Search results for: private centers

Authors: M. E. Khiav, D. J. Borah, H. T. S. Santos, V. T. Faria

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For automobile companies, it has become very important to ensure sound quality in manufacturing and assembling in order to prevent occurrence of defects and to reduce the amount of parts replacements to be done in the service centers during the warranty period. Statistical Process Control (SPC) is widely used as the tool to analyze the quality of such processes and plays a significant role in the improvement of the processes by identifying the patterns and the location of the defects. In this paper, a case study has been conducted on an Iranian automobile company. This paper performs a quality analysis of a particular component called “Internal Bearing for the Back Wheel” of a particular car model, manufactured by the company, based on the 10 million data received from its service centers located all over the country. By creating control charts including X bar–S charts and EWMA charts, it has been observed after the year 2009, the specific component underwent frequent failures and there has been a sharp dip in the average distance covered by the cars till the specific component requires replacement/maintenance. Correlation analysis was performed to find out the reasons that might have affected the quality of the specific component in all the cars produced by the company after the year 2009. Apart from manufacturing issues, some political and environmental factors have been identified to have a potential impact on the quality of the component. A maiden attempt has been made to analyze the quality issues within an Iranian automobile manufacturer; such issues often get neglected in developing countries. The paper also discusses the possibility of political scenario of Iran and the country’s environmental conditions affecting the quality of the end products, which not only strengthens the extant literature but also provides a new direction for future research.

Keywords: capability analysis, car manufacturing, statistical process control, quality control, quality tools

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Authors: Baratali Monfaredraz

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The concept of justice has been able to occupy a lot of people’s minds and speeches for a long time. Justice has various dimensions such as economic justice, judicial justice, political justice, educational justice, ethnical justice and etc. Educational justice as one of the most basic dimensions of justice can alter our education in every field and it can flourish the talents and capabilities on macro level. One of the most efficient ways for social justice realization is to provide equal opportunities for all people in the society to be able to access equally to education as their human rights since today how progress occurs in education is regarded as the index of social development. On this basis, especially developing countries try to provide equal opportunities for all people in terms of access to education, specifically in higher education. At present, private education system violates the principles of conducting effort, meeting the needs and in part realizing the capabilities and so it cannot be justified to be a fair conductance. It seems that providing higher quality education in public schools and lowering role of teacher and educational facilities in educational achievement can be considered as a proper way to remove the discrimination in terms of unequal distribution of educational facilities. In addition, higher education development in deprived regions can initialize social activities among the inhabitants of these regions. Justice in educational field can result in access of all people to economic and social situations and job opportunities in future.

Keywords: educational justice, deprivation, private schools, higher education, job opportunities

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Authors: Mas Pertiwi I. G. AG Istri, Sri Kristinayanti Wayan, Oka Aryawan I. Gede Made

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Ability of government to meet the needs of infrastructure investment constrained by the size of the budget commitments for other sectors. Another barrier is the complexity of the process of land acquisition. Public Private Partnership can help bridge the investment gap by including the amount of funding from the private sector, shifted the responsibility of financing, construction of the asset, and the operation and post-project design and care to them. In principle, a construction project implementation always requires the investor as a party to provide resources in the form of funding which it must be contained in a successor agreement in the form of a contract. In general, construction contracts consist of contracts which passed in Indonesia and contract International. One source of funding used in the implementation of construction projects comes from funding that comes from the collaboration between the government and the private sector, for example with the system: BLT (Build Lease Transfer), BOT (Build Operate Transfer), BTO (Build Transfer Operate) and BOO (Build Operate Own). And form of payment under a construction contract can be distinguished several ways: monthly payment, payments based on progress and payment after completed projects (Turn Key). One of the tools used to analyze the feasibility of the investment is to use financial models. The financial model describes the relationship between different variables and assumptions used. From a financial model will be known how the cash flow structure of the project, which includes revenues, expenses, liabilities to creditors and the payment of taxes to the government. Net cash flow generated from the project will be used as a basis for analyzing the feasibility of investment source of project financing Public Private Partnership could come from equity or debt. The proportion of funding according to its source is a comparison of a number of investment funds originating from each source of financing for a total investment cost during the construction period by selected the contract system and several alternative financing percentage ratio determined according to sources will generate cash flow structure that is different. Of the various possibilities for the structure of the cash flow generated will be analyzed by software is to test T Paired to compared the contract system used by various alternatives comparison of financing to determine the effect of the contract system and the comparison of such financing for the feasibility of investment toll road construction project for the economic life of 20 (twenty) years. In this use case studies of toll road contruction project Bali Mandara. And in this analysis only covered two systems contracts, namely Build Operate Transfer and Turn Key. Based on the results obtained by analysis of the variable investment feasibility of the NPV, BCR and IRR between the contract system Build Operate Transfer and contract system Turn Key on the interest rate of 9%, 12% and 15%.

Keywords: contract system, financing, internal rate of return, net present value

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Authors: Hamdan Hamood Aldumaini, Amjad Hussein Meqdam, Shamsaldeen kassim Ali, Hamed Mohammed Al-Yousefi, Haron Ahmed Al-Badawi

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Background: Autism Spectrum Disorder (ASD) is a complex developmental challenge characterized by significant impairments in social interaction, communication, and behavioral patterns. Diagnosing ASD is challenging due to the lack of definitive medical tests, making early identification crucial. Therefore, increasing people's awareness about autism leads to early diagnosis and better prognosis. Objective: Our study aims to identify the initial symptoms prompting families to seek medical advice, determine the timeline between symptom onset and formal diagnosis, and explore methods for assessing the severity of ASD. Subjects and Methods: The study design employed was a descriptive cross-sectional design, which was suitable for the nature of the research. The data collection took place from March 5, 2022, to April 5, 2022, in Autism Rehabilitation Centers in Sana'a, Yemen. The study population consisted of all children who were diagnosed with autism and visited Autism rehabilitation centers in Sana'a city. The sample size was determined using Epi info version 7, and a total population of 587 autistic children attending the treatment was calculated, but only 250 children were included in this study (176 were male vs. 74 female). Result: In terms of sociability problems, it was found that a significant proportion of Yemeni children with autism experienced difficulties in this area. Specifically, 39.6% were classified as having severe sociability problems, while 28.4% were classified as having moderate issues. Sensory-cognitive awareness problems were also prevalent among the respondents, with 29.6% exhibiting severe difficulties in this domain. Health and physical problems were identified as significant concerns for Yemeni children with autism. The results indicated that 38.4% of the participants experienced severe health and physical issues. Identifying the first symptoms of autism is crucial for early detection and intervention. According to the study, speech delay was the most commonly observed first abnormality, reported by 71.3% of parents. Communication difficulties with others were the second most noticed abnormality, reported by 54.9% of parents. Repetitive movements were the third most commonly observed abnormality, reported by 18% of parents. Regarding the awareness among parents of ASD, our study showed that a significant portion (62%) of parents lack awareness about Autism Spectrum Disorder (ASD) and its causes. Surprisingly, a majority of these parents (over 80%) believe that autism is a curable condition. Additionally, more than half (51.2%) of the parents surveyed reported insufficient knowledge about medication options available to support therapy and rehabilitation for their autistic children.

Keywords: autism characteristics, rehabilitation centres, yemen, children

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Authors: Kuo-Wei Hsu, Shu-Fang Huang

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Global trend in creative economies promoted the modernization process of the development of cultural and creative industries and technology coincided with the craft industry towards value-added industrial restructuring. Due to government support and economic motivation in the private sector, regional craft products have emerged across counties and cities all over Taiwan which have led to an increased focus on craft culture promotion. However, most craft industry corporations in Taiwan are micro-enterprise, restricted operating profitability. This phenomenon shows the weakness of craft industry constitution when facing the rapid expansion of global economic commerce and manufacturing. In recent years, combining public and private enterprise, Platform business models revolutionary changed in craft industries’ original operation and transaction models. Therefore, this study attempts to explore the effects by implementing platform strategy on bamboo industry development in Nantou, the hometown of crafts in Taiwan, with an experimental investigation. This study concluded that platform strategy increases essence and insubstantial value for the bamboo industry in Taiwan. This study explored the economic value added of Taiwan bamboo village with three perspectives: Community participation, Culture Conservation, Regional Rejuvenation.

Keywords: platform strategy, craft industry, economic value-added

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Authors: John Lamb, Robert Epstein, Vasundhara L. Bhupathi, Sanjeev Kumar Marimekala

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In this paper, we focus on the importance of scalable architecture for data centers and buildings in general to help an enterprise achieve environmental sustainability. The scalable architecture helps in many ways, such as adaptability to the business and user requirements, promotes high availability and disaster recovery solutions that are cost effective and low maintenance. The scalable architecture also plays a vital role in three core areas of sustainability: economy, environment, and social, which are also known as the 3 pillars of a sustainability model. If the architecture is scalable, it has many advantages. A few examples are that scalable architecture helps businesses and industries to adapt to changing technology, drive innovation, promote platform independence, and build resilience against natural disasters. Most importantly, having a scalable architecture helps industries bring in cost-effective measures for energy consumption, reduce wastage, increase productivity, and enable a robust environment. It also helps in the reduction of carbon emissions with advanced monitoring and metering capabilities. Scalable architectures help in reducing waste by optimizing the designs to utilize materials efficiently, minimize resources, decrease carbon footprints by using low-impact materials that are environmentally friendly. In this paper we also emphasize the importance of cultural shift towards the reuse and recycling of natural resources for a balanced ecosystem and maintain a circular economy. Also, since all of us are involved in the use of computers, much of the scalable architecture we have studied is related to data centers.

Keywords: scalable architectures, sustainability, application design, disruptive technology, machine learning and natural language processing, AI, social media platform, cloud computing, advanced networking and storage devices, advanced monitoring and metering infrastructure, climate change

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Authors: Darshana Lal, Sonu Rana

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Learning Resource Centers (LRC) are acquiring different kinds of documents like books, journals, thesis, dissertations, standard, databases etc. in print and e-form. This article deals with the different types of sources available in LRC. It also discusses the concept of the web, as a tool, as a multimedia system and the different interfaces available on the web. The reasons for establishing LRC are highlighted along with the assignments of LRC. Different features of LRC‘S like self-learning and group learning are described. It also implements a group of activities like reading, learning, educational etc. The use of LRC by students and faculties are given and concluded with the benefits.

Keywords: internet, search engine, resource centre, opac, self-learning, group learning

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Authors: Evgeni Baratashvili, Giorgi Sulashvili, Malkhaz Sulashvili, Bela Khotenashvili, Irma Makharashvili

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The most investment decision-making principle of regional travel firm's management and its partner is the formulation of the aims of investment programs. The investments can be targeted in order to reduce the firm's production costs and to purchase good transport equipment. In attractive region, in order to develop firm’s activities, the investment program can be targeted for increasing of provided services. That is the case where the sales already have been used in the market. The investment can be directed to establish the affiliate firms, branches, to construct new hotels, to create food and trade enterprises, to develop entertainment enterprises, etc. Economic development is of great importance to regional development. International experience shows that inclusive economic growth largely depends on not only the national, but also regional development planning and implementation of a strong and competitive regions. Regional development is considered as the key factor in achieving national success. Establishing a modern institute separate entities if the pilot centers will constitute a promotion, international best practice-based public-private partnership to encourage the use of models. Regional policy directions and strategies adopted in accordance with the successful implementation of major importance in the near future specific action plans for inclusive development and implementation, which will be provided in accordance with the effective monitoring and evaluation tools and measurable indicators combined. All of these above-mentioned investments are characterized by different levels, which are related to the following fact: How successful tourism marketing service is, whether it is able to determine the proper market's reaction according to the particular firm's actions. In the sphere of regional tourism industry and in the investment decision possible variants it can be developed the some specter of models. Each of the models can be modified and specified according to the situation, and characteristic skills of the existing problem that must be solved. Besides, while choosing the proper model, the process is affected by the regulation system of economic processes. Also, it is influenced by liberalization quality and by the level of state participation.

Keywords: net income of travel firm, economic growth, Investment profitability, regional development, tourist product, tourism development

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Authors: Mustafa İlhan Akbaş, Özlem Garibay, Ivan Garibay

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The economic entities in innovation ecosystems form various industry clusters, in which they compete and cooperate to survive and grow. Within a successful and stable industry cluster, the entities acquire different roles that complement each other in the system. The universities and research centers have been accepted to have a critical role in these systems for the creation and development of innovations. However, the real effect of research institutions on regional economic growth is difficult to assess. In this paper, we present our approach for the identification of the impact of research activities on the regional entrepreneurship for a specific high-tech industry: optics and photonics. The optics and photonics has been defined as an enabling industry, which combines the high-tech photonics technology with the developing optics industry. The recent literature suggests that the growth of optics and photonics firms depends on three important factors: the embedded regional specializations in the labor market, the research and development infrastructure, and a dynamic small firm network capable of absorbing new technologies, products and processes. Therefore, the role of each factor and the dynamics among them must be understood to identify the requirements of the entrepreneurship activities in optics and photonics industry. There are three main contributions of our approach. The recent studies show that the innovation in optics and photonics industry is mostly located around metropolitan areas. There are also studies mentioning the importance of research center locations and universities in the regional development of optics and photonics industry. These studies are mostly limited with the number of patents received within a short period of time or some limited survey results. Therefore the first contribution of our approach is conducting a comprehensive analysis for the state and recent history of the photonics and optics research in the US. For this purpose, both the research centers specialized in optics and photonics and the related research groups in various departments of institutions (e.g. Electrical Engineering, Materials Science) are identified and a geographical study of their locations is presented. The second contribution of the paper is the analysis of regional entrepreneurship activities in optics and photonics in recent years. We use the membership data of the International Society for Optics and Photonics (SPIE) and the regional photonics clusters to identify the optics and photonics companies in the US. Then the profiles and activities of these companies are gathered by extracting and integrating the related data from the National Establishment Time Series (NETS) database, ES-202 database and the data sets from the regional photonics clusters. The number of start-ups, their employee numbers and sales are some examples of the extracted data for the industry. Our third contribution is the utilization of collected data to investigate the impact of research institutions on the regional optics and photonics industry growth and entrepreneurship. In this analysis, the regional and periodical conditions of the overall market are taken into consideration while discovering and quantifying the statistical correlations.

Keywords: entrepreneurship, industrial clusters, optics, photonics, emerging industries, research centers

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Authors: David Broussard

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This review article delves into the realm of marine conservation finance, addressing the inadequacies in current financial streams from the private sector and the underutilization of existing financing mechanisms. The study emphasizes the emerging field of “blue finance”, which contributes to economic growth, improved livelihoods, and marine ecosystem health. The financial burden of marine conservation projects typically falls on philanthropists and governments, contrary to the polluter-pays principle. However, the private sector’s increasing commitment to NetZero and growing environmental and social responsibility goals prompts the need for alternative funding sources for marine conservation initiatives like marine protected areas. The article explores the potential of utilizing several financing mechanisms like carbon credits and other forms of payment for ecosystem services in the marine context, providing a solution to the lack of private funding for marine conservation. The methodology employed involves a systematic and quantitative approach, combining traditional review methods and elements of meta-analysis. A comprehensive search of the years 2000 - 2023, using relevant keywords on the Scopus platform, resulted in a review of 252 articles. The temporal evolution of blue finance studies reveals a significant increase in annual articles from 2010 to 2022, with notable peaks in 2011 and 2022. Marine Policy, Ecosystem Services, and Frontiers in Marine Science are prominent journals in this field. While the majority of articles focus on payment for ecosystem services, there is a growing awareness of the need for holistic approaches in conservation finance. Utilizing bibliometric techniques, the article showcases the dominant share of payment for ecosystem services in the literature with a focus on blue carbon. The classification of articles based on various criteria, including financing mechanisms and conservation types, aids in categorizing and understanding the diversity of research objectives and perspectives in this complex field of marine conservation finance.

Keywords: biodiversity offsets, carbon credits, ecosystem services, impact investment, payment for ecosystem services

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Authors: I. T. Adebayo, J. R. Aworemi, V. A. Ogundele, O. J. Babalola, J. O. Ajayi

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The behavior of road users is a critical element in road safety. However, despite the proven effectiveness of the seat belt in reducing injury severity, some drivers still do not use the seat belt. The study, therefore, examined seat belt usage among drivers in Ogbomoso, Oyo State, Nigeria. Face-to-face surveys were conducted to elicit data on seat belt usage and road behaviors on 54,038 drivers plying the General-Lautech Road in Ogbomoso over a period of six months. Data collected were analyzed using both descriptive and inferential statistics. Findings revealed that seat belt usage was moderate among private car drivers in the morning (52.75 percent) and much lower in the evening (37.67 percent), while less than 30 percent of the commercial bus/taxi drivers used the seat during both periods. The paired T-test revealed a significant difference in seat belt usage by all the drivers in the morning and in the evening, as indicated with a T value of 113.977 and the level of significance p < 0.05. The study concluded that there is a significant difference in the usage of the seat belt by both private car and commercial bus/taxi drivers in Ogbomoso as most drivers made use of the seat belt, especially in the morning, to avoid being delayed when flagged down and fined for non-compliance with seat belt usage by the road traffic law enforcement agents. However, most of the drivers cited inadequate/lack of enforcement of compulsory use of seat belts by the relevant agencies and discomfort as the major reasons for not using the seat belt while driving.

Keywords: drivers, road , seat belt, traffic psychology

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Authors: Mario M. Figueroa de la Cruz, Claudia I. Solorzano, Raul Acosta, Ignacio Funes

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This technological development project seeks to create a tool that allows companies, in need of implementing a Data Center, intelligently determining factors for allocating resources support cooling and power supply (UPS) in its conception. The results should show clearly the speed, robustness and reliability of a system designed for deployment in environments where they must manage and protect large volumes of data.

Keywords: telecommunications, data center, fuzzy logic, expert systems

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Authors: Ioannis Panagiotopoulos, Aristidis Anastasakis, Konstantinos Toutouzas, Ioannis Iakovou, Charalampos Vlachopoulos, Vasilis Voudris, Georgios Tziomalos, Konstantinos Tsioufis, Efstathios Kastritis, Alexandros Briassoulis, Kimon Stamatelopoulos, Alexios Antonopoulos, Paraskevi Exadaktylou, Evanthia Giannoula, Anastasia Katinioti, Maria Kalantzi, Evangelos Leontiadis, Eftychia Smparouni, Ioannis Malakos, Nikolaos Aravanis, Argyrios Doumas, Maria Koutelou

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Introduction: Cardiac amyloidosis from Transthyretin (ATTR-CA) is an infiltrative disease characterized by the deposition of pathological transthyretin complexes in the myocardium. This study describes the characteristics of patients diagnosed with ATTR-CA from 2019 until present at the Nuclear Medicine Department of Onassis Cardiac Surgery Center and AHEPA Hospital. These centers have extensive experience in amyloidosis and modern technological equipment for its diagnosis. Materials and Methods: Records of consecutive patients (N=73) diagnosed with any type of amyloidosis were collected, analyzed, and prospectively followed. The diagnosis of amyloidosis was made using specific myocardial scintigraphy with Tc-99m DPD. Demographic characteristics, including age, gender, marital status, height, and weight, were collected in a database. Clinical characteristics, such as amyloidosis type (ATTR and AL), serum biomarkers (BNP, troponin), electrocardiographic findings, ultrasound findings, NYHA class, aortic valve replacement, device implants, and medication history, were also collected. Some of the most significant results are presented. Results: A total of 73 cases (86% male) were diagnosed with amyloidosis over four years. The mean age at diagnosis was 82 years, and the main symptom was dyspnea. Most patients suffered from ATTR-CA (65 vs. 8 with AL). Out of all the ATTR-CA patients, 61 were diagnosed with wild-type and 2 with two rare mutations. Twenty-eight patients had systemic amyloidosis with extracardiac involvement, and 32 patients had a history of bilateral carpal tunnel syndrome. Four patients had already developed polyneuropathy, and the diagnosis was confirmed by DPD scintigraphy, which is known for its high sensitivity. Among patients with isolated cardiac involvement, only 6 had left ventricular ejection fraction below 40%. The majority of ATTR patients underwent tafamidis treatment immediately after diagnosis. Conclusion: In conclusion, the experiences shared by the two centers and the continuous exchange of information provide valuable insights into the diagnosis and management of cardiac amyloidosis. Clinical suspicion of amyloidosis and early diagnostic approach are crucial, given the availability of non-invasive techniques. Cardiac scintigraphy with DPD can confirm the presence of the disease without the need for a biopsy. The ultimate goal still remains continuous education and awareness of clinical cardiologists so that this systemic and treatable disease can be diagnosed and certified promptly and treatment can begin as soon as possible.

Keywords: amyloidosis, diagnosis, myocardial scintigraphy, Tc-99m DPD, transthyretin

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Authors: Sunaitan Al Mutairi, Kumar Vallatharasu, Batool Ismaeel

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The Water Knock-Out (WKO) facility project is to handle the undesirable impact of the increasing water production rate in South and East Kuwait (S&EK) areas and break the emulsions and ensure sufficient separation of water at the new upstream facility, to reduce the load on the existing separation equipment in the Gathering Centers (GC). As the existing separation equipment in the Gathering Centers are not efficient to separate the emulsions, the Compact Electrostatic Coalescer (CEC) and Vessel Internal Electrostatic Coalescer (VIEC) technologies have been selected for enhancing the liquid-liquid separation by using the alternating voltage/frequency on electrical fields, to handle the increasing water-cut in S&EK. In the Compact Electrostatic Coalescer (CEC) technology method, the CEC equipment is installed downstream of the inlet separator externally, whereas in the Vessel Internal Electrostatic Coalescer (VIEC) technology method, the VIEC is built inside the treater vessel, downstream of the inlet separator with advanced internals for implementing electrocoalescence of water particles and hence enhancing liquids separation. The CEC and VIEC technologies used in the Water Knockout Facility project has the ability to resolve the increasing water cut in the S&EK area and able to enhance the liquid-liquid separation in the WKO facility separation equipment. In addition, the WKO facility is minimizing the load on the existing Gathering Center’s separation equipment, by tackling the high water-cut wells, upstream of each GC. The required performances at the outlet of the WKO facility are Oil in Water 100ppmv, Water in Oil 15% volume, liquid carryover in gas 0.1 US gal/MMSCFD, for the water cut ranging from 37.5 to 75% volume. The WKO facility project is used to sustain, support and maintain Greater Burgan production at 1.7 Million Barrels of Oil Per Day (MMBOPD), by handling the increasing water production rate.

Keywords: emulsion, increasing water-cut, production, separation equipment

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Authors: Eyob Seife, Tesfalem Teshome, Bereket Seyoum, Behailu Getachew, Yohans Demis

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Developing countries continue to face preventable communicable diseases, such as vaccine-preventable diseases. The Expanded Programme on Immunization (EPI) was established by the World Health Organization in 1974 to control these diseases. Health data use is crucial in decision-making, but ensuring data quality remains challenging. The study aimed to assess the accuracy ratio, timeliness, and quality index of regular immunization programme data in the Birkod district of the Somali Region, Ethiopia. For poor data quality, technical, contextual, behavioral, and organizational factors are among contributors. The study used a quantitative cross-sectional design conducted in September 2022GC using WHO-recommended data quality self-assessment tools. The accuracy ratio and timeliness of reports on regular immunization programmes were assessed for two health centers and three health posts in the district for one fiscal year. Moreover, the quality index assessment was conducted at the district level and health facilities by trained assessors. The study found poor data quality in the accuracy ratio and timeliness of reports at all health units, which includes zeros. Overreporting was observed for most facilities, particularly at the health post level. Health centers showed a relatively better accuracy ratio than health posts. The quality index assessment revealed poor quality at all levels. The study recommends that responsible bodies at different levels improve data quality using various approaches, such as the capacitation of health professionals and strengthening the quality index components. The study highlighted the need for attention to data quality in general, specifically at the health post level, and improving the quality index at all levels, which is essential.

Keywords: Birkod District, data quality, quality index, regular immunization programme, Somali Region-Ethiopia

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Authors: Shreya Sirohi, Vineeta Sirohi

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In the 21st century, the nature of work has become quite complex and dynamic, and in response to this, the organizational culture continues to change and develop new perspectives. Organizational culture and leadership are important elements of any organization. Organization’s performance and success to a large extent, depend upon these two factors. The ability of a leader lies in confronting with the challenge of evolving and adapting the culture of the organization as per the situational demands. Leadership and organizational culture are conceptually intertwined. Leadership is a key ingredient for the successful transformation of any organization, and a favorable organizational culture helps to motivate the employees towards their work. Organizational culture and leadership style plays a crucial role in achieving the specified objectives of an organization. The harmony between culture and leader within organization undoubtedly affects relationships, processes, and employee performance. The present investigation aimed to study the Leadership style and Organisational Culture of private organizations and the relationship between the two. The study was carried out on a sample of 100 employees from five private organizations located in the cities of Gurgaon and Delhi in India. The data was collected by employing organisational culture profile and multifactor leadership questionnaire. The findings of the study indicate that the selected organizations had dominant transformation leadership style, whereas the organizational culture varied from one organization to another. However, technocratic culture was found to be prominent, followed by entrepreneurial organizational culture. A low positive correlation was found between leadership style and organizational culture. The transformational leaders have a positive and significant relationship with employee’s satisfaction, productivity, and organization’s culture. The leaders practicing transformational leadership style inspire their followers, are innovative and are aware of their needs as well as of their followers. Such leadership style has a positive impact both on employees and working culture. Employees of such organization are able to come up with innovative ideas and are efficient in handling situations and making effective decisions. However, low correlation is self indicative of the fact that a single leadership style or a single culture type alone cannot contribute solely towards the growth of an organization. There is a need to blend the culture types and leadership styles suiting the needs of the organization. Organisational culture represents the deeper values and beliefs of the employees and influences organizational performance; hence, the leader has a crucial role to play in creating and managing organizational culture in aligning to the requirements of the present era of competitiveness, globalization and technological advancement.

Keywords: leadership style, organizational culture, technocratic, transformational

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Authors: G. I. Ozumba, V. A. Pam, V. A. Adejoh, S. A. Odey

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Intestinal parasitic infections are the most common parasitic infections of the man commonly resulting in morbidity and mortality in infected individuals. Two hundred (200) patients from two medical centers were randomly examined for intestinal parasites using normal saline wet mount and formol-ether concentration methods. One hundred patients each were examined from Plateau State Specialist Hospital (PSSH) and Vom Christian Hospital (VCH) respectively. Of the 100 patients examined at PSSH, (22.0%) tested positive for intestinal parasites, while only (6.0%) was reported for VCH. Ascaris lumbricoides and Taenia spp. were significantly (P value=0.0002726) the most prevalent intestinal parasites in PSSH with (31.8%) respectively. Balantidium coli and Entamoeba histolytica were the least prevalent at (4.5%) respectively. Hookworm (50.0%) was significantly (P<0.0001) the most prevalent intestinal parasite in VCH, followed by A. lumbricoides (33.3%), while Taenia spp. (16.7%) was the least. Female subjects 12(54.5%) were more infected than their male 10(45.4%) counterparts in PSSH. The difference (P value=0.3633) in the infection between female and male subjects at PSSH was not significant. Female subjects were significantly (P value=0.0008586) more infected 4(66.7%) than male subjects 2(33.3%) at VCH. The prevalence of intestinal parasite in relation to age in PSSH shows a significantly (P-value = 0.02573) high level among age group 11-20years 9(36.0%). On the contrary, the high prevalence of intestinal parasites among age groups 31-40 years 2(9.1%) at VCH was not significant (P value=0.1595). The result in relation to a water source in patients attending PSSH shows that the boreholes sources (66.7%) had a significantly (P<0.0001) high prevalence of intestinal parasites, while the least prevalence was observed in tap source (7.9%). Results from VCH shows that streams/rivers (16.7%) revealed high prevalence, while the tap source was least parasitized (10.0%). There was no significant difference (P value=0.436) in the prevalence of parasites in relation to the water source at VCH. This prevalence is directly related to the sanitary condition, socio-economic status, educational level, the age and hygienic habits of the patients. Thus, necessary sanitary policies, awareness, screening and de-worming exercises and occasional check of intestinal parasites are recommended.

Keywords: intestinal parasites, Jos, patients, prevalence

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Authors: Li Pan

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The recently prevalent government procurement of public services in China boasts a new form of government’s provision of public service through the purchasing of social work from social organizations, a new measure of the transformation in governmental functions as well as an unprecedented opportunity for the development of social organizations. For the past few years, the phenomenon of a surge in the number of social work organizations and social work staff emerged right with the initiatives of energetically carrying out the purchase of public services by the government. Such efforts have presented the strong determination of the Chinese government in building a small government by streamlining administration and delegating part of the governmental power to social organizations. This paper is based on the 2012-2014 performance appraisal project of the Guangzhou municipal government’s purchasing of public services and the project was carried out in the summer of 2015. During the process of the appraisal, several general problems hindering the sustainable development of government purchasing of public service have been observed. As Guangzhou is among the rank of pioneer cities in the conduct of the reform, it is representative and imperative to study the sustainability of government purchasing of public service. In 2012, Guangzhou local government started contracting out public service to the community social organizations to provide general family services and special services to community residents, since when integrated family service centers and special service centers were established as platforms to provide public social service in a city-wide range. Consequently, taking an example of the current rapid development of government purchase of the integrated family services and special services in Guangzhou, this paper puts up several proposals for the sustainable development of Guangzhou municipal government’s procurement of public services on the perspective of social work’s resource dependence.

Keywords: government procurement of public services, Guangzhou, integrated family service center, social work, sustainability.

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Authors: Lilian Bambirra De Assis, Patricia Albuquerque Gomes, Kamila Pagel De Oliveira, Deborah Oliveira Santos, Marcelo Esteves Chaves Campos

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This paper aimed to analyze how performance management occurs in the context of the modernization of the federal public sector in Chile and Portugal. To do so, the study was based on a theoretical framework that covers the modernization of public administration to performance management, passing on people management. The work consisted of qualitative-descriptive research in which 16 semi-structured interviews were applied in the countries of study and documents and legislation were used referring to the subject. Performance management, as well as other people management subsystems, is criticized for using private sector management tools, based on a results-driven logic. From this point of view, it is understood that certain practices of the private sector, regarding the measurement of performance, can not be simply inserted in the scenario of the public administration. Beyond this criticism, performance management can contribute to the achievement of the strategic objectives of the countries and its focus is upward, a trend that can be verified through the manuals produced; by the interest of consultants and professional organizations, both public and private; and OECD (Organization for Economic Cooperation and Development) evaluations. In Portugal, public administration reform was implemented during the Constitutional Government (2005-2009) and had as its objective the restructuring of human resources management, with an emphasis on its integration with budget management, which is an inclination of the OECD, while in Chile HRM (Human Resource Management) practices are directed to ministries to a lesser extent than the OECD average. The central human resources management sector, for the most part, coordinates policy but is also responsible for other issues, including payment and classification systems. Chile makes less use of strategic Human Resource Management practices than the average of OECD countries, and its prominence lies in the decentralization of public bodies, which may grant autonomy, but fragments the implementation of policies and practices in that country since they are not adopted by all organs. Through the analysis, it was possible to identify that Chile and Portugal have practices and personnel management policies that make reference to performance management, which is similar to other OECD countries. The study countries also have limitations to implement performance management and the results indicate that there are still processes to be perfected, such as performance appraisal and compensation.

Keywords: management of people in the public sector, modernization of public administration, performance management in the public sector, HRM, OECD

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Authors: Randy D. Colon

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Through a freedom of information request, data pertaining to Housing Choice Voucher (HCV) households has been obtained from the Chicago Housing Authority, including rent price and number of bedrooms per HCV household, community area, and zip code from 2013 to the first quarter of 2018. Similar data pertaining to the private rental market will be obtained through public records found through the United States Department of Housing and Urban Development. The datasets will be analyzed through statistical and mapping software to investigate the potential link between HCV households and distorted rent prices. Quantitative data will be supplemented by qualitative data to investigate the lived experience of Chicago residents. Qualitative data will be collected at community meetings in the Chicago Englewood neighborhood through participation in neighborhood meetings and informal interviews with residents and community leaders. The qualitative data will be used to gain insight on the lived experience of community leaders and residents of the Englewood neighborhood in relation to housing, the rental market, and HCV. While there is an abundance of quantitative data on this subject, this qualitative data is necessary to capture the lived experience of local residents effected by a changing rental market. This topic reflects concerns voiced by members of the Englewood community, and this study aims to keep the community relevant in its findings.

Keywords: Chicago, housing, housing choice voucher program, housing subsidies, rental market

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Authors: Alemayehu Belay Emagnaw

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This study was conducted to investigate the relationship of mother and father involvement with students’ school performance and the effect of selected family demographic variables (mother and father education, family structure and sex of students) to the involvement of mothers and fathers in their children’s school performance. In addition, this study attempted to differentiate the level of involvement of mothers’ and fathers’ in their children’s school performance. The research was conducted in Bahirdar City, Ethiopia. A total of 175 students (boys were 85 and girls were 90) of grade 7th and 8th private primary schools were selected as respondents using stratified random sampling technique. The data were collected using a questionnaire. Analysis of the data showed that fathers and mothers have significant involvement in their children’s school performance. A significant difference was also found between mothers and fathers involvement in their children’s school performance. Mothers were better involved in their children school performance than fathers. The analysis of inter-correlation between variables showed that there is a statistically significant relationship between mother and father education, mother and father involvement, and school performance whereas, family structure and sex of the child had no significant relationship with school performance.

Keywords: family structure, parental education, parental involvement, school performance

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Authors: Salinthip Thipayang, Achara Chandrachai, Rath Pichyangkura, Sukree Sinthupinyo

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Most of the well-known frameworks and tools to measure and compare organisational innovation of the public or government agencies have been designed and used in the developed economies such as the EU, Nordic Region, Australia, and South Korea. This project is one of the very first attempts to develop a measurement tool to adequately measure the organisational (administrative) innovation of the government agencies in the developing economies in ASEAN. New measurement framework with the components including the intra and international collaborations of these government agencies to other private, public and academic sectors were added to the proposed measurement framework. Questionnaires and in-depth interviews with the experts and the middle to top executives of the participating public agencies in the ASEAN member states were conducted to determine the suitability and develop the indicators that should be included in the measurement model. The results showed that intra and international collaborations of these government organisations to other agencies in the public, private and academic sectors can lead to new changes and greatly impact the ways in which these government agencies in the ASEAN STI ecosystem are operated and administered. Government organisations in less developing countries in ASEAN are ready and willing to learn from their counterparts in other more advanced countries and adjust their internal management to be more innovative and to better handle international collaborative projects and commitments.

Keywords: organisational innovation, administrative innovation, government agencies, public agencies, ASEAN science technology and innovation ecosystem, international collaborations

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Authors: Sadaf Rafiq, Muhammad Waqas, Shakeel Ahmad Khan, Nisar Ahmad

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Everyday life information seeking (ELIS) is considered as the mastery of life. It plays an important role in daily problem solving activities. Female students living in university hostels need variety of information to fulfil their everyday information needs. To find accurate and timely information is really challenging for females students who move from rural areas for educational purposes. These challenges involve culture differences, stress, financial issues, homesickness, diet needs and change in sleeping and eating habits. These complications create numerous problems for female students to adjust themselves in new and unfamiliar environment. Although the Internet has increased the ease of seeking everyday life information to survive successfully but there is still uncertainty to fully rely on the quality of information available on the web. Pakistan is an underdeveloped country where limited budget is allocated for educational institutions to enable them in developing well established hostels for their students. Female students who pursue for higher education has to stay at hostels for years to obtain education goals. It really becomes very difficult for them to spend life in hostels if they are not properly facilitated with relevant information sources to acquire everyday life information. The proposed study attempts to investigate the everyday life information seeking behavior of female students who are living in university and private hostels of Lahore. It investigates the various sources of information used by female students. It also identifies the problems faced by the female students in accessing everyday life information. The results of this study will be helpful for university management to understand their information need and provide required information sources which are essential for them to spend a comfortable, successful and peaceful life in hostels and achieve their educational goals. To achieve the objectives of the study, we will use quantitative research approach by using questionnaire as a data collection tool. The population of this study will be the university students living in public and private hostels of Lahore, Pakistan. This study will increase the understanding of everyday life information seeking behavior of female students living in hostels. Results of the study will be helpful for hostel administrations to better understand the students’ everyday life information needs and provide high quality of information services and living environment.

Keywords: everyday, information seeking, hostel, female

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Authors: Aruna Kemisola Kehinde, Oyinloye Michael Ajide, Aboluje Oluwafemi Bolarinwa

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The development of the nation's overall growth is directly impacted by the vital substructure of the transportation system. The majority of developing countries experience issues with road transportation, including limited and low-quality infrastructure. The study assessed intra-city road infrastructure in Ado-Ekiti with a view to identifying its adequacy and functionality for efficient transport in the town. To this end, the study examined the locations of the road infrastructure, characteristics of the road infrastructure, and condition of the road infrastructure. A systematic random sampling method was adopted to select respondents for the study. Data were sourced from both primary and secondary sources. A 2.5% of 20,160 households, amounting to 503 households, was used as the sample size. Data analysis was based on responses from 500 questionnaires retrieved, and the data were analyzed using descriptive statistics. The results of this study showed that based on the locations of road infrastructure, disparity exists in the distribution of infrastructure amongst the major roads. Inferences from the results gathered also demonstrated that the infrastructure that is available is very much less than the non-available infrastructure. About 50% of the respondents are satisfied that the condition of road infrastructure in Ado-Ekiti is fair. The study's recommendations for the Ekiti state government include quantifying the number of existing road infrastructure, establishing a state maintenance board to expedite their renovation, and diversifying its goals for providing road infrastructure through public-private partnership (PPP) agreements with the private sector.

Keywords: road transportation, infrastructure, availability, intra-city

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Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani

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Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.

Keywords: emergency medicine, medical scribe, scribe, documentation

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Authors: Deinzel R. Uezono, Vivien Fe F. Fadrilan-Camacho, Bianca Margarita L. Medina, Antonio Domingo R. Reario, Trisha M. Salcedo, Luke Wesley P. Borromeo

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The environment of health care workers is considered one of the most hazardous settings due to the nature of their work. In developing countries especially, the Philippines, this continues to be overlooked in terms of programs and services on occupational health and safety (OHS). One possible reason for this is the existing information gap on OHS which limits data comparability and impairs effective monitoring and assessment of interventions. To address this gap, there is a need to determine the current conditions of Filipino health care workers in their workplace. This descriptive cross-sectional study assessed the occupational health and safety conditions of health care workers in barangay health centers in a selected city in Metro Manila, Philippines by: (1) determining the hazards present in the workplace; (2) determining the most common self-reported medical problems; and (3) describing the elements of an OHS system based on the six building blocks of health system. Assessment was done through walkthrough survey, self-administered questionnaire, and key informant interview. Data analysis was done using Epi Info 7 and NVivo 11. Results revealed different health hazards present in the workplace particularly biological hazards (exposure to sick patients and infectious specimens), physical hazards (inadequate space and/or lighting), chemical hazards (toxic reagents and flammable chemicals), and ergonomic hazards (activities requiring repetitive motion and awkward posture). Additionally, safety hazards (improper capping of syringe and lack of fire safety provisions) were also observed. Meanwhile, the most commonly self-reported chronic diseases among health care workers (N=336) were hypertension (20.24%, n=68) and diabetes (12.50%, n=42). Top commonly self-reported symptoms were colds (66.07%, n=222), coughs (63.10%, n=212), headache (55.65%, n=187), and muscle pain (50.60%, n=170) while other diseases were influenza (16.96%, n=57) and UTI (15.48%, n=52). In terms of the elements of the OHS system, a general policy on occupational health and safety was found to be lacking and in effect, an absence of health and safety committee overseeing the implementing and monitoring of the policy. No separate budget specific for OHS programs and services was also found to be a limitation. As a result, no OHS personnel and trainings/seminar were identified. No established information system for OHS was in place. In conclusion, health and safety hazards were observed to be present across the barangay health centers visited in a selected city in Metro Manila. Medical conditions identified as most commonly self-reported were hypertension and diabetes for chronic diseases; colds, coughs, headache, and muscle pain for medical symptoms; and influenza and UTI for other diseases. As for the elements of the occupational health and safety system, there was a lack in the general components of the six building blocks of the health system.

Keywords: health hazards, occupational health and safety, occupational health and safety system, safety hazards

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Authors: Mulugeta Shegaze, Mekitie Wondafrash, Alemayehu A. Alemayehu, Shikur Mohammed, Zewdu Shewangezaw, Mukerem Abdo, Gebresilasea Gendisha

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Background: The 2004 World Health Assembly called for specific actions to halt the overweight and obesity epidemic that is currently penetrating urban populations in the developing world. Adolescents require particular attention due to their vulnerability to develop obesity and the fact that adolescent weight tracks strongly into adulthood. However, there is scarcity of information on the modifiable risk factors to be targeted for primary intervention among urban adolescents in Ethiopia. This study was aimed at determining the magnitude and risk factors of overweight and obesity among high school adolescents in Addis Ababa. Methods: An institution-based cross-sectional study was conducted in February and March 2014 on 456 randomly selected adolescents from 20 high schools in Addis Ababa city.  Demographic data and other risk factors of overweight and obesity were collected using self-administered structured questionnaire, whereas anthropometric measurements of weight and height were taken using calibrated equipment and standardized techniques. The WHO STEPS instrument for chronic disease risk was applied to assess dietary habit and physical activity. Overweight and obesity status was determined based on BMI-for-age percentiles of WHO 2007 reference population. Results: The prevalence rates of overweight, obesity, and overall overweight/ obesity among high school adolescents in Addis Ababa were 9.7% (95%CI = 6.9-12.4%), 4.2% (95%CI = 2.3-6.0%), and 13.9% (95%CI = 10.6-17.1%), respectively. Overweight/obesity prevalence was highest among female adolescents, in private schools, and in the higher wealth category. In multivariable regression model, being female [AOR(95%CI) = 5.4(2.5,12.1)], being from private school [AOR(95%CI) = 3.0(1.4,6.2)], having >3 regular meals [AOR(95%CI) = 4.0(1.3,13.0)], consumption of sweet foods [AOR(95%CI) = 5.0(2.4,10.3)] and spending >3 hours/day sitting [AOR(95%CI) = 3.5(1.7,7.2)] were found to increase overweight/ obesity risk, whereas high Total Physical Activity level [AOR(95%CI) = 0.21(0.08,0.57)] and better nutrition knowledge [AOR(95%CI) = 0.160.07,0.37)] were found protective. Conclusions: More than one in ten of the high school adolescents were affected by overweight/obesity with dietary habit and physical activity are important modifiable risk factors. Well-tailored nutrition education program targeting lifestyle change should be initiated with more emphasis to female adolescents and students in private schools.

Keywords: adolescents, NCDs, overweight, obesity

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Authors: Supriadi Hardianto, Aditya Daniswara

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Today's workplace, flooded by millennial Generation or known also as Generation Y. A common problem that faced by the company towards Gen Y is a high turnover rate, attitudes problem, communication style, and different work style than the older generation. This is common in private sector. The objective of this study is to get a better understanding of the Gen Y Career Attitude at the workplace. The subject of this study is focusing on 430 respondent of Gen Y which age between 20 – 35 years old who works for a private company. The Questionnaire as primary data source captured 9 aspects of career attitude based on Career Attitudes Strategy Inventory (CASI). This Survey distributes randomly among Gen Y in the IT Industry (125 Respondent) and Manufacture Company (305 Respondent). A Random deep interview was conducted to get the better understanding of the etiology of their primary obstacles. The study showed that most of Indonesia Gen Y have a moderate score on Job satisfaction but in the other aspects, Gen Y has the lowest score on Skill Development, Career Worries, Risk-Taking Style, Dominant Style, Work Involvement, Geographical Barrier, Interpersonal Abuse, and Family Commitment. The top 5 obstacles outside that 9 aspects that faced by Gen Y are 1. Lower communication & networking support; 2. Self-confidence issues; 3. Financial Problem; 4. Emotional issues; 5. Age. We also found that parent perspective toward the way they are nurturing their child are not aligned with their child’s real life. This research fundamentally helps the organization and other Gen Y’s Stakeholders to have a better understanding of Gen Y Career Attitude at the workplace.

Keywords: career attitudes, CASI, Gen Y, career attitude at workplace

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Authors: Yasmine Aridi, Lara Nasreddine, Maya Khalil, Arafat Tfayli, Anas Mugharbel, Farah Naja

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Breast cancer is the most commonly diagnosed cancer site among women worldwide and the second most common cause of cancer mortality. Breast cancer rates differ vastly between geographical areas, countries, and within the same country. In Lebanon, the proportion of breast cancer to all other sites of tumor is 38.2%; these rates are still lower than those observed worldwide, but remain the highest among Arab countries. Studies and evidence based reviews show a strong association between breast cancer development and prognosis and dietary habits, specifically the Mediterranean diet (MD). As such, the aim of this study is to examine dietary patterns and adherence to the MD among a sample of 182 breast cancer female patients in Beirut, Lebanon. Subjects were recruited from two major hospitals; a private medical center and a public hospital. All subjects were administered two questionnaires: socio- demographics and Mediterranean diet adherence. Five Mediterranean scores were calculated: MS, MSDPS, PMDI, PREDIMED and DDS. The mean age of the participants was 53.78 years. The overall adherence to the Mediterranean diet (MD) was low since the sample means of 3 out of the 5 calculated scores were less than the scores’ medians. Given that 4 out of the 5 Mediterranean scores significantly varied between the recruitment sites, women in the private medical center were found to adhere more to the MD. Our results also show that the majority of the sample population’s intakes are exceeding the recommendations for total and saturated fat, while meeting the requirements for fiber, EPA, DHA and Linolenic Acid. Participants in the private medical center were consuming significantly more calories, carbohydrates, fiber, sugar, Lycopene, Calcium, Iron and Folate and less fat. After conducting multivariate linear regression analyses, the following significant results were observed: positive associations between MD (CPMDI, PREDIMED) and monthly income & current state of health, while negative associations between MD (MSDPS, PREDIMED) and age & employment status. Our findings indicated a low overall adherence to the MD and identified factors associated with it; which suggests a need to address dietary habits among BC patients in Lebanon, specifically encouraging them to adhere to their traditional Mediterranean diet.

Keywords: Adherence, Breast cancer, Dietary patterns, Mediterranean diet, Nutrition

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Authors: Rosemary Saunders, Courtney Glass, Karla Seaman, Karen Gullick, Julie Andrew, Anne Wilkinson, Ashwini Davray

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Current literature demonstrates that most Australians receive end-of-life care in a hospital setting, despite most hoping to die within their own home. The necessity for high quality end-of-life care has been emphasised by the Australian Commission on Safety and Quality in Health Care and the National Safety and Quality in Health Services Standards depict the requirement for comprehensive care at the end of life (Action 5.20), reinforcing the obligation for continual organisational assessment to determine if these standards are suitably achieved. Limited research exploring clinical staff perspectives of end-of-life care delivery has been conducted within an Australian private health context. This study aimed to investigate clinical staff member perceptions of end-of-life care delivery at a private hospital in Western Australia. The study comprised of a multi-faceted mixed-methods methodology, part of a larger study. Data was obtained from clinical staff utilising surveys and focus groups. A total of 133 questionnaires were completed by clinical staff, including registered nurses (61.4%), enrolled nurses (22.7%), allied health professionals (9.9%), non-palliative care consultants (3.8%) and junior doctors (2.2%). A total of 14.7% of respondents were palliative care ward staff members. Additionally, seven staff focus groups were conducted with physicians (n=3), nurses (n=26) and allied health professionals including social workers (n=1), dietitians (n=2), physiotherapists (n=5) and speech pathologists (n=3). Key findings from the surveys highlighted that the majority of staff agreed it was part of their role to talk to doctors about the care of patients who they thought may be dying, and recognised the importance of communication, appropriate training and support for clinical staff to provide quality end-of-life care. Thematic analysis of the qualitative data generated three key themes: creating the setting which highlighted the importance of adequate resourcing and conducive physical environments for end-of-life care and to support staff and families; planning and care delivery which emphasised the necessity for collaboration between staff, families and patients to develop care plans and treatment directives; and collaborating in end-of-life care, with effective communication and teamwork leading to achievable care delivery expectations. These findings contribute to health professionals better understanding of end-of-life care provision and the importance of collaborating with patients and families in care delivery. It is crucial that health care providers implement strategies to overcome gaps in care, so quality end-of-life care is provided. Findings from this study have been translated into practice, with the development and implementation of resources, training opportunities, support networks and guidelines for the delivery of quality end-of-life care.

Keywords: clinical staff, end-of-life care, mixed-methods, private hospital.

Procedia PDF Downloads 152