Search results for: hospital factors

Authors: Hala Shaari, Nuredin Ahmed

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Teaching computer programming is recognized to be difficult and a real challenge. The biggest problem faced by novice programmers is their lack of understanding of basic programming concepts. A visualized learning tool was developed and used by volunteered first-year students for two semesters. The purposes of this paper are firstly, to emphasize factors which directly affect the performance of our students negatively. Secondly, to examine whether the proposed tool would improve their performance and learning progression. The results of adopting this tool were conducted using a pre-survey and post-survey questionnaire. As a result, students who used the learning tool showed better performance in their programming subject.

Keywords: factors, novice, programming, visualization

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Authors: Hisham Arab Alkabeya, A. M. Hughes, J. Adams

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Background: People with Rheumatoid Arthritis (RA) continue to experience problems with hand function despite new drug advances and targeted medical treatment. Consequently, it is important to identify the factors that influence the impact of RA disease on hand function. This systematic review identified observational studies that reported factors that influenced the impact of RA on hand function. Methods: MEDLINE, EMBASE, CINAL, AMED, PsychINFO, and Web of Science database were searched from January 1990 up to March 2017. Full-text articles published in English that described factors related to hand functional disability in people with RA were selected following predetermined inclusion and exclusion criteria. Pertinent data were thoroughly extracted and documented using a pre-designed data extraction form by the lead author, and cross-checked by the review team for completion and accuracy. Factors related to hand function were classified under the domains of the International Classification of Functioning, Disability, and Health (ICF) framework and health-related factors. Three reviewers independently assessed the methodological quality of the included articles using the quality of cross-sectional studies (AXIS) tool. Factors related to hand function that was investigated in two or more studies were explored using a best-evidence synthesis. Results: Twenty articles form 19 studies met the inclusion criteria from 1,271 citations; all presented cross-sectional data (five high quality and 15 low quality studies), resulting in at best limited evidence in the best-evidence synthesis. For the factors classified under the ICF domains, the best-evidence synthesis indicates that there was a range of body structure and function factors that were related with hand functional disability. However, key factors were hand strength, disease activity, and pain intensity. Low functional status (physical, emotional and social) level was found to be related with limited hand function. For personal factors, there is limited evidence that gender is not related with hand function; whereas, conflicting evidence was found regarding the relationship between age and hand function. In the domain of environmental factors, there was limited evidence that work activity was not related with hand function. Regarding health-related factors, there was limited evidence that the level of the rheumatoid factor (RF) was not related to hand function. Finally, conflicting evidence was found regarding the relationship between hand function and disease duration and general health status. Conclusion: Studies focused on body structure and function factors, highlighting a lack of investigation into personal and environmental factors when considering the impact of RA on hand function. The level of evidence which exists was limited, but identified that modifiable factors such as grip or pinch strength, disease activity and pain are the most influential factors on hand function in people with RA. The review findings suggest that important personal and environmental factors that impact on hand function in people with RA are not yet considered or reported in clinical research. Well-designed longitudinal, preferably cohort, studies are now needed to better understand the causality between personal and environmental factors and hand functional disability in people with RA.

Keywords: factors, hand function, rheumatoid arthritis, systematic review

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Authors: N. P. Tsephe, S. D. Eyono Obono

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Rural tourism is usually associated with rural development because it has strong linkages to rural resources; but it remains underdeveloped compared to urban tourism. This underdevelopment of rural tourism serves as a motivation for this study whose aim is to examine the factors affecting the perceived satisfaction of rural tourists. The objectives of this study are: to identify and design theories and models on rural tourism satisfaction, and to empirically validate these models and theories through a survey of tourists from the Malealea Lodge which is located in the Mafeteng District, in the Mountain Kingdom of Lesotho. Data generated by the collection of questionnaires used by this survey was analyzed quantitatively using descriptive statistics and correlations in SPSS after checking the validity and the reliability of the questionnaire. The main hypothesis behind this study is the relationship between the demographics of rural tourists, the motivation, and their satisfaction of tourists, as supported by existing literature; except that motivation is measured in this study according to three dimensions: push factors, pull factors, and perceived usefulness of ICT's in the rural tourism experience. Findings from this study indicate that among the demographics factors, continent of origin and marital status influence the satisfaction of rural tourists; and their occupation affects their perceptions on the use of ICT's in rural tourism. Moreover, only pull factors were found to influence the satisfaction of rural tourists.

Keywords: digital world, motivation, rural tourism, satisfaction

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Authors: Muhamad N. Borhan, Nur S. Darus, Siti Z. Ishak, Rozmi Ismail, Siti F. M. Razali

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Children are at the greater risk to be involved in road traffic collisions due to the complex interaction of various elements in our transportation system. It encompasses interactions between the elements of children and driver behavior along with physical and social environment factors. The present study examined the effect between the collisions severity and physical environment factors on child pedestrian collisions. The severity of collisions is categorized into four injury outcomes: fatal, serious injury, slight injury, and damage. The sample size comprised of 2487 cases of child pedestrian-vehicle collisions in which children aged 7 to 12 years old was involved in Malaysia for the years 2006-2015. A multinomial logistic regression was applied to establish the effect between severity levels and physical environment factors. The results showed that eight contributing factors influence the probability of an injury road surface material, traffic system, road marking, control type, lighting condition, type of location, land use and road surface condition. Understanding the effect of physical environment factors may contribute to the improvement of physical environment design and decrease the collision involvement.

Keywords: child pedestrian, collisions, primary school, road injuries

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Authors: Salma Akter, Mohammad M. Haque, Lawrence Akwetey

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An empirical research design will analyze different factors/predictors children use to influence their parents in the family buying decision process in the unexplored area of British Bangladeshi children in the United Kingdom. The proposed conceptual model of factors- buying decision making process will be tested by the Structure Equation Model. A structured Questionnaire and secondary sources will employ to collect data and analyse and measure the validity by Statistical tools (SPSS) and Microsoft Excel. The Contemporary research aims to use the deductive approach developing the research questions and testing the hypothesis to identify the impact of different strategies British Bangladeshi children used to influence their parents in the family buying decision which was overlooked in the previous research.

Keywords: British Bangladeshi children, buying decision process, children influence, influential factors

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Authors: Nasrudin Andi Mappaware, Muh. Wirawan Harahap, Erlin Syahril, Farah Ekawati Mulyadi

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The increasing trend of cesarean sections, especially those performed on self-request without medical indications, presents complex dilemmas related to medical aspects, professionalism, and bioethics. This study aims to investigate the medical, professional, and bioethical considerations surrounding anesthesia in cesarean sections performed on self-request without medical indications. We report the case of a 27-year-old woman, G1P0A0 gravid 38 weeks, admitted to the hospital for a planned cesarean section on request for the reason that she could not tolerate pain and requested on a date that corresponded to the date and month of her mother's birth. Cesarean section on patient request fulfills the principle of autonomy, which states that patients have the right to themselves. However, this medical procedure is still considered no safer and riskier even though medical technology has developed rapidly. Furthermore, anesthesia during cesarean section at self-request without medical indications is a dilemma for anesthesiologists considering the risks and complications of anesthesia for both the fetus and the mother. The trend in increasing the number of cesarean sections is influenced by patient reasons such as not being able to tolerate pain, trust factors, and worry about damage to the birth canal.

Keywords: anesthesia, bioethics, cesarean section, self-request, professionalism

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Authors: Benjamin Bae, Mahdy Elhusseiny, Sherif El-Halaby

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This study investigates the relationship between some cultural factors and the level of dividend payouts of banks in a number of Muslim countries. We examine whether cultural factors play any role in determining dividend payout policy in banks. The results suggest that banks in high masculinity countries tend to pay higher dividends than low masculinity countries. The results also show that banks in high uncertainty avoidance (UA) countries tend to pay lower dividends than high UA countries. Additionally, the results of this study indicate that banks in high long-term orientation (LTO) countries tend to pay lower dividends than low LTO countries. However, two other cultural factors of power distance (PD) and individualism do not have any incremental explanatory power on the dividend payouts. Overall, this research adds to our understanding of the bank’s dividend payout policies. First, evidence on the relationship between the cultural factors and bank’s level of dividend payouts should be useful to investors. Second, the findings of this study provide financial statement users with useful information about the bank’s dividend payout levels. Third, in general, it also adds to the accounting and finance literature on dividends.

Keywords: cultural factor, dividend payout, Hofstede index, bank industry

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Authors: Suwannee Sroisong, Angkhana Ruenkon, Ronnaphop Eimtab

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The purpose of this study was twofold: First, to examine the relationship of the Readiness on the License Examination Testing (RLET) with factors namely achieved motivation, attitude on testing, self-perception, perception in testing among the nursing students at Baromarajonani College of Nursing, Buddhachinaraj, Thailand (BCNB); and secondly, to investigate the factors affecting the RLET of the nursing students. All data were collected from a set of 214 questionnaires of nursing students, second semester and in academic year 2010, at BCNB. As a set of variables in the questionnaire, it consisted of factors of readiness in testing, achieved motivation, attitude on testing, self-perception, and perception in testing. The following statistics were analyzed: frequency, percentage, means, standard deviation, and Stepwise-multiple regression correlation. Research results were as follows: 1) For the relationship among following factors, namely achieved motivation, attitude on testing, self-perception, perception in testing, there were positive correlation coefficients between .324 to .560 at the .05 level of significance; and 2) One crucial factor affecting the RLET of nursing students, namely achieved motivation, was found. The achieved motivation factor could explain the variance or predict the RLET of nursing students at 31.40 percent and at the .05 level of significance.

Keywords: readiness, nursing, license examination testing, Thailand

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Authors: Yu-Mei Hsueh, Wei-Jen Chen, Yung-Kai Huang, Cheng-Shiuan Tsai, Kuo-Cheng Yeh

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Prostate cancer occurs in men over the age of 50, and rank sixth of the top ten cancers in Taiwan, and the incidence increased gradually over the past decade in Taiwan. Arsenic is confirmed as a carcinogen by International Agency for Research on (IARC). Arsenic induces oxidative stress may be a risk factor for prostate cancer, but the mechanism is not clear. Selenium is an important antioxidant element. Whether the association between plasma selenium levels and risk of prostate cancer are modified by different genotype of selenoprotein is still unknown. Glutathione peroxidase, selenoprotein P (SEPP1) and 15 kDa selenoprotein (SEP 15) are selenoprotein and regulates selenium transport and the oxidation and reduction reaction. However, the association between gene polymorphisms of selenoprotein and prostate cancer is not yet clear. The aim of this study is to determine the relationship between plasma selenium, polymorphism of selenoprotein, urinary total arsenic concentration and prostate cancer. This study is a hospital-based case-control study. Three hundred twenty-two cases of prostate cancer and age (±5 years) 1:1 matched 322 control group were recruited from National Taiwan University Hospital, Taipei Medical University Hospital, and Wan Fang Hospital. Well-trained personnel carried out standardized personal interviews based on a structured questionnaire. Information collected included demographic and socioeconomic characteristics, lifestyle and disease history. Blood and urine samples were also collected at the same time. The Research Ethics Committee of National Taiwan University Hospital, Taipei, Taiwan, approved the study. All patients provided informed consent forms before sample and data collection. Buffy coat was to extract DNA, and the polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) was used to measure the genotypes of SEPP1 rs3797310, SEP15 rs5859, GPX1 rs1050450, GPX2 rs4902346, GPX3 rs4958872, and GPX4 rs2075710. Plasma concentrations of selenium were determined by inductively coupled plasma mass spectrometry (ICP-MS).Urinary arsenic species concentrations were measured by high-performance liquid chromatography links hydride generator and atomic absorption spectrometer (HPLC-HG-AAS). Subject with high education level compared to those with low educational level had a lower prostate cancer odds ratio (OR) Mainland Chinese and aboriginal people had a lower OR of prostate cancer compared to Fukien Taiwanese. After adjustment for age, educational level, subjects with GPX1 rs1050450 CT and TT genotype compared to the CC genotype have lower, OR of prostate cancer, the OR and 95% confidence interval (Cl) was 0.53 (0.31-0.90). SEPP1 rs3797310 CT+TT genotype compared to those with CC genotype had a marginally significantly lower OR of PC. The low levels of plasma selenium and the high urinary total arsenic concentrations had the high OR of prostate cancer in a significant dose-response manner, and SEPP1 rs3797310 genotype modified this joint association.

Keywords: prostate cancer, plasma selenium concentration, urinary total arsenic concentrations, glutathione peroxidase, selenoprotein P, selenoprotein 15, gene polymorphism

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Authors: Mariya Salihu Ingawa, Sani Suleiman Isah

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The assessment of Integrated Information System (IIS) in organisation is an important initiative to enable the Information System (IS) managers, as well as top management to understand the success status of their investment in IS integration efforts. However, without a proper assessment, an organisation will not know its IIS status, which may affect their judgment on what action should be taken onwards. Current research on IIS assessment is lacking and those related literature on IIS assessment focus more on assessing the technical aspect of IIS. It is argued that assessing technical aspect alone is inadequate since organisational and strategic aspects in IIS should also be considered. Current methods, techniques and tools used by vendors for IIS assessment also are lack of comprehensive measures to fully assess the Integrated Information System in term of technical, organisational and strategic domains. The purpose of this study is to establish critical success factors for measuring success of an Integrated Information System. These factors are used as the basis for constructing an approach to comprehensively assess IIS in an organisation. A comprehensive list of success factors for IIS assessment, established from literature, was initially presented. An expert surveys using both manual and online methods were conducted to verify the factors. Based on the factors, an instrument for IIS assessment was constructed. The results from a case study indicate that through comprehensive assessment approach, not only the level of success been known, but also reveals the contributing factors. This research contributes to the field of Information Systems specifically in the area of Integrated Information System assessment.

Keywords: integrated information system, expert surveys, organisation, assessment

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Authors: Lei Zhang, Li Ji

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Formal learning and informal learning represent two distinct learning styles: one is systematic and organized, another is causal and unstructured. Although there are many factors influencing online learning satisfaction, including self-regulation, self-efficacy, and interaction, factors influencing online formal learning and informal learning satisfaction may differ from each other. This paper investigated and compared influential factors of online formal and informal learning. Two questionnaires were created based on previous studies to explore factors influencing online formal learning and online informal learning satisfaction, respectively. A sample of 105 college students from different departments in a university located in the eastern part of China was selected to participate in this study. They all had an online learning experience and agreed to fill out questionnaires. Correlation analysis, variance analysis, and regression analysis were employed in this study. In addition, five participants were chosen for interviews. The study found that student-content, interaction, self-regulation, and self-efficacy related positively to both online formal learning and informal learning satisfaction. In addition, compared to online formal learning, student-content interaction in informal learning was the most influential factor for online learning satisfaction, perhaps that online informal learning was more goal-oriented and learners paid attention to the quality of content. In addition, results also revealed that interactions among students or teachers had little impact on online informal learning satisfaction. This study compared influential factors in online formal and informal learning satisfaction helped to add discussions to online learning satisfaction and contributed to further practices of online learning.

Keywords: learning satisfaction, formal learning, informal learning, online learning

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Authors: Mehrnoosh Askarizadeh

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Globalization of the economy, e-business, and introduction of new technologies pose new challenges to all organizations. In recent decades, globalization, outsourcing, and information technology have enabled many organizations to successfully operate collaborative supply networks in which each specialized business partner focuses on only a few key strategic activities For this industries supply network can be acknowledged as a new form of organization. We will study about critical success factors (CSFs) for implementation of SCM in companies. It is shown that in different circumstances e- supply chain management has a higher impact on performance.

Keywords: supply chain management, logistics management, critical success factors, information technology, top management support, human resource

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Authors: Hashem Dadashpoor, Sadegh Saeidi Shirvan

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While with the evolution of the economy towards a knowledge-based economy, innovation is a requirement for metropolitan regions, the adoption of an open innovation strategy is an option and a requirement for many industrial firms in these regions. Studies show that investing in research and development units cannot alone increase innovation. Within the framework of the theory of learning regions, this gap, which scholars call it the ‘innovation gap’, is filled with regional features of firms. This paper attempts to investigate the factors affecting the open innovation of firms in metropolitan regions, and it searches for these in territorial innovation models and, in particular, the theory of learning regions. In the next step, the effect of identified factors which is considered as regional learning factors in this research is analyzed on the innovation of sample firms by SPSS software using multiple linear regression. The case study of this research is constituted of industrial enterprises from two groups of food industry and auto parts in Toos industrial town in Mashhad metropolitan region. For data gathering of this research, interviews were conducted with managers of industrial firms using structured questionnaires. Based on this study, the effect of factors such as size of firms, inter-firm competition, the use of local labor force and institutional infrastructures were significant in the innovation of the firms studied, and 44% of the changes in the firms’ innovation occurred as a result of the change in these factors.

Keywords: regional knowledge networks, learning regions, interactive learning, innovation

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Authors: Wisdom Dordudnu, George M. Y. Owusu, Samuel N. Y. Simpson

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The recent failures of many corporate giants have generated intense research interest in the factors that influence accountants’ job performance. Against the backdrop that these factors also create an enabling environment for success at the work place, this study contributes to literature on job performance of accountants by exploring the impact of two psycho-spiritual factors: religiosity and spiritual intelligence on job performance of accountants in Ghana. The study employs a survey approach using questionnaires as the principal means of data collection to elicit responses from accountants working in the 222 certified firms of Institute of Chartered Accountants Ghana (ICAG). A structural equation modeling-based approach is employed to examine the relationship among the study constructs. Results of this study indicate that there is a positive relationship between these factors and accountants’ performance. It is expected that this study provides strong evidence and highlight the need for specific action from managers to look critically at the non-material aspect of accountants in accounting firms.

Keywords: job performance, psycho-spiritual, religiosity, spiritual intelligence

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Authors: Isa Shu’aibu, A. A. Mu’inat, F. U. Maigari, M. A. Mani

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Candida albicans is the common cause of both oral and vaginal candidiasis in humans. This candidiasis leads to a wide range of physical, psychological and even physiological problems in humans particularly pregnant women. Samples of endocervical and high vaginal swab were collected from 200 women attending Gombe Specialist Hospital and inoculated on Saboraud Dextrose Agar (SDA) incorporated with chloramphenicol to get rid of the unwanted bacterial contaminants. Gram staining technique and germ tube test were employed for the identification, as Candida albicans is positive for both. Gram positive samples were 70% (n=140) and were further subjected to germ tube test. The remaining 30% (n=60) were found to be Gram negative. 90% (n=126) of the Gram positive ones isolated were also found to be positive for germ tube test; confirming the presence of Candida albicans. Antifungal susceptibility testing revealed that members of Imidazole (Ketoconazole, Miconazole) and those of Triazoles (Fluconazole and Itraconazole) were found to be more effective at concentrations of 20, 50 and 100 µg/disc compared to Griseofulvin (Fulcin) with only 26.00 mm zone of inhibition at 100 µg/disc concentration.

Keywords: Candida albicans, candidiasis, endocervical, vaginal swab, antifungal susceptibility, imidazole, triazoles

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Authors: Razan Salem

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Men and women are different, and so their investment behaviors may also vary. To the author’s best knowledge, women's investment behavior and its association with demographic factors have not been explored directly in the behavioral finance literature, however, particularly in respect to the Arab region. Thus, this study extends the literature by focusing on examining the association of demographic factors (age, annual income, and education) with Arab women’s investment behavior. To achieve the study’s aim, the researcher distributed 600 close-ended online questionnaires to a sample of Arab male and female individual investors in both Saudi Arabia and Jordan; using Kruskal-Wallis H Test and the Mann-Whitney U Test to analyze the data. The findings reveal that age, education, and level of income are associated with Arab women’s investment behavior. Educational level and level of income are positively associated with Arab women investment confidence level. On the contrary, age is negatively associated with Arab women financial risk tolerance. According to annual income, Arab women with lower incomes have lower confidence and investment literacy levels. Overall, the study concludes that age, income, and education are important demographic factors that must be considered when investigating the investment behavior of women in the Arab region.

Keywords: Arab region, demographic factors, investment behavior, women investors

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Authors: Juliza Hidayati, Yesie M. Sinuhaji, Sawarni Hasibuan

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A company producing drinking water through many incompatibility issues that affect supply chain performance. The study was conducted to determine the factors that affect the performance of the supply chain and improve it. To obtain the dominant factors affecting the performance of the supply chain used Analytic Network Process, while to improve performance is done by using Kaizen. Factors affecting the performance of the supply chain to be a reference to identify the cause of the non-conformance. Results weighting using ANP indicates that the dominant factor affecting the level of performance is the precision of the number of shipments (15%), the ability of the fulfillment of the booking amount (12%), and the number of rejected products when signing (12%). Incompatibility of the factors that affect the performance of the supply chain are identified, so that found the root cause of the problem is most dominant. Based on the weight of Risk Priority Number (RPN) gained the most dominant root cause of the problem, namely the poorly maintained engine, the engine worked for three shifts, machine parts that are not contained in the plant. Improvements then performed using the Kaizen method of systematic and sustainable.

Keywords: analytic network process, booking amount, risk priority number, supply chain performance

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Authors: Martin Kartomo

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Though Management Control Systems (MCS) research has evolved beyond intra-organizational boundaries, there is limited understanding of the impact of a functioning MCS being functional beyond intra-organizational boundaries. The purpose of this research is to investigate factors that have an impact on functioning management Control Systems (MCS)becoming (dys-)functional beyond its intra-organizational boundaries. To bridge the theoretical gap, a systematic literature review is conducted to identify inter-and extra-organizational factors that are purposely suggested or unintendingly mentioned by MCS researchers to evaluate functioning MCS becoming (dys-)functional. A conceptual map is rationalized and constructed from five contingent inter-and extra-organizational MCS frameworks illuminating under-investigated MSC research areas and allowing new research avenues based on academically known factors. A multiple case study followed by a co-researcher discussion group with the purpose of identifying academically unknown factors for evaluating MCS (dys-)functionality beyond its intra-organizational boundaries. The study's result will help bridge the gap between what academics know and not know of evaluating MCS being functional beyond intra-organizational boundaries with the opportunity to develop better, more complete theories. Furthermore, it will help organizations to evaluate the impact of their activities beyond intra-organizational boundaries.

Keywords: management control systems, management control systems evaluation, management controls, control system

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Authors: K. P. v. R. de Silva, R. W. Senevirathna, M. M. A. J. Kumara, J. P. M. Kumarasinghe, R. L. Gunawardana, S. M. Uluwitiya, G. C. P. Jayawickrama, W. K. T. I. Madushani

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Introduction: The limited literature supporting the utilization of mechanical bowel preparation (MBP) for patients undergoing laparoscopic anterior resection (LAR) remains a notable issue. This study was conducted to examine the clinical consequences of anastomosis in colorectal surgery with MBP compared to cases where MBP was not utilized (no-MBP) in the context of LAR. Methods: This was a retrospective comparative study conducted in the professorial surgical wards of the teaching hospital karapitiya (THK). Colorectal cancer patients(n=306) participated in the study, including 151 MBP patients and 155 no-MBP patients, where the postoperative complications and mortality rates were compared. Results: The anastomotic leakage rate was 2.6%(n=4) in the no-MBP group and 6.0%(n=9) in the MBP group (p=0.143). The postoperative paralytic ileus rate was 18.5%(n=28) and 5.8%(n=9) in the MBP group and no-MBP group, respectively, displaying a statistically significant difference (p=0.001). Wound infection, pneumonia, urinary tract infection, and cardiac complication rates also were higher in the MBP group. The overall mortality rate was 1.3%(n=3) in the no-MBP group and 2.0%(n=2) in the MBP group. Conclusions: The evidence concludes that MBP increases post-operative complications. Therefore, prophylactic MBP in LAR has not been proven to benefit patients. However, further research is necessary to understand the comparative effects of MBP versus no preparation comprehensively.

Keywords: MBP, anastomosis, LAR, paralytic ileus

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Authors: Neeti Sharma, Harshika Pareek, Prerna Puri, Manika Mohan

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The present study is aimed at studying the significant relationship between anxiety and depression in chronic headache patients. Chronic Headache patients coming to the Neurology Unit-1 Outpatient Department of the Sawai Mansingh Hospital (SMS) Jaipur, Rajasthan, were included in this study. The sample consisted of 100 patients (N=100). Initially patients were examined by a physician and then they were assessed for Anxiety and Depression using the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Rating Scale for Depression. The relevant information was recorded on a Performa designed for this purpose comprising of socio-demographic variables like age, gender and triggering factors. The correlation-coefficient indicated a significant positive relationship between the anxiety and depression in chronic headache patients. These findings implicate high prevalence of anxiety and depression in the general population, and also indicate an association between headache and psychological disorders. Many evidences support the anxiety-headache-depression syndrome as a distinct disorder, and the association of co-morbid psychiatric illness with headache intractability. This study highlights the importance of prospective research for studying the developmental course and consequences of headache syndromes. Also, various psychotherapies should be applied to the headache patients so as to treat them, at the onset level of anxiety and depression, with the help of medication.

Keywords: anxiety, chronic headaches, depression, HAM-A, HAM

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Authors: Edy Wahyu Susilo

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This research discusses a comparative analysis of various anti-corruption responses of three Indonesian City Governments (Jakarta, Surabaya, and Medan) and completes previous findings on the effectiveness of the city anti-corruption program. Some factors (transparency, accountability, leadership, law enforcement, and bureaucratic reform) have been chosen in this study to diagnose the main role in the success and the failure of anti-corruption programs in these cities. These factors diagnose the relationship between factors and their dominancy, which is then utilized to create the city’s strategic anti-corruption programs. Although this study found leadership had a dominant influence both in encouraging and discouraging the performance of city transformation drastically, however, it is not the only factor that determined the performance of the city in the fight against corruption. It needs other factors as an ideal balancing element to achieve an anti-corruption program, namely KPK’s intervention and public engagement. Based on the dominance factors found, this research then develops an appropriate strategy using a policy evaluation approach to create a real practical guide regardless of the existence of good or bad leadership in the city. This research is expected to be a useful reference for stakeholders, especially the government, as a blueprint to prevent corruption by considering several important steps and guidance in efforts to eradicate corruption in the city, especially in Indonesia.

Keywords: intervention, KPK (corruption eradication commission), law enforcements, leadership, policy evaluation

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Authors: Zolani Metu

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The death of more than 140 psychiatric patients who were unethically deinstitutionalized from the Life Esidimeni hospital Johannesburg, in 2016, shined a light on South Africa’s failing public mental healthcare system. Compounded by insufficient research evidence on African deinstitutionalization, this necessitates inquiries into deinstitutionalized mental healthcare, reintegration and community-based mental healthcare within the South African context. This study employed a quantitative research approach which utilized a cross-sectional research design, to investigate experiences with the reintegration of institutionalized forensic mental health service users into communities in the Western Cape, South Africa. A convenience sample of 100 mental health care workers from different occupational and organizational backgrounds in the Western Cape was purposively selected using the Western Cape Health Directorate as a sampling frame. A self-administered questionnaire (SAQ) was used as the data collection instrument. The results of the study indicate that criminogenic factors such as substance use, history of violent behaviour, criminal history and disruptive social behaviour complicate the reintegration of forensic mental health service users into communities. The current extent of reintegration of forensic mental health service users was found to be 'poor' (46%; n= 46); and financial difficulties, criminogenic factors and limited Community-Based Care (CBC) facilities were identified as key barriers to the reintegration process. 56% of all job applications for forensic mental health service users were unsuccessful, and 53% of all applications for their admission into CBC facilities were declined. Although social support (informal) was found to be essential for successful reintegration, institutional support (formal) through assertive community treatment (35%; n= 35) and CBC facilities (21%) and the disability grant (DG=50%) was found to be more important for family coping and reintegration. Moreover, 72% of respondents had positive perceptions about the process of reintegration; no statistically significant relationship was found between years of experience and perceptions about reintegration (P-value = 0.062); and perceptions were not found to be a barrier to reintegration. No statistically significant relationship was found between years of working experience and understanding the legislative framework of deinstitutionalization (P-Value =.0.061). However, using a Chi-square test, a significant relationship (P-value = 0.021) was found between sex and understanding the legal framework involved in the process of reintegration. The study recommends a post-2020 deinstitutionalization agenda that factors-in criminogenic realities associated with forensic mental health service users, and affirms the strengthening of PHC and community based care systems as precedents of successful deinstitutionalization and reintegration of mental health service users.

Keywords: forensic mental health, deinstitutionalization, reintegration, mental health service users

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Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

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Authors: Chia-Jung Chen, Yu-Chi Hsu, June-Dong Lin, Kun-Chen Chan, Chieh-Tien Wang, Li-Ching Wu, Chung-Feng Liu

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With fast advances in healthcare technology, various total laboratory automation (TLA) processes have been proposed. However, adopting TLA needs quite high funding. This study explores an early adoption experience by Taiwan’s large-scale hospital group, the Chimei Hospital Group (CMG), which owns three branch hospitals (Yongkang, Liouying and Chiali, in order by service scale), based on the five stages of Everett Rogers’ Diffusion Decision Process. 1.Knowledge stage: Over the years, two weaknesses exists in laboratory department of CMG: 1) only a few examination categories (e.g., sugar testing and HbA1c) can now be completed and reported within a day during an outpatient clinical visit; 2) the Yongkang Hospital laboratory space is dispersed across three buildings, resulting in duplicated investment in analysis instruments and inconvenient artificial specimen transportation. Thus, the senior management of the department raised a crucial question, was it time to process the redesign of the laboratory department? 2.Persuasion stage: At the end of 2013, Yongkang Hospital’s new building and restructuring project created a great opportunity for the redesign of the laboratory department. However, not all laboratory colleagues had the consensus for change. Thus, the top managers arranged a series of benchmark visits to stimulate colleagues into being aware of and accepting TLA. Later, the director of the department proposed a formal report to the top management of CMG with the results of the benchmark visits, preliminary feasibility analysis, potential benefits and so on. 3.Decision stage: This TLA suggestion was well-supported by the top management of CMG and, finally, they made a decision to carry out the project with an instrument-leasing strategy. After the announcement of a request for proposal and several vendor briefings, CMG confirmed their laboratory automation architecture and finally completed the contracts. At the same time, a cross-department project team was formed and the laboratory department assigned a section leader to the National Taiwan University Hospital for one month of relevant training. 4.Implementation stage: During the implementation, the project team called for regular meetings to review the results of the operations and to offer an immediate response to the adjustment. The main project tasks included: 1) completion of the preparatory work for beginning the automation procedures; 2) ensuring information security and privacy protection; 3) formulating automated examination process protocols; 4) evaluating the performance of new instruments and the instrument connectivity; 5)ensuring good integration with hospital information systems (HIS)/laboratory information systems (LIS); and 6) ensuring continued compliance with ISO 15189 certification. 5.Confirmation stage: In short, the core process changes include: 1) cancellation of signature seals on the specimen tubes; 2) transfer of daily examination reports to a data warehouse; 3) routine pre-admission blood drawing and formal inpatient morning blood drawing can be incorporated into an automatically-prepared tube mechanism. The study summarizes below the continuous improvement orientations: (1) Flexible reference range set-up for new instruments in LIS. (2) Restructure of the specimen category. (3) Continuous review and improvements to the examination process. (4) Whether installing the tube (specimen) delivery tracks need further evaluation.

Keywords: innovation decision process, total laboratory automation, health care

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Authors: Thi Hai Anh Nguyen, Pantea Aria

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Tiki is one of the leading e-commerce companies in Viet Nam. Since the beginning of 2020, COVID-19 has been spreading around the world. Thanks to this pandemic, the Tiki platform has many strengths and has faced many threats. Customer behaviour was forecasted to change during the COVID-19 pandemic. The aim of the investigation is (1) Identifying factors affecting online consumer behaviour of Tiki in Ho Chi Minh City, Vietnam, (2) Measuring the level of impact of these factors, and (3) Recommendations for Tiki to improve its business strategy for the next stage. This research studies eight factors and collected 378 online surveys for analysis. Using SPSS software identified five factors (product, price, reliability, and web design) positively influencing customer behaviour. COVID-19 factor does not impact significantly Tiki’s customer behaviour. This research conducted some qualitative interviews to understand shopping experiences and customers’ expectations. One of these interviews’ main points is that Tiki’s customers have high trust in the Tiki brand and its high-quality products. Based on the results, the Tiki corporation should secure its core value. Tiki’s employees and logistics systems should be well-trained and optimized to improve customer experiences.

Keywords: COVID-19, e-commerce, impact, pandemic, Vietnam

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Authors: Khaliun Nyambayar, Nomindari Azzaya, Batkhuyag Purevjav

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Pharmacovigilance was officially introduced in Mongolia in 2003, in accordance with the Health Minister Order 183 for the registry of adverse drug reactions (ADR), approved in 2006 and was reviewed in 2010. This study was designed to evaluate the incidence and common types of adverse drug reactions among hospitalized children, the frequency of adverse drug reaction reported by health care providers, and the follow-up processes resulting from adverse drug reactions. A retrospective study of paediatric patients who experienced an adverse drug reaction from 2015 to 2019, extracted from the “yellow” card at the State Research Center for Maternal and Child Health, (city). A total of 417 adverse drug reactions were reported with an overall incidence was 80 (21.5%). Adverse reactions resulting from the use of antibiotics (particularly gentamycin, cephalosporins, and vancomycin) were usually mild. ADR’s were reported by physicians and nurses (93.8%), pharmacists (6.25%). Although documentation of physician notification occurred for 93% of adverse drug reactions, only 29% of cases were documented in the patient's medical chart, 13% included follow-up education for individuals involved, and 10% were updated in the allergy profile of the hospital computer system. Measures to improve the detection and reporting of adverse drug reactions by all health care professionals should be improved, to enhance our understanding of the nature and impact of these reactions in children.

Keywords: adverse drug reaction, pediatric, yellow card, Mongolia

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Authors: Rahaf Mandura, Fatmah Abusharkh, Layan Kurdi, Rahaf Shigdar, Khadijah Alattas

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Introduction: Age-related macular degeneration (AMD) in older individuals are serious health issues that severely impact the quality of life of millions globally. In 2020, the fourth leading cause of blindness worldwide was AMD. The global prevalence of AMD is estimated to be around 8.7%. AMD is a progressive disease involving the macular region of the retina, and it has a complex pathophysiology. RPE cell dysfunction plays a crucial step in the pathway leading to irreversible degeneration of photoreceptors with yellowish lipid-rich, protein-containing drusen deposits accumulating between Bruch's membrane and the RPE. Furthermore, lipofuscinogenesis, drusogenesis, inflammation, and neovascularization are four main processes responsible for the formation of the two types of AMD: the wet (exudative, neovascular) and dry (non-exudative, geographic atrophy) types. We retrospectively evaluated the prevalence of AMD among patients visiting the retina clinic at King Abdulaziz University Hospital (Jeddah, Makkah Province, Saudi Arabia) to identify the commonly associated risk factors of AMD. Methods: The records of 3,067 individuals from 2017 to 2021 were reviewed. Of these, 1,935 satisfied the inclusion criteria and were included in this study. We excluded all patient below 18 years, and those who did not undergo fundus imaging or attend their booked appointments, follow-ups, treatments, and referrals were excluded. Results: The prevalence of AMD among the patients was 4%. The age of patients with AMD was significantly greater than those without AMD (72.4 ± 9.8 years vs. 57.2 ± 15.5 years; p < 0.001). Participants with a family history of AMD tended to have the disease more than those without such a history (85.7% vs. 45%; p = 0.043). Ex- and current smokers were more likely to have AMD than non-smokers (34% and 18.6% vs. 7.2%; p < 0.001). Patients with hypertension and those without type 1 diabetes were at a higher risk of developing AMD than those without hypertension (5.5% vs. 2.8%; p = 0.002) and those with type 1 diabetes (4.2% vs. 0.8%; p = 0.040). In contrast, sex, nationality, type 2 diabetes, and abnormal lipid profile were not significantly associated with AMD. Regarding the clinical characteristics of AMD cases, most cases (70.4%) were of the dry type and affected both eyes (77.2%). The disease duration was ≥5 years in 43.1% of the patients. The most frequent chronic diseases associated with AMD were type 2 diabetes (69.1%), hypertension (61.7%), and dyslipidemia (18.5%). Conclusion: In summary, our single tertiary center study showed that AMD is widely prevalent in Jeddah, Saudi Arabia (4%) and linked to a wide range of risk factors. Some of these are modifiable risk factors that can be adjusted to help reduce AMD occurrence. Furthermore, this study has shown the importance of screening and follow-up of family members of patients with AMD to promote early detection and intervention of AMD. We recommend conducting further research on AMD in Saudi Arabia. Concerning the study design, a community-based cross-sectional study would be more helpful for assessing the disease's prevalence. Finally, recruiting a larger sample size is required for more accurate estimation.

Keywords: age related macular degeneration, prevelence, risk factor, dry AMD

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Authors: Olor Obi, Ishiekwen Bridget, Ekpeyong Edom

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Even though gout is becoming more common, the role of dietary risk factors in the development and management of this condition remains unclear. Therefore, this review work will aim at clarifying the role of dietary factors in the risk and management of gout. An extensive search of literature published between 1960 and 2018 will be performed on the databases of PubMed, CINAHL, Science Direct, Cochrane, BMJ, Ann Rheum Dis, and BioMed to identify relevant cohort, prospective, population-based, or cross-sectional studies that examined the effect of diet on gout. About 19 studies will be included in this review work. The methodological quality of these studies will be evaluated using the quality assessment tool for observational and cross-sectional studies developed by the National Heart, Lungs, and Blood Institute. This work intends to reveal that a positive association exists between the intake of sugary, sweetened beverages and the risk of gout. It will also reveal the relationship between the increase in coffee consumption and the risk of gout.

Keywords: gout, dietary factors, management of gout, gouty arthritis

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Authors: Brid Dinnee, Jessica Taylor, Joseph Hartland, Michael Natarajan

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Background:The third stage of labour (TSL) can be complicated by Post-Partum Haemorrhage (PPH), which can have a significant impact on maternal mortality and morbidity. In Africa, 33.9% of maternal deaths are attributable to PPH1. In order to minimise this figure, current recommendations for the developing world are that all women have active management of the third stage of labour (AMTSL). The aim of this project was to examine TSL practice in a rural Ugandan Hospital, highlight any deviation from best practice and identify barriers to change in resource limited settings as part of a 4th year medical student External Student Selected Component field trip. Method: Five key elements from the current World Health Organisation (WHO) guidelines on AMTSL were used to develop an audit tool. All daytime vaginal deliveries over a two week period in July 2016 were audited. In addition to this, a retrospective comparison of PPH rates, between 2006 (when ubiquitous use of intramuscular oxytocin for management of TSL was introduced) and 2015 was performed. Results: Eight vaginal deliveries were observed; at all of which intramuscular oxytocin was administered and controlled cord traction used. Against WHO recommendation, all umbilical cords were clamped within one minute, and no infants received early skin-to-skin contact. In only one case was uterine massage performed after placental delivery. A retrospective comparison of data rates identified a 40% reduction in total number of PPHs from November 2006 to November 2015. Maternal deaths per delivery reduced from 2% to 0.5%. Discussion: Maternal mortality and PPH are still major issues in developing countries. Maternal mortality due to PPH can be reduced by good practices regarding TSL, but not all of these are used in low-resource settings. There is a notable difference in outcomes between the developed and developing world. At Kitovu Hospital, there has been a reduction in maternal mortality and number of PPHs following introduction of IM Oxytocin administration. In order to further improve these rates, staff education and further government funding is key.

Keywords: post-partum haemorrhage, PPH, third stage labour, Uganda

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Authors: Mohamed Elshal, Hazim El-Mounayri, Omar El-Mounayri

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Emergency department (ED) is considered as a complex system of interacting entities: patients, human resources, software and hardware systems, interfaces, and other systems. This paper represents a research for implementing a detailed Systems Engineering (SE) approach in a mid-size hospital in central Indiana. This methodology will be applied by “The Initiative for Product Lifecycle Innovation (IPLI)” institution at Indiana University to study and solve the crowding problem with the aim of increasing throughput of patients and enhance their treatment experience; therefore, the nature of crowding problem needs to be investigated with all other problems that leads to it. The presented SE methods are workflow analysis and systems modeling where SE tools such as Microsoft Visio are used to construct a group of system-level diagrams that demonstrate: patient’s workflow, documentation and communication flow, data systems, human resources workflow and requirements, leadership involved, and integration between ER different systems. Finally, the ultimate goal will be managing the process through implementation of an executable model using commercialized software tools, which will identify bottlenecks, improve documentation flow, and help make the process faster.

Keywords: systems modeling, ED operation, workflow modeling, systems analysis

Procedia PDF Downloads 183