Search results for: quality of care

Authors: Marzena Trojanczyk, Mariusz Jaworski, Ewa Dmoch Gajzlerska

Abstract:

Purpose: The purpose of this paper is to assess the relationship between the level of quality of life and willingness to take treatment in patients with eating disorders as anorexia, bulimia and compulsive bingeing. Material and methods: The subjects consisted of 99 women with eating disorders: anorexia, n = 33; bulimia, n = 35; compulsive overeating, n = 31 and 35 women in the control group. The study used an original questionnaire to assess the overall quality of life, as well as selected areas of the physical, mental, social and spiritual satisfaction. The subjects were also asked about the level of motivation for treatment, and the importance of the disease in the lives of patients. Statistical analyses were performed using the statistical program SPSS 18.0. Results: Women with eating disorders in particular groups did not differ with respect to each other in the aspect of overall quality of life, satisfaction with the development of the spiritual, social functioning and mental health. The severity level of the disease in the lives of patients showed a negative correlation with social functioning in women with anorexia nervosa. In the case of patients with compulsive bingeing a positive relationship between the level of importance of the disease and the satisfaction of spiritual development is reported. Conclusions: Concerning the inferior quality of life, there is no relationship between a willingness to take treatment and the importance of the disease in the lives of patients with anorexia, bulimia and compulsive bingeing.

Keywords: anorexia, bulimia, compulsive overeating, quality of life

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Authors: Moses Oghnennyoreme Eyankware, Christian Ogubuchi Ede

Abstract:

Groundwater is the principal source for various uses in this study area. The quality and availability of groundwater depend on rock formation within the study area. To effectively study the quality of groundwater, 24 groundwater samples were collected. The study was aimed at investigating the hydrogeochemistry of groundwater, and additionally its suitability for drinking and irrigation purposes. The following parameters were analyzed using the American Public Health Association standard method: pH, turbidity, Ec, TDS, Mg2+, SO42-, NO3¯, Cl-, HCO3¯, K+, Na2+ and Ca2+. Results obtained from Water Quality Index revealed that the groundwater sample fell within good water quality that implies that groundwater is considered fit for drinking purposes. Deduced results obtained from irrigation indices revealed that Permeability Index (PI), Soluble Sodium Percentage (SSP), Sodium Percentage (Na %), Sodium Absorption Ratio (SAR), Kelly Ratio (KR), Magnesium Hazard (MH) ranges from 0.00 to 0.01, 4.04 to 412.9, 0.63 to 257.7, 0.15 to 2.34, 0.09 to 2.57 and 6.84 to 84.55 respectively. Findings from Total hardness revealed that groundwater fell within soft, moderately hard and hard categories. Estimated results obtained from CSMR, RI and LSI showed that groundwater showed corrosion tendency, salinization influenced groundwater at certain sampling points and chloride and sulfate unlikely to interfere with natural formation film.

Keywords: water, quality, suitability, anthropogenic, Nigeria

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Authors: Maneesha Pahlani, Najmin Sultana

Abstract:

A hospital is one of the most suitable places for acquiring an infection because it harbors a high population of virulent strains of microorganisms that may be resistant to antibiotics, especially the prevalence of Methicillin-Resistant Staphylococcus Aureus (MRSA) infections. The hospital-acquired infection has become a global challenge. In developed countries, healthcare-associated infections occur in 5-15% of hospitalized clients, affecting 9-37% of those admitted to intensive care units (ICU). A non-experimental descriptive study was conducted among 50 nursing officers working in a selected hospital in Bangalore to assess the nursing officers’ level of knowledge regarding the prevention and management of MRSA infections and to associate the pre-test knowledge mean scores of nursing officers with selected socio-demographic variables. Data was collected using a structured questionnaire consisting of socio-demographic data and a structured questionnaire on knowledge regarding the prevention and management of MRSA infections. The data was analyzed in terms of frequencies and percentages for the analysis of demographic variables and computing chi-square to determine the association between knowledge means scores and selected demographic variables. The study findings revealed that the nursing officer had an overall good level of knowledge (63.05%) regarding the prevention and management of MRSA infections, and there is no significant association found between the level of knowledge mean scores for prevention and management of MRSA infection with the selected socio-demographic variables. However, the categorization of knowledge items showed that the nursing officer must thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance for effective nursing care to patients with MRSA infections. The conclusions drawn from the study findings showed that it is necessary that the nursing officer thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance to provide effective nursing care to patients with MRSA infection as they constantly care for the patient who can be at risk for multi-drug resistance organisms to reduce the risk of MRSA infection in hospital care settings as well community settings.

Keywords: MRSA, nursing officers, knowledge, preventive and management

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Authors: Chakrit Chotamonsak

Abstract:

In this study, the Weather Research and Forecasting (WRF) model was used as regional climate model to dynamically downscale the ECHAM5 Global Climate Model projection for the regional climate change impact on air quality–related meteorological conditions in the upper northern Thailand. The analyses were focused on meteorological variables that potentially impact on the regional air quality such as sea level pressure, planetary boundary layer height (PBLH), surface temperature, wind speed and ventilation. Comparisons were made between the present (1990–2009) and future (2045–2064) climate downscaling results during majority air pollution season (dry season, January-April). Analyses showed that the sea level pressure will be stronger in the future, suggesting more stable atmosphere. Increases in temperature were obvious observed throughout the region. Decreases in surface wind and PBLH were predicted during air pollution season, indicating weaker ventilation rate in this region. Consequently, air quality-related meteorological variables were predicted to change in almost part of the upper northern Thailand, yielding a favorable meteorological condition for pollutant accumulation in the future.

Keywords: climate change, climate impact, air quality, air pollution, Thailand

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Authors: Janusz Getta, Zhaoxi Pan

Abstract:

Performance-based quality evaluation of database conceptual schemas is an important aspect of database design process. It is evident that different conceptual schemas provide different logical schemas and performance of user applications strongly depends on logical and physical database structures. This work presents the entire process of performance-based quality evaluation of conceptual schemas. First, we show format. Then, the paper proposes a new specification of object algebra for representation of conceptual level database applications. Transformation of conceptual schemas and expression of object algebra into implementation schema and implementation in a particular database system allows for precise estimation of the processing costs of database applications and as a consequence for precise evaluation of performance-based quality of conceptual schemas. Then we describe an experiment as a proof of concept for the evaluation procedure presented in the paper.

Keywords: conceptual schema, implementation schema, logical schema, object algebra, performance evaluation, query processing

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Authors: R. Cooper, M. Kurien

Abstract:

Background: Coeliac Disease affects around 1 in 100 people. Untreated, it can result in serious morbidity such as malabsorption and cancers. The only treatment is to adhere to a gluten free diet (GFD). International guidelines recommend that people with the coeliac disease receive follow-up healthcare annually to detect complications early and support their adherence to a GFD. However, there is a finite amount of healthcare in the UK, and as such, not all patients receive follow-up care as recommended by the guidelines. Furthermore, there is an increasing number of patients being diagnosed with coeliac disease. Given the potential severe morbidity that non-adherence to a GFD could result in, alongside reports that the rate of non- GFD adherence could be as high as 91%, it is imperative that action is taken. One potential solution to this would be to provide follow-up care digitally through utilising technology. This abstract reports on a rapid review undertaken to explore the existing evidence in this area. Methods: In June 2020, 11 bibliographic databases were searched to find any pertinent studies. The inclusion criteria required the study to be written in the English language and report on the use of digital healthcare interventions for people with Coeliac Disease. Results: A small amount of evidence (n=8) was found which met our inclusion criteria and pertained to the provision of CD follow-up digitally. These studies focussed either on educating and supporting patients to adhere to a GFD or providing consultation remotely with a focus on detecting complications early. These studies showed that there is potential for digital healthcare interventions to positively impact people with coeliac disease. However, it is suggested that the effectiveness of these interventions may depend on local circumstances, individual knowledge of CD and general attitudes. Conclusion: The above studies suggest that providing follow-up care digitally may offer a potential solution; however, the evidence about how this should be done and in what circumstances this will work for individuals is scarce. In the light of the COVID-19 pandemic, the introduction of digital healthcare interventions appears to be highly topical, and as such, this review may benefit from being refreshed in the future.

Keywords: coeliac disease, follow-up, gluten free diet, digital healthcare interventions

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Authors: Farhat Sultana

Abstract:

Originality: TQM principles are considered the tools to enhance organizational performance for most organizations. The paper contributes to the literature on the social enterprise because social organizations are still far behind in implementing TQM as compared to other private, public, and nonprofit organizations. Study design: The study is based on the data and information provided by two case studies and one focus group of social enterprises. Purpose: The purpose of the study is to get a deep understating of TQM implementation and to recognize the enablers of TQM in social enterprises that enhance the organizational performance of social enterprises located in UAE. Findings: As per the findings of the study, key enablers of Total Quality management in the case enterprises are leadership support, strategic approach for quality, continuous improvement, process improvement, employee empowerment and customer focus practices, though some inhibitors for TQM implementation such as managerial structure for quality assurance and performance appraisal mechanism are also pointed out by the study. Research limitations: The study findings are only based on two case studies and one focus group, which is not enough to generalize the findings to all social organizations. Practical Implications: Identified TQM enablers can help management to implement TQM successfully in social enterprises. Social implications: The study provides enabling path for Social enterprises to implement TQM to seek quality output to build a better society.

Keywords: TQM, social enterprise, enablers of TQM, UAE

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Authors: Najmin Sultana, Maneesha Pahlani

Abstract:

A hospital is one of the most suitable places for acquiring an infection because it harbors a high population of virulent strains of microorganisms that may be resistant to antibiotics, especially the prevalence of Methicillin-Resistant Staphylococcus Aureus (MRSA) infections. The hospital-acquired infection has become a global challenge. In developed countries, healthcare-associated infections occur in 5-15% of hospitalized clients, affecting 9-37% of those admitted to intensive care units (ICU). A non-experimental descriptive study was conducted among 50 nursing officers working in a selected hospital in bengaluru to assess the nursing officers’ level of knowledge regarding the prevention and management of MRSA infections and to associate the pre-test knowledge mean scores of nursing officers with selected socio-demographic variables. Data was collected using a structured questionnaire consisting of socio-demographic data and a structured questionnaire on knowledge regarding the prevention and management of MRSA infections. The data was analyzed in terms of frequencies and percentages for the analysis of demographic variables and computing chi-square to determine the association between knowledge means scores and selected demographic variables. The study findings revealed that the nursing officer had an overall good level of knowledge (63.05%) regarding the prevention and management of MRSA infections, and there is no significant association found between the level of knowledge mean scores for prevention and management of MRSA infection with the selected socio-demographic variables. However, the categorization of knowledge items showed that the nursing officer must thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance for effective nursing care to patients with MRSA infections. The conclusions drawn from the study findings showed that it is necessary that the nursing officer thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance to provide effective nursing care to patients with MRSA infection as they constantly care for the patient who can be at risk for multi-drug resistance organisms to reduce the risk of MRSA infection in hospital care settings as well community settings.

Keywords: MRSA, knowledge, nursing officers', prevention and management

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Authors: Rachel Jones

Abstract:

Systemic Family therapy in the Queensland Foster Care System is the implementation of Integrative Practice as a purposeful intervention implemented with complex ‘family’ systems (by expanding the traditional concept of family to include all relevant stakeholders for a child) and is shown to improve the overall wellbeing of children (with developmental delays and trauma) in Queensland out of home care contexts. The importance of purposeful integrative practice in the field of systemic family therapy has been highlighted in achieving change in complex family systems. Essentially, it is the purposeful use of multiple interventions designed to meet the myriad of competing needs apparent for a child (with developmental delays resulting from early traumatic experiences - both in utero and in their early years) and their family. In the out-of-home care context, integrative practice is particularly useful to promote positive change for the child and what is an extended concept of whom constitutes their family. Traditionally, a child’s family may have included biological and foster care family members, but when this concept is extended to include all their relevant stakeholders (including biological family, foster carers, residential care workers, child safety, school representatives, Health and Allied Health staff, police and youth justice staff), the use of integrative family therapy can produce positive change for the child in their overall wellbeing, development, risk profile, social and emotional functioning, mental health symptoms and relationships across domains. By tailoring therapeutic interventions that draw on systemic family therapies from the first and second-order schools of family therapy, neurobiology, solution focussed, trauma-informed, play and art therapy, and narrative interventions, disability/behavioural interventions, clinicians can promote change by mixing therapeutic modalities with the individual and their stakeholders. This presentation will unpack the implementation of systemic family therapy using this integrative approach to formulation and treatment for a child in out-of-home care in Queensland (experiencing developmental delays resulting from trauma). It considers the need for intervention for the individual and in the context of the environment and relationships. By reviewing a case example, this study aims to highlight the simultaneous and successful use of pharmacological interventions, psychoeducational programs for carers and school staff, parenting programs, cognitive-behavioural and trauma-informed interventions, traditional disability approaches, play therapy, mapping genograms and meaning-making, and using family and dyadic sessions for the system associated with the foster child. These elements of integrative systemic family practice have seen success in the reduction of symptoms and improved overall well-being of foster children and their stakeholders. Accordingly, a model for best practice using this integrative systemic approach is presented for this population group and preliminary findings for this approach over four years of local data have been reviewed.

Keywords: systemic family therapy, treating families of children with delays, trauma and attachment in families systems, improving practice and functioning of children and families

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Authors: Ferawati, H. Purwanto, Y. F. Kurnia, E. Purwati

Abstract:

The aim of this study was to evaluate the microbiological quality and safety of meatball obtained from five different manufacturers around Payakumbuh City, West Sumatra, Indonesia. Microbiological analysis of meatball sample resulted in aerobic plate count range from 7 log CFU/gr to 8.623 log CFU/gr, respectively. Total coliform ranges from 1.041 log Most Probable Number (MPN)/gr to 3.380 log MPN/gr, respectively. Chemical analysis of meatball sample consisted of borax and formalin content. The result of qualitative detection of borax and formalin content on all meatball samples were not detected. Thus, it remains essential to include the significance of effective hygiene practices as an important safety measure in consumer education programmes.

Keywords: borax, formalin, meatball, microbiological quality

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Authors: Vildan Cırık, Emine Efe

Abstract:

Complementary health approaches are growing in popularity worldwide and play a substantial role in health care. It is very important for paediatric nurses to have knowledge of practices affecting the medical conditions of patients and to communicate with them through integrative nursing care. The purpose of this study was to determine paediatric nurses’ knowledge and experiences of complementary health approaches (CHA) and their personal and professional attitudes to the use of complementary health approaches. This multicentre study was conducted with 1450 paediatric nurses in 18 hospitals in Turkey. Paediatric nurses included in the study were working in the following clinics: Paediatric Service, Paediatric Intensive Care, Paediatric Haematology/Oncology. Data collection focused on the paediatric nurses’ knowledge and experiences of CHA. A high proportion of our sample of paediatric nurses reported that they had used some form of CHA themselves; the most popular choices of CHA were prayer, massage, and vitamins techniques. Paediatric nurses reported positive experiences (drawing/music/art/dance therapies, prayer, herbs, thermal springs, massage, and reflexology) and negative experiences (herbs, thermal springs, prayer, and massage). This study may contribute to increased awareness of the potentially important role of paediatric nurses in the delivery of CHA. Paediatric nurses play important roles in helping patients to use complementary health approaches safely and accurately. Trainings on CHA should be organised, data collection forms including CHA should be created, and evidence-based studies should be focused towards improving the clinical practice of paediatric nurses.

Keywords: complementary health approaches, paediatric nurses, knowledge, experience, attitude, Turkey

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Authors: Isiya Aminu Dabai, Adebola Kayode, Adeosun Kayode Daniel

Abstract:

Rural water supply relies mainly on groundwater exploitation, because it is more accessible, reliable, cheaper to develop and maintain, also with good quality compared to the surface water. Despite these advantages, groundwater has come under pollution threats like waste dumps, mineral exploitation, industrialization etc. This study investigates the effects of an open dumping to the surrounding groundwater. Ten hand dug well water samples were collected from the surroundings and tested. The average result shows that temperature, colour and turbidity to be 8.50 c, 6.1 TCU and 3.1 NTU respectively and pH, conductivity, total dissolved solids, chloride content and hardness to be 7.2, 4.78, 1.8, 5.7, and 3.4 respectively while in the bacteriological test well no. 1, 2, 3, and 5 shows the presence of coliforms and E. Coli bacteria.

Keywords: groundwater, pollution, waste, dump site, unsafe, quality

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Authors: Redha Elhuni, M. Munir Ahmad

Abstract:

The main purpose of this research is to construct a generic model for successful implementation of Total Quality Management (TQM) in oil sector, and to find out the effects of this model on the organizational sustainability development (OSD) performance of Libyan oil and gas companies using the structured equation modeling (SEM) approach. The research approach covers both quantitative and qualitative methods. A questionnaire was developed in order to identify the quality factors that are seen by Libyan oil and gas companies to be critical to the success of TQM implementation. Hypotheses were developed to evaluate the impact of TQM implementation on O SD. Data analysis reveals that there is a significant positive effect of the TQM implementation on OSD. 24 quality factors are found to be critical and absolutely essential for successful TQM implementation. The results generated a structure of the TQMSD implementation framework based on the four major road map constructs (Top management commitment, employee involvement and participation, customer-driven processes, and continuous improvement culture).

Keywords: total quality management, critical success factors, oil and gas, organizational sustainability development (SD), Libya

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Authors: Hilary J. Watsilla, Narasimha R. Vajjhala

Abstract:

Information and Communication Technology (ICT) has made information access easier and affordable. Academic research has also benefited from this, with online journals and academic resource readily available by the click of a button. However, there are limited ways of assessing and controlling the quality of the academic research mostly in public institution. Nigeria is the most populous country in Africa with a significant number of universities and young population. The quality of knowledge created by academic researchers, however, needs to be evaluated due to the high number of predatory journals published by academia. The purpose of this qualitative study is to look at the knowledge creation, acquisition, and assimilation process by academic researchers in public universities in Nigeria. Qualitative research will be carried out using in-depth interviews and observations. Academic researchers will be interviewed and absorptive capacity theory will be used as the theoretical framework to guide the research. The findings from this study should help understand the impact of ICT on the knowledge creation process in academic research and to understand how ICT can affect the quality of knowledge produced by researchers. The findings from this study should help add value to the existing body of knowledge on the quality of academic research, especially in Africa where there is limited availability of quality academic research. As this study is limited to Nigerian universities, the outcome may not be generalized to other developing countries.

Keywords: knowledge creation, academic research, university, information and communication technology

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Authors: Sajia Islam, T. Tahsina, S. Raihana, M. M. Rahman, Q. S. Rahman, T. M. Huda, S. E. Arifeen, M. J. Dibley

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Early neonatal sepsis accounts for more than two-thirds of all deaths in the first year of life. This study assessed the counseling during antenatal, perinatal, post natal periods and its association with possible sepsis in rural Bangladesh. Method: Data were collected from a large community-based trial in Bangladesh where pregnant women were enrolled from 2013-2015 covering 29,497 newborns. Sepsis was defined using neonatal danger signs reported by 'The Young-Infants Clinical Science Study Group. 'Result: Signs of sepsis was found among 15% of the neonates. Neonatal sepsis was higher among those who did not receive advice on TT vaccinations (15.4% vs. 11%, p < 0.05) and danger signs (14.8% vs. 12.8%, p < 0.05) during pregnancy. Advice on delivering in well-lit place was significantly associated with lower incidence of sepsis (12.7% vs. 14.8% p < 0.05). Sepsis was lower among neonates whose mothers were counseled on immediate newborn care for bathing after 3 days of delivery (13.4% vs. 15.2% p=0), breastfeeding within 1hr of birth (13.82 % vs. 15.28% p=0), apply nothing on the cord (11.54 vs. 15.06 p=0), immediate drying of child (12.62% vs. 14.89%, p=0). Neonatal sepsis was lower among children whose mothers received 2-4 advice [OR=0.91(95% CI: 0.85-0.97)] compared to neonates whose mothers received only 1 or none. Overall, children to mothers who received ≥ 5 advice had lowest incidence of sepsis [OR=0.83 (95% CI: 0.71-0.97)] Conclusion: Advice on antenatal, prenatal and post natal is significantly reduced with early newborn sepsis. Further research is required to identify specific type of counseling messages that translate into practices and reduce pathways towards early-newborn morbidities.

Keywords: ante natal care, counseling, neonatal sepsis, post natal care

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Authors: N. Boutaghane, F. Z. Tounsi

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Many physical and technological factors degrade the SPECT images, both qualitatively and quantitatively. For this, it is not always put into leading technological advances to improve the performance of tomographic gamma camera in terms of detection, collimation, reconstruction and correction of tomographic images methods. We have to master firstly the choice of various acquisition and reconstruction parameters, accessible to clinical cases and using the attenuation and scatter correction methods to always optimize quality image and minimized to the maximum dose received by the patient. In this work, an evaluation of qualitative and quantitative tomographic images is performed based on the acquisition parameters (counts per projection) and reconstruction parameters (filter type, associated cutoff frequency). In addition, methods for correcting physical effects such as attenuation and scatter degrading the image quality and preventing precise quantitative of the reconstructed slices are also presented. Two approaches of attenuation and scatter correction are implemented: the attenuation correction by CHANG method with a filtered back projection reconstruction algorithm and scatter correction by the subtraction JASZCZAK method. Our results are considered as such recommandation, which permits to determine the origin of the different artifacts observed both in quality control tests and in clinical images.

Keywords: attenuation, scatter, reconstruction filter, image quality, acquisition and reconstruction parameters, SPECT

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Authors: Emily Hickmann, Peggy Richter, Maren Kaehlig, Hannes Schlieter

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Patient engagement is a cornerstone of high-quality care and essential for patients with chronic diseases to achieve improved health outcomes. Through digital transformation, possibilities to engage patients in their personal healthcare have multiplied. However, the exploitation of this potential is still lagging. To support the transmission of patient engagement theory into practice, this paper’s objective is to give a state-of-the-art overview of patient engagement tools and methods. A systematic literature review was conducted. Overall, 56 tools and methods were extracted and synthesized according to the four attributes of patient engagement, i.e., personalization, access, commitment, and therapeutic alliance. The results are discussed in terms of their potential to be implemented in digital health solutions under consideration of the “computers are social actors” (CASA) paradigm. It is concluded that digital health can catalyze patient engagement in practice, and a broad future research agenda is formulated.

Keywords: chronic diseases, digitalization, patient-centeredness, patient empowerment, patient engagement

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Authors: Shan Huang, Guanjun Huang, Yongjun Zeng, Haiyuan Wang

Abstract:

The impacts of whole-growth warming on grain yield and quality in double rice cropping systems still remain largely unknown. In this study, a two-year field whole-growth warming experiment was conducted with two inbred indica rice cultivars (Zhongjiazao 17 and Xiangzaoxian 45) for early season and two hybrid indica rice cultivars (Wanxiangyouhuazhan and Tianyouhuazhan) for late season. The results showed that whole-growth warming did not affect early rice yield but significantly decreased late rice yield, which was caused by the decreased grain weight that may be related to the increased plant respiration and reduced translocation of dry matter accumulated during the pre-heading phase under warming. Whole-growth warming improved the milling quality of late rice but decreased that of early rice; however, the chalky rice rate and chalkiness degree were increased by 20.7% and 33.9% for early rice and 37.6 % and 51.6% for late rice under warming, respectively. We found that the crude protein content of milled rice was significantly increased by warming in both early and late rice, which would result in deterioration of eating quality. Besides, compared with the control treatment, the setback of late rice was significantly reduced by 17.8 % under warming, while that of early rice was not significantly affected by warming. These results suggest that the negative impacts of whole-growth warming on grain quality may be more severe in early rice than in late rice. Therefore, adaptation in both rice breeding and agronomic practices is needed to alleviate climate warming on the production of a double rice cropping system. Climate-smart agricultural practices ought to be implemented to mitigate the detrimental effects of warming on rice grain quality. For instance, fine-tuning the application rate and timing of inorganic nitrogen fertilizers, along with the introduction of organic amendments and the cultivation of heat-tolerant rice varieties, can help reduce the negative impact of rising temperatures on rice quality. Furthermore, to comprehensively understand the influence of climate warming on rice grain quality, future research should encompass a wider range of rice cultivars and experimental sites.

Keywords: climate warming, double rice cropping, dry matter, grain quality, grain yield

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Authors: Danila Zuffetti, Lorenzo Chiesa

Abstract:

Background: A hospice narrative interview aims at putting the sick at the core of disease and treatment allowing them to explore their most intimate facets. The aim of this work is to favor authentic narration by leading towards awareness and acceptance of terminality and to face death with serenity. Narration in palliative care aims at helping to reduce the chaos generated by the disease and to elaborate interpretations on the course of reality, besides, the narration delivered to the doctor is fundamental and communicates the meaning given to symptoms. Methods: The narrative interview has become a regular activity in the Castellini Foundation since 2017. Patients take part every week, and for more days, in one hour sessions, in a welcoming and empathic setting and the interaction with the operator leads to a gradual awareness of their terminality. Patients are submitted with free answer questions with the purpose of facilitating and stimulating self-narration. Narration has not always been linear, but patients are left free to shift in time to revisit their disease process by making use of different tools, such as digital storytelling. Results: The answers provided by the patients show to which extent the narrative interview is an instrument allowing the analysis of the stories and gives the possibility to better understand and deepen the different implications of patient and caregiver’s background. Conclusion: The narration work in the hospice demonstrates that narrative medicine is an added value. This instrument has proven useful not only in the support of patients but also for the palliative doctor to identify wishes for accompanying them to the end with dignity and serenity. The narrative interview favors the construction of an authentic therapeutic relationship. The sick are taken wholly in charge, and they are guaranteed a high quality of life until their very last instant.

Keywords: construction of an authentic therapy relationship, gradual awareness of their terminality, narrative interview, reduce the chaos generated by the desease

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Authors: Sung-Chun Tsai, Li-Fang Chou, Chun-Jung Tseng

Abstract:

How relational identity of leader-subordinate relationship affects behavior of both parties is getting more and more attentions in recent years. Different from past studies on leader-subordinate relationship taking viewpoint of self-concept or interaction between categories, we took perspective of social cognitive schema with special focus on the cognition structure and category content of the vertical leader-subordinate relationship. This study firstly clarified the dimensions and contents of cognitive structure of vertical leader-subordinate relationship. By using two dimensions of “equal/unequal” and “close/distant”, the contents of the leader-subordinate relational identity (LSRI) are classified into four categories: communal affection RI (equal and close), instrumental exchange RI (equal but distant), care-repay RI (unequal but close), and authority-obedience RI (unequal and distant). Furthermore, according to the four dimensions of leader-subordinate relational identity, we explored: (1) how a leader’s LSRI leads to paternalistic leadership; and (2) how paternalistic leadership affects subordinate’s LSRI. Using 59 work group as sample (59 leaders and 251 subordinates), the results of HLM and regression analysis showed: (1) leader’s LSRI significantly affects leadership behavior: instrumental exchange RI is positively relates to authoritarian leadership behavior, but significantly has negative relationship with benevolent leadership; care-repay RI has significantly positive relationship with authoritative leadership; authority-obedience RI has significantly positive relationship with authoritarian leadership; (2) paternalistic leadership is significantly related to subordinates’ LSRI: benevolent leadership is positively related to subordinate’s communal affection and care-repay RI; authoritative leadership has significantly positive relationship with care-repay and authority-obedience RI; authoritarian leadership has significantly positive relationship with subordinate’s instrumental exchange RI. Finally, the main findings, contributions and limits, future research directions, and implications were also discussed.

Keywords: relational identity, leader-subordinate relational identity (LSRI), relational schema, paternalistic leadership

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Authors: Md. Musfiqur Rahman Bhuiya Nidalia Islam, Hossain Mohiuddin, Md. Kawser Bin Zaman

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Dhaka North City Corporation introduced first area-based bus service on 10 August 2016 to run through Gulshan and Banani area to dilute sufferings of the people which started with the ban on movement of the bus in these areas after Holy Artisan terrorist attack. This study explores service quality performance of Dhaka Chaka on the basis of information provided by its riders on a questionnaire survey. Total thirteen service quality indicators have been ranked on a scale of 1-5, and they have been classified under three latent variables based on their correlation using eigenvalue and rotated factor matrix derived through factor analysis process. Mean, and skewness has been calculated for each indicator. It has been found that ticket price and ticketing system have relatively poor average service quality rank than other factors. All other factors have moderately good performance. The study also suggests some recommendation to improve service quality of Dhaka Chaka based on the interrelation between considered parameters.

Keywords: area based bus service, eigen value, factor analysis, correlation

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Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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A preliminary systematic review shows that health professionals experience a tension when communicating with the parents and family members of children with life-threatening and life-limiting conditions. On the one hand, they want to promote open and honest communication, while on the other, they are apprehensive about fostering an unrealistic sense of hope. Defining the boundaries between information that might offer reasonable hope versus that which results in false reassurance is challenging. Some healthcare providers worry that instilling a false sense of hope could motivate parents to seek continued aggressive treatment for their child, which in turn might cause the patient further unnecessary suffering. To date, there has been a lack of research in the Middle East regarding how healthcare providers do or should communicate bad news; in particular, the issue of hope in the field of paediatric palliative care has not been researched thoroughly. This study aims to explore, from the perspective of patients’ mothers, physicians, and nurses, the experience of communicating and receiving bad news in the care of children with palliative care needs. Data were collected using a collective qualitative case study approach across three paediatric units in a Jordanian hospital. Two data collection methods were employed: participant observation and semi-structured interviews. The overall number of cases was 15, with a total of 56 interviews with mothers (n=24), physicians (n=12), and nurses (n=20) completed, as well as 197 observational hours logged. The findings demonstrate that mothers wanted their doctors to provide them with hopeful information about the future progression of their child’s illness. Although some mothers asked their doctors to provide them with honest information regarding the condition of their child, they still considered a sense of hope to be essential for coping with caring for their child. According to mothers, hope was critical to treatment as it helped them to stay committed to the treatment and protected them to some extent from the extreme emotional suffering that would occur if they lost hope. The health professionals agreed with the mothers on the importance of hope, so long as it was congruent with the stage and severity of each patient’s disease. The findings of this study conclude that while parents typically insist on knowing all relevant information when their child is diagnosed with a severe illness, they considered hope to be an essential part of life, and they found it very difficult to handle suffering without any glimmer of it. This study finds that using negative terms has extremely adverse effects on the parents’ emotions. Hence, although the mothers asked the doctors to be as honest as they could, they still wanted the physicians to provide them with a positive message by communicating this information in a sensitive manner including hope.

Keywords: health professionals, children, communication, hope, information, mothers, palliative care

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Authors: June-Jei Kuo, Yi-Chuan Hsieh

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Because of the rapid growth of information technology, more and more libraries introduce the new information retrieval systems to enhance the users’ experience, improve the retrieval efficiency, and increase the applicability of the library resources. Nevertheless, few of them are discussed the usability from the users’ aspect. The aims of this study are to understand that the scenario of the information retrieval system utilization, and to know why users are willing to continuously use the web-scale discovery system to improve the web-scale discovery system and promote their use of university libraries. Besides of questionnaires, observations and interviews, this study employs both Information System Success Model introduced by DeLone and McLean in 2003 and the flow theory to evaluate the system quality, information quality, service quality, use, user satisfaction, flow, and continuing to use web-scale discovery system of students from National Chung Hsing University. Then, the results are analyzed through descriptive statistics and structural equation modeling using AMOS. The results reveal that in web-scale discovery system, the user’s evaluation of system quality, information quality, and service quality is positively related to the use and satisfaction; however, the service quality only affects user satisfaction. User satisfaction and the flow show a significant impact on continuing to use. Moreover, user satisfaction has a significant impact on user flow. According to the results of this study, to maintain the stability of the information retrieval system, to improve the information content quality, and to enhance the relationship between subject librarians and students are recommended for the academic libraries. Meanwhile, to improve the system user interface, to minimize layer from system-level, to strengthen the data accuracy and relevance, to modify the sorting criteria of the data, and to support the auto-correct function are required for system provider. Finally, to establish better communication with librariana commended for all users.

Keywords: web-scale discovery system, discovery system, information system success model, flow theory, academic library

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Authors: Araba A. Z. Osei-Tutu, Ebenezer Odame, Joseph Bawa, Samuel Amponsah

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Education is recognized as a fundamental human right and a catalyst for development. Despite progress in the provision of higher education on the African continent, there persist challenges with the tripartite areas of access, equity and quality. Therefore, this systematic review aimed at providing a comprehensive overview of conversations and voices of scholars on these three concepts in HE in Africa. The systematic review employed a thematic analysis approach, synthesizing findings from 38 selected sources. After a critical analysis of the sources included in the systematic review, deficits in access, quality, and equity were outlined, focusing on infrastructure, regional disparities, and privatization challenges. The review also revealed the weak enforcement of quality assurance measures. Strategies for improvement, proffered by the study, include expanding public sector HE, deregulating the educational sector, promoting open and distance learning, implementing preferential admission policies, and enhancing financial aid. This research contributes valuable insights for policymakers, educators, and stakeholders, fostering a collaborative approach to address challenges and promote holistic development in African higher education.

Keywords: access, equity, quality, higher education, Africa, systematic review, strategies

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Authors: Basharat Yousuf, Abhaya K. Srivastava

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Psyllium gum alone and in combination with sunflower oil was investigated as a possible alternative edible coating for improvement of quality and shelf life of fresh-cut papaya. Different concentrations including 0.5, 1 and 1.5 percent of psyllium gum were used for coating of fresh-cut papaya. In some samples, refined sunflower oil was used as a lipid component to increase the effectiveness of coating in terms of water barrier properties. Soya lecithin was used as an emulsifier in coatings containing oil. Pretreatment with 1% calcium chloride was given to maintain the firmness of fresh-cut papaya cubes. 1% psyllium gum coating was found to yield better results. Further, addition of oil helped to maintain the quality and acted as a barrier to water vapour, therefore, minimizing the weight loss.

Keywords: coating, fresh-cut, gum, papaya, psylllium

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Authors: S. Bangphan, P. Bangphan, T.Boonkang

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Quality control helps industries in improvements of its product quality and productivity. Statistical Process Control (SPC) is one of the tools to control the quality of products that turning practice in bringing a department of industrial engineering process under control. In this research, the process control of a turning manufactured at workshops machines. The varying measurements have been recorded for a number of samples of a rice polished cylinder obtained from a number of trials with the turning practice. SPC technique has been adopted by the process is finally brought under control and process capability is improved.

Keywords: rice polished cylinder, statistical process control, control charts, process capability

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Authors: Caterina Grandi, Lukas Lochner, Marco Padovan, Mirco Rizzi, Paola Sperinde, Fabio Vittadello, Luisa Cavada

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Background: In recent years, the use of Complementary Alternative Medicine (CAM) has achieved worldwide popularity. With the increased public interest in CAMs, attention to it within Health Care Schools and Colleges has also improved. Studies generally assess the knowledge and attitudes regarding CAMs in medical and nursing students. The current study focused on the knowledge, attitudes and practice of CAM in healthcare students. Aim: To assess the knowledge and attitudes regarding complementary and alternative medicine (CAM) in healthcare students in South Tyrol, a region in Northern Italy. Methodology: This cross-sectional study was carried out among 361 students. Self-administered questionnaire was adapted and modified by the researchers from several questionnaires. The instrument consisted of three sections: 1) demographical characteristics (gender, place of residence and year of study); 2) general attitudes towards CAM, evaluated through 11 items using a Likert scale (agree, partly agree, partly disagree, disagree); 3) knowledge and use about any particular CAM practices (acupuncture, aromatherapy, creative therapies, diet/nutritional therapies, phytotherapy/herbal therapies, compresses, massage therapy, Ayurvedic therapy, Tibetan medicine, naturopathy, homeopathy, pet therapy, reflexology, therapeutic touch, chiropractic/osteopathy). Results: The sample consisted of 63 males and 297 females, 58% living in villages. 151 students (42%) were in the first year, 99 (27%) in the second and 106 (30%) in the third. Both men and women agreed with statements about the utility and benefits of CAMs. Women were significantly more likely than men to agree that the CAM practices should be included in the curriculum (p < 0.004), that the health professionals should be able to advice their patients about commonly used CAM methods (p < 0.002) and that the clinical care should integrate CAM practices (p < 0.04). Students in the second year showed the highest mean score for the statement 'CAM includes ideas and methods from which conventional medicine could benefit' (p = 0.049), highlighting a positive attitude, while students in the third year achieved the lowest mean score for the negative statement 'The results of CAM are in most cases due to a placebo effect'. Regarding this statement, participants living in villages disagreed significantly than students living in the city (p < 0.001). Females appeared to be significantly more familiar with homeopathy (p < 0.002), aromatherapy (p < 0.033), creative therapies (p < 0.001) and herbal therapies (p<0.002) than males. Moreover, women were likely to use CAM more frequently than men, particularly to solve psychological problems (p < 0.004). In addition, women perceived the benefit significantly more positive than men (p < 0.001). Students in the second year revealed to use the CAM mostly to improve the quality of life (p < 0.023), while students in the third year used CAMs particularly for chronic diseases (p < 0.001). Conclusions: Results from this study suggested that female students show more positive attitudes on CAM than male students. Moreover, the prevalence of CAM use and its perceived benefits differ between males and females, so that women are more willing to use CAM practices.

Keywords: attitude, CAM, complementary and alternative medicine, healthcare students, knowledge

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Authors: Maariyah Irfan

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Intro: Current cardiovascular (CV) care faces challenges such as low budgets and high hospital admission rates. This review aims to evaluate Big Data in CV healthcare management through the use of wearable devices in atrial fibrillation (AF) detection. AF may present intermittently, thus it is difficult for a healthcare professional to capture and diagnose a symptomatic rhythm. Methods: The iRhythm ZioPatch, AliveCor portable electrocardiogram (ECG), and Apple Watch were chosen for review due to their involvement in controlled clinical trials, and their integration with smartphones. The cost-effectiveness and AF detection of these devices were compared against the 12-lead ambulatory ECG (Holter monitor) that the NHS currently employs for the detection of AF. Results: The Zio patch was found to detect more arrhythmic events than the Holter monitor over a 2-week period. When patients presented to the emergency department with palpitations, AliveCor portable ECGs detected 6-fold more symptomatic events compared to the standard care group over 3-months. Based off preliminary results from the Apple Heart Study, only 0.5% of participants received irregular pulse notifications from the Apple Watch. Discussion: The Zio Patch and AliveCor devices have promising potential to be implemented into the standard duty of care offered by the NHS as they compare well to current routine measures. Nonetheless, companies must address the discrepancy between their target population and current consumers as those that could benefit the most from the innovation may be left out due to cost and access.

Keywords: atrial fibrillation, big data, cardiovascular healthcare management, wearable devices

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Authors: Izabela P. Vatanabe, Rafaela Peron, Patricia Manzine, Marcia R. Cominetti

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Introduction: Considering the increase in life expectancy of world population, there is an emerging concern in health services to allocate better care and care to elderly, through promotion, prevention and treatment of health. It has been observed that frailty syndrome is prevalent in elderly people worldwide and this complex and heterogeneous clinical syndrome consist of the presence of physical frailty associated with cognitive dysfunction, though in absence of dementia. This can be characterized by exhaustion, unintentional weight loss, decreased walking speed, weakness and low level of physical activity, in addition, each of these symptoms may be a predictor of adverse outcomes such as hospitalization, falls, functional decline, institutionalization, and death. Cognitive frailty is a recent concept in literature, which is defined as the presence of physical frailty associated with mild cognitive impairment (MCI) however in absence of dementia. This new concept has been considered as a subtype of frailty, which along with aging process and its interaction with physical frailty, accelerates functional declines and can result in poor quality of life of the elderly. MCI represents a risk factor for Alzheimer's disease (AD) in view of high conversion rate for this disease. Comorbidities and physical frailty are frequently found in AD patients and are closely related to heterogeneity and clinical manifestations of the disease. The decreased platelets ADAM10 levels in AD patients, compared to cognitively healthy subjects, matched by sex, age and education. Objective: Based on these previous results, this study aims to evaluate whether ADAM10 platelet levels of could act as a biomarker of cognitive frailty. Methods: The study was approved by Ethics Committee of Federal University of São Carlos (UFSCar) and conducted in the municipality of São Carlos, headquarters of Federal University of São Carlos (UFSCar). Biological samples of subjects were collected, analyzed and then stored in a biorepository. ADAM10 platelet levels were analyzed by western blotting technique in subjects with MCI and compared to subjects without cognitive impairment, both with and without presence of frailty. Statistical tests of association, regression and diagnostic accuracy were performed. Results: The results have shown that ADAM10/β-actin ratio is decreased in elderly individuals with cognitive frailty compared to non-frail and cognitively healthy controls. Previous studies performed by this research group, already mentioned above, demonstrated that this reduction is still higher in AD patients. Therefore, the ADAM10/β-actin ratio appears to be a potential biomarker for cognitive frailty. The results bring important contributions to an accurate diagnosis of cognitive frailty from the perspective of ADAM10 as a biomarker for this condition, however, more experiments are being conducted, using a high number of subjects, and will help to understand the role of ADAM10 as biomarker of cognitive frailty and contribute to the implementation of tools that work in the diagnosis of cognitive frailty. Such tools can be used in public policies for the diagnosis of cognitive frailty in the elderly, resulting in a more adequate planning for health teams and better quality of life for the elderly.

Keywords: ADAM10, biomarkers, cognitive frailty, elderly

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Authors: Luqman Afolabi

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This paper measures the impacts of trade and institutions on environmental quality in Sub-Saharan Africa (SSA). To examine the direction and the magnitude of the effects, the study employs the pooled mean group (PMG) estimation technique on the panel data obtained from the World Bank’s World Development and Governance Indicators, between 1996 and 2018. The empirical estimates validate the environmental Kuznets curve hypothesis (EKC) for the region, even though there have been inconclusive results on the environment – growth nexus. Similarly, a positive coefficient is obtained on the impact of trade on the environment, while the impact of the institutional indicators produce mixed results. A significant policy implication is that the governments of the SSA countries pursue policies that tend to increase economic growth, so that pollutants may be reduced. Such policies may include the provision of incentives for sustainable growth-driven industries in the region. In addition, the governance infrastructures should be improved in such a way that appropriate penalties are imposed on the pollutants, while advanced technologies that have the potentials to reduce environmental degradation should be encouraged. Finally, it is imperative from these findings that the governments of the region should promote their trade relations and the competitiveness of their local industries in order to keep pace with the global markets.

Keywords: environmental quality, institutional quality sustainable development goals, trade

Procedia PDF Downloads 142