Search results for: clinical nursing practice guideline

Authors: Brian Carey Sims

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The current study examines psychological factors relevant to child custody litigation among African American fathers. Thirty-seven fathers engaged in various stages of custody litigation involving their children were surveyed about their perceptions of racial stereotypes, parental motivations, and racialized dynamics of the court/ legal process. Data were analyzed using a Critical Race Theory model designed to statistically isolate fathers’ perceptions of the existence and maintenance of structural racism through the legal process. Results indicate significant correlations between fathers’ psychological measures and structural outcomes of their cases. Findings are discussed in terms of ethical implications for family court judicial systems and attorney practice.

Keywords: ethics, family, legal psychology, policy, race

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Authors: Toshiki Ito

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Mutual squiggle story making (MSSM ) is the development of Winnicott’s squiggle method in Japan. In the MSSM Method, a therapist has the client freely divide a piece of drawing paper into six spaces, and both the therapist and client do squiggle in each space. All six pictures finished, the therapist then asks the client to create a story using all the pictures. Making a story has the effect of reintegrating what is projected by consciousness. In this paper, the author presented a case with a junior high school girl using MSSM. And it is considered that the advantage of this technique is that (1) it enables non-verbal communication with children and adults who cannot express their feelings verbally. (2) Through this communication, the psychological content of the client and the characteristics of the client's mind can be understood, and (3) It can be said that mutual rapport is deepened by the supportive reaction of the therapist.

Keywords: MSSM, squiggle, Winnicott, drawing method

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Authors: Bilal Orfali

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It is common practice in modern times to read mystical poetry and apply it to our mundane lives and loves. Sufis in the early period did the opposite. Their mystical hymns often spun out of the courtly poetic ghazal, panegyric, and wine songs. This paper highlights the relation of the Arabic courtly poetic canon to early Sufism. Sufi akhbār and poetry evoke past poets and their poetic heritage. They tend to quote or refer to eminent poets whose poetry must have been widely circulated and memorized. However, Sufism places this readily recognizable poetry in a new context that deliberately changes the past. It is a process of a metaphorization in which the reality of the pre-Islamic, Umayyad, and Abbasid models now acts as a device or metaphor for the Sufi poetics.

Keywords: Sufism, Arabic poetry, literature, Islamic literature, Abbasid

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Authors: S. M. A. Ismail, M. I. Ibrahim, H. Masdar, F. M. Effendi, M. F. Suhaimi, A. Suun

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Introduction: It is generally known that the rehabilitation process is as important as the reconstruction surgery. Several literature has focused on how early the rehabilitation modalities can be initiated after the surgery to ensure a safe return of patients to sports or at least regaining the pre-injury level of function following an ACL reconstruction. Objectives: The main objective is to study and evaluate the outcome of early balance exercises and agility training in sports rehabilitation for patients post ACL reconstruction. To compare between early balance exercises and agility training as intervention and control. (material or non-material). All of them were recruited for material exercise (balance exercises and agility training with strengthening) and strengthening only rehabilitation protocol (non-material). Followed the prospective intervention trial. Materials and Methods: Post-operative ACL reconstruction patients performed in Selayang and Sg Buloh Hospitals from 2012 to 2014 were selected for this study. They were taken from Malaysian Knee Ligament Registry (MKLR) and all patients had single bundle reconstruction with autograft hamstring tendon (semitendinosus and gracilis). ACL injury from any type of sports were included. Subjects performed various type of physical activity for rehabilitation in every 18 week for a different type of rehab activity. All subject attended all 18 sessions of rehabilitation exercises and evaluation was done during the first, 9th and 18th session. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Rehabilitation protocol initiated from 24 week after the surgery. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Results and Discussion: 100 patients were selected of which 94 patients are male and 6 female. Age range is 18 to 54 year with the average of 28 years old for included 100 patients. All patients are evaluated after 24 week after the surgery. 50 of them were recruited for material exercise (balance exercises and agility training with strengthening) and 50 for strengthening only rehabilitation protocol (non-material). Demographically showed 85% suffering sports injury mainly from futsal and football. 39 % of them have abnormal BMI (26 – 38) and involving of the left knee. 100% of patient had the basic radiographic x-ray of knee and 98% had MRI. All patients had negative anterior drawer’s, Lachman test and Pivot shift test during the post ACL reconstruction after the complete rehabilitation. There was 95 subject sustained grade I injury, 5 of grade II and 0 of grade III with 90% of them had soft end-point. Overall they scored badly on presentation with 53% of Lysholm score (poor) and Tegner activity score level 3/10. After completing 9 weeks of exercises, of material group 90% had grade I laxity, 75% with firm end-point, Lysholm score 71% (fair) and Tegner activity level 5/10 comparing non-material group who had 62% of grade I laxity , 54% of firm end-point, Lyhslom score 62 % (poor) and Tegner activity level 4/10. After completed 18 weeks of exercises, of material group maintained 90% grade I laxity with 100 % with firm end-point, Lysholm score increase 91% (excellent) and Tegner activity level 7/10 comparing non-material group who had 69% of grade I laxity but maintained 54% of firm end-point, Lysholm score 76% (fair) and Tegner activity level 5/10. These showed the improvement were achieved fast on material group who have achieved satisfactory level after 9th cycle of exercises 75% (15/20) comparing non-material group who only achieved 54% (7/13) after completed 18th session. Most of them were grade I. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. Conclusions: The basic approach in ACL rehabilitation is to ensure return to sports at post-operative 6 month. Grade I and II laxity has favourable and early satisfactory outcome base on clinical assessment and Lysholm and Tegner scoring point. Reduction of laxity grading indicates satisfactory outcome. Firm end-point showed the adequacy of rehabilitation before starting previous sports game. Material exercise (balance exercises and agility training with strengthening) were beneficial and reliable in order to achieve favourable and early satisfactory outcome comparing strengthening only (non-material).We have identified that rehabilitation protocol varies between different patients. Therefore future post ACL reconstruction rehabilitation guidelines should look into focusing on rehabilitation techniques instead of time.

Keywords: post anterior cruciate ligament (ACL) reconstruction, single bundle, hamstring tendon, sports rehabilitation, balance exercises, agility balance

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Authors: Sahar Heidary

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Radiography and radiotherapy have emerged as crucial pillars of modern medical practice, revolutionizing diagnostics and treatment for a myriad of health conditions. This abstract highlights the pivotal role of radiography and radiotherapy in favor of healthcare and society. Radiography, a non-invasive imaging technique, has significantly advanced medical diagnostics by enabling the visualization of internal structures and abnormalities within the human body. With the advent of digital radiography, clinicians can obtain high-resolution images promptly, leading to faster diagnoses and informed treatment decisions. Radiography plays a pivotal role in detecting fractures, tumors, infections, and various other conditions, allowing for timely interventions and improved patient outcomes. Moreover, its widespread accessibility and cost-effectiveness make it an indispensable tool in healthcare settings worldwide. On the other hand, radiotherapy, a branch of medical science that utilizes high-energy radiation, has become an integral component of cancer treatment and management. By precisely targeting and damaging cancerous cells, radiotherapy offers a potent strategy to control tumor growth and, in many cases, leads to cancer eradication. Additionally, radiotherapy is often used in combination with surgery and chemotherapy, providing a multifaceted approach to combat cancer comprehensively. The continuous advancements in radiotherapy techniques, such as intensity-modulated radiotherapy and stereotactic radiosurgery, have further improved treatment precision while minimizing damage to surrounding healthy tissues. Furthermore, radiography and radiotherapy have demonstrated their worth beyond oncology. Radiography is instrumental in guiding various medical procedures, including catheter placement, joint injections, and dental evaluations, reducing complications and enhancing procedural accuracy. On the other hand, radiotherapy finds applications in non-cancerous conditions like benign tumors, vascular malformations, and certain neurological disorders, offering therapeutic options for patients who may not benefit from traditional surgical interventions. In conclusion, radiography and radiotherapy stand as indispensable tools in modern medicine, driving transformative improvements in patient care and treatment outcomes. Their ability to diagnose, treat, and manage a wide array of medical conditions underscores their favor in medical practice. As technology continues to advance, radiography and radiotherapy will undoubtedly play an ever more significant role in shaping the future of healthcare, ultimately saving lives and enhancing the quality of life for countless individuals worldwide.

Keywords: radiology, radiotherapy, medical imaging, cancer treatment

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Authors: Laura Southgate

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The Association of Southeast Asian Nations (ASEAN), as well as much of the scholarship on the organisation, celebrates its ability to uphold the principle of regional autonomy, understood as upholding the norm of non-intervention by external powers in regional affairs. Yet, in practice, this has been repeatedly violated. This dichotomy between rhetoric and practice suggests an interesting avenue for further study. The East Timor crisis (1975-1999) has been selected as a case-study to test the dynamics of ASEAN state resistance to sovereignty violation in two distinct timeframes: Indonesia’s initial invasion of the territory in 1975, and the ensuing humanitarian crisis in 1999 which resulted in a UN-mandated, Australian-led peacekeeping intervention force. These time-periods demonstrate variation on the dependent variable. It is necessary to observe covariation in order to derive observations in support of a causal theory. To establish covariation, my independent variable is therefore a continuous variable characterised by variation in convergence of interest. Change of this variable should change the value of the dependent variable, thus establishing causal direction. This paper investigates the history of ASEAN’s relationship to the norm of non-intervention. It offers an alternative understanding of ASEAN’s history, written in terms of the relationship between a key ASEAN state, which I call a ‘vanguard state’, and selected external powers. This paper will consider when ASEAN resistance to sovereignty violation has succeeded, and when it has failed. It will contend that variation in outcomes associated with vanguard state resistance to sovereignty violation can be best explained by levels of interest convergence between the ASEAN vanguard state and designated external actors. Evidence will be provided to support the hypothesis that in 1999, ASEAN’s failure to resist violations to the sovereignty of Indonesia was a consequence of low interest convergence between Indonesia and the external powers. Conversely, in 1975, ASEAN’s ability to resist violations to the sovereignty of Indonesia was a consequence of high interest convergence between Indonesia and the external powers. As the vanguard state, Indonesia was able to apply pressure on the ASEAN states and obtain unanimous support for Indonesia’s East Timor policy in 1975 and 1999. However, the key factor explaining the variance in outcomes in both time periods resides in the critical role played by external actors. This view represents a serious challenge to much of the existing scholarship that emphasises ASEAN’s ability to defend regional autonomy. As these cases attempt to show, ASEAN autonomy is much more contingent than portrayed in the existing literature.

Keywords: ASEAN, east timor, intervention, sovereignty

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Authors: Sara Mahmood, Omar Ahmed, Youssef Aladham, Moustafa Abdelnaby

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The varied complications of COVID-19 present an ongoing challenge to healthcare professionals. A rare presentation of complicated sinusitis with pre-septal cellulitis and hard palatal necrosis in a COVID-19 patient, was reported. A 52-year-old male was admitted to the hospital with typical COVID manifestations where he had two successive COVID-19 positive swabs. During his admission, he developed symptoms of right orbital complications of sinusitis along with both clinical and radiological evidence of ipsilateral hard palatal necrosis. Imaging confirmed a diagnosis of right pan-sinusitis complicated with right pre-septal infection and hard palatal bony defect on the same side. Intra-operatively, the sphenopalatine artery was found to be thrombosed. This case focuses on the possible association between these manifestations and the known thromboembolic complications of COVID-19. Ongoing management of such complicated rare cases should be through a multidisciplinary team.

Keywords: COVID-19, sinusitis, sphenopalatine artery, thrombosis

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Authors: Julaine Allan, Katarzyna Olcon, Padmini Pai, Lynne Keevers, Mim Fox, Maria Mackay, Ruth Everingham

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Effective local responses to community needs are grounded in contextual knowledge and build on existing resources. The Stability, Encompassing, Endurance & Direction (SEED) Wellbeing Program was created in 2020 in response to cumulative disasters, bushfires, floods and COVID, experienced by healthcare staff in the Illawarra Shoalhaven Local Health District, NSW Australia. SEED used a participatory action methodology to bring healthcare staff teams together to engage in restorative activities in the workplace. Guided by Practice Theory, this study identified the practices that supported the recovery of healthcare staff.

Keywords: mental health and wellbeing, workplace wellness, healthcare providers, natural disasters, COVID-19, burnout, occupational trauma

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Authors: Enrico Dorigatti

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The growing pile of hazardous e-waste produced especially by those developed and wealthy countries gets relentlessly bigger, composed of the EEDs (Electric and Electronic Device) that are often thrown away although still well functioning, mainly due to (programmed) obsolescence. As a consequence, e-waste has taken, over the last years, the shape of a frightful, uncontrollable, and unstoppable phenomenon, mainly fuelled by market policies aiming to maximize sales—and thus profits—at any cost. Against it, governments and organizations put some efforts in developing ambitious frameworks and policies aiming to regulate, in some cases, the whole lifecycle of EEDs—from the design to the recycling. Incidentally, however, such regulations sometimes make the disposal of the devices economically unprofitable, which often translates into growing illegal e-waste trafficking—an activity usually undertaken by criminal organizations. It seems that nothing, at least in the near future, can stop the phenomenon of e-waste production and accumulation. But while, from a practical standpoint, a solution seems hard to find, much can be done regarding people's education, which translates into informing and promoting good practices such as reusing and repurposing. This research argues that circuit bending—an activity rooted in neo-materialist philosophy and post-digital aesthetic, and based on repurposing EEDs into novel music instruments and sound generators—could have a great potential in this. In particular, it asserts that circuit bending could expose ecological, environmental, and social criticalities related to the current market policies and economic model. Not only thanks to its practical side (e.g., sourcing and repurposing devices) but also to the artistic one (e.g., employing bent instruments for ecological-aware installations, performances). Currently, relevant literature and debate lack interest and information about the ecological aspects and implications of the practical and artistic sides of circuit bending. This research, therefore, although still at an early stage, aims to fill in this gap by investigating, on the one side, the ecologic potential of circuit bending and, on the other side, its capacity of sensitizing people, through artistic practice, about e-waste-related issues. The methodology will articulate in three main steps. Firstly, field research will be undertaken—with the purpose of understanding where and how to source, in an ecologic and sustainable way, (discarded) EEDs for circuit bending. Secondly, artistic installations and performances will be organized—to sensitize the audience about environmental concerns through sound art and music derived from bent instruments. Data, such as audiences' feedback, will be collected at this stage. The last step will consist in realising workshops to spread an ecologically-aware circuit bending practice. Additionally, all the data and findings collected will be made available and disseminated as resources.

Keywords: circuit bending, ecology, sound art, sustainability

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Authors: Ouazoul Abdelouahd, Jemjami Nadia

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The concept of well-being at work is one of today's major challenges in maintaining quality of life and managing psycho-social risks at work. Indeed, work in the sports sector has evolved over time, and this exponential evolution, marked by increasing demands and psychological, physical and/or social challenges, which sometimes exceed the resources of sports players, influences their sense of well-being at work. Well-being and burnout as antagonists provide information on the quality of working life in sports. The main objective of this literature review was to examine the scientific corpus dealing with the subject of psychological well-being at work in the sports sector and, more specifically, with sports coaches while exploring the link between sports burnout and well-being. The results reveal the richness of the conceptual approaches and the difficulties of putting them into practice. Prospects for future research were put forward.

Keywords: psychological well-being, burnout, quality of life, sports coaching

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Authors: Ya-Chuan Tseng, Hsin-Yi Liu, Meei-Fang Lou, Guey-Shiun Huang

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Purpose: Sensory impairments are common in older adults. Hearing and visual impairments affect their physical and mental health and quality of life (QOL) adversely. However, systematic reviews of the relationship between hearing impairment, visual impairment, dual sensory impairment and quality of life are scarce. The purpose of this systematic review was to determine the relationship between hearing impairment, visual impairment, dual sensory impairment and quality of life. Methods: Searches of EMBASE, PubMed, CINAHL, MEDLINE, Cochrane Library and Airiti Library were conducted between January 2006 and December 2017 using the keywords ‘quality of life,’ ‘life satisfaction,’ ‘well-being,’ ‘hearing impairment’ and ‘visual impairment’ Two authors independently assessed methodologic quality using a modified Downs and Black tool. Data were extracted by the first author and then cross-checked by the second author. Results: Twenty-three studies consisting mostly of community-dwelling older adults were included in our review. Sensory impairment was found to be in significant association with quality of life, with an increase in hearing impairment or visual impairment severity resulting in a lower quality of life. Quality of life for dual sensory impairment was worse than for hearing impairment or visual impairment individually. Conclusions: A significant association was confirmed between hearing impairment, visual impairment, dual sensory impairment and quality of life. Our review can be used to enhance health care personnel’s understanding of sensory impairment in older adults and enable healthcare personnel to actively assess older adults’ sensory functions so that they can help alleviate the negative impact of sensory impairments on QOL in older adults.

Keywords: nursing, older adults, quality of life, systematic review, hearing impairment, visual impairment

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Authors: Rawaa El Ayoubi

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Many researchers, academics and practitioners have developed leadership theories during the 20th century. This substantial effort has built more leadership theories, generating considerable organisational research on leadership models in contemporary literature. This paper explores the stages and drivers of leadership theory evolution based on the researcher’s personal conclusions and review of leadership theories. The purpose of this paper is to create a Leadership Process Model (LPM) that can provide guidance in dealing with the key challenges within the organisation. This integrative model of organisational leadership is based on inner meaning, leader values and vision. It further addresses the relationships between leadership theory, practice and development, exploring why challenges exist within the field of leadership theory and how these challenges can be mitigated.

Keywords: leadership challenges, leadership process model, leadership |theories, organisational leadership, paradigm development

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Authors: James D. Beauchemin

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This study tested whether youth mental health care quality, operationalized as the extent to which youth and families experienced system-of-care principles in service interactions with providers, varied by level of youth need after adjusting for sociodemographic and treatment factors. The relationship of quality to clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1,124 caregivers of youths ages 5 to 20 within a statewide system-of-care, adjusted analyses indicated youths with the most intensive needs were significantly less likely to experience high-quality care (51% vs. 63%, p=0.016), with marked deficits on 6 of 9 items. Receipt of lower-quality care predicted less improvement in youth functioning. Despite considerable effort to develop systems-of-care for youths with the most severe mental health needs, these data suggest quality disparities remain for the most impaired youths. Policy and intervention development may be needed to improve the quality of care for this population.

Keywords: system-of-care, adherence, mental health, youth

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Authors: Monica Santi, Evita Puspitasari

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International Financial Reporting Standard (IFRS) has developed the principle based accounting standard. Based on this, IASB then eliminated the conservatism concept within accounting framework. Conservatism concept represents a prudent reaction to uncertainty to try to ensure that uncertainties and risk inherent in business situations are adequately considered. The conservatism concept has two ingredients: conditional conservatism or ex-post (news depending prudence) and unconditional conservatism or ex-ante (news-independent prudence). IFRS in substance disregards the unconditional conservatism because the unconditional conservatism can cause the understatement assets or overstated liabilities, and eventually the financial statement would be irrelevance since the information does not represent the real fact. Therefore, the IASB eliminate the conservatism concept. However, it does not decrease the practice of unconditional conservatism in the financial statement reporting. Therefore, we expected the earnings quality would be affected because of this situation, even though the IFRS implementation was expected to increase the earnings quality. The objective of this study was to provide empirical findings about the unconditional conservatism and the earnings quality before and after the IFRS adoption. The earnings per accrual measure were used as the proxy for the unconditional conservatism. If the earnings per accrual were negative (positive), it meant the company was classified as the conservative (not conservative). The earnings quality was defined as the ability of the earnings in reflecting the future earnings by considering the earnings persistence and stability. We used the earnings response coefficient (ERC) as the proxy for the earnings quality. ERC measured the extant of a security’s abnormal market return in response to the unexpected component of reporting earning of the firm issuing that security. The higher ERC indicated the higher earnings quality. The manufacturing companies listed in the Indonesian Stock Exchange (IDX) were used as the sample companies, and the 2009-2010 period was used to represent the condition before the IFRS adoption, and 2011-2013 was used to represent the condition after the IFRS adoption. Data was analyzed using the Mann-Whitney test and regression analysis. We used the firm size as the control variable with the consideration the firm size would affect the earnings quality of the company. This study had proved that the unconditional conservatism had not changed, either before and after the IFRS adoption period. However, we found the different findings for the earnings quality. The earnings quality had decreased after the IFRS adoption period. This empirical results implied that the earnings quality before the IFRS adoption was higher. This study also had found that the unconditional conservatism positively influenced the earnings quality insignificantly. The findings implied that the implementation of the IFRS had not decreased the unconditional conservatism practice and has not altered the earnings quality of the manufacturing company. Further, we found that the unconditional conservatism did not affect the earnings quality. Eventhough the empirical result shows that the unconditional conservatism gave positive influence to the earnings quality, but the influence was not significant. Thus, we concluded that the implementation of the IFRS did not increase the earnings quality.

Keywords: earnings quality, earnings response coefficient, IFRS Adoption, unconditional conservatism

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Authors: Teodora Mocan, Lucian Mocan, Cornel Iancu, Flaviu A. Tabaran, Bartos Dana, Matea Cristian

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Antimicrobial resistance, which threatens the efficacy of the existing antibiotics represents a worldwide public health issue. At the current time, vancomycin is the only responsive treatment although has significant cytotoxicity, is partially effective and it is poorly retained by infected tissues. From a clinical point of view, attractive alternative approaches for treating such Meticillin-Resistant Staphylococcus Aureus (MRSA) strains would be using agents that cause physical damage to the bacteria. Modular nanopharmaceuticals systems are being designed to address all of these multifunctional capabilities for the ideal bacterial treatment, with the ability to mix and match appropriate functions. Here we present a novel method of selective laser photothermal ablation of MRSA bacteria mediated by gold nanoparticles bound to PBP antibody against PBP protein located on the MRSA surface.

Keywords: MRSA, laser, nanoparticle, antibody

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Authors: O. Esmen, A. Beduk, K. Eryesil, F. Karacelebi

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Entrepreneurship is crucial for the economy of countries in development of economy, creating new jobs and increasing employment; therefore improving welfare and a modern point of view in the society. In the development of a country encouragement of entrepreneurship and entrepreneurial qualities also play a paramount role. The increase in the world population results in more production, which brings excessive use of resources and inevitably shortage of them. In addition to this; development in technology, mismanagement in production and deficiency of waste system cause negative effects on the environmental ecological balance. Nowadays, with the societies getting awareness of environment while buying products and services, they prefer companies which are careful about environment. And as a result of this, ecoentrepreneurship gains importance. In this study; ecoentrepreneurship, which we think will gain more importance in the world and Turkey, is presented with the examples from the world and Turkey.

Keywords: ecoentrepreneurship, entrepreneurship, environmental awareness, development of economy

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Authors: Jamaludin Tarkim, Yoga Teguh Guntara, Maftuhah

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Islamic leadership style is model of leadership style applied by the Prophet Muhammad SAW. Islamic leadership style is applied, namely Syura (deliberation), ‘Adl bil qisth (justice, with equality), and Hurriyyah al-kalam (freedom of expression) and along with the values of Islam in the Islamic leadership style. This research aims to gain an overview of the experience of Head Nurse in the implementation of Islamic leadership style. This research is a qualitative one with descriptive phenomenology design through in-depth interviews. Participants were occupied as Head Nurse at the Hospital room Syarif Hidayatullah, set directly (purposive) with the principle of suitability (appropriateness) and sufficiency (adequacy). Retrieval of data and research conducted during the month of June 2014. Data collected in the form of recording in-depth interviews and analysis with Collazi method. This research identified four themes Syura (deliberation);‘Adl bil qisth (justice, with equality); Hurriyyah al-kalam (freedom of expression) and along with the values of Islam in the Islamic leadership style. The results of this research can provide a review of the Head Room experience in the application of Islamic leadership style at Syarif Hidayatullah Hospital already skilled leadership during the process, but the application is still not maximized. Required further research on in-depth exploration of how to get more comprehensive results from room Head Nurse experience in the application of Islamic leadership style, as well as subsequent researchers can choose a wider scope and complex so get more complete data.

Keywords: experience, Islamic leadership style, head nurse, nursing management

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Authors: Martina Kaufmann, Thomas Goetz, Anastasiya A. Lipnevich, Reinhard Pekrun

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Positive emotions have been shown to benefit from optimistic perceptions, even if these perceptions are illusory. The current research investigated the impact of illusions of control on positive emotions. There is empirical evidence showing that people are more emotionally attentive to losses than to gains. Hence, we expected that, compared to gains, losses in illusory control would have a stronger impact on positive emotions. The results of two experimental studies support this assumption: Participants who experienced gains in illusory control showed no substantial change in positive emotions. However, positive emotions decreased when they perceived a loss in illusory control. These results suggest that a loss of illusory control (but not a gain thereof) mediates the impact of the situation on individuals’ positive emotions. Implications for emotion theory and practice are discussed.

Keywords: cognitive appraisal, control, illusions, optimism, positive emotions

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Authors: Hussain A. Alkharusi, Said S. Aldhafri, Hilal Z. Alnabhani, Muna Alkalbani

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Analysing classroom assessments is one of the responsibilities of the teacher. It aims improving teacher’s instruction and assessment as well as student learning. The present study investigated factors that might explain variation in teachers’ practices regarding analysis of classroom assessments. The factors considered in the investigation included gender, in-service assessment training, teaching load, teaching experience, knowledge in assessment, attitude towards quantitative aspects of assessment, and self-perceived competence in analysing assessments. Participants were 246 in-service teachers in Oman. Results of a stepwise multiple linear regression analysis revealed that self-perceived competence was the only significant factor explaining the variance in teachers’ analysis of assessments. Implications for research and practice are discussed.

Keywords: analysis of assessment, classroom assessment, in-service teachers, self-competence

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Authors: Wael El-Deeb

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The present study aimed to investigate the diagnostic importance of acute phase proteins in urinary tract infection (UTI) in cattle. We describe the clinical, bacteriological and biochemical findings in 99 lactating cows. Blood and urine samples from diseased (n=84) and control healthy cows (n=15) were submitted to laboratory investigations. The urine analysis revealed hematuria and pyuria in UTI group. The isolated bacteria were E.coli (43/84) Corynebacterium spp, (31/84), Proteus spp. (6/84) and Streptococcus spp (4/84). The concentrations of Haptoglobin (Hp), serum amyloid A (SAA), α1-Acid glycoprotein (AGP), fibrinogen (Fb), total protein, albumen, and globulin were higher in cows with UTI when compared to healthy ones. Fifty-one of 84 cows with UTI were successfully treated. The levels of Hp, SAA, AGP, total protein, and globulin were associated with the odds of treatment failure. Conclusively, acute phase proteins could be used as diagnostic and prognostic biomarkers in cows with UTI.

Keywords: cows, urinary, infections, haptoglobin, serum Amyloid A

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Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie

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Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.

Keywords: abortion, contraception, quality improvement, service provision

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Authors: Lien T. H. Tran, David A. Holloway

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Corporate governance practices have changed significantly across the world in the past three decades. Spectacular corporate failures during this period have acted as a catalyst for the development of codes and guidelines that have resulted in the global acceptance of a ‘best practice’ model. This study assesses the relevance of such a ‘one size fits all model’ for the developing nation state of Vietnam. The findings of this analytical paper is that there are three key elements (government, international institutions and the nature of business) that are pertinent and central to corporate governance developments in the country. We also find that the quality of corporate governance in Vietnam is at a medium level when compared to international practices. Vietnam still has a long way to go to construct and embed effective corporate governance policies and practices and promote ethical business behaviours and sound decision making at board level.

Keywords: corporate governance, government, international institutions, public companies, Vietnam

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Authors: Erika Duggan

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A Major Hospital had identified that there was no standard process for handling a patient’s medication that they brought with them to the hospital. It was also identified that each floor was handling the patient’s medication differently and storing it in multiple locations. Based on this disconnect many patients were leaving the hospital without their medication. The project team was tasked with creating a cohesive process to send a patient’s unneeded medication home on admission, storing any of the patient’s medication that could not be sent home, storing any of the patient’s medication for inpatient administration, and sending all of the patient’s medication home on discharge. The project team consisted of pharmacists, RNs, LPNs, members from nursing informatics and a project engineer and followed a DMAIC framework. Working together observations were performed to identify what was working and not working on the different floors which resulted in process maps. Using the multidisciplinary team, brainstorming, including affinity diagramming and other lean six sigma techniques, the best process for receiving, storing, and returning the medication was created. It was highlighted that being able to track the medication throughout the patient’s stay would be beneficial and would help make sure the medication left with the patient on discharge. Using an automated medications dispensing system would help store, and track patient’s medications. Also, the use of a specific order that would show up on the discharge instructions would assist the front line staff in retrieving the medication from a set location and sending it home with the patient. This new process will effectively streamline the admission and discharge process for patients who brought their medication with them as well as effectively tracking the medication during the patient’s stay. As well as increasing patient safety as it relates to medication administration.

Keywords: lean six sigma, medication dispensing, process improvement, process mapping

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Authors: Ayesha Sohail, Khadija Maqbool, Anila Asif, Haroon Ahmad

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The field of tissue engineering is an active area of research. Bone tissue engineering helps to resolve the clinical problems of critical size and non-healing defects by the creation of man-made bone tissue. We will design and validate an efficient numerical model, which will simulate the effective diffusivity in bone tissue engineering. Our numerical model will be based on the finite element analysis of the diffusion-reaction equations. It will have the ability to optimize the diffusivity, even at multi-scale, with the variation of time. It will also have a special feature, with which we will not only be able to predict the oxygen, glucose and cell density dynamics, more accurately, but will also sort the issues arising due to anisotropy. We will fix these problems with the help of modifying the governing equations, by selecting appropriate spatio-temporal finite element schemes, by adaptive grid refinement strategy and by transient analysis.

Keywords: scaffolds, porosity, diffusion, transient analysis

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Authors: Amadou Darboe, Kuo Hsien-Wen

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Background/Objective: The Effort-Reward Imbalance (ERI) model by Siegrist et al (1986) have been widely used to examine the relationship between psychosocial factors at work and health. It claimed that failed reciprocity in terms of high efforts and low rewards elicits strong negative emotions in combination with sustained autonomic activation and is hazardous to health. The aim of this study is to identify the association between Self-rated Health and Effort-reward Imbalance (ERI) among Nurses and Environmental Health officers in the Gambia. Method: a cross-sectional study was conducted using a multi-stage random sampling of 296 healthcare professionals (206 nurses and 90 environmental health officers) working in public health facilities. The 22 items Effort-reward imbalance questionnaire (ERI-L version 22.11.2012) will be used to collect data on the psychosocial factors defined by the model. In addition, self-rated health will be assessed by using structured questionnaires containing Likert scale items. Results: We found that self-rated health among environmental health officers has a significant negative correlation with extrinsic effort and a positive significant correlations with occupational reward and job satisfaction. However, among the nurses only job satisfaction was significantly correlated with self-rated health and was positive. Overall, Extrinsic effort has a significant negative correlation with reward and job satisfaction but a positive correlation with over-commitment. Conclusion: Because low reward and high over-commitment among the nursing group, It is necessary to modify working conditions through improving psychosocial factors, such as reasonable allocation of resources to increase pay or rewards from government.

Keywords: effort-reward imbalance model, healthcare professionals, self-rated health

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Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

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Authors: Qiuhu Shao

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Community home-based care service system, which is based on the family pension, supported by community pension and supplied by institutions pension, is an effective pension system to solve the current situation of China's accelerated aging. However, due to the fundamental realities of our country, the government is not able to bear the unilateral supply of the old-age service of the community. Therefore, based on the theory of welfare pluralism, the participation of social organizations in the home-based care service center has become an important part of the diversified supply of the old-age service for the elderly. Meanwhile, the home-based care service industry is still in the early stage, the management is relatively rough, which resulted in a large number of social resources waste. Thus, scientific, objective and long-term implementation is needed for social organizations to participate in home-based care services to guide its performance management. In order to realize the design of the performance management system, the author has done a research work that clarifies the research status of social organization's participation in home-based care service. Relevant theories such as welfare pluralism, community care theory, and performance management theory have been used to demonstrate the feasibility of data envelopment analysis method in social organization performance research. This paper analyzes the characteristics of the operation mode of the home-based care service center, and hackles the national as well as local documents, standards and norms related to the development of the home-based care industry, particularly studies those documents in Nanjing. Based on this, the paper designed a set of performance management PDCA system for home-based care service center in Nanjing and clarified each step of the system in detail. Subsequently, the research methods of performance evaluation and performance management and feedback, which are two core steps of performance management have been compared and screened in order to establish the overall framework of the performance management system of the home-based care service center. Through a large number of research, the paper summarized and analyzed the characteristics of the home-based care service center. Based on the research results, combined with the practice of the industry development in Nanjing, the paper puts forward a targeted performance evaluation index system of home-based care service center in Nanjing. Finally, the paper evaluated and sub-filed the performance of 186 home-based care service centers in Nanjing and then designed the performance optimization direction and performance improvement path based on the results. This study constructs the index system of performance evaluation of home-based care service and makes the index detailed to the implementation level, and constructs the evaluation index system which can be applied directly. Meanwhile, the quantitative evaluation of social organizations participating in the home-based care service changed the subjective impression in the previous practice of evaluation.

Keywords: data envelopment analysis, home-based care, performance management, social organization

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Authors: Haya Salah, Srinivas Sharan

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Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.

Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time

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Authors: Afef Dridi, Salah Mezlini

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Since experimental devices cannot calculate stress and deformation of complex structures. The Finite Element Method FEM has been widely used in several fields of research. One of these fields is orthodontics. The advantage of using such a method is the use of an accurate and non invasive method that allows us to have a sufficient data about the physiological reactions can happening in soft tissues. Most of researches done in this field were interested in the study of stresses and deformations induced by orthodontic apparatus in soft tissues (alveolar tissues). Only few studies were interested in the distribution of stress and strain in the orthodontic brackets. These studies, although they tried to be as close as possible to real conditions, their models did not reproduce the clinical cases. For this reason, the model generated by our research is the closest one to reality. In this study, a numerical model was developed to explore the stress and strain distribution under the application of real conditions. A comparison between different material properties was also done.

Keywords: visco-hyperelasticity, FEM, orthodontic treatment, inverse method

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Authors: Rebecca Pryce, Nijole Bernaitis, Andrew K. Davey, Shailendra Anoopkumar-Dukie

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Background: Warfarin is an oral anticoagulant widely used in the prevention of strokes in patients with atrial fibrillation (AF) and in the treatment and prevention of deep vein thrombosis (DVT). Regular monitoring of Internationalised Normalised Ratio (INR) is required to ensure therapeutic benefit with time in therapeutic range (TTR) used to measure warfarin control. A number of factors influence TTR including diet, concurrent illness, and drug interactions. Extensive literature exists regarding the effect of conventional medicines on warfarin control, but documented interactions relating to complementary medicines are limited. It has been postulated that fish oil and krill oil supplementation may affect warfarin due to their association with bleeding events. However, to date little is known as to whether fish and krill oil significantly alter the incidence of bleeding with warfarin or impact on warfarin control. Aim:To assess the influence of fish oil and krill oil supplementation on warfarin control in AF and DVT patients by determining the influence of these supplements on TTR and bleeding events. Methods:A retrospective cohort analysis was conducted utilising patient information from a large private pathology practice in Queensland. AF and DVT patients receiving warfarin management by the pathology practice were identified and their TTR calculated using the Rosendaal method. Concurrent medications were analysed and patients taking no other interacting medicines were identified and divided according to users of fish oil and krill oil supplements and those taking no supplements. Study variables included TTR and the incidence of bleeding with exclusion criteria being less than 30 days of treatment with warfarin. Subject characteristics were reported as the mean and standard deviation for continuous data and number and percentages for nominal or categorical data. Data was analysed using GraphPad InStat Version 3 with a p value of <0.05 considered to be statistically significant. Results:Of the 2081 patients assessed for inclusion into this study, a total of 573 warfarin users met the inclusion criteria. Of these, 416 (72.6%) patients were AF patients and 157 (27.4%) DVT patients and overall there were 316 (55.1%) male and 257 (44.9%) female patients. 145 patients were included in the fish oil/krill oil group (supplement) and 428 were included in the control group. The mean TTR of supplement users was 86.9% and for the control group 84.7% with no significant difference between these groups. Control patients experienced 1.6 times the number of minor bleeds per person compared to supplement patients and 1.2 times the number of major bleeds per person. However, this was not statistically significant nor was the comparison between thrombotic events. Conclusion: No significant difference was found between supplement and control patients in terms of mean TTR, the number of bleeds and thrombotic events. Fish oil and krill oil supplements when used concurrently with warfarin do not significantly affect warfarin control as measured by TTR and bleeding incidence.

Keywords: atrial fibrillation, deep vein thormbosis, fish oil, krill oil, warfarin

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