Academic literature on the topic 'Records Management Study and teaching (Higher) Standards'

Background: Water is a scarce and highly valuable natural resource. Hospitals require relatively large quantity of water and quality of water is equally important. Hospitals must focus on water efficiency and conservation measures in order to ensure the sustainable use of water. This study was undertaken to understand the current water management practices in the selected teaching hospital and to develop strategies for water conservation.Methods: Descriptive study with observational method was used, to collect the data an observational checklist based on the guidelines of bureau of Indian standards (BIS) and world health organization (WHO) was developed. To observe and collect the data, uninformed visits was done to the Department of Maintenance on random days as per the convenience and the information was collected from standard operating procedures (SOPs) and records maintained in the department of maintenance and hospital infection control unit.Results: The study found that a well-planned water supply system is present in the selected hospital to meet the required quantity of water. The study reveals that the total consumption of water per day in the hospital is higher than the BIS standards. Preventive and corrective maintenance of all the tanks, pipelines, plumbing, and equipment is done regularly. A well-organized system of quality control of water is present in the hospital and the grey water, is drained to sewage water treatment plant from where the water is recycled and reused.Conclusions: Conservation of water enables hospitals to cut cost and to be proactive stewards of their community’s natural resources.

The study examined preservice teachers’ self-efficacy in teaching cost accounting at the pretertiary level. It employed the descriptive cross-sectional survey design involving final year preservice accounting teachers at the University of Cape Coast. An adapted questionnaire referred to as Teacher Self-Efficacy and Mastery Experience Scale (TSEMES) was used to gather relevant data complemented by the academic records of the respondents to address the problem. The return rate of the instrument was 93%. Descriptive (frequencies, percentages, means, and standard deviation) and inferential statistics (simple linear regression) were used to analyse the data. The study found out that preservice accounting teachers were highly efficacious in classroom management compared to student engagement and instructional practices. Also, mastery experience had a positive influence on preservice accounting teachers’ self-efficacy in teaching cost accounting. Therefore, it was recommended that accounting teacher educators pay more attention to competencies related to instructional strategies and student engagement by engaging more with the preservice accounting teachers in these areas. In the deployment of teachers, the Ghana Education Service should prioritise preservice accounting teachers with higher academic achievement.

Abstract Background Individuals with intravenous drug use (IDU) have higher risk for Staphylococcus aureus bacteremia (SAB) and increased management complexity. The goal of this study was to compare differences in SAB characteristics, adherence to standard of care metrics, and clinical outcomes in those with and without IDU. Methods A retrospective chart review was conducted on cases of SAB between January 1, 2016 and December 31, 2017 at a 500-bed teaching hospital. Inclusion criteria was age > 18 years and ≥ one blood culture positive for S. aureus. Patients were excluded if they transferred hospitals, had care withdrawn or died within 48 hours of diagnosis or had a ventricular assist device infection. Records were reviewed for substance use, SAB characteristics, standards of care, and outcomes. Data were analyzed using SPSS software. The study was approved by the Institutional Review Board. Results In 248 patients with SAB, 28.2% had documented IDU. Median age was 37 (IDU) and 57 (non-IDU). In the IDU group, 75.7% had the formal diagnosis of opioid use disorder and 78.9% of stimulant use disorder. IDU was associated with hepatitis C and houselessness while non-IDU was associated with diabetes, hemodialysis, and cancer. Those with IDU had higher rates of MRSA, endocarditis, and spinal infections, but did not have higher rates of polymicrobial infections or venous thrombosis. There was no difference in appropriate repeat blood cultures, antibiotic management, and ID consultation. Length of stay and against medical advice (AMA) discharges were higher in those with IDU. There was no difference in 90-day recurrence or readmission, but 90-day mortality was higher in the non-IDU group. Conclusion There was no difference in adherence to SAB quality of care metrics between groups with and without IDU. Despite the IDU group being younger with fewer comorbidities, 90-day readmissions were not different between groups. This bears further analysis but may represent the influence of therapy completion, AMA discharges, and unmeasured social determinants of health. Disclosures All Authors: No reported disclosures

ABSTRACT Introduction As antimicrobial resistance continues to increase and new antimicrobial development stagnates, antimicrobial stewardship programs are being implemented worldwide. The goal of antimicrobial stewardship is to optimize antimicrobial therapy with maximal impact on subsequent development of resistance. Thirty to fifty percent of hospitalized patients receive antimicrobial therapy. Previous data suggest that inappropriate use results in higher mortality rates, longer lengths of stay, and increased medical costs. Antimicrobial stewardship programs (ASPs) reduce the improper use of antimicrobials and improve patient safety. Despite increased awareness about the benefits of these programs, few medical and surgical ASPs exist and fewer comprehensive studies evaluate their effects. Aim To study the antimicrobial stewardship program in a large tertiary care teaching center. Objectives • To study the antibiotic prescribing practices in a tertiary care government hospital • To compare the antibiotic prescribing practices with the standard guidelines available with the hospital • To make recommendation if any for rational use of antibiotics. Materials and methods • Review of literature • Prospective study of 15 days in selected general medicine and general surgery ward in which 5 to 6 reading will be taken in to know the antibiotic prescribed to patients. • Retrospective study of 15 days for study of patient records to know the antibiotic prescribed to patients. • Interaction with faculty and senior residents of general medicine and surgery to know about the pattern of infection and antibiotic prescription. • Interaction with microbiology department and their faculty to know the microbial resistance pattern and possible suggestion which need to be incorporated in antibiotic Stewardship program. Results The present study on antibiotic prescribing practices was undertaken in a super specialty hospital at New Delhi. A sample size of 100 case records was considered. There is no such stewardship program in tertiary care hospital, although it was demanded in various forum and meetings. There are no recommendations available either for patients of renal failure or other such compromised metabolic or immune states in the form of written antibiotic stewardship program of the hospital. The appropriateness of antibiotics prescribed in the case records was examined in light of the antibiotic stewardship program of the hospital. It was found that the overall adherence to antibiotic stewardship program was nil as no existing antibiotic stewardship program is exiting in this hospital. Gautum Dey in a study conducted at this hospital in New Delhi found that in 40.7% preoperative cases and 60.3% postoperative cases two or more than two antibiotics were given. The author has also commented that there was no evidence of adhering to antibiotic stewardship program or utilising culture and sensitivity reports to guide the therapy. The data obtained from the present study on further analysis has shown that in seven cases, the antibiotics prescribed were inadequate in terms of dose and duration. Thus resulting in an apparently lower cost of treatment than what was recommended by the antibiotic stewardship program of the hospital. Although such inappropriate prescription results in increased chances of antibiotic resistance, the immediate or short-term effects are not very conclusive. It is observed that there were 26 (26%) cases in medical and 12 (12%) cases in surgery disciplines in which the initial and final diagnosis was different. Uncertainty about the final diagnosis promotes empirical prescribing practices. Conclusion Antimicrobial stewards are a prominent part of local and national efforts to contain and reverse antimicrobial resistance. A range of intervention options is available with varying levels of resources and can yield substantial improvements in morbidity, mortality, quality of care, and cost. The cost of delivering such programs is dwarfed by the benefits and provides an opportunity for hospital epidemiologists to garner support. This suggests that antimicrobial management programs belong to the rarefied group of truly cost saving quality improvement initiatives. Considering the enormous implications of antibiotic resistance, it is necessary that we act in haste, lest our wonder drugs and magic bullets become ineffectual. Future systems promise greater integration and analysis of data, facilitated delivery of information to the clinician, and rapid and expert decision support that will optimize patient outcomes while minimizing antimicrobial resistance. They may also offer our best hope for avoiding an ‘Antibiotic armageddon’. In addition, the ASP plays an integral role in providing guidance to clinicians and ensures that the appropriate antimicrobial agents are used. How to cite this article Singh MM, Gupta SK, Gupta YK, Sharma DK, Kapil A. To Study the Antimicrobial Stewardship Program in a Large Tertiary Care Teaching Center. Int J Res Foundation Hosp Healthc Adm 2015;3(1):13-24.

Anopheles gambiae sensu lato is the most important malaria vector in Nigeria. Referral hospitals have a mandate to provide patients with the best health care. The persistent complaints of the nuisance caused to patients, professionals, and visitors by mosquitoes at the University of Port Harcourt Teaching Hospital (UPTH), a referral Hospital, prompted the design of this study to assess the species composition, density, and man-biting rates of endophilic mosquitoes at the UPTH. A longitudinal entomological survey covered dry and wet seasons, February–July 2017, with sampling done thrice weekly, using the aspiration method. Caught mosquitoes were identified by standard keys using a dissecting microscope and classified according to their gonotrophic status. A total of 1,307 mosquitoes in two genera (Culex, Anopheles) and three species (Culex quinguefasciatus, Anopheles gambiae s.l. and Anopheles mouchetti) were caught, comprising 150 (11.5%) males and 1,157 females. The most abundant species was Culex quinguefasciatus (98.01%), An. gambiae s.l. (1.64%), and the least abundant, An. mouchetti (0.35%). Gonotrophic examinations of caught females revealed 52.8% blood-fed and 40.1% unfed. Culex quinquefasciatus had higher man-biting rates (1.26 bites/patient/night) than Anopheles (0.2 bites/patient/night). The Accident and Emergency ward, 595 (45.5%), and the Obstetrics and Gynecology ward, 328 (25.1%), had the highest records of caught mosquitoes among the four wards visited for collections. No significant difference (Fcal = 1.0722, Ftab = 13, p > 0.05, df = 2) existed between wet and dry seasons' collections. Because of the high numbers of blood-fed Anopheles, an urgent need for intervention is required to reduce the case of vector/human contacts; notably, larval source management will be a principal approach toward control.

Introduction This is the tenth issue of the Journal of Construction Business and Management, a combination of the regular issue and a special issue of selected papers from Construction Business and Project Management CBPM 2021 conference proceedings. This issue contains five blind double peer-reviewed articles by seventeen scholars in Nigeria, South Africa, and Malaysia covering strategic management, environmental pollution, compliance with building standards, dispute resolution, and performance management. Despite the difference in the topics, one of the key issues highlighted by the papers is the emphasis on improving education and awareness in the industry to address the issues identified in the papers. Following this introduction is the discussion of the papers, after which the conclusion follows. Discussion of the papers Compliance with construction regulations, standards and codes is fundamental to improving the key performance indicators, by implication, project performance (Umeokafor et al. 2022). Further, this means that it has implications for project risks. While developed countries still record compliance issues which have resulted in tragic events such as the Grenfell fire incident, the developing ones are not left behind, demonstrated to be worse in many indicators. Opawole, Alao, Yusuf, Adu and Ofoetan (2022) examine one of the major issues in building construction in Nigeria, construction materials-related building collapse. Using survey questionnaires, the authors assess the determinants of compliance with concreting materials standards in building projects in Nigeria, using one of the country's major cities, Lagos, as a case study. Being site-based and non-site based, the factors are in six categories, regulation, procurement, capacity, technical, performance and skills components. Production quality control, non-compliance with specified concrete mix, low concrete grade and supervision by incompetent persons are among the site-based factors. However, non-site-based ones include procurement policies and regulatory frameworks in efficiency and professionalism. It was also found that non-compliance with the national standards results in rework, project delays, additional costs, and environmental issues. To improve the quality of buildings through compliance with concreting materials and reduce or eliminate building collapse, the regulatory policies and enforcement mechanism, competencies and training, and ethical standards of stakeholders require more attention. While the generalisation of the findings is limited to Lagos state, given that it is one of the states with a high volume of construction, the study is, at least, indicative of what happens in major cities in Nigeria, such as Abuja and Port-Harcourt. The second paper, by Rambaruth, Adam and Krishna (2022), on strategic management in construction small and medium enterprises (SMEs), addresses another pertinent issue. SMEs outnumber the large enterprises, the heart of the economies of countries. Yet, they face challenges, which in many cases are different from their large counterparts, for example, limited access to funds and competent persons. Many of these SMEs in construction lack strategic planning, one of the factors for early failure (Rambaruth et al., 2022). Many policies, strategies and studies are informed by large enterprises' views and contexts, overlooking the SMEs. Consequently, the authors examine the determinants of a company's decision to adopt a strategic plan, the role of strategic planning in improving a company's performance, and the challenges associated with a strategic plan in place. Using the eThekwini region of South Africa as a case study, the study found that key factors for strategic management in the construction SMEs examined include increased productivity, the quest to gain competitive advantage and improved decision-making. It was good to find that most of them adopted strategic management practices to improve business performance. The authors conclude that one of the ways of improving strategic management in construction SMEs is through improved education and awareness education and broadened skills curriculum by the government. Government and tertiary institutions can also integrate strategic management into SME training programmes. The need for education and awareness, consistent with the recommendations of Opawole et al. (2022), highlights the need for more attention to education and training in the construction and property industry. Graduate architects are the future of tomorrow in the profession; they are yet to pass the professional examination but hold a master's degree in Architecture. The need to exploit education to improve the construction industry's performance is furthered in the third paper by Tiew, Hashim and Zolkafli (2022). Tiew et al. (2022). investigate the major performance barriers that graduate architects encounter in project implementation. These factors are skills-based, poor project documentation management, lack of soft skills, inadequate quality assessment management, and a shortfall in design management. While it highlights the areas the universities can focus on, adequately integrating them into the curricula is consistent with the recommendations of Opawole et al. (2022) and Rambaruth et al. (2022) in this issue. While education empowers the learners with knowledge, the process may have implications for their health and the environment. Addressing educational issues that have consequences for the environment and students' health is the focus of Nkeleme, Mbamali and Shakantu (2022). The authors measured the number of combustion pollutants generated while learning and teaching in laboratories at one of Nigeria's leading universities (Ahmadu Bello University Zaria) and their effect on indoor air quality. Nkeleme et al. found that the presence of CO during the combustion is above ASHRAE 62 and NAAQS limit of 9ppm reaching up to 45ppm at some points and oxygen at the critical level, 20.9 per cent or below 20.4 per cent. The authors also found that the laboratories are congested, and inadequate ventilation systems exacerbate the discomforting effects of combustion-generated pollutants. Adequate ventilation should be provided, which is one of the paper's recommendations. The students learning environment, including the physical ones, is one of the barriers to learning; it should facilitate and support education (Cleveland and Fisher 2014). Undoubtedly, COVID-19 has socio-economic and health implications globally. However, it has increased attention on technology, mental health and some aspects of risk management in construction. Amoo, Lukman and Musa (2022) is the last paper, focussing on dispute resolution methods in construction during COVID-19, where South Africa is used as a case study. The aim is to determine their appropriateness and effectiveness. The findings demonstrate the negative implication of an interest-based approach rather than the right-based approach to resolving disputes in construction. Further, the study shows that negotiation, mediation, and conciliation were adopted to resolve unforeseen delays, claims, and added costs during the pandemic. The pandemic draws attention to pricing methods as a significant source of dispute in the supply and demand chain network during the period. It highlights the imperativeness of clear language in contracts, risk management training, communication improvement, and dynamic project schedule documentation as some conflict and dispute resolution tools post-COVID. Conclusion This issue which contains five papers from seventeen scholars in Nigeria, South Africa, and Malaysia, covers strategic management, environmental pollution, compliance with building standards, dispute resolution, and performance management. While the findings vary, one consistent key finding or implication of this is the need for education and training to improve the construction industry's performance. This is in terms of performance improvement skills of graduate architects, risk management training for those with contract and risk management responsibilities, integrating strategic management education in curricula, and building materials standard compliance training. We thank the authors for their contributions and the reviewers for their efforts to improve the quality of the papers published by the journal. The journal editorial board and panel of reviewers also play a critical part in the higher quality assurance of the manuscript and in keeping the journal on the path to attaining the expected standard and quality. Criticisms, feedback, and suggestions from readers on improving the journal's quality are also welcome. References Amoo, O. T., Lukman, Y. and Musa, N., 2022. Dispute Resolution Mathods adopted by Contractors during Covid-19 in Eastern Cape, South Africa: A Case Study. Journal of Construction Business and Management, 5(2): 54-67. Cleveland, B. and Fisher, K., 2014. The evaluation of physical learning environments: a critical review of the literature. Learning Environ Res, 17:1–28 Nkeleme, E. I., Mbamali, I. and Shakantu, W. M. I., 2022. A Measure of Combustion-Generated Pollutants in University Laboratories and its Effects on Indoor Air Quality. Journal of Construction Business and Management, 5(2): 44-53. Opawole, A., Alao, O. O., Yusuf, A. O., Adu, E. T. and Ofoetan, M. A., 2022. Evaluation of Compliance of Concreting Materials to Standards in Building Projects in Lagos State, Nigeria. Journal of Construction Business and Management, 5(2): 1-19. Rambaruth, A., Adam, J. K. and Krishna, S. B. N., 2022. Elements and Issues to Strategic Management in the Construction Industry Among Small and Medium Enterprises: A Case Study in South Africa’s eThekwini Region. Journal of Construction Business and Management, 5(2): 20-28. Tiew, S. Y., Hashim, H. A. and Zolkafli, U. K. B., 2022. Performance Barriers affecting Graduate Architects in Architectural Firms: A Systematic Literature Review. Journal of Construction Business and Management, 5(2): 29-43. Umeokafor, N. I., Evangelinos, K. and Windapo, A. O., 2020. Strategies for Improving Complex Construction Health and Safety Regulatory Environments. International Journal of Construction Management.Doi.org/10.1080/15623599.2019.1707853.

Purpose The purpose of this study is to determine the extent to which total quality management (TQM) initiatives can improve the quality of services delivery at the medical records unit of the Korle-Bu Teaching Hospital (KBTH) to help meet the expectations and aspirations of patients and customers of the hospital. Design/methodology/approach This research adopted the survey strategy as its research design. The total study population consisted of 114 medical records staff of the KBTH. Questionnaires and personal observations were employed as the data collection instruments. The study recorded a response rate of 98 per cent. Data gathered from respondents were analysed in qualitative terms. Findings The overall finding of this study was that, although the medical records department of the KBTH had a fair degree of understanding on the benefits of TQM to records management service delivery, the exiting values for TQM did not meet the framework of good TQM practice, principles and standards. Research limitations/implications Even though the subjects for the study were from the biggest hospital in Ghana, the findings of this study may not be generalised to the whole country. Practical implications The study has demonstrated the need for the medical records department of the KBTH to have and develop good TQM standards to improve the quality of services to patients and varied customers of the hospital. Originality/value The literature reviewed indicated that this study is a maiden attempt to examine how TQM initiatives including sensitivity, customer satisfaction, commitment of top management, team work, effective leadership and participatory management, people development and effective and open communication can improve the quality of medical records service delivery at the KBTH in Ghana.

This study shares the best practice in teaching fiscal management in athletic programs with the compliance of the National Standards for Sport Coaches (NSSC; 2006). The objective of this presentation is to provide ideas, resources, and course activities in fiscal management of athletic programs. Topics in financial operation, purchasing and inventory distribution, fund-raising, and managing financial records, as well as different modules of fiscal management in athletic programs will be covered.

The ISO standards have been traditionally used in the business context, specifically in manufacturing and services, to provide a framework for total quality management. Such application has now been found in the context of higher education; thus, this paper aims to look into the implementation of ISO standards in the management of a private university in Vietnam. Using a desk research approach, the study seeks to detail the application of ISO in the areas of educational support system and business operation system in the strategic management of this institution, showing the quantitative operational results that have been achieved in all aspects of HR management, teaching quality, new enrollment number and financial growth.

The study examined teaching faculty’s educational technology-related performances (ETRP) as a measure for predicting eLearning management in Ghana. A total of valid data ( n = 164) were collected and analyzed on applied ISTE-NETS-T Performance Standards using descriptive and ANOVA statistics. Results showed an overall moderate performance with the highest recorded for technology operation and concepts and the lowest for observance of social, ethical, legal, and human factors. Effects of age and academic discipline on ETRP were significant but gender and professional status had no significant effects.

The purpose of this study was to: (1) identify the sources of job-related stress which create excessive pressures for the directors and faculty of medical record administration and medical record technology programs; (2) identify the strategies that the directors and faculty of medical record administration and medical record technology programs find most helpful in coping with stress; (3) determine the relationship among demographic variables and job-related stressors as perceived by the directors and faculty of medical record administration and medical record technology programs; and (4) determine the difference among the means of five stress factors as perceived by the directors of medical record administration, faculty of medical record administration, directors of medical record technology and faculty of medical record technology programs. Questionnaires were mailed to 403 respondents. The response rate was 81.3%. Within the limitations of this study, the results revealed that "Having insufficient time to keep abreast of current developments in my field"was the highest stressor. The top stress coping strategy was "Social interaction." The relationship between demographic variables and five stress factors of reward and recognition, time constraint, departmental influence, professional identity and student interaction revealed a positive correlation between degree and professional identity factor, and a negative correlation between degree and student interaction factor. The results also indicated a positive correlation between type of program and the factors-time constraint, professional identity and student interaction; a positive correlation between academic rank and the factors--time constraint and student interaction; a positive correlation between teaching responsibilities and time constraint factor; and a positive correlation between marital status and professional identity factor. The directors and faculty of medical record administration perception of time constraint and professional identity factors differed from that of the directors and faculty of medical record technology programs.

This study is a systematic, objective investigation of educator empowerment, where the researcher explores the perspective of ABET educators. This study is presented against the backdrop of striking a balance between the conventional curriculum and Curriculum 2005 (OBE) because they exhibit a variety of challenges, anomalies and imbalances which led to the Revised National Curriculum Statements which will be implemented in 2006. It is informed by the fact that educators, if empowered, form an integral and central feature of changes in educational centres, especially in teaching adult learners to be able to assist their school-leaving children so as to improve provincial matric results, for example. The researcher focused on educators of ABET in Limpopo Province as the unit of analysis in this study. Interactive, cooperative, peer teaching, dialogic meditation, group and team teaching, constructivism and human resource development, reflective and multi-level approaches, are discussed with a particular focus on educator empowerment, including in-service training programmes. The researcher regards ”church settings” (her term) as inappropriate for effective teaching as they reduce educators to preachers and learners to congregants. This occurred as a result of the failure to recognise the importance of educator-learner, learner-learner and educator-educator interaction in the past curriculum. The study argues that the approaches mentioned are appropriate for this study. Educator empowerment is a lived-in and continuous process, monitoring and evaluating of in-service training to ensure quality. It was therefore necessary to develop a research design that would make it possible to enable educators to implement the new curriculum. Qualitative research is based on an in-depth inquiry which captures an educator's personal perspectives and experiences. Focus groups and in-depth interviews, which exemplify qualitative methods, were seen to be the best research tools in gathering the data for this study. The respondents, were UNISA ABET certificate students, and also professional educators at formal schools. They showed zeal in improving the educational situation. Their responses led to the model which has been developed in the thesis, culminating in uplifting the teaching profession and handling its multi-level led dynamic in an interactive and cooperative manner and reflecting in their experiences so that purposes of the National Qualifications Framework can be attained.
Educational Studies
D.Ed. (Didactics)

Massification is among the greatest challenges in higher education. In this chapter, the use of ICT was identified as a quality tool for efficient and effective teaching and learning of science and how it mitigates massification; where the ratio of educational resources and class numbers become incompatible, giving rise to stressful learning conditions resulting in loss of quality and lowering standard (Mohamedbhai, 2008). Using the qualitative and quantitative research paradigms, the survey, and single-case and parallel cross-sectional designs, the study involved 294 respondents out of 395 sampled population. The sampling techniques used were purposive, random and stratified. Data was collected through closed-ended questionnaires, oral interviews, direct observation, focus group discussion, and the use of archival records. Analysis was by use of descriptive statistics. Major findings indicated that use of ICT-enhanced quality of teaching and learning in the science-based faculties at Gulu University mitigates the burden of massification.

Multidisciplinary cooperation of participating healthcare professionals, use of common standards in diagnostics, and clinical pathways in the treatment of vascular patients should provide for a higher-quality clinical practice. Using telemedicine, a more efficient way of obtaining specialist treatment is achievable. However, its introduction may raise safety and security issues, which originate from its enabling information technology. In this chapter, a model of patient-telemonitoring after revascularization procedures in the lower extremities is presented. A protocol for proper authentication and authorization to access medical equipment and patient medical records has been introduced. The associated clinical study has shown that most post-operative follow-up examinations can successfully be performed by trained nurses. Hence, improvements to healthcare logistics, mainly due to shortening waiting times for specialist treatment and the reduction of follow-up examinations on the secondary healthcare level, can be achieved using telemedicine.

With the continuous development of Internet plus information technology and the continuous changes of the economic market environment, the traditional tax law talent training mode can no longer meet the new standards and requirements. In this context, this paper studies the reform and innovation of tax law talent training mode in universities, first it reviews the literature, then points out the relevant significance, and applies the principal component analysis method for analysis, and finally puts forward the relevant measures. Internet plus is the new form of Internet development under the innovation, and it is the new form of economic and social development promoted by the evolution of the Internet form promoted by innovation of knowledge society. The combination of Internet plus tax law talent cultivation and innovation mechanism is conducive to promoting the national tax system reform and upgrading of industrial structure, and promoting the continuous evolution of economic form, thereby promoting the vitality of social economic entities, and providing a broad platform for reform, innovation and development[1]. Under the background of Internet plus, Chinese higher education needs to train more talents for tax law practice suitable for economic development, and promote reform and innovation of tax law teaching mode and personnel training mechanism.

Air pollution has become one of the greatest challenges that the world is facing today. According to World Health Organization (WHO)there are 4.2 million annual deaths due to outdoor air pollution. Furthermore, about 90% of global population breathe polluted air. The most harmful cause of outdoor air pollution is recognized to be unorganized traffic management. In the instance of Sri Lanka, Kandy city has been recognized as crucial where necessary actions are required to be taken. This study presents harmful emission values produced by a daily count of vehicles entering the city alongside respiratory diseases and illnesses recorded. Detailed analysis provides pollutant emissions due to unorganized traffic management within Kandy city concentrating over locations from Getambe Junction to Kandy Clock tower and from the city centre towards Mahaiyawa Tunnel and Ampitiya Junction (locations are pinned on figure 1). Calculation of pollutant factors are intended to be done using three main methods namely, Tier 1, Tier 2 and V/C ratio method aided by vehicle fuel type, fuel efficiency, travelled distance and carriageway congestion values. Emission values for pollutants Carbon monoxide (CO), Nitrogen oxides (N2O, NOX) and Sulphur dioxide (SO2) were identified in this study along with PM2.5 and PM10 values. It was to be seen that, over 100,000 vehicle cross Kandy city limits on both weekdays and surprisingly higher values in weekend with each carriageway within the city resulting over a 65% of congestion value. With 31% of daily trips being travel to work, the public transport system fails to deliver its purpose efficiently and effectively. With unorganized traffic management, stagnant and slowmoving vehicles tend to pollute 41% more SO2 and 14% more NOX gasses above global standards affecting the first five kilometers from the city center, which claimed to facilitate the zone of highest quality of life. Current records show PM2.5 values in Kandy to read above 50μg/m3 and PM10 values to be as high as 100μg/m3. KEYWORDS: Kandy, Air pollution, Traffic management, Emission, Respiratory, Sri Lanka

Dynamic development of the space sector of European, and especially of Polish and German economies results in a necessity for suitable Higher Education Institution graduates. The increasing digitization, distribution and networking of technical systems leads to the necessity of a degree programme teaching “the systems view” and “interdisciplinarity” methods and skills. Furthermore, it is necessary to consider the entire life cycle of the systems starting with the analysis of the requirements, through design, integration, verification, to operation and maintenance, with supplementation of management, social and intercultural skills. Since interdisciplinarity and internationality are essential for engineering and management of space systems, the international project was launched early last year by two universities – Hochschule Bremen (Bremen City University of Applied Sciences, HSB, Germany) and Politechnika Gdańska (Gdańsk University of Technology, Gdańsk Tech, Poland) establishing an international interdisciplinary joint Master's double-degree program - Engineering and Management of Space Systems (EMSS). It consists of three different fixed three- or four- semester study paths of several mobility schemes, though individual educational pathways adjusted to students' preference are also allowed. Each path includesa joint academic year – first semester is conducted in Gdańsk, the second in Bremen. The remaining semesters can be studied at either of the universities. All of the EMSS curricula meet the highest education standards of both countries. Several mandatory modules and many elective courses are included in the EMSS curricula. Upon graduation, students of the program are awarded two Master’s degrees - in Space and Satellite Technologies, issued by Gdańsk Tech, and, depending on the chosen study path, in Aerospace Technologies, Computer Science, or Electronics Engineering issued by HSB. Work on the establishment of a new, international, joint field of study - Engineering and Management of Space Systems, run by both universities is currently in progress. The curriculum of the new study programme will be based on the recommendations of the International Council On Systems Engineering (INCOSE) and its German Chapter, Gesellschaft für Systems Engineering (GfSE), and will offer the possibility of certification as a Systems Engineering Professional, Associate Level. This paper includes the lecturers’ and students’ perspective on the program and its future development.

Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.