Search results for: person centered care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5522

Search results for: person centered care

1472 Reading against the Grain: Transcodifying Stimulus Meaning

Authors: Aba-Carina Pârlog

Abstract:

On translating, reading against the grain results in a wrong effect in the TL. Quine’s ocular irradiation plays an important part in the process of understanding and translating a text. The various types of textual radiation must be rendered by the translator by paying close attention to the types of field that produce it. The literary work must be seen as an indirect cause of an expressive effect in the TL that is supposed to be similar to the effect it has in the SL. If the adaptive transformative codes are so flexible that they encourage the translator to repeatedly leave out parts of the original work, then a subversive pattern emerges which changes the entire book. In this case, the translator is a writer per se who decides what goes in and out of the book, how the style is to be ciphered and what elements of ideology are to be highlighted. Figurative language must not be flattened for the sake of clarity or naturalness. The missing figurative elements make the translated text less interesting, less challenging and less vivid which reflects poorly on the writer. There is a close connection between style and the writer’s person. If the writer’s style is very much changed in a translation, the translation is useless as the original writer and his / her imaginative world can no longer be discovered. Then, a different writer appears and his / her creation surfaces. Changing meaning considered as a “negative shift” in translation defines one of the faulty transformative codes used by some translators. It is a dangerous tool which leads to adaptations that sometimes reflect the original less than the reader would wish to. It contradicts the very essence of the process of translation which is that of making a work available in a foreign language. Employing speculative aesthetics at the level of a text indicates the wish to create manipulative or subversive effects in the translated work. This is generally achieved by adding new words or connotations, creating new figures of speech or using explicitations. The irradiation patterns of the original work are neglected and the translator creates new meanings, implications, emphases and contexts. Again s/he turns into a new author who enjoys the freedom of expressing his / her ideas without the constraints of the original text. The stimulus meaning of a text is very important for a translator which is why reading against the grain is unadvisable during the process of translation. By paying attention to the waves of the SL input, a faithful literary work is produced which does not contradict general knowledge about foreign cultures and civilizations. Following personal common sense is essential in the field of translation as well as everywhere else.

Keywords: stimulus meaning, substance of expression, transformative code, translation

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1471 Woodcast is Ecologically Sound and Tolerated by a Majority of Patients

Authors: R. Hassan, J. Duncombe, E. Darke, A. Dias, K. Anderson, R. G. Middleton

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NHS England has set itself the task of delivering a “Net Zero” National Health service by 2040. It is incumbent upon all health care practioners to work towards this goal. Orthopaedic surgeons are no exception. Distal radial fractures are the most common fractures sustained by the adult population. However, studies are shortcoming on individual patient experience. The aim of this study was to assess the patient’s satisfaction and outcomes with woodcast used in the conservative management of distal radius fractures. For all patients managed with woodcast in our unit, we undertook a structured questionnaire that included the Patient Rated Wrist Evaluation (PRWE) score, The EQ-5D-5L score and the pain numerical score at the time of injury and six weeks after. 30 patients were initially managed with woodcast. 80% of patients tolerated woodcast for the full duration of their treatment. Of these, 20% didn’t tolerate woodcast and had their casts removed within 48 hours. Of the remaining, 79.1% were satisfied about woodcast comfort, 66% were very satisfied about woodcast weight, 70% were satisfied with temperature and sweatiness, 62.5% were very satisfied about the smell/odour, and 75% were satisfied about the level of support woodcast provided. During their treatment, 83.3% of patients rated their pain as five or less. For those who completed their treatment in woodcast, none required any further intervention or utilised the open appointment because of ongoing wrist problems. In conclusion, when woodcast is tolerated, patients’ satisfaction and outcome levels were good. However, we acknowledged 20% of patients in our series were not able to tolerate woodacst, Therefore, we suggest a comparison between the widely used synthetic plaster of Paris casting and woodcast to come in order.

Keywords: distal radius fractures, ecological cast, sustainability, woodcast

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1470 Believing in a Just-World: The Neoliberal Rationality and the Everyday Legitimation of Social Inequality

Authors: Mónica Catarina Soares

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Neoliberal rationality is currently changing the ways concepts like freedom or equality are framed. As an omnipresent and context-sensitive paradigm, homo oeconomicus is continuously taking place in realms of life previously insulated from economic and market-driven principles. This presentation is based on the argument that, more than ever, this paradigm is nowadays framing institutional and everyday discourses in regard to social problems. Although neoliberal rationality is based on the putative ideological basis that everyone is equal, equality seems to be reshaped by specific meanings apprehended by this rationality. In this sense, an illusion of equality seems to be relevant to legitimize different social inequalities (e.g., access to health care or to habitation). Political psychology has studied how ideology is relevant to legitimize market and unequal systems, but still the specific relation between markets, (in)equality and neoliberal languages is not widely addressed. The goal is to discuss the smithereens of the neoliberal rationality when it comes to legitimizing social inequalities by contesting the arguments of meritocracy, progressive freedom and minimal guarantees obeying to market-rules and principles. This analysis can be helpful to grasp for instance the continuously dismantlement of the welfare-state in different countries of the global north and how it is turning the regulation/emancipation tension inside out. The ultimate goal is to contribute to the breaking up of a paradigm that is still too big to capture, too depoliticized and chameleonic to fully acknowledge the biopolitics of power that is helping to create it.

Keywords: discourses, legitimacy, neoliberal rationality, social inequality

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1469 The Nurse Practitioner’s Role Functions in Multi-Specialist Team When Caring for a Metastatic Colon Cancer Patient with Acute Intestinal Obstruction

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

Abstract:

Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

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1468 A Study on Compromised Periodontal Health Status among the Pregnant Woman of Jamshedpur, Jharkhand, India

Authors: Rana Praween Kumar

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Preterm-low birth weight delivery is a major cause of infant morbidity and mortality in developing countries and has been linked to poor periodontal health during pregnancy. Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory oral diseases. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. This study is intended to investigate predisposing and enabling factors as determinants of oral health indicators in pregnancy as well as the association between periodontal problems during pregnancy with age and socio economic status of the individual. A community –based prospective cohort study will be conducted in Jamshedpur, Jharkhand, India among pregnant women using completed interviews and a full mouth oral clinical examination using the CPITN (Community Periodontal Index of Treatment Need) and OHI-S (Simplified Oral Hygiene) indices with adequate sample size and informed consent to the patient following proper inclusion and exclusion criteria. Multiple logistic regression analyses will be used to identify independent determinants of periodontal problems and use of dental services during pregnancy. Analysis of covariance (ANCOVA) will be used to investigate the relationship between periodontal problems with the age and socioeconomic status. The result will help in proper monitoring of periodontal health during pregnancy encouraging the delivery of healthy child and the maintenance of proper health of the mother.

Keywords: infant, periodontal problems, pregnancy, pre-term-low birth weight delivery

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1467 Motivation Needs in Working of the Employees in Rayong Province: A Case Study of Panakom Co., Ltd.

Authors: Ganratchakan Ninlawan, Witthaya Mekhum

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The objective of this research was to investigate motivation needs in working of the employees in Rayong Province at Panakom Co., Ltd. The sample group included 59 operational employees of Panakom Co., Ltd divided into 2 main parts to complete the questionnaires. Part 1 dealt with personal information of the staff in the form of checklist questions. Part 2 was about the motivation needs in working in the form of 5 rating scales. The data were analyzed to find frequency, percentage, arithmetic mean, and SD with the results as follows. They reported their working conditions in the moderate level while the first aspect was on the regulation of the Working Support Department. The second rated aspect was on the modern facilities and office stationeries followed by the working environment such as lighting, temperature, sound system, and atmosphere. The last aspect was on the provision of enough working equipment. On the part of work stability and work progress, they rated this aspect at the moderate level with the details below. The first aspect was their satisfaction in work rotation followed by the encouragement in joining training and seminar to increase working knowledge. The third aspect was their perception on the progress of their careers. The last aspect was on the chance to get promoted in special cases. On the payment and fringe benefit, they rated this part in the moderate level with the highest aspect being on the provided fringe benefit such as health care. The second aspect was on the suitable salary compared to their knowledge and proficiency. The third aspect was on the satisfaction on the activities and seminars provided by the company. Finally, the last aspect was on the sufficient salary when compared with the current cost of living.

Keywords: motivation needs, working, employees, Rayong Province

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1466 Cloud Enterprise Application Provider Selection Model for the Small and Medium Enterprise: A Pilot Study

Authors: Rowland R. Ogunrinde, Yusmadi Y. Jusoh, Noraini Che Pa, Wan Nurhayati W. Rahman, Azizol B. Abdullah

Abstract:

Enterprise Applications (EAs) aid the organizations achieve operational excellence and competitive advantage. Over time, most Small and Medium Enterprises (SMEs), which are known to be the major drivers of most thriving global economies, use the costly on-premise versions of these applications thereby making business difficult to competitively thrive in the same market environment with their large enterprise counterparts. The advent of cloud computing presents the SMEs an affordable offer and great opportunities as such EAs can be cloud-hosted and rented on a pay-per-use basis which does not require huge initial capital. However, as there are numerous Cloud Service Providers (CSPs) offering EAs as Software-as-a-Service (SaaS), there is a challenge of choosing a suitable provider with Quality of Service (QoS) that meet the organizations’ customized requirements. The proposed model takes care of that and goes a step further to select the most affordable among a selected few of the CSPs. In the earlier stage, before developing the instrument and conducting the pilot test, the researchers conducted a structured interview with three experts to validate the proposed model. In conclusion, the validity and reliability of the instrument were tested through experts, typical respondents, and analyzed with SPSS 22. Results confirmed the validity of the proposed model and the validity and reliability of the instrument.

Keywords: cloud service provider, enterprise application, quality of service, selection criteria, small and medium enterprise

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1465 Optimization of the Enzymatic Synthesis of the Silver Core-Shell Nanoparticles

Authors: Lela Pintarić, Iva Rezić, Ana Vrsalović Presečki

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Considering an enormous increase of the use of metal nanoparticles with the exactly defined characteristics, the main goal of this research was to found the optimal and environmental friendly method of their synthesis. The synthesis of the inorganic core-shell nanoparticles was optimized as a model. The core-shell nanoparticles are composed of the enzyme core belted with the metal ions, oxides or salts as a shell. In this research, enzyme urease was the core catalyst and the shell nanoparticle was made of silver. Silver nanoparticles are widespread utilized and some of their common uses are: as an addition to disinfectants to ensure an aseptic environment for the patients, as a surface coating for neurosurgical shunts and venous catheters, as an addition to implants, in production of socks for diabetics and athletic clothing where they improve antibacterial characteristics, etc. Characteristics of synthesized nanoparticles directly depend on of their size, so the special care during this optimization was given to the determination of the size of the synthesized nanoparticles. For the purpose of the above mentioned optimization, sixteen experiments were generated by the Design of Experiments (DoE) method and conducted under various temperatures, with different initial concentration of the silver nitrate and constant concentration of the urease of two separate manufacturers. Synthesized nanoparticles were analyzed by the Nanoparticle Tracking Analysis (NTA) method on Malvern NanoSight NS300. Results showed that the initial concentration of the silver ions does not affect the concentration of the synthesized silver nanoparticles neither their size distribution. On the other hand, temperature of the experiments has affected both of the mentioned values.

Keywords: core-shell nanoparticles, optimization, silver, urease

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1464 Prediction Factor of Recurrence Supraventricular Tachycardia After Adenosine Treatment in the Emergency Department

Authors: Welawat Tienpratarn, Chaiyaporn Yuksen, Rungrawin Promkul, Chetsadakon Jenpanitpong, Pajit Bunta, Suthap Jaiboon

Abstract:

Supraventricular tachycardia (SVT) is an abnormally fast atrial tachycardia characterized by narrow (≤ 120 ms) and constant QRS. Adenosine was the drug of choice; the first dose was 6 mg. It can be repeated with the second and third doses of 12 mg, with greater than 90% success. The study found that patients observed at 4 hours after normal sinus rhythm was no recurrence within 24 hours. The objective of this study was to investigate the factors that influence the recurrence of SVT after adenosine in the emergency department (ED). The study was conducted retrospectively exploratory model, prognostic study at the Emergency Department (ED) in Faculty of Medicine, Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand. The study was conducted for ten years period between 2010 and 2020. The inclusion criteria were age > 15 years, visiting the ED with SVT, and treating with adenosine. Those patients were recorded with the recurrence SVT in ED. The multivariable logistic regression model developed the predictive model and prediction score for recurrence PSVT. 264 patients met the study criteria. Of those, 24 patients (10%) had recurrence PSVT. Five independent factors were predictive of recurrence PSVT. There was age>65 years, heart rate (after adenosine) > 100 per min, structural heart disease, and dose of adenosine. The clinical risk score to predict recurrence PSVT is developed accuracy 74.41%. The score of >6 had the likelihood ratio of recurrence PSVT by 5.71 times. The clinical predictive score of > 6 was associated with recurrence PSVT in ED.

Keywords: supraventricular tachycardia, recurrance, emergency department, adenosine

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1463 Integrated Human Resources and Work Environment Management System

Authors: Loreta Kaklauskiene, Arturas Kaklauskas

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The Integrated Human Resources and Work Environment Management (HOWE) System optimises employee productivity, improves the work environment, and, at the same time, meets the employer’s strategic goals. The HOWE system has been designed to ensure an organisation can successfully compete in the global market, thanks to the high performance of its employees. The HOWE system focuses on raising workforce productivity and improving work conditions to boost employee performance and motivation. The methods used in our research are linear correlation, INVAR multiple criteria analysis, digital twin, and affective computing. The HOWE system is based on two patents issued in Lithuania (LT 6866, LT 6841) and one European Patent application (No: EP 4 020 134 A1). Our research analyses ways to make human resource management more efficient and boost labour productivity by improving and adapting a personalised work environment. The efficiency of human capital and labour productivity can be increased by applying personalised workplace improvement systems that can optimise lighting colours and intensity, scents, data, information, knowledge, activities, media, games, videos, music, air pollution, humidity, temperature, vibrations, and other workplace aspects. HOWE generates and maintains a personalised workspace for an employee, taking into account the person’s affective, physiological and emotional (APSE) states. The purpose of this project was to create a HOWE for the customisation of quality control in smart workspaces taking into account the user’s APSE states in an integrated manner as a single unit. This customised management of quality control covers the levels of lighting and colour intensities, scents, media, information, activities, learning materials, games, music, videos, temperature, energy efficiency, the carbon footprint of a workspace, humidity, air pollution, vibrations and other aspects of smart spaces. The system is based on Digital Twins technology, seen as a logical extension of BIM.

Keywords: human resource management, health economics, work environment, organizational behaviour and employee productivity, prosperity in work, smart system

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1462 Functionalized Carbon-Base Fluorescent Nanoparticles for Emerging Contaminants Targeted Analysis

Authors: Alexander Rodríguez-Hernández, Arnulfo Rojas-Perez, Liz Diaz-Vazquez

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The rise in consumerism over the past century has resulted in the creation of higher amounts of plasticizers, personal care products and other chemical substances, which enter and accumulate in water systems. Other sources of pollutants in Neotropical regions experience large inputs of nutrients with these pollutants resulting in eutrophication of water which consume large quantities of oxygen, resulting in high fish mortality. This dilemma has created a need for the development of targeted detection in complex matrices and remediation of emerging contaminants. We have synthesized carbon nanoparticles from macro algae (Ulva fasciata) by oxidizing the graphitic carbon network under extreme acidic conditions. The resulting material was characterized by STEM, yielding a spherical 12 nm average diameter nanoparticles, which can be fixed into a polysaccharide aerogel synthesized from the same macro algae. Spectrophotometer analyses show a pH dependent fluorescent behavior varying from 450-620 nm in aqueous media. Heavily oxidized edges provide for easy functionalization with enzymes for a more targeted analysis and remediation technique. Given the optical properties of the carbon base nanoparticles and the numerous possibilities of functionalization, we have developed a selective and robust targeted bio-detection and bioremediation technique for the treatment of emerging contaminants in complex matrices like estuarine embayment.

Keywords: aerogels, carbon nanoparticles, fluorescent, targeted analysis

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1461 An Overview of Electronic Waste as Aggregate in Concrete

Authors: S. R. Shamili, C. Natarajan, J. Karthikeyan

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Rapid growth of world population and widespread urbanization has remarkably increased the development of the construction industry which caused a huge demand for sand and gravels. Environmental problems occur when the rate of extraction of sand, gravels, and other materials exceeds the rate of generation of natural resources; therefore, an alternative source is essential to replace the materials used in concrete. Now-a-days, electronic products have become an integral part of daily life which provides more comfort, security, and ease of exchange of information. These electronic waste (E-Waste) materials have serious human health concerns and require extreme care in its disposal to avoid any adverse impacts. Disposal or dumping of these E-Wastes also causes major issues because it is highly complex to handle and often contains highly toxic chemicals such as lead, cadmium, mercury, beryllium, brominates flame retardants (BFRs), polyvinyl chloride (PVC), and phosphorus compounds. Hence, E-Waste can be incorporated in concrete to make a sustainable environment. This paper deals with the composition, preparation, properties, classification of E-Waste. All these processes avoid dumping to landfills whilst conserving natural aggregate resources, and providing a better environmental option. This paper also provides a detailed literature review on the behaviour of concrete with incorporation of E-Wastes. Many research shows the strong possibility of using E-Waste as a substitute of aggregates eventually it reduces the use of natural aggregates in concrete.

Keywords: dumping, electronic waste, landfill, toxic chemicals

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1460 Helping Others and Mental Health: A Qualitative Study Exploring Perspectives of Youth Engaging in Prosocial Activities

Authors: Saima Hirani, Emmanuela Ojukwu, Nilanga Aki Bandara

Abstract:

Background: Mental health challenges that begin during the youth age period may continue across the entire life course. One way to support youth mental health is to encourage youth engagement in prosocial activities. This study aimed to explore youth’s perceptions about helping others and mental well-being, barriers, and enablers for youth to initiate and continue prosocial activities, and strategies for developing the attribute of helping others in youth. Methods: We conducted a qualitative study using semi-structured, virtual interviews with 18 young individuals (aged 16-24 years) living in Vancouver, British Columbia, Canada. Results: Youth perceived helping others as a source of feeling peace and calm, finding meaning in life, experiencing social connection and promoting self-care, and relieving stress. Participants reported opportunities to learn new skills, the role of religion, social connections, previous positive experiences, and role modeling as enablers for their prosocial behaviour. Heavy time commitment, negative behaviour from others, self-doubt, and late exposure to such activities were considered barriers by youth when participating in prosocial activities. Youth also brought forward key recommendations for engaging youth in helping others. Conclusions: The findings of this study support the notion that youth have positive experiences when engaging in helping others and that involving young people in prosocial activities could be used as a protective intervention for promoting youth mental health and overall well-being.

Keywords: helping others, prosocial behaviour, youth, mental well-being

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1459 Dialectic Relationship between Urban Pattern Structural Methods and Construction Materials in Traditional Settlements

Authors: Sawsan Domi

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Identifying urban patterns of traditional settlements perfumed in various ways. One of them through the three-dimensional ‘reading’ of the urban web: the density of structures, the construction materials and the colors used. Objectives of this study are to paraphrase and understand the relation between the formation of the traditional settlements and the shape and structure of their structural method. In the beginning, the study considered the components of the historical neighborhood, which reflected the social and economical effects in the urban planning pattern. Then, by analyzing the main components of the old neighborhood which included: analysis of urban patterns & streets systems, analysis of traditional architectural elements and the construction materials and their usage. ‘’Hamasa’’ Neighborhood in ‘’Al Buraimi’’ Governorate is considered as one of the most important archaeological sites in the Sultanate of Oman. The vivid features of this archaeological site are the living witness to the genius of the Omani person and his unique architecture. ‘’Hamasa’’ Neighborhood is also considered as the oldest human settlement at ‘’Al Buraimi’’ Governorate. It used to be the gathering area for Arab and Omani tribes who are coming from other governorates of Oman. In this old settlement, local characters were created to meet the climate problems and the social, religious requirements of the life. Traditional buildings were built of materials that were available in the surround environment and within hand reach. The Historical component was containing four main separate neighborhoods. The morphological structure of ‘’Hamasa’’ was characterized by a continuous and densely built-up pattern, featuring close interdependence between the spatial and functional pattern. The streets linked the plots, the marketplace and the open areas. Consequently, the traditional fabric had narrow streets with one- and two- storey houses. The material used in building facilities at ‘’Hamasa’' historical are from the traditionally used materials. These materials were cleverly used in building of local facilities. Most of these materials are locally made and formed, and used by the locals. ‘’Hamasa’’ neighborhood is an example of analyzing the urban patterns and geometrical features. The old ‘’ Hamasa’’ retains the patterns of its old settlements. Urban patterns were defined by both forms and structure. The traditional architecture of ‘’Hamasa’’ neighborhood has evolved as a direct result of its climatic conditions. The study figures out that the neighborhood characterized by the used construction materials, the scope of the residential structures and by the streets system. All formed the urban pattern of the settlement.

Keywords: urban pattern, construction materials, neighborhood, architectural elements, historical

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1458 Community Policing Interventions in the Tribal Hamlets as a Positive Criminal Justice and Social Justice Strategy: A Study Based on the Community Policing Project of the Government of Kerala

Authors: Bharathadas Sandhya

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Janamaithri Suraksha Project is the community policing project of Kerala police, fully sponsored by the Government of Kerala and in vogue in Kerala for the last ten years. The socio-economically weaker areas in the hilly terrains consisting of tribal hamlets are given special importance under the project. These hamlets are visited by the beat police officers, and they intervene in various issues in the hamlets. This study is based on data collected from 350 respondents living in the tribal hamlets of the Nilambur area in the District of Malappuram. The respondents were personally interviewed by the research team using a questionnaire consisting of 183 questions, seeking the details regarding their interaction with beat police officers, their ability to prevent or detect crimes, the menace of Maoists (extremist) presence, their interventions in other socio-economic problems like alcoholism, school dropout issues, lack of facilities for preparation for competitive examinations for educated youth, etc. The perception of the tribal population regarding the effectiveness of police intervention in their criminal justice complaints, the attitude of the police officers towards the tribal population when they approach the police station with a criminal complaint, are also studied. The general socio-economic problems of the tribal population as perceived by them are also brought out. Being the visible agency of the government, the police person coming on beat duty to the hamlet is generally seen by the tribal population as a representative to whom they can communicate the issues, even if it’s solution rests with another department like the forest or agriculture. The analysis of the primary data is carried out using computer applications. The amount of social justice benefits the tribal hamlets received through various government schemes, and their deficiencies are brought out in the study. From the conclusions of the study, certain suggestions for positive criminal justice and social justice intervention strategies are made out. The need for various government departments to work in tandem with each other so as to bring out more effectiveness in the socio-economic projects is evident from the study. Whether it is the need to obtain a transport to go to school or problem of drinking water or even opening a bank account, at least occasionally, the visiting beat police officer is of help to the tribal population. Mostly the tribal population feels free to approach the police with a criminal complaint without any inhibitions.

Keywords: community policing, beat police officer, criminal justice, social justice

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1457 Integrating Virtual Reality and Building Information Model-Based Quantity Takeoffs for Supporting Construction Management

Authors: Chin-Yu Lin, Kun-Chi Wang, Shih-Hsu Wang, Wei-Chih Wang

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A construction superintendent needs to know not only the amount of quantities of cost items or materials completed to develop a daily report or calculate the daily progress (earned value) in each day, but also the amount of quantities of materials (e.g., reinforced steel and concrete) to be ordered (or moved into the jobsite) for performing the in-progress or ready-to-start construction activities (e.g., erection of reinforced steel and concrete pouring). These daily construction management tasks require great effort in extracting accurate quantities in a short time (usually must be completed right before getting off work every day). As a result, most superintendents can only provide these quantity data based on either what they see on the site (high inaccuracy) or the extraction of quantities from two-dimension (2D) construction drawings (high time consumption). Hence, the current practice of providing the amount of quantity data completed in each day needs improvement in terms of more accuracy and efficiency. Recently, a three-dimension (3D)-based building information model (BIM) technique has been widely applied to support construction quantity takeoffs (QTO) process. The capability of virtual reality (VR) allows to view a building from the first person's viewpoint. Thus, this study proposes an innovative system by integrating VR (using 'Unity') and BIM (using 'Revit') to extract quantities to support the above daily construction management tasks. The use of VR allows a system user to be present in a virtual building to more objectively assess the construction progress in the office. This VR- and BIM-based system is also facilitated by an integrated database (consisting of the information and data associated with the BIM model, QTO, and costs). In each day, a superintendent can work through a BIM-based virtual building to quickly identify (via a developed VR shooting function) the building components (or objects) that are in-progress or finished in the jobsite. And he then specifies a percentage (e.g., 20%, 50% or 100%) of completion of each identified building object based on his observation on the jobsite. Next, the system will generate the completed quantities that day by multiplying the specified percentage by the full quantities of the cost items (or materials) associated with the identified object. A building construction project located in northern Taiwan is used as a case study to test the benefits (i.e., accuracy and efficiency) of the proposed system in quantity extraction for supporting the development of daily reports and the orders of construction materials.

Keywords: building information model, construction management, quantity takeoffs, virtual reality

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1456 A Clear Language Is Essential: A Qualitative Exploration of Doctor-Patient Health Interaction in Jordan

Authors: Etaf Khlaed Haroun Alkhlaifat

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When doctors and patients do not share the same first language, language barriers may exist, which may have negative effects on the quality of communication and care provided. Doctors’ use of medical jargon and patients’ inability to fully express their illness, to a potential loss of relevant information can often create misunderstanding. This study sought to examine the extent to which a lack of “common” language represents one of the linguistic obstacles that may adversely influence the quality of healthcare services in Jordan. Communication Accommodation Theory (CAT) was used to interpret the phenomena under study. Doctors (n=9) and patients (n=18) were observed and interviewed in natural Jordanian medical settings. A thematic qualitative approach was employed to analyse the data. The preliminary findings of the study revealed that most doctors appeared to have a good sense of appropriate ways to break through communication barriers by changing medical terminologies or jargons into lay terms. However, for some, there were two main challenges: 1) the use of medical jargon in explaining medication and side effects and 2) the lack of patients’ knowledge in providing a full explanation about their illnesses. The study revealed that language barriers adversely affect health outcomes for patients with limited fluency in the English language. It argues that it is doctors’ responsibility to guarantee mutual understanding, educate patients on their condition and improve their health outcomes.

Keywords: communication accommodation theory, doctor-patient interaction, language barrier, medical jargon, misunderstanding

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1455 Official Seals on the Russian-Qing Treaties: Material Manifestations and Visual Enunciations

Authors: Ning Chia

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Each of the three different language texts (Manchu, Russian, and Latin) of the 1689 Treaty of Nerchinsk bore official seals from Imperial Russia and Qing China. These seals have received no academic attention, yet they can reveal a site of a layered and shared material, cultural, political, and diplomatic world of the time in Eastern Eurasia. The very different seal selections from both empires while ratifying the Treaty of Beijing in 1860 have obtained no scholarly advertency either; they can also explicate a tremendously changed relationship with visual and material manifestation. Exploring primary sources in Manchu, Russian, and Chinese languages as well as the images of the visual seals, this study investigates the reasons and purposes of utilizing official seals for the treaty agreement. A refreshed understanding of Russian-Qing diplomacy will be developed by pursuing the following aspects: (i) Analyzing the iconographic meanings of each seal insignia and unearthing a competitive, yet symbols-delivered and seal-generated, 'dialogue' between the two empires (ii) Contextualizing treaty seals within the historical seal cultures, and discovering how domestic seal system in each empire’s political institution developed into treaty-defined bilateral relations (iii) Expounding the seal confiding in each empire’s daily governing routines, and annotating the trust in the seal as a quested promise from the opponent negotiator to fulfill the treaty terms (iv) Contrasting the two seal traditions along two civilization-lines, Eastern vs. Western, and dissecting how the two styles of seal emblems affected the cross-cultural understanding or misunderstanding between the two empires (v) Comprehending the history-making events from the substantial resources such as the treaty seals, and grasping why the seals for the two treaties, so different in both visual design and symbolic value, were chosen in the two relationship eras (vi) Correlating the materialized seal 'expression' and the imperial worldviews based on each empire’s national/or power identity, and probing the seal-represented 'rule under the Heaven' assumption of China and Russian rising role in 'European-American imperialism … centered on East Asia' (Victor Shmagin, 2020). In conclusion, the impact of official seals on diplomatic treaties needs profound knowledge in seal history, insignia culture, and emblem belief to be able to comprehend. The official seals in both Imperial Russia and Qing China belonged to a particular statecraft art in a specific material and visual form. Once utilized in diplomatic treaties, the meticulously decorated and politically institutionalized seals were transformed from the determinant means for domestic administration and social control into the markers of an empire’s sovereign authority. Overlooked in historical practice, the insignia seal created a wire of 'visual contest' between the two rival powers. Through this material lens, the scholarly knowledge of the Russian-Qing diplomatic relationship will be significantly upgraded. Connecting Russian studies, Qing/Chinese studies, and Eurasian studies, this study also ties material culture, political culture, and diplomatic culture together. It promotes the study of official seals and emblem symbols in worldwide diplomatic history.

Keywords: Russia-Qing diplomatic relation, Treaty of Beijing (1860), Treaty of Nerchinsk (1689), Treaty seals

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1454 Association of Transmission Risk Factors Among HCV-infected Bangladeshi Patients With Different Genotypes

Authors: Nahida Sultana

Abstract:

Globally, an estimated 58 million people have chronic hepatitis C virus infection, with about 1.5 million new infections occurring per year. The hepatitis C virus is a blood-borne virus, and most infections occur through exposure to blood from unsafe injection practices, unsafe health care, unscreened blood transfusion, injection drug use, and sexual practices that lead to exposure to blood. Hepatitis C virus (HCV) causes chronic infections that mainly affect the liver leading to liver diseases. This study aimed to determine whether there is any significant association between HCV transmission risk factors in relation to genotypes in HCV-infected Bangladeshi patients. After quantification of HCV viral load, 36 samples were randomly selected for HCV genotyping and risk factor measurement. A greater proportion of genotype 1 (p > 0.05) patients (40%) underwent blood transfusion compared to patients (22.6%) with genotype 3 infections. More genotype 1 patient underwent surgery and invasive procedures (20%), and rather than those with genotype 3 patients (16.1%). The history of IDUs (25.8%) and sexual exposure (3.2%) are only prevalent in genotype 3 patients and absent in patients with genotype 1 (p >0.05). There was no significant statistical difference found in HCV transmission risk factors (blood transfusion, IDUs, Surgery& interventions, sexual transmission) between patients infected with genotypes 1 and 3. In HCV infection, genotype may have no relation to transmission risk factors among Bangladeshi patients.

Keywords: HCV genotype, alanine aminotransferase (ALT), HCV viral load, IDUs

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1453 Synthesis and Luminescent Properties of Barium-Europium (III) Silicate Systems

Authors: A. Isahakyan, A. Terzyan, V. Stepanyan, N. Zulumyan, H. Beglaryan

Abstract:

The involvement of silica hydrogel derived from serpentine minerals (Mg(Fe))6[Si4O10](OH)8 as a source of silicon dioxide in SiO2–NaOH–BaCl2–H2O system results in precipitating via one-hour stirring of boiling suspension such intermediates that on heating up to 800 °C crystallize into the product composed of barium ortho- Ba2SiO4 and metasilicates BaSiO3. Based on the positive results, this approach has been decided to be adapted to inserting europium (III) ions into the structure of the synthesized compounds. Intermediates previously precipitated in silica hydrogel–NaOH–BaCl2–Eu(NO3)3 system via one-hour stirring at room temperature underwent one-hour heat-treatment at different temperatures (6001200 °C). Prior to calcination, the suspension produced in the mixer was heated on a boiling-water bath until a powder-like sample was obtained. When the silica hydrogel was metered, SiO2 content in the silica hydrogel that is 5.8 % was taken into consideration in order to guaranty the molar ratios of both SiO2 to BaO and SiO2 to Na2O equal to 1:2. BaCl2 and Eu(NO3)3 reagents were weighted so that the formation of appropriate compositions was guaranteed. Samples including various concentrations of Eu3+ ions (1.25, 2.5, 3.75, 5, 6.35, 8.65, 10, 17.5, 18.75 and 20 mol%) were synthesized by the described method. Luminescence excitation, emission spectra of the products were recorded on the Agilent Cary Eclipes fluorescence spectrophotometer using Agilent Xenon flash lamp (80 Hz) as the excitation source (scanning rate=30 nm/min, excitation and emission slits width=5 nm, excitation filter set to auto, emission filter set to auto and PMT detector Voltage=800 V). Prior to optical properties measurements, each of the powder samples was put in the solid sample-holder. X-ray powder diffraction (XRPD) measurements were made on the SmartLab SE diffractometer. Emission spectra recorded for all the samples at an excitation wavelength of 394 nm exhibit peaks centered at around 536, 555, 587, 614, 653, 690 and 702.5 nm. The most intensive emission peak is observed at 614nm due to 5D0→7F2 of europium (III) ions transition. Luminescence intensity achieves its maximum for Eu3+ 17.5 mol% and heat-treatment at 1200 °C. The XRPD patterns revealed that the diffraction peaks recorded for this sample are identical to NaBa6Nd(SiO4)4 reflections. As Nd-containing reagents were not involved into the synthesis, the maximum luminescent intensity is most likely to be conditioned by NaBa6Eu(SiO4)4 formation whose reflections are not available in the ICDD-JCPDS database of crystallographic 2024. Up to Eu3+ 2.5 mol% the samples demonstrate the phases corresponding to Ba2SiO4 and BaSiO3 standards. Subsequent increasing of europium (III) concentration in the system leads to NaBa6Eu(SiO4)4 formation along with Ba2SiO4 and BaSiO3. NaBa6Eu(SiO4)4 share gradually increases and starting from 17.5 mol% and more NaBa6Eu(SiO4)4 phase is only registered. Thus, the variation of europium (III) concentration in silica hydrogel–NaOH–BaCl2–Eu(NO3)3 system allows producing by the precipitation method the products composed of europium (III)-doped Ba2SiO4 and BaSiO3 and/or NaBa6Eu(SiO4)4 distinguished by different luminescent properties. The work was supported by the Science Committee of RA, in the frames of the research projects № 21T-1D131 and № 21SCG-1D013.

Keywords: europium (III)-doped barium ortho- Ba2SiO4 and metasilicates BaSiO₃, NaBa₆Eu(SiO₄)₄, luminescence, precipitation method

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1452 Exploring Factors Associated with Substance Use among Pregnant Women in a Cape Town Community

Authors: Mutshinye Manguvhewa, Maria Florence, Mansoo Yu, Elize Koch, Kamal Kamaloodien

Abstract:

Substance use among pregnant women is a perennial problem in the Western Cape Province of South Africa. There are many influential factors are associated with substance use among women of childbearing age. The study explored factors associated with substance use among pregnant women using a qualitative research design and the bio-ecological theoretical framework to explore and guide the researcher throughout the study. Participants were selected using purposive sampling. Only participants accessed from the Department of Social Development meeting the inclusion criteria of the study were interviewed using semi structured interviews. Immediate referral for psychological intervention during the interview was available for participants who needed it. Braun and Clarke's six phases of thematic analysis were utilised to analyse the data. The study adheres to ethical guidelines for the participants' protection. Participants were informed about the study before the initiation of the interviews and the details of their voluntary participation were explained. The key findings from this study illustrate that socio-cultural factors, personal factors, emotional response and intimate relationships are the major contributing factors to substance use among pregnant women in this sample. The results outline the preventative measures that pregnant women implement. Lastly, the study reveals the positive and negative perceptions of substance use programmes that participants share. Some of the study findings are similar to the existing literature and some of the findings differed. Recommendations emanating from the study include that the stakeholders, rehabilitation centres, Department of Health and future researchers should act proactively against substance use during pregnancy.

Keywords: substance addiction, antenatal care, pregnancy, substance use

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1451 The Potential Effect of Climate Changes on Food and Water Associated Infections

Authors: Mohammed A. Alhoot, Rathika A/P Nagarajan

Abstract:

Climate change and variability are affecting human health and diseases direct or indirectly through many mechanisms. Change in rain pattern, an increase of temperature and humidity are showing an increased trend in Malaysia. This will affect the biological, physical and chemical component of water through different pathways and will enhance the risk of waterborne diseases. Besides, the warm temperature and humid climate provide very suitable conditions for the growth of pathogenic bacteria. This study is intended to highlight the relationship between the climate changes and the incidence food and water associated infections. Incidences of food and water associated infection and climate data were collected from Malaysian Ministry of health and Malaysian Metrological Department respectively. Maximum and minimum temperature showed high correlation with incidence of typhoid, hepatitis A, dysentery, food poisoning (P value <0.05 significant with 2 tailed / 0.5<[r]). Heavy rainfall does not associated with any outbreaks. Climate change brings out new challenges in controlling food and water associated infections. Adaptation strategies should involve all key stakeholders with a strong regional cooperation to prevent and deal with cross-boundary health crises. Moreover, the role of health care personnel at local, state and national levels is important to ensure the success of these programmes. As has been shown herein, climate variability is an important element influencing the food and water associated epidemiology in Malaysia. The results of this study are crucial to implementing climate changes as a factor to reduce any future outbreaks.

Keywords: climate change, typhoid, hepatitis A, dysentery, food poisoning

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1450 Telling the Truth to Patients Before Hip Fracture Surgery

Authors: Rawan Masarwa, Merav Ben Natan, Yaron Berkovich

Abstract:

Background: Hip fracture repair surgery carries a certain mortality risk, yet evidence suggests that orthopedic surgeons often refrain from discussing this issue with patients prior to surgery. Aim: This study aims to examine whether orthopedic surgeons address the issue of one-year post-surgery mortality before hip fracture repair surgery and to explore the factors influencing this decision. Method: The study uses a cross-sectional design, administering validated digital questionnaires to 150 orthopedic surgeons. Results: A minority of orthopedic surgeons reported consistently informing patients about the risk of mortality in the year following hip fracture surgery. The primary reasons for not discussing this risk were a desire to avoid frightening patients, time constraints, and concerns about undermining patient hope. Surgeons reported a medium-high level of perceived self-efficacy, with higher self-efficacy linked to a reduced likelihood of discussing one-year mortality risk. In contrast, older age and holding a specialist status in orthopedic surgery were associated with a higher likelihood of discussing this risk with patients. Conclusions: The findings suggest a need for interventions to address communication barriers and ensure consistent provision of essential information to patients undergoing hip fracture surgery. Additionally, they emphasize the importance of considering individual factors such as self-efficacy, age, and expertise in developing strategies to enhance patient-provider communication in orthopedic care settings.

Keywords: orthopedic surgeons, hip fracture surgery, mortality risk communication, patient information

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1449 The Role of Community Participation in the Socialization of the Child within the Saudi Family in Riyadh City

Authors: Ohoud Abdullatif Alshaiji

Abstract:

Child-rearing is considered as the most important family role and with the modern lifestyle and busy families social institutions has taken this role from the family to encourage the individuals active's role in the social life, this study aimed to acknowledge the contributions of the social institutions in child-rearing the Saudi children and to acknowledge The Role of the community's partnership in activating the social child-rearing for the Saudi children. The research main question was how much the community's partnership is actually participating in activating the process of the social development of the Saudi children. The importance of this study comes from the massive care that has been given from all over the world, children international organizations, and this research is focusing on the participating of five social organization in child-rearing the Saudi children. The study was limited on the mothers of the children who are enrolled in the government's kindergarten the tool that has been used was the Questionnaire, using the descriptive and analytical approach. The important role of the family in encouraging the social development for the Saudi child, and the results has shown the importance of the mosque in encouraging the good social behaviors. And the kindergarten role has shown after the mosque because of the changes that made most of the families relying on the educational institutions to help the child to adapt in a different cultures. To spread the community's partnership in all the social actions, to support and encourage the role of community's partnership in activating the process of the social development of the Saudi children, to minimize the difficulties and the provide the need to fully support the community's partnership.

Keywords: child-rearing, social development, acknowledge the contributions

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1448 Patient’s Knowledge and Use of Sublingual Glyceryl Trinitrate Therapy in Taiping Hospital, Malaysia

Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md. Saad

Abstract:

Introduction & objective: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: glyceryl trinitrate, knowledge, adherence, patient education

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1447 Rate, Indication and Outcome of Operative Vaginal Delivery at Mayo University Hospital 2022

Authors: Mohammed Mustafa, Fatima Abusin, Mariam Abufatema

Abstract:

Objective: This audit aims to evaluate the practices and outcomes of operative vaginal deliveries (OPVD) at Mayo University Hospital, focusing on identifying trends, complications, and adherence to clinical guidelines. Methods: A retrospective review was conducted on all cases of operative vaginal deliveries at Mayo University Hospital over one year. Data was collected from patient records, including demographics, OPVD indications, types of instruments used (forceps or vacuum), maternal and neonatal outcomes, and any associated complications. Statistical analyses were performed to assess the rates of successful and unsuccessful OPVDs and identify factors influencing outcomes. Results: The study included 159 [out of 174 total OPVD in 1 year] cases of operative vaginal deliveries. The indications predominantly consisted of the prolonged second stage of labor, fetal distress and suspicious CTG. The success rate of OVD was [97.5%]; maternal perineal tears [10 cases], hemorrhage[43 cases] and neonatal outcomes needed for SCBU admission[12 cases] were also assessed. Conclusion: This audit provides insights into the current practices and outcomes of operative vaginal deliveries at Mayo University Hospital. The findings underline the importance of adherence to clinical guidelines and highlight areas for potential improvement in practice

Keywords: OPVD operative vaginal delivery, GTG green top guidelines, PPH postpartum hemorrhage, SCBU special care baby unit

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1446 Spatial Analysis of the Socio-Environmental Vulnerability in Medium-Sized Cities: Case Study of Municipality of Caraguatatuba SP-Brazil

Authors: Katia C. Bortoletto, Maria Isabel C. de Freitas, Rodrigo B. N. de Oliveira

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The environmental vulnerability studies are essential for priority actions to the reduction of disasters risk. The aim of this study is to analyze the socio-environmental vulnerability obtained through a Census survey, followed by both a statistical analysis (PCA/SPSS/IBM) and a spatial analysis by GIS (ArcGis/ESRI), taking as a case study the Municipality of Caraguatatuba-SP, Brazil. In the municipal development plan analysis the emphasis was given to the Special Zone of Social Interest (ZEIS), the Urban Expansion Zone (ZEU) and the Environmental Protection Zone (ZPA). For the mapping of the social and environmental vulnerabilities of the study area the exposure of people (criticality) and of the place (support capacity) facing disaster risk were obtained from the 2010 Census from the Brazilian Institute of Geography and Statistics (IBGE). Considering the criticality, the variables of greater influence were related to literate persons responsible for the household and literate persons with 5 or more years of age; persons with 60 years or more of age and income of the person responsible for the household. In the Support Capacity analysis, the predominant influence was on the good household infrastructure in districts with low population density and also the presence of neighborhoods with little urban infrastructure and inadequate housing. The results of the comparative analysis show that the areas with high and very high vulnerability classes cover the classes of the ZEIS and the ZPA, whose zoning includes: Areas occupied by low-income population, presence of children and young people, irregular occupations and land suitable to urbanization but underutilized. The presence of zones of urban sprawl (ZEU) in areas of high to very high socio-environmental vulnerability reflects the inadequate use of the urban land in relation to the spatial distribution of the population and the territorial infrastructure, which favors the increase of disaster risk. It can be concluded that the study allowed observing the convergence between the vulnerability analysis and the classified areas in urban zoning. The occupation of areas unsuitable for housing due to its characteristics of risk was confirmed, thus concluding that the methodologies applied are agile instruments to subsidize actions to the reduction disasters risk.

Keywords: socio-environmental vulnerability, urban zoning, reduction disasters risk, methodologies

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1445 Knowledge-Attitude-Practice Survey Regarding High Alert Medication in a Teaching Hospital in Eastern India

Authors: D. S. Chakraborty, S. Ghosh, A. Hazra

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Objective: Medication errors are a reality in all settings where medicines are prescribed, dispensed and used. High Alert Medications (HAM) are those that bear a heightened risk of causing significant patient harm when used in error. We conducted a knowledge-attitude-practice survey, among residents working in a teaching hospital, to assess the ground situation with regard to the handling of HAM. Methods: We plan to approach 242 residents among the approximately 600 currently working in the hospital through purposive sampling. Residents in all disciplines (clinical, paraclinical and preclinical) are being targeted. A structured questionnaire that has been pretested on 5 volunteer residents is being used for data collection. The questionnaire is being administered to residents individually through face-to-face interview, by two raters, while they are on duty but not during rush hours. Results: Of the 156 residents approached so far, data from 140 have been analyzed, the rest having refused participation. Although background knowledge exists for the majority of respondents, awareness levels regarding HAM are moderate, and attitude is non-uniform. The number of respondents correctly able to identify most ( > 80%) HAM in three common settings– accident and emergency, obstetrics and intensive care unit are less than 70%. Several potential errors in practice have been identified. The study is ongoing. Conclusions: Situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaign with support from the hospital administration.

Keywords: high alert medication, medication error, questionnaire, resident

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1444 Community Health Commodities Distribution of integrated HIV and Non-Communicable Disease Services during COVID-19 Pandemic – Eswatini Case Study

Authors: N. Dlamini, Mpumelelo G. Ndlela, Philisiwe Dlamini, Nicholus Kisyeri, Bhekizitha Sithole

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Accessing health services during the COVID-19 pandemic have exacerbated scarcity to routine medication. To ensure continuous accessibility to services, Eswatini launched Community Health Commodities Distribution (CHCD). Eligible Antiretroviral Therapy(ART) stable clients (VL<1,000) and patients on Non-Communicable Disease (NCD) medications were attended at community pick up points (PUP) based on distance between clients’ residence and the public health facility. Services provided includes ART and Pre-Exposure prophylaxis (PrEP) refills and NCD drug refills). The number of community PUP was 14% higher than health facility visits. Among all medications and commodities distributed between April and October 2020 at the PUP, 64% were HIV-related (HIV rapid test, HIVST, VL test, PrEP meds), and 36% were NCD related. The rapid roll out of CHCD during COVID-19 pandemic reduced the risk of COVID-19 transmission to clients as travel to health facilities was eliminated. It Additionally increased access to commodities during COVID-19-driven lockdown, decongested health facilities, integrated model of care, and increase service coverage. It was also noted that CHCD added different curative and HIV related services based on client specific needs and availability of the commodities.

Keywords: community health commodities distribution, pick up points, antiretroviral therapy, pre-exposure prophylaxis

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1443 Promoting Organizational Learning Facing the Complexity of Public Healthcare: How to Design a Voluntary, Learning-Oriented Benchmarking

Authors: Rachel M. Lørum, Henrik Eriksson, Frida Smith

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Purpose: In recent years, the use of benchmarks for the improvement of healthcare has become increasingly common. There has been an increasing interest in why improvement initiatives so often fail to eliminate the problems they aspire to solve. Benchmarking comes with its fair share of challenges and problems, such as capturing the dynamics and complexities of the care environments, among others. In this study, we demonstrate how learning-oriented, voluntary benchmarks in the complex environment of public healthcare could be designed. Findings: Our four most important findings were the following: first, important organizational learning (OL) regarding the complexity of the service and implications on how to design a benchmark for learning and improvement occurred during the process. Second, participation by a wide range of professionals and stakeholders was crucial for capturing the complexity of people and organizations and increasing the quality of the template. Third, the continuous dialogue between all organizations involved was an important tool for ongoing organizational learning throughout the process. The last important finding was the impact of the facilitator’s role through supporting progress, coordination, and dialogue. Design: We chose participatory design as the research design. Data were derived from written materials such as e-mails, protocols, observational notes, and reflection notes collected during a period of 1.5 years. Originality: Our main contributions are the identification of important strategies, initiatives, and actors to involve when designing voluntary benchmarks for learning and improvement.

Keywords: organizational learning, quality improvement, learning-oriented benchmark, healthcare, patient safety

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