Search results for: elderly care facilities

Authors: Yu Sin Syu

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Objective: The study aimed to improve the patient guidance satisfaction of patients hospitalized in iodine-131 isolation rooms, as well as the patient guidance completion rate for such patients. Method: A patient care guidance checklist and patient care guidance satisfaction questionnaire were administered to 29 patients who had previously been hospitalized in iodine-131 isolation rooms. The evaluation was conducted on a one-on-one basis, and its results showed that the patients’ satisfaction with patient guidance was only 3.7 points and that the completion rate for the patient guidance performed by nurses was only 67%. Therefore, various solutions were implemented to create a more complete patient guidance framework for nurses, including the incorporation of regular care-related training in in-service education courses; the establishment of patient care guidance standards for patients in iodine-131 isolation rooms; the establishment of inpatient care standards and auditing processes for iodine-131 isolation rooms; the creation of an introductory handbook on ward environment; Invite other the care team the revision of iodine-131 health education brochures; the creation of visual cards and videos covering equipment operation procedures; and introduction of QR codes. Results: Following the implementation of the above measures, the overall satisfaction of patients hospitalized in iodine-131 isolation rooms increased from 3.7 points to 4.6 points, and the completion rate for patient guidance rose from 67% to 100%. Conclusion: Given the excellent results achieved in this study, it is hoped that this nursing project can serve as a benchmark for other relevant departments.

Keywords: admission care guidance, guidance satisfaction, integrity, Iodine131 isolation

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Authors: Wynne De Jong, Robert Miller, Ross Riggs

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Beyond the number of nurses providing care for patients, having nurses with the right skills, experience and education is essential to ensure the best possible outcomes for patients. Research studies continue to link nurse staffing and skill mix with nurse-sensitive patient outcomes; numerous studies clearly show that superior patient outcomes are associated with higher levels of regulated staff. Due to the limited number of tools and processes available to assist nurse leaders with staffing models of care, nurse leaders are constantly faced with the ongoing challenge to ensure their staffing models of care best suit their patient population. In 2009, several hospitals in Ontario, Canada participated in a research study to develop and evaluate an RN/RPN utilization toolkit. The purpose of this study was to develop and evaluate a toolkit for Registered Nurses/Registered Practical Nurses Staff mix decision-making based on the College of Nurses of Ontario, Canada practice standards for the utilization of RNs and RPNs. This paper will highlight how an organization has further developed the Patient Care Needs Assessment (PCNA) questionnaire, a major component of the toolkit. Moreover, it will demonstrate how it has utilized the information from PCNA to clearly identify patient and family care needs, thus providing evidence-based results to assist leaders with matching the best staffing skill mix to their patients.

Keywords: nurse staffing models of care, skill mix, nursing health human resources, patient safety

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Authors: Foad Alzoughool

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Conflicting studies on the association between the rs5219 polymorphism and type 2 diabetes, some studies have confirmed a strong relationship between this variant and type2 diabetes, on the other hand, many studies denied the existence of this association. This study aimed to provide evidence about whether the rs5219 polymorphism has or hasn't a role as a risk factor for diabetes and meta-analysis to investigate the role of the control age group in the association. Genotyping of the rs5219 polymorphism was performed in a cohort of 266 healthy elderly subjects with a mean age (60.2 ± 5.1) with no history of diabetes (HbA1c < 6%) using standard Sanger sequencing methods. Lys/Lys alleles were detected in 20 persons (7.5%), Lys/Glu alleles in 96 persons (36.1%), and Glu/Glu in 150 persons (56.4%). The genotype distribution was consistent with Hardy–Weinberg equilibrium (P =0.7). Meta-analysis notably indicates no association between rs5219 polymorphism and type 2 diabetes in all studies used the younger age of the control group compared to the patient's age. In conclusion, our study sheds light on the importance of age factor among the control group recruited in case-control studies.

Keywords: Type 2 diabetes, rs5219 polymorphism, E23K, KCNJ11 gene

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Authors: Muizz Sanni-Anibire

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The 21st century has witnessed growing concerns for the protection of built facilities against natural and man-made disasters. Studies in earthquake resistant buildings, fire, and explosion resistant buildings now dominate the arena. To protect people and facilities from the effects of the explosion, reinforced concrete walls have been designed to be blast resistant. Understanding the performance of these walls is a key step in ensuring the safety of built facilities. Blast walls are mostly designed using simple techniques such as single degree of freedom (SDOF) method, despite the increasing use of multi-degree of freedom techniques such as the finite element method. This study is the first stage of a continuous research into the safety and reliability of blast walls. It presents the SDOF approach applied to the analysis of a concrete wall panel under three representative bomb situations. These are motorcycle 50 kg, car 400kg and also van with the capacity of 1500 kg of TNT explosive.

Keywords: blast wall, safety, protection, explosion

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Authors: Ladislas Havugimana, Véronique Zinnen, Mary Hadley, Jean Claude Mwumvaneza, Francois Régis Habarugira, Silas Rudasingwa, Victor Ndaruhutse, Evelyne Bocquet

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Rwanda's health systems face various challenges, including low health infrastructure coverage (the objective is to have at least one health center per administrative sector) and insufficient qualified human resources for infrastructure maintenance and financing. Moreover, there is no policy for the preventive maintenance of infrastructures for the health sector. This paper presents action research conducted in seven districts, focusing on the impact of health infrastructure's quality on maternal and neonatal care, with the support of the Belgian cooperation agency through Enable Barame project.

Keywords: health infrastructure, maintenance, maternity, neonatology

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Authors: Chukwuka Justus Iwegbu

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Background: A major concern facing the world is providing senior citizens, individuals with disabilities, and other vulnerable groups with high-quality care. This issue is more serious in Nigeria's North Eastern area, where the burden of disease and disability is heavy, and access to care is constrained. This study aims to fill this gap by exploring the roles, challenges and support needs of caregivers, care home management, funding and administration in challenged communities in North Eastern Nigeria. The study will also provide a comprehensive understanding of the current situation and identify opportunities for improving the quality of care and support for caregivers and care recipients in these communities. Methods: A mixed-methods design, including both quantitative and qualitative data collection methods, will be used, and it will be guided by the stress process model of caregiving. The qualitative stage approach will comprise a survey, In-depth interviews, observations, and focus group discussion and the quantitative analysis will be used in order to comprehend the variations between caregiver's roles and care home management. A review of relevant documents, such as care home policies and funding reports, would be used to gather quantitative data on the administrative and financial aspects of care. The data collected will be analyzed using both descriptive statistics and thematic analysis. A sample size of around 200-300 participants, including caregivers, care recipients, care home managers and administrators, policymakers and health care providers, would be recruited. Findings: The study revealed that caregivers in challenged communities in North Eastern Nigeria face significant challenges, including lack of training and support, limited access to funding and resources, and high levels of burnout. Care home management and administration were also found to be inadequate, with a lack of clear policies and procedures and limited oversight and accountability. Conclusion: There is a need for increased investment in training and support for caregivers, as well as a need for improved care home management and administration in challenged communities in North Eastern Nigeria. It also highlights the importance of involving community members in decision-making and planning processes related to care homes and services. The study would contribute to the existing body of knowledge by providing a detailed understanding of the challenges faced by caregivers, care home managers and administrators.

Keywords: caregivers, care home management, funding, administration, challenge communities, North Eastern Nigeria

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Authors: Sandra Soca Lozano, Teresa Isabel Lozano Pérez, Germain Weber

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Cancer is a chronic disease of high prevalence in children and adolescents. Medical care in Cuba is carried out by a multidisciplinary team and family is the mediator between this team and the patient. Around this disease, there are interwoven many stereotypes and taboos by its relation to death. In this research report, we describe the work paradigm of psychological care to patients suffering from these diseases in the University Pediatric Hospital Juan Manuel Márquez of Havana, Cuba. We present the psychosocial factors that must be taken into account to provide comprehensive care and ensuring the quality of life of patients and their families. We also present the factors related to the health team and the management of information done with the patient. This is a descriptive proposal from the working experience accumulated in the named institution and in the review of the literature. As a result of this report we make a proposal of teamwork and the aspects in which psychological intervention should be continue performing in terms of increasing the quality of the care made by the health team. We conclude that it is necessary to continue improving the information management of children and adolescents with theses health problems and took into account their right to autonomy.

Keywords: comprehensive care, management of information, psychosocial factors, right to autonomy

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Authors: Ivonete Teresinha Schulter Buss Heidemann, Michelle Kuntz Durand, Aline Megumi Arakawa-Belaunde, Sandra Mara Corrêa, Leandro Martins Costa Do Araujo, Kamila Soares Maciel

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Primary Health Care is defined as the level of a system of services that enables the achievement of answers to health needs. This level of care produces services and actions of attention to the person in the life cycle and in their health conditions or diseases. Primary Health Care refers to a conception of care model and organization of the health system that in Brazil seeks to reorganize the principles of the Unified Health System. This system is based on the principle of health as a citizen's right and duty of the State. Primary health care has family health as a priority strategy for its organization according to the precepts of the Unified Health System, structured in the logic of new sectoral practices, associating clinical work and health promotion. Thus, this study seeks to know the possibilities and limits of the care developed by professionals working in Primary Health Care. It was conducted by a qualitative approach of the participant action type, based on Paulo Freire's Research Itinerary, which corresponds to three moments: Thematic Investigation; Encoding and Decoding; and, Critical Unveiling. The themes were investigated in a health unit with the development of a culture circle with 20 professionals, from a municipality in southern Brazil, in the first half of 2021. The participants revealed as possibilities the involvement, bonding and strengthening of the interpersonal relationships of the professionals who work in the context of primary care. Promoting welcoming in primary care has favoured care and teamwork, as well as improved access. They also highlighted that care planning, the use of technologies in the process of communication and the orientation of the population enhances the levels of problem-solving capacity and the organization of services. As limits, the lack of professional recognition and the scarce material and human resources were revealed, conditions that generate tensions for health care. The reduction in the number of professionals and the low salary are pointed out as elements that boost the motivation of the health team for the development of the work. The participants revealed that due to COVID-19, the flow of care had as a priority the pandemic situation, which affected health care in primary care, and prevention and health promotion actions were canceled. The study demonstrated that empowerment and professional involvement are fundamental to promoting comprehensive and problem-solving care. However, limits of the teams are observed when exercising their activities, these are related to the lack of human and material resources, and the expansion of public health policies is urgent.

Keywords: health promotion, primary health care, health professionals, welcoming.

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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: Liesbeth Van Kelst, Jozefiene Jansens

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Background: All care providers within mother and child care are confronted, at some point in their career, with the care for parents who (will) lose or have lost a baby. Obtaining the correct attitude and communicating well during these difficult moments are aspects that many healthcare provides continue to struggle with. Parents still encounter well-intentioned but inappropriate communication from healthcare providers. Aim: To study how communication, both verbal and non-verbal, around the death of a baby during pregnancy, birth, or in the first ten days postnatal was experienced by parents and healthcare providers. Methods: A qualitative study using grounded theory principles was conducted. Data were collected through 22 individual face-to-face in-depth interviews with parents who had lost a baby (n = 12) and intramural caregivers, such as midwives, nurses, gynecologists and neonatologists (n=10). In the first phase, data were analyzed within each group separately (parents and healthcare providers) and in the second phase, findings from both groups were compared and analyzed according to meta-synthesis principles. Results: The themes that emerged from the data demonstrated congruent experiences between the group of the parents and the health care providers. Both strengths and weaknesses in current care were named and suggestions for appropriate communication were formulated. Conclusion: Since most health care providers only occasionally care for parents with a deceased baby, a communication tool can optimize communication between healthcare professionals and parents who lose a baby. This is very important as the words which are said at this difficult period last a lifetime in the heads of parents.

Keywords: communication, death, perinatal loss, stillbirth

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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.

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Authors: Soo-Bi Lee, Jun Young Jeong, Zehgn Lin, Chenminxi

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Background: In South Korea, a problematic phenomenon has recently arisen whereby adult children continue to receive parentalcaregivingin some cases. These phenomena has been shown to affect the mental health of mothers. Study Goals: The purposes of this study are to verify whether the mediating effects of stress on the relationship between a woman’s care burden for their adult children and depression are moderated by their satisfaction about their husbands’ sharing of the caregiving. Methodology: This study analyzed 3,053 married women with adult children using the most recent data from the “Korean Longitudinal Survey of Women & Families 7th(2018)" conducted at the national level. The analysis was conducted using the SPSS Process Macro Model 7 to verify the moderated mediating effects and subsequently confirm their significance based on the bootstrapping method. Results and Implications: (1) Stress was identified a mediating factor in the relationship between the care burden for adult children and depression; and (2) the mediating effects of stress on depression from the burden of caring for adult children are modulated by the woman's satisfaction with her husband’s sharing of the care burden. In other words, the higher the caring burden of adult children, the higher the mother's stress, which increases depression. At this time, the higher the their satisfaction with the husband's share of care in the path of mother's care burden and stress, the lower the mother's stress and, ultimately, the depression be alleviated. Conclusion: Programs that promote the mental health of married women heavily with the caring burden for their adult children, as well as those that improve social awareness regarding husbands' sharing of the care burden, should be implemented. Also, social welfare policy alternatives are needed at the national level to reduce the caring burden caused by adult children.

Keywords: married women, adult children care burden, stress, depression, satisfaction with husbands sharing of the care

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Authors: Ebenezer Bayode Agboola

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The study investigated the influence of socioeconomic factors on crime perpetuation among inmates of correctional facilities in South West Nigeria. A sample size of two hundred and forty-four inmates was drawn from Ado, Akure and Ilesha correctional facilities. The sample size consisted of both male and female inmates. Individual inmate was drawn through systematic sampling with the use of inmates’ register at the correctional facilities. The study employed a mixed design, which allowed the blend of both quantitative and qualitative methods. For the quantitative method, data was collected through the use of a questionnaire and for the qualitative method; data was collected with the aid of an in-depth interview (ID. Four research questions were raised for the study and analysed descriptively using simple frequency count and percentage. Five research hypotheses were formulated for the study and tested using Analysis of Variance (ANOVA) and Multiple Regressions. Based on the data analysis, findings revealed that there was a significant relationship between family history and perpetuation of crime among inmates. Though no significant relationship was found between employment and the perpetuation of crime, however, the rate of crime perpetuation by individuals was significantly found to be related to peer pressure. Also, the study further found that there was a significant relationship between the use of substances and perpetuation of crime. Lastly, it was found that there was a significant relationship between family history, employment, and peer pressure. The study recommended that Parents should pay adequate attention to their children, especially during the adolescent stage and that the Government should enact relevant laws that will checkmate the rising involvement of young people in cybercrime or internet fraud.

Keywords: crime, socio economic factor, inmates, correctional facilities, Southwest

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Authors: Vicent Lwanga

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Background: Elderly Widows Orphans Family Support, a Community Based Organization operating in Kapchorwa with the main focus of reducing economic and social vulnerability among children affected by HIV/AIDS. The survey on reducing vulnerability targeted HIV/AIDS affected households, which included 111 adults and 185 children. The broad objective of the study was to determine how the needs of the children affected by HIV/AIDS could be appropriately met by specifically examining the situation of children affected by HIV/AIDS and establishing their needs. Methodology: The survey applied a structured questionnaire. Parents whose consent for the interview of the children had been obtained then communicated to the selected child/children. If the child consented, an arrangement for the interview was made as regards the time and place of the interview. Lessons: Adult respondents included 22.2% males and 77.8% females. Child respondents were males, 49.5%, and females 50.5%. The majority of the households are from lower economic strata. 74.1% and 63.0% of males and females, respectively, indicated that their illness had affected their income-earning activities; some of the adults have lost their jobs due to AIDS. A fair number of the children are engaged in economic activity: some of those still in school worked after school for wages and looked after their siblings. The income earned was spent mostly on household needs and school fees — one-fifth of children linked parents` inability to do more of what they desired to their ill-health. Elderly Widows Orphans Family Support secured sponsors to educate 22 girls and 16 boys in the community. Income-generating projects like piggery and skill training are given to orphans. The specific vulnerability of HIV/AIDS orphan's needs is responded to now more than ever. Community organisations interventions such as financial support to orphans introduced to moderate the impact of the disease on orphans and families.

Keywords: aids, children, needs, vulnerability

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Authors: Xiyue Wen

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With the rapid development of the city, old communities in the city are facing a series of problems. On one hand, aging facilities, obsolete spatial patterns, aging populations arouse in the aging of the community. On the other hand, public space is reduced and is taking up by cars parking or facilities setting, which lead to the collapse of traditional life in the old communities. That is to say, modern amenities haven’t helped to reform the old community, but have leading to tedious and inefficient, when it is not accommodated in the traditional space. Exploring a way is imminent to the east the contradiction between modern living facilities and spatial patterns of traditional. We select a typical site-GeDa Community in Xi’an, built in 70-80s，and carry out a concept calling 'Raising Landscape', which enables a convenient and efficient space for parking, as well as a high-quality yard for activities. In addition, the design implements low cost, simple construction, resident participation, so that it can be spread in the same texture of urban space.

Keywords: old communities, renewal strategy, raising landscape, public space, parking space

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Authors: Tania Chalton

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In June 2013, an independent review of the Liverpool Care Pathway (LCP) identified a number of problems with the implementation of the LCP in the UK and recommended that it be replaced by individual care plans for each patient. As a result of the UK findings, in November 2013 the Ministry of Health (MOH) commissioned the Palliative Care Council to initiate a programme of work to investigate an appropriate approach for the care of people in their last days of life in New Zealand (NZ). The Last Days of Life Working Group commenced a process to develop national consensus on the care of people in their last days of life in April 2014. In order to develop its advice for the future provision of care to people in their last days of life, the Working Group (WG) established a comprehensive work programme and as a result has developed a series of working papers. Specific areas of focus included: An analysis of the UK Independent Review findings and an assessment of these findings to the NZ context. A stocktake of services providing care to people in their last days of life, including aged residential care (ARC); hospices; hospitals; and primary care. International and NZ literature reviews of evidence and best practice. Survey of family to understand the consumer perspective on the care of people in their last days of life. Key aspects of care that required further considerations for NZ were: Terminology: clarify terminology used in the last days of life and in relation to death and dying. Evidenced based: including specific review of evidence regarding, spiritual, culturally appropriate care as well as dementia care. Diagnosis of dying: need for both guidance around the diagnosis of dying and communication with family. Workforce issues: access to an appropriate workforce after hours. Nutrition and hydration: guidance around appropriate approaches to nutrition and hydration. Symptom and pain management: guidance around symptom management. Documentation: documentation of the person’s care which is robust enough for data collection and auditing requirements, not ‘tick box’ approach to care. Education and training: improved consistency and access to appropriate education and training. Leadership: A dedicated team or person to support and coordinate the introduction and implementation of any last days of life model of care. Quality indicators and data collection: model of care to enable auditing and regular reviews to ensure on-going quality improvement. Cultural and spiritual: address and incorporate any cultural and spiritual aspects. A final document was developed incorporating all the evidence which provides guidance to the health sector on best practice for people at end of life: “Principles and guidance for the last days of life: Te Ara Whakapiri”.

Keywords: end of life, guidelines, New Zealand, palliative care

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Authors: Huang Chiung Chiu

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This article is about the nursing experience of assisting an outpatient with premature menopause, osteoporosis and sarcopenia through a multi-discipline care model. The nursing period is from September 22nd, 2020, to December 7th, 2020, collecting data through interviews with the patient, observation, and physical assessment. It was found that the main health problems were insufficient nutrition, less physical need, insomnia, and potentially dangerous falls. As an outpatient nurse, the author observed that in recent years, the age group of women with premature menopause, osteoporosis and sarcopenia had shifted downward. Integrated multi-disciplinary interventions were provided upon the initial diagnosis of osteoporosis and sarcopenia. Under the outpatient care setting, the collaborative team works between the doctors, nutritionists, osteoporosis educators, rehabilitates, physical therapists and other specialized teams were applied to provide individualized, integrated multi-disciplinary care. Through empathy and the establishment of attentive care, companionship and trust, we discussed care plans and treatment guidelines with the case, providing accurate, complete disease information and feedback education to strengthen the patient’s knowledge and motivation for exercise. Nursing guidance regarding the dietary nutrition and adjustment of daily routine was provided to increase the self-care ability, improve the health problems of muscle weakness and insomnia, and prevent falls. For patients with postmenopausal osteoporosis and sarcopenia, it is recommended that the nurses coordinate the multi-discipline integrated care model, adjust patients’ lifestyle and diet, and establish a regular exercise plan so that the cases can be evaluated holistically to improve the quality of care and physical and mental comfort.

Keywords: multi-discipline care model, premature menopause, osteoporosis, sarcopenia, insomnia

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Authors: Elham Azimzadeh, Fahimeh Khorshidi, Alireza Farsi

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Balance impairment and fear of falling in older adults may reduce their quality of life. Reactive balance training could improve rapid postural responses and fall prevention in the elderly during daily tasks. Performing postural training and simultaneously cognitive dual tasks could be similar to the daily circumstances. Purpose: This study aimed to determine the effect of balance training on stable and unstable surfaces under dual cognitive task conditions on postural control and fear of falling in the elderly. Methods: Thirty non-fallers of older adults (65-75 years) were randomly assigned to two training groups: stable-surface (n=10), unstable-surface (n=10), or a control group (n=10). The intervention groups underwent six weeks of balance training either on a stable (balance board) or an unstable (wobble board) surface while performing a cognitive dual task. The control group received no balance intervention. COP displacements in the anterioposterior (AP) and mediolateral (ML) directions using a computerized balance board, functional balance using TUG, and fear of falling using FES-I were measured in all participants before and after the interventions. Summary of Results: Mixed ANOVA (3 groups * 2 times) with repeated measures and post hoc test showed a significant improvement in both intervention groups in AP index (F= 11/652, P= 0/0002) and functional balance (F= 9/961, P= 0/0001). However, the unstable surface training group had more improvement. However, the fear of falling significantly improved after training on an unstable surface (p= 0/035). All groups had no significant improvement in the ML index (p= 0/817). In the present study, there was an improvement in the AP index after balance training. Conclusion: Unstable surface training may reduce reaction time in posterior ankle muscle activity. Furthermore, focusing attention on cognitive tasks can lead to maintaining balance unconsciously. Most of the daily activities need attention distribution among several activities. So, balance training concurrent to a dual cognitive task is challenging and more similar to the real world. According to the specificity of the training principle, it may improve functional independence and fall prevention in the elderly.

Keywords: cognitive dual task, elderly, fear of falling, postural control, unstable surface

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Authors: Taner Ersoz, Filiz Ersoz

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This study was designed enable application of multivariate technique in the interpretation of categorical data for measuring health care services satisfaction in Turkey. The data was collected from a total of 17726 respondents. The establishment of the sample group and collection of the data were carried out by a joint team from The Ministry of Health and Turkish Statistical Institute (Turk Stat) of Turkey. The multiple correspondence analysis (MCA) was used on the data of 2882 respondents who answered the questionnaire in full. The multiple correspondence analysis indicated that, in the evaluation of health services females, public employees, younger and more highly educated individuals were more concerned and complainant than males, private sector employees, older and less educated individuals. Overall 53 % of the respondents were pleased with the improvements in health care services in the past three years. This study demonstrates the public consciousness in health services and health care satisfaction in Turkey. It was found that most the respondents were pleased with the improvements in health care services over the past three years. Awareness of health service quality increases with education levels. Older individuals and males would appear to have lower expectancies in health services.

Keywords: multiple correspondence analysis, multivariate categorical data, health care services, health satisfaction survey

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Authors: S. Vadivukkarasi, K. Karthi, M. Karthick, C. Dinesh, S. Santhosh, A. Yogaraj

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The appointment system was designed to minimize patient’s idle time overlooking patients waiting time in hospitals. This is no longer valid in today’s consumer oriented society. Long waiting times for treatment in the outpatient department followed by short consultations has long been a complaint. Nowadays, customers use waiting time as a decisive factor in choosing a service provider. Queuing theory constitutes a very powerful tool because queuing models require relatively little data and are simple and fast to use. Because of this simplicity and speed, modelers can be used to quickly evaluate and compare various alternatives for providing service. The application of queuing models in the analysis of health care systems is increasingly accepted by health care decision makers. Timely access to care is a key component of high-quality health care. However, patient delays are prevalent throughout health care systems, resulting in dissatisfaction and adverse clinical consequences for patients as well as potentially higher costs and wasted capacity for providers. Arguably, the most critical delays for health care are the ones associated with health care emergencies. The allocation of resources can be divided into three general areas: bed management, staff management, and room facility management. Effective and efficient patient flow is indicated by high patient throughput, low patient waiting times, a short length of stay at the hospital and overtime, while simultaneously maintaining adequate staff utilization rates and low patient’s idle times.

Keywords: appointment system, patient scheduling, bed management, queueing calculation, system analysis

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Authors: R. Knizek, D. Karhankova

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The production of nanofibers and the machinery for their production is a current issue. The pioneer, in the industrial production of nanofibers, is the machinery with the sales descriptions Nanospider^TM from the company Elmarco, which came into being in 2008. Most of the production facilities, like Nanospider^TM, use electrospinning. There are also other methods of industrial production of nanofibers, such as the centrifugal spinning process, which is used by FibeRio Technology Corporation. However, each method and machine has its advantages, but also disadvantages and that is the reason why a new machine called as Nanomachine, which eliminates the disadvantages of other production facilities producing nanofibers, has been developed.

Keywords: nanomachine, nanospider, spinning slat, electrospinning

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Authors: Abdullateef Abdulkarim Jimoh, Muhammad Lawal A., Usman Muhammad, Hamisu Abdullahi, Nuhu Abdullahi Jega

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Smart city projects can be aided by urban development policies in public facilities, but economic resources to finance urban system reorganization is an issue to various governments. This is further compounded with the impact of the slowing down of national economies. The aim of this paper is to emphasize the need to prioritize the economic benefits of smart city projects and, specifically, in towns transforming into cities like Birnin kebbi. The smart-city projects can aim at developing a new form of ‘‘modernity and civilization’’ of the productive economy. This study adopts the descriptive statistical approach to identify the key performance indicators (KPI) for tracking the progress of cities and its developmental objectives. It has been established that numerous aspects of the modernization policies can enhance the competitiveness of territories, particular in aspects of social cohesion, the diffusion of knowledge, creativity, accessibility, etc.

Keywords: economy, economic policy, public facilities, smart city, urbanization

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Authors: Sakul Jariyachamsit

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The objectives of this research were to study the behaviour of inbound tourist who visited Ratanakosin Island and to study their needs concerning support facilities. The independent variables included gender, age, levels of education, occupation, and income while the dependent variables were classified into two groups: tourists’ behaviour variables and tourists’ need of supporting facilities. A simple random sampling method was utilized to get 225 respondents. The majority of respondents were both male and female in the same proportion but most were between 21-30 years old. Most were married with a graduated degree. The average income of the respondents was between $20,000-30,000. The findings revealed that the majority of respondents came to Thailand for the first time and spent about 8 days in Thailand and preferred to travel in small groups. Their decision to come to Thailand was influenced by word of mouth. When they first thought of Thailand, they thought of Thai food. In terms of the needs for tourists around the Ratanakosin Island, and ranked in importance, are as follows: a tourist centre, somebody who can speak English, a trustable agency, police patrol, and the availability of maps and brochures.

Keywords: Rattanakosin Island, tourist, travelling behaviour, media engineering

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Authors: S. Kurian, S. Satpathy, S. K. Gupta, S. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: adverse events, health care technology, medical devices, public sector hospital, reporting systems

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Authors: A. Sathiya Susuman

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Background: The importance of maternal and child healthcare services cannot be stressed enough. These services are very important for the health and health outcomes of the mother and that of the child and in ensuring that both maternal and child deaths are prevented. The objective of the study is to inspire good quality maternal and child health care services in Swaziland. Specifically, is Swaziland on track with the 2015 Millennium Development Goals? Methods: The study used secondary data from the Swaziland Demographic and Health Survey 2006-07. This is an explorative and descriptive study which used pre-selected variables to study factors influencing the use of maternal and child healthcare services in Swaziland. Different types of examinations, such as univariate, bivariate, and multivariate statistical analysis were adopted. Results: The study findings showed a high use rate of antenatal care (97.3%) and delivery care (74.0%), and a low rate of postnatal care use (20.5%). The uptake childhood immunization is also high in the country, averaging more than 80.0%. Moreover, certain factors which were found to be influencing the use of maternal healthcare and childhood immunization include: woman’s age, parity, media exposure, maternal education, wealth status, and residence. The findings also revealed that these factors affect the use of maternal and child health differently. Conclusion: It is important to study factors related to maternal and child health uptake to inform relevant stakeholders about possible areas of improvement. Programs to educate families about the importance of maternal and child healthcare services should be implemented. Swaziland needs to work hard on child survival and maternal health care services, no doubt it is on track with the MDG 4 & 5.

Keywords: maternal healthcare, antenatal care, delivery care, postnatal care, child health, immunization, socio-economic and demographic factors

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Authors: M. A. Marlow, R. Sørly, H. K. Kaatrakoski

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Social work practice produces and circulates dominant narratives of young women in residential care. These stories are characterised by negative descriptions and hopelessness while dismissing the capabilities of narrative practice. This paper gives an account of how young women with histories in residential care can resist the dominant narratives. The analysis is based on a study of five young women aged 17 to 26 years old with different backgrounds and experiences with Norwegian residential care. The meaning of the context is analysed based on two interviews that were completed and one that was cancelled in the field. The contextual narrative analysis was oriented around the understanding of stories as performances and provided insight into a possible future storytelling practice in social work. The first author’s field notes are included as part of the data material in the analysis and provide a picture of important knowledge development related to stories and the value of being able to tell one’s own experiences. Faced with the dominant narratives that define young women with negative experiences with residential care, we provide a more contextualised understanding of storytelling as a possibility for positive change. To allow young women to create new stories from their lives, we, as both social workers and researchers, must be aware of what kinds of stories we relate to our own practices.

Keywords: context analysis, narrative research, rejection, residential care, social work practice

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Authors: Adrita Banerjee, Ajeet Kumar Singh

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Antenatal care (ANC) from a skilled provider is important to monitor the pregnancy and reduce the risk of morbidity for mother and baby during pregnancy and delivery. The quality of antenatal care can be monitored through the content of services received and the kind of information mothers are given during their visit. Objective: The paper tries to examine the association between ANC check-ups and size/ birth weight. It also focuses on investigating the relationship between utilization of recommended prenatal care for mothers and its effect on infant survival in Nepal. Data and methods: This paper uses data from Nepal demographic Health Survey 2011. To understand the relationship bi-variate statistical analysis and logistic regressions has been done. Maternal health care utilization include ANC check-ups i.e. the type of ante-natal care providers, the number and timing of the visit. The various components of the check-ups include intake of iron tablets/syrups, intestinal parasitic drugs, etc. Results: The results show that women who had no antenatal care visits about 40% had small sized babies at the time of birth compared to women to had at least 3 ANC check up. Women who had at least 3 check-ups 17% of the babies have a small size. It has also been found that about 50 % of the women prefer ANC check-ups during pregnancies which have resulted in lowering the infant mortality by about 40% during 1996-2011. Conclusion: Ante natal care check is care and monitoring of the pregnant woman and her foetus throughout pregnancy. ANC checks have an effect on the infant health and child survival. A woman who had at least three check-ups the possibilities of adverse effect on infant health and infant survival was significantly lower. The findings argue for a more enhanced focus on ANC check-ups for improving the maternal and child health in Nepal.

Keywords: maternal, health, pregnancy, outcome

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Authors: Anthoni Jeorge

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Throughout the history of the world, servant leadership has been researched, and favourable results such as individual, team, and organizational have been linked to the construct. This research paper designates St. Camillus de Lellis, a practitioner of servant leadership and founder of the Ministers of the Sick as a servant leader in his approach to care for the sick. Service is the visible face of his servant leadership. First of all, despite many challenges, St. Camillus de Lellis practiced leadership by the example of compassionate service to the sick. Second, he made service to the sick the highest priority of his life. Third, Camillus displayed servant leadership such that his manner of leadership gave birth to a New School of Service to the Sick. The paper identifies the distinctive dimensions and essential elements which characterized his service-centered leadership. Furthermore, discuss the six major characteristics of a servant leader as set forth by St. Camillus’s life example. The research illustrates the transformational power of servant leadership infield healthcare in general and, in doing so, provides servant leadership seekers ways servant leadership can transform elder care in one’s own field (St. Camillus Health Systems). Thus, it ascertains that servant leadership is best-fit for humanized elder care. Supported by the review of literature, the paper ascertains that Camillus, by identifying himself with the sick, gained deeper insights concerning the pain and suffering of the population. Uniquely drawn from his true grit, Camillus’ service-centered leadership is value-based, people-oriented, and compassion-filled. His way of service to the sick is the prolongation of gestures of mercy and compassion. It is hoped that the results of this study will help health care workers and servant leadership practitioners to humanize elder care and cultivate servant leadership attitude in their health care services to the sick. By incorporating such service-oriented elements into their leadership orientation, health care workers will be true servant leaders of the sick.

Keywords: leadership, service, healthcare, compassion

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Authors: Ebenezer Kwesi Armah-Ansah, Kenneth Fosu Oteng, Esther Selasi Avinu, Eugene Budu, Edward Kwabena Ameyaw

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Background: Maternal mortality, particularly in Benin, is a major public health concern in Sub-Saharan Africa. To provide a positive pregnancy experience and reduce maternal morbidities, all pregnant women must get appropriate and timely prenatal support. However, many pregnant women in developing countries, including Benin, begin antenatal care late. There is a paucity of empirical literature on the prevalence and predictors of early antenatal care visits in Benin. As a result, the purpose of this study is to investigate the prevalence and predictors of early antenatal care visits among women of productive age in Benin. Methods: This is a secondary analysis of the 2017/2018 Benin Demographic and Health Survey (BDHS) data. The study involved 6,919 eligible women. Data analysis was conducted using Stata version 14.2 for Mac OS. We adopted a multilevel logistic regression to examine the predictors of early ANC visits in Benin. The results were presented as odds ratios (ORs) associated with 95% confidence intervals (CIs) and p-value <0.05 to determine the significant associations. Results: The prevalence of early ANC visits among pregnant women in Benin was 57.03% [95% CI: 55.41-58.64]. In the final multilevel logistic regression, early ANC visit was higher among women aged 30-34 [aOR=1.60, 95% CI=1.17-2.18] compared to those aged 15-19, women with primary education [aOR=1.22, 95% CI=1.06-142] compared to the non-educated women, women who were covered by health insurance [aOR=3.03, 95% CI=1.35-6.76], women without a big problem in getting the money needed for treatment [aOR=1.31, 95% CI=1.16-1.49], distance to the health facility, not a big problem [aOR=1.23, 95% CI=1.08-1.41], and women whose partners had secondary/higher education [aOR=1.35, 95% CI=1.15-1.57] compared with those who were not covered by health insurance, had big problem in getting money needed for treatment, distance to health facility is a big problem and whose partners had no education respectively. However, women who had four or more births [aOR=0.60, 95% CI=0.48-0.74] and those in Atacora Region [aOR=0.50, 95% CI=0.37-0.68] had lower odds of early ANC visit. Conclusion: This study revealed a relatively high prevalence of early ANC visits among women of reproductive age in Benin. Women's age, educational status of women and their partners, parity, health insurance coverage, distance to health facilities, and region were all associated with early ANC visits among women of reproductive in Benin. These factors ought to be taken into account when developing ANC policies and strategies in order to boost early ANC visits among women in Benin. This will significantly reduce maternal and newborn mortality and help achieve the World Health Organization’s recommendation that all pregnant women should initiate early ANC visits within the first three months of pregnancy.

Keywords: antenatal care, Benin, maternal health, pregnancy, DHS, public health

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Authors: Ansari Mohammad Reza, Hiroko Ono, Fakhrullah Sarwari

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Our world is fast heading toward being a predominantly urban planet. This can be a double-edged sword reality where it is as much frightening as it seems interesting. Moreover, a look to the current predictions and taking into the consideration the fact that about 90 percent of the coming urbanization is going to be absorbed by the towns and the cities of the developing countries of Asia and Africa, directly provide us the clues to assume a much more tragic ending to this story than to the happy one. Likewise, in a situation wherein most of these countries are still severely struggling to find the proper answer to their very first initial questions of urbanization—e.g. how to provide the essential structure for their cities, define the regulation, or even design the proper pattern on how the cities should be expanded—thus it is not weird to claim that most of the coming urbanization of the world is going to happen informally. This reality could not only bring the feature, landscape or the picture of the cities of the future under the doubt but at the same time provide the ground for the rise of a bunch of other essential questions of how the facilities would be distributed in these cities, or how fair will this pattern of distribution be. Kabul the capital of Afghanistan, as a city located in the developing world that its process of urbanization has been starting since 2001 and currently hold the position to be the fifth fastest growing city in the world, contained to a considerable slum ratio of 0.7—that means about 70 percent of its population is living in the informal areas—subsequently could be a very good case study to put this questions into the research and find out how the informal development of a city can lead to the unfair and unbalanced distribution of its facilities. Likewise, in this study we tried our best to first propose the ideal model for the fair distribution of the facilities in the Kabul city—where all the citizens have the same equal chance of access to the facilities—and then evaluate the situation of the city based on how fair the facilities are currently distributed therein. We subsequently did it by the comparative analysis between the existing facility rate in the formal and informal areas of the city to the one that was proposed as the fair ideal model.

Keywords: Afghanistan, facility distribution, formal settlements, informal settlements, Kabul

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