Search results for: clinical quality

Authors: Hyun-Woo Cho

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The monitoring of industrial production quality has to be implemented to alarm early warning for unusual operating conditions. Furthermore, identification of their assignable causes is necessary for a quality control purpose. For such tasks many multivariate statistical techniques have been applied and shown to be quite effective tools. This work presents a process data-based monitoring scheme for production processes. For more reliable results some additional steps of noise filtering and preprocessing are considered. It may lead to enhanced performance by eliminating unwanted variation of the data. The performance evaluation is executed using data sets from test processes. The proposed method is shown to provide reliable quality control results, and thus is more effective in quality monitoring in the example. For practical implementation of the method, an on-line data system must be available to gather historical and on-line data. Recently large amounts of data are collected on-line in most processes and implementation of the current scheme is feasible and does not give additional burdens to users.

Keywords: detection, filtering, monitoring, process data

Procedia PDF Downloads 559

Authors: Joy Cao, Min Zhou

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Purpose: Acute Type A aortic dissection is a well-known cause of extremely high mortality rate. A highly accurate and cost-effective non-invasive predictor is critically needed so that the patient can be treated at earlier stage. Although various CFD approaches have been tried to establish some prediction frameworks, they are sensitive to uncertainty in both image segmentation and boundary conditions. Tedious pre-processing and demanding calibration procedures requirement further compound the issue, thus hampering their clinical applicability. Using the latest physics informed deep learning methods to establish an accurate and cost-effective predictor framework are amongst the main goals for a better Type A aortic dissection treatment. Methods: Via training a novel physics-informed deep residual network, with non-invasive 4D MRI displacement vectors as inputs, the trained model can cost-effectively calculate all these biomarkers: aortic blood pressure, WSS, and OSI, which are used to predict potential type A aortic dissection to avoid the high mortality events down the road. Results: The proposed deep learning method has been successfully trained and tested with both synthetic 3D aneurysm dataset and a clinical dataset in the aortic dissection context using Google colab environment. In both cases, the model has generated aortic blood pressure, WSS, and OSI results matching the expected patient’s health status. Conclusion: The proposed novel physics-informed deep residual network shows great potential to create a cost-effective, non-invasive predictor framework. Additional physics-based de-noising algorithm will be added to make the model more robust to clinical data noises. Further studies will be conducted in collaboration with big institutions such as Cleveland Clinic with more clinical samples to further improve the model’s clinical applicability.

Keywords: type-a aortic dissection, deep residual networks, blood flow modeling, data-driven modeling, non-invasive diagnostics, deep learning, artificial intelligence.

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Authors: Amer Obaid Saud

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Water quality index (WQI) is considered as an effective tool in categorization of water resources for its quality and suitability for different uses. The Canadian version of water quality index (CCME WQI) which based on the comparison of the water quality parameters to regulatory standards and give a single value to the water quality of a source was applied in this study to assess the water quality of Euphrates river in Iraq at Babylon Governorate north of Baghdad and determine its suitability for aquatic environment (GWQI), drinking water (PWSI) and irrigation(IWQI). Five stations were selected on the river in Babylon (Euphrates River/AL-Musiab, Hindia barrage, two stations at Hilla city and the fifth station at Al-Hshmeya north of Hilla. Fifteen water samples were collected every month during August 2013 to July 2014 at the study sites and analyzed for the physico-chemical parameters like (Temperature, pH, Electrical Conductivity, Total Dissolved Solids(TDS), Total Suspended Solids(TSS), Total Alkalinity, Total Hardness, Calcium and Magnesium Concentration, some of nutrient like Nitrite, Nitrate, Phosphate also the study of concentration of some heavy metals (Fe, Pb, Zn, Cu, Mn, and Cd) in water and comparison of measures to benchmarks such as guidelines and objectives to assess change in water quality. The result of Canadian version of(CCME .WQI) to assess the irrigation water quality (IWQI) of Euphrates river was (83-good) at site one during second seasonal period while the lowest was (66-Fair) in the second station during the fourth seasonal period, the values of potable water supply index (PWSI)that the highest value was (68-Fair) in the fifth site during the second period while the lowest value (42 -Poor) in the second site during the first seasonal period,the highest value for general water quality (GWQI) was (74-Fair) in site five during the second seasonal period, the lowest value (48-Marginal) in the second site during the first seasonal period. It was observed that the main cause of deterioration in water quality was due to the lack of, unprotected river sites ,high anthropogenic activities and direct discharge of industrial effluent.

Keywords: Babylon governorate, Canadian version, water quality, Euphrates river

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Authors: Levan Sabauri

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Audit is an independent inspection of the financial statement of the audited person and expresses the opinion of an auditor on the reliability of this statement. The auditor’s activity (auditor’s service) is realized by auditing organizations, individual auditors in connection to conduction of an audit and rendering of audit accompanying services. The profession of auditor means a high level of responsibility for rendered service. Results of decisions made by information users depend on the quality of the auditor’s conclusion. Owners, investors, creditors, and society rely on the opinion of the auditor under the condition that inspection was conducted with good quality. Therefore, the existence of the well-functioning audit quality control system for the administering of the audit is an important issue. An efficient audit quality control system is a substantial challenge that many countries face worldwide, especially those states where these systems are being formed within the respective reform program. The presented article reflects on the best practices of the leading countries, the assumptions and recommendations for the financial accounting, reporting and audit; current reforms in Georgia are made based on this comparative analysis.

Keywords: audit quality control, audit program, financial statement, perspective analysis

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Authors: Mingming Leng

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Wal-Mart has allocated considerable human resources for its quality assurance program, in which the largest retailer serves its supply chains as a quality gatekeeper. Asda Stores Ltd., the second largest supermarket chain in Britain, is now investing £27m in significantly increasing the frequency of quality control checks in its supply chains and thus enhancing quality across its fresh food business. Moreover, Tesco, the largest British supermarket chain, already constructed a quality assessment center to carry out its gatekeeping responsibility. Motivated by the above practices, we consider a supply chain in which a retailer plays the gatekeeping role in quality assurance by identifying defects among a manufacturer's products prior to selling them to consumers. The impact of a retailer's gatekeeping activity on pricing and quality assurance in a supply chain has not been investigated in the operations management area. We draw a number of managerial insights that are expected to help practitioners judiciously consider the quality gatekeeping effort at the retail level. As in practice, when the retailer identifies a defective product, she immediately returns it to the manufacturer, who then replaces the defect with a good quality product and pays a penalty to the retailer. If the retailer does not recognize a defect but sells it to a consumer, then the consumer will identify the defect and return it to the retailer, who then passes the returned 'unidentified' defect to the manufacturer. The manufacturer also incurs a penalty cost. Accordingly, we analyze a two-stage pricing and quality decision problem, in which the manufacturer and the retailer bargain over the manufacturer's average defective rate and wholesale price at the first stage, and the retailer decides on her optimal retail price and gatekeeping intensity at the second stage. We also compare the results when the retailer performs quality gatekeeping with those when the retailer does not. Our supply chain analysis exposes some important managerial insights. For example, the retailer's quality gatekeeping can effectively reduce the channel-wide defective rate, if her penalty charge for each identified de-fect is larger than or equal to the market penalty for each unidentified defect. When the retailer imple-ments quality gatekeeping, the change in the negotiated wholesale price only depends on the manufac-turer's 'individual' benefit, and the change in the retailer's optimal retail price is only related to the channel-wide benefit. The retailer is willing to take on the quality gatekeeping responsibility, when the impact of quality relative to retail price on demand is high and/or the retailer has a strong bargaining power. We conclude that the retailer's quality gatekeeping can help reduce the defective rate for consumers, which becomes more significant when the retailer's bargaining position in her supply chain is stronger. Retailers with stronger bargaining powers can benefit more from their quality gatekeeping in supply chains.

Keywords: bargaining, game theory, pricing, quality, supply chain

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Authors: Nancy Wilson

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In utero, fetal drug exposure is prevalent amongst birthing facilities. Assessment tools for neonatal abstinence syndrome (NAS) are often cumbersome and ill-fitting, harboring immense subjectivity. This paradox often leads the clinical assessor to be hypervigilant when assessing the newborn for subtle symptoms of NAS, often mistaken for normal newborn behaviors. As a quality improvement initiative, this project led to a more adaptable NAS tool termed eat, sleep, console (ESC). This function-based NAS assessment scores the infant based on the ability to accomplish three basic newborn necessities- to sleep, to eat, and to be consoled. Literature supports that ESC methodology improves patient and family outcomes while providing more cost-effective care.

Keywords: neonatal abstinence syndrome, neonatal opioid withdrawal, maternal substance abuse, pregnancy, and addiction, Finnegan neonatal abstinence syndrome tool, eat, sleep, console

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Authors: Julie Wittmannová, Petr Šeda

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Quality of life measurements (QLF) help to evaluate interventions programs in different groups of persons with special needs. Our presentation deals with QLF of persons with addiction in relation to the physical activity (PA), type of addiction, age, gender and other variables. The aim of presentation is to summarize the basic findings and offer thoughts for questions arose. Methods: SQUALA (Subjective Quality of Life Analysis); SEIQoL (Schedule for the Evaluation of Individual Quality of Life); questionnaire of own construction. The results are evaluated by Mann­Whitney U test and Kruskall­Wallis ANOVA test (p ≤ 0,05). Sample of 64 participants – clients of aftercare center, aged 18 plus. Findings: Application of the methods SQUALA and SEIQoL in the chosen population seems appropriate, the obtaining information regarding the QLF correlate to intervention program topics, the need of an activelifestyle and health related topics in persons with addiction is visible. Conclusions or Implications: The subjective evaluation of quality of life of Aftercare clients is an important part of evaluation process, especially used to evaluate satisfaction with offered services and programs. Techniques SQUALA and SEIQoL gave us the desired outcomes.

Keywords: adapted physical activity, addiction, quality of life, physical activity, aftercare

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Authors: Yasuyuki Takahashi, Hayato Ishimura, Masao Miyagawa, Teruhito Mochizuki

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Quantitative measurement of myocardium perfusion is possible with single photon emission computed tomography (SPECT) using a semiconductor detector. However, accumulation of ^99mTc-tetrofosmin in the liver may make it difficult to assess that accurately in the inferior myocardium. Our idea is to reduce the high accumulation in the liver by using dynamic SPECT imaging and a technique called time subtraction. We evaluated the performance of a new SPECT system with a cadmium-zinc-telluride solid-state semi- conductor detector (Discovery NM 530c; GE Healthcare). Our system acquired list-mode raw data over 10 minutes for a typical patient. From the data, ten SPECT images were reconstructed, one for every minute of acquired data. Reconstruction with the semiconductor detector was based on an implementation of a 3-D iterative Bayesian reconstruction algorithm. We studied 20 patients with coronary artery disease (mean age 75.4 ± 12.1 years; range 42-86; 16 males and 4 females). In each subject, 259 MBq of ^99mTc-tetrofosmin was injected intravenously. We performed both a phantom and a clinical study using dynamic SPECT. An approximation to a liver-only image is obtained by reconstructing an image from the early projections during which time the liver accumulation dominates (0.5~2.5 minutes SPECT image-5~10 minutes SPECT image). The extracted liver-only image is then subtracted from a later SPECT image that shows both the liver and the myocardial uptake (5~10 minutes SPECT image-liver-only image). The time subtraction of liver was possible in both a phantom and the clinical study. The visualization of the inferior myocardium was improved. In past reports, higher accumulation in the myocardium due to the overlap of the liver is un-diagnosable. Using our time subtraction method, the image quality of the ^99mTc-tetorofosmin myocardial SPECT image is considerably improved.

Keywords: 99mTc-tetrofosmin, dynamic SPECT, time subtraction, semiconductor detector

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Authors: Linta Koka

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Aim: The way people with severe mental disorders deal with self-stigma and how it affects their self-esteem is a problem that has gained much attention in recent years. The primary aim of this study was to empirically explore the link between self-stigma and self-esteem of individuals with the presence of a mental illness, offering a novel perspective by exploring the same variables amongst a sample without a mental illness. Methods: This study utilized a cross-sectional study. Participants with (N=85) and without (N=75) a mental health issue were included from Darlingdon's Mind organization. Participants completed two scales, one of Self-Stigma of Mental Illness Scale and one of Self-Esteem, following some demographics questions. Results: According to the primary hypothesis, self-stigma significantly correlates with self-esteem in the clinical population. Furthermore, gender and ethnicity, above all the demographics, positively correlates to the relationship of self-stigma with self-esteem in people who endure a mental health issue. Limitations: A significant limitation is that of the size of the sample of participants conducted in this study. The clinical population was limited to 85 participants, and the control group consisted of 76 participants. Since the sample was not representative. The small size used did not allow any comparisons between the group with mental illness and the control group. There was a restricted time to approach the participants since the online survey was released by the end of May. Conclusions: Individuals suffering from mental illnesses may internalize stigmatizing stereotypes on an explicit level. Efforts should be made to lessen the harmful impact stigma may have on mentally ill people, such as worsening symptoms or delays in receiving care. Further study is needed within this small research topic to improve awareness and regulate mental health among the general population. Undoubtedly, people with mental disorders are stigmatized; therefore, more research is required to explore all factors contributing to mentally ill patients' devaluation.

Keywords: self-stigma, mental illness, self-esteem, clinical population, non-clinical population

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Authors: Matthias Nnadi

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Using samples of 250 large listed firms by market capitalization in China and Hong Kong, we conducted empirical test to determine the impact of regulatory environment on reporting quality following IFRS convergence using three financial reporting measures; earning management, timely loss recognition and value relevance. Our results indicate that accounting data are more value relevant for Hong Kong listed firms than the Chinese A-share firms. The empirical results for timely loss recognition further reveal that there is a larger coefficient estimate on bad news earnings, which suggests that Chines A-share firms are more likely to report losses in a timely manner. The results support the evidence that substantial convergence of IFRS can improve financial reporting quality in a regulated environment such as China. This further supports the expectation that IFRS are relevant to China and has positive effect on its accounting practice and quality.

Keywords: reporting, quality, earning, loss, relevance, financial, China, Hong Kong

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Authors: Komang Rahayu Indrawati, Ni Wayan Sinthia Widiastuti, Ratna Dewi Santosa

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Today the career of Balinese working women has been highly developed where able to work with loyalty and high professionalism. Career for a woman is one conscious choice and a call of conscience, which provides financial support for her family. Career for women can develop their own potencies, intellectually, and socially, so women feel that their role is meaningful and beneficial for herself and others. Emotional support becomes important to understand certainly for women who have multirole like Balinese working women to meet the demands of their role and also enhancing their work motivation and the quality of work life. This research used quantitative research method with questionnaires dissemination to 120 respondents and analyzed using Multiple Regression Analysis. The purpose of this study was to see the role of emotional support for work motivation and quality of work life in working Balinese women. The results of this study showed that emotional support and work motivation give a significant role in the quality of work life on Balinese working women.

Keywords: Balinese working women, emotional support, quality of work life, work motivation

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Authors: Gianluca Castelnuovo, Giada Pietrabissa, Gian Mauro Manzoni, Margherita Novelli, Emanuele Maria Giusti, Roberto Cattivelli, Enrico Molinari

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Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. Such conditions include not only type 2 diabetes, but also cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. The financial direct and indirect burden (considering also the clinical resources involved and the loss of productivity) is a real challenge in many Western health-care systems. Recently the Lancet journal defined diabetes as a 21st-century challenge. In order to promote patient compliance in diabesity treatment reducing costs, evidence-based interventions to improve weight-loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. Moreover, new technologies can provide useful solutions in this multidisciplinary approach, above all in maintaining long-term compliance and adherence in order to ensure clinical efficacy. Psychological therapies with diet and exercise plans could better help patients in achieving weight loss outcomes, both inside hospitals and clinical centers and during out-patient follow-up sessions. In the management of chronic diseases clinical psychology play a key role due to the need of working on psychological conditions of patients, their families and their caregivers. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of many chronic pathologies: one of the best up-to-date application is the management of obesity with type 2 diabetes, where mHealth solutions can provide remote opportunities for enhancing weight reduction and reducing complications from clinical, organizational and economic perspectives. A stepped care mHealth-based approach is an interesting perspective in chronic care management of obesity with type 2 diabetes. One promising future direction could be treating obesity, considered as a chronic multifactorial disease, using a stepped-care approach: -mhealth or traditional based lifestyle psychoeducational and nutritional approach. -health professionals-driven multidisciplinary protocols tailored for each patient. -inpatient approach with the inclusion of drug therapies and other multidisciplinary treatments. -bariatric surgery with psychological and medical follow-up In the chronic care management of globesity mhealth solutions cannot substitute traditional approaches, but they can supplement some steps in clinical psychology and medicine both for obesity prevention and for weight loss management.

Keywords: clinical health psychology, mhealth, obesity, type 2 diabetes, stepped care, chronic care management

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Authors: Abdulrahman Algaeed

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The Ophthalmic Ultrasound is the easiest method of early diagnosing Retinoblastoma after clinical examination. It can be done with ease without sedation. King Khaled Eye Specialist Hospital is a tertiary care center where Retinoblastoma patients are often seen and treated there. The first modality to rule out the disease is Ophthalmic Ultrasound. Classic Retinoblastoma is easily diagnosed by using the conventional 10MHz Ophthalmic Ultrasound probe in the regular clinic setup. Retinal lesion with multiple, very highly reflective surfaces within lesion typical of Calcium deposits. The use of Standardized A-scan is very useful where internal reflectivity is classified as very highly reflective. Color Doppler is extremely useful as well to show the blood flow within lesion/s. In conclusion: Ophthalmic Ultrasound should be the first tool to be used to diagnose Retinoblastoma after clinical examination. The accuracy of the Exam is very high.

Keywords: doppler, retinoblastoma, reflectivity, ultrasound

Procedia PDF Downloads 113

Authors: Ben Clapperton, Daniel Stahl, Kimberley Goldsmith, Trudie Chalder

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Chronic fatigue syndrome (CFS) is a condition characterised by chronic disabling fatigue and other symptoms that currently can't be explained by any underlying medical condition. Although clinical trials support the effectiveness of cognitive behaviour therapy (CBT), the success rate for individual patients is modest. Patients vary in their response and little is known which factors predict or moderate treatment outcomes. The aim of the project is to develop a prediction model from baseline characteristics of patients, such as demographics, clinical and psychological variables, which may predict likely treatment outcome and provide guidance for clinical decision making and help clinicians to recommend the best treatment. The project is aimed at identifying subgroups of patients with similar baseline characteristics that are predictive of treatment effects using modern cluster analyses and data mining machine learning algorithms. The characteristics of these groups will then be used to inform the types of individuals who benefit from a specific treatment. In addition, results will provide a better understanding of for whom the treatment works. The suitability of different clustering methods to identify subgroups and their response to different treatments of CFS patients is compared.

Keywords: chronic fatigue syndrome, latent class analysis, prediction modelling, self-organizing maps

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Authors: Sunny Deo, Eve Barnes, Peter Arnold-Smith

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Introduction: Healthcare technology is a rapidly expanding field in healthcare, with enthusiasts suggesting a revolution in the quality and efficiency of healthcare delivery based on the utilisation of better e-healthcare, including the move to paperless healthcare. The role and use of computers and programmes for healthcare have been increasing over the past 50 years. Despite this, there is no standardised method of assessing the quality of hardware and software utilised by frontline healthcare workers. Methods and subjects: Based on standard Patient Related Outcome Measures, a questionnaire was devised with the aim of providing quantitative and qualitative data on clinicians’ perspectives of their hospital’s Information Technology (IT). The survey was distributed via the Institution’s Intranet to all contracted doctors, and the survey's qualitative results were analysed. Qualitative opinions were grouped as positive, neutral, or negative and further sub-grouped into speed/usability, software/hardware, integration, IT staffing, clinical risk, and wellbeing. Analysis was undertaken on the basis of doctor seniority and by specialty. Results: There were 196 responses, with 51% from senior doctors (consultant grades) and the rest from junior grades, with the largest group of respondents 52% coming from medicine specialties. Differences in the proportion of principle and sub-groups were noted by seniority and specialty. Negative themes were by far the commonest stated opinion type, occurring in almost 2/3’s of responses (63%), while positive comments occurred less than 1 in 10 (8%). Conclusions: This survey confirms strongly negative attitudes to the current state of electronic documentation and IT in a large single-centre cohort of hospital-based frontline physicians after two decades of so-called progress to a paperless healthcare system. Greater use would provide further insights and potentially optimise the focus of development and delivery to improve the quality and effectiveness of IT for clinicians and their patients.

Keywords: information technology, electronic patient records, digitisation, paperless healthcare

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Authors: Lazhar Belkhiri, Ammar Tiri, Lotfi Mouni

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In this research, we analyzed the groundwater quality index in the El Milia plain, Kebir Rhumel Basin, Algeria. Thirty-three groundwater samples were collected from wells in the El Milia plain during April 2015. In this study, pH and electrical conductivity (EC) were conducted at each sampling well. Eight hydrochemical parameters such as calcium (Ca), magnesium (Mg), sodium (Na), potassium (K), chlorid (Cl), sulfate (SO4), bicarbonate (HCO3), and Nnitrate (NO3) were analysed. The entropy water quality index (EWQI) method was employed to evaluate the groundwater quality in the study area. Moran’s I and the ordinary kriging (OK) interpolation technique were used to examine the spatial distribution pattern of the hydrochemical parameters in the groundwater. It was found that the hydrochemical parameters Ca, Cl, and HCO3 showed strong spatial autocorrelation in the El Milia plain, indicating a spatial dependence and clustering of these parameters in the groundwater. The groundwater quality was evaluated using the entropy water quality index (EWQI). The results showed that approximately 86% of the total groundwater samples in the study area fall within the moderate groundwater quality category. The spatial map of the EWQI values indicated an increasing trend from the south-west to the northeast, following the direction of groundwater flow. The highest EWQI values were observed near El Milia city in the center of the plain. This spatial pattern suggests variations in groundwater quality across the study area, with potentially higher risks near the city center. Therefore, the results obtained in this research provide very useful information to decision-makers.

Keywords: entropy water quality index (EWQI), moran’s i, ordinary kriging interpolation, el milia plain

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Authors: A. Sawangsuriya, T. B. Edil

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Microstructure and fabric of soils play an important role on structural properties e.g. stiffness and strength of compacted earthwork. Traditional quality control monitoring based on moisture-density tests neither reflects the variability of soil microstructure nor provides a direct assessment of structural property, which is the ultimate objective of the earthwork quality control. Since stiffness and strength are sensitive to soil microstructure and fabric, any independent test methods that provide simple, rapid, and direct measurement of stiffness and strength are anticipated to provide an effective assessment of compacted earthen materials’ uniformity. In this study, the soil stiffness gauge (SSG) and the dynamic cone penetrometer (DCP) were respectively utilized to measure and monitor the stiffness and strength in companion with traditional moisture-density measurements of various earthen materials used in Thailand road construction projects. The practical earthwork quality control criteria are presented herein in order to assure proper earthwork quality control and uniform structural property of compacted earthworks.

Keywords: dynamic cone penetrometer, moisture content, quality control, relative compaction, soil stiffness gauge, structural properties

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Authors: Philemon Rakoto

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Most executive compensation packages consist of four major components: base fixed salary, annual and long-term non-equity incentive plans, share-based and option-based awards and pension value. According to agency theory, the relative composition of executive compensation packages is one of the mechanisms that firms use to align the interests of executives and shareholders in order to mitigate agency costs. This paper tests the effect of the relative composition of executive compensation packages on financial reporting quality. Financial reporting quality is measured by the value relevance of accounting earnings. Corporate governance is a moderating variable in the model. Using data from Canadian firms composing S&P/TSX index of the year 2013 and governance scores based on Board Games, the analysis shows that, only for firms with good governance, there is an optimal level of the proportion of executive equity-based compensation in relation to total compensation that enhances the quality of financial reporting.

Keywords: Canada, corporate governance, executive compensation packages, financial reporting quality

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Authors: Merav Ben Natan, May Revach, Or Sade, Yaniv Yonay, Yaron Berkovich

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Background: The inclusion of nurse practitioners (NPs) specializing in orthopedics holds promise for enhancing the quality of care for orthopedic patients. Understanding patients’ perspectives on this role is crucial for evaluating the feasibility and acceptance of integrating NPs into orthopedic settings. This study aims to explore the receptiveness of orthopedic patients to treatment by orthopedic NPs and examines potential associations between patients’ willingness to engage with NPs, their familiarity with the NP role, perceptions of nursing, and satisfaction with orthopedic nursing care. Methods: This cross-sectional study involved patients admitted to an orthopedic department at a central Israeli hospital between January and February 2023. Data was collected using a validated questionnaire consisting of five sections, reviewed by content experts. Statistical analyses were conducted using SPSS and included descriptive statistics, independent samples t-tests, Pearson correlations, and linear regression. Results: Participants in the study showed a moderate willingness to receive treatment from orthopedic NPs, with more than two-thirds expressing strong openness. Patients were generally receptive to NPs performing various clinical tasks, though there was less enthusiasm for NPs’ involvement in medication management and preoperative evaluations. Positive attitudes towards nurses and familiarity with the NP role were significant predictors of patient receptiveness to NP treatment. Conclusion: Patient acceptance of orthopedic NPs varies across different aspects of care. While there is a general willingness to receive care from NPs, these nuanced preferences must be considered when implementing NPs in orthopedic settings. Awareness and positive perceptions of the NP role play crucial roles in shaping patients’ willingness to engage with NPs.

Keywords: orthopedic nurse practitioners, patient receptiveness, perceptions of nursing, clinical tasks

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Authors: Suppara Charoenpoom

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This study focuses on 1) a good-quality management procedures of buildings and environment in schools 2) designing the management procedures and 3) creating an operation manual for the procedures. This study is the combination of qualitative and quantitative research method. Populations in the research were 83 deans and directors of primary and secondary schools from the 10th educational district in Samut Songkram. Sample group was selected from the voluntary deans and directors. There were 14 participants in sample group. Research tools in this study were divided into 2 categories. The first one was data-collecting tools, which were in-depth interview and questionnaires. The second one was the designing tools to help creating management procedures: quality business, quality work procedure and key quality indicator of each activity in schools. All data were analyzed by mean and standard deviation. The result from this study has found out 1 effective process of building and environment management for basic education schools which is called Quality Business Process (QBP) and 7 Quality Work Procedures (QWP). In terms of academic feasibility checkup by experts, the research had shown that new design of building and environment management was approved unanimously. It means that new process of building and environment management in schools works very well and can be adapted. After examining the possibility of management process being used in schools by calculating the mean value among sample group (14 school deans and directors), the mean value was between 0.64-1.00. It means that the new design of building and environment management can be operated effectively in schools. For the satisfaction part, deans and school directors gave the satisfaction score in the highest level (Mean = 4.7372, S.D. = 0.4385).

Keywords: buildings, environment, procedures, quality management

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Authors: Walid A. Alkeridy, Arwa Aljasser, Khalid Mohammed Alayed, Saad Alsaad, Amani S. Alqahtani, Claire Ann Lim, Sultan H. Alamri, Doaa Zainhom Mekkawy, Mohammed Al-Sofiani

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Introduction: The history of publicly funded Home Health Care (HHC) service in Saudi Arabia dates back to 1991. The first HC program was launched to provide palliative home care services for patients with terminal cancer. Thereafter, more programs launched across Saudi Arabia most remarkably was launching the national program for HHC by the Ministry Of Health (MOH) in 2008. The national HHC MOH program is mainly providing long-term care home care services for over 40,000 Saudi citizens. The scope of the HHC service program provided by the Saudi MOH is quite diverse, ranging from basic nursing care to specialized care programs, e.g., home peritoneal dialysis, home ventilation, home infusion therapy, etc. Objectives: The primary aim of our study is to report the prevalence of chronic conditions among Saudi people receiving long-term HHC services. Secondary aims include identifying the predictors of mortality among individuals receiving long-term HHC services and studying the association between frailty and poor health outcomes among HHC users. Methods: We conducted a retrospective and cross-sectional data collection from participants receiving HHC services at King Saud University Medical City, Riyadh, Saudi Arabia. Data were collected from electronic health records (EHR), patient charts, and interviewing caregivers from the year 2019 to 2022. We assessed functional performance by Katz's activity of daily living and the Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). Mortality was assessed by reviewing the death certificates if patients were hospitalized through discharge status ascertainment from EHR. Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. The following variables were statistically significant between deceased and alive individuals receiving HHC services; clinical frailty scale, the total number of comorbid conditions, and functional performance based on the KATZ activity of daily living scale and the BADLS. We found that the strongest predictors for mortality were pressure ulcers which had an odds ratio of 3.75 and p-value of < 0.0001, and the clinical frailty scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis. In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services. Moreover, we found a high rate of annual readmission for individuals enrolled in HHC, which requires further analysis to understand the possible contributing factors for the increased rate of hospital readmission and develop strategies to address them. Future studies should focus on designing quality improvement projects aimed at improving the quality of life for individuals receiving HHC services, especially those who have pressure ulcers at the end of life.

Keywords: homecare, Saudi, prevalence, chronic

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Authors: Ni Wayan Sinthia Widiastuti, Komang Rahayu Indrawati

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The increasing number of tourists coming to Bali, causing accommodation facilities, such as hotels have increased. The existence of hotel needs will be the source of labor and cost efficiency, so that hotel management employs employees with different working status. The hospitality industry is one of the sectors that require organizational citizenship behavior because, the main goal of every hotel, in general, was to provide the best service and quality to tourists. The purpose of this study was to determine the differences in organizational citizenship behavior based on work status of employees at the Hotel in Bali in terms of quality of work life. Research sample was chosen randomly through two-stage cluster sampling which succeeds to obtain 126 samples from 11 hotels in Denpasar, Bali. The subjects consisted of 64 employees with Employment Agreement of Uncertain Time or who is often called a permanent employee and 62 employees with Employment Agreement of Certain Time or better known as contract employees, outsourcing, and daily workers. Instruments in this study were the scale of organizational citizenship behavior and the scale of quality of work life. The results of ANCOVA analysis showed there were differences in organizational citizenship behavior based on employee work status in terms of quality of work life. Differences in organizational citizenship behavior and quality of work life based on work status of employees using comparative test was analysis by independent sample t-test shows there were differences in organizational citizenship behavior and quality of work life between employees with different working status in hotels in Bali. The result of the regression analysis showed the functional relationship between quality of work life and organizational citizenship behavior.

Keywords: hotel in Bali, organizational citizenship behavior, quality of work life, work status of employees

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Authors: Ilma Robo, Saimir Heta, Gerhard Nokaj

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Introduction: The method of treatment and the treatment protocols of apical periodontitis are now known, but the ongoing debate remains on whether or not prescription antibiotics should be given to patients suffering from this type of pathology. In fact, as an indication for prescribing antibiotics, this type of pathology remains between clinical indication and contraindication. Material and Methods: This article is of the short-communication type and has the sole purpose of analyzing the clinical picture of apical periodontitis and the fact that the appearance and extent of this pathology in the periapex area passes the stage when the host or the immune cells of the organism of the affected individual, react against bacterial factors. Results: Determining whether or not to prescribe systemic antibiotics according to literature sources can be avoided. In some cases, research in this field about this pathology even indicates endodontic rinsers or irrigants, such as chlorhexidine, in typical cases, mainly in persistent apical periodontitis. Conclusions: In times when bacterial resistance is a hot topic in some fields of scientific research, it is important to divide dental pathologies of bacterial origin into those when systemic antibiotic prescriptions must be given and those when every clinical issue is resolved only with endodontic root canal treatment. Even certain sources of published literature show the specifics of the most effective antibiotics against the bacterial flora causing the pathology of apical periodontitis.

Keywords: endodontic treatment, apical periodontitis, antibiotics, chlorhexidine

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Authors: Parmeet Kaur, Nighat Yaseen Sofi, Shakti Kumar Gupta, Veena Pandey, Rajvaedhan Azad

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Nutritional status and prevailing blood glucose level trends amongst hospitalized patients has been linked to clinical outcome. Therefore, the present study was undertaken to assess hospitalized Diabetic Eye Disease (DED) patients' anthropometric and dietary intake trends. DED patients with type 1 or 2 diabetes > 20 years were enrolled. Actual food intake was determined by weighed food record method. Mifflin St Joer predictive equation multiplied by a combined stress and activity factor of 1.3 was applied to estimate caloric needs. A questionnaire was further administered to obtain reasons of inadequate dietary intake. Results indicated validity of joint analyses of body mass index in combination with waist circumference for clinical risk prediction. Dietary data showed a significant difference (p < 0.0005) between average daily caloric and carbohydrate intake and actual daily caloric and carbohydrate needs. Mean fasting and post-prandial plasma glucose levels were 150.71 ± 72.200 mg/dL and 219.76 ± 97.365 mg/dL, respectively. Improvement in food delivery systems and nutrition educations were indicated for reducing plate waste and to enable better understanding of dietary aspects of diabetes management. A team approach of nurses, physicians and other health care providers is required besides the expertise of dietetics professional. To conclude, findings of the present study will be useful in planning nutritional care process (NCP) for optimizing glucose control as a component of quality medical nutrition therapy (MNT) in hospitalized DED patients.

Keywords: nutritional status, diabetic eye disease, nutrition care process, medical nutrition therapy

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Authors: S. Aberkane, N. Djabali, S. Fafi, A. Baghezza

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Chronic illnesses affect many Algerians. It is possible to investigate the impact of illness representations and coping on quality of life and whether illness representations are indirectly associated with quality of life through their influence on coping. This study aims at investigating the relationship between illness perception, coping strategies and quality of life with chronic illness. Illness perceptions are indirectly associated with the quality of life through their influence on coping mediation. A sample of 316 participants with chronic illness living in the region of Batna, Algeria, has been adopted in this study. A correlation statistical analysis is used to determine the relationship between illness perception, coping strategies, and quality of life. Multiple regression analysis was employed to highlight the predictive ability of the dimensions of illness perception and coping strategies on the dependent variables of quality of life, where mediation analysis is considered in the exploration of the indirect effect significance of the mediator. This study provides insights about the relationship between illness perception, coping strategies and quality of life in the considered sample (r = 0.39, p < 0.01). Therefore, it proves that there is an effect of illness identity perception, external and medical attributions related to emotional role, physical functioning, and mental health perceived, and these were fully mediated by the asking for assistance (c’= 0.04, p < 0.05), the guarding (c’= 0.00, p < 0.05), and the task persistence strategy (c’= 0.05, p < 0.05). The findings imply partial support for the common-sense model of illness representations in a chronic illness population. Directions for future research are highlighted, as well as implications for psychotherapeutic interventions which target unhelpful beliefs and maladaptive coping strategies (e.g., cognitive behavioral therapy).

Keywords: chronic illness, coping, illness perception, quality of life, self- regulation model

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Authors: Nopadol Burananat, Kedsara Tripaichayonsak

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This research aims to study the level of expectations and participation of personnel in implementing educational quality assurance of programs in Graduate School, Rajabhat Suan Sunandha University. The sample used in this study is 60 participants. The tool used for data collection is a questionnaire constructed by the researcher. The analysis is done by frequency, percentage, mean and standard deviation. It was found that the level of expectations personnel in Graduate School, Suan Sunandha Rajabhat University in implementing educational quality assurance is at high level. The category which received the most score is Action, followed by Check, Do and Plan, respectively. For the level of participation of personnel at program level of Graduate School, Suan Sunandha Rajabhat University in implementing educational quality assurance, the overall score is at high level. The category which received the most score is Action, followed by Do, Check and Plan, respectively.

Keywords: participation, implementation of educational quality assurance, educational quality assurance, expectations and participation

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Authors: Vladyslav Povoroznyuk, Oksana Ivanyk, Nataliia Dzerovych

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In the diagnostics of osteoporosis, the gold standard is considered to be bone mineral density; however, X-ray densitometry is not an accurate indicator of osteoporotic fracture risk under all circumstances. In this regard, the search for new methods that could determine the indicators not only of the mineral density, but of the bone tissue quality, is a logical step for diagnostic optimization. One of these methods is the evaluation of trabecular bone quality. The aim of this study was to examine the quality and mineral density of spine bone tissue, femoral neck, and body composition of women depending on the duration of the postmenopausal period, to determine the correlation of body fat with indicators of bone mineral density and quality. The study examined 179 women in premenopausal and postmenopausal periods. The patients were divided into the following groups: Women in the premenopausal period and women in the postmenopausal period at various stages (early, middle, late postmenopause). A general examination and study of the above parameters were conducted with General Electric X-ray densitometer. The results show that bone quality and mineral density probably deteriorate with advancing of postmenopausal period. Total fat and lean mass ratio is not likely to change with age. In the middle and late postmenopausal periods, the bone tissue mineral density of the spine and femoral neck increases along with total fat mass.

Keywords: osteoporosis, bone tissue mineral density, bone quality, fat mass, lean mass, postmenopausal osteoporosis

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Authors: Dimitar N. Karastoianov, Stanislav D. Gyoshev, Todor N. Penchev

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Preparation of briquettes of metal chips with good density and quality is of great importance for the efficiency of this process. In this paper are presented the results of impact briquetting of grey cast iron chips with rectangular shape and dimensions 15x25x1 mm. Density and quality of briquettes of these chips are compared with those obtained in another work of the authors using cast iron chips with smaller sizes. It has been found that by using a rectangular chips with a large size are produced briquettes with a very low density and poor quality. From the photographs taken by X-ray tomography, it is clear that the reason for this is the orientation of the chip in the peripheral wall of the briquettes, which does not allow of the air to escape from it. It was concluded that in order to obtain briquettes of cast iron chips with a large size, these chips must first be ground, for example in a small ball mill.

Keywords: briquetting, chips, impact, rocket engine

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Authors: Saman Sobhani

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Historical neighborhoods have special values inside them, and, in addition to inducing a sense of collective memories, they have to have some criteria in respect of achieving desirable environmental quality in order for citizens to live. From the perspective of urban planners and designers, a neighborhood as an urban space has to satisfy various needs of citizens in terms of activities as well as their spiritual requirements. In the research based on the component of environmental quality in one of the neighborhoods with historical value resulting from the theoretical model presented (functional-structural, physical-spatial, and substantive), integrated analysis has been performed on the Khajeh Khezr neighborhood in Kerman. Then, after studying the weaknesses and strengths points of it based on the AIDA model, some mechanisms have been presented to promote environmental quality based on neighborhood organization, and related urban design projects have been defined accordingly. Analyzing the findings shows that inhabitants in the Khajeh Khezr neighborhood are not much satisfied with the quality of the urban environment of the neighborhood. In the research, the descriptive-analytical method and review of texts have been used in the form of library studies, and case study has been applied as well as observation and questionnaire in the form of field studies.

Keywords: environmental quality, Kerman, Khajeh Khezr, neighborhood

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Authors: Auj-E Taqaddas

Abstract:

The use of proton beam therapy is increasing globally. It seems to offer dosimetric advantages, especially in paediatric central nervous system (CNS) and brain tumours. A short E-survey was conducted to assess the clinical, technical, and educational resources and strategies employed in the state of the art proton beam therapy (PBT) centres in the USA to determine the current status of proton beam therapy. The study also aimed at finding out which PBT skills are in demand as well as what improvements are needed to ensure efficient treatment planning, delivery, and dosimetry. The study resulted in identifying areas for future research and development and in identifying cancers for which PBT is most suitable compared to other modalities to facilitate the implementation and use of PBT in clinical settings for cancer treatment.

Keywords: cancer, intensity modulated proton therapy, proton beam therapy, single field uniform scanning

Procedia PDF Downloads 205