Search results for: skilled nursing

Authors: Eva de Mingo-Fernández, Lourdes Rubio Rico, Carmen Ortega-Segura, Montserrat Querol-García, Raúl González-Jauregui

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Today, one of the great challenges that the university faces is to get closer to society and transfer knowledge. The competency-based training approach favours a continuous interaction between practice and theory, which is why it is essential to establish real experiences with reflection and debate and to contrast them with personal and professional knowledge. Service-learning (SL) consists of an integration of academic learning with service in the community, which enables teachers to transfer knowledge with social value and students to be trained on the basis of experience of real needs and problems with the aim of solving them. SLE combines research, teaching, and social value knowledge transfer with the real social needs and problems of a community. Goal: The objective of this study was to design, implement, and evaluate a service-learning program in the subject of adult nursing for second-year nursing students. Methodology: After establishing collaboration with eight associations of people with different pathologies, the students were divided into eight groups, and each group was assigned an association. The groups were made up of 10-12 students. The associations willing to participate were for the following conditions: diabetes, multiple sclerosis, cancer, inflammatory bowel disease, fibromyalgia, heart, lung, and kidney diseases. The methodological design consisting of 5 activities was then applied. Three activities address personal and individual reflections, where the student initially describes what they think it is like to live with a certain disease. They then express their reflections resulting from an interview conducted by peers, in person or online, with a person living with this particular condition, and after sharing the results of their reflections with the rest of the group, they make an oral presentation in which they present their findings to the other students. This is followed by a service task in which the students collaborate in different activities of the association, and finally, a third individual reflection is carried out in which the students express their experience of collaboration. The evaluation of this activity is carried out by means of a rubric for both the reflections and the presentation. It should be noted that the oral presentation is evaluated both by the rest of the classmates and by the teachers. Results: The evaluation of the activity, given by the students, is 7.80/10, commenting that the experience is positive and brings them closer to the reality of the people and the area.

Keywords: academic learning integration, knowledge transfer, service-learning, teaching methodology

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Authors: Elucir Gir, Myllena Nilce de Freitas Surmano, Laelson Rochelle Milanês Sousa, Mayra Gonçalves Menegueti, Ana Cristina de Oliveira E Silva, Renata Karina Reis

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Objective: To analyze the factors associated with the worsening of the quality of life of health professionals in the Southeast region of Brazil during the COVID-19 pandemic and its associated factors. Method: Analytical cross-sectional study carried out with health professionals from the southeastern region of Brazil. Data collection took place through an online survey with a form stored on the Survey Monkey platform. Bivariate analysis was used, and the chi-square test was adopted, followed by the multiple binary logistic regression model based on the stepwise method. Results: 3,493 health professionals participated in the study. Factors associated with worsening quality of life were: Professional Category (Nursing assistant) [OR 1.851 (95%CI 1.035-3.311) p= 0.038]; types of people who provided care (people in general) [OR 1.445 (95%CI 1.072-1.945) p=0.015]; Supply of good quality PPE by the institution where he works (no) [OR 1.595 (CI 95% 1.144-2.223) p= 0.006] and Supply of good quality PPE by the institution where he works (in part) [OR 1.563 (CI 95% 1.257-1.943) p < 0.001]. Conclusion: The factors associated with the worsening of the quality of life of health professionals during the COVID-19 pandemic were: Professional Category (Nursing assistant); types of people who provided assistance (people in general); Supply of sufficient PPE by the institution where you work (no) and Supply of good quality PPE by the institution where you work (in part). Future studies should investigate to what extent QoL can be improved based on modifiable factors.

Keywords: COVID-19, quality of life, health professionals, respiratory infections

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Authors: Don Buddika Oshadi Malaweera, Lora Harris, Bruce Rathgeber, Chibuike C. Udenigwe, Kirsti Rouvinen-Watt

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Fatty liver disease is among the three most severe health concerns for mink and believed to occur through the same mechanism as nursing sickness. In North America, nursing sickness affects about 45% of mink farms and in Canada, approximately 50,000 mink females is affected annually. Orotic acid (OA) plays a critical role in lipid metabolism and can increase hepatic lipids by enhancing Sterol regulatory element binding protein-1c expression and decreasing Carnitine palmitoyl transferase I activity. This study was conducted to identify particular pathways and regulatory control points involved in fatty liver development, and evaluate the effectiveness of arginine and bioactive peptides for prevention and treatment of fatty liver disease in mink. A total of 45 mink were used in 9 treatments. The experimental diets consisted of 1% OA, 2% L-arginine and 5% of whey protein hydrolysates. At the end of 10 days of experimental period, the mink were anaesthetized, sampled for blood and euthanized, samples were obtained for histological, biochemical and molecular assays. The blood samples will be analyzed for clinical chemistry and triacylglycerol. The liver samples will be analyzed for total lipid content and analyzed for 6 genes of interest involved in adipogenic transformation, ER stress, and liver inflammation.

Keywords: fatty liver, L-arginine, mink, orotic acid, whey protein hydrolysates

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Authors: Marta Fernández Batalla, José María Santamaría García, Maria Lourdes Jiménez Rodríguez, Roberto Barchino Plata, Adriana Cercas Duque, Enrique Monsalvo San Macario

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Background: Primary Care Nursing is taking more autonomy in clinical decisions. One of the most frequent therapies to solve is related to the problems of maintaining a sufficient supply of food. Nursing diagnoses related to food are addressed by the nurse-family and community as the first responsible. Objectives and interventions are set according to each patient. To improve the goal setting and the treatment of these care problems, a technological tool is developed to help nurses. Objective: To evaluate the computational tool developed to support the clinical decision in feeding problems. Material and methods: A cross-sectional descriptive study was carried out at the Meco Health Center, Madrid, Spain. The study population consisted of four specialist nurses in primary care. These nurses tested the tool on 30 people with ‘need for nutritional therapy’. Subsequently, the usability of the tool and the satisfaction of the professional were sought. Results: A simple and convenient computational tool is designed for use. It has 3 main entrance fields: age, size, sex. The tool returns the following information: BMI (Body Mass Index) and caloric consumed by the person. The next step is the caloric calculation depending on the activity. It is possible to propose a goal of BMI or weight to achieve. With this, the amount of calories to be consumed is proposed. After using the tool, it was determined that the tool calculated the BMI and calories correctly (in 100% of clinical cases). satisfaction on nutritional assessment was ‘satisfactory’ or ‘very satisfactory’, linked to the speed of operations. As a point of improvement, the options of ‘stress factor’ linked to weekly physical activity. Conclusion: Based on the results, it is clear that the computational tools of decision support are useful in the clinic. Nurses are not only consumers of computational tools, but can develop their own tools. These technological solutions improve the effectiveness of nutrition assessment and intervention. We are currently working on improvements such as the calculation of protein percentages as a function of protein percentages as a function of stress parameters.

Keywords: feeding behavior health, nutrition therapy, primary care nursing, technology assessment

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Authors: Wannee Sutthachaidee

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The study of the production process of coconut-shell product in Amphawa, Samutsongkram Province is objected to study the pattern of the process of coconut-shell product by focusing in the 3 main processes which are inbound logistics process, production process and outbound process. The result of the research: There were 4 main results from the study. Firstly, most of the manufacturer of coconut-shell product is usually owned by a single owner and the quantity of the finished product is quite low and the main labor group is local people. Secondly, the production process can be divided into 4 stages which are pre-production process, production process, packaging process and distribution process. Thirdly, each 3 of the logistics process of coconut shell will find process which may cause the problem to the business but the process which finds the most problem is the production process because the production process needs the skilled labor and the quantity of the labor does not match with the demand from the customers. Lastly, the factors which affect the production process of the coconut shell can be founded in almost every process of the process such as production design, packaging design, sourcing supply and distribution management.

Keywords: production process, coconut-shell product, Amphawa District, inbound logistics process

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Authors: Nabil A. Albaser

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Background: There is a serious problem with adverse drug reactions (ADRs) everywhere, including Yemen. Since it helps with the detection, assessment, reporting and prevention of ADRs, pharmacovigilance (PV) is an essential part of the healthcare system. The unbiased reporting of ADRs remains the foundation of PV. Students majoring in healthcare should acquire the knowledge and skills necessary to conduct PV in a range of clinical settings. The primary objective of this study was to evaluate the understanding and attitudes of final-year Pharmacy, Nursing, and Midwifery students at Al-Razi University in Sana'a, Yemen, regarding PV and ADRs reporting. Methods: The study followed descriptive cross-sectional approach. A validated, self-administered questionnaire with three parts—demographic information, knowledge, and perceptions of Pharmacovigilance was online distributed to final-year Pharmacy, Nursing, and Midwifery students. The questionnaire was given to 175 students; 122 of them responded with a percentage (69.7%). Results: The majority of respondents were male (79.5%). More than the tow-third of the students, 68.9%, were beyond the age of 23. Although the majority of students, 80%, heard about the terms of ADRs and PV, but only 50% and 57.4% of the respondents, respectively, could define the both terms correctly. However, only 11.48 % of them, nevertheless, took a PV course. More than a half of them (56.6%) had a positive perceptions towards pharmacovigilance and ADR reporting and had a moderate degree of knowledge (68.9%). Conclusion: The study demonstrated that the participants lacked sufficient knowledge of pharmacovigilance and ADR reporting. They showed a moderate level of understanding of reporting ADRs as well as a favorable opinion of dealing with and reporting ADRs. Yemen's health care curriculum should include lessons on pharmacovigilance.

Keywords: adverse drug reaction reporting, pharmacovigilance, yemen, knowlegde

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Authors: Okoro Ngozi Priscilla

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Education is the bedrock of development in every nation of the world, and it is very useful in ensuring quality of life for every individual and a better world for the people. Education, therefore, is the basic instrument of economic growth and technological advancement in any society. It is in recognition of this fact that the Nigerian government commits immense resources to ensuring that its citizens acquire education and also policies are being made to ensure the accessibility of education, qualitative higher education is highly recognized as a vital driving force for the socio-economic growth and technological development of nations yet the problem of access to University education in the country persists and therefore brought about the introduction of Open and Distance Learning (ODL) which has as its main objective, the attainment of mass literacy and providing opportunities for those who could not gain admission through designated entrance examination agencies as well as those who could not afford to leave their job to attend a full-time educational programme. Open and distance learning seeks to improve skilled manpower and also improve the skills for those already at work.

Keywords: accessibility, open and distant learning programme, fulltime educational programme, distance learning

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Authors: Magda Milleyde de Sousa Lima, Letícia Lima Aguiar, Marina Guerra Martins, Erika Veríssimo Dias Sousa, Lizandra Sampaio de Oliveira, Lívia Moreira Barros, Joselany Áfio Caetano

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Patients with chronic kidney disease are vulnerable to episodes which make the safety of their health vulnerable, mainly due to the treatment process that exposes them to high rates of interventions during hemodialysis sessions. Some factors associated with health care contribute to the risk of death and complications. However, there are a small number of scientific studies evaluating the level of safety of hemodialysis clinics, and the sociodemographic characteristics of patients and professionals associated with this safety. Therefore, the present study aims to examine the level of patient safety in hemodialysis clinics in the Brazilian capital, to identify the sociodemographic and clinical factors of patients and nursing staff associated with the level of safety. This is an observational, descriptive and quantitative research conducted in three hemodialysis clinics placed in the city of Fortaleza-CE, Brazil, from September to November 2019. The sample was formed after a sample calculation for finite inhabitants of correlation with 200 chronic renal patients, 30 nursing technicians and seven nurses. Conventional sampling was used based on the inclusion criteria: being present at the hemodialysis session on the day the researcher performed the data collection and being 18 years of age or older. Participants who presented communication difficulties to listen to and/or answer the sociodemographic and clinical questionnaire were excluded. Two instruments were applied: sociodemographic and clinical characterization form and Chronic Renal Patient Safety Assessment Scale on Hemodialysis (EASPRCH). The data were analyzed using the Kruskal Walls Test for categorical variables and Spearman correlation coefficient for non-categorical variables, using the Statistical Package SPSS version 20.0. The present study respected the ethical and legal principles determined by resolution 466/2012 of the National Health Council, under the approval of the Ethics and Research Committee with an opinion number: 3,255,635. The results showed that a hemodialysis clinic presented unsafe care practices of 32 points in the EASPRCH (p=0.001). A statistical association was identified between the level of safety and the variables of the patients: level of education (p=0.018), family income (p=0.049), type of employment (p=0.012), venous access site (p=0.009), use of medication during the session (p=0.008) and time of hemodialysis (p=0.002). When evaluating the profile of nurses, a statistical association was evidenced between the level of safety with the variables: marital status (p=0.000), race (p=0.017), schooling (p= 0.000), income (p=0.013), age (p=0.000), clinic workload (p=0.000), time working with hemodialysis (p=0.000), time working in the clinic (p= 0.007) and clinic sizing (p=0.000). In order, the sociodemographic factors of nursing technicians associated with the level of patient safety were: race (p= 0.001) and weekly workload at (p=0.010). Therefore, it is concluded that there is a non-conformity in the level of patient safety in one of the clinics studied and, that sociodemographic and clinical factors of patients and health professionals corroborate the level of safety of the health unit.

Keywords: hemodialysis, nursing, patient safety, quality improvement

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Authors: Rusmawati Said, N. Kar Yee, Asmaddy Haris

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This study employs a panel data set of ASEAN member states, 17 European Union (EU) countries, 7 American countries and 11 other Asia Pacific countries (China Mainland and Hong Kong SAR are treated as two separated countries) to investigate the role of labour standards in explaining the pattern of bilateral migration flows in ASEAN. Using pooled Ordinary Least Square (OLS) this study found mixed results. The result varies on how indicators were used to measure the level of labour standards in the empirical analysis. In one side, better labour standards (represented by number of strikes and weekly average working hours) promote bilateral migration among the selected countries. On the other side, increase in cases of occupational injuries lead to an increase in bilateral migration, reflecting that worsen in working conditions do not influence the workers’ decision from moving. The finding from this study become important to policy maker as the issues of massive low skilled workers have a significant impact to the role of labour standard in shaping the migration flows.

Keywords: labour standard, migration, ASEAN, economics and financial engineering

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Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

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An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: emergency nurses, nursing care, workload, work sampling

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Authors: Rana Alkattan

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Aim: This study aims to identify and analyze the factors predicting the professional clinical competency among newly recruited registered nurses. In addition, it aims to explore factors significantly correlated with high and low professional clinical competency score. Method: A descriptive analytical is applied in this study, cross-sectional which conducted between June 2012 and June 2013 at King Abdulaziz University Hospital, as one of the largest governmental university tertiary Hospital in Saudi Arabia. A survey questionnaire was designed to collect data. And then, data were analyzed using the SPSS. Results: A total of the 86 nurses provided valid responses. 69 were female and 17 were male. The majority of the participants in this study were married, from the Philippines, between 20-29 years old. The majority had certified university bachelor’s degree in nursing, as well as had prior experience in nursing between 1 to 5 years. There are two categories emerged from the data, which significantly correlated with nurses' professional competence and development. The first was the newly employed registered nurses demographic characteristic (correlation coefficients 0.154 to 0.470, P < 0.05), while the second was the list of studied environmental factors except 'job rotation factor' (correlation coefficients 0.122 to 0.540, P < 0.01). However, nurses' attitude including motivation and confidence were not associated with nurse's professional competency. Conclusion: that nurses' professional competence development is a process affected by certain personal demographic and environmental factors which will enable newly graduates nurses to provide safe effective patients' care and maintain their career responsibilities.

Keywords: clinical, competence, development nurses professional, registered

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Authors: Gunawan Prayitno, Kakuya Matshusima, Kiyoshi Kobayashi

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Indonesia’s rural regions are characterized by wide-spread poverty, under-employment, and surplus of low-skilled labor. The aim of this paper is to empirically prove the effect of social ties (strong and weak tie) as social capital construct on households’ migration decision in the case of developing country (Indonesia). The methodology incorporated indicators of observe variables (four demographic attributes data: income, occupation, education, and family members) and indicators of latent variables (ties to neighbors, ties to community and sense of place) provided by responses to survey questions to aid in estimating the model. Using structural equation model that we employed in Mplus program, the result of our study shows that ties to community positively have a significant impact to the decision of respondents (migrate or not). Besides, education as observed variable directly influences the migration decisions. It seems that higher level of education have impact on migration decision. Our current model so far could explain the relation between social capital and migration decision choice.

Keywords: migration, ties to community, ties to neighbors, education

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Authors: R. Khoza, K. K. Govender

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The aim of the study was to review and critically evaluate the supply chain management (SCM) strategies and challenges in the private residential construction sector in South Africa. The study was grounded in three theories, namely, theory of constraints, principal-agency theory, and stakeholder theory. A quantitative approach was used to survey 320 private residential construction companies which registered with the National Homebuilders Registration Council (NHBRC) within the Gauteng province. The data from 250 questionnaires returned were analysed using SPSS (Versions 23) and Smart PLS. It became evident that the SCM challenges included lack of trust between the supplier and the organization; lack of adoption of SCM system; lack of a sufficiently skilled SCM workforce; and poor implementation of contract management. The findings also indicate that there is a significant positive relationship between the performance of the private residential construction sector in South Africa and SCM challenges, SCM strategies and SCM processes. A framework is proposed comprising SCM practices and strategies of private residential construction sector in South Africa, which will enable them to enhance performance.

Keywords: management challenges, residential housing, South Africa, supply chain management

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Authors: Piyush Swami, Bijaya Ketan Panigrahi, Sneh Anand, Manvir Bhatia, Tapan Gandhi

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Visual inspection of electroencephalogram (EEG) signals to detect epileptic signals is very challenging and time-consuming task even for any expert neurophysiologist. This problem is most challenging in under-developed and developing countries due to shortage of skilled neurophysiologists. In the past, notable research efforts have gone in trying to automate the seizure detection process. However, due to high false alarm detections and complexity of the models developed so far, have vastly delimited their practical implementation. In this paper, we present a novel scheme for epileptic seizure detection using empirical mode decomposition technique. The intrinsic mode functions obtained were then used to calculate the standard deviations. This was followed by probability density based classifier to discriminate between non-ictal and ictal patterns in EEG signals. The model presented here demonstrated very high classification rates ( > 97%) without compromising the statistical performance. The computation timings for each testing phase were also very low ( < 0.029 s) which makes this model ideal for practical applications.

Keywords: electroencephalogram (EEG), epilepsy, ictal patterns, empirical mode decomposition

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Authors: Danny Hjeij, Karine Bilodeau, Caroline Arbour

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Background: Chemotherapy infusions often lead to a cluster of co-occurring and difficult-to-treat symptoms (nausea, tingling, etc.), which may negatively impact the treatment experience at the outpatient clinic. Although several complementary approaches have shown beneficial effects for chemotherapy-induced symptom management, they are not easily implementable during chemotherapy infusion. In response to this limitation, comfort talk (CT), a simple, fast conversational method inspired by the language principles of clinical hypnosis, is known to optimize the management of symptoms related to antineoplastic treatments. However, the perception of nurses who have had to integrate this practice into their care has never been documented. Study design: A qualitative descriptive study with iterative content analysis was conducted among oncology nurses working in a chemotherapy outpatient clinic who had previous experience with CT. Semi-structured interviews were conducted by phone, using a pre-tested interview guide and a sociodemographic survey to document their perception of CT. The conceptual framework. Results: A total of six nurses (4 women, 2 men) took part in the interviews (N=6). The average age of participants was 49 years (36-61 years). Participants had an average of 24 years of experience (10-38 years) as a nurse, including 14.5 years in oncology (5-32 years). Data saturation (i.e., redundancy of words) was observed around the fifth interview. A sixth interview was conducted as confirmation. Six themes emerged: two addressing contextual and organizational obstacles at the chemotherapy outpatient clinic, and three addressing the added value of CT for oncology nursing care. Specific themes included: 1) the outpatient oncology clinic, a saturated care setting, 2) the keystones that support the integration of CT into care, 3) added value for patients, 4) a positive and rewarding experience for nurses, 5) collateral benefits, and 6) CT an approach to consider during the COVID-19 pandemic. Conclusion: For the first time, this study describes nurses' perception of the integration of CT into the care surrounding the administration of chemotherapy at the outpatient oncology clinic. In summary, contextual and organizational difficulties, as well as the lack of training, are among the main obstacles that could hinder the integration of CT in oncology. Still, the experience was reported mostly as positive. Indeed, nurses saw HC as an added value to patient care and meeting their need for holistic care. HC also appears to be beneficial for patients on several levels (for pain management in particular). Results will be used to inform future knowledge transfer activities related to CT in oncology nursing.

Keywords: cancer, chemotherapy, comfort talk, oncology nursing role

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Authors: P. Mbecke

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Developmental social welfare implemented through developmental social work is being applauded internationally as an approach that facilitates social development theory and practice. However, twenty-two years into democracy, there are no tangible evidences that the much-desired developmental social welfare approach has assisted the post-apartheid macroeconomic policy frameworks in addressing poverty and inequality, thus, the derailment of the post-apartheid development approach in South Africa. Based on the implementation research theory, and the literature review technique, this paper recognizes social work as a principal role-player in social development. It recommends the redesign and implementation of an effective developmental social welfare approach with specific strategies, programs, activities and sufficient resources aligned to and appropriate in delivering on the promises of the government’s macroeconomic policy frameworks. Such approach should be implemented by skilled and dedicated developmental social workers in order to achieve transformation in South Africa.

Keywords: apartheid, developmental social welfare, developmental social work, inequality, poverty alleviation, social development, South Africa

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Authors: Pinar Dogan, Merve Tarhan, Ahu Kurklu

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Syrian refugees who sheltering due to war has protected by the Government of Turkey since 2011. Since Syria was a medium-low income country prior to the war, it is known that chronic health problems weren’t common among citizens. However, it is also known that they frequently use health services in our country because of the spread of infectious and acute diseases due to insufficient sanitation and crowding after the war. This study was planned to compare the social distances of the community against the Syrian refugees and the perceptions of accessing health care services. The descriptive-cross sectional study was carried out on 1262 individuals living in Istanbul. A questionnaire form consisted of Personal Information Form, The Bogardus Social Distance Scale (BSDS) and The Survey of Access to Healthcare Services (AHS) was used as data collection tool. Descriptive tests and chi-square test were used for statistical analysis. It was found that the majorities of participants was satisfied with the health services and were waiting for more than 40 minutes to be examined. It was determined that participants have high scores from BSDS. At the same time, the majority of participants stated that their level of access to health care is diminishing due to refugees. Participants who experienced disruption in access to health services due to refugees were found to have higher scores from BSDS. The data collection process in the study will continue until 2400 individuals are reached. With these conclusions, it is considered necessary that the effect of the presence of the refugees in reaching the health services and nursing care of the society should be revealed through extensive researches to be conducted in Turkey.

Keywords: health care services, nursing care, social distances, Syrian refugees

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Authors: Julia Reinold, Inge Hooijen, Christoph Meng, Melissa Siegel

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This paper investigates whether or not students intend to stay in the Euregio Meuse-Rhine (EMR) after graduation taking into account the role of hard and soft locational factors, social factors as well as demographic aspects in shaping their mobility preferences. Since graduates are considered a convenient source of human capital in today’s knowledge based economy, it is crucial to understand what drives their mobility intentions in order to retain larger numbers of graduates. This is particularly true for peripheral regions, which need to compete with assumed more attractive economic centres. This paper adds a euregional perspective to the existing literature on graduate migration. Using survey data from 2015 from five higher education institutions in the EMR, this paper finds that mobility intentions are determined by students’ perceptions of the quality of life, openness and career opportunities in the euroregion. In addition, distance to the partner and other social ties such as family and friends influence migration intentions.

Keywords: Euroregion, graduate migration, highly skilled migration, human capital

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Authors: Gholamreza Madad

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The role of medical equipment in modern advanced hospitals is irrefutable. Despite limited financial resources, developing countries have taken an uncontrollable manner to the purchase of complex and expensive equipment, although they have not taken good maintenance to keep these huge capitals. In our country, limited studies have indicated that the irregularities exist in the management of medical equipment maintenance. Research method: The research was done as a cross-sectional one, and in this study, a questionnaire was used to collect data in 10 hospitals. After distributing and collecting questionnaires in person, the collected data were analyzed using descriptive statistics and SPSS software. Research findings: According to the obtained results from the four dimensions of the management of medical equipment maintenance, only (maintenance planning) was in a moderate position and other components with a score of less than 50% were at a low level. There was a direct relationship between the total score of maintenance management and guidance points and coordination of medical equipment maintenance, and as well as the age of hospital managers. Discussion and conclusion: In sum, we can say that problems such as lack of skilled staff in medical engineering departments of hospitals, lack of funds and unaware of the authorities of medical engineering units to their duties have caused that the maintenance situation of medical equipment maintenance is in poor condition (near average). The low inexperience of the authorities of the unit has also contributed to this problem.

Keywords: equipment, maintenance, medical equipment, hospitals

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Authors: Ridha Abdulla Al Hammam

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Purpose: to measure the extent of perceived structural empowerment and work commitment the intensive care unit in SMC have in their work place. Background: nurses’ access to power structures (information, recourses, opportunity, and support) directly influences their productivity, retention, and job satisfaction. Exploring nurses’ level and sources of work commitment (affective, normative, and continuance) is very essential to guide nursing leaders making decisions to improve work environment to facilitate effective nursing care. Both concepts (Structural Empowerment and Work Commitment) were never investigated in our critical care unit. Methods: a sample of 50 nurses attained from the Intensive Care Unit (Adult). Conditions for Workplace Effectiveness Questionnaire and Three-Component Model Employee Commitment Survey were used to measure the two concepts respectively. The study is quantitative, descriptive, and correlational in design. Results: the participants reported moderate structural empowerment provided by their work place (M=15 out of 20). The sample perceived high access to opportunity mainly through gaining more skills (M=4.45 out of 5) where the rest power structures were perceived with moderate accessibility. The participants’ affective commitment (M=5.6 out of 7) to work in the ICU overweighed their normative and continuance commitment (M=5.1, M=4.9 out of 7) implying a stronger emotional connection with their unit. Strong positive and significant correlations were observed between the participants’ structural empowerment scores and all work commitment sources. Conclusion: these results provided an insight on aspects of work environment that need to be fostered and improved in our intensive care unit which have a direct linkage to nurses’ work commitment and potentially to their quality of care they provide.

Keywords: structural empowerment, commitment, intensive care, nurses

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Authors: Corbel Camille, Le Cerf Flora, Corveleyn Xavier

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Introduction: Aging is a physiological phenomenon accompanied by anatomical and cognitive changes leading to anxiety and pain. This could have significant impacts on quality of life, life expectancy, and the progression of cognitive disorders. Virtual Reality Intervention (VRI) is increasingly recognized as a non-pharmacological approach to alleviate pain and anxiety in children and young adults. However, while recent studies have explored the feasibility of applying VRI in the older population, confirmation through studies is still required to establish its benefits in various contexts. Objective: This pilot study, following a clinical trial methodology international recommendation for VRI in healthcare, aims to evaluate the feasibility and effects of using VRI with a 101-year-old woman residing in a nursing home undergoing weekly painful and anxious wound dressing changes. Methods: Following the international recommendations, this study focused on feasibility and preliminary results. A Single Case Experimental Design protocol consists of two distinct phases: control (Phase A) and personalized VRI (Phase B), each lasting for 6 sessions. Data were collected before, during and after the care, using measures of pain (Algoplus and numerical scale), anxiety (Hospital anxiety scale and numerical scale), VRI experience (semi-structured interview) and physiological measures. Results: The results suggest that the utilization of VRI is both feasible and well-tolerated by the participant. VRI contributed to a decrease in pain and anxiety during care sessions, with a more significant impact on pain compared to anxiety, which showed a gradual and slight decrease. Physiological data, particularly those related to stress, also indicate a reduction in physiological activity during VRI. Conclusion: This pilot study confirms the feasibility and benefits of using virtual reality in managing pain and anxiety in an older adult in a nursing home. In light of these results, it is essential that future studies focus on setting up randomized controlled trials (RCTs). These studies should involve a representative number of older adults to ensure generalizable data. This rigorous, controlled methodology will enable us to assess the effectiveness of virtual reality more accurately in various care settings, measure its impact on clinical parameters such as pain and anxiety, and explore the long-term implications of this intervention.

Keywords: anxiety reduction, nursing home, older adult, pain management, virtual reality

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Authors: Manana Lobzhanidze

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The COVID-19 pandemic has made significant changes in migration processes, notably changes in the study migration process. The constraints caused by the COVID-19 pandemic led to changes in the studying process, which negatively affected its efficiency. The educational process has partially or completely shifted to distance learning; Both labor and study migration have increased significantly in the world. The employment and education market has become global and consequently, a number of challenges have arisen for employers, researchers, and businesses. The role of preparing qualified personnel in achieving high productivity is justified, the benefits for employers and employees are assessed on the one hand, and the role of study migration for the country’s development is examined on the other hand. Research methods. The research is based on methods of analysis and synthesis, quantitative and qualitative, groupings, relative and mean quantities, graphical representation, comparison, analysis and etc. In-depth interviews were conducted with experts to determine quantitative and qualitative indicators. Research findings. Factors affecting study migration are analysed in the paper and the environment that stimulates migration is explored. One of the driving forces of migration is considered to be the desire for receiving higher pay. Levels and indicators of study migration are studied by country. Comparative analysis has found that study migration rates are high in countries where the price of skilled labor is high. The productivity of individuals with low skills is low, which negatively affects the economic development of countries. It has been revealed that students leave the country to improve their skills during study migration. The process mentioned in the article is evaluated as a positive event for a developing country, as individuals are given the opportunity to share the technology of developed countries, gain knowledge, and then introduce it in their own country. The downside of study migration is the return of a small proportion of graduates from developed economies to their home countries. The article concludes that countries with emerging economies devote less resources to research and development, while this is a priority in developed countries, allowing highly skilled individuals to use their skills efficiently. The paper studies the national education system examines the level of competition in the education market and the indicators of educational migration. The level of competition in the education market and the indicators of educational migration are studied. The role of qualified personnel in achieving high productivity is substantiated, the benefits of employers and employees are assessed on the one hand, and the role of study migration in the development of the country is revealed on the other hand. The paper also analyzes the level of competition in the education and labor markets and identifies indicators of study migration. During the pandemic period, there was a great demand for the digital technologies. Open access to a variety of comprehensive platforms will significantly reduce study migration to other countries. As a forecast, it can be said that the intensity of the use of e-learning platforms will be increased significantly in the post-pandemic period. The paper analyzes the positive and negative effects of study migration on economic development, examines the challenges of study migration in light of the COVID-19 pandemic, suggests ways to avoid negative consequences, and develops recommendations for improving the study migration process in the post-pandemic period.

Keywords: study migration, COVID-19 pandemic, factors affecting migration, economic development, post-pandemic migration

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Authors: Kimiyo Shimomai, Mihoko Harada

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This study is a literature review of the psychological reactions that occur in end-of-life cancer patients who are nearing death. It searched electronic databases and selected literature related to psychological studies of end-of-life patients. There was no limit on the search period, and the search was conducted until the second week of December 2021. The keywords were specified as “death and dying”, “terminal illness”, “end-of-life”, “palliative care”, “psycho-oncology” and “research”. These literatures referred to Holly (2017): Comprehensive Systematic Review for Advanced Practice Nursing, P268 Figure 10.3 to ensure quality. These literatures were selected with a dissertation score of 4 or 5. The review was conducted in two stages with reference to the procedure of George (2002). First, these references were searched for keywords in the database, and then relevant references were selected from the psychology and nursing studies of end-of-life patients. The number of literatures analyzed was 76 for overseas and 17 for domestic. As for the independent variables, "physical variable" was the most common in 36 literatures (66.7%), followed by "psychological variable" in 35 literatures (64.8%), "spiritual variable" in 21 literatures (38%), and "social variable" in 17 literatures. (31.5%), "Variables related to medical care / treatment" were 16 literatures (29.6%). To summarize the relationship between these independent variables and the dependent variable, when the dependent variable is "psychological variable", the independent variables are "psychological variable", "social variable", and "physical variable". Among the independent variables, the physical variables were the most common. The psychological responses that occur in end-stage cancer patients who are nearing death are mutually influenced by psychological, social, and physical variables. Therefore, it supported the "total pain" advocated by Cicely Saunders.

Keywords: cancer patient, end-of-life, literature review, psychological process

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Authors: Lagnajeet Mohanty, Mohnish Mishra, Pratham Tapdiya, Himanshu Sekhar Nayak, Swetapadma Singh

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In the era of global interconnectedness, effective risk assessment and management are critical for organizational resilience. This review explores the integration of machine learning (ML) into risk processes, examining its transformative potential and the challenges it presents. The literature reveals ML's success in sectors like consumer credit, demonstrating enhanced predictive accuracy, adaptability, and potential cost savings. However, ethical considerations, interpretability issues, and the demand for skilled practitioners pose limitations. Looking forward, the study identifies future research scopes, including refining ethical frameworks, advancing interpretability techniques, and fostering interdisciplinary collaborations. The synthesis of limitations and future directions highlights the dynamic landscape of ML in risk management, urging stakeholders to navigate challenges innovatively. This abstract encapsulates the evolving discourse on ML's role in shaping proactive and effective risk management strategies in our interconnected and unpredictable global landscape.

Keywords: machine learning, risk assessment, ethical considerations, financial inclusion

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Authors: Mary Therese G. Caluna, Mark Justin B. Campanero, Erlin Maris T. Cantiller, Claudine Mae A. Cantillo, Nerissa L. Caño

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Objective: The study determined the effectiveness of cold tomato paste in relieving pain caused by exacerbation of arthritis in the elderly, specifically on clients 60 years old and above. The study focused on alternative, cost-effective and non-pharmacological techniques in relieving pain experienced by the older people with osteoarthritis and rheumatoid arthritis. Methods: Using purposive non-probability sampling, the researchers gathered a total number of 40 subjects that passed the inclusion criteria provided by the researchers. The subjects were divided into two groups, experimental group (20 subjects) and control groups (20 subjects). The Numeric Rating 11-point Scale (NRS-11) was utilized to assess the pain level of the subject prior the application of the treatment and after the application of the treatment. Key findings: There is a significant difference in the pain levels of the experimental group before and after the application of cold tomato paste. This indicates that that the application of cold tomato paste alleviates the pain experienced by elderly clients with exacerbation of arthritis. Conclusion: The effectiveness of cold tomato paste in relieving pain experienced by elderly clients who are in exacerbation of arthritis was proven to be evidence-based. The cold tomato paste application has significant impact in the field of nursing and therefore, can be used in both clinical trials and practices. The effectiveness of cold tomato application promotes innovation in the field of nursing, thus encouraging further researches regarding other uses of tomato and other herbal interventions to relieve the pain caused by osteoarthritis and rheumatoid arthritis.

Keywords: alternative therapy, arthritis, cold tomato paste, elderly clients, exacerbation

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Authors: Jennifer Wheeldon, Nick de Viggiani, Nikki Cotterill

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Background: Urinary and fecal incontinence affect a significant proportion of older adults aged 65 and over who permanently reside in residential and nursing home facilities. Incontinence symptoms have been linked to comorbidities, an increased risk of infection and reduced quality of life and mental wellbeing of residents. However, continence care provision can often be poor, further compromising the health and wellbeing of this vulnerable population. Objectives: To identify experiences and perceptions of continence care provision in older adult residential care settings and to identify factors that help or hinder good continence care provision. Settings included both residential care homes and nursing homes for older adults. Methods: A qualitative evidence synthesis using systematic review methodology established the current evidence-base. Data from 20 qualitative and mixed-method studies was appraised and synthesized. Following the review process, 10* qualitative interviews with staff working in older adult residential care settings were conducted across six* sites, which included registered managers, registered nurses and nursing/care assistants/aides. Purposive sampling recruited individuals from across England. Both evidence synthesis and interview data was analyzed thematically, both manually and with NVivo software. Results: The evidence synthesis revealed complex barriers and facilitators for continence care provision at three influencing levels: macro (structural and societal external influences), meso (organizational and institutional influences) and micro (day-to-day actions of individuals impacting service delivery). Macro-level barriers included negative stigmas relating to incontinence, aging and working in the older adult social care sector, restriction of continence care resources such as containment products (i.e. pads), short staffing in care facilities, shortfalls in the professional education and training of care home staff and the complex health and social care needs of older adult residents. Meso-level barriers included task-centered organizational cultures, ageist institutional perspectives regarding old age and incontinence symptoms, inadequate care home management and poor communication and teamwork among care staff. Micro-level barriers included poor knowledge and negative attitudes of care home staff and residents regarding incontinence symptoms and symptom management and treatment. Facilitators at the micro-level included proactive and inclusive leadership skills of individuals in management roles. Conclusions: The findings of the evidence synthesis study help to outline the complexities of continence care provision in older adult care homes facilities. Macro, meso and micro level influences demonstrate problematic and interrelated barriers across international contexts, indicating that improving continence care in this setting is extremely challenging due to the multiple levels at which care provision and services are impacted. Both international and national older adult social care policy-makers, researchers and service providers must recognize this complexity, and any intervention seeking to improve continence care in older adult care home settings must be planned accordingly and appreciatively of the complex and interrelated influences. It is anticipated that the findings of the qualitative interviews will shed further light on the national context of continence care provision specific to England; data collection is ongoing*. * Sample size is envisaged to be between 20-30 participants from multiple sites by Spring 2023.

Keywords: continence care, residential and nursing homes, evidence synthesis, qualitative

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Authors: Ehsan Ahmed Yahia

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Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

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Authors: S. S. Ramis Rauf

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This study will be explained the role of local wisdom in Tolakinese customary law on customs offense. The scope of this study was the informants who have a conflict located in Southeast Sulawesi. Then, their conflicts were resolved by using Kalosara tradition. The method of this study was a qualitative research by applying the techniques of deep interviews, revealing experiences and stories from informants, interviews customary leaders who are skilled and experienced in the customary settlement process of Kalosara tradition. Kalosara, as Tolakinese local wisdom, has contained in Tolakinese customary law. Kalosara was the application of customary law which was guided by Tolaki’s people when there was a problem. Knowledge and understanding of the customs have been conceived as something that comes from the ancestors. They created custom rules based on the law of Allah SWT for the elderly to do with full of awareness. Then, it was hereditary obeying by their children from generation to generation. The conflict occurred because of several things, namely bad words, aspersion, and other violations (such as harassment and affair). In custom settlement process, kalosara was done by using the enforcement of Tolakinese customary law that managed within an institution. It was called as Sara Wonua. It led by someone who was called as Pu'utobu that serves as a customary leader.

Keywords: kalosara, conflict resolution, tradition, unity, diversity

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Authors: Pi-Chi Wu, Tsui-Ping Chu, Hsiu-Hung Wang

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Background: The ability to provide immediate medical service in outpatient departments is one of the keys to patient satisfaction. Objectives: This project used electronic equipment to integrate nursing care information to patient care at a blood pressure diagnostic counter. Through process reengineering, the average patient waiting time decreased from 35 minutes to 5 minutes, while service satisfaction increased from a score of 2.7 to 4.6. Methods: Data was collected from a local hospital in Southern Taiwan from a daily average of 2,200 patients in the outpatient department. Previous waiting times were affected by (1) space limitations, (2) the need to help guide patient mobility, (3) the need for nurses to appease irate patients and give instructions, (4), the need for patients to replace lost counter tickets, (5) the need to re-enter information, (6) the replacement of missing patient information. An ad hoc group was established to enhance patient satisfaction and shorten waiting times for patients to see a doctor. A four step strategy consisting of (1) counter relocation, (2) queue reorganization, (3) electronic information integration, (4) process reengineering was implemented. Results: Implementation of the developed strategy decreased patient waiting time from 35 minutes to an average of 5 minutes, and increased patient satisfaction scores from 2.7 to 6.4. Conclusion: Through the integration of information technology and process transformation, waiting times were drastically reduced, patient satisfaction increased, and nurses were allowed more time to engage in more cost-effective services. This strategy was simultaneously enacted in separate hospitals throughout Taiwan.

Keywords: process reengineering, electronic information integration, patient satisfaction, patient waiting time

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Authors: Lei Ye, Min Liu, Yong-Li Gao, Jun Zhang

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Purpose: The aims of the study are to investigate the status of health-promoting lifestyle and to compare the healthy lifestyle of emergency nurses in different levels of hospitals in Sichuan province, China. The investigation is mainly about the health-promoting lifestyle, including spiritual growth, health responsibility, physical activity, nutrition, interpersonal relations, stress management. Then the factors were analyzed influencing the health-promoting lifestyle of emergency nurses in hospitals of Sichuan province in order to find the relevant models to provide reference evidence for intervention. Study Design: A cross-sectional research method was adopted. Stratified cluster sampling, based on geographical location, was used to select the health facilities of 1389 emergency nurses in 54 hospitals from Sichuan province in China. Method: The 52-item, six-factor structure Health-Promoting Lifestyle Profile II (HPLP- II) instrument was used to explore participants’ self-reported health-promoting behaviors and measure the dimensions of health responsibility, physical activity, nutrition, interpersonal relations, spiritual growth, and stress management. Demographic characteristics, education, work duration, emergency nursing work duration and self-rated health status were documented. Analysis: Data were analyzed through SPSS software ver. 17.0. Frequency, percentage, mean ± standard deviation were used to describe the general information, while the Nonparametric Test was used to compare the constituent ratio of general data of different hospitals. One-way ANOVA was used to compare the scores of health-promoting lifestyle in different levels hospital. A multiple linear regression model was established. P values which were less than 0.05 determined statistical significance in all analyses. Result: The survey showed that the total score of health-promoting lifestyle of nurses at emergency departments in Sichuan Province was 120.49 ± 21.280. The relevant dimensions are ranked by scores in descending order: interpersonal relations, nutrition, health responsibility, physical activity, stress management, spiritual growth. The total scores of the three-A hospital were the highest (121.63 ± 0.724), followed by the senior class hospital (119.7 ± 1.362) and three-B hospital (117.80 ± 1.255). The difference was statistically significant (P=0.024). The general data of nurses was used as the independent variable which includes age, gender, marital status, living conditions, nursing income, hospital level, Length of Service in nursing, Length of Service in emergency, Professional Title, education background, and the average number of night shifts. The total score of health-promoting lifestyle was used as dependent variable; Multiple linear regression analysis method was adopted to establish the regression model. The regression equation F = 20.728, R2 = 0.061, P < 0.05, the age, gender, nursing income, turnover intention and status of coping stress affect the health-promoting lifestyle of nurses in emergency department, the result was statistically significant (P < 0.05 ). Conclusion: The results of the investigation indicate that it will help to develop health promoting interventions for emergency nurses in all levels of hospital in Sichuan Province through further research. Managers need to pay more attention to emergency nurses’ exercise, stress management, self-realization, and conduct intervention in nurse training programs.

Keywords: emergency nurse, health-promoting lifestyle profile II, health behaviors, lifestyle

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