The Need for Head Protection Protocols for Craniectomy Patients during Rest, Transfers and Turning

After craniectomy, patients are generally advised to wear a helmet when mobilising to protect the unshielded brain from damage. However, there exists limited guidance regarding head protection for patients at rest and when being transferred or turned. Here, we emphasise the need for such protocols and utilise evidence from several sources to affirm our viewpoint. A literature search was first performed using MEDLINE and EMBASE, looking for published material relating to head protection for patients post-craniectomy during rest, transfer or turning. No articles were identified using a wide-ranging search strategy. Next, we surveyed and interviewed staff and patients from our neurosurgical centre to ascertain how often their craniectomy site was exposed to external pressure and the precautions taken to prevent this. 59% of patients admitted resting in contact with the craniectomy site, in agreement with the observations of 67% of staff. In 63% of these patients, this occurred on a daily basis and for some, was associated with symptoms suggestive of raised intracranial pressure. 44% of staff did not use a method to prevent craniectomy site contact while 65% utilised no additional precautions during transfer or turning. 63% of patients received no information about avoiding craniectomy site contact upon discharge, and almost all surveyed wished for resting head protection if it were available. We argue that pragmatic guidelines are needed and that our results support this perspective. As such, we offer a simple, practical protocol which can be adopted and iteratively improved as further evidence becomes available in this area

The effect of mobile-wallet service dimensions on customer satisfaction and loyalty: An empirical study

AbstractElectronic payment options have mostly superseded traditional cash payment methods. The growth of digital wallets, e-commerce, mobile payments, and other unusual payment methods has moved the global economy one step closer to a cashless society. Therefore, this study aims to understand how mobile-wallet service quality dimensions affect customer satisfaction and loyalty, as well as to explore users’ experiences with these wallets. The dimensions of the mobile wallet adopted were service quality, ease of use, usefulness, cost, and security. A quantitative approach was used, and a questionnaire was utilized and distributed based on a convenience sample of 557 respondents who were located in Jordan. The statistical techniques of AMOS and SPSS have been applied. The analysis results supported all the main hypotheses, arguing that mobile-wallet service quality leads to customer satisfaction and loyalty. Additionally, mobile wallet service dimensions have an impact on customer loyalty through customer satisfaction. Furthermore, it found that the perceived ease of use, perceived usefulness, and perceived security dimensions have no impact on customer satisfaction. Moreover, perceived ease of use and perceived security dimensions have no impact on customer loyalty. The study recommended the need for m-wallet providers to support m-wallets and other electronic services to enhance the possibility of good control over their technological tools to improve service quality, reduce costs, improve security, develop the relationship between the organization and its customers, and learn more about their desires and aspirations