Search results for: health care workers' knowledge

Authors: Shalitha Jayasekara, Saluk Bawantha, Dinithi Anupama, Isuru Gunarathne, Pradeepa Bandara, Hansi De Silva

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Dogs have been known as "man's best friend" for generations, providing friendship and loyalty to their human counterparts. However, due to people's busy lives, they are unaware of the ailments that can affect their pets. However, in recent years, mobile technologies have had a significant impact on our lives, and with technological improvements, a rule-based expert system allows the end-user to enable new types of healthcare systems. The advent of Android OS-based smartphones with more user-friendly interfaces and lower pricing opens new possibilities for continuous monitoring of pets' health conditions, such as healthy dogs, dangerous ingestions, and swallowed objects. The proposed ‘Best Bark’ Dog care and owner consultation system is a mobile application for dog owners. Four main components for dog owners were implemented after a questionnaire was distributed to the target group of audience and the findings were evaluated. The proposed applications are widely used to provide health and clinical support to dog owners, including suggesting exercise and diet plans and answering queries about their dogs. Additionally, after the owner uploads a photo of the dog, the application provides immediate feedback and a description of the dog's skin disease.

Keywords: Convolution Neural Networks, Artificial Neural Networks, Knowledgebase, Sentimental Analysis.

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Authors: Hualter Oliveira Barbosa, Raquel Feitosa do Vale Cunha, Erika Muniz dos Santos, Fernanda Belmira Souza, Fabio Sousa, Luis Henrique Pascareli, Franciney de Oliveira Lima, Ana Cláudia Reis da Silva, Christiane Moreira de Almeida

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Software development is intrinsic human-based knowledge-intensive. Due to globalization, software development has become a complex challenge and we usually face barriers related to knowledge management, team building, costly testing processes, especially in distributed settings. For this reason, several approaches have been proposed to minimize barriers caused by geographic distance. In this paper, we present as we use experimental studies to improve our knowledge management process using the Wiki system. According to the results, it was possible to identify learning preferences from our software projects leader team, organize and improve the learning experience of our Wiki and; facilitate collaboration by newcomers to improve Wiki with new contents available in the Wiki.

Keywords: mobile product, knowledge transfer, knowledge management process, wiki, GSD

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Authors: Madeline Tagg, Choihoong Mui, Elizabeth Lek, Jide Menakaya

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Introduction: Simulation technology is used by neonatal teams to learn and refresh skills and gain the knowledge and confidence to care for sick neonates. In-situ simulation is considered superior to laboratory-based programmes as it closely mirrors real life situations. This study reports our experience of running regular laboratory-based simulation sessions for senior clinicians and nurses and its impact on their knowledge, skills and confidence. Methods: A before and after questionnaire survey was carried out on senior clinicians and nurses that attended a scheduled laboratory-based simulation session. Participants were asked to document their expectations before a 3-hour monthly laboratory programme started and invited to feedback their reflections at the end of the session. The session included discussion of relevant clinical guidelines, immersion in a scenario and video led debrief. The results of the survey were analysed in three skills based categories - improved, no change or a worsened experience. Results: 45 questionnaires were completed and analysed. Of these 25 (55%) were completed by consultants seven and six by nurses and trainee doctors respectively, and seven respondents were unknown. 40 (88%) rated the session overall and guideline review as good/excellent, 39 respondents (86%) rated the scenario session good/excellent and 40/45 fed back a good/excellent debrief session. 33 (73%) respondents completed the before and after questionnaire. 21/33 (63%) reflected an improved knowledge, skill or confidence in caring for sick new-bon babies, eight respondents reported no change and four fed back a worse experience after the session. Discussion: Most respondents found the laboratory based structured simulation session beneficial for their professional development. They valued equally the whole content of the programme such as guideline review and equipment training as well as the simulation and debrief sessions. Two out three participants stated their knowledge of caring for sick new-born babies had been transformed positively by the session. Sessions where simulation equipment failed or relevant staff were absent contributed to a poor educational experience. Summary: A regular structured laboratory-based simulation programme with a rich content is a credible educational resource for improving the knowledge, skills and confidence of senior clinicians caring for sick new born babies.

Keywords: knowledge, laboratory based, neonates, simulation

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Authors: Roongtiwa Chobchuen, Siriporn Mongkholthawornchai, Boonsong Hatawaikarn, Uriwan Chaichangreet, Kobkaew Thongtid, Pusda Pukdeekumjorn, Panita Limpawattana

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Background: Age-friendly nursing service system in Srinagarind Hospital has been developed continuously based on the value and cultural background of Thailand which corporates with the modified WHO’s Age friendly Primary Care Service System. It consists of 3 issues; 1) development of staff training, 2) age-friendly service and 3) appropriate physical environment. Objective: To evaluate the efficacy of Age-friendly Nursing Service System: KKU (AFNS:KKU) model and to evaluate factors associated with nursing perception with AFN:KKU. Study design: Descriptive study Setting: 31 wards that served older patients in Srinagarind Hospital Populations: Nursing staff from 11 departments (31 wards) Instrument: Age-friendly nursing care scale as perceived by hospitalized older person Procedure and statistical analysis: All participants were asked questions using age-friendly nursing care scale as perceived by hospitalized older person questionnaires. Descriptive statistics and multiple logistic regression analyses were used to analyse the outcomes. Results: There were 337 participants recruited in this study. The majority of them were women (92%) with the mean ages of 29 years and 77.45% were nurse practitioners. They had average nursing experiences of 5 years. The average scores of age-friendly nursing care scale were high and highest in the area of attitude and communication. Age, sex, educational level, duration of work among, and having experience in aging training were not associated with nursing perception where type of department was an independent factor. Nurses from department of Surgery and Orthopedic, Eye and ENT, special ward and Obstetrics and Gynecological had significant greater perception than nurses from Internal Medicine Department (p < 0.05). Conclusion: Nurses had high scores in all dimensions of age-friendly concept. The result indicates that nurses have good attitude to aging care which can lead to improve quality of care. Organization should support other domains of ageing care to achieve greater effectiveness in geriatric care.

Keywords: age-friendly, nursing service system, excellence model, geriatric care

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Authors: Benbya Hind, Belbaly Nassim

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Markets and communities are often cast as alternative forms of knowledge sharing, but an open question is how and why people dynamically transition between them. To study these transitions, we design a technology that allows geographically distributed participants to either buy knowledge (using virtual points) or request it for free. We use a data-driven, inductive approach, studying 550 members in over 5000 interactions, during nine months. Because the technology offered participants choices between market or community forms, we can document both individual and collective transitions that emerge as people cycle between these forms. Our inductive analysis revealed that uncertainties endemic to knowledge sharing were the impetus for these transitions. Communities evoke uncertainties about knowledge sharing’s costs and benefits, which markets resolve by quantifying explicit prices. However, if people manipulate markets, they create uncertainties about the validity of those prices, allowing communities to reemerge to establish certainty via identity-based validation.

Keywords: knowledge sharing, communities, information technology design, transitions, markets

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Authors: Petros Dlamini, Bethiweli Malambo, Maggie Masenya

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Knowledge management practices are very important in public libraries, especial in the era of the information society. The success of public libraries depends on the recognition and application of knowledge management practices. The study investigates the value and challenges of knowledge management practices in public libraries. Three research objectives informed the study: to identify knowledge management practices in public libraries, understand the value of knowledge management practices in public libraries, and determine the factors hampering knowledge management practices in public libraries. The study was informed by the interpretivism research paradigm, which is associated with qualitative studies. In that light, the study collected data from eight librarians and or library heads, who were purposively selected from public libraries. The study adopted a social anthropological approach, which thoroughly evaluated each participant's response. Data was collected from the respondents through telephonic semi-structured interviews and assessed accordingly. Furthermore, the study used the latest content concept for data interpretation. The chosen data analysis method allowed the study to achieve its main purpose with concrete and valid information. The study's findings showed that all six (100%) selected public libraries apply knowledge management practices. The findings of the study revealed that public libraries have knowledge sharing as the main knowledge management practice. It was noted that public libraries employ many practices, but each library employed its practices of choice depending on their knowledge management practices structure. The findings further showed that knowledge management practices in public libraries are employed through meetings, training, information sessions, and awareness, to mention a few. The findings revealed that knowledge management practices make the libraries usable. Furthermore, it has been asserted that knowledge management practices in public libraries meet users’ needs and expectations and equip them with skills. It was discovered that all participating public libraries from Umkhanyakude district municipality valued their knowledge management practices as the pillar and foundation of services. Noticeably, knowledge management practices improve users ‘standard of living and build an information society. The findings of the study showed that librarians should be responsible for the value of knowledge management practices as they are qualified personnel. The results also showed that 83.35% of public libraries had factors hampering knowledge management practices. The factors are not limited to shortage of funds, resources and space, and political interference. Several suggestions were made to improve knowledge management practices in public libraries. These suggestions include improving the library budget, increasing libraries’ building sizes, and conducting more staff training.

Keywords: knowledge management, knowledge management practices, storage, dissemination

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Authors: Amira Khelil, Habib Affes

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The XXIst century is characterized by promoting teamwork as one of the main drivers of firms` performance. Collective competence is becoming crucial in developing and maintaining a firm’s competitive advantage, as well as its contributions to organizational innovation. In other words, the improvement of collective competence for a firm is no longer a choice, but rather an obligation. Learning capabilities of a firm in the context of knowledge management are assumed to be the main drivers of collective competence. Although there are some efforts to consider these concepts together; they are mostly discussed separately in the management theory. Thus, this paper aims to offer a holistic approach for development collective competence on the basis of Knowledge Management and Organizational Learning Capabilities. A theoretical model that defines a relationship between knowledge management, organizational learning and collective competence is presented at the end of this paper.

Keywords: collective competence, exploitation learning, exploration learning, knowledge management, organizational learning capabilities

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Authors: Muhammad Fayyaz Nazir, Ellen Wayenberg, Shahzadaah Faahed Qureshi

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Introduction: The study is based on the Contextual Interaction Theory (CIT) constructs to explore the role of policy actors in implementing the COVID-19 Disease Prevention and Control (DP&C) Policy. The study analyzes the role of healthcare workers' contextual factors, such as cognition, motives, and resources, and their interactions in implementing Social Distancing (SD). In this way, we test a two actors policy implementation theory, i.e., the CIT in a three-actor context. Methods: Data was collected through document analysis and semi-structured interviews. For a qualitative study design, interviews were conducted with questions on cognition, motives, and resources from the healthcare workers involved in implementing SD in the local context in Multan – Pakistan. The possible interactions resulting from contextual factors of the policy actors – healthcare workers were identified through framework analysis protocol guided by CIT and supported by trustworthiness criterion and data saturation. Results: This inquiry resulted in theory application, addition, and enrichment. The theoretical application in the three actor's contexts illustrates the different levels of motives, cognition, and resources of healthcare workers – senior administrators, managers, and healthcare professionals. The senior administrators working in National Command and Operations Center (NCOC), Provincial Technical Committees (PTCs), and Districts Covid Teams (DCTs) were playing their role with high motivation. They were fully informed about the policy and moderately resourceful. The policy implementors: healthcare managers working on implementing the SD within their respective hospitals were playing their role with high motivation and were fully informed about the policy. However, they lacked the required resources to implement SD. The target medical and allied healthcare professionals were moderately motivated but lack of resources and information. The interaction resulted in cooperation and the need for learning to manage the future healthcare crisis. However, the lack of resources created opposition to the implementation of SD. Objectives of the Study: The study aimed to apply a two actors theory in a multi actors context. We take this as an opportunity to qualitatively test the theory in a novel situation of the Covid-19 pandemic and make way for its quantitative application by designing a survey instrument so that implementation researchers can apply CIT through multivariate analyses or higher-order statistical modeling. Conclusion: Applying two actors' implementation theory in exploring a complex case of healthcare intervention in three actors context is a unique work that has never been done before, up to the best of our knowledge. So, the work will contribute to the policy implementation studies by applying, extending, and enriching an implementation theory in a novel case of the Covi-19 pandemic, ultimately fulfilling the gap in implementation literature. Policy institutions and other low or middle-income countries can learn from this research and improve SD implementation by working on the variables with weak significance levels.

Keywords: COVID-19, disease prevention and control policy, implementation, policy actors, social distancing

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Authors: Maciej Bialorudzki, Zbigniew Izdebski, Alicja Kozakiewicz, Joanna Mazur

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The quality of sleep is extremely important for physical and mental health, especially among professional groups exposed to the suffering of the people they serve. The aim of the study is to assess sleep quality and various aspects of physical and mental health. A nationwide cross-sectional survey conducted in the first quarter of 2022 included 2227 healthcare professionals from 114 Polish hospitals and specialized outpatient clinics. The following distribution for each professional group was obtained (22% doctors; 52.6% nurses; 7.3% paramedics; 10.1% other medical professionals; 7.9% other non-medical professionals). The mean age of the respondents was 46.24 (SD=11.53). The Jenkins Sleep Scale with four items (JSS-4) was used to assess sleep quality, yielding a mean value of 5.35 (SD=5.20) in the study group and 13.7% of subjects with poor sleep quality using the cutoff point of the mean JSS-4 sum score as >11. More often, women than men reported poorer sleep quality (14,8% vs. 9,1% p=0,002). Respondents with poor sleep quality were more likely to report occupational burnout as measured by the BAT-12 (43.1% vs. 12.9% p<0.001) and high levels of stress as measured by the PSS-4 (72.5% vs. 27.5% p<0.001). In addition, those who declare experiencing a traumatic event compared to those who have not experienced it has an almost two times higher risk of poorer sleep quality (OR:1.958; 95% CI:1.509-2.542; p<0.001). In contrast, those with occupational burnout had more than five times the risk of those without occupational burnout (OR:5.092; 95% CI: 3.763-6.889; p<0.001). Sleep quality remains an important predictor of stress levels, job burnout, and quality of life assessment.

Keywords: quality of sleep, medical staff, mental health, physical health, occupational burnout, stress

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Authors: Kayum Fokoue Carole

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This paper aims at verifying the effectiveness of reaching target populations while paying attention to their cultural background when communicating new knowledge, ideas or technology in a multicultural world. Our case study is an experiment on the communication of knowledge on breast cancer in three sub-Saharan countries (Ghana, Tchad, and Cameroon health). The methodology consisted of submitting a semi-structured questionnaire to local populations in some localities in these target countries in order to determine the cultural barriers hindering the effective communication of knowledge on breast cancer. Once this done, sensitization documents on breast cancer were translated into Ewe (Ghana), Mbaye (Tchad), Ghomala’, Ewondo, and Fufulde (Cameroon). In each locality, a sensitization programme was organised for two groups. For one group, the cultural barriers discovered were taken into consideration while communicating during the programme whereas in the other group, they were not. Another questionnaire was disseminated after three months to verify the level of appropriation of those who attended the campaign based on Chumbow’s appropriation theory. This paper, therefore, discusses some spiritual beliefs, representations and practices in the target African communities hindering effective communication of issues on breast cancer in the target localities. Findings reveal that only 38% of respondents in the group of those for whom cultural barriers were not taken into account during the programme had a high level of appropriation while for the other group, 86% had a high level of appropriation. This is evidence that the communication of issues on breast cancer can be more effective by reaching different populations in a language they best master while paying attention to their culture. Therefore, international communication of new knowledge should be culturally contextualised. Suggestions at the end of the paper are directed towards the achievement of these goals. The present work promotes international partnership in addressing and resolving global health preoccupations since research findings from one community/country can be mutualized in partnership with other communities and countries.

Keywords: cultural barriers, communication, health, breast cancer

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Authors: Baluku Nathan

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Transferring critically ill patients from one health facility to another poses a major risk to the patient because of increased oxygen demands. transferring patients with critical COVID-19 from a rural health canter in a rural district to a national referral hospital over 350 km in 7 hours would require three size H oxygen cylinders for successful transfer. It was always difficult to arrange the three size cylinders in the ambulance as workspace was greatly compromised for the ambulance assistant. Purpose: The purpose of this study was to investigate the impact and effectiveness of transport ventilators on the transportation of the critically ill patients from rural health canters to national referral hospitals in Uganda. Methodology: This was a descriptive cross-sectional study conducted in sept 2022 among critical care nurses and ambulance assistants who had used both methods of transportation (ventilators and cylinders). A semi structured questionnaire was used to collect quantitative data after informed consent. Results: From the findings, distribution of transport ventilators to the regional referral hospitals by the Ministry of Health has gradually improved patient transfer as the team requires less than one size oxygen cylinder to successfully transfer a patient. We use two ambulance assistants (a critical care nurse and another nurse who has been trained on use of the ventilator) when transferring patients with critical COVID-19 as the teams have to interchange over the long distance. Conclusions: Transport ventilators are effective and efficient in transferring critically ill patients, therefore should be rolled out to lower levels coupled with user training to improve outcomes of patients transferred in ambulances in lower income countries.

Keywords: emergency medical technician, critically ill, COVID-19, transport ventilator

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Authors: Jacqueline A. G. Sachett, Cláudia S. Nogueira, Diana C. P. Lima, Jessica T. S. Oliveira, Guilherme K. M. Salazar, Lílian K. Aguiar

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The Polo Amazon Telehealth offers several tools for professionals working in Primary Health Care as a second formative opinion, teleconsulting and training between the different areas, whether medicine, dentistry, nursing, physiotherapy, among others. These activities have a monthly schedule of free access to the municipalities of Amazonas registered. With this premise, and in partnership with the University of the State of Amazonas (UEA), is promoting the practice of the triad; teaching-research-extension in order to collaborate with the enrichment and acquisition of knowledge through educational practices carried out through teleconferences. Therefore, nursing is to join efforts and inserts as a collaborator of this project running, contributing to the education and training of these professionals who are part of the health system in full Amazon. The aim of this study is to report the experience of academic of Amazonas State University nursing course, about the experience in the extension project underway in Polo Telemedicine Amazon. This was a descriptive study, the experience report type, about the experience of nursing academic UEA, by extension 'Telenursing: teleconsulting and second formative opinion for FHS professionals in the state of Amazonas' project, held in Polo Telemedicine Amazon, through an agreement with the UEA and funded by the Foundation of Amazonas Research from July / 2012 to July / 2016. Initially developed active search of members of the Family Health Strategy professionals, in order to provide training and training teams to use the virtual clinic, as well as the virtual environment is the focus of this tool design. The election period was an aggravating factor for the implementation of teleconsulting proposal, due to change of managers in each municipality, requiring the stoppage until they assume their positions. From this definition, we established the need for new training. The first video conference took place on 03.14.2013 for learning and training in the use of Virtual Learning Environment and Virtual Clinic, with the participation of municipalities of Novo Aripuanã, São Paulo de Olivença and Manacapuru. During the whole project was carried out literature about what is being done and produced at the national level about the subject. By the time the telenursing project has received twenty-five (25) consultancy requests. The consultants sent by nursing professionals, all have been answered to date. Faced with the lived experience, particularly in video conferencing, face to cause difficulties issues, such as the fluctuation in the number of participants in activities, difficulty of participants to reconcile the opening hours of the units with the schedule of video conferencing, transmission difficulties and changes schedule. It was concluded that the establishment of connection between the Telehealth points is one of the main factors for the implementation of Telenursing and that this feature is still new for nursing. However, effective training and updating, may provide to these professional category subsidies to quality health care in the Amazon.

Keywords: Amazon, teleconsulting, telehealth, telenursing

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Authors: Peter Kutis, Vladimir Littva

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Nowadays, it is necessary to ensure that this reduction in costs is not at the expense of the quality of health care and future medical success. In general, physiotherapy for total hip joint arthroplasty is considered to be a routine matter that deals mainly with mobility training, increased muscular strength, and basic day-to-day activities such as bed-to-chair transition, standing, and walking. Within the KEGA project no. 003KU-4-2021, we decided to investigate preoperative physiotherapy care in Slovakia and Austria in total hip arthroplasty patients to shortened overall recovery. Research Sample and Methods: The sample comprised 498 respondents –patients who were indicated to total hip arthroplasty on the territory of Slovakia and Austria. There were 130 women in Slovakia and 135 women in Austria. The numbers of men were 120 in Slovakia and 113 men in Austria. The age of respondents was between 40 and 85 years of age. As a method of our research, we chose a non-standardized questionnaire, which consisted of three parts. The first part for the initial examination of the patient contained the identification of the patient according to the assigned number and subsequently 19 questions conditioned by the physical examination and evaluation of the patients. The second part of our questionnaire was completed after the patient's hospitalization and contained 10 questions that were conditioned by the patient's examination. The last third part for the overall assessment of the patient's state of health consisted of 12 questions conditioned by the patient's examination. This part was performed at the last meeting with the patient at the end of the treatment. All data were statistically processed by SPSS 25. Results: All data were evaluated at a significance level of p = 0.05. From the comparison of patients who underwent preoperative preparation, we can clearly state that the total duration of treatment is significantly shorter. A t-test of two mean values with uneven variance was used to verify the validity of the assumption. The total duration of treatment in patients with preoperative preparation was on average 92,635 days and without preoperative preparation was on average 135,884 days (t-Stat = 44,52784, t Critical one-tail = 1,648187415, t Critical two-tail = 1,965157). Conclusion: The results obtained during the research show the importance of adequate preoperative physiotherapeutic preparation of the patient. The results of total hip joint arthroplasty studies showed a significant reduction in a hospital stay as well as shortened total treatment time.

Keywords: THA, physiotherapy, recovery, preoperative physiotherapy care

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Authors: Wed Othman Alghamdi

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The current study aims to find a non-toxic, low density, hydrogen-rich material that can be used in aprons without causing health issues for nuclear medical workers that could hinder their work and negatively affect patients. Five samples were tested in terms of fast neutron removal cross-section(C21H25ClO5, C2H4, LiH,H3NBH3,MgH2) mathematically using computer program called Phy-x/PSD it is a computer program designed to calculate the fast neutron removal cross section, and it was obtained that ammonia borane (𝐻3𝑁𝐵𝐻3) with a density of 0.78 (g/ cm3) ,And it containment of the three most important elements that play a major role in protection shields, which are (hydrogen, boron, nitrogen), Hydrogen works as a moderator that slows neutrons and turn them into thermal neutrons, boron and nitrogen both have the largest neutron absorption cross section. Ammonia borane has the highest fast neutron removal cross-section with the value of (0.122959317985393cm-1) and the least for polyethylene (𝐶2𝐻4) with the value of (0.0838038707225853 cm-1) which made the ammonia borane a better candidate than polyethylene and other compounds that have been tasted in previous research for multi-layer aprons in nuclear medicine, and may approve a proper protection against the hazard radiations that its produced in nuclear medicine filed by several ways, due to it is low density and non-toxicity.

Keywords: aprons, radiation, non-toxic, nuclear medicine, neutrons

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Authors: Lu-Chiu Huang, Pei-Pei Chen, Li-Chin Yu, Chiao-Wen Kuo, Tsui-Tao Liu, Rung-Chuang Feng

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Purpose: People put increasing emphasis on demands of medical quality and protecting their interests. Patients' or family's dissatisfaction with medical care may easily lead to medical dispute. Physician-family communication plays an essential role in medical care. A sound communication cannot only strengthen patients' belief in the medical team but make patient have definite insight into treatment course of the disease. A family meeting provides an effective platform for communication between clinical staff, patients and family. Decisions and consensuses formed in family meetings can promote patients' or family's satisfaction with medical care. Clinical staff's attitudes toward family meeting may determine behavioral intentions to hold family meeting. This study aims to explore clinical staff's difficulties in holding family meeting and evaluate how their attitudes and behavior influence the effect of family meetings. Methods: This was a cross-sectional study. It was conducted at a regional teaching hospital in Taipei city. The research team developed its own structural questionnaires, whose expert validity was checked by the nursing experts. Participants filled in the questionnaires online. Data were collected by convenience sampling. A total of 568 participants were invited. They included doctors, nurses, social workers, and so on. Results: 1) The average score of ‘clinical staff’s attitudes to family meetings’ was 5.15 (SD=0.898). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It indicated that clinical staff had positive attitudes toward family meetings, 2) The average score of ‘clinical staff’s behavior to family meetings’ was 5.61 (SD=0.937). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It meant clinical staff tended to have positive behavior at the family meeting, and 3) The average score of ‘Difficulty in conducting family meetings’ was 5.15 (SD=0.897). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. The higher the score was, the less difficulty the clinical staff felt. It demonstrated clinical staff felt less difficulty in conducting family meetings. Clinical staff's identification with family meetings brought favored effects. Persistent and active promotion for family meetings can bring patients and family more benefits. Implications for practice: Understanding clinical staff's difficulty in participating family meeting and exploring their attitudes or behavior toward physician-family communication are helpful to develop modes of interaction. Consequently, quality and satisfaction of physician-family communication can be increased.

Keywords: clinical staff, communication, family meeting, physician-family

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Authors: Stela Doncheva

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Postpartum distress, encompassing depressive symptoms, obsessions, and anxiety, remains a subject of significant scientific interest due to its prevalence among individuals giving birth. This critical and transformative period presents a multitude of factors that impact women's health. On the one hand, variables such as social support, satisfaction in romantic relationships, shared newborn care, and birth satisfaction directly affect the mental well-being of new mothers. On the other hand, the interplay of hormonal changes, personality characteristics, emotional difficulties, and the profound life adjustments experienced by mothers can profoundly influence their self-esteem and overall physical and emotional well-being. This paper extensively explores the factors of alexithymia, social support, partners' support, and birth satisfaction to gain deeper insights into their impact on postpartum distress. Utilizing a qualitative survey consisting of six self-reflective questionnaires, this study collects valuable data regarding the individual postpartum experiences of Bulgarian mothers. The primary objective is to enrich our understanding of the complex factors involved in the development of postpartum distress during this crucial period. The results shed light on the intricate nature of the problem and highlight the significant influence of bio-psycho-social elements. By contributing to the existing knowledge in the field, this research provides valuable implications for the development of interventions and support systems tailored to the unique needs of mothers in the postpartum period. Ultimately, this study aims to improve the overall well-being of new mothers and promote optimal maternal health during the postpartum journey.

Keywords: maternal mental health, postpartum distress, postpartum depression, postnatal mothers

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Authors: Hazlin Kadir Shahar, Razaleigh Muhamat Kawangit, Badlihisham Mohd Nasir, Rosmawati Mohamad Rasit

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Stigma and discrimination have become the main topic of discussion when dealing with HIV/AIDS issues. They affect the daily life of People Living With HIV(PLHIV), families, friends and people around them indirectly. This paper discusses the potential measurement in helping to reduce stigma and discrimination existence among Islamic Religious Officers towards PLHIV in Malaysia. These people have been trained with special programmes to tackle the HIV/AIDS issues by using a manual, namely as ‘The Manual of Islam and HIV/AIDS’, specifically designed by the Islamic Development Department of Malaysia (JAKIM). The objectives of the training programmes are to give the accurate information about HIV/AIDS and to suggest ways on how to handle the PLHIV issues in Islamic perspective. This research used quantitative methodology by survey. A pilot test had been done over thirty (30) trained Islamic Religious Officers in Malaysia. The findings have shown that the trainings have given a positive impact for them as they managed to acquire the knowledge of HIV/AIDS from both primer and authorized sources such as medical practitioners, Muslim chaplains and social workers. The knowledge they have acquired from the trainings has guided them in changing their perception, thus helping to reduce their own stigma and discrimination towards PLHIV. The training programmes have given them opportunities to practice what they have learned through several outreach sessions as they have had the opportunities to approach PLHIV directly.

Keywords: Islamic religious officers, people with HIV, stigma and discrimination, training programmes

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Authors: Liu Yi Hui, Chun-Liang Lai, Jhang Yu Cih, He You Jing, Chiu Fan-Yun, Lin Yu Fang

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For universities offering long-term care education, the inclusion of adulting learning and practices in professional courses as appropriate based on holistic design and evaluation could improve talent empowerment by leveraging social capital. Moreover, it could make the courses and materials used in long-term care education responsive to real-life needs. A mixed research method was used in the research design. A quantitative study was also conducted using a questionnaire survey, and the data were analyzed by SPSS 22.0 Chinese version. The qualitative data included students’ learning files (learning reflection notes, course reports, and experience records).

Keywords: adult learning, community empowerment, social capital, mixed research

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Authors: Jung Lee

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The last decade has witnessed more people than ever before using social media and broadening their social circles. Social media users connect not only with their friends but also with professional acquaintances, primarily coworkers, and clients; personal and professional social circles are mixed within the same social media platform. Considering the positive aspect of social media in facilitating communication and mutual understanding between individuals, we infer that social media interactions with co-workers could indeed benefit one’s professional life. However, given privacy issues, sharing all personal details with one’s co-workers is not necessarily the best practice. Should one connect with coworkers via social media? Will social media connections with coworkers eventually benefit one’s long-term career? Will the benefit differ across cultures? To answer, this study examines how social media can contribute to organizational communication by tracing the foundation of user motivation based on social capital theory, leader-member exchange (LMX) theory and expectancy theory of motivation. Although social media was originally designed for personal communication, users have shown intentions to extend social media use for professional communication, especially when the proper incentive is expected. To articulate the user motivation and the mechanism of the incentive expectation scheme, this study applies those three theories and identify six antecedents and three moderators of social media use motivation including social network flaunt, shared interest, perceived social inclusion. It also hypothesizes that the moderating effects of those constructs would significantly differ based on the relationship hierarchy among the workers. To validate, this study conducted a survey of 329 active social media users with acceptable levels of job experiences. The analysis result confirms the specific roles of the three moderators in social media adoption for organizational communication. The present study contributes to the literature by developing a theoretical modeling of ambivalent employee perceptions about establishing social media connections with co-workers. This framework shows not only how both positive and negative expectations of social media connections with co-workers are formed based on expectancy theory of motivation, but also how such expectations lead to behavioral intentions using career success model. It also enhances understanding of how various relationships among employees can be influenced through social media use and such usage can potentially affect both performance and careers. Finally, it shows how cultural factors induced by social media use can influence relations among the coworkers.

Keywords: the social network, workplace, social capital, motivation

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Authors: Adisu Mengesha Assefa

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The field of cardiovascular care is being transformed by the incorporation of Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR), collectively known as Extended Reality (XR), into medical education, procedural planning, and patient care. This review examines the state-of-the-art applications of XR in cardiology, emphasizing its role in enhancing the precision of interventional procedures and understanding complex anatomical structures. XR technologies complement conventional imaging methods by enabling immersive three-dimensional interaction that facilitates both preoperative planning and intraoperative guidance. Despite these promising developments, challenges such as harmonizing data, integrating various imaging systems, and addressing the prevalence of cybersickness remain. Ethical considerations, including maintaining physician focus and ensuring patient safety, are crucial when implementing XR in clinical settings. This review summarizes the existing literature and highlights the need for more rigorous future studies to validate therapeutic benefits and ensure safe application. By examining both the potential and the challenges, this paper aims to delineate the current and future roles of XR in cardiovascular care, emphasizing the necessity for continued innovation and ethical oversight to improve patient outcomes.

Keywords: virtual reality, augmented reality, mixed reality, cardiovascular care, education, preprocedural planning, intraoperative guidance, postoperative patient rehabilitation

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Authors: Rosemary R. Carlton, Roxane Caron

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Almost three decades ago, bell hooks (1994) identified the classroom as “the most radical space of possibility in the academy”. A feminist scholar, educator, and activist, hooks urged educators to transgress the boundaries of what might be customary or considered acceptable in teaching, thus encouraging the pursuit of new ways of knowing and different strategies for sharing knowledge. This paper reflects upon a particular response to hooks’ still relevant call for transgression in teaching. Specifically, this paper reports on the design, implementation, and preliminary analysis of a social work course integrating active pedagogy and transnational exchange to encourage students’ critical thinking and autonomous learning in their development as social workers in a global context. The bachelor’s level course, Pratiques spécifiques: Projet international, was developed collaboratively across three francophone institutions of higher learning in Belgium, Canada, and France: the Haute École de Namur-Liège-Luxembourg (Hénallux); the Université de Montréal; and, the Institut d’enseignement supérieur et professionnel, l’IRTS Paris Île-de-France. The driving aims of the course are to promote autonomous learning and critical thinking through a lens of transnational understandings of social problems -competencies indispensable to students’ development as social workers. The course is offered to two paired cohorts, one addressing the subject of “migrations” (Canada/France) and the other the subject of “sexual exploitation” (Canada/Belgium). Through the adaptation of a critical pedagogy of problem-based learning, students are called upon to actively engage in acquiring and applying knowledge to respond to “real life” social issues relating to migration or sexual exploitation. At the conclusion of the course, each cohort of students is brought together for a week-long intensive period of transnational exchange either at the Université de Montréal in Canada or at Hénallux in Belgium. Extending the bounds of the classroom across international borders allows students novel opportunities to deepen and expand their understandings of issues relating to predefined social issues and to critically examine associated social work practices. The paper opens with a presentation of the social work course. Specifically, the authors will outline their adaptation of a pedagogy of problem-based learning integrating transnational exchange in the design and implementation of the course. Returning to hooks’ notion of transgression in teaching, the paper offers a preliminary analysis of how and with what effect the course provides opportunities to transgress hierarchical student-teacher relationships; transgress conventional modes of learning to explore diverse sources of knowledge and transgress the walls of the university to engage with and learn from local and global partners. The paper concludes with a consideration of the potential influence of such transgressions in teaching for students’ development of critical thinking in their practice of social work in global context.

Keywords: active learning, critical pedagogy, social work intervention, transnational learning

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Authors: Piyaorn Wajanatinapart, Diane R. Lauver

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The number of persons with dementia (PWD) has increased. Informal caregivers are the major providing care. They can have perceived gains and burdens. Caregivers who reported high in perceived gains may report low in burdens and better health. Gaps of caregiving literature were: no report psychometrics in a few studies and unclear definitions of gains; most studies with no theory-guided and conducting in Western countries; not fully described relationships among caregiving variables: motivations, satisfaction with psychological needs, social support, gains, burdens, and physical and psycho-emotional health. Those gaps were filled by assessing psychometric properties of selected measures, providing clearly definitions of gains, using self-determination theory (SDT) to guide the study, and developing the study in Thailand. The study purposes were to evaluate six measures for internal consistency reliability, content validity, and construct validity. This study also examined relationships of caregiving variables: motivations (controlled and autonomous motivations), satisfaction with psychological needs (autonomy, competency, and relatedness), perceived social support, perceived gains, perceived burdens, and physical and psycho-emotional health. This study was a cross-sectional and correlational descriptive design with two convenience samples. Sample 1 was five Thai experts to assess content validity of measures. Sample 2 was 146 Thai caregivers of PWD to assess construct validity, reliability, and relationships among caregiving variables. Experts rated questionnaires and sent them back via e-mail. Caregivers answered questionnaires at clinics of four Thai hospitals. Data analysis was used descriptive statistics and bivariate and multivariate analyses using the composite indicator structural equation model to control measurement errors. For study results, most caregivers were female (82%), middle age (M =51.1, SD =11.9), and daughters (57%). They provided care for 15 hours/day with 4.6 years. The content validity indices of items and scales were .80 or higher for clarity and relevance. Experts suggested item revisions. Cronbach’s alphas were .63 to .93 of ten subscales of four measures and .26 to .57 of three subscales. The gain scale was acceptable for construct validity. With controlling covariates, controlled motivations, the satisfaction with three subscales of psychological needs, and perceived social support had positive relationships with physical and psycho-emotional health. Both satisfaction with autonomy subscale and perceived social support had negative relationship with perceived burdens. The satisfaction with three subscales of psychological needs had positive relationships among them. Physical and psycho-emotional health subscales had positive relationships with each other. Furthermore, perceived burdens had negative relationships with physical and psycho-emotional health. This study was the first use SDT to describe relationships of caregiving variables in Thailand. Caregivers’ characteristics were consistent with literature. Four measures were valid and reliable except two measures. Breadth knowledge about relationships was provided. Interpretation of study results was cautious because of using same sample to evaluate psychometric properties of measures and relationships of caregiving variables. Researchers could use four measures for further caregiving studies. Using a theory would help describe concepts, propositions, and measures used. Researchers may examine the satisfaction with psychological needs as mediators. Future studies to collect data with caregivers in communities are needed.

Keywords: caregivers, caregiving, dementia, measures

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Authors: Aseela Alhinaai, Suliman Abdullah, Adil Albusaidi

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Knowledge has been considered an important asset in private and public organizations. It is utilized in the libraries sector to run different operations of technical services and administrative works. As a result, the International Federation of Library Association (IFLA) established a department “Knowledge Management” in December 2003 to provide a deep understanding of the KM concept for professionals. These are implemented through different programs, workshops, and activities. This study aims to identify the impact of the knowledge-sharing factors (technology, collaboration, management support) to improve decision-making at Sultan Qaboos University Libraries. This study conducted a quantitative method using a questionnaire instrument to measure the impact of technology, collaboration, and management support on knowledge sharing that lead to improved decision-making. The study population is the (SQU) libraries (Main Library, Medical Library, College of Economic and political science library, and Art Library). The results showed that management support, collaboration, and technology use have a positive impact on the knowledge-sharing process, and knowledge-sharing positively affects the decision making process.

Keywords: knowledge sharing, decision-making, information technology, management support, corroboration, Sultan Qaboos University

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Authors: Md, MCS, MPH Munyangi Wa Nkola Jerome

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The pandemic of COVID-19, a recently discovered contagious respiratory disease called SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus 2 Majority of people infected with SARS-CoV-2: Asymptomatic or mildly ill 14% of patients will develop severe illness requiring hospitalization and oxygen support, and 5% of these will be transferred to an intensive care unit, Urgent need for new treatments that can be used quickly to avoid transfer of patients to intensive care and death. Objective: To evaluate the clinical activity (efficacy) of ArtiCovid Hypothesis: Administration of 3 times a teaspoon per day by COVID patients (symptomatic, mild, or moderate forms) results in the disappearance of symptoms and improvement of biological parameters (including viral suppression). Clinical efficacy: the disappearance of clinical signs after seven days of treatment; reduction in the rate of patients transferred to intensive care units for mechanical ventilation and a decrease in mortality related to this infection Paraclinical efficacy: improvement of biological parameters (mainly d-dimer, CRP) Virological efficacy: suppression of the viral load after seven days of treatment (control test on the seventh day is negative) Pilot study using a standardized solution based on Artemisia annua (ARTICOVID) Obtaining authorization from the health authorities of the province of Central Kongo Recruitment of volunteer patients, mainly in the Kinkanda HospitalCarrying out tests before and after treatment as well as analyses before and after treatment. The protocol obtained the approval of the ethics committee 50 patients who completed the treatment were aged between 2 and 70 years, with an average age of 36 yearsMore half were male (56%). One in four patients was a health professional (25%) Of the 12 health professionals, 4 were physicians. For those who reported the date of onset of the disease, the average duration between the appearance of the first symptoms and the medical consultation was 5 days. The 50 patients put on ARTICOVID were discharged alive with CRP levels substantially normalizedAfter seven to eight days, the control test came back negative. This pilot study suggests that ARTICOVID may be effective against COVID-19 infection.

Keywords: artiCovid, DRC, Covid-19, SARS_COV_2

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Authors: Mahmoud M. AbuAlSamen, Tamam El-Elimat

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Amid the economic crisis in Jordan, the Jordanian government has opted for a knowledge economy where education is promoted as a mean for economic development. University education usually comes at the expense of study-related stress that may adversely impact the health of students. Since stress is a latent variable that is difficult to measure, a valid tool should be used in doing so. The effort-reward imbalance (ERI) is a model used as a measurement tool for occupational stress. The model was built on the notion of reciprocity, which relates ‘effort’ to ‘reward’ through the mediating ‘over-commitment’. Reciprocity assumes equilibrium between both effort and reward, where ‘high’ effort is adequately compensated with ‘high’ reward. When this equilibrium is violated (i.e., high effort with low reward), this may elicit negative emotions and stress, which have been correlated to adverse health conditions. The theory of ERI was established in many different parts of the world, and associations with chronic diseases and the health of workers were explored at length. While much of the effort-reward imbalance was investigated in work conditions, there has been a growing interest in understanding the validity of the ERI model when applied to other social settings such as schools and universities. The ERI questionnaire was developed in Arabic recently to measure ERI among high school teachers. However, little information is available on the validity of the ERI questionnaire in university students. A cross-sectional study was conducted on 833 students in Jordan to measure the validity and reliability of the ERI questionnaire in Arabic among university students. Reliability, as measured by Cronbach’s alpha of the effort, reward, and overcommitment scales, was 0.73, 0.76, and 0.69, respectively, suggesting satisfactory reliability. The factorial structure was explored using principal axis factoring. The results fitted a five-solution model where both the effort and overcommitment were uni-dimensional while the reward scale was three-dimensional with its factors, namely being ‘support’, ‘esteem’, and ‘security’. The solution explained 56% of the variance in the data. The established ERI theory was replicated with excellent validity in this study. The effort-reward ratio in university students was 1.19, which suggests a slight degree of failed reciprocity. The study also investigated the association of effort, reward, overcommitment, and ERI with participants’ demographic factors and self-reported health. ERI was found to be significantly associated with absenteeism (p < 0.0001), past history of failed courses (p=0.03), and poor academic performance (p < 0.001). Moreover, ERI was found to be associated with poor self-reported health among university students (p=0.01). In conclusion, the Arabic ERI questionnaire is reliable and valid for use in measuring effort-reward imbalance in university students in Jordan. The results of this research are important in informing higher education policy in Jordan.

Keywords: effort-reward imbalance, factor analysis, validity, self-reported health

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Authors: F. Forouharmajd, S. Pourabdian, N. Ziayi Ghahnavieh

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For many years, the ear protectors have been used to preventing the audio and non-audio effects of received noise from occupation environments. Despite performing hearing protection programs, there are many people which still suffer from noise-induced hearing loss. This study was conducted with the aim of determination of human hearing system response to received noise and the effectiveness of ear protectors on preventing of noise-induced hearing loss. Sound pressure microphones were placed in a simulated ear canal. The severity of noise measured inside and outside of ear canal. The noise reduction values due to installing ear protectors were calculated in the octave band frequencies and LabVIEW programmer. The results of noise measurement inside and outside of ear canal showed a different in received sound levels by ear canal. The effectiveness of ear protectors has been considerably reduced for the low frequency limits. A change in resonance frequency also was observed after using ear protectors. The study indicated the ear canal structure may affect the received noise and it may lead a difference between the received sound from the measured sound by a sound level meter, and hearing system. It means the human hearing system may probably respond different from a sound level meter. Hearing protectors’ efficiency declines by increasing the noise levels, and thus, they are not suitable to protect workers against industrial noise particularly low frequency noise. Hearing protectors may be solely a reason to damaging of hearing system in a special frequency via changing of human hearing system acoustical structure. We need developing the subjective method of hearing protectors testing, because their evaluation is not designed based on industrial noise or in the field.

Keywords: ear protector, hearing system, occupational noise, workers

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Authors: Lucie Cote, Isabelle Rodier

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The main objective of the research was to identify demonstrated mechanisms promoting psychological well-being and psychological health in the workplace, and to take a critical look at the 'National Standard of Canada for Psychological Health and Safety in the Workplace - Prevention, Promotion and Guidance to Staged Implementation (Standard)' as a mechanism to promote the psychological well-being and psychological health in the workplace. A review of the scientific literature was conducted, and a case study was done using data from a Canadian federal department. The following six mechanisms with an efficiency supported by most of the studies reviewed were identified: improving psychological well-being in the workplace literacy; strengthening the resilience of employees; creating an environmentally friendly and healthy workplace; promoting a healthy lifestyle; taking into account psychological characteristics in the drafting of job descriptions and tasks during the hiring process; and offering psychological self-care tools. The Standard offers several mechanisms beyond those previously identified and their implementation can be demanding. Research based on objective data and addressing the magnitude of the effect would be required.

Keywords: critical review, national standard of Canada, psychological health, workplace

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Authors: Jui Chen Wu, Ming Yi Hsu

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Background and Purpose: Shift work of nursing staff is inevitable in hospital to provide continuing medical care. However, shift work is considered as a health hazard that may cause physical and psychological problems. Serious workplace fatigue of nursing shift work might impact on family, social and work life, moreover, causes serious reduction of quality of medical care, or even malpractice. This study aims to explore relationships among nursing staff’s shift, workplace fatigue and quality of working life. Method: Structured questionnaires were used in this study to explore relationships among shift work, workplace fatigue and quality of working life in nursing staffs. We recruited 590 nursing staffs in different Community Teaching hospitals in Taiwan. Data analysed by descriptive statistics, single sample t-test, single factor analysis, Pearson correlation coefficient and hierarchical regression, etc. Results: The overall workplace fatigue score is 50.59 points. In further analysis, the score of personal burnout, work-related burnout, over-commitment and client-related burnout are 57.86, 53.83, 45.95 and 44.71. The basic attributes of nursing staff are significantly different from those of workplace fatigue with different ages, licenses, sleeping quality, self-conscious health status, number of care patients of chronic diseases and number of care people in the obstetric ward. The shift variables revealed no significant influence on workplace fatigue during the hierarchical regression analysis. About the analysis on nursing staff’s basic attributes and shift on the quality of working life, descriptive results show that the overall quality of working life of nursing staff is 3.23 points. Comparing the average score of the six aspects, the ranked average score are 3.47 (SD= .43) in interrelationship, 3.40 (SD= .46) in self-actualisation, 3.30 (SD= .40) in self-efficacy, 3.15 (SD= .38) in vocational concept, 3.07 (SD= .37) in work aspects, and 3.02 (SD= .56) in organization aspects. The basic attributes of nursing staff are significantly different from quality of working life in different marriage situations, education level, years of nursing work, occupation area, sleep quality, self-conscious health status and number of care in medical ward. There are significant differences between shift mode and shift rate with the quality of working life. The results of the hierarchical regression analysis reveal that one of the shifts variables 'shift mode' which does affect staff’s quality of working life. The workplace fatigue is negatively correlated with the quality of working life, and the over-commitment in the workplace fatigue is positively related to the vocational concept of the quality of working life. According to the regression analysis of nursing staff’s basic attributes, shift mode, workplace fatigue and quality of working life related shift, the results show that the workplace fatigue has a significant impact on nursing staff’s quality of working life. Conclusion: According to our study, shift work is correlated with workplace fatigue in nursing staffs. This results work as important reference for human resources management in hospitals to establishing a more positive and healthy work arrangement policy.

Keywords: nursing staff, shift, workplace fatigue, quality of working life

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Authors: Manal Ahmed, Amal Shehata, Shereen Deeb

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The study's purpose was to determine the effect of the perioperative protocol of care on clinical outcomes among patients undergoing coronary artery bypass graft. Subjects: A sample of 100 adult patients who were planned for coronary artery bypass graft, were selected and divided alternatively and randomly into two equal groups (50 study -50 control).The study was carried out at National heart Institute in Cairo and open heart surgical intensive care unit in Shebin El-Kom Teaching Hospital. Instruments: Four instruments were used for data collection: Interviewing questionnaire, dyspnea analogue scale, Biophysiological measurement instrument, and Compliance assessment sheet. Results: There were statistically significant differences between both groups regarding most respiratory system assessment findings at discharge. More than two-thirds of the study group of the current study had a continuous and regular commitment to diet regimen, which ranked first followed by the compliance of daily living activities then quitting smoking. Conclusions: The perioperative protocol of care has a significant improving effect on respiratory findings, dyspnea degree, duration of mechanical ventilation, length of hospital stay, compliance to diet, therapeutic regimen, daily living activities, and quit smoking among study group undergoing CABG. Recommendations: Perioperative protocol of care should be carried out for CABG patients at open-heart surgical units as well as an illustrative colored booklet about CAD, CABG and perioperative care should be available and distributed to all CABG patients.

Keywords: perioperative, effect, clinical outcomes, coronary artery, bypass graft, protocol of care

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Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

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Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: catchment area of healthcare, chronic disease management, Geographic information system, quality of diabetes care

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