Assessment of early warning signs in hospital projects' front-end phase

PurposeThe front-end phase plays an important role in achieving project success, and establishment of performance measurement systems considering project challenges or pitfalls is a way of keeping track of this phase. Early warning signs, a type of proactive performance indicators, may serve as means for improving decision-making and project processes aiming for short- and long-term project success. In this paper, the authors present findings from a study on early warning signs (EWS) in hospital projects' front-end. A preliminary systematisation of identified signs as a contribution to front-end improvement is provided.Design/methodology/approachThe paper is based on a mixed methods approach, using a sequential, exploratory research design comprising document studies, interviews and a survey.FindingsThe authors identified 62 challenges for hospital projects' front-end performance and further established four categories of EWS as follows: (1) structure and tools, (2) context and frame factors, (3) management and (4) relational factors and properties. This mirrors the presence of hard and soft issues from previous studies. There is need for clarifying terminology and raising consciousness on EWS. Processual approaches to identify EWS are considered more useful than subsequent established indicators.Originality/valueThe findings from this paper provide insight into EWS in hospital projects' front-end phase. This adds to the general understanding of EWS and contributes to more knowledge on the front-end phase in general.

Personalized Lifestyle Intervention and Functional Evaluation Health Outcomes SurvEy: Presentation of the LIFEHOUSE Study Using N-of-One Tent–Umbrella–Bucket Design

The working definition of health is often the simple absence of diagnosed disease. This common standard is limiting given that changes in functional health status represent early warning signs of impending health declines. Longitudinal assessment of functional health status may foster prevention of disease occurrence and modify disease progression. The LIFEHOUSE (Lifestyle Intervention and Functional Evaluation-Health Outcomes SurvEy) longitudinal research project explores the impact of personalized lifestyle medicine approaches on functional health determinants. Utilizing an adaptive tent–umbrella–bucket design, the LIFEHOUSE study follows the functional health outcomes of adult participants recruited from a self-insured employee population. Participants were each allocated to the tent of an all-inclusive N-of-one case series. After assessing medical history, nutritional physical exam, baseline functional status (utilizing validated tools to measure metabolic, physical, cognitive, emotional and behavioral functional capacity), serum biomarkers, and genomic and microbiome markers, participants were assigned to applicable umbrellas and buckets. Personalized health programs were developed and implemented using systems biology formalism and functional medicine clinical approaches. The comprehensive database (currently 369 analyzable participants) will yield novel interdisciplinary big-health data and facilitate topological analyses focusing on the interactome among each participant’s genomics, microbiome, diet, lifestyle and environment.

Threat Assessment Teams for Institutions of Higher Education: A Review of Key Ideas and Practices for Professional Counselors

This review of literature provides a comprehensive account of the instigative factors, history, and evolution of threat assessment teams (TATs) for target-based violence in institutions of higher education (IHEs). Through examining diverse approaches to threat assessment, this review investigates the most effective criteria for creating protocols to identify and manage threats of target-based violence. The objective is to provide a greater understanding of the precursors and warning signs to threats of violence, including an understanding of what psychosocial factors impel students to enact mass murder, so that TATs can implement preventative strategies to school violence. The generalized findings of the majority of studies point to the necessity for a multi-disciplinary team referencing fact-based predictors of violence, yet applying an individualized and preventative approach to each case of suspected violence.

Why postmortems fail

Most high-profile disasters are followed by demands for an investigation into what went wrong. Even before they start, calls for finding the missed warning signs and an explanation for why people did not “connect the dots” will be common. Unfortunately, however, the same combination of political pressures and the failure to adopt good social science methods that contributed to the initial failure usually lead to postmortems that are badly flawed. The high stakes mean that powerful actors will have strong incentives to see that certain conclusions are—and are not—drawn. Most postmortems also are marred by strong psychological biases, especially the assumption that incorrect inferences must have been the product of wrong ways of thinking, premature cognitive closure, the naive use of hindsight, and the neglect of the comparative method. Given this experience, I predict that the forthcoming inquiries into the January 6, 2021, storming of the US Capitol and the abrupt end to the Afghan government will stumble in many ways.

Correlation of Dengue Warning Signs during Febrile Phase with Rotational Thromboelastometry, Cortisol and Feritin

Dengue mortality remains high despite monitoring against warning signs (WS). The associations of WS at febrile phase (FP) and hemorrhage at defervescence with the levels and kinetics of ROTEM, platelet count, cortisol, and ferritin were analyzed. Patients with confirmed dengue serology and WS in two centers were screened (n = 275) and 62 eligible patients were recruited prospectively over 9 months. “Vomiting” was the commonest WS (62.9%), with shortened clotting time (CT) INTEM (p = 0.01). “Hematocrit increase” showed significant prolonged CT INTEM, EXTEM, and FIBTEM (p < 0.05). “Platelet decrease” showed reduced platelet function and reduced clot amplitude at 10 min (A10) and maximum clot firmness (MCF) in INTEM and EXTEM (p < 0.001). The kinetics were reduced in platelet count, CT EXTEM, and cortisol (p < 0.05) but increased in CT INTEM (p = 0.03). At FP, “vomiting”, “hematocrit increase”, and “platelet decrease” demonstrated impaired CT, clot strengths A10/MCF and platelet functions. Majority (60/62, 96.7%) had non-severe outcomes, consistent with increase in cortisol kinetics. In conclusion, “vomiting”, “hematocrit increase” and “platelet decrease” at FP correlated with ROTEM. No conclusion could be made further regarding ferritin and cortisol. Larger study is required to study “hematocrit increase” with ROTEM as a potential marker for hemorrhage.

Factors Associated with Knowledge and Awareness of Stroke Among the Jordanian Population: A Cross-Sectional Study

Background and objective: Stroke is the second leading cause of death in Jordan and over the world. Knowledge and awareness towards stroke play a crucial role in the management and prevention of its complications. This study aims to assess the knowledge and awareness about stroke among the Jordanian population and determine factors associated with stroke awareness. Methods: This cross-sectional study through a web-based anonymous questionnaire that needed 10 minutes to be completed. It examined sociodemographic characteristics and recognition of the risk factors, warning signs, stroke consequences, and early response to stroke symptoms. Logistic regression analysis identified the factors associated with poor knowledge of stroke. Results: A total of 573 Jordanian adults participated in this study. The participant's ability to identify at least one early symptom of stroke and the proper response to the symptoms were significantly correlated with the educational level (OR of 3.4 and 2.5, respectively). At least one consequence of stroke was significantly associated with different demographic factors such as gender, socioeconomic income, females versus males and those with medium income versus low income had significantly higher odds (OR of 6.6 and 4.1, respectively). Conclusion: This study revealed a good knowledge and awareness level about stroke among Jordanians correlated mainly with their educational level. Therefore, new strategies should be considered to decrease the prevalence of stroke in Jordan, including the need for engagement in enhanced awareness campaigns.

Non-accidental Trauma in Infants: a Review of Evidence-Based Strategies for Diagnosis, Management, and Prevention

Purpose of Review To provide a resource for providers that may be involved in the diagnosis and management of infant non-accidental trauma (NAT). Recent Findings Infants are more likely to both suffer from physical abuse and die from their subsequent injuries. There are missed opportunities among providers for recognizing sentinel injuries. Minority children are overrepresented in the reporting of child maltreatment, and there is systemic bias in the evaluation and treatment of minority victims of child abuse. Summary Unfortunately, no single, primary preventative intervention has been conclusively shown to reduce the incidence of child maltreatment. Standardized algorithms for NAT screening have been shown to increase the bias-free utilization of NAT evaluations. Every healthcare provider that interacts with children has a responsibility to recognize warning signs of NAT, be able to initiate the evaluation for suspected NAT, and understand their role as a mandatory reporter.

A Novel Financial Risk Early Warning Strategy Based on Decision Tree Algorithm

This paper requires a lot of assumptions for financial risk, which cannot use all of the data and is often limited to financial data; and in the past, most early warning models for financial crises did not, so they could not track the fluctuation and change trend of financial indicators. A decision tree algorithm model is used to propose a financial risk early warning method. Enterprises have suffered as a result of the financial crisis, and some have even gone bankrupt. Any financial crisis, on the other hand, has a gradual and deteriorating course. As a result, it is critical to track and monitor the company's financial operations so that early warning signs of a financial crisis can be identified and effective measures taken to mitigate the company’s business risk. This paper establishes a financial early warning system to predict financial operations using the decision tree algorithm in big data. Operators can take measures to improve their enterprise’s operation and prevent the failure of the embryonic stage of the financial crisis, to avoid greater losses after discovering the bud of the enterprise’s financial crisis, and to avoid greater losses after discovering the bud of the enterprise’s financial crisis. This prediction can be used by banks and other financial institutions to help them make loan decisions and keep track of their loans. Relevant businesses can use this signal to make credit decisions and effectively manage accounts receivable; CPAs can use this early warning information to determine their audit procedures, assess the enterprise's prospects, and reduce audit risk. As a result, the principle of steady operation should guide modern enterprise management. Prepare emergency plans in advance of a business risk or financial crisis to resolve the financial crisis and reduce the financial risk.

A Synoptic Review of Forestry and Forest Products Trade and Production in Africa- The Case of Wood and Non-Wood Forest Products in West Africa

According to this study, approximately half of Africa's forests are utilized primarily or partially for the production of wood and non-wood commodities. Aims to evaluate Africa's forestry and forest products, namely Wood Forest Products (WFPs) and Non-wood Forest Products (NWFPs) in the sixteen (16) West African countries. While adhering to the following guidelines: wood extraction and preparation, analyzing wood primarily used as an energy source in Africa, identifying non-wood forest products in Africa, the state of export, trade, and customs procedures in West Africa, and examining the role of forests and forest stakeholders in Africa's low-carbon economy transition. An exploratory literature review of selected wood forest products and non-wood forest products (plants and animals) in West Africa identifying the country, the natural land area with the natural habitat issues of the forest, the species most harvested and traded in the West African sub-region. The study reemphasized some government legislation, policies, and market trade failures and limitations while also stating that trees may help in the low-carbon revolution through interventions aimed at maintaining, improving, and restoring natural capital have demonstrated that high environmental requirements of sustainable forest management (SFM) may be met in both natural and planted forests. The study identified a systematic assessment of the most common forest products (wood and non-wood forest products) considering the available data on the national forest reserves of the selected countries in West Africa. The study also revealed the need for biodiversity conservation of the available forest reserves to help mitigate the impact of global warming targeting the United Nation’s Sustainable Development Goal 13- Climate Action. Which is focused on integrating climate change mitigation, adaptation, impact reduction, and early warning signs into the national policies, improving forest planning and management education, awareness-raising, and institutional capacity within the sub-region.