Search results for: family care team

Authors: Josephine Aikpitanyi, Friday Okonofua, Lorrettantoimo, Sandy Tubeuf

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Every day, 800 women die from conditions related to pregnancy and childbirth, resulting in an estimated 300,000 maternal deaths worldwide per year. Over 99 percent of all maternal deaths occur in developing countries, with more than half of them occurring in sub-Saharan Africa. Nigeria being the most populous nation in sub-Saharan Africa bears a significant burden of worsening maternal and child health outcomes with a maternal mortality rate of 917 per 100,000 live births and child mortality rate of 117 per 1,000 live births. While several studies have documented that financial barriers disproportionately discourage poor women from seeking needed maternal and child healthcare, other studies have indicated otherwise. Evidence shows that there are instances where health facilities with skilled healthcare providers exist, and yet maternal, and child health outcomes remain abysmally low, indicating the presence of non-cognitive and behavioural factors that may affect the utilization of healthcare services. This study investigated the influence of locus of control and self-esteem on utilization of maternal and child healthcare services in Nigeria. Specifically, it explored the differences in utilization of antenatal care, skilled birth care, postnatal care, and child vaccination by women having an internal and external locus of control and women having high and low self-esteem. We collected information on non-cognitive traits of 1411 randomly selected women, along with information on utilization of the various indicators of maternal and child healthcare. Estimating logistic regression models for various components of healthcare services utilization, we found that women’s internal locus of control was a significant predictor of utilization of antenatal care, skilled birth care, and completion of child vaccination. We also found that having high self-esteem was a significant predictor of utilization of antenatal care, postnatal care, and completion of child vaccination after adjusting for other control variables. By improving our understanding of non-cognitive traits as possible barriers to maternal and child healthcare utilization, our findings offer important insights for enhancing participant engagement in intervention programs that are initiated to improve maternal and child health outcomes in low-and-middle-income countries.

Keywords: behavioural economics, health-seeking behaviour, locus of control and self-esteem, maternal and child healthcare, non-cognitive traits, and healthcare utilization

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Authors: Kairat T. Mynbaev, Elena N. Lomakina

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We consider a Hardy-type operator generated by a family of open subsets of a Hausdorff topological space. The family is indexed with non-negative real numbers and is totally ordered. For this operator, we obtain two-sided bounds of its norm, a compactness criterion, and bounds for its approximation numbers. Previously, bounds for its approximation numbers have been established only in the one-dimensional case, while we do not impose any restrictions on the dimension of the Hausdorff space. The bounds for the norm and conditions for compactness earlier have been found using different methods by G. Sinnamon and K. Mynbaev. Our approach is different in that we use domain partitions for all problems under consideration.

Keywords: approximation numbers, boundedness and compactness, multidimensional Hardy operator, Hausdorff topological space

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Authors: Peter Boyes, Sarah Sharples, Paul Tennent, Gary Priestnall, Jeremy Morley

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Significant long-term investment projects can involve complex decisions. These are often described as capital projects, and the factors that contribute to their complexity include budgets, motivating reasons for investment, stakeholder involvement, interdependent projects, and the delivery phases required. The complexity of these projects often requires management groups to be established involving stakeholder representatives; these teams are inherently multidisciplinary. This study uses two university campus capital projects as case studies for this type of management group. Due to the interaction of projects with wider campus infrastructure and users, decisions are made at varying spatial granularity throughout the project lifespan. This spatial-related context brings complexity to the group decisions. Sensemaking is the process used to achieve group situational awareness of a complex situation, enabling the team to arrive at a consensus and make a decision. The purpose of this study is to understand the role of people and data in the complex spatial related long-term decision and sensemaking processes. The paper aims to identify and present issues experienced in practical settings of these types of decision. A series of exploratory semi-structured interviews with members of the two projects elicit an understanding of their operation. From two stages of thematic analysis, inductive and deductive, emergent themes are identified around the group structure, the data usage, and the decision making within these groups. When data were made available to the group, there were commonly issues with the perception of veracity and validity of the data presented; this impacted the ability of group to reach consensus and, therefore, for decisions to be made. Similarly, there were different responses to forecasted or modelled data, shaped by the experience and occupation of the individuals within the multidisciplinary management group. This paper provides an understanding of further support required for team sensemaking and decision making in complex capital projects. The paper also discusses the barriers found to effective decision making in this setting and suggests opportunities to develop decision support systems in this team strategic decision-making process. Recommendations are made for further research into the sensemaking and decision-making process of this complex spatial-related setting.

Keywords: decision making, decisions under uncertainty, real decisions, sensemaking, spatial, team decision making

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Authors: Erin Lynne Plettenberg, Jeremy Vickery

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In an access-control situation, the role of a user determines whether a data request is appropriate. This paper combines vetted web mining and logic modeling to build a lightweight system for determining the role of a health care provider based only on their prior authorized requests. The model identifies provider roles with 100% recall from very little data. This shows the value of vetted web mining in AI systems, and suggests the impact of the ICD classification on medical practice.

Keywords: electronic medical records, information extraction, logic modeling, ontology, vetted web mining

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Authors: Tareg Belali, Mosleh Abomughaid, Muhanad Alhujaily

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HNF4a is one of the steroid hormone receptor family of transcription factors with roles in the development of the liver and the regulation of several critical metabolic pathways, such as glycolysis, drug metabolism, and apolipoproteins and blood coagulation. The transcriptional potency of HNF4a is well known due to its involvement in diabetes and other metabolic diseases. However, recently HNF4a has been discovered to be closely associated with several haematological disorders, mainly because of genetic mutations, drugs, and hepatic disorders. We review HNF4a structure and function and its role in haematological disorders. We discuss possible good therapies that are based on targeting HNF4a.

Keywords: hepatocyte nuclear factor 4 alpha, HNF4a nuclear receptor, steroid hormone receptor family of transcription factors, hematological disorders

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Authors: Aditya Jayadas

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During a pandemic like the one we are in with COVID-19, older adults, especially those who live in a senior retirement facility, experience even bigger challenges as they are often dependent on other individuals for care. Many older adults are dependent on caregivers to assist with their instrumented activities of daily living (IADL). With travel restrictions imposed during a pandemic, there is a critical need to ensure that older adults who are homebound continue to be able to participate in physical exercise, cognitive exercise, and social interaction programs. The objective of this study was to better understand the challenges that older adults faced during the pandemic and what they were doing specifically to cope with the pandemic physically, mentally, and through social interaction. A focus group was conducted with ten older adults (age: 82.70 ± 7.81 years; nine female and one male) who resided in a senior retirement facility. During the course of one hour, seven open-ended questions were posed to the participants: a) What has changed in your life since the start of the pandemic, b) What has been most challenging for you, c) What are you doing to take care of yourself, d) Are you doing anything specifically as it relates to your physical health, e) Are you doing anything specifically as it relates to your mental health, f) What did you do for social interaction during the pandemic, g) Is there anything else you would like to share as it relates to your experience during the pandemic. The focus group session was audio-taped, and verbatim transcripts were created to evaluate the responses of the participants. The transcript consisted of 4,698 words and 293 lines of text. The data was analyzed using content analysis. The unit of analysis was the text from the audio recordings that were transcribed. From the review of the transcribed text, themes and sub-themes were identified, along with salient quotes under each sub-theme. The major themes that emerged from the data were: having a routine, engaging in activities, attending exercise classes, use of technology, family, community, and prayer. The quotes under the sub-themes provided compelling evidence of how older adults coped during the pandemic while addressing the challenges they faced and developing strategies to address their physical and mental health while interacting with others. Lessons learned from this focus group can be used to develop specific physical exercise, cognitive exercise, and social interaction programs that benefit the health and well-being of older adults.

Keywords: cognitive exercise, pandemic, physical exercise, social interaction

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Authors: Mohammed Amin, Debra Kerr, Yacoba Atiase, Andrea Driscoll

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Background: Physical activity (PA) is a major component of diabetes self-care management; although this is often stressed to patients, many adults with Type 2 Diabetes Mellitus (T2DM)lead sedentary lifestyles, and barriers exist for uptake of PA. Aim: To explore opinions of healthcare professionals about barriers to PA for adults with T2DM in Ghana. Methods: This qualitative descriptive study included 13healthcare professionals (3 Physiotherapists, 3 exercise physiologists, 3 nurses, and 4 physicians) who provide care to individuals with T2DM in Ghana. Data was collected by semi-structured interviews. The social cognitive theory guided the design of the interview schedule. Data was analysed using thematic analysis. Results: Four main themeswere identified: 1) Individual-related factors, 2) Interpersonal factors, 3) Environment-related factors, and 4) Health system-related factors. Fear of injury, existing co-morbidities, and lack of time make it difficult for people with T2DM to engage in PA. Lack of family support, fear of social ridicule, and cultural beliefs prevent uptake of PA. Poorly designed community spaces, including safe walkways and lack of exercise facilities, inhibit PA participation. Few physical therapists and physical therapy centres exist to support PA participation among people with T2DM. Some nurses and doctors lack adequate knowledge to deliver proper PA education to clients, thereby making clients lack the needed support. Conclusion: Adults with T2DM may be restricted from partaking in PA arising from personal and external factors. This study has identified that barriers to exercise need consideration when designing PA programs that aim to improve health outcomes for people with T2DM in Ghana.

Keywords: type 2 diabetes, physical activity, exercise, ghana, qualitative, barriers

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Authors: V. Karuppaiah, J. C. Padaria, C. Srivastava

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The tobacco caterpillar, Spodoptera litura Fab (Lepidoptera: Noctuidae) is a polyphagous pest various field and horticulture crops in India. Pest had virtually developed resistance to all commonly used insecticides. Enhanced detoxification is the prime mechanism that is dictated by detoxification different enzymes and carboxylesterase is one of the major enzyme responsible development of resistance. In India, insecticide resistance studies on S. litura are mainly deployed on detoxification enzymes activity and investigation at gene level alteration i.e. at nucleotide level is very merger. In the present study, we collected the S. litura larvae from three different cauliflower growing belt viz., IARI, New Delhi (Delhi), Palari, Sonepat (Haryana) and Varanasi (Uttar Pradesh) to study the role of carboxylesterase activity and its gene level variation The CarE activity was measured using UV-VIS spectrophotometer with 3rd instar larvae of S. litura. The elevated activity of CarE was observed in Sonepat strain (28.09 ± 0.09 µmol/min/mg of protein) followed by Delhi (26.72 ± 0.04 µmol/min/mg of protein) and Varanasi strain (10.00 ± 0.44 µmol/min/mg of protein) of S. litura. The genomic DNA was isolated from 3rd instar larvae and CarE gene was amplified using a primer sequence, F:5’tccagagttccttgtcaggcac3’; R:5’ctgcatcaagcatgtctc3. CarE gene, about 500bp was partially amplified, sequenced and submitted to NCBI (Accession No. KF835886, KF835887 and KF835888). The sequence data revealed polymorphism at nucleotide level in all the three strains and gene found to have 88 to 97% similarity with previous available nucleotide sequences of S. litura, S. littoralis and S. exiqua. The polymorphism at the nucleotide level could be a reason for differential activity of carboxylesterase enzymes among the strains. However, investigation at gene expression level would be useful to analyze the overproduction of carboxylesterase enzyme.

Keywords: carboxylesterase, CarE gene, nucleotide polymorphism, insecticide resistance, spodoptera litura

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Authors: Maciej Zareba, Pawel Dawid

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The integration of serious games into the onboarding process is radically changing the way organizations seek to engage and retain new employees, especially in digital generations such as Millennials (Generation Y) and Generation Z. Serious gamification uses game design elements - such as points, leaderboards and progress indicators - to create interactive, goal-oriented and engaging experiences that facilitate smoother transitions to new roles and acceptance of organizational cultures. The use of serious games in onboarding reduces the stress of starting a new job while accelerating the learning curve through mechanisms that reward achievements, such as completing milestones, connecting with other team members or learning about company values. These tools promote immediate recognition and a sense of belonging to the team and organization, thereby significantly increasing retention and engagement rates. The article also outlines the benefits of using serious games in the onboarding process. It focuses on increasing employee motivation, accelerating learning about the organization and increasing engagement in the long term. In addition, the paper outlines the potential of using a serious game - 4FactoryManager - in the onboarding process. The article provides useful information for HR professionals who are looking for innovative ways to recruit, onboard and keep the best employees in a changing labor market.

Keywords: HR, oboarding, digital generation, serious games

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Authors: Sasiwan Tassana-iem, Sumattana Glangkarn

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Diabetic nephropathy is a major complication in diabetic patients whom as the glomerular filtration rate falls. The affects their quality of life and results in loss of money for kidney replacement therapy costs. There is an existing intervention, but the prevalence remains high, thus this research aims to study lessons learned in implementing programs to delay diabetic nephropathy management in primary health care. Method: The target settings are, 24 sub-district health promoting hospital in Sakon Nakhon province. Participants included the health care professionals, head of the sub-district health promoting hospital and the person responsible for managing diabetic nephropathy in each hospital (n= 50). There are 400 patients with diabetes mellitus in an area. Data were collected using questionnaires, patient records data, interviews and focus groups and analyzed by statistics and content analysis. Result: Reflection of participants that the interventions to delay diabetic nephropathy management in each area, the Ministry of Public Health has a policy to screen and manage this disease. The implementing programs aimed to provide health education, innovative teaching media used in communication to educate. Patients and caregivers had misunderstanding about the actual causes and prevention of this disease and how to apply knowledge suitable for daily life. Conclusion: The obstacles to the success of the implementing programs to delay diabetic nephropathy management in primary health care were most importantly, the patient needs self-care and should be evaluated for health literacy. This is crucial to promote health literacy; to access and understand health information as well to decide their health-related choices based on health information which will promote and maintain a good health. This preliminary research confirms that situation of diabetic nephropathy still exists. The results of this study will lead to the development of delay in diabetic nephropathy implementation among patients in the province studied.

Keywords: diabetic nephropathy, chronic kidney disease, primary health care, implementation

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Authors: Sneha Shankar, Orlando Buendia, Will Evans

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Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.

Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis

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Authors: Hui Fang Huang Su, Leanne Lai, Pei-Fen Li, Mei-Hwei Ho, Yu-Wen Chiu

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This study aimed to provide a practical, systematic, and comprehensive intervention for children with Autism Spectrum Disorder (ASD). A pilot study of quasi-experimental pre-post intervention with control group design was conducted to evaluate if the mathematical intervention (Project MIND - Math Is Not Difficult) increases the math comprehension of children with ASD Children with ASD in the primary grades (K-1, 2) participated in math interventions to enhance their math comprehension and cognitive ability. The Bracken basic concept scale was used to evaluate subjects’ language skills, cognitive development, and school readiness. The study found that our systemic interventions of Project MIND significantly improved the mathematical and cognitive abilities in children with autism. The results of this study may lead to a major change in effective and adequate health care services for children with ASD and their families. All statistical analyses were performed with the IBM SPSS Statistics Version 25 for Windows. The significant level was set at 0.05 P-value.

Keywords: autism, mathematics, technology, family

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Authors: Delband Yekta Moazami

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Background: For proper care and treatment of HIV patients and drug users, the medical staff and physicians must have a correct and positive attitude and knowledge towards such patients. We aimed to assess the attitudes in a sample of health care workers (HCW) working in different hospitals and clinics and medical students in Georgia towards HIV infected people and drug users in Tbilisi. Method: We conducted a cross-sectional study to assess attitudes of health care workers towards people living with HIV and drug users in hospitals and clinics in Tbilisi. The study was carried out from 1st of May 2020 till 30th of September 2020. Data were collected using a self-administered structured online questionnaire. With this tool we evaluated four facets of attitudes: Discrimination, Acceptance of HIV/AIDS patients, Acceptance of drug users and Fear. All data were imported and analyzed with the software SPSS 22 for windows. Results: In total data was collected from168 respondents, that among them 107 (65%) were women and majority of the participants were medical doctors. Women had more acceptance attitudes rather than men towards drug abusers. We found significant differences regarding expressing negative attitudes among HCW who were more than 50 years old comparing with other age groups in all four aspects. Medical doctors expressed more acceptances towards people with HIV and drug users comparing two other groups. Also our study revealed that the group with working experience 21 years and more, showed more discriminatory attitudes comparing other groups. Conclusion: Based on our study findings, there are significant differences regarding respondent’s attitudes based on gender, medical specialty and working experience in health care system. People struggling with HIV and drug use need nonjudgmental and positive behaviors from health care workers and physicians in order to help them for harm reduction and receiving appropriate treatment.

Keywords: hiv, addiction, attitudes, healthcare workers

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Authors: Hana A. Jameel Alsaeed, Rayyan Ibrahim Khaleel, Hanaa Hussein Mukhlif

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Background: Contamination in Iraq's hospitals is a localized problem with high rates of disease And deaths that mainly affect poor areas. Thus, this study aims to evaluate hospital infections in the city of Mosul and to identify the etiology. So to assess environmental infection prevention in pediatric wards and newborn critical care units in Mosul city. Methods: The present study is a cross-sectional hospital based in Mosul-Iraq between (10th February to 1st April 2022). Purposive sample of 60 nurses from neonatal intensive care units and pediatric wards in three pediatric teaching hospitals in Mosul city; Data was gathered using a questionnaire created by the researchers after reviewing previous studies. Results: The study showed that the majority of the study infection prevention and control policy isn't available in 46.7% of departments, and 45% of hospital workers in Iraq don't know if there is an Iraqi version of it. 70% of the study group had participated in an infection control training program. Conclusions: In the majority of samples 55% of respondents to the study claimed not to be aware of these rules. 60% of the study's participants had never attended a course on infection prevention and control, according to the study's findings on education and training programs. In the neonatal and critical care unit, nurses' skill levels, years of experience, and actual duties varied by wide statistically significant differences.

Keywords: pediatric, infection control, assessment, mosul city

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Authors: Ana Staneva, Vessela Stoimenova

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A parametric estimation of the MBP with Power Series offspring distribution family is considered in this paper. The MLE for the parameters is obtained in the case when the observable data are incomplete and consist only with the generation sizes of the family tree of MBP. The parameter estimation is calculated by using the Monte Carlo EM algorithm. The estimation for the posterior distribution and for the offspring distribution parameters are calculated by using the Bayesian approach and the Gibbs sampler. The article proposes various examples with bivariate branching processes together with computational results, simulation and an implementation using R.

Keywords: Bayesian, branching processes, EM algorithm, Gibbs sampler, Monte Carlo methods, statistical estimation

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Authors: Mohammad Amjad, Muhammad Iqbal Zafar, Ashfaq Ahmed Maan, Muhammad Tayyab Kashif

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Obesity is an abnormal physical condition where an increased and undesirable fat accumulates in the human body. Obesity is an international phenomenon. In the present study, 12 schools were randomly selected from each district considering the areas i.e. Elite Private Schools in the private sector, Government schools in urban areas and Government schools in rural areas. Interviews were conducted with male students studying in grade 5 to grade 9 in each school. The sample size was 600 students; 300 from Faisalabad district and 300 from Rawalpindi district in Pakistan. A well-structured and pre-tested questionnaire was used for data collection. The calibrated scales were used to attain the heights and weights of the respondents. Obesity of school-going children depends on family types, family size, family history, junk food consumption, mother’s education, weekly time spent in walking, and sports facility at school levels. Academic performance, physical health and psychological health of school going children are affected with obesity. Concrete steps and policies could minimize the incidence of obesity in children in Pakistan.

Keywords: body mass index, cardiovascular disease, fast food, morbidity, overweight

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Authors: Su Hui Tsai, Weir Sen Lin, Rhay Hung Weng

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There are numerous outpatient departments at hospitals with enormous amounts of outpatients. Although the work of outpatient nursing staff does not include the ward, emergency and critical care units that involve patient life-threatening conditions, the work is cumbersome and requires facing and dealing with a large number of outpatients in a short period of time. Therefore, nursing staff often do not feel satisfied with their work and cannot identify with their professional role, leading to intentions to leave their job. Thus, the main purpose of this study is to explore the correlation between the job satisfaction and role identity of nursing staff with turnover intention. This research was conducted using a questionnaire, and the subjects were outpatient nursing staff in three regional hospitals in Southern Taiwan. A total of 175 questionnaires were distributed, and 166 valid questionnaires were returned. After collecting the data, the reliability and validity of the study variables were confirmed by confirmatory factor analysis. The influence of role identity and job satisfaction on nursing staff’s turnover intention was analyzed by descriptive analysis, one-way ANOVA, Pearson correlation analysis and multiple regression analysis. Results showed that 'role identity' had significant differences in different types of marriages. Job satisfaction of 'grasp of environment' had significant differences in different levels of education. Job satisfaction of 'professional growth' and 'shifts and days off' showed significant differences in different types of marriages. 'Role identity' and 'job satisfaction' were negatively correlated with turnover intention respectively. Job satisfaction of 'salary and benefits' and 'grasp of environment' were significant predictors of role identity. The higher the job satisfaction of 'salary and benefits' and 'grasp of environment', the higher the role identity. Job satisfaction of 'patient and family interaction' were significant predictors of turnover intention. The lower the job satisfaction of 'patient and family interaction', the higher the turnover intention. This study found that outpatient nursing staff had the lowest satisfaction towards salary structure. It is recommended that bonuses, promotion opportunities and other incentives be established to increase the role identity of outpatient nursing staff. The results showed that the higher the job satisfaction of 'salary and benefits' and 'grasp of environment', the higher the role identity. It is recommended that regular evaluations be conducted to reward nursing staff with excellent service and invite nursing staff to share their work experiences and thoughts, to enhance nursing staff’s expectation and identification of their occupational role, as well as instilling the concept of organizational service and organizational expectations of emotional display. The results showed that the lower the job satisfaction of 'patient and family interaction', the higher the turnover intention. It is recommended that interpersonal communication and workplace violence prevention educational training courses be organized to enhance the communication and interaction of nursing staff with patients and their families.

Keywords: outpatient, job satisfaction, turnover, intention

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Authors: Mohammed Qutishat, Loai Abu Sharour, Kholoud Al-Damery, Ibtisam Al Harthy, Sulaiman Al-Sabei

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Background: The 2019 coronavirus outbreak (COVID-19) has been declared a pandemic and has greatly affected both patients and healthcare workers. This study was conducted to explore the extent of posttraumatic stress disorder (PTSD) experiences among nurses as a result of the COVID-19 pandemic in Jordan. Method: This study used a cross-sectional study design with a convenience sampling approach. A sample of 259 participants completed the study questionnaires, including a sociodemographic questionnaire and the posttraumatic stress disorder checklist for DSM‐5, between May and July 2020. Result: The prevalence of PTSD among the study participants was 37.1%. The majority of study participants who exhibited PTSD symptoms presented the lowest level of PTSD (17%). The results indicated significant differences in overall COVID-19-related PTSD according to the participant’s age (F = 14.750, P = .000), gender (F = 30.340, P = .000), level of education (F = 51.983, P =.000), years of experience (F = 52.33, P = .000), place of work (F = 19.593, P = .000), and working position (F = 11.597, P = .000), as determined by one-way ANOVA. Conclusion: Nurses must be qualified and accredited to cope with reported PTSD cases and their consequences in relation to COVID-19 outbreaks. Close collaboration with a multidisciplinary team is required to recognise, manage, and encourage safety literacy among health care professionals and individuals diagnosed with or suspected of PTSD due to COVID-19 outbreaks or any other viral outbreaks.

Keywords: PTSD, nursing, coronavirus, pandemic, infectious disease

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Authors: Soiduate Ogoye-Atanga

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During funeral ceremonies, it has become common for attendees to jostle for burial programs in some southern Nigerian towns. Beginning from ordinary typewritten text only sheets of paper in the 1980s to their current digitally formatted multicolor magazine style, burial programs continue to be collected and kept in homes where they remain as archival documents of family photo histories and as a veritable form of leveraging family status and visibility in a social economy through the inclusion of lots of choreographically arranged photographs and text. The biographical texts speak of idealized and often lofty and aestheticized accomplishments of deceased peoples, which are often corroborated by an accompanying section of tributes from first the immediate family members, and then from affiliations as well as organizations deceased people belonged, in the form of scanned letterheaded corporate tributes. Others speak of modest biographical texts when the deceased accomplished little. Usually, in majority of the cases, the display of photographs and text in these programs follow a trajectory of historical compartmentalization of the deceased, beginning from parentage to the period of youth, occupation, retirement, and old age as the case may be, which usually drives from black and white historical photographs to the color photography of today. This compartmentalization follows varied models but is designed to show the deceased in varying activities during his lifetime. The production of these programs ranges from the extremely expensive and luscious full colors of near fifty-eighty pages to bland and very simplified low-quality few-page editions in a single color and no photographs, except on the cover. Cost and quality, therefore, become determinants of varying family status and social visibility. By a critical selection of photographs and text, family members construct an idealized image of deceased people and themselves, concentrating on mutuality based on appropriate sartorial selections, socioeconomic grade, and social temperaments that are framed to corroborate the public’s perception of them. Burial magazines, therefore, serve purposes beyond their primary use; they symbolize an orchestrated social site for image-making and the validation of the social status of families, shaped by prior family histories.

Keywords: biographical texts, burial programs, compartmentalization, magazine, multicolor, photo-histories, social status

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Authors: Ahmed Mohamed Elnady Mohamed Elsafty

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This paper explains a developed applied objective model to measure the culture qualitatively and quantitatively, whether in individuals or in teams, in order to be able to use culture correctly or modify it efficiently. This model provides precise measurements and consistent interpretations by being comprehensive, updateable, and protected from being misled by imitations. Methodically, the provided model divides the culture into seven dimensions (total 43 cultural factors): First dimension is outcome-orientation which consists of five factors and should be highest in leaders. Second dimension is details-orientation which consists of eight factors and should be in highest intelligence members. Third dimension is team-orientation which consists of five factors and should be highest in instructors or coaches. Fourth dimension is change-orientation which consists of five factors and should be highest in soldiers. Fifth dimension is people-orientation which consists of eight factors and should be highest in media members. Sixth dimension is masculinity which consists of seven factors and should be highest in hard workers. Last dimension is stability which consists of seven factors and should be highest in soft workers. In this paper, the details of all cultural factors are explained. Practically, information collection about each cultural factor in the targeted person or team is essential in order to calculate the degrees of all cultural factors using the suggested equation of multiplying 'the score of factor presence' by 'the score of factor strength'. In this paper, the details of how to build each score are explained. Based on the highest degrees - to identify which cultural dimension is the prominent - choosing the tested individual or team in the supposedly right position at the right time will provide a chance to use minimal efforts to make everyone aligned to the organization’s objectives. In other words, making everyone self-motivated by setting him/her at the right source of motivation is the most effective and efficient method to achieve high levels of competency, commitment, and sustainability. Modifying a team culture can be achieved by excluding or including new members with relatively high or low degrees in specific cultural factors. For conclusion, culture is considered as the software of the human beings and it is one of the major compression factors on the managerial discretion. It represents the behaviors, attitudes, and motivations of the human resources which are vital to enhance quality and safety, expanding the market share, and defending against attacks from external environments. Thus, it is tremendously essential and useful to use such a comprehensive model to measure, use, and modify culture.

Keywords: culture dimensions, culture factors, culture measurement, cultural analysis, cultural modification, self-motivation, alignment to objectives, competency, sustainability

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Authors: Therese Scali

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Over the years, the European Union has continued to extend its action on lesbian, gay men, bisexual and transgender (LGBT) rights to a range of areas including access to justice, asylum, freedom of expression and assembly, parenting, and mutual recognition of civil status within the EU. The European Parliament has been a driving force behind such action adopting a range of resolutions calling for continued progress in this field. In particular, Belgium has been one of the first countries to legalize same-sex parenting and to create a general framework for action against negative attitudes towards gay and lesbian parents. The present paper aims at highlighting public healthcare workers’ attitudes towards different types of same-sex headed families in Belgium, and the content of their interventions in schools. Results revealed that attitudes can go from supportive to unsupportive, and participants do not show the same degree of support towards the different types of same-sex parenting. This contribution highlights work’s implication for public policy by understanding the resources and challenges that health-care professionals face in their work.

Keywords: attitudes, gay and lesbian parents, health-care workers, homophobia, prevention

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Authors: B. Self, V. Fleming, C. Maxwell

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The fourth clause of the UK 1967 Abortion Act allows individuals (including health care practitioners) to conscientiously object to participating in an abortion. Individuals are able to object if they consider that participating is incompatible with their religious, moral, philosophical, ethical, or personal beliefs. Currently, there is no research on service users’ opinions and understandings of conscientious objection or the impact of conscientious objection from the UK service users’ perspective. This perspective is imperative in understanding the real-world consequences and impact of conscientious objection and essential when creating policy and guidelines. This qualitative research took a liberal feminist approach. It provided a platform for service users to share their experiences of abortion and conscientious objection, as well as their opinions and understandings of conscientious objection. The method employed was semi-structured interviews. Findings indicated that conscientious objection could work in practice. However, it is currently failing some individuals, as health care practitioners are not always referring and informing service users. Participants didn’t experience burdens such as long waiting times and were still able to access legal abortion. However, participants did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred. Moreover, participants’ opinions on conscientious objection in the UK varied greatly. The majority supported the most common approach within the literature and in practice, whereby health care practitioners are able to object so long as they refer and inform the service user. However, the opinion that health care practitioners should not be allowed to object or should be able to object without referring and informing was also present. Without this research, the impact that conscientious objection is having on service users in the UK and service users’ opinions on conscientious objection wouldn’t be known. These findings will be used to inform national policy and guidelines, making access to abortion fairer and safer for all.

Keywords: conscientious objection, abortion, medical ethics, reproductive justice

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Authors: Akbar Ali

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This study played an important role in the investigation of social adjustment of adolescent living with step parent families in Pakistan. Families plays an crucial role in the training and adjustment of adolescents’ personal, social and academic life. Adolescents living with parent families often experience different challenges which affects their social adjustment in the family and which further have impact on their academic and social life. One of central theme investigated in this study is parenting practice and other major theme is parental capital. The objectives of the study were to determine how different parenting styles being practiced in family affects adolescents’ adjustment and what is the role of parental capital in adolescents adjustment. qualitative approach was adopted for this research. Adolescents who are studying at college and living with step parent families participated in this study. Data was collected through interviews. Collected data was analyzed through NVIVO. Through findings, it is stated that parenting style and parental capital determining factors affecting adolescents’ adjustment and family experiences. The study suggest a comprehensive and practical approach for the adjustment of adolescents. Government should establish counselling and enabling facilities for adolescents’ for the wellbeing and better social adjustment.

Keywords: adolescents, academic life, parental capital, parental practices, social adjustment

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Authors: Fahmi Hassan, Noorizan Abdul Aziz, Yahaya Hassan, Hazlinda Abu Hassan

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Sepsis incidence in critical care settings is a major problem in health care. Extended antibiotic infusion is thought to be superior to traditional dosing especially when treating critically ill patients with sepsis. We compared clinical outcomes of critically ill patients with sepsis receiving 30-minute meropenem infusion and three-hour meropenem infusion. A retrospective case-control study was conducted among septic patients treated with meropenem infusion in ICUs of three hospitals. Patients included in the study received either extended or standard meropenem infusion as per the practice of individual settings. Outcomes and clinical data were retrospectively collected from the electronic databases and patients’ files. A total of 108 patients received extended meropenem infusion while another 117 patients received standard meropenem infusion. Patients receiving the extended meropenem infusion were found to have a significantly lower shorter length of hospital and ICU stay. It was also found that among those receiving extended meropenem infusion, 54.7% (64/117) had a reduction of SAPS II score, while only 44% (48/108) of patients receiving standard meropenem infusion had reduced scores. This study will strengthen the evidence in using extended meropenem infusion as a standard practice in critical care settings. As this is the first study of its kind done in Malaysia, it proves that prolonged meropenem infusion may be beneficial to critically ill patients with sepsis. However, randomized clinical trials with large sample size should be carried out in local settings in order to minimize other confounders that may influence with the result of the study.

Keywords: antibiotics, beta lactams, critical care, extended infusion, meropenem

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Authors: Adamnesh A. Bogale, Dorte Thorsen

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This paper aims to learn how children/siblings left behind due to parental migration experience care and the effects of the separation. It also aims to unpack the experiences of youth migrants in rural Ethiopia. It focuses specifically on how children and youth are affected in order to highlight in which areas intervention can enhance or inadvertently undermine the development impact of migration on young people. Based on a qualitative study in South Wollo, Ethiopia, which was undertaken in three stages in 2017-19 and involved 34 households and a number of key informants, the analysis offers insights into how migration contributes to household sustainability and, in the process, alters intergenerational relationships and dynamics. Contemporary migration in Ethiopia is complex and highly gendered. For young women, the migration corridor from Ethiopia to the Middle East is the most important, whereas young men mostly engage in local migration or travel to South Africa or Sudan. Arguing that children and youths’ experience of migration must be understood in the context of the moral, affective, and material economies, the paper distinguishes between young people’s experiences of migration as children of migrants, as siblings of a migrant, and as migrants. The material shows that children and youths demonstrate different experiences in parental migration depending on age, care arrangement, and the ability to communicate with an absent mother. Migration has a different implication for younger siblings depending on their gender. The division of work and future responsibilities post marriage combine to disadvantage female siblings while male siblings are either unaffected or reaped the benefits of investments made with remittances. Finally, migration is a mechanism to change generational power relationships. As remitters, young migrants yield better recognition in the family, though not always to the degree that they can control the use of remittances. The power to make decisions is not tied only to material resources and the household; migration facilitates social change that opens space for young women to have more influence over their own lives.

Keywords: migration, youth, Ethiopia, generations

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Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

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In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

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Authors: Rezky Rifaini, Raden Bagus Fajriya Hakim

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This research was conducted at the Bolo primary health Care in Bima Regency. The purpose of the research is to find out the association pattern that is formed of medical record database from Bolo Primary health care’s patient. The data used is secondary data from medical records database PHC. Sequential pattern mining technique is the method that used to analysis. Transaction data generated from Patient_ID, Check_Date and diagnosis. Sequential Pattern Discovery Algorithms Using Equivalent Classes (SPADE) is one of the algorithm in sequential pattern mining, this algorithm find frequent sequences of data transaction, using vertical database and sequence join process. Results of the SPADE algorithm is frequent sequences that then used to form a rule. It technique is used to find the association pattern between items combination. Based on association rules sequential analysis with SPADE algorithm for minimum support 0,03 and minimum confidence 0,75 is gotten 3 association sequential pattern based on the sequence of patient_ID, check_Date and diagnosis data in the Bolo PHC.

Keywords: diagnosis, primary health care, medical record, data mining, sequential pattern mining, SPADE algorithm

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Authors: Leanne Sanders, Leonie Hallo, Tiep Nguyen, Nicholas Chileshe.

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Purpose – Small and Medium-Sized Enterprises (SMEs) play an important role globally, yet the investigation of sustainability in this context is limited. The leader’s relationships with employees are a critical aspect of creating a positive and supportive organizational culture. Therefore, to bridge the knowledge gap, the aim of this paper is to extend the notion that the creation of trust is central to the sustainability of SMEs. Design: The study employs a case study observational research (CSOR) approach, and data were collected using first-hand observations and interviews. Findings: A model of leadership behaviour and a series of steps that leaders can take to leverage trust are presented. Leaders can have a positive impact even if the team is operating in a challenging context. Creating a positive environment brings sustainability to the team and perhaps the wider organization as well. Originality: This paper provides detailed information about the context in which developing trust can produce positive outcomes despite the prevailing overall toxic culture of an organization. The paper provides concrete advice for leaders to assist them in this highly important task.

Keywords: leadership, organizational culture, organizational sustainability, trust, positive culture

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Authors: Jocelyne Uwibambe, Ange Thaina Ndizeye, Dinah Ishimwe, Emmanuel Mugabo Byakagaba

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Background: In low- and middle-income countries (LMICs), the use of modern contraceptive methods among women, including adolescents, is still low despite the desire to avoid pregnancy. In addition, countries have set a minimum age for marriage, which is 21 years for most countries, including Rwanda. The Rwandan culture, to a certain extent, and religion, to a greater extent, however, limit the freedom of young women to use contraceptive services because it is wrongly perceived as an encouragement for premarital sexual intercourse. In the end, what doesn’t change is that denying access to contraceptives to either male or female adolescents does not translate into preventing them from sexual activities, hence leading to an ever-increasing number of unwanted pregnancies, possible STIs, HIV, Human Papilloma Virus, and subsequent unsafe abortion followed by avoidable expensive complications. The purpose of this study is to evaluate the perception of healthcare providers regarding contraceptive use among adolescents. Methodology: This was a qualitative study. Interviews were done with different healthcare providers, including doctors, nurses, midwives, and pharmacists, through focused group discussions and in-depth interviews, then the audio was transcribed, translated and thematic coding was done. Results: This study explored the perceptions of healthcare workers regarding the provision of modern contraception to adolescents in Rwanda. The findings revealed that while healthcare providers had a good understanding of family planning and contraception, they were hesitant to provide contraception to adolescents. Sociocultural beliefs played a significant role in shaping their attitudes, as many healthcare workers believed that providing contraception to adolescents would encourage promiscuous behavior and go against cultural norms. Religious beliefs also influenced their reluctance, with some healthcare providers considering premarital sex and contraception as sinful. Lack of knowledge among parents and adolescents themselves was identified as a contributing factor to unwanted pregnancies, as inaccurate information from peers and social media influenced risky sexual behavior. Conditional policies, such as the requirement for parental consent, further hindered adolescents' access to contraception. The study suggested several solutions, including comprehensive sexual and reproductive health education, involving multiple stakeholders, ensuring easy access to contraception, and involving adolescents in policymaking. Overall, this research highlights the need for addressing sociocultural beliefs, improving healthcare providers' knowledge, and revisiting policies to ensure adolescents' reproductive health rights are met in Rwanda. Conclusion: The study highlights the importance of enhancing healthcare provider training, expanding access to modern contraception, implementing community-based interventions, and strengthening policy and programmatic support for adolescent contraception. Addressing these challenges is crucial for improving the provision of family planning services to adolescents in Rwanda and achieving the Sustainable Development Goals related to sexual and reproductive health. Collaborative efforts involving various stakeholders and organizations can contribute to overcoming these barriers and promoting the well-being of adolescents in Rwanda.

Keywords: adolescent, health care providers, contraception, reproductive health

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Authors: Muhammad Shoaib Iqbal, Shih Ping Ho

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Megaprojects are large-scale, complex ventures with significant financial investments, numerous stakeholders, and extended timelines, requiring meticulous management for successful completion. This study explores the interplay between project governance, project complexity, and servant leadership and their combined effects on project success, specifically within the context of Pakistani megaprojects. The primary objectives are to examine the direct impact of project governance on project success, understand the negative influence of project complexity, assess the positive role of servant leadership, explore the moderating effect of servant leadership on the relationship between governance and success, and investigate how servant leadership mitigates the adverse effects of complexity. Using a quantitative approach, survey data were collected from project managers and team members involved in Pakistani megaprojects. Using a Comprehensive empirical model, 257 Valid responses were analyzed. Multiple regression analysis tested the hypothesized relationships and interaction effects using PLS-SEM. Findings reveal that project governance significantly enhances project success, emphasizing the need for robust governance structures. Conversely, project complexity negatively impacts success, highlighting the challenges of managing complex projects. Servant leadership significantly boosts project success by prioritizing team support and empowerment. Although the interaction between governance and servant leadership is not significant, suggesting no significant change in project success, servant leadership significantly mitigates the negative effects of project complexity, enhancing team resilience and adaptability. These results underscore the necessity for a balanced approach integrating strong governance with flexible, supportive leadership. The study offers valuable insights for practitioners, recommending adaptive governance frameworks and promoting servant leadership to improve the management and success rates of megaprojects. This research contributes to the broader understanding of effective project management practices in complex environments.

Keywords: project governance, project complexity, servant leadership, project success, megaprojects, Pakistan

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