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Enhancing Private Healthcare Effectiveness in Lagos State, Nigeria: An Overview of the Effect of Quality Improvement Initiatives and Implications for Sustainable Healthcare Delivery
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作者 Nnenna Mba-Oduwusi Ifesinachi Eze +11 位作者 Tochukwu Osuji Maxwell Obubu Tolulope Oyekanmi Oluwatosin Kolade Ozioma Oguguah Jane Martins Nkata Chuku Alozie Ananaba Rodio Diallo Firdausi Umar Sadiq Emmanuella Zamba Abiola Idowu 《Health》 2024年第2期93-104,共12页
Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge... Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge of ensuring quality healthcare access. The overview of the effect of quality improvement initiatives in this paper focuses on private healthcare providers in Lagos State, Nigeria. The study assesses the impact of donor-funded quality improvement projects on these private healthcare facilities. It explores the level of participation, perceived support, and tangible effects of the initiatives on healthcare delivery within private healthcare facilities. It also examines how these initiatives influence patient inflow and facility ratings, and bring about additional benefits and improvements, provides insights into the challenges faced by private healthcare providers in implementing quality improvement projects and elicits recommendations for improving the effectiveness of such initiatives. Methods: Qualitative research design was employed for in-depth exploration, utilizing semi-structured interviews. Private healthcare providers in Lagos involved in the SP4FP Quality Improvement Project were purposively sampled for diversity. Face-to-face interviews elicited insights into participation, perceived support, and project effects. Questions covered participation levels, support perception, changes observed, challenges faced, and recommendations. Thematic analysis identified recurring themes from interview transcripts. Adherence to ethical guidelines ensured participant confidentiality and informed consent. Results: Respondents affirmed active involvement in the SP4FP Quality Improvement Project, echoing literature emphasizing private-sector collaboration with the public sector. While acknowledging positive influences on facility ratings, respondents highlighted challenges within the broader Nigerian healthcare landscape affecting patient numbers. Respondents cited tangible improvements, particularly in staff management and patient care processes, validating the positive influence of quality improvement projects. Financial constraints emerged as a significant challenge, aligning with existing literature emphasizing the pragmatic difficulties faced by private healthcare providers. Conclusions: This study illuminates the complex landscape of private healthcare provision in Lagos State, emphasizing the positive impact of donor-funded quality improvement projects. The findings provide nuanced insights, guiding policymakers, healthcare managers, and practitioners toward collaborative, sustainable improvements. As Nigeria progresses, these lessons will be crucial in shaping healthcare policies prioritizing population well-being. 展开更多
关键词 Private Healthcare quality improvement Projects Donor-Funded Initiatives Healthcare Delivery Lagos State NIGERIA
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Analysis of the Ideological and Political Concepts and Teaching Strategies for Quality Improvement in Physical Education Courses in Colleges and Universities
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作者 Chenglin Li Hui Cai 《Journal of Contemporary Educational Research》 2024年第7期240-245,共6页
In today’s higher education system,the physical education program is not only for teaching sports skills and exercising physical fitness but also an important position for cultivating students’character,emotions,and... In today’s higher education system,the physical education program is not only for teaching sports skills and exercising physical fitness but also an important position for cultivating students’character,emotions,and values.With the in-depth development of the concept of ideological education,the ideology of college physical education courses has become an important direction of educational reform.In this paper,we will discuss the connotation of the concept of ideology and politics in college physical education courses,analyze the methods to effectively integrate the ideology and politics elements while guaranteeing the quality of teaching,and put forward the corresponding strategies to improve the quality,with a view to providing new ideas and methods for the construction of ideology and politics in college physical education courses. 展开更多
关键词 College physical education Course ideology and politics Teaching quality improvement
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Post-operative morbidity after neoadjuvant chemotherapy and resection for gallbladder cancer: A national surgical quality improvement program analysis
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作者 Minha Kim Stephanie Stroever +3 位作者 Krist Aploks Alexander Ostapenko Xiang Da Dong Ramanathan Seshadri 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第1期95-102,共8页
BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for ... BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for neoadjuvant therapy in gallbladder cancer.As investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative period.We hypothesized patients who underwent NACT were more likely to have higher post-operative morbidity.AIM To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had surgery.METHODS A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had surgery.To calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was performed.RESULTS Of the 452 patients,52 patients received NACT prior to surgery.There were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group. 展开更多
关键词 Gallbladder cancer Neoadjuvant chemotherapy Radical cholecystectomy National Surgery quality improvement Program Postoperative outcome
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Improving the Quality of Public Space in Old Residential Areas Based on Superposition and Intervention:A Case Study of Baihuazhou District of Nanchang City
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作者 LI Shengnan 《Journal of Landscape Research》 2024年第4期13-16,20,共5页
With the development of cities,China has entered an era of stock planning.The functions of old residential areas in urban development can no longer meet the needs of residents in the new era for a better life,and new ... With the development of cities,China has entered an era of stock planning.The functions of old residential areas in urban development can no longer meet the needs of residents in the new era for a better life,and new standards have been put forward for the quality of public spaces for living.This paper analyzes and sorts out the characteristics and problems of the public space in the old residential areas of Baihuazhou district.Combining superposition and intervention techniques,the spatial,historical,cultural and other characteristic elements of the residential areas are preserved to the greatest extent.The public space in the old residential areas of Baihuazhou District is updated and reconstructed in order to achieve the goal of improving the quality of its public space. 展开更多
关键词 Superposition and intervention Old residential area Public space quality improvement Baihuazhou District
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Interventions to Improve HIV Viral Load Suppression among the Adolescents: Evidence of Improvement Science through a Quality Improvement Approach in Eastern Uganda 被引量:1
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作者 Bonniface Oryokot Yunus Miya +6 位作者 Barbara Logose Eunice Ajambo Abraham Ignatius Oluka Charles Odoi Bernard Michael Etukoit Levicatus Mugenyi Kenneth Mugisha 《World Journal of AIDS》 2020年第2期94-106,共13页
<b>Introduction:</b> Achieving viral load suppression among the adolescents living with HIV continues to hold back attainment of sustainable development goals. TASO Mbale realized a viral load suppression ... <b>Introduction:</b> Achieving viral load suppression among the adolescents living with HIV continues to hold back attainment of sustainable development goals. TASO Mbale realized a viral load suppression rate of 63.1% among the adolescents living with HIV in care in quarter 4 of 2016. We therefore, instituted a quality imrpovement project to improve Viral load suppression from 63.1% in quarter 4 2016 to 90% by the end of quarter 4 2017. <b>Method:</b> Baseline data from the Uganda viral load dashboard were analyzed, and fishbone diagram was utilized to provide root causes of low viral load suppression among the adolescents living with HIV at TASO Mbale. The identified barriers were Knowlegde gap, among the adolescents, on positive living, Missing clinic appointments, Sub-optimal adherence, Poorly planned adolescent HIV clinic, Inadequate follow-up and Low use of data for informed decisions. A plan-do-study-act (PDSA) model was applied to implement tested changes. Strategies that worked included introduction of appointment register to track appointment behaviour of the adolescents, generating lists of clients on appointment who were due for Viral Load bleeding, telephone calls for follow up, increasing the frequency of reviewing adolescents from once a month to twice a week, committing a dedicated team responsible for adolescent care. <b>Results:</b> The viral load suppression improved from 63.1% in quarter 4 of 2016 to 63.8% in the first quarter of 2017, to 87.5% in quarter 2 of 2017, 97.6% in the third quarter and 91.4% in quarter 4 of 2017. <b>Conclusion:</b> The use of quality improvement in addressing gaps in HIV service delivery is highly effective. 展开更多
关键词 HIV Adolescents Viral Load Suppression quality improvement
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Empirical Research on Quality Improvement and Effect Increase of Rural Tourist Destination Under the Strategic Background of Rural Revitalization: A Case Study of Xishan District, Kunming City, Yunnan Province
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作者 MA Ying ZHANG Chaoxuan 《Journal of Landscape Research》 2019年第1期90-94,共5页
As one of important channels in rural revitalization and development, rural tourism obtains a lot of remarkable achievements in rural development. However, relatively single product and homogenized development model m... As one of important channels in rural revitalization and development, rural tourism obtains a lot of remarkable achievements in rural development. However, relatively single product and homogenized development model make competition gradually intensify, and many once glorious rural tourist destinations gradually decline. Xishan District of Kunming City of Yunnan Province is taken as research object in this paper. Via literature research, field survey and depth interview, development process, status quo and existing problems of its rural tourism are deeply explored. Based on above research results, development idea, strategy and countermeasure for quality improvement and effect increase of traditional rural tourism destination are proposed, and cooperative development, mutual benefit and win-win are taken as the ultimate development goals. 展开更多
关键词 RURAL REVITALIZATION strategy RURAL tourism DESTINATION quality improvement and EFFECT INCREASE Development path
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Studying Design and Use of Healthcare Technologies in Interaction: The Social Learning Perspective in a Dutch Quality Improvement Collaborative Program
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作者 Esther van Loon Nelly Oudshoorn Roland Bal 《Health》 2014年第15期1903-1918,共16页
Designing technologies is a process that relies on multiple interactions between design and use contexts. These interactions are essential to the development and establishment of technologies. This article seeks to un... Designing technologies is a process that relies on multiple interactions between design and use contexts. These interactions are essential to the development and establishment of technologies. This article seeks to understand the attempts of healthcare organisations to integrate use contexts into the design of healthcare technologies following insights of the theoretical approaches of social learning and user representations. We present a multiple case study of three healthcare technologies involved in improving elderly care practice. These cases were part of a Dutch quality improvement collaborative program, which urged that development of these technologies was not “just” development, but should occur in close collaboration with other parts of the collaborative program, which were more focused on implementation. These cases illustrate different ways to develop technologies in interaction with use contexts and users. Despite the infrastructure of the collaborative program, interactions were not without problems. We conclude by arguing that interactions between design and use are not naturally occurring phenomena, but must be actively organised in order to create effects. 展开更多
关键词 quality improvement COLLABORATIVE PROGRAM SOCIAL Learning User Representation Healthcare Technology LONG-TERM Healthcare
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Effects of Biochar on Tobacco-planting Soil Improvement and Tobacco Quality in Mudanjiang Area 被引量:2
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作者 王欢欢 任天宝 +5 位作者 张志浩 元野 王博 匡岗 刘德玉 刘国顺 《Agricultural Science & Technology》 CAS 2017年第5期820-826,共7页
This study was conducted to study the feasibility of biochar in soil im- provement and tobacco quality. The black soil in NinganCountry of Mudanjiang was used as the material in this study, and the effects of biochar ... This study was conducted to study the feasibility of biochar in soil im- provement and tobacco quality. The black soil in NinganCountry of Mudanjiang was used as the material in this study, and the effects of biochar on tobacco-planting soil C/N, soil microorganisms, the development of tobacco, and chemical compo- nents and neutral aroma components in flue-cured tobacco werestudied. The results showed that the application of biochar at a rate of 1 800 kg/hm2 could increase soil C/N by 31.79%, and the quantity of actinomycetes in the soil was 3.8 times as much as that in control. The growth wasobviously better after biochar application, plant height and effective leaf number were significantly higher than those ofcontrol, but total sugar and nicotine were not significantly different. The application of biochar at a rate of 1 200 kg/hm2 increased the potassium content by 11%, the application of biochar at a rate of 2 400 kg/hm2 improved total sugar content by 5.40%, and the application of biochar at a rate of 1 800 kg/hm2 made the tobacco solanone content 1.97 times as that of control. Comprehensive studies showed that the application of biochar 1 200-1 800 kg/hm2 could improvesoilenvironment, and promote tobacco growth and quality. 展开更多
关键词 Flue-cured tobacco BIOCHAR Soil improvement quality
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Influencing Factors and Improvement Strategy to the Quality of Nursing Work Life: A Review
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作者 Hong Hu Hong Zhou +3 位作者 Fangju Mao Jing Geng Liu Zhang Xi Zhang 《Yangtze Medicine》 2019年第4期253-260,共8页
This review introduces the definition, influencing factors and improvement strategy to the quality of nursing work life, which can provide references for nursing managers to understand the factors affecting the qualit... This review introduces the definition, influencing factors and improvement strategy to the quality of nursing work life, which can provide references for nursing managers to understand the factors affecting the quality of nursing work life and choose effective measures to improve the quality of nursing work life. 展开更多
关键词 Nurses quality of WORK LIFE quality of NURSING WORK LIFE Influencing FACTORS improvement Strategy
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Research on the Construction and Quality Improvement of Art Curriculum in Rural Primary Schools
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作者 Yanjin Li 《Journal of Contemporary Educational Research》 2023年第10期145-149,共5页
Curriculum quality is the foundation of education development and the core element of primary education and teaching.It is a key indicator to measure and evaluate the level of educational development in a country and ... Curriculum quality is the foundation of education development and the core element of primary education and teaching.It is a key indicator to measure and evaluate the level of educational development in a country and region.Curriculum quality needs to be examined not only from the perspective of the degree of achievement of the preset curriculum goals,but also from the perspective of students’subjective feelings and experiences.Art course is the core service provided by the school for students,and the quality of the course is judged by the acquisition and development of students.At the same time,the value of aesthetic education also calls for the reform and improvement of the fine arts curriculum,which requires the fine arts curriculum in all stages in rural areas to get closer and change in this direction.After the promulgation of art curriculum standards,the fine arts curriculum of rural primary schools should follow high quality standards,which is a process of optimization and iteration of various elements of primary art curriculum.The fine arts curriculum of rural primary schools needs to meet the exploration needs of current students,effectively and appropriately develop excellent local resources while enriching the curriculum content,introduce the essence of regional culture and art,improve the evaluation of curriculum quality,and form a scientific curriculum management system,so as to promote the sustainable development of students.According to this understanding,we can improve the quality of art curriculum in rural primary schools from four dimensions:curriculum objectives,curriculum content,curriculum implementation,and curriculum evaluation. 展开更多
关键词 Primary school Art curriculum quality improvement
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Rationale and protocol for estimating the economic value of a multicomponent quality improvement strategy for diabetes care in South Asia
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作者 Kavita Singh Mohammed KAli +17 位作者 Raji Devarajan Roopa Shivashankar Dimple Kondal Vamadevan S.Ajay VUsha Menon Premlata KVarthakavi Vijay Viswanathan Mala Dharmalingam Ganapati Bantwal Rakesh Kumar Sahay Muhammad Qamar Masood Rajesh Khadgawat Ankush Desai Dorairaj Prabhakaran K.M.Venkat Narayan Victoria LPhillips Nikhil Tandon On behalf of the CARRS Trial Group 《Global Health Research and Policy》 2019年第1期333-342,共10页
Background:Economic dimensions of implementing quality improvement for diabetes care are understudied worldwide.We describe the economic evaluation protocol within a randomised controlled trial that tested a multicomp... Background:Economic dimensions of implementing quality improvement for diabetes care are understudied worldwide.We describe the economic evaluation protocol within a randomised controlled trial that tested a multicomponent quality improvement(QI)strategy for individuals with poorly-controlled type 2 diabetes in South Asia.Methods/design:This economic evaluation of the Centre for Cardiometabolic Risk Reduction in South Asia(CARRS)randomised trial involved 1146 people with poorly-controlled type 2 diabetes receiving care at 10 diverse diabetes clinics across India and Pakistan.The economic evaluation comprises both a within-trial cost-effectiveness analysis(mean 2.5 years follow up)and a microsimulation model-based cost-utility analysis(life-time horizon).Effectiveness measures include multiple risk factor control(achieving HbA1c<7%and blood pressure<130/80 mmHg and/or LDL-cholesterol<100 mg/dl),and patient reported outcomes including quality adjusted life years(QALYs)measured by EQ-5D-3 L,hospitalizations,and diabetes related complications at the trial end.Cost measures include direct medical and non-medical costs relevant to outpatient care(consultation fee,medicines,laboratory tests,supplies,food,and escort/accompanying person costs,transport)and inpatient care(hospitalization,transport,and accompanying person costs)of the intervention compared to usual diabetes care.Patient,healthcare system,and societal perspectives will be applied for costing.Both cost and health effects will be discounted at 3%per year for within trial cost-effectiveness analysis over 2.5 years and decision modelling analysis over a lifetime horizon.Outcomes will be reported as the incremental cost-effectiveness ratios(ICER)to achieve multiple risk factor control,avoid diabetes-related complications,or QALYs gained against varying levels of willingness to pay threshold values.Sensitivity analyses will be performed to assess uncertainties around ICER estimates by varying costs(95%CIs)across public vs.private settings and using conservative estimates of effect size(95%CIs)for multiple risk factor control.Costs will be reported in US$2018.Discussion:We hypothesize that the additional upfront costs of delivering the intervention will be counterbalanced by improvements in clinical outcomes and patient-reported outcomes,thereby rendering this multi-component QI intervention cost-effective in resource constrained South Asian settings.Trial registration:ClinicalTrials.gov:NCT01212328. 展开更多
关键词 Economic evaluation Diabetes care Multicomponent strategy quality improvement South Asia
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Stroke nurse-led intravenous thrombolytic therapy strategy for ischemic stroke based on timeline process:A quality improvement program from China
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作者 Baiyu Li Zhufeng Zhang +2 位作者 Keye Li Lingdie Zhao Rong Niu 《International Journal of Nursing Sciences》 CSCD 2024年第5期521-527,I0001,共8页
Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy stra... Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy strategies for stroke could reduce treatment delays.Methods:To reduce delays in IVT therapy for ischemic stroke,a series of quality improvement measures were implemented at a tertiary hospital in Hangzhou,Zhejiang Province,from June 2021 to August 2023,which included developing a timeline process management system,forming a nurse-led stroke process management team,providing homogeneous training,standardizing the IVT therapy process for ischemic stroke,and introducing an incentive policy.During the pre-(from June 2021 to February 2022,group A)and post-(from March to November 2022,group B1;from December 2022 to August 2023,group B2[implementation of an additional incentive policy])of the implementation the strategy,the door-tocomputed tomographic angiography(CTA)time(DCT),CTA time,neurology consultation to consent for IVT,CTA-to-needle time(CNT),and door-to-needle time(DNT),the percentage of people who underwent CTA within 20 min,15 min,and 10 min and DNT within 60 min,45 min,and 30 min were collected and compared.Results:Following the implementation of the standardized IVT process management strategy for stroke,the DNT for group B1 and group B2 were 30(24,44)min and 31(24,41)min,respectively,both significantly lower than the 46(38,58)min in group A(P<0.001);the median DCT were both 13 min in group B1 and B2 lower than 17min in group A(P<0.001);the median CTA were 12 min in Group B1 and 9 min in Group B2 lower than 14 min in group A(P<0.001);similar results were observed during the neurology consultation to obtain consent for IVT and CNT.Compared with group A,the proportion of DCT20 min,15 min,and 10 min was higher in groups B1 and B2(P<0.05),and the same result was observed at DNT60 min,45 min,and 30 min(P<0.05).However,the additional incentive policy did not significantly differ between Group B2 and Group B1.Conclusions:Optimizing IVT therapy for ischemic stroke is a feasible approach to limit the DNT to 30 min in ischemic stroke,significantly reducing delays within the therapeutic window and increasing the number of patients meeting target time segments.Additionally,generating a timeline for the IVT therapy process by scanning positioning quick response codes was a significant breakthrough in achieving the informatization of IVT quality management for stroke. 展开更多
关键词 Ischemic stroke Intravenous thrombolytic therapy Nurses Stroke process quality improvement
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Assessment of Appropriateness of Diagnostic Lymph Node Tissue Collection from the Operating Theater and by Interventional Radiologist. A Clinical Audit
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作者 Kowthar Salman Hassan Divya Deodhar +1 位作者 Abdullah T. Al-Rawahi Mahmood H. Al Abri 《Advances in Infectious Diseases》 CAS 2024年第3期541-548,共8页
Background: Appropriate sample requesting, collecting and timely dispatch to the appropriate laboratory is essential in establishing diagnosis of pathologies with lesions. Much time and effort may be wasted if this is... Background: Appropriate sample requesting, collecting and timely dispatch to the appropriate laboratory is essential in establishing diagnosis of pathologies with lesions. Much time and effort may be wasted if this is not done according to certain standards. We conducted this study to assess the route of lymph node samples from requests to reaching the laboratories. Methods: We conducted an audit over a period from 4th June until 10th Aug 2023. Data for all the procedures performed over this period on lymph node samples (was entered into and analysed using Excel. Results: A total of eighteen samples for sixteen patients were obtained during this period. Median age of the patients was 34 years (19 - 73) with a M:F ratio of 5:11. Among the IR samples, nine samples were from the neck, three from inguinal area and one from axilla. Seven samples (53.8%) were tru-cut biopsies, six samples (46.15%) were FNA. All samples were sent to the pathology laboratory fixed in formalin. Samples for TB were sent only for five cases (31.25%) and for only two cases (12.5%) were samples sent for bacterial culture. For the OR samples, none were sent for either bacterial culture or TB. Overall, eight patients (50%) were not investigated for any infectious etiologies like brucella, toxoplasmosis, CMV, EBV plus other possible causes. Repeat sampling was required for 25% of patients (within and out of the audit period). Conclusions: to avoid delays in making diagnoses, it is paramount to consider infectious etiologies as possible diagnosis for lymphadenopathy and request appropriate investigations. This requires liaising with infectious diseases/clinical microbiology experts to guide regarding types of samples, types of media and timely dispatch to the correct laboratory. 展开更多
关键词 Clinical Audit Clinical Samples BIOPSIES Lymph Nodes Saline FORMALIN quality improvement
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In situ digital testing method for quality assessment of soft soil improvement with polyurethane
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作者 X.F.Wang C.J.Wang +2 位作者 W.V.Yue Z.J.Zhang Z.Q.Yue 《Journal of Rock Mechanics and Geotechnical Engineering》 SCIE CSCD 2024年第5期1732-1748,共17页
This study purposes an in situ testing method on quality assessment of soil improvement.Factual drilling data includes the spatial distribution and in situ strength of untreated and treated soil along three different ... This study purposes an in situ testing method on quality assessment of soil improvement.Factual drilling data includes the spatial distribution and in situ strength of untreated and treated soil along three different drillholes measured by on-site drilling monitoring method.These factual drilling data can characterize the degree of soil improvement by penetration injection with permeable polyurethane.Result from on-site drilling monitoring shows that the linear zones represent constant drilling speeds shown in the plot of drill bit advancement vs.net drilling time,which indicates the spatial distributions of soil profile.The soil profile at the study site is composed of four layers,which includes fill,untreated silty clay,treated silty clay,and mucky soil.The results of soil profile are verified by the parallel site loggings.The constant drilling speeds profile the coring-resistant strength of drilled soils.By comparing with the untreated silty clay,the constant drilling speeds of the treated silty clay have been decreased by 13.0-62.8%.Two drilling-speed-based indices of 61.2%and 65.6%are proposed to assess the decreased average drilling speed and the increased in situ strength of treated silty clay.Laboratory tests,i.e.uniaxial compressive strength(UCS)test,have been performed with core sample to investigate and characterize in situ strength by comparing that with drilling speeds.Results show that the average predicted strengths of treated silty clay are 2.4-6.9 times higher than the average measured strength of untreated silty clay.The UCS-based indices of 374.5%and 344.2%verified the quality assessment(QA)results by this new in situ method.This method provides a cost-effective tool for quality assessment of soil improvement by utilizing the digital drilling data. 展开更多
关键词 Drilling process monitoring system Hydraulic rotary drilling process Constant drilling speed Soil improvement quality assessment
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Assessment of the Physical Capabilities of Heart Failure Patients before and after Cardiovascular Rehabilitation: A Study of 125 Patients from West Africa, Dakar, Senegal
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作者 Aliou Alassane Ngaide Ngoné Diaba Gaye +6 位作者 Joseph Salvador Mingou Mahugbe L. C. Houenassi Aminata Mbaye Aime Mbaye Sy Fatou Aw Alassane Mbaye Abdoul Kane 《World Journal of Cardiovascular Diseases》 CAS 2024年第8期490-501,共12页
Background: Cardiac rehabilitation represents a critical therapeutic strategy for patients suffering from chronic heart failure. The physical capacity of patients with heart failure, assessed using the exercise test a... Background: Cardiac rehabilitation represents a critical therapeutic strategy for patients suffering from chronic heart failure. The physical capacity of patients with heart failure, assessed using the exercise test and the 6-minute walk test, is the measure of the patient’s overall functional ability to perform physical activities and tolerate exercise loads. The objective of this study was to assess the impact of cardiac rehabilitation on patients’ physical capabilities and to conduct a thorough comparison of data obtained via exercise testing and the 6-minute walk test before and after the rehabilitation programme. Methods: This was a descriptive and analytical cross-sectional study, conducted from 1 February 2021 to 31 June 2022. Included were heart failure patients who had participated in an outpatient cardiovascular rehabilitation programme. The collected data included anamnestic, clinical, paraclinical data, and the 6-minute walk test. Informed consent was obtained. Data analysis, word processing, and charting were performed using Microsoft Word 2016, Excel 2013, and Sphinx version 5.1.0.2. Data analysis was performed using SPSS (Statistical Package for Social Sciences) version 24.0. Any difference less than 0.05 was considered statistically significant. Results: In a Senegalese study, heart failure patients undergoing rehabilitation in a cardiac unit represented 45.59% of all cases, with a prevalence rate of 3.21%. The average participant was 57.97 years old, with those aged 61 to 70 forming the largest group (35.5%). The study noted a male predominance (sex ratio of 2.1) and identified dyslipidaemia (80.6%) and sedentarism (71%), as prevalent cardiovascular risk factors. All participants initially suffered from NYHA stage 2 or 3 dyspnoea, yet 80.65% showed no symptoms following rehabilitation. Significant improvements were recorded in resting heart rate (from 79 to 67 bpm), and the 6-minute walk test distance (from 328 m to 470 m). Enhanced exercise tolerance and walking test outcomes were particularly notable in patients with LVEF ≥ 50%, women, non-obese individuals, those initially walking less than 300 m, achieving more than 3 METs, and non-smokers. Conclusion: The findings underscore the effectiveness of cardiovascular rehabilitation in improving symptoms, physical capability, and overall quality of life for heart failure patients in Senegal. 展开更多
关键词 Cardiovascular Rehabilitation Heart Failure Physical Capabilities quality of Life improvement West Africa
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Quieting the neonatal intensive care unit:A quality improvement initiative
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作者 Darshan Rajatadri Rangaswamy Niranjan Kamble Amulya Veeramachaneni 《World Journal of Clinical Pediatrics》 2024年第3期53-60,共8页
BACKGROUND The neonatal intensive care unit(NICU)is vital for preterm infants but is often plagued by harmful noise levels.Excessive noise,ranging from medical equipment to conversations,poses significant health risks... BACKGROUND The neonatal intensive care unit(NICU)is vital for preterm infants but is often plagued by harmful noise levels.Excessive noise,ranging from medical equipment to conversations,poses significant health risks,including hearing impairment and neurodevelopmental issues.The American Academy of Pediatrics recommends strict sound limits to safeguard neonatal well-being.Strategies such as education,environmental modifications,and quiet hours have shown to reduce noise levels.However,up to 60%of the noises remain avoidable.High noise exposure exacerbates physiological disturbances,impacting vital functions and long-term neurological outcomes.Effective noise reduction in the NICU is crucial for promoting optimal neonatal development.AIM To measure the sound levels in a NICU and reduce ambient sound levels by at least 10%from baseline.METHODS A quasi-experimental quality improvement project was conducted over 4 mo in a 20-bed level 3 NICU in a tertiary care medical college.Baseline noise levels were recorded continuously using a sound level meter.The interventions included targeted education,environmental modifications,and organizational changes,and were implemented through three rapid Plan-Do-Study-Act(PDSA)cycles.Weekly feedback and monitoring were conducted,and statistical process control charts were used for analysis.The mean noise values were compared using the paired t-test.RESULTS The baseline mean ambient noise level in the NICU was 67.8 dB,which decreased to 50.5 dB after the first cycle,and further decreased to 47.4 dB and 51.2 dB after subsequent cycles.The reduction in noise levels was 21%during the day and 28%PDSA cycle(mean difference of−17.3 dB,P<0.01).Peak noise levels decreased from 110 dB to 88.24 dB after the intervention.CONCLUSION A multifaceted intervention strategy reduced noise in the NICU by 25%over 4 months.The success of this initiative emphasizes the significance of comprehensive interventions for noise reduction. 展开更多
关键词 quality improvement Noise pollution Preterm care Sound measurement Plan-Do-Study-Act
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Strategies for Enhancing the Affinity of College Ideological and Political Course Teachers
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作者 WANG Na 《Cultural and Religious Studies》 2024年第2期113-117,共5页
This article aims to explore effective ways to enhance the affinity of ideological and political course teachers in universities.By analyzing the connotation of affinity,the factors that affect the affinity of ideolog... This article aims to explore effective ways to enhance the affinity of ideological and political course teachers in universities.By analyzing the connotation of affinity,the factors that affect the affinity of ideological and political course teachers are analyzed,and corresponding improvement strategies are proposed.Research suggests that strengthening the construction of teacher ethics and conduct,improving teaching skills,enhancing emotional engagement,and enhancing practical training are key paths to enhance the affinity of ideological and political course teachers.The implementation of these paths will help improve the teaching quality and effectiveness of ideological and political courses,and promote the comprehensive development of students. 展开更多
关键词 ideological and political courses in universities teacher affinity improvement path teaching quality
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Phytosynthetic bacteria (PSB) as a water quality improvement mechanism in saline-alkali wetland ponds 被引量:11
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作者 LiuFJ HuWY 《Journal of Environmental Sciences》 SCIE EI CAS CSCD 2002年第3期339-344,共6页
The efficiency of phytosynthetic bacteria (PSB) to improve the water quality in saline alkali ponds was studied, the result showed that (1) PSB application could increase the content of DO, NO\+-\-3\|N and effective ... The efficiency of phytosynthetic bacteria (PSB) to improve the water quality in saline alkali ponds was studied, the result showed that (1) PSB application could increase the content of DO, NO\+-\-3\|N and effective phosphorus (EP) in ponds; (2) the changes of COD were not evident, just effective in later period after PSB application; (3) PSB application could decrease the contents of NH\+-\-4\|N (NH\-3\|N), NO\+-\-2\|N ; (4) PSB application could improve the structure of the effective nitrogen (EN) and EP, stimulate the growth of phytoplankton, and increase primary productivity, and finally increase the commercial profits of ponds because of the increase of EP and the decrease of EN contents; (5) the effect exerting speed of PSB was slower, but the effect sustaining time was longer; (6) the appropriate concentration of PSB application in saline alkali wetland ponds was 10×10 -6 mg/L, one time effective period was more than 15 days. So PSB was an efficient water quality improver in saline alkali ponds. 展开更多
关键词 phytosynthetic bacteria (PSB) saline alkali wetland fishpond water quality improving
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Application of PDCA in improving hand hygiene compliance and nosocomial infection quality in orthopedics
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作者 Ya-Ping Su Rui-Ling Li +2 位作者 Yuan-Yuan Wang Yu-Rui Zhang Ya-Jie Ji 《Frontiers of Nursing》 2024年第3期327-336,共10页
Objective:To explore the effect of the Plan-Do-Check-Action(PDCA)cycle on hand hygiene and nosocomial infection quality of or thopedic medical staff.Methods:The whole year of 2021 was selected to monitor the quality o... Objective:To explore the effect of the Plan-Do-Check-Action(PDCA)cycle on hand hygiene and nosocomial infection quality of or thopedic medical staff.Methods:The whole year of 2021 was selected to monitor the quality of hand hygiene and hospitalization.Follow-up monitoring and real-time recording during the period of morning shift and medical operation concentration time,and compare the compliance of hand hygiene before and after implementation,and evaluate the quality of nosocomial infection.Results:The hand hygiene compliance of doctors and nurses in stage P was 82%.The compliance of medical staff in stage D was 93%.The compliance of stage C was 94%and that of stage A was 95%.The quality score of hospital self-examination nosocomial infection was also significantly increased.Conclusions:The PDCA management cycle can effectively improve the compliance of hand hygiene and the nosocomial infection quality,which is wor thy of circulatory application in or thopedic nosocomial infection quality control,especially improving the quality of hand hygiene. 展开更多
关键词 hand hygiene quality improvement PDCA nosocomial infection infection control nursing management
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Analysis of The Impact of Excellent Event Management on the Safety of Patients and Clinical Caregivers
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作者 Linlin He Junwei Guo Jinxia Liu 《Journal of Clinical and Nursing Research》 2024年第4期169-173,共5页
Objective: To investigate the impact of excellent event management in improving patient safety and nursing staff care satisfaction. Methods: The study was analyzed by retrospective comparison, and routine management f... Objective: To investigate the impact of excellent event management in improving patient safety and nursing staff care satisfaction. Methods: The study was analyzed by retrospective comparison, and routine management from January 2022 to December 2022 was set as the control group, and excellent event management from January 2023 to January 2024 was set as the study group. The differences in nursing outcomes between both groups were compared. Results: The rate of adverse events in the study group (0.61%) was lower than that in the control group (0.96%), and the rate of excellent events in the study group (2.57%) was higher than that in the control group (0.97%) (P < 0.05). Meanwhile, the satisfaction level of nursing safety in the study group reached 98.81%, which was much higher than in the control group (92.21%) (P < 0.05). Conclusion: Nursing excellent event management had a positive impact on improving patient care safety satisfaction, reducing the rate of adverse events, and increasing the rate of reporting excellent events. 展开更多
关键词 Excellent events quality of care IMPACT Safety management
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