Search results for: residents’ satisfaction

Authors: Pellecchia M. T., Savarese G., Carpinelli L., Calabrese M.

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Introduction: Parkinson's disease (PD) is characterized by a progressive loss of autonomy which undoubtedly has a significant impact on the quality of life of caregivers, and parents are the main informal caregivers. Caring for a person with PD is associated with an increased risk of psychiatric morbidity and persistent anxiety-depressive distress. The aim of the study is to investigate the burden on caregivers of patients with PD, through the use of multidimensional scales and to identify their personological and environmental determinants. Methods: The study has been approved by the Ethic Committee of the University of Salerno and informed consent for participation to the study was obtained from patients and their caregivers. The study was conducted at the Neurology Department of the A.O.U. "San Giovanni di Dio and Ruggi D’Aragona" of Salerno between September 2020 and May 2021. Materials: The questionnaires used were: a) Caregiver Burden Inventory - CBI a questionnaire of 24 items that allow identifying five sub-categories of burden (objective, psychological, physical, social, emotional); b) Depression Anxiety Stress Scales Short Version - DASS-21 questionnaire consisting of 21 items and valid in examining three distinct but interrelated areas (depression, anxiety and stress); c) Family Strain Questionnaire Short Form - FSQ-SF is a questionnaire of 30 items grouped in areas of increasing psychological risk (OK, R, SR, U); d) Zarit Caregiver Burden Inventory - ZBI, consisting of 22 items based on the analysis of two main factors: personal stress and pressure related to his role; e) Life Satisfaction, a single item that aims to evaluate the degree of life satisfaction in a global way using a 0-100 Likert scale. Findings: N ° 29 caregivers (M age = 55.14, SD = 9.859; 69% F) participated in the study. 20.6% of the sample had severe and severe burden (CBI score = M = 26.31; SD = 22.43) and 13.8% of participants had moderate to severe burden (ZBI). The FSQ-SF highlighted a minority of caregivers who need psychological support, in some cases urgent (Area SR and Area U). The DASS-21 results show a prevalence of stress-related symptoms (M = 10.90, SD = 10.712) compared to anxiety (M = 7.52, SD = 10.752) and depression (M = 8, SD = 10.876). There are significant correlations between some specific variables and mean test scores: retired caregivers report higher ZBI scores (p = 0.423) and lower Life Satisfaction levels (p = -0.460) than working caregivers; years of schooling show a negative linear correlation with the ZBI score (p = -0.491). The T-Test indicates that caregivers of patients with cognitive impairment are at greater risk than those of patients without cognitive impairment. Conclusions: It knows the factors that affect the burden the most would allow for early recognition of risky situations and caregivers who would need adequate support.

Keywords: anxious-depressive axis, caregivers’ burden, Parkinson’ disease, psychological risks

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Authors: Prescott C. Ensign

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Social enterprises play a vital role in Canada’s rural and northern communities. Most operate as non-profit organizations, use market approaches, and generate revenue from services or goods to support goals that address social, cultural, and environmental issues. As provincial and federal governments make reductions to programs providing social services to local communities, rural and northern residents who already have fewer resources from which to draw will be especially affected. Social enterprises will be called on to take up the slack. The aim of this paper is to provide a more comprehensive picture of the social enterprise as an organization and to understand the impact that context/ecosystem has on a social enterprise as it develops.

Keywords: social enterprises, structuration, embeddedness, ecosystem

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Authors: Hosein Almasikia

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Sarableh City is located in the west of Iran and in the seismic zone of Zagros. After the Azgole-Sarpol Zahab earthquake with a magnitude of 3.7 Richter on November 21, 2016, in some parts of Sarableh city, horrible sounds were heard by people. There is also a sound similar to the wear of the mill by some of the residents. Vibration studies and field investigations showed that these sounds have a geological origin and are emitted from the ground to the surface and may be related to geological hazards such as landslides, collapse of karstic zones, etc. In this study, an attempt has been made to investigate the possible relationship between these abnormal sounds and geological hazards.

Keywords: Sarable, Zagros, landslide, karstic zone

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Authors: F. Iberraken, R. Medjoudj, D. Aissani

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The development of the smart grids concept is built around two separate definitions, namely: The European one oriented towards sustainable development and the American one oriented towards reliability and security of supply. In this paper, we have investigated reliability merits enabling decision-makers to provide a high quality of service. It is based on system behavior using interruptions and failures modeling and forecasting from one hand and on the contribution of information and communication technologies (ICT) to mitigate catastrophic ones such as blackouts from the other hand. It was found that this concept has been adopted by developing and emerging countries in short and medium terms followed by sustainability concept at long term planning. This work has highlighted the reliability merits such as: Benefits, opportunities, costs and risks considered as consistent units of measuring power customer satisfaction. From the decision making point of view, we have used the analytic hierarchy process (AHP) to achieve customer satisfaction, based on the reliability merits and the contribution of such energy resources. Certainly nowadays, fossil and nuclear ones are dominating energy production but great advances are already made to jump into cleaner ones. It was demonstrated that theses resources are not only environmentally but also economically and socially sustainable. The paper is organized as follows: Section one is devoted to the introduction, where an implicit review of smart grids development is given for the two main concepts (for USA and Europeans countries). The AHP method and the BOCR developments of reliability merits against power customer satisfaction are developed in section two. The benefits where expressed by the high level of availability, maintenance actions applicability and power quality. Opportunities were highlighted by the implementation of ICT in data transfer and processing, the mastering of peak demand control, the decentralization of the production and the power system management in default conditions. Costs were evaluated using cost-benefit analysis, including the investment expenditures in network security, becoming a target to hackers and terrorists, and the profits of operating as decentralized systems, with a reduced energy not supplied, thanks to the availability of storage units issued from renewable resources and to the current power lines (CPL) enabling the power dispatcher to manage optimally the load shedding. For risks, we have razed the adhesion of citizens to contribute financially to the system and to the utility restructuring. What is the degree of their agreement compared to the guarantees proposed by the managers about the information integrity? From technical point of view, have they sufficient information and knowledge to meet a smart home and a smart system? In section three, an application of AHP method is made to achieve power customer satisfaction based on the main energy resources as alternatives, using knowledge issued from a country that has a great advance in energy mutation. Results and discussions are given in section four. It was given us to conclude that the option to a given resource depends on the attitude of the decision maker (prudent, optimistic or pessimistic), and that status quo is neither sustainable nor satisfactory.

Keywords: reliability, AHP, renewable energy resources, smart grids

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Authors: Esha Thakkar, Ina Liu, Kalynn Hosea, Shana Katz, Katie Marks, Sarah Hall, Cat Liu, Suzanne Harris

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Purpose: Inequities in mental healthcare accessibility are cited as an international public health concern by the World Health Organization (WHO) and National Alliance on Mental Illness (NAMI). These disparities are further exacerbated in racial and ethnic minority groups and are especially concerning in health professional training settings such as Doctor of Pharmacy (PharmD) programs and postgraduate residency training where mental illness rates are high. The purpose of the study was to determine baseline access to culturally sensitive mental healthcare and how to improve such access and communication for racially and ethnically minoritized pharmacy students and residents at one school of pharmacy and a partnering academic medical center in the United States. Methods: This IRB-exempt study included 60-minute focus groups conducted in person or online from November 2021 to February 2022. Eligible participants included PharmD students in their first (P1), second (P2), third (P3), or fourth year (P4) or pharmacy residents completing a postgraduate year 1 (PGY1) or PGY2 who identify as Black, Indigenous, or Person of Color (BIPOC). There were four core theme questions asked during the focus groups to lead the discussion, specifically on the core themes of personal barriers, identities, areas that are working well, and areas for improvement. Participant responses were transcribed and analyzed using an open coding system with two individual reviews, followed by collaborative and intentional discussion and, as needed, an external audit of the coding by a third research team member to reach a consensus on themes. Results: This study enrolled 26 participants, with eight P1, five P2, seven P3, two P4, and four resident participants. Within the four core themes of barriers, identities, areas working well, and areas for improvement, emerging subthemes included: lack of time, access to resources, and stigma under barriers; lack of representation, cultural and family stigma, and gender identities for identity barriers; supportive faculty, sense of community and culture supporting paid time off for areas going well; and wellness days, reduced workload and diversity of the workforce in areas of improvement. Subthemes sometimes varied within a core theme depending on the participant year. Conclusions: There is a gap in the literature in addressing barriers and disparities in mental health access for pharmacy trainees who identify as BIPOC. We identified key findings in regards to barriers, identities, areas going well and areas for improvement that can inform the School and the Residency Program in two priority initiatives of well-being and diversity equity and inclusion in creating actionable recommendations for trainees, program directors, and employers of our institutions, and also has the potential to provide insight for other organizations about the structures influencing access to culturally sensitive care in BIPOC trainees. These findings can inform organizations on how to continue building on communication with those who identify as BIPOC and improve access to care.

Keywords: mental health, disparities, minorities, wellbeing, identity, communication, barriers

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Authors: Tanu Sharma, Bikramjit Singh Bajwa, Inderpreet Kaur

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Monitoring of groundwater in Tarn-Taran, Bathinda, Faridkot and Mansa districts of Punjab state, India is essential where this freshwater resource is being over-exploited causing quality deterioration, groundwater depletion and posing serious threats to residents. The present integrated study was done to appraise quality and suitability of groundwater for drinking/irrigation purposes, hydro-geochemical characteristics, source identification and associated health risks. In the present study, groundwater of various districts of Punjab state was found to be heavily contaminated with As followed by U, thus posing high cancerous risks to local residents via ingestion, along with minor contamination of Fe, Mn, Pb and F−. Most health concerns in the study region were due to the elevated concentrations of arsenic in groundwater with average values of 130 µg L-1, 176 µg L-1, 272 µg L-1 and 651 µg L-1 in Tarn-Taran, Bathinda, Faridkot and Mansa districts, respectively, which is quite high as compared to the safe limit as recommended by BIS i.e. 10 µg L-1. In Tarn-Taran, Bathinda, Faridkot and Mansa districts, average uranium contents were found to be 37 µg L-1, 88 µg L-1, 61 µg L-1 and 104 µg L-1, with 51 %, 74 %, 61 % and 71 % samples, respectively, being above the WHO limit of 30 µg L-1 in groundwater. Further, the quality indices showed that groundwater of study region is suited for irrigation but not appropriate for drinking purposes. Hydro-geochemical studies revealed that most of the collected groundwater samples belonged to Ca2+ - Mg2+ - HCO3- type showing dominance of MgCO3 type which indicates the presence of temporary hardness in groundwater. Rock-water reactions and reverse ion exchange were the predominant factors for controlling hydro-geochemistry in the study region. Dissolution of silicate minerals caused the dominance of Na+ ions in the aquifers of study region. Multivariate statistics revealed that along with geogenic sources, contribution of anthropogenic activities such as injudicious application of agrochemicals and domestic waste discharge was also very significant. The results obtained abolished the myth that uranium is only root cause for large number of cancer patients in study region as arsenic and mercury were also present in groundwater at levels that were of health concern to groundwater.

Keywords: uranium, trace elements, multivariate data analysis, risk assessment

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Authors: Zhongzhong Zeng, Zichen Liang

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In recent years, Beijing courtyards have been facing the problem of renewal and renovation, and the residents are faced with the problems of small house areas, large household sizes, old and dangerous houses, etc. Among the many renovation methods, the authors note two more common practices of using the front porch to expand the floor area and adding a loft. Residents and architects, however, did not give the ventilation performance of the significant interior consideration before beginning the remodeling. The aim of this article is to explore the good or negative impacts of both front porch and loft structures on the manner of interior ventilation in the courtyard. Ventilation, in turn, is crucial to the indoor environmental quality of a home. The major method utilized in this study is the comparative analysis method, in which the authors create four alternative house models with or without a front porch and an attic as two variables and examine internal ventilation using the CFD(Computational Fluid Dynamics) technique. The authors compare the indoor ventilation of four different architectural models with or without front porches and lofts as two variables. The results obtained from the analysis of the sectional airflow and the plane 1.5m height cloud are the existence of the loft, to a certain extent, disrupts the airflow organization of the building and makes the rear wall high windows of the building less effective. Occupying the front porch to become the area of the house has no significant effect on ventilation, but try not to occupy the front porch and add the loft at the same time in the building renovation. The findings of this study led to the following recommendations: strive to preserve the courtyard building's original architectural design and make adjustments to only the inappropriate elements or constructions. The ventilation in the loft portion is inadequate, and the inhabitants typically use the loft as a living area. This may lead to the building relying more on air conditioning in the summer, which would raise energy demand. The front porch serves as a transition place as well as a source of shade, weather protection, and inside ventilation. In conclusion, the examination of interior environments in upcoming studies should concentrate on cross-disciplinary, multi-angle, and multi-level research topics.

Keywords: Beijing courtyard renewal, CFD, indoor environment, ventilation analysis

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Authors: Sharifa Alduraibi, Abir El Sadik, Ahmed Elzainy, Alaa Alduraibi, Ahmed Alsolai

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Introduction: Problem-based learning (PBL) is an active student-centered educational modality, influenced by the students' interest that required continuous motivation to improve their engagement. The new era of professional information technology facilitated the utilization of educational multimedia, such as videos, soundtracks, and photographs promoting students' learning. The aim of the present study was to introduce multimedia-enriched PBL scenarios for the first time in college of medicine, Qassim University, as an incentive for better students' engagement. In addition, students' performance and satisfaction were evaluated. Methodology: Two multimedia-enhanced PBL scenarios were implemented to the third years' students in the urinary system block. Radiological images, plain CT scan, and X-ray of the abdomen and renal nuclear scan correlated with their pathological gross photographs were added to the scenarios. One week before the first sessions, pre-recorded orientation videos for PBL tutors were submitted to clarify the multimedia incorporated in the scenarios. Other two traditional PBL scenarios devoid of multimedia demonstrating the pathological and radiological findings were designed. Results and Discussion: Comparison between the formative assessments' results by the end of the two PBL modalities was done. It revealed significant increase in students' engagement, critical thinking and practical reasoning skills during the multimedia-enhanced sessions. Students' perception survey showed great satisfaction with the new strategy. Conclusion: It could be concluded from the current work that multimedia created technology-based teaching strategy inspiring the student for self-directed thinking and promoting students' overall achievement.

Keywords: multimedia, pathology and radiology images, problem-based learning, videos

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Authors: Kim Dongwon, Yu Songjin

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This study identifies the business value of VOC (Voice of Customer) on the business. Precisely, we intend to demonstrate how much negative and positive sentiment of VOC has an influence on car sales market share in the unites states. We extract 7 emotions such as sadness, shame, anger, fear, frustration, delight and satisfaction from the VOC data, 23,204 pieces of opinions, that had been posted on car-related on-line community from 2007 to 2009(a part of data collection from 2007 to 2015), and intend to clarify the correlation between negative and positive sentimental keywords and contribution to market share. In order to develop a lexicon for each category of negative and positive sentiment, we took advantage of Corpus program, Antconc 3.4.1.w and on-line sentimental data, SentiWordNet and identified the part of speech(POS) information of words in the customers' opinion by using a part-of-speech tagging function provided by TextAnalysisOnline. For the purpose of this present study, a total of 45,741 pieces of customers' opinions of 28 car manufacturing companies had been collected including titles and status information. We conducted an experiment to examine whether the inclusion, frequency and intensity of terms with negative and positive emotions in each category affect the adoption of customer opinions for vehicle organizations' market share. In the experiment, we statistically verified that there is correlation between customer ideas containing negative and positive emotions and variation of marker share. Particularly, "Anger," a domain of negative domains, is significantly influential to car sales market share. The domain "Delight" and "Satisfaction" increased in proportion to growth of market share.

Keywords: data mining, opinion mining, sentiment analysis, VOC

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Authors: Nilgün Katrancı, Pınar Göv

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The privatization of public services has intensified and extended the delivery of healthcare services at hospitals, which leads to an increase in health and safety risks for healthcare professionals. More efficient and effective delivery of healthcare services can be realized through the provision of occupational safety of healthcare professionals. However, healthcare professionals are exposed to more dangers, accidents, and diseases because of such reasons as present working conditions, hospital infections, lack of ergonomic design, medication, wastes, excessive work load, negligent attitudes of workers, violence, psychological risks, etc. Unsafe working conditions cause fear, injury and wearing impacts in healthcare professionals in many countries. Thus, it is emphasized that the protection of the health of healthcare professionals is important to have educated, healthy workers and adequate workforce. Occupational health and safety measures applied in health facilities are aimed at protecting workers and providing the safety of services and facilities. All activities to be undertaken at hospitals with regard to occupational safety in accordance with these goals will help to reduce costs and provide continuous services. At the same time, a safe working environment will increase worker satisfaction and motivation, sense of institutional belonging and indirectly patient safety and satisfaction. In addition, the control and correction of occupational safety activities are also as important as the implementation. Occupational health and safety practices in the facilities will also lead to positive developments for national economy and society. This study emphasizes that approaching occupational safety practices for healthcare professionals in a sensitive manner is important for enabling healthcare professionals to do more productive works in terms of physical, social and psychological aspects, maintaining the continuity of healthcare services and social and economic contributions.

Keywords: health facilities, healthcare professional, occupational health, occupational safety

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Authors: Majid Alsubaie, Hamed Sarbazhosseini

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Many working environments have experienced increased uncertainty due to the fast-moving and unpredictable world. IT systems development projects, in particular, face several challenges because of their rapidly changing environments and emerging technologies. Information technology organizations within these contexts adapt systems development methodology and new software approaches to address this issue. One of these methodologies is the Agile method, which has gained huge attention in recent years. However, due to failure rates in IT projects, there is an increasing demand for the use of hybrid Agile methods among organizations. The scarce research in the area means that organizations do not have solid evidence-based knowledge for the use of hybrid Agile. This research was designed to provide further insights into the development of hybrid Agile methods within systems development projects, including how frameworks and processes are used and what benefits and challenges are gained and faced as a result of hybrid Agile methods. This paper presents how three organizations (two government and one private) use hybrid Agile methods in their Agile environments. The data was collected through interviews and a review of relevant documents. The results indicate that these organizations do not predominantly use pure Agile. Instead, they are waterfall organizations by virtue of systems nature and complexity, and Agile is used underneath as the delivery model. Prince2 Agile framework, SAFe, Scrum, and Kanban were the identified models and frameworks followed. This study also found that customer satisfaction and the ability to build quickly are the most frequently perceived benefits of using hybrid Agile methods. In addition, team resistance and scope changes are the common challenges identified by research participants in their working environments. The findings can help to understand Agile environmental conditions and projects that can help get better success rates and customer satisfaction.

Keywords: agile, hybrid, IT systems, management, success rate, technology

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Authors: Huan Zhang, Darius K. S Chan

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Despite a large number of studies linking emotional labor and its detrimental impact for laborer, research on how emotional labor would influence the receiver is still in its infancy. Especially under the call for “people management”, supervisors inside the organization are more inclined to display happy mood to support their employees, thus endorsing emotional labor. The present study focuses on the employees in the service industry as emotional labor recipients and investigates how they respond to their supervisors’ emotional display, given their sensitivity to emotional cues. Targeted at a sample of 250 survey data from a wide range of customer service professions, this ongoing study examines how perceived supervisory emotional labor would moderate the relationship between employees surface acting and their well-being. Our major hypotheses are that employees’ surface acting predicts well-being level, and that perceived supervisory emotional labor to moderate the surface acting—outcome links. Preliminary findings have provided some support to the hypothesized model. Specifically, supervisors who are perceived to be high in surface acting are also regarded as fake and pseudo, hence the enhancing the detrimental effect of employees’ surface acting is attenuated, resulting in lower job satisfaction, higher physical stress and burnout; whereas perceived high supervisor’s deep acting, as associated with genuine and authenticity, buffers the negative impact and leads to higher job satisfaction, lower physical stress and burnout. This study first confirms the negative impacts of the surface acting on well-being for service industry employees as laborer and then extends the emotional labor studies by considering them as recipients of supervisory emotional labor. The findings provide insights for leaders by pointing out the importance of authentic emotional expression in workplace.

Keywords: perceived supervisory emotional labor, surface acting, well-being

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Authors: Bayarmaa Enkhbold, Kenichi Matsui

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Urban parks are important assets to every community in terms of providing space for health, cultural and leisure activities. However, Ulaanbaatar, the capital of Mongolia, faces a shortage of green spaces, particularly urban parks, due to overpopulation and haphazard growth. Therefore, in order to increase green space per person, the city government has planned to increase green space per person up to 20m² by 2020 and 30m² by 2030 by establishing more urban parks throughout the city. But this plan was estimated that it is highly unlikely to reach those goals according to the analysis of the present status of plan implementation because the current amount of green space per person is still 4m². In the past studies globally, city planners and scientists agree that it is highly improbable to develop urban parks and keep maintenance sustainably without reflecting community perceptions and their involvement in the park establishment. Therefore, this research aims to find the challenges which stymie urban park development in Ulaanbaatar city and recommend dealing with the problems. In order to reach the goal, communities’ perceptions about the current challenges and their necessity for urban parks were identified and determined whether they differentiated depending on two different types of residential areas (urban and suburban areas). It also attempted to investigate international good practices on how they deal with similar problems. The research methodology was based on a questionnaire survey among city residents, a document review regarding the involvement of stakeholders, and a literature review of relevant past studies. According to the residents’ perceptions, the biggest challenge was a lack of land availability and followed by a lack of proper policy, planning, management, and maintenance out of seven key challenges identified. The biggest community demand from the urban park was a playground for children and followed by recreation and relaxation out of six types of needs. Based on research findings, the study proposed several recommendations for enhancements as institutional and legal framework, park plan and management, supportive environment and monitoring, evaluation, and reporting.

Keywords: challenges of urban park planning and maintenance, community-based urban park establishment, community perceptions and participation, urban parks in Ulaanbaatar, Mongolia

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Authors: Shwadhin Sharma

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As there has been increasing focus on the shorter attention span of the millennials students, there is a relative absence of instructional tools on behavioral assessments in learning information technology skills within the information systems field and textbooks. This study uses project-based learning in which students gain knowledge and skills related to information technology by working on an extended project that allows students to find a real business problem design information systems based on information collected from the company and develop an information system that solves the problem of the company. Eighty students from two sections of the same course engage in the project from the first week of the class till the sixteenth week of the class to deliver a small business information system that allows them to employ all the skills and knowledge that they learned in the class into the systems they are creating. Computer Information Systems related courses are often difficult to understand and process especially for the Under Representative Minorities students who have limited computer or information systems related (academic) experiences. Project-based learning demands constant attention of the students and forces them to apply knowledge learned in the class to a project that helps retaining knowledge. To make sure our assumption is correct, we started with a pre-test and post-test to test the students learning (of skills) based on the project. Our test showed that almost 90% of the students from the two sections scored higher in post-test as compared to pre-test. Based on this premise, we conducted a further survey that measured student’s job-search preparation, knowledge of data analysis, involved with the course, satisfaction with the course, student’s overall reaction the course and students' ability to meet the traditional learning goals related to the course.

Keywords: project-based learning, job-search preparation, satisfaction with course, traditional learning goals

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Authors: Elena G. Diryugina, Maria A. Dovger, Maria V. Lunkina, Alexandra A. Ianchenko

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The personality development and well-being of children have become important focuses of school education and indicators of its quality. The studies show that academic success depends more on personality and motivation than on intelligence and giftedness. Those personality resources that help a person to maintain well-being both here and now and in the future constitute their personality potential. The development of schoolchildrens' personality potential can help them meet the challenges of the modern world and achieve new educational goals. At the same time, it is noted that the pedagogical factor is one of the most significant in relation to schoolchildrens' success and well-being. What is important for teachers to develop in order to make their students feel more competent and maintain well-being? As part of the Developmental Environment Programme of the Charitable Foundation ‘Investment in the Future’, a longitudinal study of the personality potential and well-being of educators and schoolchildren was conducted from 2018 to 2023. More than 2,500 teachers and over 4,000 students from Russia took part. It was found that behind a teacher's communication style, an important construct that influences the motivation of schoolchildren and the satisfaction of their basic psychological needs, is the personal potential of that teacher. Their personality potential correlates with the social-emotional development of schoolchildren in junior grades. A teacher's communication style with adolescents contributes to their academic motivation, self-esteem and satisfaction with life and learning. In addition, child well-being cannot be promoted in isolation from attention to the psychological well-being of teachers. Their social well-being and engagement are higher when they are included in professional learning communities. The results will be helpful for both positive education researchers and practitioners to identify an approach to child personality development and well-being that is achieved primarily through the personality development and well-being of school staff members and mostly teachers.

Keywords: Personality development, personality potential, schoolchildren, teaching style, well-being

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Authors: Glenn Koonce

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There is a need to address the improvement of university educational leadership preparation programs through the processes of accreditation and continuous improvement. The program faculty in a university in the eastern part of the United States has incorporated an employer satisfaction focus group to address their national accreditation standard so that employers are satisfied with completers' preparation for the position of principal or assistant principal. Using the Council for the Accreditation of Educator Preparation (CAEP) required proficiencies, the following research questions are investigated: 1) what proficiencies do completers perform the strongest? 2) what proficiencies need to be strengthened? 3) what other strengths beyond the required proficiencies do completers demonstrate? 4) what other areas of responsibility beyond the required proficiencies do completers demonstrate? and 5) how can the program improve in preparing candidates for their positions? This study focuses on employers of one public school district that has a large number of educational leadership completers employed as principals and assistant principals. Central office directors who evaluate principals and principals who evaluate assistant principals are focus group participants. Construction of the focus group questions is a result of recommendations from an accreditation regulatory specialist, reviewed by an expert panel, and piloted by an experienced focus group leader. The focus group session was audio recorded, transcribed, and analyzed using the NVivo Version 14 software. After constructing folders in NVivo, the focus group transcript was loaded and skimmed by diagnosing significant statements and assessing core ideas for developing primary themes. These themes were aligned to address the research questions. From the transcript, codes were assigned to the themes and NVivo provided a coding hierarchy chart or graphical illustration for framing the coding. A final report of the coding process was designed using the primary themes and pertinent codes that were supported in excerpts from the transcript. The outcome of this study is to identify themes that can provide evidence that the educational leadership program is meeting its mission to improve PreK-12 student achievement through well-prepared completers who have achieved the position of principal or assistant principal. The considerations will be used to derive a composite profile of employers' satisfaction with program completers with the capacity to serve, influence, and thrive as educational leaders. Analysis of the idealized themes will result in identifying issues that may challenge university educational leadership programs to improve. Results, conclusions, and recommendations are used for continuous improvement, which is another national accreditation standard required for the program.

Keywords: educational leadership preparation, CAEP accreditation, principal & assistant principal evaluations, continuous improvement

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Authors: Hanjun Hu, Jinxiang Zhang

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With the decline of "growthism", China's urbanization process has shifted from the stage of spatial expansion to the stage of optimization of built-up spaces, and urban renewal has gradually become a new wave of China's urban movement in recent years. The ongoing urban renewal movement in China not only needs to generate new motivation for urban development but also solve the backlog of social problems caused by rapid urbanization, which provides an opportunity for the transformation of China's urban governance model. Unlike previous approaches that focused on physical space and functional renewal, such as urban reconstruction, redevelopment, and reuse, the key challenge of urban renewal in the post-growth era lies in coordinating the complex interest relationships between multiple stakeholders. The traditional theoretical frameworks that focus on the structural relations between social groups are insufficient to explain the behavior logic and mutual cooperation mechanism of various groups and individuals in the current urban renewal practices. Therefore, based on the long-term tracking of the urban renewal practices in the Old City of Nanjing (OCN), this paper introduces the "collective action" theory to deeply analyze changes in the urban renewal governance model in OCN and tries to summarize the governance strategies that promote the formation of collective action within recent practices from a micro-scale. The study found that the practice in OCN experienced three different stages "government-led", "growth coalition" and "asymmetric game". With the transformation of government governance concepts, the rise of residents' consciousness of rights, and the wider participation of social organizations in recent years, the urban renewal in OCN is entering a new stage of "collective renewal action". Through the establishment of the renewal organization model, incentive policies, and dynamic negotiation mechanism, urban renewal in OCN not only achieves a relative balance between individual interests and collective interests but also makes the willingness of residents the dominant factor in formulating urban renewal policies. However, the presentation of "collective renewal action" in OCN is still mainly based on typical cases. Although the government is no longer the dominant role, a large number of resident-led collective actions have not yet emerged, which puts forward new research needs for a sustainable governance policy innovation in this action.

Keywords: urban renewal, collective action theory, governance, cooperation mechanism, China

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Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

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Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

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Authors: Idris M. Olatunde, Kareem B.

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In manufacturing systems, especially job shops, service performance is a key factor that determines customer satisfaction. Service performance depends not only on the quality of the output but on the delivery lead times as well. Besides product quality enhancement, delivery lead time must be minimized for optimal patronage. Quoting accurate due dates is sine quo non for job shop operational survival in a global competitive environment. Quoting accurate due dates in job shops has been a herculean task that nearly defiled solutions from many methods employed due to complex jobs routing nature of the system. This class of NP-hard problems possessed no rigid algorithms that can give an optimal solution. Jobshop operational problem is more complex in developing nations due to some peculiar factors. Operational complexity in job shops emanated from political instability, poor economy, technological know-how, and the non-promising socio-political environment. The mentioned exogenous factors were hardly considered in the previous studies on scheduling problem related to due date determination in job shops. This study has filled the gap created in the past studies by developing a dynamic model that incorporated the exogenous factors for accurate determination of due dates for varying jobs complexity. Real data from six job shops selected from the different part of Nigeria, were used to test the efficacy of the model, and the outcomes were analyzed statistically. The results of the analyzes showed that the model is more promising in determining accurate due dates than the traditional models deployed by many job shops in terms of patronage and lead times minimization.

Keywords: due dates prediction, improved performance, customer satisfaction, dynamic model, exogenous factors, job shops

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Authors: Shasta Bula

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This research provides the first case study of the Santa Ana riverbed homeless encampment. It contributes valuable information about the little-studied factors contributing to the formation and dismantling of transient homeless encampments. According to the author’s best knowledge, this is the discussion of three reoccurring characteristics of homeless camps: camps form a self-governing system, camps are viewed by the community as unsavory places, and the campers are viewed as being unable or unwilling to participate in normal society. Three theories are proposed as explanations for these characteristics: the social capital theory as a reason for homeless campers to develop a system of self-government, the aesthetics theory as rationale for camps being viewed as unsavory places, and the theory of vulnerable and inevitable inequality as a reason why campers are seen as being unable or unwilling to participate in normal society. Three hypotheses are introduced to assess these theories: The encampment was created because it provided inhabitants a sense of safety and autonomy. It was dismantled due to its highly visible location and lack of adherence to the Orange County consumption and leisure aesthetic. Most homeless people from this encampment relocated approximately thirty miles east to Riverside County to avoid harassment by police. An extensive review of interviews with camp inhabitants revealed that fifty-one percent resided in the camp because it gave them a sense of safety and autonomy. An examination of Anaheim city council meeting meetings showed that thirty-eight percent of complaints were related to aesthetic concerns. Analysis of population reports from the U.S. Department of Housing and Urban Development indicated that there was a notable increase in homelessness in Orange County the year after the camp was dismantled. These results reflect that the social capital theory is an applicable explanation for the homeless being drawn to set up camp as a collective. The aesthetics theory can be used to explain why a third of residents complained about the encampment. Camp residents did not move East to Riverside after the camp was dismantled. Further investigation into the enforcement of anti-camping ordinances needs to be conducted to evaluate if policing contributed to the vulnerability of the homeless.

Keywords: poverty, social relations, transformation of urban settlements, urban anthropology

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Authors: Dylan Shiting Lu, Samson Okello, Anita Chunyan Wei, Daniel Xiao Li

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Mammotome vacuum-assisted breast biopsy (MVB) introduced in 1995 can be used for the removal of benign breast lesions. Whether or not MVB is a better option compared to conventional open surgery is inconclusive. We aim to compare the clinical and patient-related outcomes between MVB and open surgery to remove benign breast tumors less than 5 cm in women. We searched English and Chinese electronic databases with the keywords of Mammotome, clinical trial (CT), vacuum-assisted breast biopsy for studies comparing MVB and open surgery until May 2021. We performed a systematic review and random-effects meta-analysis to compare incision size, operation time, intraoperative blood loss, healing time, scar length, patient satisfaction, postoperative hematoma rate, wound infection rate, postoperative ecchymosis, and postoperative sunken skin among those who have Mammotome and those who have surgery. Our analysis included nine randomized CTs with 1155 total patients (575 Mammotome, 580 surgery) and mean age 40.32 years (standard deviation 3.69). We found statistically significant favorable outcomes for Mammotome including blood loss (ml) [standardized mean difference SMD -5.03, 95%CI (-7.30, -2.76)], incision size (cm) [SMD -12.22, 95%CI (-17.40, -7.04)], operation time (min) [SMD -6.66, 95%CI (-9.01, -4.31)], scar length (cm) [SMD -7.06, 95%CI (-10.76, -3.36)], healing time (days) [SMD -6.57, 95%CI (-10.18, -2.95)], and patient satisfaction [relative risk RR 0.38, 95%CI (0.13, 1.08)]. In conclusion, Mammotome vacuum-assisted breast biopsy compared to open surgery shows better clinical and patient-related outcomes. Further studies should be done on whether or not MVB is a better option for benign breast tumors excision.

Keywords: clinical and patient outcomes, open surgery, Mammotome vacuum-assisted breast biopsy, meta-analysis

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Authors: Jia-Jin He, Tzu-Yuan Stessa Chao

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It is generally accepted that community residents with abundant open space have better health status on average, and thus more and more cities around the world began their pursuit of the greatest possible amount of green space within urban areas through urban planning approach. Nevertheless, only a few studies managed to provide empirical evidence regarding the actual relationship between 'providing' green space and 'improving' human health at city level. There is also lack of evidence of direct positive improvement of health by increasing the amount of green space. For urban planning professional, it is important to understand citizens’ usage behaviour towards green space as a critical evidence for future planning and design strategies. There is a research need to further investigate the amount of green space, user behaviour of green spaces and the health outcome of urban dwellers. To this end, we would like to find out other important factors for urban dwellers’ usage behaviours of green spaces. 'Average green spaces per person' is one of the National well-being Indicators in Taiwan as in many other countries. Through our preliminary research, we collected and analyzed the official data of planned open space coverages, average life expectancy, exercise frequency and obesity ratio in all cities of Taiwan. The study result indicates an interesting finding that Kaohsiung city, the second largest city in Taiwan, tells a completely different story. Citizens in Kaosiung city have more open spaces than any other city through urban planning, yet have relatively unhealthy condition in contrary. Whether it pointed out that the amount of the open spaces per person has would not direct to the health outcome. Therefore, the pre-established view which states that open spaces must have positive effects on human health should be examined more prudently. Hence, this paper intends to explore the relationship between user behaviour of open spaces and citizens’ health conditions by critically analyzing past related literature and collecting selective data from government health database in 2015. We also take Kaohsiung city, as a case study area to conduct statistical analysis first followed by questionnaire survey to gain a better understanding. Finally, we aim to feedback our findings to the current planning system in Taiwan for better health promotion urbanized areas.

Keywords: open spaces, urban planning systems, healthy cities, health outcomes

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Authors: Artitaya Sabangbal, Darawan Augsornwan, Palakorn Surakunprapha, Lalida Petphai

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Background: Srinagarind Hospital Ward 3C has about 180 cases of patients with head and neck cancer per year. Almost all of these patients suffer with pain, fatigue, low self image, swallowing problem and when the tumor is larger they will have breathing problem. Many of them have complication after operation such as pressure sore, pneumonia, deep vein thrombosis. Nursing activity is very important to prevent the complication especially promoting patients early ambulation. The objective of this study was to develop early ambulation protocol for patients with head and neck cancer undergoing operation. Method: this study is one part of nursing system development in patients undergoing operation in Ward 3C. It is a participation action research divided into 3 phases Phase 1 Situation review: In this phase we review the clinical outcomes, process of care, from document such as nurses note and interview nurses, patients and family about early ambulation. Phase 2 Searching nursing intervention about early ambulation from previous study then establish protocol . This phase we have picture package of early ambulation. Phase 3 implementation and evaluation. Result: Patients with head and neck cancer after operation can follow early ambulation protocol 100%, 85 % of patients can follow protocol within 2 days after operation and 100% can follow protocol within 3 days. No complications occur. Patients satisfaction in very good level is 58% and in good level is 42% Length of hospital stay is 6 days in patients with wide excision and 16 day in patients with flap coverage. Conclusion: The early ambulation protocol is appropriate for patients with head and neck cancer who undergo operation. This can restore physical health, reduce complication and increase patients satisfaction.

Keywords: nursing system, early ambulation, head and neck cancer, operation

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Authors: John Scanlon, Antony Raymond, Randeep Aujla, Peter D’Alessandro, Satyen Gohil

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Background: The incidence of significant acute chondral injuries with patella dislocation is around 10-15%. It is accepted that chondral procedures should only be performed in the presence of joint stability Methods:Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging, and complications were recorded. PROMs and patient satisfaction was obtained. Results:20 knees (18 patients) were included. Mean age was 18.6 years (range; 11-39), and the mean follow-up was 16.6 months (range; 2-70). The defect locations were the lateral femoral condyle (9/20; 45%), patella (9/20; 45%), medial femoral condyle (1/20; 5%) and the trochlea (1/20; 5%). The mean defect size was 2.6cm2. Twelve knees were treated with cartilage fixation, 5 with microfracture, and 3 with OATS. At follow up, the overall mean Lysholm score was 77.4 (± 17.1), with no chondral regenerative procedure being statistically superior. There was no difference in Lysholm scores between those patients having acute medial patellofemoral ligament reconstruction versus medial soft tissue plication (p=0.59). Five (25%) knees required re-operation (one arthroscopic arthrolysis; one patella chondroplasty; two removal of loose bodies; one implant adjustment). Overall, 90% responded as being satisfied with surgery. Conclusion: Our aggressive pathway to identify and treat acute cartilage defects with early operative intervention and patella stabilisation has shown high rates of satisfaction and Lysholm scores. The full range of chondral restoration options should be considered by surgeons managing these patients.

Keywords: patella dislocation, chondral restoration, knee, patella stabilisation

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Authors: S. Srinivas Rao, Pallavi Chitnis, Himanshu Prajapati

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The green building movement in India commenced in 2003. Since then, more than 4,300 projects have adopted green building concepts. For last 15 years, the green building movement has grown strong across the country and has resulted in immense tangible and intangible benefits to the stakeholders. Several success stories have demonstrated the tangible benefit experienced in green buildings. However, extensive data interpretation and qualitative analysis are required to report the intangible benefits in green buildings. The emphasis is now shifting to the concept of people-centric design and productivity, health and wellbeing of occupants are gaining importance. This research was part of World Green Building Council’s initiative on 'Better Places for People' which aims to create a world where buildings support healthier and happier lives. The overarching objective of this study was to understand the perception of users living and working in green buildings. The study was conducted in twenty-five IGBC certified green buildings across India, and a comprehensive questionnaire was designed to capture occupant’s perception and experience in the built environment. The entire research focussed on the eight attributes of healthy buildings. The factors considered for the study include thermal comfort, visual comfort, acoustic comfort, ergonomics, greenery, fitness, green transit and sanitation and hygiene. The occupant’s perception and experience were analysed to understand their satisfaction level. The macro level findings of the study indicate that green buildings have addressed attributes of healthy buildings to a larger extent. Few important findings of the study focussed on the parameters such as visual comfort, fitness, greenery, etc. The study indicated that occupants give tremendous importance to the attributes such as visual comfort, daylight, fitness, greenery, etc. 89% occupants were comfortable with the visual environment, on account of various lighting element incorporated as part of the design. Tremendous importance to fitness related activities is highlighted by the study. 84% occupants had actively utilised sports and meditation facilities provided in their facility. Further, 88% occupants had access to the ample greenery and felt connected to the natural biodiversity. This study aims to focus on the immense advantages gained by users occupying green buildings. This will empower green building movement to achieve new avenues to design and construct healthy buildings. The study will also support towards implementing human-centric measures and in turn, will go a long way in addressing people welfare and wellbeing in the built environment.

Keywords: health and wellbeing, green buildings, Indian green building council, occupant’s satisfaction

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Authors: Ariadne Katsouras, Andrea Chareunsy

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The number of large hydroelectric dams in the world has increased from almost 6,000 in the 1950s to over 45,000 in 2000. Dams are often built to increase the economic development of a country. This can occur in several ways. Large dams take many years to build so the construction process employs many people for a long time and that increased production and income can flow on into other sectors of the economy. Additionally, the provision of electricity can help raise people’s living standards and if the electricity is sold to another country then the money can be used to provide other public goods for the residents of the country that own the dam. Dams are also built to control flooding and provide irrigation water. Most dams are of these types. This paper will give an overview of the environmental and economic theories of the impact of dams in different regions of the world. There is a difference in the degree of environmental and economic impacts due to the varying climates and varying social and political factors of the regions. Production of greenhouse gases from the dam’s reservoir, for instance, tends to be higher in tropical areas as opposed to Nordic environments. However, there are also common impacts due to construction of the dam itself, such as, flooding of land for the creation of the reservoir and displacement of local populations. Economically, the local population tends to benefit least from the construction of the dam. Additionally, if a foreign company owns the dam or the government subsidises the cost of electricity to businesses, then the funds from electricity production do not benefit the residents of the country the dam is built in. So, in the end, the dams can benefit a country economically, but the varying factors related to its construction and how these are dealt with, determine the level of benefit, if any, of the dam. Some of the theories or practices used to evaluate the potential value of a dam include cost-benefit analysis, environmental impacts assessments and regressions. Systems analysis is also a useful method. While these theories have value, there are also possible shortcomings. Cost-benefit analysis converts all the costs and benefits to dollar values, which can be problematic. Environmental impact assessments, likewise, can be incomplete, especially if the assessment does not include feedback effects, that is, they only consider the initial impact. Finally, regression analysis is dependent on the available data and again would not necessarily include feedbacks. Systems analysis is a method that can allow more complex modelling of the environment and the economic system. It would allow a clearer picture to emerge of the impacts and can include a long time frame.

Keywords: comparison, economics, environment, hydroelectric dams

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Authors: Dorcas Matowe

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Inequality in health care for racial and ethnic minorities continues to be a growing concern for many Americans. Some of the barriers hindering the elimination of health disparities include lack of insurance, socioeconomic status (SES), and racism. This study will specifically focus on the association between some of these factors- health care access, which includes insurance coverage and frequency of doctor visits, race, ethnicity, and health status. The purpose of this study will be to address the following questions: is having health insurance associated with increased doctor visits? Are racial and ethnic minorities with health insurance more or less likely to see a doctor? Is the association between having health insurance moderated by being an ethnic minority? Given the current implications of the 2010 Affordable Care Act, this study will highlight the need to prioritize health care access for minorities and confront institutional racism. Critical Race Theory (CRT) will demonstrate how racism has reinforced these health disparities. This quantitative study design will analyze secondary data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire, a telephone survey conducted annually in all 50 states and three US territories by state health departments in conjunction with the Center for Disease Control (CDC). Non-identifying health-related data is gathered annually from over 400,000 adults 18 years and above about their health status and use of preventative services. Through Structural Equation Modeling (SEM), the relationship between the predictor variables of health care access, race, and ethnicity, the criterion variable of health status, and the latent variables of emotional support and life satisfaction will be examined. It is hypothesized that there will be an interaction between certain racial and ethnic minorities who went to see a doctor, had insurance coverage, experienced racism, and the quality of their health status, emotional support, and life satisfaction.

Keywords: ethnic minorities, health disparities, health access, racism

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Authors: Susan Evans, Janna Gordon-Elliott, Katarzyna Wyka, Virginia Mutch

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During the rise of the COVID-19 pandemic, healthcare workers needed an intervention that could address their profound acute stress. Mindfulness-based stress reduction (MBSR) is a program that has long established effectiveness for mental and physical health outcomes. In recent years, MBSR has been modified such that the duration of both class time and number of sessions has been abbreviated, and its delivery has been adapted for online dissemination, thus increasing the likelihood that individuals who could most benefit from the program would do so. We sought to investigate whether a brief, online version of MBSR could be feasible and acceptable for health care workers (HCW) in acute stress in response to the COVID-19 pandemic. Participants were recruited via an email sent to all hospital employees, which spans residents, physicians, nurses, housekeeping, lab technicians, administrators, and others. Participating HCW were asked about their previous experience with mindfulness and asked to commit to a minimum of 3 sessions. They were then provided with four weekly 1-hour sessions online that included the major mindfulness exercises taught during traditional MBSR programs (i.e., body scan, sitting meditation, mindful eating, and yoga). Participants were provided with supporting slides, videos, demonstrations and asked to track their practice. Hospital staff enrolled in the program; by the end of the first day of recruitment, 40 had applied; by the start date, about 100 were enrolled, and n attended a minimum of 3 sessions, supporting feasibility. Hospital staff also participated and practiced the mindfulness exercises (n=42), thus supporting acceptability. Participants reported that the program was logical, successful, and worth recommending both before starting the program and after completing it (M= 22.02 and M=21.76, respectively, possible range 0-27). There was a slight decline in the belief in improvement in health and well-being due to the program (ES=.37, p=.021). Secondary hypotheses regarding participants’ self-reported stress and levels of mindfulness were also supported, such that participants reported improvements in perceived stress (ES=.45, p=.006), compassion satisfaction, burnout, and secondary traumatic stress (ES=.41, ES=.31, ES=.35, respectively, p<.05). Participants reported significant improvements in the describing facet of mindfulness (ES=.49, p=.004), while all other facets (observing, acting with awareness, nonjudging of inner experience, nonreactivity to inner experience) remained unchanged pre- to post-program. Results from this study suggest that an abridged, online version of MBSR is feasible and accessible to health care workers in acute stress and provides benefits expected from traditional MBSR programs. The lack of a randomized control group limits generalizability. We intend to provide a structure, framework, and lessons learned to hospital administrators and clinical staff seeking to support their employees in acute stress.

Keywords: acute stress, health care workers, mindfulness, online interventions

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Authors: Chueh Chi-An, Chan Hui-Ya

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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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Authors: Glauberto S. Quirino, Emanuelly V. Pereira, Amana S. Figueiredo, Antonia T. F. Santos, Paulo R. A. Firmino, Denise F. F. Barbosa, Caroline B. Q. Aquino, Eveliny S. Martins, Cinthia G. P. Calou, Ana K. B. Pinheiro

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Introduction: During pregnancy there are adjustments in the physical, emotional, existential and sexual areas, which may contribute to changes in sexual behavior. The objective was to analyze the sexual behavior of pregnant women. Methods: Quantitative, exploratory-descriptive study, approved by the Ethics and Research Committee of the Regional University of Cariri. For data collection, it was used the Sexuality Questionnaire in Gestation and Sexual Quotient - Female Version. It was carried out in public institutions in the urban and rural areas of three municipalities of the Metropolitan Region of Cariri, south of Ceará, Brazil from February to September 2016. The sampling was proportional stratified by convenience. A total of 815 pregnant women who were literate and aged 20 years or over were broached. 461 pregnant women were excluded because of high risk, adolescence, saturation of the extract, incomplete filling of the instrument, mental and physical handicap, without sexual partner, and the sample was 354 pregnant. The data were grouped, organized and analyzed in the statistical program R Studio (version 386 3.2.4). Descriptive frequency statistics and non-parametric tests were used to analyze the variables, and the results were shown in graphs and tables. Results: The women presented a minimum age of 20, maximum 35 and average of 26.9 years, predominantly urban area residents, with a monthly income of up to one minimum wage (US$ 275,00), high school, catholic, with fixed partner, heterosexuals, multiparous, multiple sexual partners throughout life and with the beginning of sexual life in adolescence (median age 17 years). There was a reduction in sexual practices (67%) and when they were performed, they were more frequent in the first trimester (79.7%) and less frequent in the third trimester (30.5%). Preliminary sexual practices did not change and were more frequent in the second trimester (46.6%). Throughout the gestational trimesters, the partner was referred as the main responsible for the sexual initiative. The women performed vaginal sex (97.7%) and provided greater pleasure (42.8%) compared to non-penetrative sex (53.9%) (oral sex and masturbation). There was also a reduction in the sexual disposition of pregnant women (90.7%) and partner (72.9%), mainly in the first trimester (78.8%), and sexual positions. Sexual performance ranged from regular to good (49.7%). Level of schooling, marital status, sexual orientation of the pregnant woman and the partner, sexual practices and positions, preliminaries, frequency of sexual practices and importance attributed to them were variables that influenced negatively sexual performance and satisfaction. It is concluded that pregnancy negatively changes the sexual behavior of the women and it is suggested to further investigations and approach of the partner, in order to clarify the influence of these variables on the sexual function and subsidize intervention strategies, with a view to the integrality of sexual and reproductive health.

Keywords: obstetric nursing, pregnant women, sexual behavior, women's health

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