antibiotic utilization, comparing the efficacy of different antibiotic regimens, and determining the optimal dosage and duration of treatment in different setting. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Conclusion A competency training index system was designed in public health emergencies for community nurses. The purpose of this approach is to provide community nurses with guidelines for standardized training programs on how to respond to public health emergencies.Through semi‐structured interviews, a literature review, and team discussion, the first draft of competency training index system in public health emergencies for community nurses was formed. The Delphi method was used for two rounds of expert consultation to screen, modify and determine indicators. Finally, the analytic hierarchy process was utilized to calculate the weights of indicators at all levels.A total of 15 expert consultants were included. The effective recovery rate of the two rounds of expert consultation questionnaire was 100%, the expert authority coefficient was 0.880, 0.887, and the Kendall coordination coefficient was 0.172 and 0.171 (p < 0.001). Expert opinions have determined that the final revised competency index system in public health emergencies for community nurses training consists of 2 primary indicators, 10 secondary indicators, and 46 tertiary indicators.The study has developed a competency training index system in public health emergencies for community nurses. This system can serve as a foundation for standardized training in community health service institutions. It is characterized by its high demand, scientific approach, reliability, and rationality. [ABSTRACT FROM AUTHOR]

This study aims to investigate the key features necessary for the development of a mobile application for human resource management (HRM). It addresses the shortage of empirical studies on digital HRM in the Middle East and emphasizes the increasing importance of HRM mobile applications in the region. The research utilizes qualitative research methods, including the Delphi method, in-depth interviews, literature review, historical analysis, and critical discussion. A qualitative research strategy is employed, analyzing data from 43 HR experts and mobile app development team members from international and local businesses in the UAE and the Kingdom of Bahrain. NVivo software is used for data analysis, encompassing over 120 transcriptions, notes, and academic papers. The study identifies and explores the logical and practical features required for an HRM mobile app. It uncovers challenges related to the Delphi survey experiences, such as managing heterogeneous information and ensuring compatibility with iOS and Android platforms. This research fills a gap in the literature by investigating the digital HRM landscape and HRM mobile applications in the Middle East. It provides valuable insights from HR and technology experts, contributing to the advancement of digital HRM, mobile applications, and the application of the Delphi method methodology. The study highlights implications for industries to enhance HR operations and productivity through the adoption of mobile HR applications. Theoretical contributions include new insights into the digital HRM literature, specifically regarding the identification and discussion of essential features in HRM mobile applications. Practical implications involve the benefits of transitioning from traditional HRM to digitalized HRM in the professional era, as identified through the analyzed features of the HR app. The study offers practical insights for the development and implementation of mobile HR apps. Organizations can leverage these insights to create effective mobile HR apps that enhance HR operations and employee productivity. [ABSTRACT FROM AUTHOR]

Background: High quality diabetes care is an essential service in primary care settings since the prevalence and associated complications of diabetes is increasing. Physical activity is effective for the prevention and management of diabetes yet is underutilized in diabetes care. Exercise professionals have specialized skills to deliver physical activity interventions, but effective interprofessional collaboration for diabetes care requires role clarity. This study established the competencies of entry-level physiotherapists and kinesiologists for physical activity interventions for diabetes care in primary care settings and used these competencies to develop clinical tools to promote role clarity in interprofessional care teams. Methods: We used a modified Delphi process. Eleven physiotherapy and three kinesiology subject matter experts participated in two rounds of Delphi surveys to develop discipline and context specific competencies. These competencies were used to draft competency profiles and a referral pathway tool. Eleven of the participants then participated in a focus group for member-checking of the tools. Descriptive statistics and content analysis were used to analyze quantitative and qualitative data respectively. Results: The modified Delphi process resulted in 38 physiotherapy and 27 kinesiology competencies that identify the distinct roles of physiotherapists and kinesiologists in delivering physical activity interventions for diabetes care. The physiotherapy competencies describes their unique role in supporting people with all types of diabetes to engage in physical activity despite complex medical or physical barriers. The kinesiology competencies indicate where these professionals may require additional training, especially when working with people living with type 1 diabetes or who are pregnant. All developed tools had good face validity and were seen to be potentially useful tools by the subject matter experts. Conclusions: The findings highlight that both physiotherapists and kinesiologists have fundamental skills and abilities to deliver physical activity interventions to people living with diabetes, but that different exercise professionals may be needed depending on the complexity of the clinical profile. The developed clinical tools support improved interprofessional collaboration by clarifying physiotherapy and kinesiology roles in delivering physical activity interventions for diabetes care and highlighting how the two distinct professions can contribute to addressing the growing diabetes epidemic in primary care. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Implication for the Profession and Patient Care Patient or Public Contribution This study aimed to establish a comprehensive set of nursing‐sensitive quality indicators (NSQIs) for patients with dysphagia following tracheotomy due to acquired brain injury (ABI), based on the ‘structure‐process‐outcome’ model.A Delphi survey.The research utilised a mixed‐methods approach, including systematic literature reviews, qualitative interviews and two rounds of Delphi expert consultations. A diverse team comprising specialists in dysphagia rehabilitation and nursing management conducted the research, which involved defining and refining NSQIs through extensive evaluations and consensus among recruited experts.The finalised NSQI includes 4 structural indicators, 13 process indicators and 4 outcome indicators, covering key aspects such as resource allocation, patient assessment and clinical outcomes. The expert consensus provides verification. Kendall's harmony coefficients are 0.304 and 0.138 (p < 0.001), respectively, and the mean importance assignments of indicators at all levels are 3.90–5.00. The final care of patients with tracheotomy and dysphagia after brain injury was constructed. The evaluation indicators include a total of 4 first‐level indicators, 23 second‐level indicators and 52 third‐level indicators.The established NSQIs offer a systematic framework to enhance the quality of nursing care for ABI patients with posttracheotomy dysphagia. This model facilitates precise monitoring and proactive management of nursing practices, promising better patient outcomes and streamlined care processes.This study develops targeted NSQIs to improve dysphagia management in ABI patients’ posttracheotomy, fostering better patient outcomes and advancing nursing education through essential specialised training.Expert‐driven insights from experienced clinicians informed the NSQIs, ensuring their relevance and effectiveness in enhancing patient‐centred care. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Discussion Long‐term recovery rates following eating disorders (EDs) treatment remain low. This might be partly due to a lack of agreement between key stakeholder groups, including people with lived experience, carers, clinicians, and researchers, regarding optimal therapeutic targets and strategies. We aimed to reach a consensus across these diverse groups on the most valued treatment targets and strategies for fostering ED recovery.We used the Delphi method with two phases: (i) Survey development and (ii) Expert rating. The survey development phase included the design of an initial set of items through scoping review and feedback from a committee of 14 experts. During the survey rating, we engaged a larger panel of 185 experts who comprised the stakeholder groups: Individuals with lived ED experience (n = 49), carers (n = 44), researchers (n = 46), and clinicians (n = 46).Thirty‐one targets and 29 strategies reached consensus (> 70% agreement over three rounds). Psychological‐emotional–social targets including quality of life, sense of purpose, and emotion regulation, along with ED behaviors, reached the highest agreement (> 90%). Strategies reflecting an individualized approach to treatment (i.e., considering diversity, assessing comorbidities, and enhancing rapport) achieved the highest agreement (> 90%). Responses across groups were similar, except researchers leaning more towards consideration of weight‐ and eating‐related targets.Holistic targets and individualized therapeutic strategies have consistent support from the different stakeholder groups involved in ED treatment. The agreed set of targets/strategies may be used, in triangulation with other sources of evidence, to design and evaluate coproduced and personalized interventions. [ABSTRACT FROM AUTHOR]

Background: There has been a progressive increase in the use of percutaneous cholecystostomy (PC) in acute cholecystitis (AC) over the last decades due to population aging, and the support of guidelines (Tokyo Guidelines (TG), World Society of Emergency Surgery (WSES) Guidelines) as a valid therapeutical option. However, there are many unanswered questions about the management of PCs. An international consensus on indications and PC management using Delphi methodology with contributions from experts from three surgical societies (EAHPBA, ANS, WSES) have been performed. Methods: A two-round Delphi consensus, which included 27 questions, was sent to key opinion leaders in AC. Participants were asked to indicate their 'agreement/disagreement' using a 5-point Likert scale. Survey items with less than 70% consensus were excluded from the second round. For inclusion in the final recommendations, each survey item had to have reached a group consensus (≥ 70% agreement) by the end of the two survey rounds. Results: 54 completed both rounds (82% of invitees). Six questions got > 70% and are included in consensus recommendations: In patients with acute cholecystitis, when there is a clear indication of PC, it is not necessary to wait 48 h to be carried out; Surgery is the first therapeutic option for the TG grade II acute cholecystitis in a patient suitable for surgery; Before PC removal a cholangiography should be done; There is no indication for PC in Tokyo Guidelines (TG) grade I patients; Transhepatic approach is the route of choice for PC; and after PC, laparoscopic cholecystectomy is the preferred approach (93.1%). Conclusions: Only six statements about PC management after AC got an international consensus. An international guideline about the management of PCs are necessary. [ABSTRACT FROM AUTHOR]

Background: The prevalence of chronic disease and multimorbidity is increasing and the associated disease and treatment burden is particularly heavy. Coordinated multidisciplinary, patient-centered care is particularly important for people living with chronic disease or multimorbidity. There was no valid tool to measure the quality of coordinated patient-centered care from the patient's perspective until the Patient-Centered Coordination by a Care Team (PCCCT) questionnaire was recently developed in Canada (Quebec/Ontario). The Quebecois version has been validated but is not directly transferable to France due to linguistic, cultural and health system differences between the two countries. To perform a cross-cultural adaptation of the Quebecois PCCCT questionnaire is therefore necessary to obtain a questionnaire's new version adapted for use in France, ensuring item and semantic equivalence. Methods: The adaptation process consisted of two stages, both of which were supervised by a scientific committee made up of five healthcare professionals. The first stage was a Delphi consensus involving a multidisciplinary healthcare professional panel to evaluate and harmonize the clarity and appropriateness of the questionnaire for patients in the French health system. During the second stage, adult patients with one or more chronic diseases, from various age, sex, socio-occupational categories, assessed the comprehensibility and conformity of the adapted version of the questionnaire resulting from stage 1 and improved it if necessary. This was achieved using cognitive interviews. Results: During Stage 1, two rounds were undertaken with 10 professional experts resulting in consensual reformulation of 10 out of the 14 items. These newly formulated items and the 4 remaining items were submitted to patients in Stage 2. Cognitive interviews were undertaken with 14 patients, testing 3 successively adapted versions of the questionnaire, until three consecutive patients did not find any ambiguity or misunderstanding. The final version resulting from the cross-cultural adaptation process aimed at being used in France, has item and semantic equivalence to the original Quebecois version. Conclusions: Measurement equivalence will be addressed in a future study. This French version is intended to be a useful resource for the health system reforms aimed at promoting more integrated and patient-centered care pathways. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) stages 3-4 present a significant clinical challenge due to the absence of a systematic approach to managing associated medication-related problems (MRPs). This lack of a structured framework hinders the timely identification and effective intervention for these complications, potentially compromising patient safety and prognosis. Objective: This study aims to leverage the Delphi method to establish an evaluation index for a rational drug use evaluation system dedicated to CKD patients in stages 3-4. This system will function as a platform for the continuous identification and management of MRPs, ultimately contributing to improved medication safety and patient outcomes. Methods: This research uses the modified Delphi technique to develop an evaluation system for rational drug use in patients with chronic kidney disease. The initial questionnaire was developed by literature review for patients with chronic kidney disease. Twenty-six senior experts formed a panel in order to evaluate items across two Delphi rounds. Consensus was defined as at least 95% agreement (first round) and 85% agreement (second round), agreeing with an average score of at least 4.5 (first round) and 4.0 (second round). Items that fulfill the stipulated criteria are eligible for inclusion in the consensus list. Results: All experts participated in both rounds (100% response rate). Consensus was achieved on three patient-related items in the first round of 34 items. Based on expert feedback, 18 revised items were included in the second round after refining, restructuring, and removing some elements. Following two rounds of consultation, 20 items achieved consensus, encompassing aspects such as drug selection, dosage assessment, treatment duration, prescription and dispensing practices, patient-related factors, and other relevant considerations. Conclusion: This study has successfully identified 20 key evaluation indicators for a rational drug use evaluation system specifically designed for CKD patients in stages 3 and 4. This system will serve as a tool for continuous MRP identification and timely intervention, ultimately enhancing medication safety and patient prognosis. [ABSTRACT FROM AUTHOR]

AbstractIn today’s fast-paced and and high-stress society, trekking tourism is a leisure activity for stress relief and closer nature engagement. Given the adventurous nature inherent in trekking tourism, risk assessment is deemed both crucial and imperative. This study aims to develop a risk assessment framework for trekking tourism based on the Delphi method and Analytic Hierarchy Process (AHP). Initially, we conducted a literature review and expert interviews grounded in the Systems Theory of Accident Causation and the Human Factors Theory to establish the risk assessment paradigm specific to trekking tourism. Subsequently, we ascertained specific weights for each evaluation criterion and delineated explicit data sources for each operational indicator. The findings indicate that the formulated risk assessment system for trekking tourism is both scientifically grounded and practical, furnishing stakeholders in the tourism industry, organizational teams, and management authorities with an efficacious tool for evaluating the safety conditions of trekking tourism activities. [ABSTRACT FROM AUTHOR]

Background: Prehypertension is a preclinical state of hypertension which leads to an increased likelihood of coronary heart disease, myocardial infarction, cerebrovascular disease as well as target organ damage. Addressing pre-hypertension through early lifestyle interventions is crucial to mitigating these detrimental effects and improving long-term health outcomes. So, the main objective of this study is to develop a lifestyle intervention program (LSIP) for the management of prehypertension using consensus building approach. Methods: It was a three round online modified Delphi study with 70 members panellists. All panellists had an experience of prehypertension either as patients (n = 30) or professionals (n = 40). Round 1 included initial recommendations developed from a previous systematic review and metanalysis, which were rated by panellists for their importance on a 5-point Likert scale. Panellists could also suggest additional items in the Round 1. Round 2 and 3 included all items from the Round 1 with new items suggested by the panellists. Data was analysed descriptively using SPSS version 29. All items receiving at least 70% of all respondents combined rating of 'Important' and 'Very Important' in Round 3 were included in the final set of recommendations. Results: Fifty-one panellists (80.9%) (patients = 25, professionals = 26) completed Round 3. Twenty-six recommendation items were included in the Round 1. Twenty new items were added in Round 2 with 46 total items in Round 2 and 3. Thirty-five of these items reached consensus in Round 3. The final set of recommendation comprised of 15 educational. 10 dietary, and 10 exercise recommendations. Conclusion: This modified Delphi study developed a comprehensive LSIP for the prevention of prehypertension, incorporating a holistic approach with educational, dietary, and exercise components aimed at the general population. Previously established standards of care (SOC) for managing prehypertension varied significantly and often provided fragmented guidance particularly on physical activity and education. This preventive model offers a novel and scalable approach for early intervention in prehypertension, potentially reducing reliance on medications and improving long-term health outcomes. [ABSTRACT FROM AUTHOR]

This document discusses the development of near-miss criteria for stillbirth research as part of the "In Utero" program. The criteria aim to identify live births at high risk of stillbirth and focus on placental insufficiency as a common cause. The document acknowledges limitations in the consensus procedure used to develop the criteria but concludes that they are a step closer to recognizing and addressing the issue of stillbirth. The criteria can be applied in both high-income and low- and middle-income countries. [Extracted from the article]

Background: Currently, there is no consensus on the optimal management of women with low prognosis in ART. In this Delphi consensus, a panel of international experts provided real-world clinical perspectives on a series of literature-supported consensus statements regarding the overall relevance of the POSEIDON criteria for women with low prognosis in ART. Methods: Using a Delphi-consensus framework, twelve experts plus two Scientific Coordinators discussed and amended statements and supporting references proposed by the Scientific Coordinators (Round 1). Statements were distributed via an online survey to an extended panel of 53 experts, of whom 36 who voted anonymously on their level of agreement or disagreement with each statement using a six-point Likert-type scale (1 = Absolutely agree; 2 = More than agree; 3 = Agree; 4 = Disagree; 5 = More than disagree; 6 = Absolutely disagree) (Round 2). Consensus was reached if > 66% of participants agreed or disagreed. Results: The extended panel voted on seventeen statements and subcategorized them according to relevance. All but one statement reached consensus during the first round; the remaining statement reached consensus after rewording. Statements were categorized according to impact, low-prognosis validation, outcomes and patient management. The POSEIDON criteria are timely and clinically sound. The preferred success measure is cumulative live birth and key management strategies include the use of recombinant FSH preparations, supplementation with r-hLH, dose increases and oocyte/embryo accumulation through vitrification. Tools such as the ART Calculator and Follicle-to-Oocyte Index may be considered. Validation data from large, prospective studies in each POSEIDON group are now needed to corroborate existing retrospective data. Conclusions: This Delphi consensus provides an overview of expert opinion on the clinical implications of the POSEIDON criteria for women with low prognosis to ovarian stimulation. [ABSTRACT FROM AUTHOR]

Introduction: A Delphi consensus was performed to evaluate expert opinions on the management of key aspects of ovarian stimulation. Methods: A Scientific Committee developed eleven statements for patient profiles corresponding to predicted ovarian responses (low, normal, and high) based on antral follicle count (AFC) and anti-Müllerian hormone (AMH). The statements were distributed (online survey) to French and Belgian fertility specialists. Consensus was reached when =66.7% of participants agreed or disagreed. Results: Among 52 respondents, a consensus agreement was reached for each patient profile for personalizing the initial dose of gonadotropin, taking age, weight, body mass index, nature of the cycle, and the decision to perform a fresh transfer or a freeze-all strategy into consideration. The respondents preferred a fresh transfer for low and normal responders and a freeze-all strategy in case of high risk of hyperstimulation, newly diagnosed uterine or tubal pathology and premature progesterone elevation. A consensus was reached for 10-15 oocytes as optimal oocyte target from the first round of voting. The panel agreed to increase the gonadotropin dose in case of insufficient response and preferred a GnRH antagonist protocol for a subsequent cycle in case of excessive response. Finally, a consensual answer was obtained for using LH/hCG activity in case of hypogonadotropic hypogonadism, advanced age, inadequate response during first stimulation and suspected FSH receptor polymorphism. Discussion: The AMPLITUDE consensus supports the importance of optimizing the ovarian stimulation protocol for patients undergoing assisted reproductive technology treatment. Additional studies could complete these findings and guide fertility specialists in their daily practice to improve ovarian stimulation outcomes. [ABSTRACT FROM AUTHOR]

Lean Six Sigma (LSS) implementation still shows a high failure rate. Lack of readiness is one of the causes. Readiness assessment requires special exploration of each sector, including the hotel sector, where there is still no development of an LSS readiness assessment model. This study aims to develop a readiness assessment model for LSS implementation in the hotel sector. Data processing in the readiness assessment model uses the fuzzy logic method, is translated again into linguistic terms using Euclidean distance, and is ranked using the TOPSIS approach. The literature review produced 34 Readiness Factors (RF) that were validated by eight credible hotel practitioners and used as guidelines in conducting LSS readiness assessments in the hotel sector. Case studies were conducted on Hotel A and Hotel B, which showed that Hotel A was “Very Ready” and Hotel B was “Ready” to implement LSS. This research is perhaps the first of its kind in the hotel sector. This research also uses the Delphi method to collect data on the importance level, which may not have been done in collecting data on LSS readiness in any sector. [ABSTRACT FROM AUTHOR]

Ethical codes are written documents that delineate a set of rules and principles that guide the duties and responsibilities of professionals within a professional organization from an ethical perspective. The research aims to develop an ethical code framework for instructors engaged in distance education. The Delphi, a qualitative research method, was employed to achieve this aim. The study included 22 distance education experts, selected via purposive sampling. The Delphi technique, conducted in three rounds, commenced with an evaluation of the ethical dimensions of distance education. In the study’s second phase, we invited participants to suggest additional ethical codes for the agreed-upon dimensions. We collected the suggestions and agreed on specific ethical code items in the third round. The researchers thus established the final form of the ethical code list. This process resulted in developing an ethical code framework for instructors engaged in distance education. The framework comprises sixdimensions: Instructional Design (ID), Social Interaction (SI), Content Provision (CP), Technology Usage (TU), Management (M), and Assessment and Evaluation (AE). It includes 62 ethical code items. The study demonstrates that the ethical code dimensions align with the roles of online instructors, as described in the relevant literature. This alignment substantiates the ethical code framework's validity and reliability. [ABSTRACT FROM AUTHOR]

Introduction: Cerebral palsy (CP) is a common motor and postural developmental disability impacting daily activities like toileting. Despite its importance, toileting has often been undervalued in healthcare. This study is aimed at identifying and assessing the level of influence of various factors affecting toileting in individuals with CP using the International Classification of Functioning, Disability and Health for Children and Youth (ICF‐CY) framework. Methods: The Delphi method was employed to reach a consensus on factors influencing toileting in individuals with CP. One hundred fifty‐eight professionals from 17 countries, each with at least 3 years' experience in CP and/or toileting, participated in this two‐round study. Ethical approval (IR.IUMS.REC.1400.1111) and informed consent were obtained. The questionnaire, available in Farsi and English, used a Likert scale (5 = very high impact to 1 = no impact). Factors with 75% agreement and a mean above 3.75 were included in the final list, while those with 50%–75% agreement or a mean between 2.5 and 3.75 proceeded to the second round. Factors were initially identified through a literature review and research team consultation and categorized according to the ICF‐CY framework using the ICF 10 RULES. Validation and refinement were done through focus groups with caregivers and experienced professionals to ensure alignment with the framework and methodological rigor. Results: The study highlighted significant factors influencing toileting activities in individuals with CP. Within the ICF‐CY framework, "neuromusculoskeletal and movement‐related functions" scored highest at 94.5% in "body functions and structures." "Toilet environment" scored 90.5% in "environmental factors." Support and relationship factors scored 82.3%. Attitudes toward "menstruation" ranked highest at 92.9%. Associated deficits with CP ranked top in personal factors at 93.7%. Conclusion: The study identifies key factors influencing toileting activity performance in individuals with CP. "Main caregiver" emerges as a pivotal factor, followed by neuromusculoskeletal functions, personal factors, attitudes toward menstruation, the toilet environment, and support and relationships. [ABSTRACT FROM AUTHOR]

PurposeDesign/methodology/approachFindingsOriginality/valueRelying on regulatory focus theory (RFT), this study examines the mechanisms that guide managers’ positioning-related decisions in business-to-business contexts. Specifically, this research answers two main questions: what motivates managers to recommend specific positioning strategies and what motivates related decisions regarding contextual and market conditions?Two studies are undertaken in this research. Using the Delphi method, Study 1 adopted an online scenario-based experimental design related to the positioning decisions of three companies. A panel of expert informants assisted in the design process. Study 2 tested the stability of the results from Study 1 and then extended the analysis through the introduction of an additional dependent variable and market feedback. The results of the scenario-based online surveys are subjected to partial least squares structural equation analyses.The findings are in line with regulatory focus theory and show that RFT can provide motivationally derived answers to questions regarding inter-manager differences in positioning decision-making under similar market and company conditions. The results further show that decisions made by marketing managers in B2B contexts are guided by a desire to achieve congruity (fit) between their regulatory focus and their positioning strategy. Moreover, there is a differential impact of the regulatory foci on the likelihood of changing a recommended strategy.This paper investigates the moderating effects of involvement, valence framing, and market feedback. The study finds that the valence of the recommendation of a positioning strategy moderates the relationship between regulatory focus and the type of positioning strategy. [ABSTRACT FROM AUTHOR]

A methodology is presented for the objective and transparent screening of hydrocarbon reservoirs for underground hydrogen storage (UHS), with subsequent testing on a large confidential dataset provided by the energy company Eni. The procedure uses the Analytic Hierarchy Process and the Delphi technique to gather expert opinions and weight 27 screening parameters in terms of: health, safety, and environment; geotechnical performance; and economic performance. A set of scores is produced that characterizes each site in terms of these three categories, as well as a comprehensive site ranking based on their overall suitability for UHS. The results highlight the importance of geotechnical parameters, while the characterization of faults and hydrocarbon type, the onshore or offshore location, the number of wells, and the reservoir architecture yielded the highest individual weights. Potential scores are also estimated for sites with incomplete datasets. Two blind tests evaluated the method's effectiveness against preexisting industrial assessments. • Screening and ranking of porous-media depleted hydrocarbon reservoirs for UHS. • Utilization of the AHP multi-criteria decision-making method for parameter weighting. • Application of the screening method to a large industrial dataset with blind tests. • Scoring of the HSE, geotechnical and economic performances of sites. • Site performance scoring for UHS site-screening. [ABSTRACT FROM AUTHOR]

Summary: New sleep technologies are being developed, refined and delivered at a fast pace. However, there are serious concerns about the validation and accuracy of new sleep‐related technologies being made available, as many of them, especially consumer‐sleep technologies, have not been tested in comparison with gold‐standard methods or have been approved by health regulatory agencies. The importance of proper validation and performance evaluation of new sleep technologies has already been discussed in previous studies and some recommendations have already been published, but most of them do not employ standardized methodology and are not able to cover all aspects of new sleep technologies. The current protocol describes the methods of a Delphi consensus study to create guidelines for the development, performance evaluation and validation of new sleep devices and technologies. The resulting recommendations are not intended to be used as a quality assessment tool to evaluate individual articles, but rather to evaluate the overall procedures, studies and experiments performed to develop, evaluate performance and validate new technologies. We hope these guidelines can be helpful for researchers who work with new sleep technologies on the appraisal of their reliability and validation, for companies who are working on the development and refinement of new sleep technologies, and by regulatory agencies to evaluate new technologies that are looking for registration, approval or inclusion on health systems. [ABSTRACT FROM AUTHOR]

Aims: The revolution in the therapeutic approach to type 2 diabetes (T2D) requires a rethinking of the positioning of basal insulin (BI) therapy. Given the considerable number of open questions, a group of experts was convened with the aim of providing, through a Delphi consensus method, practical guidance for doctors. Methods: A group of 6 experts developed a series of 29 statements on: the role of metabolic control in light of the most recent guidelines; BI intensification strategies: (1) add-on versus switch; (2) inertia in starting and titrating; (3) free versus fixed ratio combination; basal-bolus intensification and de-intensification strategies; second generation analogues of BI (2BI). A panel of 31 diabetologists, by accessing a dedicated website, assigned each statement a relevance score on a 9-point scale. The RAND/UCLA Appropriateness Method was adopted to assess the existence of disagreement among participants. Results: Panelists showed agreement for all 29 statements, of which 26 were considered relevant, one was considered not relevant and two were of uncertain relevance. Panelists agreed that the availability of new classes of drugs often allows the postponement of BI and the simplification of therapy. It remains essential to promptly initiate and titrate BI when required. BI should always, unless contraindicated, be started in addition to, and not as a replacement, for ongoing treatments with cardiorenal benefits. 2BIs should be preferred for their pharmacological profile, greater ease of self-titration and flexibility of administration. Conclusion: In a continuously evolving scenario, BI therapy still represents an important option in the management of T2D patients. [ABSTRACT FROM AUTHOR]

The objective of this article was to demonstrate that the third-grade elementary school mobile application for mathematics, Matercergrado, enhanced collaborative problem-solving. The instructional design of the application followed the ADDIE methodology, and its creation employed the Mobile-D methodology. The research approach was mixed and descriptive, with a convenience sample of 18 participants from an elementary school in the municipality of Nezahualcóyotl, State of Mexico. These participants completed a Likert-type survey, validated using the Delphi method and Cronbach's Alpha, which evaluated usability, interface design, functionality, thematic content, and comprehension of exercises and components. The results indicated that students highly appreciated Matercergrado, and teachers validated its thematic content and explanatory procedures for teaching mathematics. In addition, students reported collaborative and union sentiments while solving problems and doing exercises. Overall, Matercergrado achieved excellent results during the study, showing the potential to enhance students' understanding and academic performance. [ABSTRACT FROM AUTHOR]

The topic of this research is to examine the impact of culture on knowledge sharing in Hungary and Sweden. Exploring cultural differences can help the authors to understand which factors influence knowledge sharing in different contexts and how these differences can be used to work more effectively. Their aim is to examine the impact of culture on knowledge sharing from different aspects by comparing the two nations. The authors want to prove that organisations should organise knowledge sharing, taking cultural factors into account. They use the Delphi method for this research. In the first round they asked open questions, and in the second round they sent out a questionnaire. The results of the first round were analysed using ATLAS. ti and Voyant Tools text analysis software, and the results of the second round were analysed using IBM SPSS software. The research results show that Hungarian and Swedish respondents have different perceptions of knowledge sharing. [ABSTRACT FROM AUTHOR]

Simple Summary: Prostate cancer is most commonly diagnosed in males after the age of 55 years. These patients are also at risk for cardiovascular disease and venous thromboembolism requiring antithrombotic therapy. Prostate cancer treatments, such as androgen receptor axis-targeted therapies (ARATs, i.e., abiraterone acetate, apalutamide, darolutamide, and enzalutamide), may interact with common antithrombotic medications like warfarin, clopidogrel, and the direct oral anticoagulants. However, the data detailing the clinical outcomes of patients treated with these combinations are limited. We undertook a comprehensive review of the literature and modified Delphi process to enable development of an evidence-based consensus document for the co-prescribing of ARATs with antithrombotic medications. Our assessments relied heavily on pharmacokinetic data and extrapolation from drug interaction studies of similarly metabolized drugs, highlighting the need for more research into the clinical impact of drug interactions in prostate cancer patients. Nonetheless, we provide a practical framework to support clinicians in day-to-day therapeutic decision making. Background/Objectives: Abiraterone acetate, apalutamide, darolutamide, and enzalutamide, which make up the androgen receptor axis-targeted therapies (ARATs) drug class, are commonly used in the management of prostate cancer. Many patients on ARATs also receive oral antithrombotic therapy (i.e., anticoagulants or antiplatelets). The concomitant use of ARATs and antithrombotic therapies creates the potential for clinically relevant drug–drug interactions, but the literature regarding the actual consequences of these interactions, and guidance for co-prescribing, is limited. We assembled a multidisciplinary panel of experts and provided them with clinical information derived from a comprehensive literature review regarding the drug–drug interactions between ARATs and antithrombotic therapies. Methods: A three-stage modified electronic Delphi process was used to gather and consolidate opinions from the panel. Each stage consisted of up to three rounds of voting to achieve consensus on which ARAT/antithrombotic therapy drug pairs warrant attention, the possible clinical consequences of drug–drug interactions, and suggested actions for management. Results: The panel achieved consensus to avoid 11 ARAT/antithrombotic therapy drug pairs and modify therapy for eight pairs. Assessments relied heavily on pharmacokinetic data and extrapolation from drug–drug interaction studies of similarly metabolized drugs. Conclusions: This e-Delphi process highlights the need for further research into the clinical impact of ARAT/antithrombotic drug interactions. Nonetheless, the suggested actions aim to provide clinicians with a practical framework for therapeutic decision making. [ABSTRACT FROM AUTHOR]

Background: Cardiac rehabilitation (CR) can reduce mortality and improve physical functioning in older patients, but current programs do not support the needs of older patients with comorbidities or frailty, for example due to transport problems and physical limitations. Home-exercise-based cardiac rehabilitation (HEBCR) programs may better meet these needs, but physiotherapy guidelines for personalising HEBCR for older, frail patients with cardiovascular disease are lacking. Purpose: To provide expert recommendations for physiotherapists on how to administer HEBCR to older adults with comorbidities or frailty. Methods: This Delphi study involved a panel of Dutch experts in physiotherapy, exercise physiology, and cardiology. Three Delphi rounds were conducted between December 2020 and February 2022. In the first round panellists provided expertise on applicability and adaptability of existing CR-guidelines. In the second round panellists ranked the importance of statements about HEBCR for older adults. In the third round panellists re-ranked statements when individual scores were outside the semi-interquartile range. Consensus was defined as a semi-interquartile range of ≤ 1.0. Results: Of 20 invited panellists, 11 (55%) participated. Panellists were clinical experts with a median (interquartile range) work experience of 20 (10.5) years. The panel reached a consensus on 89% of statements, identifying key topics such as implementing the patient perspective, assessing comorbidity and frailty barriers to exercise, and focusing on personal goals and preferences. Conclusion: This Delphi study provides recommendations for personalised HEBCR for older, frail patients with cardiovascular disease, which can improve the effectiveness of CR-programs and address the needs of this patient population. Prioritising interventions aimed at enhancing balance, lower extremity strength, and daily activities over interventions targeting exercise capacity may contribute to a more holistic and effective approach, particularly for older adults. [ABSTRACT FROM AUTHOR]

Purpose: While research on inguinal hernias is well-documented, ventral/incisional hernias still require investigation. In India, opinions on laparoscopic ventral hernia repair (LVHR) techniques are contested. The current consensus aims to standardize LVHR practice and identify gaps and unfulfilled demands that compromise patient safety and therapeutic outcomes. Methods: Using the modified Delphi technique, panel of 14 experts (general surgeons) came to a consensus. Two rounds of consensus were conducted online. An advisory board meeting was held for the third round, wherein survey results were discussed and the final statements were decided with supporting clinical evidence. Results: Experts recommended intraperitoneal onlay mesh (IPOM) plus/trans-abdominal retromuscular/extended totally extraperitoneal/mini- or less-open sublay operation/transabdominal preperitoneal/trans-abdominal partial extra-peritoneal/subcutaneous onlay laparoscopic approach/laparoscopic intracorporeal rectus aponeuroplasty as valid minimal access surgery (MAS) options for ventral hernia (VH). Intraperitoneal repair technique is the preferred MAS procedure for primary umbilical hernia < 4 cm without diastasis; incisional hernia in the presence of a vertical single midline incision; symptomatic hernia, BMI > 40 kg/m2, and defect up to 4 cm; and for MAS VH surgery with grade 3/4 American Society of Anaesthesiologists. IPOM plus is the preferred MAS procedure for midline incisional hernia of width < 4 cm in patients with a previous laparotomy. Extraperitoneal repair technique is the preferred MAS procedure for L3 hernia < 4 cm; midline hernias < 4 cm with diastasis; and M5 hernia. Conclusion: The consensus statements will help standardize LVHR practices, improve decision-making, and provide guidance on MAS in VHR in the Indian scenario. [ABSTRACT FROM AUTHOR]

Aims: This study aims to investigate the clinical practice of physicians working in obstetric setting toward postoperative nausea and vomiting (PONV) in parturients undergoing cesarean delivery (CD) with neuraxial anesthesia. Methods: We conducted this online survey to all active members of the Japan Society of Obstetric Anesthesiology and Perinatology (JSOAP), where leads academic society in obstetric anesthesia in Japan. The questionnaire was developed using the Delphi method. The survey included questions about routine practices for PONV prevention, the use of neuraxial opioids, optimal practices, and perceived obstacles. The email sent three times every 2 weeks as a reminder. Results: A total of 1046 e‐mails were sent, and 307 JSOAP members responded to the survey (29.3%). More than half of responders (62.7%) used neuraxial opioids with intrathecal morphine being the most frequent. They had a higher rate of multimodal PONV prophylaxis compared with who did not use neuraxial opioids for postoperative analgesia (19.9% vs 6.7%). Metoclopramide was the commonest medication for PONV prevention, and there was a significant difference in the use of 5‐hydroxytryptamine receptor antagonists (19.9% vs. 8.6%, p = 0.012). We observed that 80% of physicians reported the routine administration of prophylaxis for PONV for CD. Among these, 20% indicated the use of two or more agents. Conversely, in the cohort not administering neuraxial opioids, only 6.7% reported the use of two or more agents. Conclusion: The online survey showed that the physicians using neuraxial opioids for CD had a higher proportion of multimodal PONV management involving two or more agents. [ABSTRACT FROM AUTHOR]

Twelve polyphenol derivatives were obtained in a protective activity-guided isolation from the Portulaca oleracea L. extract on a cell model of human umbilical vein endothelial cells (HUVECs) under diethylhexyl phthalate (DEHP) exposure. Among them, methyl (3,4,5-trimethoxybenzoyl) valylprolinate (PP-10) performed the most protective activity and inhibited DEHP exposure-induced HUVECs' apoptosis. PP-10 also inhibited the DEHP-induced inflammatory cytokines (TNF-α, IL-6, IL-1β, and IL-8) and adhesion molecule (ICAM-1 andVCAM-1) overexpression. Furthermore, DEHP-induced NLRP3 inflammasomes' and NF-κB signaling pathway activation was significantly inhibited after the PP-10 treatments. Of note, the current results suggest the potential application of Portulaca oleracea L. and PP-10 in the prevention of DEHP-induced inflammatory damages in HUVECs. [ABSTRACT FROM AUTHOR]

Background: The present study is a type of exploratory qualitative studies and applied research. The approach of this study is a prospective policy analysis in which we will formulate appropriate policy options to prevent and control iron deficiency anemia in Iran. Methods and materials: Current study is a multi-method research with an analysis for policy approach containing three phases. First, through a literature review study, policies, programs and interventions of different countries to control and prevent anemia caused by iron deficiency will be identified. Then, in the qualitative phase of the study, the challenges, barriers, facilitators of the policies and programs implemented and ongoing in Iran will be examined. The content and policy-making process, as well as the context and role of stakeholders and actors will be analyzed using the framework of the policy triangle and analysis of the policy process using the Kingdon's multiple streams model. Then, the proposed initial policy options will be developed. In the next phase, an expert panel contain experts, authorities and policymakers will be formed and the proposed options will be reviewed and categorized. In order to prioritize policy options and evaluate their feasibility in Iran, the Delphi technique and the policy options analysis framework of the Centers for Disease Control and Prevention (CDC) will be used. At the end, policy options will be selected based on the highest score and will be presented as appropriate policy options. Conclusion: Prospective policy analysis allows the selection of potentially practical and effective policy options to control iron deficiency anemia. The findings of current study will be presented as reports and research articles for policy makers. [ABSTRACT FROM AUTHOR]

Introduction Currently, there are no guidelines for the management of locally advanced unresectable or metastatic urothelial carcinoma (mUC) from an Indian perspective. There is a lack of consensus on the utility of treatment options in firstline (1L) and second-line (2L) settings, especially in cisplatin- and platinum-unfit mUC patient subgroups. Objective This articles aims to develop evidence-based practical consensus recommendations for the management of mUC in Indian settings. Methods Modified Delphi consensus methodology was considered to arrive at a consensus. An expert scientific committee of 15 medical oncologists from India constituted the panel. Twelve clinically relevant questions were grouped into five categories for presentation and discussion: (1) cisplatin and platinum ineligibility criteria; (2) programmed death ligand 1 and fibroblast growth factor receptor (FGFR) testing in mUC patients; (3) treatment options in 1L settings; (4) role of switch maintenance; and (5) treatment options in 2L. Statements that reached high (- 80%) and moderate (60-79%) levels of consensus in the first round (electronic survey) did not undergo the second Delphi round. The questions that received a low level of consensus (< 60%) were discussed during the virtual meeting. Results Renal impairment (creatinine clearance [CrCl]<60mL/min) and New York Heart Association class 3 heart failure are important assessment criteria for determining cisplatin ineligibility. Patients are unfit for any platinum-based chemotherapy in case of Eastern Cooperative Oncology Group performance status> 3 or severe renal impairment (CrCl<30 mL/min). Gemcitabine and platinum with cisplatin over carboplatin were preferred in 1L settings. In patients unfit for cisplatin-based regimens, carboplatin-gemcitabine chemotherapy was preferred over immunotherapy (atezolizumab or pembrolizumab). Selected patients who are platinum ineligible may be considered for immunotherapy. Post-induction chemotherapy, those who do not progress may be strongly considered for avelumab maintenance. Experts recommended erdafitinib in FGFR-positive mUC patients in 2L settings. In FGFR-negative patients, immunotherapy (pembrolizumab, nivolumab, or avelumab)may be preferred over chemotherapy (paclitaxel, docetaxel, or vinflunine). Enfortumab vedotin and sacituzumab govitecan may be considered for further lines of therapy. Conclusion Expert panel consensus will offer expert guidance to oncologists/clinicians on the management of mUC in Indian settings. [ABSTRACT FROM AUTHOR]

Meta-analyses are highly valued in medical science, yet accurately reporting complications in neurosurgical studies remains challenging. Examples include inconsistencies in defining and classifying complications and variations in reporting methods. This lack of reproducibility and comparability, along with other issues related to biases, hinders the ability of meta-analyses to yield significant advancements. This systematic review investigated the challenges and limitations inherent in meta-analyses of complications in neurosurgery. Based on the identified challenges and our group's experience, we developed a practical checklist to mitigate and avoid common errors in meta-analyses of complications in neurosurgery.We searched PubMed, Embase, and Web of Science for studies addressing challenges in assessing complications in neurosurgery. The main findings were qualitatively synthesized to identify common challenges and limitations. The proposed checklist was developed using a modified Delphi technique. Eleven studies were included, uncovering heterogeneity and a lack of standardization regarding the classification of complications in neurosurgery across various authors and institutions. They suggested solutions such as implementing a more uniform classification system. Additionally, the NeuroComp Meta-Analysis Checklist was developed, comprising 23 items divided into 5 domains, with a practical approach and suggestions on how to deal with the challenges when meta-analyzing.We identified numerous challenges and concerns when assessing complications in the neurosurgical field. The NeuroComp Meta-Analysis Checklist incorporated methodologies and approaches we utilized in several previously published meta-analyses. While we acknowledge that the proposal cannot solve all the issues involved in comparing and meta-analyzing complications in neurosurgery, it has the potential to enhance the informativeness of future meta-analyses and help authors mitigate common errors. Ultimately, this tool has the potential to contribute to the advancement of accumulating real-world evidence in neurosurgical science. [ABSTRACT FROM AUTHOR]

Nowadays, a new emerging tourism industry, named fisherman's homestay, has become a very representative marine leisure tourism project, widely promoted in coastal areas in China. However, the development of China's fisherman's homestay industry is not yet mature and there are many problems, such as incomplete laws and regulations, lack of infrastructure, and severe homogenization. Therefore, it is very important to help the owners of fisherman's homestay improve the service quality. Based on the Service Quality Gap Model, this paper establishes an evaluation index that affects the service quality of fishermen's homestay. We apply decisionmaking trial and evaluation laboratory-based analytic network process (DANP) to identify the critical factors and the causal relationship between them. And the grey clustering model is used to evaluate the service quality of Liaoning province and other five places. Experimental results reveal those six factors, including surrounding facilities, online marketing, room infrastructure, personalized service, community co-prosperity, and attention to harmonization with the environment, contribute to improving the service quality of fisherman's homestays. The fisherman's homestays in Shandong Province, Liaoning Province, and Zhejiang Province are in "excellent" level, and the fisherman's homestays in Fujian Province and Guangxi Zhuang Autonomous Region are in "good" level. [ABSTRACT FROM AUTHOR]

Background & Objective: It is crucial to have a transparent and comprehensive tool in place to ensure accurate information on the educational performance of faculties. With this in mind, the aim of this study was to develop a model for ranking the educational performance of faculties in Iranian medical universities. Material & Methods: This study involved the development of an educational ranking tool for the faculties, which was carried out in 4 stages: compilation of indicators, conducting a focus group discussion, utilizing the Delphi technique, and finally consulting with an expert panel. In the given process, the tool's primary indicators were gathered based on various factors, such as the "educational ranking of medical sciences universities," the "ranking of educational services of universities," and the "postgraduate education performance evaluation system in medical sciences universities." These indicators were designed over a course of 17 sessions. After compiling the primary indicators, the indicators were thoroughly reviewed in four sessions in the presence of educational experts. Subsequently, the Delphi technique was employed, and eight expert panel meetings were held to finalize the indicators and areas, the weight of each indicator and domain, data collection methods, and the method of ranking the faculties. Finally, a scoring guide was prepared for all criteria to ensure a fair and objective evaluation process. Results: The educational ranking model of faculties was designed to evaluate three educational fields - "educational services", "postgraduate education", and "the educational field". The educational field was assessed based on 16 indicators in five areas, including education development, governance, education management, quality development of education, and moving in line with the comprehensive scientific map of the country. These indicators were carefully chosen to ensure a comprehensive evaluation of the faculties' educational excellence. The educational services sector has developed 11 checklists across five key areas: objective factors, reliability, accountability and responsibility, assurance, and empathy. Additionally, the evaluation of postgraduate education performance includes 36 indicators across seven areas: educational program, student evaluation, students, faculty members, educational resources, program evaluation, and senior and executive management. Conclusion: An educational ranking tool has been developed for faculties in medical science universities. This tool evaluates all educational fields of faculties, including educational services, postgraduate education, and the educational field. It also offers the possibility of comparing faculties within a university. The use of this ranking model can lead to improvements in both quantitative and qualitative educational indicators and ultimately improve the educational rank of the university among other medical science universities. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To standardize optic nerve sheath diameter (ONSD) point-of-care ultrasonography (POCUS) and improve its research and clinical utility by developing the ONSD POCUS Quality Criteria Checklist (ONSD POCUS QCC). DESIGN: Three rounds of modified Delphi consensus process and three rounds of asynchronous discussions. SETTING: Online surveys and anonymous asynchronous discussion. SUBJECTS: Expert panelists were identified according to their expertise in ONSD research, publication records, education, and clinical use. A total of 52 panelists participated in the Delphi process. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Three Delphi rounds and three asynchronous discussion rounds generated consensus on quality criteria (QC). This started with 29 QC in addition to other QC proposed by expert panelists. The QC items were categorized into probe selection, safety, body position, imaging, measurement, and research considerations. At the conclusion of the study, 28 QC reached consensus to include in the final ONSD POCUS QCC. These QC were then reorganized, edited, and consolidated into 23 QC that were reviewed and approved by the panelists. CONCLUSIONS: ONSD POCUS QCC standardizes ONSD ultrasound imaging and measurement based on international consensus. This can establish ONSD ultrasound in clinical research and improve its utility in clinical practice. [ABSTRACT FROM AUTHOR]

Terminology in schistosomiasis is not harmonised, generating misunderstanding in data interpretation and clinical descriptions. This study aimed to achieve consensus on definitions of clinical aspects of schistosomiasis in migrants and returning travellers. We applied the Delphi method. Experts from institutions affiliated with GeoSentinel and TropNet, identified through clinical and scientific criteria, were invited to participate. Five external reviewers revised and pilot-tested the statements. Statements focusing on the definitions of acute or chronic; possible, probable, or confirmed; active; and complicated schistosomiasis were managed through REDCap and replies managed in a blinded manner. Round 1 mapped the definitions used by experts; subsequent rounds were done to reach consensus, or quantify disagreement, on the proposed statements. Data were analysed with percentages, medians, and IQRs of a 5-point Likert scale. The study was terminated on the basis of consensus or stability-related and time-related criteria. 28 clinicians and scientists met the criteria for experts. 25 (89%) of 28 experts replied to Round 1, 18 (64%) of 28 to Round 2, 19 (68%) of 28 to Round 3, and 21 (75%) of 28 to at least two rounds. High-level consensus (79–100% agreement and IQRs ≤1) was reached for all definitions. Consensus definitions will foster harmonised scientific and clinical communication and support future research and development of management guidelines for schistosomiasis. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic put unprecedented pressure on weight management services. These services were required to adapt to continue to provide care for people living with obesity. This study sought to develop consensus recommendations on the best practice solutions adopted by weight management services in the United Kingdom during the COVID‐19 pandemic. Methods: This study utilised a semi‐structured interview and a modified Delphi methodology to develop a consensus of best practice recommendations identified by specialist weight management services during the pandemic. Results: Twenty‐three healthcare professionals working in weight management service across the United Kingdom participated in the study. Analysis of interview transcripts identified four key thematic domains: outpatient, patient education and support, perioperative care and team working. Of the initial 43 unique recommendations, 30 reached consensus agreement. Outpatient recommendations focused on communication strategies, patient self‐monitoring and remote patient tracking. Patient education and support recommendations addressed the development of online educational resources and support groups. Perioperative care recommendations emphasised case prioritisation, waiting list support and postoperative care. Team working recommendations targeted the use of digital collaboration tools and strategies for effective teamwork. Conclusion: Developing consensus recommendations on best practice is a critical step for weight management and outpatient services to achieve higher standards of care. These recommendations provide a springboard for departmental discussions, paving the way for improved experiences for individuals living with obesity as they progress along their weight management journey. Key points: During times of crisis, healthcare providers in weight management services can rapidly adopt innovative digital solutions to support good patient care.Thirty expert consensus recommendations relating to outpatient management, patient education and support, perioperative care and team working were found.Collaborative research is key to further guideline development on obesity management in areas of outpatient care, patient education, perioperative care and team working. [ABSTRACT FROM AUTHOR]

Background: Advanced nursing practice and education with a Master's degree as the necessary preparation, is viewed as a major strategy to cultivate senior nursing talents. Competencies are central to advanced nursing practice and education, but how can competencies be measured? Entrustable professional activities (EPAs) have been used widely in medicine as a practical approach for bridging the gaps between competency and clinical practice. Considering the paucity of research in EPAs for nursing graduates in China, it is needed to develop EPAs specifically for Chinese Master of Nursing Specialist (MNS) graduates to improve patient safety and quality patient care. Objectives: To develop and evaluate a core competency-based EPAs framework for Chinese MNS graduates. Methods: A four-stage approach was adopted for the EPAs development, including: (1) forming a research team, (2) drafting an initial EPAs framework, (3) reviewing EPAs framework, and (4) conducting EPAs consensus assessment. Results: A framework containing twelve EPAs was developed, including: 1) perform health assessments, 2) identify and prioritize nursing diagnoses, 3) formulate and implement care plan, 4) perform basic and specialized care operations, 5) recognize and manage medication needs of patients, 6) assess and manage patients with mental health problems, 7) recognize and assist in rescuing critically ill patients, 8) perform transition and handover, 9) participate in multidisciplinary team collaborative care, 10) provide health education and nursing consultation, 11) formulate and implement discharge plans, and 12) instruct nursing students in a clinical setting. The I-CVI score for the two rounds of Delphi ranged from 0.92 ∼ 1.00 and 0.96 ∼ 1.00, respectively. The mean of Equal's score for the three domains ranged from 4.20 ∼ 4.47, 4.25 ∼ 4.51, and 4.23 ∼ 4.37, respectively. Conclusion: The developed EPAs framework in this study is a reliable tool to assess the core competencies of Chinese MNS graduates in clinical practice and assist with their curricula design. [ABSTRACT FROM AUTHOR]

Abstract: Nerve conduction studies are a commonly performed procedure and a core competency for physical medicine and rehabilitation residents. Nerve conduction studies are complex to learn and no standardized training protocols exist across physical medicine and rehabilitation programs. The aims of this study are to standardize training and assessment of resident proficiency in nerve conduction studies skills and to evaluate the impact of an educational intervention on skills development. This was a repeated measures design wherein 36 physical medicine and rehabilitation residents underwent a pretest, followed by a mastery learning-based intervention, including deliberate practice. Residents were then expected to meet or exceed a minimum passing score at posttest. Performance improved from a median score of 4.5/ 66 on the pretest to a median score of 63/66 on the posttest. Thirty three of 36 residents achieved the minimum passing score on the first attempt; three residents required additional deliberate practice and met the minimum passing score on the second attempt. A curriculum featuring deliberate practice dramatically increased checklist scores of residents performing nerve conduction studies. This mastery learning program shows a reliable and reproducible method to achieve procedural competency within a physical medicine and rehabilitation residency program and can shift the curve to allow residents to immediately start performing nerve conduction studies at the start of their clinical experience. [ABSTRACT FROM AUTHOR]

The ability to orient attention to one's environment is a prerequisite for developing executive functions (EF) from preschool age. Very preterm children are vulnerable for delays in visual orienting function (VOF) and EF deficits. This study aimed to investigate associations between objective VOF and subjective parent-reported EF in very preterm–born children at 3 years corrected age (CA). In a prospective cohort study (BOND) involving 90 children born < 30 weeks, VOF and EF were assessed using an eye tracking–based method and BRIEF-P questionnaire. Associations between abnormal VOF (viewing reaction times) and EF scores (BRIEF-P scores) were studied using multivariable regression. Using a modified Delphi method, a subset of eight items related to VOF and EF was explored. Abnormal VOF was observed in 31% of the children and abnormal global EF composite scores in 41%. Abnormal VOF was not associated with global or domain-level EF scores. However, children with abnormal VOF more frequently had EF problems related to attentional behavior: "easily sidetracked" (OR 4.18 (CI: 1.21–14.41), p = 0.02) and "short attention span" (OR 4.52 (CI: 1.34–15.22), p = 0.02). Conclusion: Although abnormal VOF was not associated with global, parent-reported, EF at 3 years CA, secondary analyses did show a relation to specific attention and concentration span items. Further research is needed to study the role of VOF in objectifying preschool EF assessments in very preterm born children. What is known: • Very preterm children are vulnerable for executive function (EF) deficits and for delays in visual orienting function, as compared to term-born children • The ability to orient attention to one's visual environment is an important prerequisite for EF early in life and is easy to measure objectively with visual orienting function (VOF) assessment What is new: • VOF measurement at 3 years of age relates to parent-reported attention and concentration span items, important aspects of executive functions • Future work should explore the clinical additional value of early VOF measurement in children at risk for EF deficits [ABSTRACT FROM AUTHOR]

This commentary article describes the results of a Delphi Method discussion between an interdisciplinary team of state dyslexia policy implementers. The authors argue that the International Dyslexia Association (IDA) definition of dyslexia from 2001 skews toward the perspectives of the research community, inadvertently creating implementation challenges for school practice. The article describes how the authors reached this determination; why they believe Vaughn et al.'s (Annals of Dyslexia, 2024) proposed definition marks an improvement over the 2001 IDA definition; and the need for continued support in the dyslexia policy implementation process, including knowledge dissemination efforts and updates to other relevant policy documents. This collaboration between policymakers, educators, and researchers contributes to the special issue by considering how the definition of dyslexia is situated in policy and practice. In so doing, it addresses a longstanding gap in academic research on how policy implementers understand and use the IDA definition. [ABSTRACT FROM AUTHOR]

Background: Reporting standards of discrete choice experiments (DCEs) in health have not kept pace with the growth of this method, with multiple reviews calling for better reporting to improve transparency, assessment of validity and translation. A key missing piece has been the absence of a reporting checklist that details minimum standards of what should be reported, as exists for many other methods used in health economics. Methods: This paper reports the development of a reporting checklist for DCEs in health, which involved a scoping review to identify potential items and a Delphi consensus study among 45 DCE experts internationally to select items and guide the wording and structure of the checklist. The Delphi study included a best–worst scaling study for prioritisation. Conclusions: The final checklist is presented along with guidance on how to apply it. This checklist can be used by authors to ensure that sufficient detail of a DCE's methods are reported, providing reviewers and readers with the information they need to assess the quality of the study for themselves. Embedding this reporting checklist into standard practice for health DCEs offers an opportunity to improve consistency of reporting standards, thereby enabling transparency of review and facilitating comparison of studies and their translation into policy and practice. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the application of a rehabilitation management protocol for urinary incontinence after robot-assisted laparoscopic prostatectomy (RALP). Methods: We conducted a retrospective cohort study of 114 patients who underwent RALP between August 2021 and November 2021 as the control group and a prospective analysis of 114 patients who underwent RALP between May 2022 and August 2022 as the experimental group. The rehabilitation management protocol focused on preoperative stage, postoperative care, day of catheter removal, 1 month postoperative, 3 months postoperative, 6 months postoperative, and 12 months or more postoperative. Results: The 24-h pad test was significantly lower in the experimental group compared with the control group at 2 and 6 months after RALP (both P < 0.01). The scores of the international consultation on incontinence questionnaire-short form (ICIQ-SF) in the experimental group were significantly lower than those in the control group at 1 month after RALP (P < 0.01).The scores of quality of life in the experimental group were significantly higher than those of the control group at 1, 2, and 6 months after RALP (all P < 0.01).The scores of Broome Pelvic Muscle Self-efficacy Scale (BPMSES) were lower than those of the control group at 1, 2, 3, and 6 months after RALP (all P < 0.01). Conclusion: The application of the rehabilitation management protocol had significant beneficial effects on urinary functions and quality of life in patients with prostate cancer after RALP. [ABSTRACT FROM AUTHOR]

Objective: The limited research funding available needs to be directed towards stakeholder-identified priorities that will have the largest positive impacts on mental health. This study aimed to identify consensus mental health research priorities across lived experience and mental health professional panels. Method: A modified Delphi study with two panels (lived and professional experience in mental health) was used to identify priorities over three rounds. Priorities were rated on a 9-point scale from not important, important but not critical, to critical. Consensus (≥80% agreement on items rated ≥ 6 in importance across both panels) was analysed descriptively. Results: 1015 initial potential priorities and 18 additional priorities were rated by panel members (N = 120, 52 lived experience, 68 professionals), with 608 priorities achieving consensus across 23 mental health domains. Priority themes included: services; prevention, early intervention, detection and health promotion; intersectionality; determinants of mental health; translation; culture, spirituality and wellbeing (identity); suicide and self-harm; data and technology; capacity building; trauma; physical health; stigma and shame; help-seeking and coping; and co-design. Conclusions: There was high agreement across stakeholders on mental health research priorities, which may provide a basis for funding allocations for impactful research that would improve the mental health of the community. Key Points: What is already known about this topic: There is very limited funding for research in mental health. It is essential to identify what areas of mental health research would be most relevant and meaningful to the community. Co-design is important for authentic participation in priority-setting between different stakeholders in the community. What this paper adds: People with lived and/or professional experience identified research priorities across a broad array of mental health challenges, populations, and settings in the Australian community. The mental health research priorities can be used to guide policy, funding, and researchers in conducting future projects. Results pointed to the need for more research in a range of critical areas within the themes of services-based research; prevention, early intervention, detection and health promotion; and intersectionality. [ABSTRACT FROM AUTHOR]