Search results for: quality of care

Authors: Rachel M. Lørum, Henrik Eriksson, Frida Smith

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Purpose: In recent years, the use of benchmarks for the improvement of healthcare has become increasingly common. There has been an increasing interest in why improvement initiatives so often fail to eliminate the problems they aspire to solve. Benchmarking comes with its fair share of challenges and problems, such as capturing the dynamics and complexities of the care environments, among others. In this study, we demonstrate how learning-oriented, voluntary benchmarks in the complex environment of public healthcare could be designed. Findings: Our four most important findings were the following: first, important organizational learning (OL) regarding the complexity of the service and implications on how to design a benchmark for learning and improvement occurred during the process. Second, participation by a wide range of professionals and stakeholders was crucial for capturing the complexity of people and organizations and increasing the quality of the template. Third, the continuous dialogue between all organizations involved was an important tool for ongoing organizational learning throughout the process. The last important finding was the impact of the facilitator’s role through supporting progress, coordination, and dialogue. Design: We chose participatory design as the research design. Data were derived from written materials such as e-mails, protocols, observational notes, and reflection notes collected during a period of 1.5 years. Originality: Our main contributions are the identification of important strategies, initiatives, and actors to involve when designing voluntary benchmarks for learning and improvement.

Keywords: organizational learning, quality improvement, learning-oriented benchmark, healthcare, patient safety

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Authors: Chan Kwon Park, Chae-Bogk Kim, Sung-Min Park

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This study is a research on the authenticity of transactions between corporations and quality of their relationships and transaction performances. As the factors of authenticity of transactions, honesty, transparency, customer orientation and consistency were selected; as the factors of quality of relationships, trust and commitment were selected, and as the factors of transactions performances, intention of repeat transactions and switching intention were selected, and on these relationships a hypothesis was established, and verification was conducted. First, the factors of the authenticity of transactions positively influenced the factors of quality of relationships. Thus, a higher level of authenticity of transactions can lead to higher level of trust and commitment. Second, the factors of quality of relationships made a positive influence on the intention of repeat transactions, while a negative influence in the switching intention. Third, it showed that trust and commitment as the factors of quality of relationships functioned partly as the parameter between the authenticity of transactions and transaction performances. Finally, it proved that the factors of the authenticity of transactions improved trust and commitment in transactions between corporations and further improved the intention of repeat transactions while they decreased the switching intention.

Keywords: authenticity of transactions, trust, commitment, intention of repeat transactions, switching intention

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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Authors: Sastry Y. Kandukuri, Isak Andersen

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Despite recent advances in the manufacturing sector, quality issues remain a frequent occurrence, and can result in fatal accidents, equipment downtime, and loss of life. Adequate quality is of high importance in high-risk industries such as sea-going vessels and offshore installations in which third party quality assurance and product control play an important essential role in ensuring manufacturing quality of critical components. Classification societies play a vital role in mitigating risk in these industries by making sure that all the stakeholders i.e. manufacturers, builders, and end users are provided with adequate rules and standards that effectively ensures components produced at a high level of quality based on the area of application and risk of its failure. Quality issues have also been linked to the lack of competence or negligence of stakeholders in supply value chain. However, continued actions and regulatory reforms through modernization of rules and requirements has provided additional tools for purchasers and manufacturers to confront these issues. Included among these tools are updated ‘approval of manufacturer class programs’ aimed at developing and implementing a set of standardized manufacturing quality metrics for use by the manufacturer and verified by the classification society. The establishment and collection of manufacturing and testing requirements described in these programs could provide various stakeholders – from industry to vessel owners – with greater insight into the state of quality at a given manufacturing facility, and allow stakeholders to anticipate better and address quality issues while simultaneously reducing unnecessary failures that are costly to the industry. The publication introduces, explains and discusses critical manufacturing and testing requirements set in a leading class society’s approval of manufacturer regime and its rationale and some case studies.

Keywords: classification society, manufacturing, materials processing, materials testing, quality control

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Authors: Mary Deyo, Zmara Harrison

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This study reports the outcomes of an 8-week experiential learning program for 6 adults with Intellectual and Developmental Disabilities (IDD) at a day habilitation program. The intervention foci for this program include executive function, language learning in the domains of expressive, receptive, and pragmatic language, and quality of life. The interprofessional collaboration aimed at supporting adults with IDD to reach person-centered, functional goals across skill domains is critical. This study is a significant addition to the speech-language pathology literature in that it examines a therapy method that potentially meets this need while targeting domains within the speech-language pathology scope of practice. Communication therapy was provided during highly valued and meaningful hands-on learning experiences, referred to as the Garden Club, which incorporated all aspects of planting and caring for a garden as well as related journaling, sensory, cooking, art, and technology-based activities. Direct care staff and an undergraduate research assistant were trained by SLP to be impactful language guides during their interactions with participants in the Garden Club. SLP also provided direct therapy and modeling during Garden Club. Research methods used in this study included a mixed methods analysis of a literature review, a quasi-experimental implementation of communication therapy in the context of experiential learning activities, Quality of Life participant surveys, quantitative pre- post- data collection and linear mixed model analysis, qualitative data collection with qualitative content analysis and coding for themes. Outcomes indicated overall positive changes in expressive vocabulary, following multi-step directions, sequencing, problem-solving, planning, skills for building and maintaining meaningful social relationships, and participant perception of the Garden Project’s impact on their own quality of life. Implementation of this project also highlighted supports and barriers that must be taken into consideration when planning similar projects. Overall findings support the use of experiential learning projects in day habilitation programs for adults with IDD, as well as additional research to deepen understanding of best practices, supports, and barriers for implementation of experiential learning with this population. This research provides an important contribution to research in the fields of speech-language pathology and other professions serving adults with IDD by describing an interprofessional experiential learning program with positive outcomes for executive function, language learning, and quality of life.

Keywords: experiential learning, adults, intellectual and developmental disabilities, expressive language, receptive language, pragmatic language, executive function, communication therapy, day habilitation, interprofessionalism, quality of life

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Authors: Scott Cavinder

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Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.

Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery

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Authors: Hyun-Woo Cho

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

Keywords: detection, filtering, monitoring, process data

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Authors: Amer Obaid Saud

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

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

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Authors: Levan Sabauri

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

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

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Authors: Mingming Leng

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

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

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Authors: Helen Coronel, Will Brewer, Peggy Bergeron, Clarissa Hall, Victoria Casson

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Simulation-based training provides the nurse practitioner (NP) student with a safe and controlled environment in which they can practice a real-life scenario. This type of learning fosters critical thinking skills essential to practice. The expectation of this study was that students would have an increase in their competency and confidence after performing the simulation. Approximately 8.4% of Americans suffer from depression. The state of Alabama is ranked 47th out of 50 for access to mental health care. As a result of this significant shortage of mental health providers, primary care providers are frequently put in the position of screening for and treating mental health conditions, such as depression. Family nurse practitioners are often utilized as primary care providers, making their ability to assess, diagnose and treat these disorders a necessary skill. The expected outcome of this simulation is an increase in confidence, competency and the empowerment of the nurse practitioner student’s ability to assess, diagnose and treat a common mood disorder they may encounter in practice. The Kirkpatrick Module was applied for this study. A non-experimental design using descriptive statistical analysis was utilized. The simulation was based on a common psychiatric mood disorder frequently observed in primary care and mental health clinics. Students were asked to watch a voiceover power point presentation prior to their on-campus simulation. The presentation included training on the assessment, diagnosis, and treatment of a patient with depression. Prior to the simulation, the students completed a pre-test, then participated in the simulation, and completed a post-test when done. Apple iPads were utilized to access a simulated health record. Major findings of the study support an increase in students’ competency and confidence when assessing, diagnosing, and treating an adult patient with depression.

Keywords: advanced practice, nurse practitioner, simulation, primary care, depression

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Authors: Nancy Wilson

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

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

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Authors: Julie Wittmannová, Petr Šeda

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

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

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Authors: Kingston Rajiah, Mari Kannan Maharajan, Si Jen Yeen, Sara Lew

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Parkinson’s disease (PD) is a progressive neurodegenerative disorder with evolving layers of complexity. Both motor and non-motor symptoms of PD may affect patients’ quality of life (QoL). Life expectancy for an individual with Parkinson’s disease depends on the level of care the individual has access to, can have a direct impact on length of life. Therefore, improvement of the QoL is a significant part of therapeutic plans. Patients with PD, especially those who are in advanced stages, are in great need of assistance, mostly from their family members or caregivers in terms of medical, emotional, and social support. The role of a caregiver becomes increasingly important with the progression of PD, the severity of motor impairment and increasing age of the patient. The nature and symptoms associated with PD can place significant stresses on the caregivers’ burden. As the prevalence of PD is estimated to more than double by 2030, it is important to recognize and alleviate the burden experienced by caregivers. This study focused on the impact of the clinical features on the QoL of PD patients, and of their caregivers. This study included PD patients along with their caregivers and was undertaken at the Malaysian Parkinson's Disease Association from June 2016 to November 2016. Clinical features of PD patients were assessed using the Movement Disorder Society revised Unified Parkinson Disease Rating Scale (MDS-UPDRS); the Hoehn and Yahr Staging of Parkinson's Disease were used to assess the severity and Parkinson's disease activities of daily living scale were used to assess the disability of Parkinson’s disease patients. QoL of PD patients was measured using the Parkinson's Disease Questionnaire-39 (PDQ-39). The revised version of the Zarit Burden Interview assessed caregiver burden. At least one of the clinical features affected PD patients’ QoL, and at least one of the QoL domains affected the caregivers’ burden. Clinical features ‘Saliva and Drooling’, and ‘Dyskinesia’ explained 29% of variance in QoL of PD patients. The QoL domains ‘stigma’, along with ‘emotional wellbeing’ explained 48.6% of variance in caregivers’ burden. Clinical features such as saliva, drooling and dyskinesia affected the QoL of PD patients. The PD patients’ QoL domains such as ‘stigma’ and ‘emotional well-being’ influenced their caregivers’ burden.

Keywords: carers, quality of life, clinical features, Malaysia

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Authors: Matthias Nnadi

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

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

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

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

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

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Authors: Prama Mukhopadhyay, Rishika Mukhopadhyay

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The twentieth century has seen the world getting divided into three distinct blocks, created by the proponents of the mainstream developmental discourse. India, which has now gained the label of being a ‘developing nation’, stands in between these three groups, as it constantly tries to ‘catch up’ and emulate the developmental standards of the ‘west’. In this endeavour, we find our country trying really hard to blindly replicate the health care infrastructures of the ‘first worlds’, without realizing the needs of evaluating the ground reality. In such a situation, the sudden outbreak of child death in the district of Malda, WB, poses an obvious questions towards the kind of development that our country has been engaging in, ever since its Post Colonial inception. Through this paper we thus try to understand the harsh veracity of the health care facility that exists in rural Bengal, and thereby challenge the conventional notion of ‘health-care’ as is normally discussed in the mainstream developmental discourse. Grounding our research work on detailed ethnography and through the help of questionnaire, interviews and focus group discussions with the local government officials(BDOs), health workers (ICDS, ASHA workers, ANHM and BMOHs) and members of families with experiences of child deaths, we have tried to find out the real and humane factors behind the sudden rise of reported infant deaths in the district, issues which are normally neglected and left out while discussing and evaluating IMR in the mainstream studies on health care and planning in our nation. Therefore the main aim of this paper is to try and look at child death from a ‘wider perspective’, where it is seen from an eye not bounded by the common registers of caste, class and religion. This paper, would thus be an eye opener in some sense, bringing in stories from the rural belt of the country; where the people are regularly torn between the binaries of the developing and shining modernity of ‘India’ which now gets ready to run the last lap and gain the status of becoming a ‘developed nation’ by 2020, and the staggering, dark traditional ‘ Bharat, which lags behind.

Keywords: child mortality, development discourse, health care, tradition and modernity

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Authors: Maria Rodriguez-Gazquez, Sara Chaparro-Hernandez, Jose Rafael Gonzalez-Lopez

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Introduction: Nurses are models in healthy behaviors for their patients. This is why it is important for these professionals to not only have a good knowledge of healthy behaviors but also practice. Today’s nursing students will be tomorrow’s professionals and to fulfill their role in caring they not only need knowledge, they also must maintain behaviors which enable them to improve and protect both the health of others and their own. This is why the university is a unique environment of opportunities to foster the maximum potential of health. To care for others we first have to take care of ourselves. It is important for these behaviors in Nursing students to be evaluated during the years of their university education in order to design timely interventions which improve the health behaviors of the future professionals. Aim: The objective of this study was to evaluate the lifestyles of first year nursing students of two Universities. Methodology: Cross-sectional study. In 2014, 140 first year Nursing students of two Universities Seville –US- (Spain -Europe, n=37) and Antioquia –UA- (Colombia -South America, n=93) self-reported the FANTASTIC Lifestyle checklist. Results: Findings reveal that (I) UA students doubled the percentage of dangerous or bad lifestyles with respect to the US students, (II) the lifestyles are not appropriate in 1 of 3 of nursing students in both Universities, (II) there are statistically significant differences for family support items (higher in US), positive thinkers (higher in UA), the use of safety belts and alcohol consumption before driving (higher in US). Discussion: The nursing students are mostly young people who are at a stage in which some of the most important behaviors for adult life can still be molded. It is necessary to develop educational interventions in their Nursing curricula to strengthen healthy behaviours during training. Nursing Schools not only have the duty to train professionals, but to also be agents that foster the health, welfare and quality of those who study and work there. It must encourage knowledge and skills oriented to healthy lifestyles.

Keywords: cross-sectional studies, life style, nursing students, questionnaires

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Authors: Rebecca Oakes

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In the New Zealand public health system, work has been taking place to use electronic systems to convey data from the ‘floor to the board’ that makes patient needs, and therefore nursing work, visible. For nurses, these developments in health information technology puts us in a very new and exciting position of being able to articulate the work of nursing through a language understood at all levels of an organisation, the language of acuity. Nurses increasingly have a considerable stake-hold in patient acuity data. Patient acuity systems, when used well, can assist greatly in demonstrating how much work is required, the type of work, and when it will be required. The New Zealand Safe Staffing Unit is supporting New Zealand nurses to create a culture of shared governance, where nursing data is informing policies, staffing methodologies and forecasting within their organisations. Assisting organisations to understand their acuity data, strengthening user confidence in using electronic patient acuity systems, and ensuring nursing and midwifery workload is accurately reflected is critical to the success of the safe staffing programme. Nurses and midwives have the capacity via an acuity tool to become key informers of organisational planning. Quality patient care, best use of health resources and a quality work environment are essential components of a safe, resilient and well resourced organisation. Nurses are the key informers of this information. In New Zealand a national level approach is paving the way for significant changes to the understanding and use of patient acuity and nursing workload information.

Keywords: nursing workload, patient acuity, safe staffing, New Zealand

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

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

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

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Authors: Viktorya Sargsyan, Arax Hovhannesyan, Karine Abelyan

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Introduction: During the last decade, scientific studies have proven the importance of Early Childhood Development (ECD) interventions. These interventions are shown to create strong foundations for children’s intellectual, emotional and physical well-being, as well as the impact they have on learning and economic outcomes for children as they mature into adulthood. Many children in rural Armenia fail to reach their full development potential due to lack of early brain stimulation (playing, singing, reading, etc.) from their parents, and lack of community tools and services to follow-up children’s neurocognitive development. This is exacerbated by high rates of stunting and anemia among children under 3(CU3). This research study tested the effectiveness of an integrated ECD and Maternal, Newborn and Childhood Health (MNCH) model, called “Go Baby, Go!” (GBG), against the traditional (MNCH) strategy which focuses solely on preventive health and nutrition interventions. The hypothesis of this quasi-experimental study was: Children exposed to GBG will have better neurocognitive and nutrition outcomes compared to those receiving only the MNCH intervention. The secondary objective was to assess the effect of GBG on parental child care and nutrition practices. Methodology: The 14 month long study, targeted all 1,300 children aged 0 to 23 months, living in 43 study communities the in Gavar and Vardenis regions (Gegharkunik province, Armenia). Twenty-three intervention communities, 680 children, received GBG, and 20 control communities, 630 children, received MCHN interventions only. Baseline and evaluation data on child development, nutrition status and parental child care and nutrition practices were collected (caregiver interview, direct child assessment). In the intervention sites, in addition to MNCH (maternity schools, supportive supervision for Health Care Providers (HCP), the trained GBG facilitators conducted six interactive group sessions for mothers (key messages, information, group discussions, role playing, video-watching, toys/books preparation, according to GBG curriculum), and two sessions (condensed GBG) for adult family members (husbands, grandmothers). The trained HCPs received quality supervision for ECD counseling and screening. Findings: The GBG model proved to be effective in improving ECD outcomes. Children in the intervention sites had 83% higher odd of total ECD composite score (cognitive, language, motor) compared to children in the control sites (aOR 1.83; 95 percent CI: 1.08-3.09; p=0.025). Caregivers also demonstrated better child care and nutrition practices (minimum dietary diversity in intervention site is 55 percent higher compared to control (aOR=1.55, 95 percent CI 1.10-2.19, p =0.013); support for learning and disciplining practices (aOR=2.22, 95 percent CI 1.19-4.16, p=0.012)). However, there was no evidence of stunting reduction in either study arm. he effect of the integrated model was more prominent in Vardenis, a community which is characterised by high food insecurity and limited knowledge of positive parenting skills. Conclusion: The GBG model is effective and could be applied in target areas with the greatest economic disadvantages and parenting challenges to improve ECD, care practices and developmental outcomes. Longitudinal studies are needed to view the long-term effects of GBG on learning and school readiness.

Keywords: early childhood development, integrated interventions, parental practices, quasi-experimental study

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Authors: Jared Abuga, Wesley Too

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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023

Keywords: errors, medical, kenya, nurses, safety

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Authors: Kadhim Alabady

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Purpose: Mental health problems affect women and men equally, but some are more common among women. To Provide a baseline of the current picture of major mental health challenges among women in Dubai. which can then be used to measure the impact of interventions or service development. Method: We have used mixed methods evaluation approaches. This was used to increase the validity of findings by using a variety of data collection techniques. We have integrated qualitative and quantitative methods in this piece of work. Conducting the two approaches is to explore issues that might not be highlighted enough through one method. Results: The key findings are: The prevalence of people who suffer from different types of mental disorders remains largely unknown, many women are unwilling to seek professional help because of lack of awareness or the stigma attached to it. -It is estimated there were around 2,928–4,392 mothers in Dubai (2014) suffering from postnatal depression of which 858–1,287, early intervention can be effective. -The system for managing health care for women with mental illness is fragmented and contains gaps and duplications. -It is estimated 1,029 girl aged 13–19 years affected with anorexia nervosa and there would be an estimated 1,029 girl aged 13–19 years affected with anorexia nervosa. Recommendations: -Work is required with primary health care in order to identify women with undiagnosed mental illnesses. Further work is undertaken within primary health care to assess disease registries with the aim of helping GP practices to improve their disease registers. -It is important to conduct local psychiatric morbidity surveys in Dubai to obtain data and assess the prevalence of essential mental health symptoms and conditions that are not routinely collected to get a clear sense of what is needed and to assist decision and policy making in getting a complete picture on what services are required. -Emergency Mental Health Care – there is a need for a crisis response team to respond to emergencies in the community. -Continuum of care – a significant gap in the services for women once they diagnosed with mental disorder.

Keywords: mental health, depression, schizophrenia, women

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Authors: Lazhar Belkhiri, Ammar Tiri, Lotfi Mouni

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

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

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Authors: A. Sawangsuriya, T. B. Edil

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

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

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Authors: Chen-Ya Juan

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In recent years, the increasing number of children with special needs has brought a lot of attention by many scholars and experts in education, which enforced the preschool teachers face the harsh challenge in the classroom. To protect the right of equal education for all children, enhance the quality of children learning, and take care of the needs of children with special needs, the special education paraprofessional becomes one of the future employment trends for students of the department of the early childhood care and education. Problem-based learning is a problem-oriented instruction, which is different from traditional instruction. The instructor first designed an ambiguous problem direction, following the basic knowledge of early intervention, students had to find clues to solve the problem defined by themselves. In the class, the total instruction included 20 hours, two hours per week. The primary purpose of this paper is to investigate the relationship of student academic scores, self-awareness, learning motivation, learning attitudes, and early intervention knowledge. A total of 105 college students participated in this study and 97 questionnaires were effective. The effective response rate was 90%. The student participants included 95 females and two males. The average age of the participants was 19 years old. The questionnaires included 125 questions divided into four major dimensions: (1) Self-awareness, (2) learning motivation, (3) learning attitudes, and (4) early intervention knowledge. The results indicated (1) the scores of self-awareness were 58%; the scores of the learning motivations was 64.9%; the scores of the learning attitudes was 55.3%. (2) After the instruction, the early intervention knowledge has been increased to 64.2% from 38.4%. (3) Student’s academic performance has positive relationship with self-awareness (p < 0.05; R = 0.506), learning motivation (p < 0.05; R = 0.487), learning attitudes (p < 0.05; R = 0.527). The results implied that although students had gained early intervention knowledge by using PBL instruction, students had medium scores on self-awareness and learning attitudes, medium high in learning motivations.

Keywords: college students, children with special needs, problem-based learning, learning motivation

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Authors: Kumar Gular, Viswanathan S., Mastour Saeed Alshahrani, Ravi Shankar Reddy, Jaya Shanker Tedla, Snehil Dixit, Ajay Prasad Gautam, Venkata Nagaraj Kakaraparthi, Devika Rani Sangadala

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Background: Despite trunk control’s significant contribution to improving various functional activity components, the independent effect of trunk performance on quality of life is yet to be estimated in stroke survivors. Ascertaining the correlation between trunk control and self-reported quality of life while evaluating the effect of demographic and clinical characteristics on their relationship will guide concerned healthcare professionals in designing ideal rehabilitation protocols during the late sub-acute stroke stage of recovery. The aims of the present research were to (1) investigate the associations of trunk performance with self-rated quality of life and (2) evaluate if age, body mass index (BMI), and clinical characteristics mediate the relationship between trunk motor performance and perceived quality of life in the sub-acute stroke population. Methods: Trunk motor functions and quality of life among the late sub-acute stroke population aged 57.53 ± 6.42 years were evaluated through the trunk Impairment Scale (TIS) and Stroke specific quality of life (SSQOL) questionnaire, respectively. Pearson correlation coefficients and mediation analysis were performed to elucidate the relationship of trunk motor function with quality of life and determine the mediation impact of demographic and clinical characteristics on their association, respectively. Results: The current study observed significant correlations between trunk motor functions (TIS) and quality of life (SSQOL) with r=0.68 (p<0.001). Age, BMI, and type of stroke were detected as potential mediating factors in the association between trunk performance and quality of life. Conclusion: Validated associations between trunk motor functions and perceived quality of life among the late sub-acute stroke population emphasize the importance of comprehensive evaluation of trunk control. Rehabilitation specialists should focus on appropriate strategies to enhance trunk performance anticipating the potential effects of age, BMI, and type of stroke to improve health-related quality of life in stroke survivors.

Keywords: sub-acute stroke, quality of life, functional independence, trunk control

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Authors: Philemon Rakoto

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

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

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Authors: Suppara Charoenpoom

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

Keywords: buildings, environment, procedures, quality management

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Authors: Ni Wayan Sinthia Widiastuti, Komang Rahayu Indrawati

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

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

Procedia PDF Downloads 286