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Objective: In epilepsy, early diagnosis, accurate determination of epilepsy type, proper selection of antiseizure medication, and monitoring are all essential. However, despite recent therapeutic advances and conceptual reconsiderations in the classification and management of epilepsy, serious gaps are still encountered in day‐to‐day practice in Egypt as well as several other resource‐limited countries. Premature mortality, poor quality of life, socio‐economic burden, cognitive problems, poor treatment outcomes, and comorbidities are major challenges that require urgent actions to be implemented at all levels. In recognition of this, a group of Egyptian epilepsy experts met through a series of consecutive meetings to specify the main concepts concerning the diagnosis and management of epilepsy, with the ultimate goal of establishing a nationwide Egyptian consensus. Methods: The consensus was developed through a modified Delphi methodology. A thorough review of the most recent relevant literature and international guidelines was performed to evaluate their applicability to the Egyptian situation. Afterward, several remote and live rounds were scheduled to reach a final agreement for all listed statements. Results: Of 278 statements reviewed in the first round, 256 achieved ≥80% agreement. Live discussion and refinement of the 22 statements that did not reach consensus during the first round took place, followed by final live voting then consensus was achieved for all remaining statements. Significance: With the implementation of these unified recommendations, we believe this will bring about substantial improvements in both the quality of care and treatment outcomes for persons with epilepsy in Egypt. Plain Language Summary: This work represents the efforts of a group of medical experts to reach an agreement on the best medical practice related to people with epilepsy based on previously published recommendations while taking into consideration applicable options in resource‐limited countries. The publication of this document is expected to minimize many malpractice issues and pave the way for better healthcare services on both individual and governmental levels. [ABSTRACT FROM AUTHOR]

Steering committees are pivotal for governing complex collaborations by consensus to facilitate coordination and knowledge sharing. Although consensus-based governance promotes mutuality, it can also cause deadlocks, stalling expeditious decision making. We examine the conditions under which alliance partners delegate decision-making authority to steering committees as well as the conditions under which authority over discordant matters can be relocated to one of the alliance partners. We argue that joint coordination concerns increase the likelihood of authority delegation, whereas the higher costs and stakes associated with decision stalemates provide grounds for authority reversion. Empirical analyses of strategic alliances in the biopharmaceutical industry support our arguments. Our paper demonstrates the versatility of contractually defined administrative interfaces in alliance governance, allowing partners to coordinate bilaterally and adapt hierarchically as and when required. [ABSTRACT FROM AUTHOR]

It is a great privilege to highlight the important contribution of this internationally renowned and versatile linguist to the 2020-translation of the Bible in Afrikaans. Initial phase Since the beginning of the translation project prof. Kotzé, chair of the Language Commission of the South African Academy for Science and Arts (2003-2012), was involved in the planning of the manual for all collaborators, as well as the identification of language specialists to serve in various book teams as well as the linguistic advisory committee. Linguistic advisory committee The Bible Society invited Kotzé to chair a panel of linguistic advisers that eventually became a broader linguistic advisory panel and a smaller linguistic advisory committee respectively. In his capacity as chair, he played an essential role in the identification and placement of language specialists in the respective book translation teams, as well as the linguistic evaluation of the trial translations by language practitioners endeavouring to be part of the project. The linguistic advisory committee attended to various problematic issues such as punctuation, linguistic and textual features, etcetera. Kotzé then provided extensive guidelines to collaborators and proof-readers concerning various tricky issues. Since the beginning of the project, he was also a member of various book teams, as well as at a later stage of the editorial committees of the Old and the New Testament. Whenever expedient, he consulted with members of the Language Commission of the South African Academy for Science and Arts. Executive committee At the executive committee (policy committee) his opinion carried great weight. He submitted proposals concerning Fauna and Flora emanating from deliberations in this committee to the Language Commission of the South African Academy for Science and Arts to be considered for inclusion in their planned CD Rom, and saw to it that the project remained in sync with the Afrikaanse Woordelys en Spelreëls (Afrikaans Glossary and Spelling rules). With respect to the vexing issue of second person pronouns as form of address in Afrikaans, he also provided clear guidelines with regard to the dynamic of power and the dynamic of solidarity, respectively. Editorial committees In the editorial committees of the Old Testament and the New Testament, he was responsible for the final linguistic editing. He could, furthermore, substantiate the suitability of a specific word with reference to the statistical frequency of its usage in the Afrikaans linguistic corpus. Given his broad linguistic and semantic background, he could often pose probing questions to the exegetes and source language specialists concerning a specific translation proposal that often led to an adaptation of the translation. In this respect, his self-acquired knowledge of the source languages (as a non-theologian) often took the source language specialists by surprise. When the discussion sometimes became a bit heated, his sense of humour and witty remarks would invariably defuse the situation. Approachability The executive committee and the project leader had great appreciation for the fact that Ernst Kotzé was always willing to answer any enquiry by colleagues or proof-readers speedily and in detail. Even at a late stage in the project, he was still willing to edit the Introduction, Glossary and Accountability for consistency. Even after the publication of the translation, he still remains selflessly willing to answer enquiries to the Bible Society arising from feedback by readers. Public contributions Prof. Kotzé often delivered addresses about Bible translation, speaking specifically about the linguistic aspects of the 2020 translation on Radio Sonder Grense (Radio Without Borders) and Radio Cape Pulpit. On the project's website (www.bybeldirektevertaling.co.za) he answered specific questions received from readers. He explained different ways of spelling as well as the issue of loan-words resembling the source languages. [ABSTRACT FROM AUTHOR]

IntroductionCluster randomized crossover trials are often faced with a dilemma when selecting an optimal model of consent, as the traditional model of obtaining informed consent from participant's before initiating any trial related activities may not be suitable. We describe our experience of engaging patient advisors to identify an optimal model of consent for the PREP-IT trials. This paper also examines surrogate measures of success for the selected model of consent.MethodsThe PREP-IT program consists of two multi-center cluster randomized crossover trials that engaged patient advisors to determine an optimal model of consent. Patient advisors and stakeholders met regularly and reached consensus on decisions related to the trial design including the model for consent. Patient advisors provided valuable insight on how key decisions on trial design and conduct would be received by participants and the impact these decisions will have.ResultsPatient advisors, together with stakeholders, reviewed the pros and cons and the requirements for the traditional model of consent, deferred consent, and waiver of consent. Collectively, they agreed upon a deferred consent model, in which patients may be approached for consent after their fracture surgery and prior to data collection. The consent rate in PREP-IT is 80.7%, and 0.67% of participants have withdrawn consent for participation.DiscussionInvolvement of patient advisors in the development of an optimal model of consent has been successful. Engagement of patient advisors is recommended for other large trials where the traditional model of consent may not be optimal.

IntroductionPragmatic trials in comparative effectiveness research assess the effects of different treatment, therapeutic, or healthcare options in clinical practice. They are characterized by broad eligibility criteria and large sample sizes, which can lead to an unmanageable number of participants, increasing the risk of bias and affecting the integrity of the trial. We describe the development of a sampling strategy tool and its use in the PREPARE trial to circumvent the challenge of unmanageable work flow.MethodsGiven the broad eligibility criteria and high fracture volume at participating clinical sites in the PREPARE trial, a pragmatic sampling strategy was needed. Using data from PREPARE, descriptive statistics were used to describe the use of the sampling strategy across clinical sites. A Chi-square test was performed to explore whether use of the sampling strategy was associated with a reduction in the number of missed eligible patients.Results7 of 20 clinical sites (35%) elected to adopt a sampling strategy. There were 1539 patients excluded due to the use of the sampling strategy, which represents 30% of all excluded patients and 20% of all patients screened for participation. Use of the sampling strategy was associated with lower odds of missed eligible patients (297/4545 (6.5%) versus 341/3200 (10.7%) p

Literature aimed at practitioners recommends dedicated Steering Committees for oversight of a project. However, most scientific research focusses on project governance in general or the role of the single owner. This paper adds to literature by inductively exploring the formation and the functioning of a Project Steering Committees, based on experiences of both members and project managers. Nine project managers and four Steering Committee members were interviewed. Data was analyzed, leading to five aggregate dimensions: on relevance and goals, the formation process, decision-making, roles and responsibilities of the members and ideal characteristics of the members. Findings were triangulated by a qualitative questionnaire. The study shows that dedicated Project Steering Committees are used for oversight of a project. As predicted by literature, the oversight consists of governance and support activities. The Steering Committee structure is primarily based on existing practices in the organization and the needed support from owners and other stakeholders. The project owner, often in consultation with the project manager, selects Steering Committee members based on functional representation. Competences needed for a role in the Steering Committee and interest in the project are generally taken for granted, but not always present. Follow-up research can focus on the roles and responsibilities of the members, characteristics the members should have, and the decision-making process. [ABSTRACT FROM AUTHOR]

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.

Large Capital Projects (LCPs) have a significant impact on the growth and development of local and international economies. Their failure stagnates progress, is not sustainable and cripples the economy and society in which they exist. This research study investigated the effective functioning of a Project Steering Committee (PSC) as a pivotal component to project management. Based on the findings of the literature review, the research model consists of four PSC function categories: (i) configuration, (ii) competency, (iii) decision authority, and (iv) communication. A 5-point Likert scale survey was used, and the results from 46 respondents within the South African industry was analyzed. The results concurred with previous studies that PSCs' knowledge of Structured Corporate and Project Governance is essential for the efficient functioning of a steering committee. Contrary to the expectations of experienced project practitioners, Communication Management ranked relatively low in importance. Whilst there was consensus on the ratings of the PSC competencies, the variance noted can be attributed to factors such as the project experience of participants, the type and location of the project, and the PSC construct in different organizations. This can indicate that there is no single PSC attribute, but a combination of technical and interpersonal skills, necessary for effective PSC functioning. Based on the results, it is recommended that the roles and responsibilities of the PSC are confirmed and understood by project stakeholders early in a project to ensure clear guidance and authority. [ABSTRACT FROM AUTHOR]

Established in 1990, Israel's Healthy Cities Network (HCN) performed its first evaluation in 2003–2004. A decade later, the present evaluation was implemented to assess members' compliance with the European HCN requirements and to determine progress made since the initial evaluation. A total of 31 of the existing 42 HCN members participated in this mixed methods evaluation. Based on the Monitoring, Accountability, Reporting, and Impact assessment framework, the evaluation questionnaire integrated Healthy Cities' principles and strategies. Univariate and bivariate analyses were used to investigate municipality performance as well as associations between indicators and structural or process measures. Matched-paired t -tests were performed to compare HCN member cities' initial evaluation with the current evaluation. Qualitative analyses explored the processes involved in implementing the Healthy Cities approach. The current evaluation found that Israel's HCN complies with all European HCN requirements, except for producing a city health profile. Increased coordinators' time investment, maintaining municipal health steering committee meetings and attending HCN activities were positively associated with better score on all dimensions. There was no significant difference between the two evaluation scores for all HCN cities collectively; however, within city comparisons indicated significant change. Coordinators reported that there was added value in HCN membership and conveyed a need for better network facilities, publicity and improved public relations. This evaluation validates the previous evaluation's findings and informs decision makers and municipal leaders regarding potential areas to modify or expand, both on the municipality level and the network at large. [ABSTRACT FROM AUTHOR]

Leaders in perioperative and interventional procedure areas need to be able to initiate and sustain change to improve operational processes in their departments or service lines. Although available literature discusses change in health care organizations, there is a lack of published articles on the implementation and sustainment of change. This article provides a review of supporting literature on change management and an infrastructure model that we have successfully implemented to sustain change. An organizational case study focused on creating sustained improvements for first procedure on‐time starts and turnover times details the process of creating the accountability system for actualizing the performance targets in a perioperative environment. The case study examines the existing process and initial challenges with creating sustainable and quantifiable outcomes, describes the process of implementing the infrastructure discussed in the article, and evaluates the results. Perioperative leaders can use the information to improve processes in their work environments. [ABSTRACT FROM AUTHOR]

In the spring of 2021, the ACR approved a proposal to improve the consistency, transparency, and administrative oversight of the ACR Reporting and Data Systems (RADS). A working group of experts and stakeholders was convened to draft this governance document. Major advances include (1) forming a RADS Steering Committee, (2) establishing minimum requirements and evidence standards for new and existing RADS, and (3) outlining a governance structure and communication strategy for RADS. [ABSTRACT FROM AUTHOR]

In the private sector, research on information technology (IT) governance has frequently applied the classical view of agency theory and focused on the controlling role played by the board of directors in constraining a potentially opportunistic manager/agent. However, in the public sector, the board of directors does not exist and there may be less need to focus on the controlling aspect of governance and more need to focus on the politically challenging distribution of state resources. In this U.S.-state–based study, we adopt, apply, and extend the legal view of agency theory past its sole focus on the board of directors as the solitary mediating hierarch in order to examine the strategic mediating hierarch role played by the state legislature and then conceptualize and test for the existence of a tactical mediating hierarch played by the IT steering committee and the production role of an independent Office of the Chief Information Officer (OCIO) in using a fee-for-service funding model. We apply these concepts to extend theory to examine the combination of roles that lead to superior outcomes for the state (the principal) versus those necessary for the IT department (the agent). Our results show that by shifting from the control-oriented view of governance in the private sector to a more mediating view in the public sector, important practices may be portable between the public and private sector, despite their widely differing structures. [ABSTRACT FROM PUBLISHER]

This paper presents a collaborative research, based on the work of a steering committee in charge of implementing an innovative training scheme to support the equestrian artists' (EA) professionalisation. The article analyses the exchanges in the five meetings from this committee with regard to the concept of professionalisation and the actor-network theory. The results show that the steering committee constitutes a relevant socio-scientific space to study the two heuristic and praxeological dimensions of this technological research. This space allows, under ethical conditions, not only the understanding of the institutional, political, social, cultural and economic stakes of the EA world but also the co-construction of a relevant training scheme and the production of results in an epistemic nature on the EAs' professionalisation process. [ABSTRACT FROM AUTHOR]

Women are under-represented as leaders of cardiovascular randomized controlled trials, representing 1 in 10 lead authors of cardiovascular trials published in high-impact journals. Although the proportion of cardiovascular specialists who are women has increased in recent years, the proportion of cardiovascular clinical trialists who are women has not. This gap, underpinned by systemic sexism, has not been adequately addressed. The benefits of diverse randomized controlled trial leadership extend to patients and professionals. In this position statement, we present strategies adopted by some organizations to end gender inequality in research leadership. We offer an actionable roadmap for early-career researchers, scientists, academic institutions, professional societies, trial sponsors, and journals to follow, with the goal of harnessing the strength of women and under-represented groups as research leaders and facilitating a just culture in the cardiovascular clinical trial enterprise. [ABSTRACT FROM AUTHOR]

The literature addressing the subject of projects and megaprojects governance is somewhat incipient and ambiguous. This work aims at a discussion of the possible contribution of the business policy approach as a means to overcome this gap in the practical governance of megaprojects. The category of megaprojects was chosen because they are organizations with some resemblance to companies in the wider sense of the word, despite some fundamental differences. Within the scope of megaprojects, we find a governance architecture that parallels the double tier of traditional corporate governance models. Project directors usually have a team similar to that of traditional companies. This can be envisioned as the executive board or managing structure of a traditional company. But these sorts of projects generally have a project steering committee, which is a nonexecutive governing structure addressing the scope of the project and which broadly considered might be compared with the non-executive board (or supervisory council) from traditional organizations. We propose for discussion an example of double tier project governance, approached from a business policy viewpoint, distinguishing executives from non-executive roles. The text ends by addressing the institutional configuration area of business policy in the context of megaprojects, as well as a reflection on the validity of the points of view proposed. [ABSTRACT FROM AUTHOR]

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Managing multicenter clinical trials (MCTs) is demanding and complex. The Randomized controlled Evaluation of high-volume hemofiltration in adult burn patients with Septic shoCk and acUte kidnEy injury (RESCUE) trial was a prospective, MCT involving the impact of high-volume hemofiltration continuous renal replacement therapy on patients experiencing acute kidney injury and septic shock. Ten clinical burn centers from across the United States were recruited to enroll a target sample size of 120 subjects. This manuscripts reviews some of the obstacles and knowledge gained while coordinating the RESCUE trial. The first subject was enrolled in February 2012, 22 months after initial IRB approval and 29 months from the time the grant was awarded. The RESCUE team consisted of personnel at each site, including the lead site, a data coordination center, data safety monitoring board, steering committees, and the sponsor. Seven clinical sites had enrolled 37 subjects when enrollment stopped in February 2016. Obstacles included changes in institutional review boards, multiple layers of review, staffing changes, creation and amendment of study documents and procedures, and finalization of contracts. Successful completion of a MCT requires a highly functional research team with sufficient patient population, expertise, and research infrastructure. Additionally, realistic timelines must be established with strategies to overcome challenges. Inevitable obstacles should be discussed in the pretrial phase and continuous correspondence must be maintained with all relevant research parties throughout all phases of study. [ABSTRACT FROM AUTHOR]