Walkability evaluation sourounding university campus

The pedestrian space should encourage walking and offer safety and comfort for all people. One of the most widely used modes of transportation to access a university campus is on foot. To identify the degree of safety and comfort offered by the infrastructure intended for pedestrians around three university campuses in Marilia (SP), to develop their daily activities such as study, research, work and medical care, performance indicators were used, developed by Cerna (2014), and a walkability index, developed by Pires et al. (2017), based on the method proposed by Cerna. The results show that among the evaluated themes, the indicators related to Traffic light, sidewalks, passenger shelters (bus stop), bus stops and sidewalks had the worst scores. These results point to the effectiveness of the method and thus, they can contribute so that managers and owners of buildings around these university campuses can improve the quality of the access infrastructure to the respective universities.

Destructive Role of COVID-19 Fear on Nurses Performance: Mediating Role of Stress

Given its importance to psychological issues, the COVID-19 pandemic has created numerous challenges for all individuals, but healthcare professionals and particularly nursing staff are at front lines, and their performance is significantly affected. The current study relates COVID-19 fear with psychological strain, i.e., stress amongst the nursing staff. Moreover, the intervening role of COVID-19 stress between COVID-19 fear and the performance of the nursing staff has also been tested. An online survey was conducted to collect data from nurses. A total of 471 responses of nurses were received during the process of online data collection from 16 November 2020 to 30 April 2021. Results revealed the significant effect of COVID-19 fear on COVID-19 stress and the performance of nurses. Additionally, the results substantiate that COVID-19 stress mediates between COVID-19 fear and the health care performance of nurses. COVID-19 fear has become a psychological consequence that increases stress among nursing staffs. This study fills the research gap about the performance of the health care sectors, particularly with respect to COVID-19 fear and COVID-19 stress among nurses. Hence, COVID-19 fear plays a significant role in COVID-19 stress in terms of influencing the health care performance of nurses. Overall, the results give pragmatic insights for the consequences of the COVID-19 pandemic.

Quality of Care: Performance Measurement and Quality Improvement in Clinical Practice

Attention to the quality of care within the United States health care system has grown tremendously over the past decade. We have witnessed a significant change in how quality improvement and clinical performance measurement are approached. The current focus on quality and safety stems in part from the increasingly clear realization that more services and technological advancement are not automatically equivalent to high-quality care. Much of the discussion about cost and quality in health care is shifting towards the concept of value. Value is defined as health outcomes achieved per dollar spent (in other words, an assessment of the quality of care per cost). This chapter reviews the current state of quality improvement in health care and, because improvement cannot be determined without measurement, reviews several aspects of effective clinical performance measurement. Since many measures are already in place, the chapter describes some of the organizations involved in quality measurement and improvement, as well the approaches they utilize. It looks at the multiple strategies in place to improve quality, from process management to collaboration, from financial incentives to transparency, and reviews newer models of care delivery that may materialize in the near future. Tables list types of quality measures, characteristics to consider when developing a quality measure, and organizations involved in quality improvement and performance measurement. A figure shows strategies used by the federal government to spur performance measurement and quality improvement. This review contains 1 figure, 3 tables, and 56 references Keywords: Quality of care, performance measure, quality improvement, clinical practice, sigma six, transparency

Orem's Self-Care Deficit Nursing Theory to Improve Children's Self-Care: An Integrative Review

Often school-age children are thought of as dependent on their parents and not necessarily involved in behaviors related to their own self-care. It is important to implement and advance self-care performance early in life to promote healthy lifestyles. This review examined the use of Orem's Self Care Deficit Nursing Theory in relation to children's self-care behaviors. This integrative review followed the Whittemore and Knafl guidelines. A systematic search was conducted using the nursing databases. The sixteen study articles were identified for the review, and five themes were identified. Children can develop skills and actively participate in maintaining health and wellbeing. Self-care programs based on Orem's theory are well suited to assist individuals including children to improve self-care skills that lead better self-care practices. Nurses guided by Orem's SCDNT will be well equipped to promote children's knowledge and self-care skills for maintaining health and preventing negative health outcomes.

The Quality of Primary Care Performance in Private Sector Facilities in Nairobi, Kenya: A Cross-Sectional Descriptive Survey

BackgroundIntegrated health services with an emphasis on primary care are needed for effective primary health care and achievement of universal health coverage. The key elements of high quality primary care are first-contact access, continuity, comprehensiveness, coordination, and person-centredness. In Kenya, there is little information on these key elements and such information is needed to improve service delivery. This study aimed to evaluate the quality of primary care performance in a group of private sector clinics in Nairobi, Kenya.Methods A cross-sectional descriptive study adapted the Primary Care Assessment Tool for the Kenyan context and surveyed 412 systematically sampled primary care users, from 13 PC clinics. Data was analysed to measure 11 domains of primary care performance and two aggregated primary care scores using the Statistical Package for Social Sciences.Results Mean primary care score was 2.64 (SD=0.23) and the mean expanded primary care score was 2.68 (SD=0.19), implying poor overall performance. The domains of first contact-utilisation, coordination (information system), family-centredness and cultural competence had mean scores of >3.0 (acceptable to good performance). The domains of first contact (access), coordination, comprehensiveness (provided and available), ongoing care and community-orientation had mean scores of < 3.0 (poor performance). Older respondents (p=0.05) and those with higher affiliation to the clinics (p=0.01) were more likely to rate primary care as acceptable to good.Conclusion These primary care clinics in Nairobi had a poor overall performance. There was a report of acceptable-to-good performance in first-contact utilisation, the information systems, family centredness and cultural competence. However, patients rated first-contact access, ongoing care, coordination of care, comprehensiveness of services, community orientation and availability of a complete primary health care team, as poor. Performance could be improved by deploying family physicians, increasing the scope of practice to become more comprehensive, improving access after-hours and marketing the use of the clinics to the practice population.

Usual Source of Primary Care and Preventive Care Measures in a Pandemic: A Nationwide Study in Japan

Objectives. In a pandemic when there are many barriers to providing preventive care by health care workers, it is unclear whether primary care contributes to the quality of preventive care and what type of preventive care delivery is a challenge for primary care providers. This study aimed to assess multiple preventive care measures and to examine their associations with having a usual source of primary care and primary care performance during the COVID-19 pandemic in Japan. Design. Nationwide cross-sectional study. Setting. Japanese general adult population. Participants. 1,757 adult residents. Primary outcome measures. Fourteen preventive care measures aggregated the overall, screening, immunization, and counseling composites. Results. Depression screening, zoster vaccination, and tetanus vaccination had low implementation rates even among participants with a usual source of primary care. After adjustment for possible confounders, having a usual source of primary care was positively associated with all preventive care composites. Primary care performance assessed by the Japanese version of Primary Care Assessment Tool Short Form was also dose-dependently associated with an increase in all composites. Results of the sensitivity analyses using a different calculation of preventive care composite were similar to those of the primary analyses. Conclusions. Receipt of primary care, particularly high-quality primary care, contributed to increased preventive care utilization even during the COVID-19 pandemic. However, the rate of mental health screening in primary care was at a very low level. Therefore, addressing mental health issues should be a major challenge for primary care providers during and after the pandemic.

Research trend analysis of Korean new graduate nurses using topic modeling

Purpose: The aim of this study is to analyze the research trends of articles on just graduated Korean nurses during the past 10 years for exploring strategies for clinical adaptation. Methods: The topics of new graduate nurses were extracted from 110 articles that have been published in Korean journals between January 2010 and July 2020. Abstracts were retrieved from 4 databases (DBpia, RISS, KISS and Google scholar). Keywords were extracted from the abstracts and cleaned using semantic morphemes. Network analysis and topic modeling were performed using the NetMiner program. Results: The core keywords included ‘education’, ‘training’, ‘program’, ‘skill’, ‘care’, ‘performance’, and ‘satisfaction’. In recent articles on new graduate nurses, three major topics were extracted by Latent Dirichlet Allocation (LDA) techniques: ‘turnover’, ‘adaptation’, ‘education’. Conclusion: Previous articles focused on exploring the factors related to the adaptation and turnover intentions of new graduate nurses. It is necessary to conduct further research focused on various interventions at the individual, task, and organizational levels to improve the retention of new graduate nurses.