The implementation of systematic nursing in selected hospitals in India: a chronicle of the change process

This study presents a chronicle of the change process involved in the implementation of systematic nursing in two hospitals in India. The theoretical foundation of the study is drawn from systems theory and planned change theory. Action research methods were employed and the study was conducted in phases. An exploratory study was under¬ taken involving participant observation and unstructured interviews. The existing system of nursing practice was found to be traditional, task-oriented and ritualistic. Preparations for change, including a teaching programme, were carried out over a three month period, and data collecting tools were developed. Two male medical and surgical and three female medical and surgical wards (altogether five wards) were involved in the study. A period of six months was spent on the implementation of systematic nursing. The nurse managers, educators, ward sisters, trained nurses and general nursing students were involved in the change process.The study suggesued . that a model of planned change was necess¬ ary in order to implement systematic nursing. It was concluded that an education programme is necessary to prepare nurses to participate in such a change process. The managerial support and involvement of all those who were concerned with the change was deemed essential. Implications arising from the present study for the development of systematic nursing in research, nursing education and practice are outlined

Profil Hasil Pemeriksaan Darah pada Pasien Positif Malaria di Salah Satu Layanan Primer X di Timika Papua Tahun 2020

Tingkat penyebaran penyakit malaria di berbagai daerah di Papua memiliki jumlah frekuensi yang berbeda-beda. Hal ini disebabkan karena faktor iklim, lingkungan, dan kepadatan penduduk di daerah tersebut. Penelitian ini bertujuan untuk mengetahui daerah atau lokasi bagian mana saja yang memiliki penyebaran penyakit malaria yang terbanyak berdasarkan jumlah kunjungan di Salah Satu Layanan Primer X. Jenis penelitian ini adalah deskriptif retrospektif cross sectional. Penelitian ini dilakukan pada bulan Desember 2020 dengan jumlah sampel 150 responden yang diambil menggunakan metode total sampling. Hasil yang didapatkan adalah lokasi pasien bagian barat dan bagian tengah memiliki kesamaan terdapat 58 orang dengan persentase 38,7% dan yang terendah adalah lokasi pasien bagian timur sebanyak 34 orang dengan persentase 22,7%. Kesimpulan yang didapatkan adalah distribusi frekuensi tempat tinggal pasien penyakit malaria di Salah Satu Layanan Primer X di Timika Papua yaitu lokasi bagian barat dan timur memiliki kesamaan sebanyak 58 pasien (38,7%). Kata kunci: Transmisi, Endemis, Anemia, Relaps. / The level of spread of malaria in various regions in Papua has a number of different frequencies. This is due to climatic, environmental, and population density factors in the area. This study aims to determine which areas or locations have the highest prevalence of malaria based on the number of visits at One of the X Primary Services. This type of research is cross sectional retrospective descriptive. This research was conducted in December 2020 with a total sample of 150 respondents who were taken using the total sampling method. The results obtained were that the xvi western and central patient locations had in common 58 people with a percentage of 38.7% and the lowest was the eastern patient location of 34 people with a percentage of 22.7%. The conclusion obtained is the distribution of the frequency of residence of malaria patients in the practice at One of the X Primary Services in Timika Papua, namely the western and eastern locations, has the same number of 58 patients (38.7%). Keyords: Transmission, Endemic, Anemia, Relapse

Malaria related myalgia-arthralgia: an imported case report treated with anti-malarial drug

Malaria is still a major health problem in Indonesia, especially in endemic areas. We present an imported case of malaria with prominent subjective complaint of the patient is in the form of persistent muscles and joints pain. A 21 years old female with complaint of intermittent fever and persistent muscle joints paint since one week before seeing a doctor. She had history of repetitive attack of malaria tropica. Physical examination in general showed no clear derangements, but on thick and thin blood smear stained with Giemsa revealed malaria falciparum (+). Combo therapy of antimalarial drug soon be given and the patient healed with the disappearance of all previous complaint. Myalgia and arthralgia in case of malaria falciparum (+) might be the earliest subjective sign of rhabdomyolisis, a potentially fatal and lethal complication of malaria

Pelastustoimen mittarit. Katsaus kansainvälisiin mittareihin

Pelastustoimen strategian laadintaa varten on vuonna 2015 perustettu hanke, jonka tavoitteena on määrittää pelastustoimen strategiset painopistealueet ja niille vaikuttavuutta kuvaavat toiminnan mittarit/indikaattorit. Pelastustoimen vaikuttavuuden mittaaminen – kansainväliset mittarit (PetoMitta) –tutkimushanke tukee strategian laadintaa esittelemällä pelastustoimen tehokkuuden ja vaikuttavuuden kansainvälisiä mittareita. Hanke vaikuttaa pelastustoimen kehittämiseen edesauttamalla resurssien oikeaa suuntaamista toiminnan vaikuttavuuden mittaamisen avulla. Pelastustoimen vaikuttavuuden mittaamista kehitetään useissa maissa. Joissain maissa ollaan vasta lähtemässä liikkeelle ja kehitetään ensimmäisiä toiminnan mittareita, kuten Portugalissa metsäpalojen hallinnan mittareita. Palokuntien syntymaissa, kuten Saksassa ja Yhdysvalloissa, pelastuslaitosten toiminnan tärkeimmät mittarit, vasteajat ja vastehenkilöstö, on puolestaan standardoitu. Pelastuslaitosten tavoiteasetannassa ja mittarien valinnassa näkyy kyseisten maiden yleinen tietoisuus yhteiskunnan tilasta. Ruotsissa, Virossa sekä Yhdistyneiden kuningaskuntien alueella on kehitetty paljon mittareita ennaltaehkäisevää työtä varten, jolloin kyseessä on valistustyö ja suoritetut palotarkastukset. Näillä alueilla myös työhyvinvointi- ja tasa-arvotekijöille on asetettu mittareita. Lontoon ja Vancouverin pelastuslaitoksille on asetettu tavoitteita ympäristöpäästöjen vähentämiseksi. Tutkimus osoitti, että eri maissa pelastustoimen toiminnan mittaamisella on kolme erilaista roolia. Ensinnäkin toiminnan mittareilla mitataan pelastuslaitosten nopeutta saavuttaa kohde ja palotilanteissa sattuneiden palokuolemien määrää. Nämä mittarit katsovat taaksepäin, ja niiden saavuttamiseen vaikuttaa pelastustoimen oman toiminnan lisäksi monet muut yhteiskunnalliset tekijät, kuten kaupungistuminen, rakentamistekniikka, infrastruktuurin kunto, yhteiskunnallinen vakaus tai epävakaus yms. Toiseksi, pelastustoimi pyrkii kehittämään omaa toimintaansa ennaltaehkäisevään suuntaan antamalla koulutusta ja opastusta, parantamalla yhteiskunnan omia valmiuksia kouluttamalla vapaaehtoista henkilöstöä, ja suorittamalla tehostetusti palotarkastuksia. Kolmantena pelastustoimen roolina on vastata osaltaan yhteiskunnalliseen kehitykseen. Tästä ovat esimerkkeinä vaatimukset polttoaineiden kulutuksen vähentämisestä, päästöjen pienentämisestä ja tasa-arvon edistämisestä henkilöstöä palkattaessa. Tällä hetkellä Suomi on eräällä tavalla keskikastia pelastustoimen toiminnan mittauksessa. Koko maata koskevia mittareita on vähän, eikä niillä ole suurta ohjaavaa roolia. Tässä näkyy todennäköisesti pelastuslaitoksen asema valtionhallinnon ja kunnallisen hallinnon välillä; ei ole selvää kenen tehtävänä olisi asettaa tulevaisuuteen tähtäävät valtakunnalliset tavoitteet, kuten yhteistoimintaa, ympäristötehokkuutta, tasa-arvoasioita tai vaaraa aiheuttavien kohteiden / yksityisten talouksien tarkastusmääriä koskevat tavoitteet. Tutkimuksen rahoittajana olivat sisäministeriön pelastusosasto, Teknologian tutkimuskeskus VTT Oy ja Palosuojelurahasto. Hankkeen ohjausryhmässä toimivat sisäministeriöstä neuvotteleva virkamies Tiina Männikkö ja ylitarkastaja Jouni Pousi sekä tutkimusjohtaja Esa Kokki Pelastusopistosta ja tiimipäällikkö Liisa Poussa VTT:ltä

Malaria related myalgia-arthralgia: an imported case report treated with anti-malarial drug

Malaria is still a major health problem in Indonesia, especially in endemic areas. We present an imported case of malaria with prominent subjective complaint of the patient is in the form of persistent muscles and joints pain. A 21 years old female with complaint of intermittent fever and persistent muscle joints paint since one week before seeing a doctor. She had history of repetitive attack of malaria tropica. Physical examination in general showed no clear derangements, but on thick and thin blood smear stained with Giemsa revealed malaria falciparum (+). Combo therapy of antimalarial drug soon be given and the patient healed with the disappearance of all previous complaint. Myalgia and arthralgia in case of malaria falciparum (+) might be the earliest subjective sign of rhabdomyolisis, a potentially fatal and lethal complication of malaria

Facilitating free travel in the Schengen area - A position paper by the European Association for Biometrics

Due to migration, terror‐threats and the viral pandemic, various EU member states have re‐established internal border control or even closed their borders. European Association for Biometrics (EAB), a non‐profit organisation, solicited the views of its members on ways which biometric technologies and services may be used to help with re‐establishing open borders within the Schengen area while at the same time mitigating any adverse effects. From the responses received, this position paper was composed to identify ideas to re‐establish free travel between the member states in the Schengen area. The paper covers the contending needs for security, open borders and fundamental rights as well as legal constraints that any technological solution must consider. A range of specific technologies for direct biometric recognition alongside complementary measures are outlined. The interrelated issues of ethical and societal considerations are also highlighted. Provided a holistic approach is adopted, it may be possible to reach a more optimal trade‐off with regards to open borders while maintaining a high‐level of security and protection of fundamental rights. European Association for Biometrics and its members can play an important role in fostering a shared understanding of security and mobility challenges and their solutions

D.5.4 Evaluation Protocol and KPIs

The Cyber-MAR project aims to develop a framework to support maritime stakeholders in their security management programs and provider concrete measures, training, and tools, e.g. integrated cyber ranges.The general challenge is that cyber readiness and awareness among businesses and individuals remain low, and there is a major shortage of cybersecurity skills in the workforce. The growing demand for the cybersecurity skills and cybersecurity professionals is boosting the development and implementation of cyber ranges and development of training. Cyber ranges are simulative operational representations of real systems, networks, IT and OT hardware and applications. They offer a plausible environment for enhancing cybersecurity skills of personnel or cybersecurity professionals, evaluate and test cybersecurity management or to develop cybersecurity solutions. The purpose of the document is to define the Key Performance Indicators (KPIs) and Critical Success Factors (CSF) for measuring the efficiency of developed cyber-MAR solution, as it will be demonstrated during the scenarios performed in the pilots. Key Performance Indicators are composed of critical subsets of performance parameters representing the most critical capabilities and characteristics of the Cyber-MAR system. The document first explains the general background of performance evaluation and background of key performance indicators and critical success factor implementation and their current state in cyber security management and cyber ranges’ development. It also discusses shortly the main resilience areas or preparedness and availability. Then the Cyber-MAR KPI and evaluation framework is presented. In the Cyber-Mar project, evaluation is based on the developed pilot use case scenarios. The project carries out two pilots at defined ports and one pilot for a vessel navigation, as defined in WP5. As annexes of the report the evaluation protocols for the pilot events are presented.The results, methodologies and templates of this deliverable are used in T5.4 Pilot Deployments &amp; Simulations Activities.<br/