Effect of combined care nursing on patient satisfaction, staff satisfaction, and quality of care /

This research evaluates the effect of combined care nursing on three outcomes: i) patient satisfaction; ii) staff satisfaction; and iii) quality of care. Oakville-Trafalgar Memorial Hospital was in the early planning stages of changing to combined care nursing from the traditional method of providing separate postpartum and nursery care to mothers and babies. The opportunity existed to evaluate formally the change to combined care. There were three hypotheses to be investigated. Data were collected from four sources: patient surveys, staff surveys, informal interviews, and internal hospital documents. Both quantitative and qualitative data were analyzed. The surveys were administered on three different occasions to patients and staff. Other sources of data included informal interviews with patients and staff who responded to the surveys, and chart audits.The study findings revealed that the majority of respondents had increased levels of satisfaction and perceptions of increased quality of care following implementation of combined care. These findings, related to combined care and the role of change in its implementation and evaluation, indicate that there are no right or easy answers about how to make new ideas become reality in a smooth, pleasant way.

The Effect of Functional Electrically Stimulated Ambulation Training on Locomotor Function and Quality of Life in Individuals With Incomplete Spinal Cord Injury

The purpose of this study was to investigate the effects of a 12-week FES-ambulation program on locomotor function and quality of life after incomplete spinal cord injury. Six individuals with incomplete SCI participated in the study. Over-ground walking endurance (6MWT), speed (10MWT), independence (WISCI II) and body-weight support were assessed. Quality of life was assessed via the SF-36, WHOQOL-BREF, Perceived Stress Scale, Center of Epidemiological Studies for Depression scale, and task self-efficacy. Participants experienced significant improvements in walking endurance (223.6±141.5m to 297.3±164.5m; p=0.03), body-weight support (55.3±12.6% to 14.7±23.2%; p= 0.005) and four of the six participants showed improvements on the WISCI II scale (1-4 points). In addition, there was a significant reduction in reported bodily pain (6.5±1.2 to 5.0±1.7; p=0.04). Therefore, FES-ambulation is an effective means for enhancing over-ground locomotor function in individuals with incomplete SCI. It may also be an effective method for reducing pain in individuals with SCI.

Socio-demographic factors, smoking, symptoms, morbidities and pulmonary function and quality of life in individuals with a heavy smoking history

Objective: To determine which socio-demographic, exposure, morbidity and symptom variables are associated with health-related quality of life among former and current heavy smokers. Methods: Cross sectional data from 2537 participants were studied. All participants were at ≥2% risk of developing lung cancer within 6 years. Linear and logistic regression models utilizing a multivariable fractional polynomial selection process identified variables associated with health-related quality of life, measured by the EQ-5D. Results: Upstream and downstream associations between smoking cessation and higher health-related quality of life were evident. Significant upstream associations, such as education level and current working status and were explained by the addition of morbidities and symptoms to regression models. Having arthritis, decreased forced expiratory volume in one second, fatigue, poor appetite or dyspnea were most highly and commonly associated with decreased HRQoL. Discussion: Upstream factors such as educational attainment, employment status and smoking cessation should be targeted to prevent decreased health-related quality of life. Practitioners should focus treatment on downstream factors, especially symptoms, to improve health-related quality of life.

A randomized follow-up study of the general health and quality of life of an elderly edentulous population wearing either mandibular two-implant overdentures or conventional dentures

L’augmentation de la population âgée dans la société indique que les systèmes de soins de la santé font face à de nouveaux défis. Les hauts niveaux d’incapacité qui en résultent peuvent être réduits par les nouvelles technologies, la promotion de la santé ainsi que des stratégies de prévention. Les écrits scientifiques récents soulignent la supériorité des prothèses dentaires implanto-portées par rapport aux prothèses conventionnelles en termes de satisfaction et de qualité de la vie des patients. Cependant, il n'est toujours pas clair si ces avantages ont des effets positifs à long terme sur la santé orale et générale ainsi que sur la qualité de vie des populations âgées. Objectifs, Hypothèses : Notre but était de mesurer l’impact des prothèses mandibulaires retenues par 2 implants sur la qualité de vie associée à la santé bucco-dentaire et générale ainsi que sur la santé orale et la qualité du sommeil des aînés édentés. Nous avons évalué les hypothèses nulles suivantes : il n'y a aucune différence entre les individus portants des prothèses mandibulaires retenues par 2 implants (IODs) et ceux qui portent des prothèses conventionnelles (CDs), par rapport à la qualité de vie reliée à la santé bucco-dentaire et générale, la santé orale et la qualité du sommeil, un an après avoir reçu leurs nouvelles prothèses. Méthodes : Dans cette étude randomisée contrôlée, 255 aînés ont reçu au hasard IODs ou les CDs, les deux types de prothèses étant opposés à des prothèses maxillaires conventionnelles. La qualité de la vie reliée à la santé bucco-dentaire (OHRQoL) et la santé générale subjective ont été mesurées avec les questionnaires Oral Health Impact Profile (OHIP-20) et Short Form-36 (SF-36) en condition pré-traitement et après un an. La qualité du sommeil et la somnolence diurne ont été mesurées à l’aide du questionnaire Qualité de Sommeil de Pittsburg et de l'Échelle de Somnolence Epworth. La santé orale a été évaluée par un examen clinique. Les variables indépendantes étaient le sens de cohérence et le type de prosthèse, ainsi que des variables socio-démographiques. En utilisant des analyses statistiques bi et multi-factorielles, des comparaisons à l’intérieur d’un même groupe et entre deux groupes ont été effectuées. Résultats : Les différences pré et post traitement pour les cotes OHIP étaient significativement plus grandes pour le groupe IOD que le groupe CD (p<0.05). Le type de traitement et la cote pré-traitement étaient des facteurs significatifs à OHRQoL (p < 0.0001). Dans le groupe CD, il y avait une diminution significative par rapport aux cotes de «Physical Component Scores (PCS)», le fonctionnement physique, le rôle physique et la douleur physique entre les données pré-traitement et un an après le traitement, ce qui indique une diminution au niveau de la santé générale subjective. Dans le groupe IOD, une diminution statistiquement non significative a été remarquée par rapport à toutes les cotes des sous-échelles de SF-36, sauf pour la douleur physique. Le modèle final de régression a démontré qu’après ajustement pour les variables âge, sexe, statut marital et type de traitement, la cote totale finale d’OHIP et les données de bases de PCS prédisaient la cote finale de PCS (p < 0.0001). Aucune corrélation significative entre sens de cohérence et OHRQoL n'a été détectée (r =-0.1; p > 0.05). Les aînés porteurs des prothèses conventionnelles avaient presque 5 fois plus de chance d’avoir une stomatite prothétique que ceux portant des prothèses mandibulaires hybrides retenues par 2 implants (p < 0.0001). Les aînés ayant subjectivement une mauvaise santé générale avaient une qualité de sommeil moins bonne que ceux avec une meilleure santé générale subjective (p < 0.05). Les personnes qui avaient une OHRQoL moins bonne étaient presque 4 fois plus somnolentes pendant le jour que celles avec une meilleure OHRQoL (p=0.003, χ2; OR =3.8 CI 1.5 to 9.8). L'analyse de régression a montré que la santé générale subjective et OHRQoL prévoient la qualité du sommeil (p=0.022 et p=0.001, respectivement) et la somnolence diurne (p=0.017 et p=0.005, respectivement). Conclusions: Les résultats de cette étude suggèrent que, chez les aînés édentés, des prothèses mandibulaires hybrides retenues par deux implants amènent une amélioration significative de la qualité de vie reliée à la santé bucco-dentaire et maintiennent la sensation d’une meilleure santé physique. Des prothèses hybrides implanto-portées peuvent contribuer à la santé orale en réduisant les traumatismes infligés à la muqueuse orale et en contrôlant la stomatite prothétique. Les aînés édentés dont le niveau de qualité de vie reliée à la santé bucco-dentaire est bas, peuvent aussi avoir des troubles de qualité du sommeil.

Patterns and quality of object-oriented software systems

Lors de ces dix dernières années, le coût de la maintenance des systèmes orientés objets s'est accru jusqu' à compter pour plus de 70% du coût total des systèmes. Cette situation est due à plusieurs facteurs, parmi lesquels les plus importants sont: l'imprécision des spécifications des utilisateurs, l'environnement d'exécution changeant rapidement et la mauvaise qualité interne des systèmes. Parmi tous ces facteurs, le seul sur lequel nous ayons un réel contrôle est la qualité interne des systèmes. De nombreux modèles de qualité ont été proposés dans la littérature pour contribuer à contrôler la qualité. Cependant, la plupart de ces modèles utilisent des métriques de classes (nombre de méthodes d'une classe par exemple) ou des métriques de relations entre classes (couplage entre deux classes par exemple) pour mesurer les attributs internes des systèmes. Pourtant, la qualité des systèmes par objets ne dépend pas uniquement de la structure de leurs classes et que mesurent les métriques, mais aussi de la façon dont celles-ci sont organisées, c'est-à-dire de leur conception, qui se manifeste généralement à travers les patrons de conception et les anti-patrons. Dans cette thèse nous proposons la méthode DEQUALITE, qui permet de construire systématiquement des modèles de qualité prenant en compte non seulement les attributs internes des systèmes (grâce aux métriques), mais aussi leur conception (grâce aux patrons de conception et anti-patrons). Cette méthode utilise une approche par apprentissage basée sur les réseaux bayésiens et s'appuie sur les résultats d'une série d'expériences portant sur l'évaluation de l'impact des patrons de conception et des anti-patrons sur la qualité des systèmes. Ces expériences réalisées sur 9 grands systèmes libres orientés objet nous permettent de formuler les conclusions suivantes: • Contre l'intuition, les patrons de conception n'améliorent pas toujours la qualité des systèmes; les implantations très couplées de patrons de conception par exemple affectent la structure des classes et ont un impact négatif sur leur propension aux changements et aux fautes. • Les classes participantes dans des anti-atrons sont beaucoup plus susceptibles de changer et d'être impliquées dans des corrections de fautes que les autres classes d'un système. • Un pourcentage non négligeable de classes sont impliquées simultanément dans des patrons de conception et dans des anti-patrons. Les patrons de conception ont un effet positif en ce sens qu'ils atténuent les anti-patrons. Nous appliquons et validons notre méthode sur trois systèmes libres orientés objet afin de démontrer l'apport de la conception des systèmes dans l'évaluation de la qualité.

Studies on the effect of Polycyclic Aromatic Hydrocarbons in the life and activity of Perna spp

In the present study an endeavour has been made to analyse the acute toxicity of WAFs of Bombay High crude and Light Diesel oil on commercially important bivalve species Perna viridis and Perna indica by static bioassay methods. The toxic effects of chemicals in the WAF on the organisms ; their tissues and eventually on rate functions have been elucidated. Marine oil pollution not only affects productivity and quality of marine organisms but also eventually affects the health of human population due to a possible health risk by way of consumption of oil contaminated seafood

Effects of row spacing on productivity and nodulation of two soybean varieties under hot sub-moist tropical conditions in south-western Ethiopia

The objective of this study was to determine the optimum row spacing to improve the productivity of two soybean (Glycine max L.) varieties under the tropical hot sub-moist agroecological conditions of Ethiopia. A two-year split-plot design experiment was conducted to determine the effect of variety (Awasa-95 [early-maturing], Afgat [medium-maturing]) and row spacing (RS: 20, 25, 30, 35, 40, 45, 50, 55, 60 cm) on the productivity, nodulation and weed infestation of soybean. Seed and total dry matter (TDM) yield per ha and per plant, and weed dry biomass per m^2 were significantly affected by RS. Soybean variety had a significant effect on plant density at harvest and some yield components (plant height, number of seeds/pod, and 1000 seed weight). Generally, seed and TDM yield per ha and per plant were high at 40 cm RS, and weed dry biomass per m^2 was higher for RS >= 40 cm than for narrower RS. However, the results did not demonstrate a consistent pattern along the RS gradient. The medium-maturing variety Afgat experienced higher mortality and ended up with lower final plant density at harvest, but higher plant height, number of seeds per pod and 1000 seed weight than the early-maturing variety Awasa-95. The results indicate that 40 cm RS with 5 cm plant spacing within a row can be used for high productivity and low weed infestation of both soybean varieties in the hot sub-moist tropical environment of south-western Ethiopia.

Effect of planting methods and cyanobacterial inoculants on yield, water productivity and economics of rice cultivation

The impact of two crop planting methods and of the application of cyanobacterial inoculants on plant growth, yield, water productivity and economics of rice cultivation was evaluated with the help of a split plot designed experiment during the rainy season of 2011 in New Delhi, India. Conventional transplanting and system of rice intensification (SRI) were tested as two different planting methods and seven treatments that considered cyanobacterial inoculants and compost were applied with three repetitions each. Results revealed no significant differences in plant performance and crop yield between both planting methods. However, the application of biofilm based BGA bio-fertiliser + 2/3 N had an overall positive impact on both, plant performance (plant height, number of tillers) and crop yield (number and weight of panicles) as well as on grain and straw yield. Higher net return and a higher benefit-cost ratio were observed in rice fields under SRI planting method, whereas the application of BGA + PGPR + 2/3 N resulted in highest values. Total water productivity and irrigation water productivity was significantly higher under SRI practices (5.95 and 3.67 kg ha^(-1) mm^(-1)) compared to practices of conventional transplanting (3.36 and 2.44), meaning that using SRI method, water saving of about 34 % could be achieved and significantly less water was required to produce one kg of rice. This study could show that a combination of plant growth promoting rhizobacteria (PGPR) in conjunction with BGA and 2/3 dose of mineral N fertiliser can support crop growth performance, crop yields and reduces overall production cost, wherefore this practices should be used in the integrated nutrient management of rice fields in India.

Meat yield and quality of Tanzania Shorthorn Zebu cattle finished on molasses/maize grain with agro-processing by-products in 90 days feedlot period

This study was conducted to evaluate the effects of feeding molasses or maize grain with agro-processing by-products on yield and quality of meat from Tanzania shorthorn zebu (TSZ) cattle. Forty five steers aged 2.5 to 3.0 years with 200 +/- 5.4 kg body weight were allocated into five dietary treatments namely hominy feed with molasses (HFMO), rice polishing with molasses (RPMO), hominy feed with maize meal (HFMM), rice polishing with maize meal (RPMM) and maize meal with molasses (MMMO). Ad libitum amount of each dietary treatment and hay were offered to nine steers for 90 days. Cooking loss (CL) and Warner Bratzler shear force (WBSF) values were determined on M. longissimus thoracis et lumborum aged for 3, 6, 9 and 12 days. Steers fed on HFMO diet had higher (P < 0.05) nutrient intake (86.39 MJ/d energy; 867 g/d CP), weight gain (919 g/d) and half carcass weight (75.8 kg) than those fed other diets. Meat of steers from all diets was tender with average WBSF values of 47.9 N cm^(−2). The CL (22.0 +/- 0.61%) and WBSF (53.4 +/- 0.70 N cm^(−2)) were highest in meat aged for 3 days followed by 6, 9 and 12 days. WBSF values for meat aged for 9 and 12 days from steers fed HFMO and RPMM diets were similar and lower than those on other dietary treatments x aging periods. Overall, molasses and hominy feed can be used to replace maize meal in feedlot finishing diets to spare its use in animal feeds.

Neurocognition in schizophrenia : A study of the productivity and visibility of Spanish authors

Resumen tomado de la publicaci??n

Relationship between physical capacity and quality of life in workers university

Aim: Examine the relationship between the functional capacity and the quality of life related to health in university workers. Methodology: Cross-sectional study in 146 subjects, divided in two groups: Low functional Capacity (< 9 METs) and High functional Capacity (> 9.1 METs). We evaluated quality of life related to health (HRQOL-Health Questionnaire SF-12) and functional capacity (Questionnaire PAR/PAF) as indicators of health status. Results: 47.3% (69 men) and 52.7% (78 women). The average age of the groups was 35.0 ± 9.7 years (range 19,0-60,0 years). For HRQOL, the average found in the population assessed was 45.2 ± 4.42 (range 33,0-58,1) and 43.8 ± 6.87 (range 19,8-43,8) in components Physical Component Summary (PCS-12) and Mental Component Summary (MCS-12), respectively p = NS. Significant differences were found when comparing functional ability and sex, p<0,001 in both groups. Similarly, sex and mental component MCS-12 (group of Lower Functional) p = 0,049 as well as women and the physical component PCS-12, p = 0,05 between groups. Finally, a better score in HRQL observed in the group of High Capacity and functional components in both sex OR 0.59 (0.25-1.38). Conclusions: The results of this study demonstrate the relationship between High functional Capacity and a better HRQOL in this population.

Effects of restricted water availability and increased temperature on the grain filling, drying and quality of winter wheat

Experiments in controlled environments examined the effects of the timing and severity of drought, and increased temperature, on grain development of Hereward winter wheat. Environmental effects on grain specific weight, protein content, Hagberg Falling Number, SDS-sedimentation volume, and sulphur content were also studied. Drought and increased temperature applied before the end of grain filling shortened the grain filling period and reduced grain yield, mean grain weight and specific weight. Grain filling was most severely affected by drought between days 1-14 after anthesis. Protein content was increased by stresses before the end of grain growth, because nitrogen harvest index was less severely affected than was dry matter harvest index. Hagberg Falling Number was increased to the greatest extent by stresses applied 15-28 days after anthesis. Treatment effects on grain sulphur content were similar to those on protein content, such that N:S ratio was not significantly affected by drought nor temperature stresses. The effects of restricted water on grain yield and quality were linearly related to soil moisture between 44 and about 73% field capacity (FC) from days 15-28. Drought stress (but not temperature stress) before the end of grain filling decreased SDS-sedimentation volume relative to drought applied later. (C) 2003 Elsevier Science Ltd. All rights reserved.