Search results for: reduced private care use

Authors: Tahsien Okasha

Abstract:

Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page.". The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: organ transplant, clinical pathway, postoperative care, same page

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Authors: Tahsien Okasha

Abstract:

Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page." .The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: postoperative care, organ transplant, clinical pathway, patient

Procedia PDF Downloads 459

Authors: S. O. Ayansina, O. A. Adekunle

Abstract:

There is an increasing demand for a functional extension delivery services in Nigeria with a view to meet up with the food and fiber needs of the ever growing population of human and animal respectively. The study was therefore designed to examine the farmers’ preference for public and private extension services in Southwestern Nigeria, specifically to determine the farmers’ level of participation in the two types of organizations involved and also to evaluate the Performance level of personnel in the two organizations in order to ascertain the beneficiaries’ satisfaction. A multi-stage random sampling technique was used to samples 30 respondents from each of the three selected organizations in each of the three states sampled in Southwestern Nigeria. Hence, 270 respondents were sampled for the study. Data collected were analyzed with Kruskal Wallis one-way Analysis of variance to test the difference between the participation of beneficiaries in the public and private extension services and the level of benefit accrued from the two organizations involved in the study. Results generally revealed that private organizations were performing better and were more preferred by the beneficiaries. Results of the tested hypotheses as shown by Kruskal Wallis test of difference (x2=0.709) indicates no significant difference between farmers’ participation in the extension services of public and private organizations but however shows significant difference (X2=12.074) in the benefits achieved by respondents in the two organizations, such benefits include: increased quantity of Crop produced, farm income, skill acquisition, and improved Education in private extension organizations. Based on this result, it could be inferred that beneficiaries generally preferred private extension organizations because of their effectiveness and vibrancy in programme administration. Public extension is therefore recommended for general overhauling and possibly “merging” of public and private sectors in order to cater for teeming population of farmers demanding for efficient and functional extension services to better their lots both in production and processing.

Keywords: public and private involvement, extension services, farmers’ preferences, Kruskal Wallis Test

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Authors: Kiana Taghikhan, Shamim Sherafat, Mostafa Taheri

Abstract:

Although many people with autism spectrum disorder around the world face many problems and challenges, their conditions may unintentionally affect the lives of the people around them. In this research the experiences of siblings of autistic children have been investigated in both the public and private spheres of their lives. "Private sphere" includes the experiences of research participants in socializing with relatives and family, assignments and responsibilities, as well as how they spend their leisure time and lifestyle. The "public sphere" includes the experience of their presence in society, such as university, or workplace and any outdoor activities that could have been affected by their sibling’s disorder. The present research has been done using the qualitative research method and in-depth interview technique with siblings of autistic children. The sample population is 15 individuals who participated in the research theoretically and purposefully. Based on the findings, the private and social experiences of these individuals is very different compared to peers who do not have siblings with autism disorder in the family. The difference is to such an extent that causes them to separate and distance themselves from other members of the society, and depending on their special conditions, it can affect their goals and life opportunities such as job, marriage, having children, etc.

Keywords: autism spectrum disorder, siblings, private sphere, public sphere

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Authors: Lukasz Grzegorz Broda, Taiwo Oseni, Andrew Stranieri, Rodrigo Marino, Ronelle Welton, Mark Yates

Abstract:

The oral health of residents in aged care centres in Australia is poor, contributing to infections, hospital admissions, and increased suffering. Although the use of electric toothbrushes has been deployed in many centres, smartbrushes that record and transmit information about brushing patterns and duration are not routinely deployed. Yet, the use of smartbrushes for aged care residents promises better oral care. Thus, a study aimed at investigating the appropriateness and suitability of a smartbrush for aged care residents is currently underway. Due to the peculiarity of the aged care setting, the incorporation of smartbrushes into residents’ care does require careful planning and design considerations. This paper describes an initial design process undertaken through the use of an actor to understand the important elements to be incorporated whilst installing a smartbrush for use in aged care settings. The design covers the configuration settings of the brush and app, including ergonomic factors related to brush and smartphone placement. A design science approach led to an installation re-design and a revised protocol for the planned study, the ultimate aim being to design installations to enhance perceived usefulness, ease of use, and attitudes towards the incorporation of smartbrushes for improving oral health care for aged care residents.

Keywords: smartbrush, applied computing, life and medical sciences, health informatics

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Authors: Mubita Namuyamba

Abstract:

Despite an increase in the number of cancer programs and partnerships in cancer care provision, the burden of cancer in Zambia is increasingly having a significant impact on morbidity and mortality rates. The increase in cancer morbidity and mortality rates has given rise to psychological and psycho social implications (PPsI) in cancer care. Cancer patients, care givers and health care providers are faced with a multitude of PPsIs in cancer care that mainly impact negatively on the management of cancer patients. The study adopted a case study design and was purposively conducted at the Cancer Diseases Hospital in Lusaka (Zambia) after obtaining ethical clearance from the Ethics committee. The sample for this study included 70 cancer patients, 20 care givers and 5 hospital staff (4 nurses and 1 doctor). Data was collected using interviews guides, focus group discussion guides and questionnaires respectively. The qualitative data was analysed thematically. The various psychological and psychosocial challenges that conspire to deter the provision of effective cancer care nursing and improved methods of minimizing the psychological and psychosocial implications in cancer care are the products of this study.

Keywords: case study, enquiry, psychological and psycho social aspects, Zambia

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Authors: Areej Makeineldein Mustafa

Abstract:

The study evaluates the management processes and healthcare provider compliance with the National Institute for Health and Care Excellence recommendations for constipation management. We aimed to evaluate the adherence to National Institute for Health and Care Excellence guidelines in the management of constipation during the period from February to June 2023. We collected data from a random sample ( 51 patients) over 4 months with inclusion criteria for patients above 60 who were just admitted to the care of the elderly department during this period. Patient age, sex, medical records for constipation, acute or chronic constipation, or opioid-induced constipation, and treatment options were used to identify constipation and the type of treatment given. Our findings indicate that there is a gap between practice and National Institute for Health and Care Excellence guideline steps; only 3 patient was given medications according to National Institute for Health and Care Excellence guidelines in order of combination or steps of escalation. Addressing these gaps could potentially lead to enhanced patient outcomes and an overall improvement in the quality of care provided to individuals suffering from constipation.

Keywords: constipation, elderly, management, patient

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Authors: J. J. Mathew

Abstract:

Pulmonary tuberculosis is highly prevalent in the Indian subcontinent. Most cases of pulmonary tuberculosis are diagnosed with sputum examinations and the vast majority of these are undertaken by the government run establishments. However, mycobacterial cultures are not routinely done, unless drug resistance is detected based on clinical response. Modern diagnostic tests like bronchoscopy and Genexpert are not routinely employed in the government institutions for the diagnosis of pulmonary tuberculosis, but have been accepted widely by good private institutions. The utility of these investigations in the private sector is not yet well recognized. This retrospective study aims to assess the usefulness of bronchoscopy and Genexpert in the diagnosis of pulmonary tuberculosis in quaternary care private hospital in India. 30 patients with respiratory symptoms raising the possibility of tuberculosis based on clinical and radiological features, but without any significant sputum production, were subject to bronchoscopy and BAL samples taken for microbiological studies, including Genexpert. 6 out of the 30 patients were found to be Genexpert positive and none of them showed Rifampicin resistance. All the 6 cases had upper zone predominant disease. One of the 6 cases of tuberculosis had another co-existent bacterial infection according to the routine culture studies. 6 other cases were proven to be due to other bacterial infections alone, 2 had a malignant diagnosis and the remaining cases were thought to be non-infective pathologies. The Genexpert results were made available within 48 hours in the 6 positive cases. All of them were commenced on standard anti-tuberculous regimen with excellent clinical response. The other infective cases were also managed successfully based on the drug susceptibilities. The study has shown the usefulness of these investigations as early intervention enabled diagnosis facilitating treatment and prevention of any clinical deterioration. The study lends support to early bronchoscopy and Genexpert testing in suspected cases of pulmonary tuberculosis without significant sputum production, in a high prevalence country which normally relies on sputum examination for the diagnosis of pulmonary tuberculosis.

Keywords: pulmonary, tuberculosis, bronchoscopy, genexpert

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Authors: Faiza Marrium, Masood Rabbani, Ali Ahmad Sheikh, Muhammad Yasin Tipu Javed Muhammad, Sohail Raza

Abstract:

More than 75% diseases spreading in the past 10 years in human population globally are linked to veterinary sector. Veterinary diagnostic labs are the powerful ally for diagnosis, prevention and monitoring of animal diseases in any country. In order to avoid detrimental effects of errors in disease diagnostic and biorisk management, there is a dire need to establish quality control system. In current study, 3 private and 6 public sectors veterinary diagnostic labs were selected for survey. A questionnaire survey in biorisk management guidelines of CWA 15793 was designed to find quality control breaches in lab design, personal, equipment and consumable, quality control measures adopted in lab, waste management, environmental monitoring and customer care. The data was analyzed through frequency distribution statistically by using (SPSS) version 18.0. A non-significant difference was found in all parameters of lab design, personal, equipment and consumable, quality control measures adopted in lab, waste management, environmental monitoring and customer care with an average percentage of 46.6, 57.77, 52.7, 55.5, 54.44, 48.88 and 60, respectively. A non-significant difference among all nine labs were found, with highest average compliance percentage of all parameters are lab 2 (78.13), Lab 3 (70.56), Lab 5 (57.51), Lab 6 (56.37), Lab 4 (55.02), Lab 9 (49.58), Lab 7 (47.76), Lab 1 (41.01) and Lab 8 (36.09). This study shows that in Lahore district veterinary diagnostic labs are not giving proper attention to quality of their system and there is no significant difference between setups of private and public sector laboratories. These results show that most of parameters are between 50 and 80 percent, which needs some work and improvement as per WHO criteria.

Keywords: veterinary lab, quality management system, accreditation, regulatory body, disease identification

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Authors: Souhir Chelly, Chahida Harizi, Aicha Hechaichi, Sihem Aissaoui, Leila Ben Ayed, Maha Bergaoui, Mohamed Kouni Chahed

Abstract:

Introduction: The International Classification of Primary Care (ICPC) is part of the morbidity classification system. It had 17 chapters, and each is coded by an alphanumeric code: the letter corresponds to the chapter, the number to a paragraph in the chapter. The objective of this study is to show the utility of this classification in the coding of the reasons for demand for care in Primary health care (PHC), its advantages and limits. Methods: This is a cross-sectional descriptive study conducted in 4 PHC in Ariana district. Data on the demand for care during 2 days in the same week were collected. The coding of the information was done according to the CISP. The data was entered and analyzed by the EPI Info 7 software. Results: A total of 523 demands for care were investigated. The patients who came for the consultation are predominantly female (62.72%). Most of the consultants are young with an average age of 35 ± 26 years. In the ICPC, there are 7 rubrics: 'infections' is the most common reason with 49.9%, 'other diagnoses' with 40.2%, 'symptoms and complaints' with 5.5%, 'trauma' with 2.1%, 'procedures' with 2.1% and 'neoplasm' with 0.3%. The main advantage of the ICPC is the fact of being a standardized tool. It is very suitable for classification of the reasons for demand for care in PHC according to their specificity, capacity to be used in a computerized medical file of the PHC. Its current limitations are related to the difficulty of classification of some reasons for demand for care. Conclusion: The ICPC has been developed to provide healthcare with a coding reference that takes into account their specificity. The CIM is in its 10th revision; it would gain from revision to revision to be more efficient to be generalized and used by the teams of PHC.

Keywords: international classification of primary care, medical file, primary health care, Tunisia

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Authors: R. K. Yadav, S. Baral, H. R. Paudel, R. Basnet

Abstract:

The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public healthcare providers in the fight against tuberculosis using international healthcare standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. A total of 20 respondents participated in the study. Barriers to PPM were identified in the following three themes: 1) Obstacles related to TB case detection, 2) Obstacles related to patients, and 3) Obstacles related to the healthcare system. PPM implementation was challenged by following subthemes that included staff turnover, low private sector participation in workshops, a lack of training, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. The study concludes that numerous barriers exist in the way of effective implementation of the PPM approach, including TB cases detection barriers such as knowledge of TB diagnosis and treatment, HW attitude, workload, patient-related barriers such as knowledge of TB, self-medication practice, stigma and discrimination, financial status, and health system-related barriers such as staff turnover and poor engagement of the private sector in workshops, training, recording, and re-evaluation. Government stakeholders must work together with private sector stakeholders to perform joint monitoring and supervision. Private practitioners should receive training and orientation, and presumptive TB patients should be given adequate time and counseling as well as motivation to visit a government health facility.

Keywords: barrier, tuberculosis, case finding, PPM, nepal

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Authors: Omar Amoudi, Mariya Khalid

Abstract:

The limitation of the public funds for the infrastructure projects and with the deterioration of international oil prices and the negative consequences on the economies of oil producing and exporting countries, Oman has encouraged the partnership between the public and private sectors. As the private sector has a role in planning, financing, designing, operating and the maintenance of the public services. There is no doubt that, the adoption of Public Private Partnership (PPP) strategy faces many challenges which might affect the project seriously if it is not overcome in earlier time. These challenges depend on the level of understanding of the strategy, the roles and regulations and the availability of resources as well. This research aims at identifying the challenges facing the PPP infrastructure projects in Oman based on the similar previous studies supported by questionnaire survey and semi structured interviews. It also seeks to discuss the rationale for adoption in Oman and uncover the current status of PPP strategy. The identified challenges were ranked according to the importance index of each challenge. After analysis of data, it has observed that, the main challenges facing PPPs projects in Oman are high participation cost, high projects cost and regulation changes. The PPP strategy has to be adopted well and with a high level of experience in order to ensure a successful implementation of PPP projects in Oman.

Keywords: public private partnership (PPP), challenges, infrastructure, Oman

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Authors: Manee Arpanantikul, Pennapa Unsanit, Dolrat Rujiwatthanakorn, Aporacha Lumdubwong

Abstract:

In order to continuously perform self-care based on the sufficiency economy philosophy for the length of women’s lives is not easy. However, there are different ways that women can use to carry out self-care activities regularly. Some women individually perform self-care while others perform self-care in groups. Little is known about ways to sustaining self-care of women based on the fundamental principle of Thai culture. The purpose of this study was to investigate ways to sustaining self-care based on the sufficiency economy philosophy of Thai middle-aged women living in the community in order to achieve future healthy aging. This study employed a qualitative research design. Twenty women who were willing to participate in this study were recruited. Data collection were conducted through in-depth interviews with tape recording, doing field notes, and observation. All interviews were transcribed verbatim, and data were analyzed by using content analysis. The findings showed ways to sustaining self-care of Thai community women to achieve future healthy aging consisting of 7 themes: 1) having determination, 2) having a model, 3) developing a leader, 4) carrying on performing activities, 5) setting up rules, 6) building self-care culture, and 7) developing a self-care group/network. The findings of this study suggested that in order to achieve self-care sustainability women should get to know themselves, have intention and belief, together with having the power of community and support. Therefore, having self-care constantly will prevent disease and promote healthy in women’s lives.

Keywords: qualitative research, sufficiency economy philosophy, Thai middle-aged women, ways to sustaining self-care

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Authors: Alex Hughes

Abstract:

Patients with advanced heart failure develop specific palliative care needs due to the progressive symptom burden and unpredictable disease trajectory. NICE guidance advises that palliative care should be provided to patients with both cancer and non-cancer conditions as and when required. However, there is some way to go before this guidance is consistently and effectively implemented nationwide in conditions such as heart failure. The Ambitions for Palliative and End of Life Care: A national framework for local action in England provides a set of foundations and ambitions which outline a vision for what high-quality palliative and end-of-life care look like in England. This poster aims to critically consider how to improve access to palliative care for heart failure patients in England by analysing the foundations taken from this framework to generate specific recommendations using Soft Systems Methodology (SSM). The eight foundations analysed are: ‘Personalised care planning’, ‘Shared records’, ‘Evidence and information’, ‘Involving, supporting and caring for those important to the dying Person’, ‘Education and training’, ‘24/7 access’, ‘Co-design’ and ‘Leadership.’ A number of specific recommendations have been generated which highlight a need to close the evidence-policy gap and implement policy with sufficient evidence. These recommendations, alongside the creation of an evidence-based national strategy for palliative care and heart failure, should improve access to palliative care for heart failure patients in England. Once implemented, it will be necessary to evaluate the effect of these proposals to understand if access to palliative care for heart failure patients actually improves.

Keywords: access, health systems, heart failure, palliative care

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Authors: S. O. Ayansina, R. A. Oyeyinka, K. K. Bolarinwa

Abstract:

There is an increasing demand for a functional extension delivery services in Nigeria with a view to meet up with the food and fiber needs of the ever growing population of human and animal respectively. This study was designed to examine farmers’ involvement in public and private extension services in southwestern Nigeria, specifically to explore the farmers’ participation in the two types of organizations involved. It also evaluates the performances of personnel in the organizations. A multi-stage random sampling technique was used to select 30 respondents from each of the three selected organizations in Ogun, Osun and Oyo states in Southwestern Nigeria. Data was collected with interview schedule and analyzed both at descriptive and inferential levels. Kruskal Wallis one-way Analysis of variance was used to test the differences between the participation of beneficiaries who are farmers under the public and private extension services and the level of benefit accrued to them from the various extension organizations involved in the study. Results revealed that private extension organizations were performing better and were more preferred by the beneficiaries. Results of the tested hypotheses as shown by Kruskal Wallis test of difference (x2 = 0.709) S no significant difference between farmers’ participation in the extension services of public and private organizations but however showed significant difference (X2 =12.074) in the benefits achieved by respondents in the two organizations. These include: increased quantity of crop produced, farm income, skill acquisition, and improved education in private extension organizations. Based on this result, it could be inferred that beneficiaries generally preferred private extension organizations because of their effectiveness and vibrancy in programme administration. Public extension is therefore recommended for general overhauling and possibly privatization in order to cater for teeming population of farmers demanding for efficient and functional extension services to better their lots in production, processing and marketing of agricultural produce.

Keywords: public and private involvement, extension services, farmers' participation

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Authors: Hanneke J. A. Smaling, Mandy Visser

Abstract:

One way to reduce the risk of COVID-19 infection is by preventing close interpersonal contact with distancing measures. These social distancing measures presented challenges to the health and wellbeing of people with dementia and their informal and professional caregivers. This study describes the concerns and recommendations of informal and professional caregivers for COVID-19 policy for home care and long-term care for people with dementia during the first and second COVID-19 wave in the Netherlands. In this qualitative interview study, 20 informal caregivers and 20 professional caregivers from home care services and long-term care participated. Interviews were analyzed using an inductive thematic analysis approach. Both informal and professional caregivers worried about getting infected or infecting others with COVID-19, the consequences of the distancing measures, and quality of care. There was a general agreement that policy in the second wave was better informed compared to the first wave. At an organizational level, the policy was remarkably flexible. Recommendations were given for dementia care (need to offer meaningful activities, improve the organization of care, more support for informal caregivers), policy (national vs. locally organization, social isolation measures, visitor policy), and communication. Our study contributes to the foundation of future care decisions by (inter)national policymakers, politicians, and healthcare organizations during the course of the COVID-19 pandemic, underlining the need for balance between safety and autonomy for people with dementia.

Keywords: covid-19, dementia, home care, long-term care, policy

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Authors: Amardass Dhami, Clare Samuelson

Abstract:

Background: Sickle cell disease (SCD) is a complex, multisystem condition that significantly impacts patients' quality of life, characterized by acute illness episodes, progressive organ damage, and reduced life expectancy. In the UK, over 13,000 individuals are affected, with South Yorkshire having the fifth highest prevalence, including approximately 800 patients. Retinal complications in SCD can manifest as either proliferative or non-proliferative disease, with proliferative changes being more prevalent. These retinal issues can cause significant morbidity, including visual loss and increased care requirements, underscoring the need for regular monitoring. An integrated approach was applied to ensure timely interventions, ultimately enhancing patient outcomes and reduce ‘did not attend’ rates. Aim: To assess the factors which may influence attendance to Haematology and Ophthalmology Clinics with attention towards levels of deprivation towards non-attendance. Method : A retrospective study on 84 eligible patients, from the regional tertiary Centre for Sickle Cell Care (Sheffield Teaching Hospital) from 2017 to 2023. The study focused on the incidence of sickle cell eye disease, specifically examining the outcomes of patients who attended the combined haematology and ophthalmology clinics. Patients who did not attend either clinic were excluded from the analysis to ensure a clear understanding of the combined clinic's impact. This data was then compared with the United Kingdom’s Index of Multiple Deprivation (IMD) datasets to assess if inequalities of care affected this population. Results: The study concluded that the effectiveness of combining haematology and ophthalmology clinics was reduced following the intervention. The DNA rates increased to 40% for the haematology clinic. Additionally, a significant proportion of the cohort was classified as residing in areas of deprivation, suggesting a possible link between socioeconomic factors and non-attendance rates Conclusion: These findings underscore the challenges of integrating care for SCD patients, particularly in relation to socioeconomic barriers. Despite the intent to streamline care and improve patient outcomes, the increase in DNA rates points to the need for further investigation into the underlying causes of non-attendance. Addressing these issues, especially in deprived areas, could enhance the effectiveness of combined clinics and ensure that patients receive the necessary monitoring and interventions for their eye health and overall well-being. Future strategies may need to focus on improving accessibility, outreach, and support for patients to mitigate the impact of socioeconomic factors on healthcare attendance.

Keywords: south yorkshire, sickle cell anemia, deprivation, factors, haematology

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Authors: Hung-Yi Chen, Shih-Jye Wu

Abstract:

The existing literature provides little discussion on why a public monopolist gives up its market dominant position and allows private firms entering the market. We argue that the privatization of a public monopolist under a vertically related market may induce the entry of private firms. We develop a model of a mixed oligopoly with vertically related markets to explain the change in the market from a public monopolist to a mixed oligopoly and examine issues on privatizing the downstream public enterprise both in the short run and long run in the vertically related markets. We first show that the welfare-maximizing public monopoly firm is suboptimal in the vertically related markets. This is due to the fact that the privatization will reduce the input price charged by the upstream foreign monopolist. Further, the privatization will induce the entry of private firms since input price will decrease after privatization. Third, we demonstrate that the complete privatizing the public firm becomes a possible solution if the entry cost of private firm is low. Finally, we indicate that the public firm should partially privatize if the free-entry of private firms is allowed. JEL classification: F12, F14, L32, L33

Keywords: free entry, mixed oligopoly, public monopoly, the initiation of privatization, vertically related markets, mixed oligopoly

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Authors: Fedorova Elena

Abstract:

In this article, we draw a distinction between two important functions of public policy in private international law. The first function is widely recognized and relates to the prevention of application of foreign laws and enforcement of foreign court judgments whenever their effects are incompatible with the domestic legal system of the forum. This effectively protects sovereign rights of the forum state as it allows to resist against the undesirable effects of foreign law-making and law-enforcement policies. The second function is less obvious, but not less important. As the internal private legal relationships, international private relationships are usually governed by rules of public policy, to which the parties can not derogate by mutual agreement. Thefore, for international private law relations public policy has a different function than previously mentioned: in this case, the public policy acts as a defense against unacceptable effects of the party autonomy. Thus, this second function of public policy consists in the limitation of the party autonomy wich effects would be unacceptable for the local legal system. In the frame of this second function the author will analyse two types of public policy which can limit the party autonomy: « substantial » public policy (which regulates the substance of international legal relationship) and « conflictual » public policy (which regulates the party autonomy to choose the law applicable for the substance of relationship). The author provides an analysis of these functions of the public policy in the field of international contract law because of the important role of the principle of party autonomy for international contract relations.

Keywords: public policy, general theory of private international law, substantial public policy, conflictual public policy

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Authors: Babajide Solomon Faloore

Abstract:

This study on the comparative analysis of the performance of teachers in private and public schools was carried out in Ibadan North West Local Government Area of Oyo State. This study examined the justification for the claim that there is a difference in the performance of teachers in private and public primary schools and at the same time identified factors responsible for the difference in the performance of these teachers. A descriptive survey research design was used for the study. Data generated were analyzed using t-test and regression analysis. The findings of the study revealed that there is significance difference in the performance of teachers in private and private primary schools in Ibadan North West Local Government Area of Oyo State( t=64.09; df=459; p,.05). The findings also revealed that the method of teaching in private primary schools is significantly different from the method of teaching in public primary schools in Ibadan North West Local Government Area of Oyo State (t=73.08; df=459; p,.05). Findings revealed that school leadership and management have a significant contribution on the performance of private and public primary school teachers in Ibadan North West Local Area of Oyo State. Based on the finding, the following recommendations were made: Primary school teachers need to be motivated and rewarded for excellent performance. Primary schools should be properly equipped with teaching–aid facilities, laboratories, and libraries. The government should use the findings of this study to improve on teaching materials provided to the primary school teachers in Nigeria. Public primary schools should be designed by education planners, administrators, and government. Headmasters, proprietors, and teachers of primary schools should look inward and give a performance appraisal and evaluation of themselves from time to time based on the subject they taught. Finally, school administrators should be conscious of the way they manage the teachers in schools not only in informal situations but also in formal settings.

Keywords: private education, public education, school leadership, school management, teachers performance

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Authors: Jakob Renko, Deja Praprotnik, Kristina Martinovič, Igor Karnjuš

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Introduction: Catheter-related bloodstream infections are a major burden for healthcare and patients. Although infections of this type cannot be completely avoided, they can be reduced by taking preventive measures. The aim of this study is to review and analyze the existing literature on preventive interventions to prevent central venous catheters (CVC) infections. Methods: A systematic literature review was carried out. The international databases CINAHL, Medline, PubMed, and Web of Science were searched using the search strategy: "catheter-related infections" AND "intensive care units" AND "prevention" AND "central venous catheter." Articles that met the inclusion and exclusion criteria were included in the study. The literature search flow is illustrated by the PRISMA diagram. The descriptive research method was used to analyze the data. Results: Out of 554 search results, 22 surveys were included in the final analysis. We identified seven relevant preventive measures to prevent CVC infections: washing the whole body with chlorhexidine gluconate (CHG) solution, disinfecting the CVC entry site with CHG solution, use of CHG or silver dressings, alcohol protective caps, CVC care education, selecting appropriate catheter and multicomponent care bundles. Discussion and conclusions: Both single interventions and multicomponent care bundles have been shown to be currently effective measures to prevent CVC infections in adult patients in the ICU. None of the measures identified stood out in terms of their effectiveness. Prevention work to reduce CVC infections in the ICU is a complex process that requires the simultaneous consideration of several factors.

Keywords: central venous access, critically ill patients, hospital-acquired complications, prevention

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Authors: Rajendra Raval

Abstract:

Tele ICU services leverage advanced telecommunication technologies to enhance intensive care unit (ICU) capabilities. By integrating real-time remote monitoring, diagnostic tools, and expert consultations, these services provide continuous, high-quality care to critically ill patients. Healthcare professionals can access patient data, view live video feeds, and collaborate with on-site ICU teams, regardless of their physical location. This model improves patient outcomes through timely interventions, optimizes resource utilization, and extends the reach of specialized care to underserved or remote areas. The implementation of Tele ICU services represents a significant advancement in critical care, bridging gaps in accessibility and ensuring a consistent standard of care across various settings.

Keywords: optimised human resource, remote areas, tele-ICU, telemedicine

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Authors: Kingkan Chumjamras

Abstract:

There are permanent and temporary tracheostomies, and in a permanent tracheostomy, care giver are important persons to know and be able to care for the tracheostomy patient. The objective of this quasi-experimental study was to evaluate outcomes of educating care giver in tracheostomy wound care for discharge planning of tracheostomy patients. The subjects of the study were relatives who directly cared for tracheostomy patients. Thirty subjects were selected according to specified criteria. The research instruments consisted of practice guidelines, manual for relatives in caring for the tracheostomy wound, an assisted model with a tracheostomy wound, a test, an observation form, and a patient’s relative satisfaction questionnaire. The instrument validity was tested by three experts, and the questionnaire reliability was tested with Cronbach’s alpha, and the reliability coefficient was 0.83; the data were analyzed using descriptive statistics, and paired t-test. The results of the study on educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients revealed that the score for knowledge and ability in caring for the tracheostomy wound before receiving the education was at a low level (M= 19.23, SD= 1.57) compared with the very high score (M= 36.40, SD= 19.23) after receiving the education. The difference was statistically significant (p < .05), and relatives’ satisfaction was at a high level (80 percent). Knowledge and ability in caring for tracheostomy patients among patients’ relatives could cause tracheostomy wound complications for tracheostomy patients. One way to control such complications and returns to hospital from infection, in addition to care by the health care team, is educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients.

Keywords: outcomes, educating, care giver, Tracheostomy Wound Care, discharge planning

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Authors: Andre Slonopas, Zona Kostic, Warren Thompson

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Obfuscation is one of the most useful tools to prevent network compromise. Previous research focused on the obfuscation of the network communications between external-facing edge devices. This work proposes the use of two edge devices, external and internal facing, which communicate via private IPv4 addresses in a software-defined pseudo-random IP hopping. This methodology does not require additional IP addresses and/or resources to implement. Statistical analyses demonstrate that the hopping surface must be at least 1e3 IP addresses in size with a broad standard deviation to minimize the possibility of coincidence of monitored and communication IPs. The probability of breaking the hopping algorithm requires a collection of at least 1e6 samples, which for large hopping surfaces will take years to collect. The probability of dropped packets is controlled via memory buffers and the frequency of hops and can be reduced to levels acceptable for video streaming. This methodology provides an impenetrable layer of security ideal for information and supervisory control and data acquisition systems.

Keywords: moving target defense, cybersecurity, network security, hopping randomization, software defined network, network security theory

Procedia PDF Downloads 185

Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

Procedia PDF Downloads 409

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

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

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

Procedia PDF Downloads 408

Authors: Maria Luisa T. Uayan

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The global need for qualified nurses to take care of the clients with various health needs is an incessant occurrence that persistently cause migration of nurses from developing to developed countries. The pull-push theory of migration greatly affects health care delivery systems of sending countries which is the same way affects nursing management. The exodus of nurses prepared to provide the much needed leadership at the bedside leaves the country in clusters giving health care institutions limited time to develop the next front-line managers that will assure quality patient care. This paper focuses on the extent and consequences of the massive recurring migration phenomena that is felt ONLY IN THE PHILIPPINE health care arena. It deals with the causes, problems, and effects of the cyclical loss of competent Filipina nurses in terms of emigration. Also, it will highlights the difficulties confronted by nursing service departments and health care teams when more experienced nurses set out for the “greener pastures” and patients are placed under the care of novice nurses. Fundamentally, it will emphasize the impact of suffering the loss of competent nurse managers in the Philippine health care institutions and provide contemporary recommendations on how to responsd accordingly to this very timely issue.

Keywords: Migration, Nurse Manager, Philippines

Procedia PDF Downloads 361

Authors: Natália Bruno Chaves, Richardes Caúla, Roosevelt do Vale, Daniela Toneti, Rafaela Carvalho, Renata Silva Lopes, Antônio Carlos Júnior, Adner Nobre, Viviane Santiago, Yara Alana Caldato, Estefania Rodriguez Urrego, André Buarque Lemos, Catarina Nucci Stetner, Marcos Mauro Barreto, Stefany Moreira Lima, Mara Cavalcante, Ticiane Ribeiro

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The Well Born (Nascer Bem – in Portuguese) Program was created in the Hapvida health network with the aim of improving access to safe and quality prenatal care for users. In addition to offering a line of prenatal care, the inclusion of obstetric nursing and the decentralization of childbirth, bring security that professionals did not indicate the route of delivery for professional convenience. The introduction of the nursing consultation came to reinforce the care to our users, strengthening their bond and reception. In 2021, the program maintained an average of 40% of normal births in the north, northeast and central-west regions of Brazil, an average above that observed in the rest of the country's private health systems, around 20%. In addition, the neonatal hospitalization rate of this population remained around 5.1%, a figure below the national average. With these data, the “Nascer Bem” program is affirmed as a safe and effective strategy for the promotion of safe normal birth.

Keywords: quality, safe, prenatal, obstetric nursing

Procedia PDF Downloads 119

Authors: Ciaran Smiddy, Fergus Nugent, Karen Fitzmaurice

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A measure of prescribing and administration of Antimicrobial Prophylaxis before and during Covid-19(2019 vs. 2021) was desired to assess how these were affected by Covid-19. Antimicrobial Prophylaxis was assessed for 60 patients, under 3 Orthopaedic Consultants, against local guidelines. The study found that compliance with guidelines improved significantly, from 60% to 83%, but Appropriate use of Vancomycin reduced from 37% to 29%.

Keywords: antimicrobial stewardship, prescribing, spinal surgery, vancomycin

Procedia PDF Downloads 172

Authors: Oyetunji John Adenuga

Abstract:

This study on the comparative analysis of the performance of teachers in private and public schools was carried out in Ibadan North West Local Government Area of Oyo State. This study examined the justification for the claim that there is difference in the performance of teachers in private and public primary schools and at the same time identified factors responsible for the difference in the performance of these teachers. A descriptive survey research design was used for the study. Data generated were analysed using t-test and regression analysis. The findings of the study revealed that there is significant difference in the performance of teachers in private and private primary schools in Ibadan North West Local Government Area of Oyo State (t=64.09; df=459; p,.05). The findings also revealed that the method of teaching in private primary schools is significantly different from the method of teaching in public primary schools in Ibadan North West Local Government Area of Oyo State (t=73.08; df=459; p,.05). Findings revealed that school leadership and management have significant contribution on the performance of private and public primary school teachers in Ibadan North West Local Area of Oyo State. Based on the finding, the following recommendations were made: Primary school teachers need to be motivated and rewarded for excellent performance. Primary schools should be properly equipped with teaching-aid facilities, laboratories and libraries. Government should use the findings of this study to improve on teaching materials provided to the primary school teachers in Nigeria. Public primary schools should be designed by education planners, administrators and government. Headmasters, proprietors and teachers of primary schools should look inward and give a performance appraisal and evaluation of themselves form time to time based on subject they taught. Finally, school administrators should be conscious of the way they manage the teachers in schools not only in informal situations but also in formal settings.

Keywords: private education, public education, school leadership, school management, teachers performance

Procedia PDF Downloads 342