Using the QI Maturity Tool – Modified Ontario Version to assess the state of QI maturity in Ontario’s public health units

Background Implementation of quality improvement (QI) practices varies considerably among public health units (PHUs) in Ontario. With the emphasis on continuous quality improvement (CQI) in the revised Ontario Public Health Standards (OPHS), there is a need to understand the level of QI maturity in Ontario’s PHUs. The objective of this research was to establish a baseline understanding of QI maturity in Ontario’s PHUs. Methods The QI Maturity Tool - Modified Ontario Version was used to assess the state of QI maturity in 34 PHUs across Ontario. QI maturity was assessed through 23 questions across three dimensions: QI Organizational Culture; QI Capacity and Competency; and QI Perceived Value. QI maturity scores were classified into five stages: Beginning; Emerging; Progressing; Achieving; and Excelling. QI maturity scores were calculated for each of the 34 participating PHUs to determine their stage of QI maturity. Each PHU’s score was then used to determine the provincial average for QI maturity. Participants were also asked to answer three questions related to core CQI organizational structures. Results Across the 34 PHUs, 3503 staff participated in the survey. A review of individual PHU scores indicates that Ontario’s PHUs are at varying stages of QI maturity. The average QI maturity score of 4.94 for the 34 participating PHUs places the provincial average in the “Emerging” stage of QI maturity. By QI dimensions, the participating PHUs scored in the “Emerging” stage for QI Organizational Culture (5.09), the “Beginning” stage for QI Competency and Capacity (4.58), and the “Achieving” stage for QI Perceived Value (6.00). Conclusion There is an urgent need for Ontario’s PHUs to progress to higher stages of QI maturity. Participants place a high value on QI, but collectively are at less “mature” stages of QI in relation to QI organizational culture and the competency and capacity to engage in QI activities. PHUs should leverage the value that staff place on QI to foster the development of a culture of QI and provide staff with relevant knowledge and skills to engage in QI activities.

Correlation and Correspondence between Skeletal Maturation Indicators in Hand-Wrist and Cervical Vertebra Analyses and Skeletal Maturity Score in Korean Adolescents

This retrospective observational study aimed to examine the correlation and correspondence between skeletal maturation indicators (SMI), cervical vertebral maturation indicators (CVMI), and radius-ulna-short bones (RUS) skeletal maturity scores in Korean adolescents, and to determine whether easily obtainable SMI or CVMI can replace the RUS skeletal maturity score. A total of 1017 participants were included with both hand-wrist radiograph and lateral cephalogram acquired concurrently. From the lateral cephalogram, CVMI was determined; through the hand-wrist radiograph, SMI was categorized, and the RUS skeletal maturity score was evaluated as well. Associations were examined using the Mann–Whitney U test, Spearman’s rank-order correlation analysis, and multiple correspondence analysis. There was no statistically significant difference in chronological age between males and females; however, the SMI, CVMI, and RUS skeletal maturity scores were significantly higher in females. The SMI, CVMI, and RUS skeletal maturity scores showed a statistically significant strong degree of both positive correlation and correspondence. However, a precisely corresponding RUS skeletal maturity score was difficult to obtain for a specific CVMI and SMI stage, implying the absence of a quantitative correlation. In conclusion, detailed evaluation should be conducted using the RUS skeletal maturity score, preferably in cases that require bone age determination or residual growth estimation.

Diploma Nursing Final Year Students with that of Degree Nursing Final Year Students

Background: Everyone is special, but we also have a couple of things in common. In psychology, one of the most interesting questions is to get to grips with human nature and what makes a personality. The type of personality that we hold is essential to our human perception. This study aimed to compare the emotional maturity of diploma nursing final year students with that of degree nursing final year students. Objective: 1. To evaluate the level of emotional maturity of final year students in diploma nursing. 2. To evaluate emotional maturity rates of degree nursing final year students. 3. To compare the level of emotional maturity of diploma nursing final year students with that of degree nursing final year students. 3. To associate the level of emotional maturity of diploma Students in the nursing final year with their demographic variables selected. 4. To associate the level of emotional maturity of degree nursing final year students with their selected demographic variables. Materials and Methods: A Comparative study was conducted among diploma Nursing students from the final year and nursing students from the final year Wardha. Purposive sampling technique was used. Result: The data obtained to describe the that 11 % of the diploma final year nursing students had extremely emotionally maturity level, 21 % of them had emotionally immature 56% moderately emotionally maturity level 12% of diploma final year nursing students had extremely emotionally immature level. Minimum emotional maturity score was 67 and maximum emotional maturity score was 207.Mean emotional maturity score was 97.28 ± 22.08. degree final year nursing students that 82% of the degree final year nursing students had extremely emotionally mature level, 05 of them had moderately emotionally mature level, 10% of them had emotionally immature level and 3% them had extremely emotionally immature. Minimum emotional maturity score was 73 and maximum emotional maturity score was 235.Mean emotional maturity score was 179.98 ± 41.25. Conclusion: The majority of diploma final year nursing students statistically significant difference was found in emotionally mature are degree final year students. Hence H1 is accepted. There is positive correlation between emotional maturities of diploma Nursing students and in final year and nursing students in the final year.

Using the QI Maturity Tool – Modified Ontario Version to Assess the State of QI Maturity in Ontario’s Public Health Units

Background Implementation of quality improvement (QI) practices varies considerably among public health units (PHUs) in Ontario. With the emphasis on continuous quality improvement (CQI) in the revised Ontario Public Health Standards (OPHS), there is a need to understand the level of quality improvement (QI) maturity in Ontario’s PHUs. The objective of this research was to establish a baseline understanding of QI maturity in Ontario’s PHUs. Methods The QI Maturity Tool - Modified Ontario Version was used to assess the state of QI maturity in 34 PHUs across Ontario. QI maturity was assessed through 23 questions across three dimensions: QI Organizational Culture; QI Capacity and Competency; and QI Perceived Value. QI maturity scores were classified into five stages: Beginning; Emerging; Progressing; Achieving; and Excelling. QI maturity scores were calculated for each of the 34 participating PHUs to determine their stage of QI maturity. Each PHU’s score was then used to determine the provincial average for QI maturity. Participants were also asked to answer three questions related to core CQI organizational structures. Results Across the 34 PHUs, 3,503 staff participated in the survey. A review of individual PHU scores indicates that Ontario’s PHUs are at varying stages of QI maturity. The average QI maturity score of 4.94 for the 34 participating PHUs places the provincial average in the “Emerging” stage of QI maturity. By QI dimensions, the participating PHUs scored in the “Emerging” stage for QI Organizational Culture (5.09), the “Beginning” stage for QI Competency and Capacity (4.58), and the “Achieving” stage for QI Perceived Value (6.00). Conclusion There is an urgent need for Ontario’s PHUs to progress to higher stages of QI maturity. Participants place a high value on QI, but collectively are at less “mature” stages of QI in relation to QI organizational culture and the competency and capacity to engage in QI activities. PHUs should leverage the value that staff place on QI to foster the development of a culture of QI and provide staff with relevant knowledge and skills to engage in QI activities.

A Framework for Industry 4.0 Readiness and Maturity of Smart Manufacturing Enterprises: A Case Study

Recently, researchers have proposed various maturity models (MMs) for assessing Industry 4.0 (I4.0) adoption; however, few have proposed a readiness framework (F/W) integrated with technology forecasting (TF) to evaluate the growth of I4.0 adoption and consequently provide a roadmap for the implementation of I4.0 for smart manufacturing enterprises. The aims of this study were (1) to review the research related to existing I4.0 MMs and F/Ws; (2) to propose a modular MM with four dimensions, five levels, 60 second-level dimensions, and 246 sub-dimensions, and a generic F/W with four layers and seven hierarchy levels; and (3) to conduct a survey-based case study of an automobile parts manufacturing enterprise by applying the MM and F/W to assess the I4.0 adoption level and TF model to anticipate the growth of I4.0. MM and F/W integrated with TF provides insight into the current situation and growth of the enterprise regarding I4.0 adoption, by identifying the gap areas, and provide a foundation for I4.0 integration. Case study findings show that the enterprise’s overall maturity score is 2.73 out of 5.00, and the forecasted year of full integration of I4.0 is between 2031 and 2034 depending upon the policy decisions.

Studi Deskriptif Tingkat Toleransi Beragama dan Kematangan Beragama di Kota Tangerang

Tangerang is a city whose people consist of various ethnicities or religions, such as Muslims, Christians, Catholics, and Buddhists. Even in Tangerang, there are quite a lot of temples / temples. In the last 20 years, the people of Tangerang City have never faced horizontal conflicts between religious believers. But interestingly, based on the results of the Setara Institute study in 2018, Tangerang as a city has a tolerance index of 4.58 from a range of scores of 1-7. This figure puts Tangerang in the 61st position of the 94 cities surveyed. These results can be said to be low. Of course, this is somewhat different from the phenomenon which recorded the absence of horizontal conflicts in Tangerang City. The purpose of this research is to see a picture of religious maturity and religious tolerance in the people of Tangerang city. This study used a quantitative approach, target participants in this study were 150 (n = 150) participants. The research instrument was a questionnaire containing statements / items related to religious tolerance. Data was collected by means of online administration because this study was conducted during the Covid-19 pandemic. The results of the mean difference test show that there is no significant difference, both in terms of religious tolerance and religious maturity based on the demographic group of age, gender, and education. But in terms of histogram distribution, it shows the outlier score on the variable of religious maturity. Therefore, in general, demographic factors do not affect the variation of religious tolerance and religious maturity. However, the religious maturity score of the people of Tangerang City is relatively low.

Assessment of the Predictive Capability of VERA—CS for CASL Challenge Problems

This paper describes the process for assessing the predictive capability of the Consortium for the advanced simulation of light-water reactors (CASL) virtual environment for reactor applications code suite (VERA—CS) for different challenge problems. The assessment process is guided by the two qualitative frameworks, i.e., phenomena identification and ranking table (PIRT) and predictive capability maturity model (PCMM). The capability and credibility of VERA codes (individual and coupled simulation codes) are evaluated. Capability refers to evidence of required functionality for capturing phenomena of interest while credibility refers to the evidence that provides confidence in the calculated results. For this assessment, each challenge problem defines a set of phenomenological requirements (based on PIRT) against which the VERA software is evaluated. This approach, in turn, enables the focused assessment of only those capabilities that are relevant to the challenge problem. The credibility assessment using PCMM is based on different decision attributes that encompass verification, validation, and uncertainty quantification (VVUQ) of the CASL codes. For each attribute, a maturity score from zero to three is assigned to ascertain the acquired maturity level of the VERA codes with respect to the challenge problem. Credibility in the assessment is established by mapping relevant evidence obtained from VVUQ of codes to the corresponding PCMM attribute. The illustration of the proposed approach is presented using one of the CASL challenge problems called chalk river unidentified deposit (CRUD) induced power shift (CIPS). The assessment framework described in this paper can be considered applicable to other M & S code development efforts.

Demirjian’s Eight Teeth Method for Dental age Estimation in Nepalese Population

Background: Demirjian’s method is widely used method for dental age estimation. This study was conducted with objectives of applying Demirjian’s 8 teeth method to estimate age in Nepalese Population and to determine Nepal-specific formulas.Methods: We had used the Orthopantomographs of Nepalese people of age above five and below 23 years. The radiographs were compared to the ‘Tooth Development Chart’ and each tooth studied was assigned with any one of the 10 developmental stages using Demirijian’s 8 teeth method and total maturity scores determined. Formulas were derived using regression analysis, wherein the total maturity score obtained for each individual was considered as the independent variable and the corresponding age as the dependent variable in the STATA 15.1 statistical program. Results: There was underestimation of age in both the sexes by the original method. Regression equations were derived for males and females separately for age five to 18 years and again after adding cases up to 23 years. The estimation was better for males up to 18 years [R2=0.94, Mean Absolute Error (MAE) 0.747 years and SD 0.644] than for females up to 18 years (R2 = 0.89, MAE 0.886 years and SD 0.925). The estimation was better for up to 18 years than for up to 23 years in both sexes.Conclusions: Demirijian’s 8 teeth method underestimated age in the study population and thus population specific equations based on the method are better for dental age estimation. The age estimation utilizing the equations from Nepalese population has given acceptable results.Keywords: Age estimation; demirijian’s method; dental age estimation; forensic age estimation; tooth development chart

Evaluation of Characteristics of the Dental Maturity in Girls with Precocious Puberty

Precocious puberty (PP) is defined as the early development of secondary sexual characteristics (before the ages of 8 years in girls and 9 years in boys). The aim of this study is to identify characteristics of the dental maturity in girls with PP that discriminate them from normal healthy girls.This study included 99 girls aged 6 - 8 years with PP and 99 girls without past medical history of same chronological age (control group). The study was performed on 198 panoramic radiographs (99 PP girls, 99 control group girls). Demirjian method was used to evaluate the panoramic radiographs and determine dental maturity. Difference in dental maturity score and tooth formation stages between the two groups were analyzed.The PP group showed significant higher maturity score than control group. Among mandibular teeth, mandibular 2nd premolar and 2nd molar were significantly more mature in the PP group than control group. Logistic regression analysis showed that mandibular 2nd molar was only significant predictor for PP girls.