The impact of the digital divide on the perceived interest of an e-Marketplace to support healthcare and social care services

HCIST 2014 - International Conference on Health and Social Care Information Systems and Technologies, Procedia TechnologyIn a Europe increasingly aging, it is now recognized the importance and potential of the service industry for ageing well based on information and communication technologies (ICT), as exemplified by the electronic market of social services and health care, the GuiMarket, proposed by the authors. However, this new range of services requires that individuals have advanced digital skills to fully participate in society. Based on the results of a survey made on a sample of 315 individuals, this paper discusses the importance granted GuiMarket and the intended frequency of use, concluding there is a close relationship between ICT access and use that respondents anticipate making of GuiMarket and alike services

Pointwise estimates for the Bergman kernel of the weighted Fock space

We prove upper pointwise estimates for the Bergman kernel of the weighted Fock space of entire functions in $L^2(e^{-2\phi})$ where $\phi$ is a subharmonic function with $\Delta \phi$ a doubling measure. We derive estimates for the canonical solution operator to the inhomogeneous Cauchy-Riemann equation and we characterize the compactness of this operator in terms of $\Delta \phi$

A new organizational model for preventing inpatient falls using a computerized control system

Medical administrators continue to be challenged by the goal of providing safe and qualitative care to all patients. To the constant demand for care improvement and quality assurance in accordance with high standards expectations of safe care have been added. Despite efforts, the high incidence of patient\u27s falls in a hospital setting remains unresolved. Systemic review of the literature on fall prevention in hospitals has found no consistent evidence regarding the effectiveness of single or multiple interventions to prevent falls. Research on the prevention of inpatient falls has largely focused on two main areas: (1) Patient risk factors related to inpatients falls and (2) Interventions (fall risk assessment, armbands, medication review and use of physical restraints) to reduce falls in hospitals. Findings nonetheless show that inpatient falls cannot be resolved by any one measure. Purpose: To assess introduction of a new organizational model for reducing rates of inpatient falls based on a computerized control system operating in three essential spheres. Method: The intervention was introduced in 2013 in a major medical center (1,500 beds, 120 wards, 2,500 nurses) located in Israel within the framework of the international Joint Commission for Hospital Accreditation. The intervention program was implemented in three spheres. Sphere 1: Declaration by nursing management of policy aimed at reducing the incidence of patient falls and minimizing the harm from falls during hospitalization. The intervention focused on changing perception of this issue by increasing knowledge and awareness among all levels of the caregiving staff, from nurses\u27 shift managers to auxiliary caregivers, by using an e-learning course and participation in dedicated seminars. These training programs followed up with computerized control reports, which received by deputy nurses. Sphere 2: Introduction of a computerized control system to ensure that all patient fall risk factors are assessed and appropriate intervention documented according to the adopted prevention policy. The reports enabled nurses in charge as well as nursing management to identify the effective aspects of fall prevention requiring reinforcement in addition to those aspects requiring immediate intervention. Sphere 3: Introduction of a computerized control system enabling real-time transmission of alerts and information on each fall incident documented in the patient\u27s file. In response to the current data, the nursing management introduced a post-fall assessment procedure to be completed immediately after the incident. This data also enabled profiling patients who fell during hospitalization together with provision of immediate as well as quarterly feedback to all nurse managers regarding their meeting of the annual fall-reduction goals defined by nursing management (reduction of fall rate by at least 10% annually). All three spheres were accompanied by deputy nurse\u27s assigned responsibility for inpatient fall prevention, who acted under the direction and supervision of the Supervisor of Fall Prevention. Assessment of the project\u27s implementation indicated attainment of the goals set: During the first three quarters of 2015, there was a 20% reduction of reported falls when compared with the equivalent period in 2014. This model for the promotion and improvement of patient care by means of a computerized control system was shown to be effective in assisting decision-making in other areas of care as well, such as prevention of bedsores and pain reduction. Pivotal aspects of the program and its implementation will be discussed further during the presentation

Nurse\u27s turnover in acute clinical setting

Session presented on Friday, July 24, 2015: Purpose: To describe the causes of nurses\u27 resignation, and to compare the demographic, professional and attitudinal characteristics of nurses that resign with those of nurses that choose to remain in two major hospitals in Israel. Methods: A matched case control study conducted among 100 resigning nurses and 200 remaining nurses (matching by age, gender and department). Exit interviews to obtain data on reasons for resignation, job satisfaction, buRNt, perception of quality of patient care and perception of professional autonomy. A retrospective study to compare demographic and professional characteristics of entire nursing staff (n=1897) with all nurses resigning (n=153) from one hospital during 2012. Results: Findings from the case control analysis indicate that resigning nurses are young in terms of age but also years of experience in the organization (23% of the nurses had up to one-year\u27s experience, about 40% had up to 2 years of experience, with 70% of the resignations occurring within the first 5 years of employment in the hospital), have no managerial positions (91%), work part time, and have an academic degree (30% had eaRN an MSN). Comparison between the entire population of nurses working and all the nurses resigning from the selected hospital during 2012 indicates that resigning nurses were characterized by young age (30% were under 30 years of age) and a high percentage of male nurses. Distance from place of employment (37%) and working conditions (28%) were given as primary causes of resignation. Distance from place of employment was the most frequent reason given by young, single women holding no managerial positions, working part time, with seniority of up to 5 years. Working conditions were the most frequent reason given by married men aged 30+ with seniority of over 5 years, holding part-time managerial positions, and having no academic education. Lack of professional advancement was most frequently indicated as another reason for resigning by men with an academic education holding part-time managerial positions. Nurses having a master degree but no managerial position in the organization were found to be much more likely (2.6 times as much) to resign in comparison to others, or occupying a managerial position in the organization. In addition, less-experienced nurses and nurses working part time were much more likely to resign in comparison to more experienced nurses or nurses working full time. A significant difference was found between resigning and remaining nurses regarding their perceptions of professional autonomy, with resigning nurses reporting a lower level of autonomy than remaining nurses. In addition, aspirations for professional advancement were found to be higher among resigning than among remaining nurses. BuRNt, job satisfaction and perception of quality of care did not predict resignation. Conclusion: Mapping the causes of tuRNer according to the characteristics of those resigning contributed to our understanding several important aspects of nursing staff retention in hospitals. Such understanding is crucial for decision makers when identifying the weaknesses and strengths of their organization\u27s efforts to retain employees and making informed decisions regarding future modes of operation and organizational strategies. Findings that nurses resigning differed from those remaining by demographic variables and professional skills, not attitudes, indicate low organizational commitment among young nurses working part time. In light of the current findings and a survey of the research literature, we believe it important that interventions aimed at new nursing staff retention focus on developing professional career paths/professional autonomy, especially among nurses having a master degree and working part time in departments having a large nursing staff and male gender. Professional advancement among nurses has been found to contribute to organizational commitment, with a decline in commitment found to motivate the taking of pre-resignation actions and ultimately to the act of resignation

The correlation between anxiety and depression levels and functional capacity in pregnant women with cardiac disease

Session presented on: Monday, July 22, 2013: Purpose: The study aimed to evaluate anxiety and depression levels in pregnant women with cardiac disease; and their relationship with NYHA functional capacity. Methods: A follow-up longitudinal study that included 47 pregnant women with cardiac disease treated in our Heart Center (from a total of 114) was conducted in 3 stages ; after 3 and 6 months of pregnancy and 1 month post delivery . A questionnaire containing personal and medical details, an anxiety questionnaire (Spielberger 1970) and a depression questionnaire (Beck 1961) were utilized. Forty-four of the 47 patients answered all three questionnaires successfully. Data were collected and analyzed using SPSS software. Results: During the 1st trimester 38 women were in NYHA I, 4 in NYHA II and one in NYHA III. In the 2nd trimester, 29 were NYHA I, 10 NYHA II and 3 NYHA III. After delivery, 39 were NYHA I, 3 NYHA II and 1 NYHA III. For the whole cohort average depression and anxiety levels remained low (\u3c 40) throughout pregnancy and there was a significant correlation between functional capacity and anxiety level (p\u3c0.05). When compared to patients in NYHA class I, patients in NYHA class II-III showed more signs of depression and anxiety in all stages of pregnancy, p=0.014. Conclusion: There is a significant correlation between functional capacity, anxiety and depression levels during pregnancy and post- delivery in women with cardiac disease. Clinical deterioration is associated with an increase in depression and anxiety levels

An improved Riemann Mapping Theorem and complexity in potential theory

We discuss applications of an improvement on the Riemann mapping theorem which replaces the unit disc by another "double quadrature domain," i.e., a domain that is a quadrature domain with respect to both area and boundary arc length measure. Unlike the classic Riemann Mapping Theorem, the improved theorem allows the original domain to be finitely connected, and if the original domain has nice boundary, the biholomorphic map can be taken to be close to the identity, and consequently, the double quadrature domain close to the original domain. We explore some of the parallels between this new theorem and the classic theorem, and some of the similarities between the unit disc and the double quadrature domains that arise here. The new results shed light on the complexity of many of the objects of potential theory in multiply connected domains.Comment: 23 page

On a hyperconvex manifold without non-constant bounded holomorphic functions

An example is given of a hyperconvex manifold without non-constant bounded holomorphic functions, which is realized as a domain with real-analytic Levi-flat boundary in a projective surface.Comment: 10 pages, final version, to appear in "Geometric Complex Analysis", Springer Proceedings in Mathematics & Statistic

Antihypertensive therapy adherence in subjects working on rotational basis in Extreme North (notes from practice)

In the camp on the basis of departmental Yamburg MSU in 294 patients with Stage II stage at the age of 20 -59 years studied adherence. The average age of the surveyed was 46,0 ± 6,0 years. Long service manned -12,2 + 4,7 years. The average office BP -157,5 ± 13,7 and 106,7+8,8 mm Hg Mean disease duration - 6,4 ±5,7 years. Prevention education programs 6CC cardiology service in a coverage IFL treatment 98.6% of patients studied. Despite the free drugs only 49.3% of the 294 people regularly take prescribed medication to them. In this case, the target level of office BP was detected in 60.7% of those treated with regular people. The main reasons for refusing treatment were younger age, oligosymptomatic flow (87%), low health literacy - 32%, poor tolerability of the drug -12%. Only 35% of 294 surveyed used the self-BP. Patients took almost the entire range of modern AGT as a single agent and in combination therapy mode, but monotherapy has a leading position. Conclusion: young age, low health literacy, and the need for malosimptomno taking several drugs were the main causes of poor adherence to AHT in patients with hypertension in the watch.В условиях вахтового поселка Ямбург на базе ведомственной МСЧ у 294 больных АГ II стадией в возрасте 20 -59 лет исследована приверженность лечению. Средний возраст обследованных составил 46,0+6,0 лет. Длительность стажа работы вахтой — 12,2+ 4,7лет. Среднее офисное АД - 157,5±13,7 и 106,7±8,8 мм рт.ст. Средняя длительность заболевания - 6,4+5,7 лет. Проведение программы профилактики ССЗ кардиологической службой МСЧ позволило охватить лечением 98,6 % обследованных пациентов. Несмотря на бесплатное лекарственное обеспечение только 49,3% из 294 человек регулярно принимали назначенный им препарат. При этом, целевой уровень офисного АД определялся у 60,7% из числа регулярно лечившихся лиц. Основными причинами отказа от лечения были: молодой возраст, малосимптомное течение (87%), низкая медицинская грамотность - 32%, плохая переносимость назначенного препарата -12%. Только 35% из 294 обследованных применяли самоконтроль АД. Пациенты принимали практически весь спектр современных АГТ, как в режиме монотерапии, так и в режиме комбинации препаратов, но монотерапия занимала ведущие позиции. Заключение: молодой возраст, низкая медицинская грамотность, малосимптомное течение и необходимость приема нескольких препаратов стали основными причинами низкой приверженности АГТ у больных АГ в условиях вахты