This study aimed to further elucidate the process of identity adaptation in people with schizophrenia by talking to them about their illness. Semi-structured interviews were conducted with nine community-dwelling people with schizophrenia. Analysis was performed using Krippendorf’s approach, and Text Mining. Eleven content categories were derived: “illness acceptance”, “self-control”, “help from family”, “help from friends”, “help from doctors or nurses”, “modifying thinking”, “social roles and activities”, “worthwhile work”, “enjoyment of life”, “being happy”, and “being free”. Participants with schizophrenia were found to attain “illness acceptance” based on “help from family”, “help from friends”, and “help from doctors and nurses”. Text mining results is 400 keywords were identified. The top 5 in order of importance and frequency were: “omou” (feel/think), “naru” (become), “iu” (say), “suru” (do), and “kusuri” (medication).As a result of an interactive process surrounding the concepts of “illness acceptance”, “self-control” and “modifying thinking” the participants sought out “social roles and activities” and “worthwhile work” to acquire a social identity. Thus, it was found that the participants felt they “enjoyed life and were happy” and “they were free”, because they were productive members of society.
In Japan cancer has been the most common cause of deaths since 1981, and effort has been made to provide countermeasure for cancers. The key to countermeasures is for the general population including cancer patients to know about and overcome cancer. Because the development of cancer is related to lifestyle, it is necessary to work at preventing cancer with attention to the conduct of daily life. The five-year relative survival rate registered in the community from 2006 to 2008 was 62.1%, and this illustrates that there are many cancer survivors leading daily lives after contracting cancer. Uterine cancer was the fifth most common in cancer in 2013. However, it is an important object of the treatment to prevent postoperative complications in gynecologic cancer patients, such as development of lymphedema, because it is reported that the survival rate of uterine cancer is high. The incidence of lymphedema is reported to be between 27.2% and 42% in Japan. Once lymphedema develops, it is difficult to cure, making prevention of the onset an important issue. As a result of the multiple logistic regression analysis performed here using patients where the right femoral circumference increased 2 cm or more as an objective variable, there were differences between the groups analyzed (intervention and control). Compared to the intervention group, 4.46 times more patients in the control group had increases in the right femoral circumference by 2 cm or more. We conducted a randomized controlled trial of an intervention program to promote self-management to prevent lymphedema development after gynecological cancer surgery, and examined the effectiveness at 12 months after the surgery. From the results it can be inferred that observing the lymphedema symptoms including measuring and recording of femoral circumferences and body weight by patients themselves influenced the promotion of self-management. Six months after the surgery, there were significantly more patients who developed lymphedema in the control group, but there were no differences between the groups at 12 months after the surgery. Lymphedema development after gynecological cancer surgery appears about 2.6 months after surgery and chronic lymphedema often appears around 9.7 months after surgery. It can be inferred that this difference is due to the temporary improvement of lymphatic reflux after the improvement of edema. The difference in femoral circumferences is sometimes used as one diagnostic tool for the determination of lymphedema. In this study, we compared the right femoral circumferences before discharge and 12 months after the surgery. Mild lymphedema is defined as larger than 10 mm but smaller than 20 mm in any dimension. In severe cases, a dimension may be larger than 20 mm]. In this study, we performed a multiple logistic regression analysis by defining the patients with lymphedema as patients whose right femoral circumference is increased more than 2 cm. The analysis showed the following as factors influencing the increase in the right femoral circumference by more than 2 cm: group (intervention and control), aerobic exercise, and self-efficacy. Compared to the intervention group, 4.46 times more patients in the control group had increases in the right femoral circumference of more than 2 cm, and this suggests that the intervention program to promote self-management to prevent lymphedema after gynecological cancer surgery is effective at 12 months after the surgery.
in exploring the occurrence of CF in acute care contexts [5].As a result of the practice contexts, evidence suggests that healthcare workers in acute care contexts are at additional risk for developing CF [6].It is noted from the existing literature that the concept of CF has been described in various terminologies, some of which included secondary traumatization, secondary traumatic stress, and vicarious traumatization [7].Despite the subtle difference of the concepts of these terms, these terms were often used interchangeably with CF in studies related to the cumulative effects of exposure to traumatic on healthcare workers [8,9].However, very few studies have systematically integrated and synthesized the literature on CF and the related terminologies [5], which could result in ambiguity and misinterpretation in the understanding of the existing evidence [10].This integrative review intends to contribute to this growing area of research by scrutinizing, appraising, and synthesizing the international evidence on the key issues of CF and the related concepts among healthcare personnel in acute care contexts.By addressing the available evidence comprehensively, it is anticipated that this review could provide grounds for future researchers pertain to CF. II. METHODS A. Search strategy and selection criteriaTo enable a comprehensive understanding of the manifestation of CF, this review has incorporated quantitative, qualitative, and mixed methods data.Integrating evidence from different research methods and designs would probably enhance the utility and relevance of the findings of a literature review to inform policy and practice [11].A comprehensive literature search was conducted following the adapted PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines [12] on various wide-ranging electronic databases, including CINAHL, EBSCOhost, EMBASE, MEDLINE, ProQuest, PsycINFO, and PubMed.The review considered qualitative and quantitative studies published in the period from 2000 to 2016 September that addressed issues of compassion fatigue and the related concepts.The search terms used for the retrieval of literature were as follows: [compassion fatigue OR secondary traumatization OR secondary traumatic stress OR vicarious traumatization*] AND [healthcare personnel OR healthcare worker* OR healthcare professional* OR healthcare specialist*].A list of 363 articles was retrieved after the search.Seven additional articles were identified
Emergency nurses are regarded as the key healthcare professional (HCP) in the emergency department endof-life (ED-EOL) care. The emergency nurses encountered the dying and death on a regular base. Still, they find the EOL care is another aspect and caring from their usual practice. With the successful ED-EOL care delivery, it can help to meet the needs of the imminent patients and families. Emergency nurses admired the pain and symptoms management helping the ED-EOL patients. This paper reviewed the existing literature on the emergency nurses’ perception of ED-EOL care. A systematic search of the literature published between January 2005 and January 2016 was conducted to identify published studies concerning emergency nurses’ practice and the influencing factors in EOL care provision. The final sample for this integrative review was comprised of 23 studies. It is suggested in the results of the included studies that emergency nurses’ EOL care in the clinical context could involve the care of the dying patients and their families in both physical, psychosocial and spiritual aspects. Further study of the emergency nurses and different ED-HCPs are encouraged which could make the ED-EOL care more fruitful and bright in the future.
The objective of this study was to determine a causal process underlying work engagement, in which individual resources (i.e., resilience) and job resources influence work performance, mediated by work engagement in different types of nurses working in long-term care contexts. We investigated a work engagement causal model in which individual and job resources were set as antecedent factors, work engagement as a mediating factor, and work performance as the outcome, to clarify differences between registered nurses (RNs) and licensed practical nurses (LPNs) working in long-term care contexts. We conducted a questionnaire-based survey with 1,786 Japanese nurses working in long-term care contexts in the Tohoku region. Using 1,269 respondents, we examined the causal model using structural equation modeling (SEM) and multiple population analysis to compare between RNs and LPNs. The results revealed a process whereby individual and job resources influenced work performance, mediated by work engagement, in RNs. In other words, greater individual and job resources enhance pride in work and positive emotion (i.e., work engagement), and greater positive emotion improves work performance. This process was not equivalent in LPNs. In LPNs, the most significant factor affecting work performance was the direct effect of job resources; moreover, the mediating effect of work engagement was not supported. The results demonstrated that in order to improve performance among LPNs working in long-term care contexts, it is important to provide job resource support, as well as to facilitate positive emotion through pride in one’s work.
— In December 2012 a norovirus infection outbreak occurred in the Orthopedic Surgery Ward of Hospital A in Japan. This study aims to establish details of coping behaviors used by nurses, physicians, physiotherapists, and pharmacists of the facility, and examine the issues involved in infection control by team collaboration as well as the ways employed to deal with the infections. Participants in this study were thirty-seven medical professionals who were working in the Orthopedic Surgery Ward of Hospital A at the time the infection outbreak occurred, and who were still working there when the interviews were conducted. Interviews were conducted from January to April 2015, and the data from the interviews were analyzed using the “Trend Search 2008” text mining software. As a result of the analysis it was found that the nurses primarily communicated information by passing messages to the nurses who took over the duty at shift changes, but did not pass on the information to staff in other occupations or to the ward as a whole. The nurses clearly remembered that the ward was closed and it was a difficult experience, but did not remember details of the patients they were in charge of. The physicians clearly remembered individual patients they were in charge of, but they were not aware of the situation and state throughout the ward. The findings suggest that this difference is due to the differences in the occupational nature and sense of values of the staff involved. It is also found that physiotherapists did not feel a sense of crisis about the norovirus outbreak because they felt the patients in the ward appeared to be in better condition than patients in other wards, and that pharmacists lacked communication with staff in other occupations because they usually have heavy workloads. In concept mappings of physicians, physiotherapists, and pharmacists, the keyword places in the center of the maps, and is linked to and . Because the nurse plays a central role to report information among the four occupations, nurses should be aware of and assigned to play the role to coordinate team collaboration.
— The aim of this study is to identify relationships between striving for work-life balance (S-WLB), sense of coherence (SOC), and intention to leave among hospital nurses. In August of 2017, we conducted a self-administered questionnaire survey to 2239 nurses at nine public hospitals. The questionnaire included demographic factors, work environmental factors, organizational factors, striving for worklife balance, a 13-item SOC, the Maslach Burnout Inventory, and intention to leave. We carried out a multiple regression analysis with intention to leave as the dependent variable and others as independent variables. We obtained valid responses from 1368 full-time employed nurses (61.1%). The mean age of respondents was 36.38 ± 10.18 years, and the length of clinical experience 13.4 ± 9.65 years. The mean total score of the intention to leave was 14.58 ± 5.09. As a result of the multiple regression analysis, the S-WLB and the SOC were found to be statistically related to the intention to leave even after controlling for the confounding factor of burnout. In addition, the satisfaction of desire level for the actual working assignment at the workplace was a significant independent factor. In this study, the full-time nursing staff had a low intention to leave score when they had a high score in the S-WLB and the SOC. It was also found that the level of satisfaction with appointment to a desired assignment is a significant factor in the intention to leave. In establishing an attractive workplace for nursing staff, it is important to create a workplace environment and supports to be able to properly evaluate workplace satisfaction after assignments are made while taking into account individual S-WLB and SOC functions.
Background: Human papillomavirus (HPV) infection is a sexually transmitted infection common in teenagers and adults in their early 20s. Some types of HPV are associated with 90% of cervical cancer around the world. The risk of HPV infection in women can be reduced by giving HPV vaccine to girls beginning at the age of 9, as recommended by Centers for Disease Control and Prevention (CDC). For children and young adolescents, parental decision on HPV vaccination is crucial for the uptake of HPV vaccine rate. This study explored the factors influencing parental decisions on HPV vaccination for their daughters. Methods: A cross-sectional survey was conducted between February and March 2017. Data were collected from parents of girls aged 9 to 17 (n=420, 100 % response rate) in Hong Kong. A validated 27-item questionnaire was used to elicit parents’ knowledge on HPV and HPV vaccine, barriers to HPV vaccination, and willingness toward vaccinating their daughter(s). Results: Only 59.6% of respondents were aware of the HPV vaccine before this study. Among the parents who were aware of the vaccine, around 32% had already vaccinated their daughters. Majority (83%) of the parents had heard of HPV, but the knowledge levels were poor (70% scored below average). The reasons parents did not vaccinate their daughters were fear of the side-effects of the vaccine (85.7%) and feared the vaccine would affect the immune system of their daughters (38.5%); around 18% believed that HPV vaccination would encourage early sexual activity or promiscuity. More than half of the respondents (69.7%) were willing to vaccine their daughter(s). Conclusions: Given the evidence of suboptimal awareness about HPV vaccination, education and promotional strategies should be enhanced. Interventions should address parental concerns about the misconceptions between vaccination and early sexual activity and promiscuity.
Surrogacy is always a controversial topic in the world, especially when it is with payment. In this article, the issues about the surrogacy and its risks the women’s health, treating women as a commodity, constitutes babies-selling, changes the traditional family structure and values, degrades women productive dignity and exploits women from lower social stratum have been discussed. In Hong Kong, surrogacy is not against the law. However, using it for commercial surrogacy is prohibited. Surrogacy is gaining popularity in the West. However, it is still not widely accepted because of the strong sense of blood ties within the family in Chinese society. The non-commercialization and non-enforcement approaches of surrogacy are adopted in Hong Kong to protect the welfare of the child and the surrogate mother to uphold family values and family integrity, as well as to keep the commercial market out of family relationships.
Breast cancer is a global public health concern. Currently, the crude incidence rate of breast cancer in Hong Kong is increasing. Although breast self-examination (BSE) is an effective screening method which able to reduce mortality rates, only a few women perform it monthly. As nurses play a significant role in promoting BSE, this study aims to study the knowledge, attitude, and practice of BSE for nursing students. A crosssectional design was employed, and 372 nursing students participated in this study. Results reveal that even BSE are compulsory in nursing curriculum, poor knowledge (“don’t know” 46.9%, incorrect 9.4%.), poor attitude (mean = 24.29, SD = 3.49) and limited practice (mean = 7.69, SD = 4.66) were found. Regression analysis support that knowledge and attitude predict practice of BSE. It is important to promote and build up the awareness of BSE to nursing students by enhancing their knowledge and attitude.
—Background: Urinary incontinence is a common disorder that affects men and women of all ages. An effective management of urinary incontinence requires adequate knowledge and positive attitudes from health care professionals. Nursing students who share similar care tasks with qualified nurses should have adequate knowledge to provide quality continence care. There is little evidence to inform the knowledge and attitudes toward urinary incontinence among nursing students in Hong Kong. The purpose of this study was to examine nursing students’ urinary incontinence knowledge and attitude. Methods: A crosssectional survey was conducted in February 2017. A sample of 392 nursing students from 5 different educational institutions in Hong Kong was recruited. Two validated questionnaires, the Urinary Incontinence Knowledge Scale (UIKS) and Urinary Incontinence Attitude Scale (UIAS) were used to measure knowledge and attitudes towards urinary incontinence respectively. Results: Overall urinary incontinence knowledge was moderate (73.3%, mean 22.0/30, SD 4.4) and attitudes concerning urinary incontinence were generally positive (69.3%, mean 41.6/60, SD 4.5). There was a weak correlation between urinary incontinence knowledge and attitudes (r = 0.175, p = 0.001). A high level of interest in learning more about urinary incontinence was reported (71.2%). Conclusions: Hong Kong nursing students had moderate level of knowledge and positive attitude towards urinary incontinence. This study suggests that nursing students in Hong Kong are not well prepared to provide urinary incontinence care. There is still a need to examine the urinary incontinence course content within the nursing programme in Hong Kong.
Substance abuse is a global challenge with an inimical effect on an individual’s health. It has been associated with crime, violence, risky behaviour, and poor health consequences. The term “Pink Cloud” is used to describe a state in which a person undergoing treatment manifests euphoria, overconfidence, and a false sense of well-being, therefore making them vulnerable to relapse. This study determined the demographic profile, and risk status for relapse, and motivation, readiness for and retention in treatment of ruled drug users in ICDTRC and their corresponding relationships with one another. The researchers utilized a descriptive-correlational design and two modified questionnaires were employed to 22 respondents. The data obtained were analyzed through Pearson Correlational Formula. It was found that 13 or 59% of the respondents are not at risk for relapse. There is a direct relationship between their risk status for relapse and gender, educational attainment, marital status, employment status, and length of stay in rehab. Furthermore, majority of the respondents have medium to high motivation, readiness for and retention in treatment, which has an inverse relationship with their age, marital status, employment status, and length of stay in rehab. The researchers conclude that men have a higher rate of drug abuse than women and being single, unemployed, having a high education level and low income may increase one’s risk for drug use. Additionally, single, unemployed, and younger respondents who stayed for less than 90 days in rehab tended to have better motivation to retain treatment. Thus, it is imperative for symptoms of relapse to be continually assessed throughout the treatment program to promote a lasting recovery. Increasing awareness on Pink Cloud Syndrome and its symptoms through health teaching and use of a targeted treatment approach for each individual are also recommended to improve treatment outcome.
Dementia prevalence is accelerating internationally commensurate with population aging causing suffering from families as well as society burden because it is generally met with misunderstanding, fear, and stigma. Therefore, it is hoped that efforts to increase awareness, reduce stigma, and clarify misunderstandings of the illness can enable early detection of dementia. There are many different tests that were used to assess dementia knowledge however the use of inferior methods could account for some inconsistent findings related to dementia knowledge. It is important to define robustness of the psychometric properties of dementia knowledge tools. The aim of this study is to provide a systematic overview of what is known from previous research on assessing the reliability and validity of psychometric properties of dementia knowledge scales. A systematic literature search (2009 - 2017) was performed using the electronic databases PubMed, Web of science and Google scholar in English and Vietnamese. References and citations were tracked to identify additional, relevant studies basing on study eligibility criteria and excluded criteria. Five original studies were recruited from 562 studies in the selected databases for analyzing of the measurement properties of dementia knowledge scales. Quality judgment criteria were formulated and used to evaluate the psychometric aspects of the scales. Results: This systematic review revealed 4 dementia knowledge scales (ADKS, DKAS, DK-20, DKAT2) in 5 selected researches. Our findings (based on quality judgment criteria relating to validity, reliability, feasibility) demonstrate that ADKS, DKAS show good psychometric qualities, ranging from 15-17 score of psychometric qualities of dementia knowledge scale. The last two (DK-20 and DKAT2) scored 11 and 13 points of a maximum quality score of 20, respectively, so their psychometric quality can be regarded as moderate. Therefore, these tools await confirmation of various aspects of their psychometric properties. Conclusion: Based on the psychometric qualities, we concluded that ADKS and DKAS are the appropriate scales currently available. Further research should focus on improving these scales by further testing their validity, reliability, and utility.
Purpose: Volunteer activities in Japan may be expected to result in a variety of effects on health conditions and social contributions of the elderly depending on the degree of their activity participation. This study aims to identify differences in the health conditions and social contributions of the elderly in relation to the degree of volunteer activity participation, and determine what effective support can be provided for these elderly persons. Further, focusing on the differences in the level of activity of the elderly persons in volunteer activities, we discuss the effect of management through SWOT analysis from the perspectives suggested by the Balanced Scorecard (BSC), which is a performance management tool. Participants and Methods: The participants are elderly persons participating in volunteer activities, living in municipal housing owned by the Kumamoto prefecture in Japan. We classified the participants into an active group who contributed to the raising of funds for activities, and a non-active group. We conducted group interviews with the volunteers, organized interview data on the thoughts of the two groups according to the five perspectives of the balanced score card (BSC) management tool: (1) learning and development, (2) participants, (3) financial matters, (4) process of conducting activities, and (5) social contributions, and conducted a Strength-Weakness-OpportunityThreat (SWOT) analysis. In the SWOT analysis internal factors are distinguished into strengths and weaknesses, and external factors into opportunities and threats. Combining the internal and external factors, problems were extracted from the perspective of a positive strategy (S+O: strength + opportunity), a differentiation strategy (S+T: strength L threat), a stepwise strategy (W+O: weakness + opportunity), and a defensive strategy (W+T: weakness + threat). Then, we confirmed the main results by identifying the major factors in success to achieve salient aims, activity goals, and specific measures from the five perspectives provided by the BSC. Results: When comparing the strengths of the two groups, the active group showed the following characteristics in the information collecting: more variety in the collected information (perspective of learning and development), ease of obtaining information of potential volunteers (perspective of participants), knowledge of how to raise funds (perspective of financial matters), and being physically more active and knowledgeable of the local community (perspective of social contributions).From the perspective of the process of conducting activities, both groups place importance on the relations among people. For weaknesses, and from the perspective of learning and development, the active group had difficulty in maintaining their motivation, and from the perspective of financial matters this group had difficulties in securing funds. From the perspective of social contributions, the non-active group depended on the active members. From the perspective of participants, both groups experienced a decline in physical function with age, and from the perspective of the process of activities there was a possibility that family or individual circumstances make it difficult to participate in all activities. In the SWOT analysis, combining the internal and external factors, we evaluated the directionality of volunteer activities from the five perspectives of the BSC. From the perspective of learning and development, regardless of the differences in the level of activity of the elderly persons in the volunteer activities, the volunteer members conducted a signature-collecting campaign to call for continuing volunteer activities for residents among those in their surroundings, and this made it possible to continue volunteer activities. From the perspective of the process of conducting activities, regardless of the differences in the level of activity of the elderly persons in the volunteer activities, the volunteer members became active in making remarks, and started to assume roles voluntarily. From the perspective of financial matters, the volunteer members were able to obtain donations for volunteer activities from neighboring establishments, as well as financial support from the social welfare council, by applying for subsidies for activities. From the perspective of participants, the number of new members increased through word of mouth spread by the existing membership. From the perspective of social cost, there was a remark that “I would like my schedule to be full of enjoyable events so that I become too busy to go to the hospital”, and in fact some members did reduce the frequency of hospital visits Discussion: Participants in this study are members of a volunteer group of elderly persons voluntarily formed in a regional city in Kumamoto prefecture where the elderly population accounts for 25.7% and is expected to increase. It appears that there is a self- and mutual- help relationship between active and non-active members where non-active members rely on the active members who assist the non-active members to be in harmony with the volunteer activities led by the active members, and that this relationship helps maintain independent lives. For the strengths, active members were able to collect more information from the perspective of learning and development, and contributed more through physical activity from the perspective of social contributions. It can be inferred that physically more active elderly persons are in a situation where they remain able to use their cognitive functions to collect information. For the weaknesses, the active members experienced loss of motivation. This may be due to the possibility that active members feel it a burden to assist non-active members. We wish to conduct further studies to understand how to maintain and improve motivation. The results of the SWOT analysis from the perspectives suggested by the BSC showed that there are differences in health conditions and social contributions of the elderly depending on the participation in volunteer activities, and what types of support from health services can be expected to be effective. This study evaluated the achievements of the volunteer activity goals of elderly persons by identifying the details of volunteer activities and quantifying the goals. The elderly members began to seek for new ideas to achieve better results when they were convinced that there were favorable results of their activities. This suggests that the PDCA cycle in volunteer activities may work by effecting empowerment in the process of BSC.
Purpose: This study aims to understand the assertiveness of preceptors of novice nurses and factors affecting the assertiveness through a longitudinal perspective. Methods: Anonymous self-rating questionnaire surveys were administered to 1292 preceptors working in participating city and university hospitals across Japan (August, 2013 (baseline) and March, 2014 (second survey)). The surveys had question items from the Japanese version of the Rathus Assertiveness Schedule (J-RAS, 30 items), demographic details of the participants, evaluation of novice nurses by preceptors, instruction framework, selfevaluation of preceptors, working environment, and a burnout inventory (Japanese version of the Maslach Burnout InventoryHuman Services Survey, 22 items). Bivariate analyses (T-tests and one-way analysis of variance) were conducted using assertiveness of the second survey as the objective variable, and other items of the baseline survey as explanatory variables. Selecting variables with p values smaller than 0.2 obtained in the bivariate analysis as explanatory variables, a multiple linear regression analysis (Stepwise method) was conducted. For the analyses, we used a statistics analysis software, SPSS Statistic 22. Results: Choosing 836 valid respondents of the baseline survey as a cohort group, we repeated the survey 8 months after the baseline survey to identify the factors affecting the assertiveness of preceptors of novice nurses. Excluding 62 who had missing values in the question items for assertiveness, 472 participants who were followed were included in analyses. As the results, following factors were found to affect the assertiveness: thinking that ‘they make rapid decisions’, and that ‘they are valuable as others’. Further, participants who have higher total burnout scores had lower assertiveness. Adjusted coefficient of determination was 0.153. Discussion: It can be inferred that the assertiveness of preceptors is higher than that of novice nurses measured by the J-RAS used in this study, and lower than that of administrative nurses. The assertiveness of preceptors was higher among participants who evaluated themselves positively, thinking that ‘they make rapid decisions’, and that ‘they are valuable as others’. It was also found that higher ‘total burnout scores’ was a factor that lowers the assertiveness. These findings suggest that a positive self-evaluation improves assertiveness and helps to prevent burnout
Ash is not a homogenous product. It is the solid residue of combustion and contains a complex mixture of chemical products. The ash residue resulting from fires varies and is dependent on its source, and burn characteristics such as the temperature of the fire. Ash comprises particles of carbon, soot and trace elements. Ash presents public health risk to people and communities, through direct and indirect ingestion and inhalation. The health effects of ash exposure are not limited to symptoms affecting the eyes, throat and lungs. They can contribute to chronic disease and increase the risk of cancer. The purpose of this study was to evaluate the public health implications of controlled burns in the Darling Escarpment, adjacent to Perth’s metropolitan area in Western Australia. Concentrations of metals in unburnt vegetative litter and ash (post burn), stratified by size fraction, were determined to assess the potential mobilisation of metals caused by prescribed burns and the potential public health implications associated with burns. These data can also be used in predictive modelling to ascertain the amount of metals likely to be released per hectare when authorities plan future burns in the area. Ash samples were collected immediately following the fire to capture fine material before it was blown away. The ash samples were separated into size fractions to investigate whether there are differences within each sub sample. Australia’s National Environmental Protection Measures were used to establish whether the metal concentrations were above designated thresholds for health and environmental investigation, these being the recognised levels above which metals are deemed to pose a risk to public (or environmental) health. Vegetation and ash samples were collected from three sites immediately after the prescribed burn. Samples were analysed for thirteen (13) metals with nine (9) showing statistically significant increases in concentrations in vegetation as compared to ash. The percentages of metals are higher in ash than in vegetative ground litter. The metals identified are Manganese - Vegetation (158.3 ± 89.3 mg/kg), Ash (442.2 ± 462.6 mg/kg); Barium - Vegetation (19.4 ± 25.3 mg/kg); Ash (41.8 ± 62.7 mg/kg); Zinc - Vegetation (15.3 ± 9.7 mg/kg), Ash (25.6 ± 29.7 mg/kg); Vanadium - Vegetation (31.0 mg/kg ± 76.3 mg/kg), Ash (32.2 mg/kg ± 51.0 mg/kg); Copper - Vegetation (4.2 ± 1.5 mg/kg), Ash (10.9 ± 9.8 mg/kg); Chromium (Total) - Vegetation (8.3 ± 15.6 mg/kg), Ash (9.6 ± 12.4 mg/kg); Lead - Vegetation (6.1 ± 8.3 mg/kg), Ash (12.2 ± 8.5 mg/kg); Nickel - Vegetation (2.2 ± 2.2 mg/kg), Ash (4.7 ± 4.4mg/kg) and Cadmium - Vegetation (0.6 ± 0.9 mg/kg), Ash (0.6 ± 0.9 mg/kg). The ash samples were sieved through three aperture’s (2-4 mm, 1-2 mm, <1 mm) to stratify the samples by size fraction and concentrations in all but three of the metals increased as the ash size decreased. It was demonstrated that the level of metal present within the ash samples did not exceed health investigation levels and, with the exception of Manganese, and did not exceed environmental investigations levels. Metals were unlikely to pose a risk if left insitu. However, modelling estimated the volume of metal released and it was determined that metals can pose a subsequent risk if mobilised by wind or water. The likelihood of such mobilisation is high and this finding therefore has public health implications for surrounding communities that are subjected to increases in their exposure to metals, associated with bushfires. The findings from this study contribute to the management of prescribed burns by providing a better understanding of the composition of ash and the effects of potential distribution via aerial deposition or runoff. Data from this study can be used to do predictive modelling of heavy metal mobilisation that may result from burns of similar vegetation environments. This becomes particularly significant where burns are conducted in water catchment areas
Background: Obesity is a global problem. Healthy workplace and personal lifestyle behavior are crucial for obesity prevention. A workplace weight management program could create a culture of health and facilitate weight control among health care providers. The study aims to describe and evaluate the health outcomes of the interaction of professional work and organizational infrastructure. Method: The hospital-based weight management program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index. The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, highdensity and low-density lipoprotein, body fat percentage, and body mass. The RE-AIM framework was used to examine the intervention’s Reach, Effectiveness, Adoption, Implementation and Maintenance at individual and organizational level. Results: The program was successful in reaching the target population. Health care providers demonstrated shortterm weight loss and decrease in serum fasting cholesterol level after completing the program. The excellent retention rate (89%) of the study suggested that the participants were well engaged in self-weight management. The program was implemented with adequate resource and support from the health organization. The organization may consider to continue the program in view of the long term benefits of the health care providers Conclusion: Supportive organizational structure and culture not only enhance professional practice but also improve the health outcomes of the participants in hospital-based weight management program
In their attempts to balance sleep routines with service schedules, nurses working in shifts are at risk for developing sleep disorders. Furthermore, nurses often experience considerable stress. In recent years, research has acknowledged the importance of activities other than work, and in particular recovery experiences. Therefore, the current study aimed to explore gender differences in sleeping hours and recovery experience of psychiatric nurses from a 16-hour shift to two days off duty. We found that males went to bed late and that females rose slightly early on days where they worked night shifts. On average, the sleeping hours of males were about 2 hours longer than were those of females. Furthermore, sleeping hours was positively related to mastery in males, while in females working hours was negatively related to psychological detachment and relaxation. Before the night shift, females engaged more housekeeping and used short sleeping hours during rest to compensate for the lack of sleep. Thus, recovery experience had different relationships with various life activities between male and female nurses. The results highlighted the need for health management interventions
Knowledge and understanding of Tuberculosis (TB) is essential in rendering quality care to all individuals, since Nursing is a profession of caring individuals from womb to tomb. This research is about the level of performance of staff nurses on their rendering care among TB patients in the wards. It is quantitative and comparative which covered 22 staff nurses and five head nurses from selected government hospitals in Quezon province. They were selected using purposive sampling. The profile of staff nurses includes gender, age, and length of service. The head nurses are all female and in their late adulthood. The study was conducted in Guinayangan Medicare Community Hospital, Maria L. Eleazar District Hospital, and Magsaysay Memorial District Hospital. The respondents answered the adapted questionnaires from the Orientation of Hospitals on Benchbook Self-Assessment and Accreditation Process Manual II 2005 of Philippine Health Insurance Corporation which was modified by the researcher into two questionnaires and were validated by experts. The questionnaire for staff nurses had a reliability result of 0.97 and 0.99 for head nurses respectively using Cronbach Alpha. Statistical treatments that were utilized includes: frequency and percentage, mean, standard deviation, and independent sample t-Test. The result elucidated that there was no significant difference in their perceived level of performance in rendering care among TB patients in the wards when their profiles were considered. It can also be concluded that there was no significant difference between the perception of the head nurses and the staff nurses on their level of performance in rendering care among TB patients in the wards. Moreover, enhancement program pertaining to Evaluation of Care, Access, and Assessment through trainings and seminars were included
