Knowledge, attitude and practice of hospital senior and middle management towards health care quality programs in eastern Saudi Arabia

Quality programs are not new to Saudi hospitals. The first known quality program was started in ARAMCO Hospital in 1982. Besides the Ministry of Health, the main provider of health care, more than 15 providers share in the delivery of the health care in Saudi Arabia. Quality activities being sporadic, with no national control, the programs depend'heavily on the top management commitment and support. The success of quality programs varies among the different health care providers. Hence the need to investigate the knowledge, attitude and practice of the senior and middle managers (HSMM) towards quality programs. The findings of their investigation could throw some light on some incorrect concepts and explain the reasons behind the ineffective practice of quality. Two studies were conducted simultaneously for this research. A descriptive study to investigate the knowledge, attitude and practice of the HSMM, for which two data collecting tools were used. The HSMM self administered questionnaire was completed by the HSMM of 20 selected hospitals in the Eastern Saudi Arabia; 173 HSMM responded to the study giving response rate of 86.5%. The other tool used for the descriptive study was a check list completed by the researcher on each studied hospital. The other part of this research was the action research aimed at exploring the amount of the support HSMM extends to these activities in order to enhance quality services in their hospitals. The study revealed that a majority of senior and middle managers had enough knowledge to initiate very promising quality programs, but there seemed to be a problem with their attitude on quality which affected the implementation of the quality program. Attending training courses on quality subjects made a significant difference to the general information, factor enhancing quality program, causes of quality program failure and the ranking of HSMM towards quality programs. Combining all of these significant variables and classifying them based on their relation with the patient, quality program and staff gave a clear indication that most were related to attitude. The study concluded " that the input and the output of the hospital had less impact on quality programs compared to the process reflected by the knowledge, attitude and practice of the HSMM. Recommendations cover the input, output and the process of quality programs, with more emphasis on the process. The HSMM should pave the way for a quality culture in the hospital which pays proper attention to the development of the skills of the staff and their orientation to the quality environment

Knowledge, attitude and practice of hospital senior and middle management towards health care quality programs in eastern Saudi Arabia

Quality programs are not new to Saudi hospitals. The first known quality program was started in ARAMCO Hospital in 1982. Besides the Ministry of Health, the main provider of health care, more than 15 providers share in the delivery of the health care in Saudi Arabia. Quality activities being sporadic, with no national control, the programs depend'heavily on the top management commitment and support.The success of quality programs varies among the different health care providers. Hence the need to investigate the knowledge, attitude and practice of the senior and middle managers (HSMM) towards quality programs. The findings of their investigation could throw some light on some incorrect concepts and explain the reasons behind the ineffective practice of quality.Two studies were conducted simultaneously for this research. A descriptive study to investigate the knowledge, attitude and practice of the HSMM, for which two data collecting tools were used. The HSMM self administered questionnaire was completed by the HSMM of 20 selected hospitals in the Eastern Saudi Arabia; 173 HSMM responded to the study giving response rate of 86.5%. The other tool used for the descriptive study was a check list completed by the researcher on each studied hospital. The other part of this research was the action research aimed at exploring the amount of the support HSMM extends to these activities in order to enhance quality services in their hospitals.The study revealed that a majority of senior and middle managers had enough knowledge to initiate very promising quality programs, but there seemed to be a problem with their attitude on quality which affected the implementation of the quality program.Attending training courses on quality subjects made a significant difference to the general information, factor enhancing quality program, causes of quality program failure and the ranking of HSMM towards quality programs. Combining all of these significant variables and classifying them based on their relation with the patient, quality program and staff gave a clear indication thatmost were related to attitude.The study concluded " that the input and the output of the hospital had less impact on quality programs compared to the process reflected by the knowledge, attitude and practice of the HSMM.Recommendations cover the input, output and the process of quality programs, with more emphasis on the process. The HSMM should pave the way for a quality culture in the hospital which pays proper attention to the development of the skills of the staff and their orientation to the quality environment

Antimicrobial activity of Dracaena cinnabari resin from Soqotra Island on multi drug resistant human pathogens

Background: Few studies showed that Dracaena cinnabari resin, collected from Soqotra Island,  Yemen,  has antimicrobial activity. This study is the first to investigate antimicrobial activity of the resin on both antibiotic multi-resistant human pathogens and on poly-microbial culture.Material and Methods: Antimicrobial activity of ethanolic extract of Dracaena cinnabari resin from  Soqotra Island on multidrug resistant Gram-positive and Gram-negative human ATCC standard pathogens  and Ascosphaera apis, the causal organism of chalkbrood disease of honeybee was studied using the agar disc diffusion method. The minimal inhibitory concentration of extracts was carried out by  the broth micro dilution method.Results: Ethanolic extract of Dracaena cinnabari resin showed a considerable antimicrobial activity  against all the pathogens tested. The zone of inhibition were between 4.9-11.5 mm. The most sensitive  microbe was Staphylococcus aureus and least sensitive was Aspergillus nidulans. The minimal inhibitory concentration of the extract against Escherichia. coli ATCC 10402, Klebsiella pneumonia ATCC 10031, and Staphylococcus aureus ATCC 29212 was 1.25 μg/mL (w/v) and for the other pathogens (Candida albicans ATCC 10231, Salmonella typhimurum ATCC 3311 and Pseudomonos aeruginosa ATCC 2785) was 2.5 μg/mL (w/v).Conclusion: Ethanolic extract of Dracaena cinnabari resin has a considerable antimicrobial activity  against Gram-positive and Gram-negative human pathogens and fungi. This extract might possess a role in the management of microbial infections in human and honeybee disease.Key words: Antimicrobial Activity, Dracaena cinnabari, Human pathogens, Minimum Inhibitory Concentratio

Knowledge and Attitude of Saudi Arabian School Teachers with Regards to Emergency Management of Dental Trauma

Injury to both the primary and the permanent dentitions and their supporting structures is one of the most common dental problems seen in children.  School is one of the locations with greatest prevalence of occurrence of traumatic dental injuries.  School teachers play important role in prevention of dental trauma and improving its prognosis. The present study was undertaken to assess knowledge and attitudes regarding emergency management of dental trauma, first aid for avulsed tooth and influence of dental education among school teachers in Abha city. METHODS: The participants were 100 school teachers from Abha city and were interviewed using a questionnaire regarding management of dental trauma.  The completed proformas was collected and the result was statistically analyzed to know the knowledge and attitudes regarding emergency management of dental trauma. CONCLUSIONS: Majority of school staff had little knowledge related to handling of traumatic dental injuries and emergency management of avulsed permanent teeth in school children. Majority of school teachers were eager to have knowledge regarding dental trauma through continues dental education programs and workshops.  First aid training increases knowledge about dental trauma and should be included in the course curriculum of teachers training program

Survival implications vs. complications: unraveling the impact of vitamin D adjunctive use in critically ill patients with COVID-19—A multicenter cohort study

BackgroundDespite insufficient evidence, vitamin D has been used as adjunctive therapy in critically ill patients with COVID-19. This study evaluates the effectiveness and safety of vitamin D as an adjunctive therapy in critically ill COVID-19 patients.MethodsA multicenter retrospective cohort study that included all adult COVID-19 patients admitted to the intensive care units (ICUs) between March 2020 and July 2021. Patients were categorized into two groups based on their vitamin D use throughout their ICU stay (control vs. vitamin D). The primary endpoint was in-hospital mortality. Secondary outcomes were the length of stay (LOS), mechanical ventilation (MV) duration, and ICU-acquired complications. Propensity score (PS) matching (1:1) was used based on the predefined criteria. Multivariable logistic, Cox proportional hazards, and negative binomial regression analyses were employed as appropriate.ResultsA total of 1,435 patients were included in the study. Vitamin D was initiated in 177 patients (12.3%), whereas 1,258 patients did not receive it. A total of 288 patients were matched (1:1) using PS. The in-hospital mortality showed no difference between patients who received vitamin D and the control group (HR 1.22, 95% CI 0.87–1.71; p = 0.26). However, MV duration and ICU LOS were longer in the vitamin D group (beta coefficient 0.24 (95% CI 0.00–0.47), p = 0.05 and beta coefficient 0.16 (95% CI −0.01 to 0.33), p = 0.07, respectively). As an exploratory outcome, patients who received vitamin D were more likely to develop major bleeding than those who did not [OR 3.48 (95% CI 1.10, 10.94), p = 0.03].ConclusionThe use of vitamin D as adjunctive therapy in COVID-19 critically ill patients was not associated with survival benefits but was linked with longer MV duration, ICU LOS, and higher odds of major bleeding

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Rheological and thermal behaviour of high impact polystyrene nanocomposite

This paper presents the study of rheological and thermal behaviour of high impact polystyrene/multiwall carbon nanotubes (HIPS/MWCNTs) nanocomposite. The nanocomposite was prepared via melt mixing method. The influence of different loadings of MWCNTs on the HIPS viscosity and other rheological characteristics were analyzed experimentally. Other rheological characteristics were studied using dynamic analysis of viscosity through rotational rehometer. Glass transition temperature (Tg) were also investigated using non-isothermal differential scanning calorimeter analysis. The viscosity was found to be directly proportional to MWCNTs’ loading, up to five times the value of pure HIPS at loading level of 7.5wt% of MWCNTs. The MWCNTs loading demonstrated a marginal effect (1-2%) on the Tg

Mechanical performance and water absorption resistance of HIPS/MWCNTs nanocomposite

The purpose of this research work is to evaluate the effects of reinforcing high impact polystyrene (HIPS’s) with multiwall carbon nanotubes (MWCNTs) on the mechanical performance and the water absorption resistance. The significant changes in HIPS/MWCNTs nanocomposite on the mechanical performance and water absorption resistance were investigated with different weight percentage of MWCNTs in the range of 0.10 wt% to 10 wt%