Search results for: critical care transition program

Authors: Jennifer Stephens, Nichole Parker, Kristin Petrovic

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To gain a better understanding of how students enrolled in a Bachelor of Nursing (BN) program are educated, faculty members in the BN program at Athabasca University (AU) in Alberta, Canada, developed a 3-phase comprehensive curriculum review project. Phase one of this review centered around hiring an external curriculum expert to examine and analyze the current curriculum and to propose recommendations focused on identifying gaps as well as building on strengths towards meeting changing health care trends. Phase two incorporated extensive institutional document analysis as well as qualitative and quantitative data collection in reciprocated critical reflection and has yielded insights into valuable processes, challenges, and solutions inherent to the complexities of undertaking curriculum review and analysis. Results of our phase one and two analysis generated a quality improvement (QI) template that could benefit other nursing education programs engaged in curriculum review and analysis. The key processes, lessons, and insights, as well as future project phase three plans, will be presented for iterative discussion and role modelling for other institutions undergoing, or planning, content-based curriculum review and evaluation.

Keywords: curriculum, education, nursing, nursing faculty practice, quality improvement

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Authors: Zeynep Karacor, Rahime Hulya Ozturk

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In recent years, the rise of population density and the problem of aging population took attention to the health expenditures. In Turkey, some regulations and infrastructure changes in health sector have occurred. These changes are called Health Transformation Program. The productivity of health services, patient satisfaction, quality of services are tried to be improved with this program. Some radical changes are applied in Turkish economy in this context. The aim of this paper is to present the effects of Health Transformation Program on health expenditures. In the first part of the paper, some information’s about health system and applications in Turkey are discussed. In the second part, the aims of Health Transformation Program are explained. And in the third part the effects of Health Transformation Program on health expenditures are examined.

Keywords: health transformation program, Turkey, health services, health expenditures

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Authors: Hadda Krarcha, S. Messaasdi

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In order to investigate Hafnium transition metal alloys HfM (M= Co, Ir, Os,Pt, Rh, Ru) phase diagrams in the region of 50/50% atomic ratio, we performed ab initio Full-Potential Linearized Augmented Plane Waves calculations of the enthalpies of formation of HfM compounds at B2 (CsCl) structure type. The obtained enthalpies of formation are discussed and compared to some of the existing models and available experimental data.

Keywords: enthalpy of formation, transition metal, binarry compunds, hafnium

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Authors: Yıldırım I. Tosun, Halim Cevizci, Hakan Ceylan

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By GEO5 FEM program with four rockfill slope modeling and stability analysis was performed for S1, S2, S3 and S4 slopes where landslides of the shalefills were limited. Effective angle of internal friction (φ'°) 17°-22.5°, the effective cohesion (c') from 0.5 to 1.8 kPa, saturated unit weight 1.78-2.43 g/cm3, natural unit weight 1.9-2.35 g/cm3, dry unit weight 1.97-2.40 g/cm3, the permeability coefficient of 1x10-4 - 6.5x10-4 cm/s. In cross-sections of the slope, GEO 5 FEM program possible critical surface tension was examined. Rockfill dump design was made to prevent sliding slopes. Bulk material designated geotechnical properties using also GEO5 programs FEM and stability program via a safety factor determined and calculated according to the values S3 and S4 No. slopes are stable S1 and S2 No. slopes were close to stable state that has been found to be risk. GEO5 programs with limestone rock fill dump through FEM program was found to exhibit stability.

Keywords: slope stability, stability analysis, rockfills, sock stability

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Authors: Modi M. Ahmed, Noor Al-Dousari, Ali M. Al-Dousari

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Cornulaca aucheri is an annual herb consider as disturbance indicator currently visible and widely distributed in disturbed lands in Liyah area. Such area is suffered from severe land degradation due to multiple interacting factors such as, overgrazing, gravel and sand quarrying, military activities and natural process. The restoration program is applied after refilled quarries sites and levelled the surface irregularities in order to rehabilitate the natural vegetation and wildlife to its original shape. During the past 10 years of rehabilitation, noticeable greenery healthy cover of Cornulaca sp. are shown specially around artificial lake and playas. The existence of such species in high density it means that restoration program has succeeded and transit from bare ground state to Cornulaca and annual forb state. This state is lower state of Range State Transition Succession model, but it is better than bare soil. Cornulaca spp is native desert plant grows in arid conditions on sandy, stony ground, near oasis, on sand dunes and in sandy depressions. The sheep and goats are repulsive of it. Despite its spiny leaves, it provides good grazing for camels and is said to increase the milk supply produced by lactating females. It is about 80 cm tall and has stems that branched from the base with new faster greenery growth in the summer. It shows good environmental potential to be managed as natural types used for the restoration of degraded lands in desert areas.

Keywords: land degradation, range state transition succession model, rehabilitation, restoration program

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Authors: Ambreen Amir Ali

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In todays’ dynamic environment, it has become very crucial to have comprehensive management trainee program to hire future leaders of organization. It is being proved that fresh graduates mostly join organizations because of its institution but later on they leave organization because of their immediate manager or supervisor. The concept of coaching and mentoring in talent management systems are very important, because mentors are those who can advise, facilitate, help and support new entrants to advance in their career. When it comes to going for talent hunt, one point needs to be highlighted that MTs are the raw talent for your organization, now it’s the responsibility of employers to nourish them, polish and developed them so that they can enthusiastically take care of senior leadership roles.

Keywords: management trainee, retention, leadership roles, coaching

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Authors: Lee Ock-Sun

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The effective development of a geoscience education and training program takes account of the rapidly changing environment in the geoscience market, includes information about resource-rich countries which have international education demands. In this paper, we introduce the geoscience program run bythe International School for Geoscience Resources at the Korea Institute of Geoscience and Mineral Resources (IS-Geo of KIGAM),and show its remarkable performance. To further effective geoscience program planning and operation, we present recommendations for strategic management for customer-oriented operation with a more favorable program format and advanced training aids. Above all, the IS-Geo of KIGAM should continue improve through‘plan-do-see-feedback’activities based on the recommendations.

Keywords: demand survey, geoscience program, program performance, strategic management

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Authors: Susan Evans, Janna Gordon-Elliott, Katarzyna Wyka, Virginia Mutch

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During the rise of the COVID-19 pandemic, healthcare workers needed an intervention that could address their profound acute stress. Mindfulness-based stress reduction (MBSR) is a program that has long established effectiveness for mental and physical health outcomes. In recent years, MBSR has been modified such that the duration of both class time and number of sessions has been abbreviated, and its delivery has been adapted for online dissemination, thus increasing the likelihood that individuals who could most benefit from the program would do so. We sought to investigate whether a brief, online version of MBSR could be feasible and acceptable for health care workers (HCW) in acute stress in response to the COVID-19 pandemic. Participants were recruited via an email sent to all hospital employees, which spans residents, physicians, nurses, housekeeping, lab technicians, administrators, and others. Participating HCW were asked about their previous experience with mindfulness and asked to commit to a minimum of 3 sessions. They were then provided with four weekly 1-hour sessions online that included the major mindfulness exercises taught during traditional MBSR programs (i.e., body scan, sitting meditation, mindful eating, and yoga). Participants were provided with supporting slides, videos, demonstrations and asked to track their practice. Hospital staff enrolled in the program; by the end of the first day of recruitment, 40 had applied; by the start date, about 100 were enrolled, and n attended a minimum of 3 sessions, supporting feasibility. Hospital staff also participated and practiced the mindfulness exercises (n=42), thus supporting acceptability. Participants reported that the program was logical, successful, and worth recommending both before starting the program and after completing it (M= 22.02 and M=21.76, respectively, possible range 0-27). There was a slight decline in the belief in improvement in health and well-being due to the program (ES=.37, p=.021). Secondary hypotheses regarding participants’ self-reported stress and levels of mindfulness were also supported, such that participants reported improvements in perceived stress (ES=.45, p=.006), compassion satisfaction, burnout, and secondary traumatic stress (ES=.41, ES=.31, ES=.35, respectively, p<.05). Participants reported significant improvements in the describing facet of mindfulness (ES=.49, p=.004), while all other facets (observing, acting with awareness, nonjudging of inner experience, nonreactivity to inner experience) remained unchanged pre- to post-program. Results from this study suggest that an abridged, online version of MBSR is feasible and accessible to health care workers in acute stress and provides benefits expected from traditional MBSR programs. The lack of a randomized control group limits generalizability. We intend to provide a structure, framework, and lessons learned to hospital administrators and clinical staff seeking to support their employees in acute stress.

Keywords: acute stress, health care workers, mindfulness, online interventions

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Authors: Sawyer Spurry

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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

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Authors: Kunthida Kulprateepunya, Napat Boontiam, Bunthita Phuasa, Chatsuda Kankayant, Bantoeng Polsawat, Sumran Poontong

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Frailty is the thin line between good health and illness. The syndrome is more common in the elderly who transition from strong to weak. (Vulnerability). Fragility can prevent and promote healthy recovery before it goes into disability. This research and development aim to analyze the situation analysis of frailty of the elderly, develop a program, and evaluate the effect of a health promotion program to prevent and solve the problem of frailty among the elderly. The research consisted of 3 phases: 1) analysis of the frailty situation, 2) development of a model, 3) evaluation of the effectiveness of the model. Samples were 328, 122 elderlies using the multi-stage random sampling method. The research instrument was a frailty questionnaire use of the five symptoms, the main characteristics were muscle weakness, slow walking, low physical activity. Fatigue and unintentional weight loss, criteria frailty use more than or equal to three or more symptoms are frailty. Data were analyzed by descriptive and t-test dependent test statistics. The findings showed three parts. First, frailty in the elderly was 23.05 percentage and 56.70% pre-frailty. Second, it was development of a health promotion program to prevent and solve the problem of frailty the elderly with a combination of Nine-Square Exercise, Elastic Band Exercise, Elastic Coconut Shell. Third, evaluation of the effectiveness of the model by comparison of the elderly's get up and go test, the average time before using the program was 14.42 and after using the program was 8.57. It was statistically significant at the .05 level. In conclusion, the findings can used to develop guidelines to promote the health of the frailty elderly.

Keywords: elderly, fragile, nine-square exercise, elastic coconut shell

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Authors: Louise Penzenstadler, Tiphaine Robet, Radu Iuga, Daniele Zullino

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Context: The outpatient clinic of the psychiatric addiction service of Geneva University Hospital has been providing support to individuals affected by various narcotics for 30 years. However, the increasing consumption of crack cocaine in Geneva has presented a new challenge for the healthcare system. Research Aim: The aim of this research is to evaluate the impact of an outreach intervention on crack cocaine addiction in users with co-occurring opioid use disorder. Methodology: The research utilizes a combination of quantitative and qualitative retrospective data analysis to evaluate the effectiveness of the outreach intervention. Findings: The data collected from October 2023 to December 2023 show that the outreach program successfully made 1,071 contacts with drug users and led to 15 new requests for care and enrollment in treatment. Patients expressed high satisfaction with the intervention, citing easy and rapid access to treatment and social support. Theoretical Importance: This research contributes to the understanding of the challenges and specific needs of a complex group of drug users who face severe health problems. It highlights the importance of outreach interventions in establishing trust, connecting users with care, and facilitating medication-assisted treatment for opioid addiction. Data Collection: Data was collected through the outreach program's interactions with drug users, including street outreach interventions and presence at locations frequented by users. Patient satisfaction surveys were also utilized. Analysis Procedures: The collected data was analyzed using both quantitative and qualitative methods. The quantitative analysis involved examining the number of contacts made, new requests for care, and treatment enrollment. The qualitative analysis focused on patient satisfaction and their perceptions of the intervention. Questions Addressed: The research addresses the following questions: What is the impact of an outreach intervention on crack cocaine addiction in users with co-occurring opioid use disorder? How effective is the outreach program in connecting drug users with care and initiating medication-assisted treatment? Conclusion: The outreach program has proven to be an effective intervention in establishing trust with crack users, connecting them with care, and initiating medication-assisted treatment for opioid addiction. It has also highlighted the importance of addressing the specific challenges faced by this group of drug users.

Keywords: crack addiction, outreach treatment, peer intervention, polydrug use

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Authors: Amal Ait El Djoudi

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A thermodynamical model of coexisting hadronic and quark–gluon plasma (QGP) phases is used to study the thermally driven deconfining phase transition occurring between the two phases. A color singlet partition function is calculated for the QGP phase with two massless quarks, as in our previous work, but now the finite extensions of the hadrons are taken into account in the equation of state of the hadronic phase. In the present work, the finite-size effects on the system are examined by probing the behavior of some thermodynamic quantities, called response functions, as order parameter, energy density and their derivatives, on a range of temperature around the transition at different volumes. It turns out that the finiteness of the system size has as effects the rounding of the transition and the smearing of all the singularities occurring in the thermodynamic limit, and the additional finite-size effect introduced by the requirement of exact color-singletness involves a shift of the transition point. This shift as well as the smearing of the transition region and the maxima of both susceptibility and specific heat show a scaling behavior with the volume characterized by scaling exponents. Another striking result is the large similarity noted between the behavior of these response functions and that of the cumulants of the probability density. This similarity is worked to try to extract information concerning the occurring phase transition.

Keywords: equation of state, thermodynamics, deconfining phase transition, quark–gluon plasma (QGP)

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Authors: Rasikha Ramanand, Priyanka Dixit

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Background: Continuum of maternal care which includes antenatal care, delivery care and postnatal care aids in averting maternal deaths. The objective of this paper is to identify the association between previous experiences of child death on Continuum of Care (CoC) of recent child. Further, the study aimed at understanding where the drop-out rate was high in the continuum. Methods: The study was based on the Nation-wide District Level Household and Facility Survey (DLHS-4) conducted during 2012-13, which provides information on antenatal care, delivery care, percentage of women who received JSY benefits, percentage of women who had any pregnancy, delivery, the place of delivery etc. The sample included women who were selected from the non-EAG states who delivered at least two children. The data were analyzed using SPSS 20.Binary Logistic regression was applied to the data in which the Continuum of Care (CoC) was the dependent variable while the independent variables were entered as the covariates. Results: A major finding of the study was the antenatal to delivery care period where the drop-out rates were high. Also, it was found that a large proportion of women did not receive any of the services along the continuum. Conclusions: This study has clearly established the relationship between previous history of child loss and continuum of maternal care.

Keywords: antenatal care, continuum of care, child loss, delivery care, India, maternal health care, postnatal care

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Authors: Milind Bharambe, Chander Shekhar

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India is a vast country with its 1.21 billion population at the dawn of new decade, which accounts for one sixth of the global human capital in the world today. It is well known that health expenditure in India is dominated by private spending. This is an unfortunate consequence of India’s development because of large positive externality associated with health spending, which make health a merit good. This paper has used data from NSSO and Indian Government’s spending on health as reported by Ministry of Health and Family Welfare. Understanding of the dynamism of age-structure of the population would greatly optimize the expenditure on health care services. A country with good public health indicators is bound to possess good human capital which is an asset to the economic growth and indicator of development status of country. The paper tries to present the linkages between the health expenditure incurred by different states at various levels of demographic transition levels and the efficiency in utilization of health expenditure. It also looks into the way in which allocative efficiency health services can be improved. Paper tries to explore the per capita spending on health and how the demographic transition taking place in different states of India affect the required quantity and quality of health services.

Keywords: age structure, demographic transition, health expenditure, morbidity

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Authors: Nikolay E. Dubinin

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Pair-interaction approximations allow to consider a different states of condensed matter from a single position. At the same time, description of an effective pair interaction in transition metal is a hard task since the d-electron contribution to the potential energy in this case is non-pairwise in principle. There are a number of models for transition-metal effective pair potentials. Here we use the Wills-Harrison (WH) approach to calculate pair potentials for Fe, Co, and Ni in crystalline, liquid, and nano states. Last is especially interesting since nano particles of pure transition metals immobilized on the dielectric matrices are widely used in different fields of advanced technologies: as carriers and transmitters of information, as an effective catalytic materials, etc. It is found that the minimum of the pair potential is deeper and oscillations are stronger in nano crystalline state in comparison with the liquid and crystalline states for all metals under consideration.

Keywords: effective pair potential, nanocrystalline state, transition metal, Wills-Harrison approach

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Authors: Chenhui Wang, Chwee Beng Lee

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The practice of critical pedagogy is challenged by resistance from teachers. This study presents a discussion on teachers' resistance to critical pedagogy and previous practical frameworks for assessing critical thinking in formative assessment in the classroom through a critical review of the related literature. The authors found out that the main issue of teachers' resistance is not whether teachers should possess theoretical knowledge of critical thinking but how they apply that knowledge in their classroom teaching. In addition, critical thinking in formative assessment may provide teachers with a comprehensive understanding of critical pedagogical planning, implementing, and reflecting. Therefore, this paper intends to discuss a practical step-by-step framework for critical thinking formative assessment to address this resistance. Such discussion is based on a thorough examination of the related theories and frameworks. This review paper will benefit teachers in understanding and reducing their resistance to critical pedagogy as well as in implementing critical pedagogy.

Keywords: critical thinking, critical pedagogy, critical thinking formative assessment framework, teachers resistance

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Authors: Joyce Fernandez

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This study examined the effects of critical incident stress debriefing and other related interventions on the psychological recovery of earthquake survivors. It is a mixed experimental and qualitative study using post-test only control group design and focus group discussion. After the conduct of critical incident stress debriefing activities and other related interventions in the form of counseling and psychiatric treatment to the survivors of a 6.9 magnitude earthquake, a post-test measuring the level of psychological recovery was given to randomized participants categorized as intervention and control groups. Using the traumatic assessment and belief scale as instrument for the quantitative aspect in order to gauge recovery in the psychological need areas of safety, trust, esteem, intimacy and control, the findings are the following: Intervention group participants have relatively better adjustment along the five psychological need areas compared to the control group participants; there is no significant difference in the psychological recovery among female and male participants of the invention and control groups and; there are significant differences between intervention and control groups in the psychological need areas of self-safety, self-trust, other-trust, self-esteem, and self-intimacy. Using a guided interview for the qualitative data, the themes derived are the following. Safety: The world is an unsafe place to live because of the calamities. Trust: Trust and dependence are anchored on the family. Esteem: Participants are having confused self-worth. Intimacy: Participants are thriving on attachment with their family. Control: Participants have unaltered desire to help but feeling restricted because of personal and logistical concerns.As an outcome of the study a Psychosocial Care Program for Individuals, Families and Communities Affected by Disaster and Trauma was proposed.

Keywords: critical incident stress debriefing, earthquake survivors, psychological recovery, related interventions

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Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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Authors: Areej Al-Hamad, Cheryl Forchuk, Abe Oudshoorn, Gerald Patrick Mckinley

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Syrian refugee women face many obstacles when accessing health services in host countries that are influenced by various cultural, structural, and practical factors. This paper is based on critical ethnographic research undertaken in Canada to explore Syrian refugee women's migration experiences. Also, we aim to critically examine how the intersection of gender, trauma, violence and the political and economic conditions of Syrian refugee women shapes their everyday lives and health. The study also investigates the strategies and practices by which Syrian refugee women are currently addressing their healthcare needs and the models of care that are suggested for meeting their physical and mental health needs. Findings show that these women experienced constant worries, hardship, vulnerability, and intrusion of dignity. These experiences and challenges were aggravated by the structure of the Canadian social and health care system. This study offers a better understanding of the impact of migration and trauma on Syrian refugee women's roles, responsibilities, gender dynamics, and interaction with Ontario's healthcare system to improve interaction and outcomes. Health care models should address these challenges among Syrian refugee families in Canada.

Keywords: Syrian refugee women, intersectionality, critical ethnography, migration

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Authors: M. Khazam, M. Altawil, A. Eljabri

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Fluid properties in states near a vapor-liquid critical region are the most difficult to measure and to predict with EoS models. The principal model difficulty is that near-critical property variations do not follow the same mathematics as at conditions far away from the critical region. Libyan NC98 field in Sirte basin is a typical example of near critical fluid characterized by high initial condensate gas ratio (CGR) greater than 160 bbl/MMscf and maximum liquid drop-out of 25%. The objective of this paper is to model NC98 phase behavior with the proper selection of EoS parameters and also to model reservoir depletion versus gas cycling option using measured PVT data and EoS Models. The outcomes of our study revealed that, for accurate gas and condensate recovery forecast during depletion, the most important PVT data to match are the gas phase Z-factor and C7+ fraction as functions of pressure. Reasonable match, within -3% error, was achieved for ultimate condensate recovery at abandonment pressure of 1500 psia. The smooth transition from gas-condensate to volatile oil was fairly simulated by the tuned PR-EoS. The predicted GOC was approximately at 14,380 ftss. The optimum gas cycling scheme, in order to maximize condensate recovery, should not be performed at pressures less than 5700 psia. The contribution of condensate vaporization for such field is marginal, within 8% to 14%, compared to gas-gas miscible displacement. Therefore, it is always recommended, if gas recycle scheme to be considered for this field, to start it at the early stage of field development.

Keywords: EoS models, gas-condensate, gas cycling, near critical fluid

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Authors: James D. Beauchemin

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This study tested whether youth mental health care quality, operationalized as the extent to which youth and families experienced system-of-care principles in service interactions with providers, varied by level of youth need after adjusting for sociodemographic and treatment factors. The relationship of quality to clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1,124 caregivers of youths ages 5 to 20 within a statewide system-of-care, adjusted analyses indicated youths with the most intensive needs were significantly less likely to experience high-quality care (51% vs. 63%, p=0.016), with marked deficits on 6 of 9 items. Receipt of lower-quality care predicted less improvement in youth functioning. Despite considerable effort to develop systems-of-care for youths with the most severe mental health needs, these data suggest quality disparities remain for the most impaired youths. Policy and intervention development may be needed to improve the quality of care for this population.

Keywords: system-of-care, adherence, mental health, youth

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Authors: Abdulmajid Mukhtar Afat

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This paper aims at introducing finite automata theory, the different ways to describe regular languages and create a program to implement the subset construction algorithms to convert nondeterministic finite automata (NFA) to deterministic finite automata (DFA). This program is written in c++ programming language. The program reads FA 5tuples from text file and then classifies it into either DFA or NFA. For DFA, the program will read the string w and decide whether it is acceptable or not. If accepted, the program will save the tracking path and point it out. On the other hand, when the automation is NFA, the program will change the Automation to DFA so that it is easy to track and it can decide whether the w exists in the regular language or not.

Keywords: finite automata, subset construction, DFA, NFA

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Authors: Ashley R. Logsdon, Becky F. Antle, Cynthia M. Kamer

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This study examines the cost and benefits of a family treatment drug court in an urban county in a southeastern state. Additionally, this cost analysis will provide a detailed description of the type and cost of activities to produce the services provided to child welfare families. This study utilized return-on-investment analysis, which uses child welfare practices, disaggregates them into separate activities and estimates costs for these activities including child-level placement data for total cost of care for the child. Direct and indirect costs were considered as well as saving calculations what costs would be associated with child welfare outcomes both short and long term. The costs included were general program costs (salaries, drug screens, transportation, childcare, parent education, program evaluation, visitation, incentives) or personnel costs for other team members (judges, court administrators, child welfare workers, child welfare supervisors, and community mental health provider). The savings that were used in the study were length of time in out of home care, Medicaid costs, substance exposed births, emergency room utilization and jail/probation costs. This study documents an overall savings of between $168,993.30 and $837,993.30. The total savings per family divided by the 40 families who have participated in the program was between $4,224.83 to $20,949.83 per family. The results of this cost benefit analysis are consistent with prior research documenting savings associated with out of home care and jail/probation; however, there are also unique contributions of this study to the literature on cost effectiveness of family treatment drug courts. We will present recommendations for further utilization of family treatment drug courts and how to expand the current model.

Keywords: child welfare, cost analysis, family drug court, family treatment drug court

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Authors: Johannes J. Schneider, Mathias S. Weyland, Peter Eggenberger Hotz, William D. Jamieson, Oliver Castell, Alessia Faggian, Rudolf M. Füchslin

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Agglomerations of polydisperse systems of spherical particles are created in computer simulations using a simplified stochastic-hydrodynamic model: Particles sink to the bottom of the cylinder, taking into account gravity reduced by the buoyant force, the Stokes friction force, the added mass effect, and random velocity changes. Two types of particles are considered, with one of them being able to create connections to neighboring particles of the same type, thus forming a network within the agglomeration at the bottom of a cylinder. Decreasing the fraction of these particles, a percolation transition occurs. The critical regime is determined by investigating the maximum cluster size and the percolation susceptibility.

Keywords: binary system, maximum cluster size, percolation, polydisperse

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Authors: Shaista Meghani, Rozina Karmaliani, Khairulnissa Ajani, Shireen Shahzad, Nadeem Ullah Khan

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Background: The concept of Family Presence During Resuscitation (FPDR) is gradually gaining recognition in western countries, however, it is rarely considered in South Asian countries including Pakistan. Over time, patients’ and families’ rights have gained recognition and healthcare has progressed to become more patient-family centered. Objectives: The objective of this study was to evaluate the impact of an educational program on the Knowledge, Attitude, and Practices (KAP) of healthcare professionals (HCPs) towards FPDR in Emergency Department (ED), at a tertiary care setting, in Karachi, Pakistan. Methods: This was a Pre-test and Post-test study design. A convenient universal sampling was done, and all ED nurses and physicians with more than one year of experience were eligible. The intervention included one-hour training sessions for physicians (three sessions) and nurses (eight sessions), The KAP of nurses and physicians were assessed immediately after (post-test I), and two weeks(post-test II) after the intervention using a pretested questionnaire. Results: The findings of the study revealed that the mean scores of knowledge and attitude of HCPs at both time points were statistically significant (p-value=<0.001), however, an insignificant difference was found on practice of FPDR (p-value=>0.05). Conclusion: The study findings recommend that the educational program on FPDR for HCPs needs to be offered on an ongoing basis. Moreover, training modules need to be developed for the staff, and formal guidelines need to be proposed for FPDR, through a multidisciplinary team approach.

Keywords: family presence, cardiopulmonary resuscitation, attitude, education, practices, health care professionals

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Authors: Athanase Gahungu, Karen Freeman

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Different groups of stakeholders expect the evaluation of an international, grant-funded program to inform them of the worth of the program - the funder, the agency operating the program and its community, and the citizens of the country where the program is implemented. This paper summarizes the challenges that intercultural teams of researchers faced as they crisscrossed a host country while evaluating a teaching and learning materials program, and offers useful tips for effective collaboration. Firstly, was recommended that the teams be representative of the cultures involved, and have the required research and program evaluation skills. Secondly, cultures involved must consistently establish and maintain a shared performance system. Thirdly, successful team members must be self-aware, inter-culturally knowledgeable, not just in communication, but in conceptualizing the political and social context of international grant-funded projects.

Keywords: program evaluation, international collaboration, intercultural, shared performance

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Authors: Omer Ibrahim Abdallh Omer

Abstract:

Cancer patients often face complex medication regimens, leading to challenges in treatment adherence and clinical outcomes. Pharmacist-led medication therapy management (MTM) has emerged as a potential solution to optimize medication use and improve patient outcomes in oncology settings. In this prospective intervention study, we aimed to evaluate the impact of pharmacist-led MTM on treatment adherence and clinical outcomes among cancer patients. Participants were randomized to receive either pharmacist-led MTM or standard care, with assessments conducted at baseline and follow-up visits. Pharmacist interventions included medication reconciliation, adherence counseling, and personalized care plans. Our findings reveal that pharmacist-led MTM significantly improved medication adherence rates and clinical outcomes compared to standard care. Patients receiving pharmacist interventions reported higher satisfaction levels and perceived value in pharmacist involvement in their cancer care. These results underscore the critical role of pharmacists in optimizing medication therapy and enhancing patient-centered care in oncology settings. Integration of pharmacist-led MTM into routine cancer care pathways holds promise for improving treatment outcomes and quality of life for cancer patients.

Keywords: cancer, medications adherence, medication therapy management, pharmacist

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Authors: Suteera Pradubwong, Darawan Augsornwan, Pornpen Pathumwiwathana, Benjamas Prathanee, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) congenital anomalies have a high prevalence in the Northeast of Thailand. A care team’s understand of treatment plan would help to guide the family of patients with CLP to achieve the treatment. Objectives: To examine the impact of the empowering volunteer project, established in the northeast Thailand. Materials and Methods: The Empowering Volunteer project was conducted in 2008 under the Tawanchai Royal Granted project. The patients and family’s general information, treatment, the group brainstorming, and satisfaction with the project were analyzed. Results: Participants were 12 children with CLP, their families and five volunteers with CLP; the participating patients were predominantly females and the mean, age was 12.2 years. The treatment comprised of speech training, dental hygiene care, bone graft and orthodontic treatment. Four issues were addressed including: problems in taking care of breast feeding; instructions’ needs for care at birth; difficulty in access information and society impact; and needs in having a network of volunteers. Conclusions: Empowering volunteer is important for holistic care of patients with CLP which provides easy access and multiple channels for patients and their families. It should be developed as part of the self-help and family support group, the development of community based team and comprehensive CLP care program.

Keywords: self-help and family support group, community based model, volunteer, cleft lip-cleft palate

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Authors: David P. Horton, Gary Lynch-Wood

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Western populations are aging, prone to various lifestyle health problems, and increasing their demand for health and social care services. This demand has created enormous fiscal and regulatory challenges. In response, government institutions have deployed strategies of behavior modification to encourage people to exercise greater personal responsibility over their health and care needs (i.e., welfare responsibilisation). Policy strategies are underpinned by the assumption that people if properly supported, will make better health and lifestyle selections. Not only does this absolve governments of the responsibility for meeting all health and care needs, but it also enables government institutions to assert fiscal control over welfare spending. Looking at the regulation of health and social care in the UK, the authors identify and outline a suite of regulatory tools that are designed to extract and manage the resources of health and social care services users and to encourage them to make (‘better’) use of these resources. This is important for our understanding of how health and social care regulation is responding to ongoing social and economic challenges. It is also important because there has been a failure to systematically examine the relevance of resources for regulation, which is surprising given that resources are crucial to how and whether regulation succeeds or fails. In particular, drawing from the regulatory welfare state concept, the authors analyse the key legal and regulatory changes and mechanisms that have been introduced since the 2008 financial crisis, focusing on critical measures such as the Health and Social Care Act and regulations introduced under the National Health Service Act. The authors show how three types of user resources (i.e., tangible, labor, and data) are being used to assert fiscal control and increase welfare responsibilisation. Amongst other things, the paper concludes that service users have become more than rule followers and targets of behavioral modification; rather, they are producers of resources that regulatory systems have come to rely on.

Keywords: health care, regulation, resources, social care

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Authors: Hyun-Ji Choi

Abstract:

This paper aims to examine the meaning of ‘state’ as a monopoly of violence, in regard with South Korean democratic transition. Since institutional democratization in 1987, it is conventionally known that governmental authority has exercised its power through law and police force, rather than inclusive or private violence. In other words, 1987 pro-democracy movement has been a critical juncture for a step towards democratic consolidation. However, state coercion may continually be exerted despite institutional specification by law in South Korean context. Explicit case would be amendment of ‘the Law on Assembly and Demonstration’ which determines citizens’ right to take collective action mostly against government actions. This paper investigates amendment process of the law along with social reality since 1987 until 2015 to see how effectively institutionalization has progressed.

Keywords: democratic transition, historical institutionalism, state coercion, the law on Assembly and Demonstration

Procedia PDF Downloads 160