bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improvement of hand hygiene compliance among health professional staff of Neonatology Department in Nyamata Hospital
Authors: Umulisa Solange , Musabyimana Angele , Wong Rex , Adomako Eva , Budd April , Ntakirutimana Theoneste 
Published: September 2016

Purpose
The purpose of this study is to improve the hand hygiene compliance in a hospital in Rwanda. Hand hygiene is a fundamental routine practice that can greatly reduce risk of hospital-acquired infections; however, hand hygiene compliance in the hospital was low.

Design/methodology/approach
A multiple-strategy intervention was implemented with a focus on ensuring stable water supply was available through installing mobile hand hygiene facilities.

Findings
The intervention significantly increased the overall hand hygiene compliance rate by 35 per cent. The compliance for all of the five hand hygiene moments and all professions also significantly increased.

Practical implications
By implementing an intervention that involved multiple strategies to address the root causes of the problem, this quality improvement project successfully created an enabling environment to increase hand hygiene compliance. The hospital should encourage using the strategic problem-solving method to conduct more quality improvement projects in other departments.

Originality/value
Findings from this study may be useful for hospitals in similar settings seeking to improve hand hygiene compliance.
Increasing patient medical record completion by assigning nurses to specific patients in maternity ward at Munini hospital
Authors: Ufitinema Yvonne , Wong Rex , Adomako Eva , Kanyamarere Léonard , Kayonga Ntagungira Egide , Kagwiza Jeanne 
Published: September 2016

Purpose
The purpose of this paper is to describe the quality improvement project to increase the medical record documentation completion rate in a district hospital in Rwanda. Despite the importance of medical records to support high quality and efficient care, incomplete documentation is common in many hospitals.

Design/methodology/approach
The pre- and post-intervention record completion rate in the maternity unit was assessed. Intervention included assigned nurse to specific patients, developed guideline, provided trainings and supervisions.

Findings
The documentation completion rate significantly increased from 25 per cent pre-intervention to 67 per cent post-intervention, p < 0.001. The completeness of seven out of the ten elements of medical records also significantly increased.

Practical implications
The quality improvement project created a cost-effective intervention that successfully improved the documentation completion rate. Ongoing monitoring should be continued to learn sustainability.

Originality/value
The results are useful for hospitals with similar settings to improve completion of nursing documentation and increase nursing accountability on patient care.
Efficient information-related practices in companies committed to EFQM
Authors: Zárraga-Rodríguez Marta , Álvarez M. Jesús 
Published: September 2016

Purpose
The purpose of this paper is to explore whether or not companies committed to quality management within the European Foundation for Quality Management (EFQM) Excellence Model framework use and manage the information in an efficient way, i.e., they have developed information capability. In particular, this research investigates the links between information capability and the EFQM Excellence Model.

Design/methodology/approach
This study is an extension of previous work by Zárraga-Rodríguez and Alvarez (2013), which was a first qualitative approach to the subject. In that work the EFQM Excellence Model criteria were analysed to see if somehow they illustrate practices associated to a company’s information capability, self-analysis reports of a set of quality award winners were reviewed and interviews were conducted with members of those companies. The present research adopts a quantitative approach to gain deeper knowledge. Through a questionnaire survey the perceptions of managers in companies committed to the EFQM Excellence Model with respect to information capability-related practices and about the information they managed are captured.

Findings
The analysis shows evidence that many information practices are common practices among companies committed to the EFQM Excellence Model and reveals information practices that should be improved.

Originality/value
Practices that lead to efficient use and management of information have not been studied in detail in companies committed to quality management within the EFQM Excellence Model framework. Companies that are aware of the importance of handling quality information when making the decisions will find in this study a set of practices they can implement in order to achieve excellent performance based on the use and management of information.
Customers’ needs and expectations on servicescape surveillance management
Authors: Bonfanti Angelo 
Published: September 2016

Purpose
The purpose of this paper is to identify customers’ needs and expectations regarding servicescape surveillance management (SSM) in order to suggest to service managers how they can carefully design a service environment to ensure a high level of security while concurrently enhancing the customer service experience.

Design/methodology/approach
Given that this study is explorative in nature, it is based on a specific method of qualitative data collection: focus group interviews. Three focus group sessions were organised with 24 Italian customers of retail stores, hotels and hospitals. The multi-expectation model proposed by Parasuraman, Berry and Zeithaml, which distinguishes between what customers consider acceptable (adequate service level) and what they hope to receive (desired service level), was chosen as the reference framework to investigate customers’ needs and expectations from SSM.

Findings
Servicescape surveillance must be compatible with customer satisfaction. Customers are acceptably satisfied when servicescape surveillance offers them feelings of physical safety, psychological security, economic security and the right to privacy. They desire that surveillance also allows them to live a positive service experience in sensorial, psychological, social and temporal terms. However, customers’ expectations of adequate and desired service levels are different in terms of the presence, quantity and visibility of surveillance in the three service areas examined. Interestingly, customers expect to find more visible surveillance measures inside retail stores rather than in hotels and hospitals, but they prefer to receive invisible surveillance in the servicescape.

Practical implications
Service managers should consider surveillance not as a cost or a tool for detecting and punishing inappropriate or criminal behaviour, but rather, as an opportunity for enhancing the customer service experience. They can invest in servicescape design elements, technological surveillance solutions and continuous training of security personnel to meet their customers’ adequate and desired service levels.

Originality/value
This study provides two major contributions. From the theoretical viewpoint, it extends knowledge of the hitherto under-researched area of SSM by identifying customers’ needs and expectations of surveillance and the customer service experience, which are topics usually examined separately in the literature. In terms of managerial implications, it provides store/hotel/hospital managers with recommendations on how to design a servicescape that is both secure and pleasant.
Operationalising performance measurement dimensions for the Australasian nonprofit healthcare sector
Authors: Soysa Ishani Buddika , Jayamaha Nihal Palitha , Grigg Nigel Peter 
Published: September 2016

PurposeThe purpose of this paper is to develop a performance measurement (PM) framework for Australasian nonprofit organisations (NPOs) involved in healthcare, and operational descriptions for each PM dimension within this framework.Design/methodology/approachLiterature relating to the balanced scorecard and other PM frameworks was examined to develop an initial conceptual model, and this model was substantially improved by collecting qualitative data from nine Australian and New Zealand healthcare NPOs using a case study approach.FindingsThe study identifies nine causally related PM dimensions: mission, strategy, organisational capabilities, infrastructure and people development (people and information), financial health, processes, and stakeholder satisfaction (clients, people, and donors). The study also recognised that “Mission” and “Strategy” should be PM dimensions and that healthcare NPOs should focus on satisfying its people, not only donors and clients. Additionally, 41 operational descriptions are developed for each of these dimensions and can enable detailed PM items to be derived by organisations.Originality/valueThe study is the first study that has been undertaken to develop a PM framework for the Australasian NPOs to a level that it can be readily used by the practitioners (following customisation to their own specific context). The developed model also serves as a basis for future quantitative academic research aimed at testing and empirical validation of the conceptual model.
Model based integration of management systems (MSs) – case study
Authors: Rebelo Manuel Ferreira , Silva Rui , Santos Gilberto , Mendes Pedro 
Published: September 2016

Purpose
The purpose of this paper is to present a case study regarding the deployment of a previously developed model for the integration of management systems (MSs). The case study is developed at a manufacturing site of an international enterprise. The implementation of this model in a real business environment is aimed at assessing its feasibility.

Design/methodology/approach
The presented case study takes into account different management systems standards (MSSs) progressively implemented, along the years, independently. The implementation of the model was supported by the results obtained from an investigation performed according to a structured diagnosis that was conducted to collect information related to the organizational situation of the enterprise.

Findings
The main findings are as follows: a robust integrated management system (IMS), objectively more lean, structured and manageable was found to be feasible; this study provided an holistic view of the enterprise’s global management; clarifications of job descriptions and boundaries of action and responsibilities were achieved; greater efficiency in the use of resources was attained; more coordinated management of the three pillars of sustainability – environmental, economic and social, as well as risks, providing confidence and added value to the company and interested parties was achieved.

Originality/value
This case study is pioneering in Portugal in respect to the implementation, at the level of an industrial organization, of the model previously developed for the integration of individualized MSs. The case study provides new insights regarding the implementation of IMSs including the rationalization of several resources and elimination of several types of organizational waste leveraging gains of efficiency. Due to its intrinsic characteristics, the model is able to support, progressively, new or revised MSSs according to the principles of annex SL (normative) – proposals for MSSs – of the International Organization for Standardization and the International Electrotechnical Commission, that the industrial organization can adopt beyond the current ones.
Effects of fluid displacement pattern on complex electrical impedance in Berea sandstone over frequency range 104–106 Hz
Authors: Zhang Yi , Park Hyuck , Nishizawa Osamu , Kiyama Tamotsu , Liu Yu , Chae Kwangseok , Xue Ziqiu 
Published: September 2016

ABSTRACTTo better understand the effect of fluid distribution on the electric response of rocks saturated with oil and brine, we conducted experimental studies on the complex electrical impedance in a Berea sandstone, together with in situ acquisitions of oil distribution images employing a high‐resolution medical X‐ray computed tomography. We performed two tests of brine displacement by oil under high (10 MPa) and low (5 MPa) pressures, which were accompanied by fingering and stable displacement patterns, respectively. The measured complex impedance data were fitted to the Cole model to obtain the resistance, capacitance, peak frequency of the imaginary impedance, and the exponent α of the rock–fluid system. With increasing oil saturation, the resistance showed an increasing trend, whereas the other three parameters decreased. The fingering displacement exhibited lower resistance and capacitance than the stable displacement. The analysis of the resistance changes using a simple parallel connection model indicates that there are more components of residual brine in parallel connections in the fingering pattern than in the stable displacement pattern at the same saturation. We also interpreted the normalised changes in the capacitance (or apparent dielectric constant) with respect to the oil saturation via an analysis of the shape factor of fluid distribution based on the Maxwell–Wagner–Brugermann–Hanai model. The changes in the shape factor suggest that the pinch‐off of the brine in parallel connection by the oil is a dominant mechanism reducing the capacitance. In the stable displacement, most of the connections in the brine phase are immediately pinched off by oil displacement front at a local oil saturation of 65%. Conversely, in the fingering displacement, there is a transition from the bulk or layered brine to the pinched‐off at a local oil saturation below 60%. The analyses indicate that the difference in the fluid distribution under different fluid conditions is responsible for the non‐Archie behaviour.
Forbidden fruit: human settlement and abundant fruit create an ecological trap for an apex omnivore
Authors: Lamb Clayton T. , Mowat Garth , McLellan Bruce N. , Nielsen Scott E. , Boutin Stan 
Published: September 2016

Summary

Habitat choice is an evolutionary product of animals experiencing increased fitness when preferentially occupying high‐quality habitat. However, an ecological trap (ET) can occur when an animal is presented with novel conditions and the animal's assessment of habitat quality is poorly matched to its resulting fitness.

We tested for an ET for grizzly (brown) bears using demographic and movement data collected in an area with rich food resources and concentrated human settlement.

We derived measures of habitat attractiveness from occurrence models of bear food resources and estimated demographic parameters using DNA mark–recapture information collected over 8 years (2006–2013). We then paired this information with grizzly bear mortality records to investigate kill and movement rates.

Our results demonstrate that a valley high in both berry resources and human density was more attractive than surrounding areas, and bears occupying this region faced 17% lower apparent survival. Despite lower fitness, we detected a net flow of bears into the ET, which contributed to a study‐wide population decline.

This work highlights the presence and pervasiveness of an ET for an apex omnivore that lacks the evolutionary cues, under human‐induced rapid ecological change, to assess trade‐offs between food resources and human‐caused mortality, which results in maladaptive habitat selection.
Vinegar Functions on Health: Constituents, Sources, and Formation Mechanisms
Authors: Chen Hengye , Chen Tao , Giudici Paolo , Chen Fusheng 
Published: September 2016

AbstractVinegars are one of only a few acidic condiments throughout the world. Vinegars can mainly be considered grain vinegars and fruit vinegars, according to the raw materials used. Both grain vinegars and fruit vinegars, which are fermented by traditional methods, possess a variety of physiological functions, such as antibacteria, anti‐infection, antioxidation, blood glucose control, lipid metabolism regulation, weight loss, and anticancer activities. The antibacteria and anti‐infection abilities of vinegars are mainly due to the presence of organic acids, polyphenols, and melanoidins. The polyphenols and melanoidins also provide the antioxidant abilities of vinegars, which are produced from the raw materials and fermentation processes, respectively. The blood glucose control, lipid metabolism regulation, and weight loss capabilities from vinegars are mainly due to acetic acid. Besides caffeoylsophorose (inhibits disaccharidase) and ligustrazine (improves blood circulation), other functional ingredients present in vinegars provide certain health benefits as well. Regarding anticancer activities, several grain vinegars strongly inhibit the growth of some cancer cells in vivo or in vitro, but related functional ingredients remain largely unknown, except tryptophol in Japanese black soybean vinegar. Considering the discovering of various functional ingredients and clarifying their mechanisms, some vinegars could be functional foods or even medicines, depending on a number of proofs that demonstrate these constituents can cure chronic diseases such as diabetes or cardiovascular problems.
Survival of Probiotics in Hypromellose Capsules with Rice or Potato Maltodextrin Excipient
Authors: Chen Jinru , Bechman Allison , Klu Yaa Asantewaa Kafui , Phillips Robert D. 
Published: September 2016

AbstractThere is currently no authorized or established therapeutic level/dose of probiotics for proposed health benefits; however, a daily probiotic consumption of 108 to 1010 CFU has been recommended. This study determined the survival of 5 individual probiotic strains, Lactobacillus rhamnosus, Lactobacillus paracasei, Lactobacillus plantarum, Lactobacillus acidophilus, and Bifidobacterium lactis, along with a mixture of the 5 strains in hypromellose capsules with rice or potato maltodextrin at 4, 25, and 37 °C for 12 mo. Samples were collected monthly and plated on deMan‐Rogosa Sharpe agar with 0.05% l‐cysteine hydrochloride. Results showed that samples stored at 4 °C had an average count of 108 to 1011 CFU/g of probiotic cells during the 12 mo period, whereas at 25 °C, L. rhamnosus and L. paracasei had an average counts below 108 CFU/g during the storage period. L. rhamnosus was the most vulnerable strain used in this study, having the least viable counts at all 3 storage temperatures. Probiotics stored in rice maltodextrin, on average, had higher probiotic counts compared to those stored in potato maltodextrin. Study suggests that to provide consumers with 108 to 1010 CFU/d of probiotic cells, robust bacterial strains, suitable carriers, and a storage temperature of 4 °C are required.
A national survey of practical airway training in UK anaesthetic departments. Time for a national policy?
Authors: Lindkær Jensen N. H. , Cook T. M. , Kelly F. E. 
Published: September 2016

SummaryThe Fourth National Audit Project (NAP4) recommended airway training for trainee and trained anaesthetists. As the skills required for management of airway emergencies differ from routine skills and these events are rare, practical training is likely to require training workshops. In 2013, we surveyed all UK National Health Service hospitals to examine the current practices regarding airway training workshops. We received responses from 206 hospitals (62%) covering all regions. Regarding airway workshops, 16% provide none and 51% only for trainees. Of those providing workshops, more than half are run less than annually. Workshop content varies widely, with several Difficult Airway Society (DAS) guideline techniques not taught or only infrequently. Reported barriers to training include lack of time and departmental or individual interest. Workshop‐based airway training is variable in provision, frequency and content, and is often not prioritised by departments or individual trainers. It could be useful if guidance on workshop organisation, frequency and content was considered nationally.
Oxidized LDL, insulin resistance and central blood pressure after gestational diabetes mellitus
Authors: Vilmi‐Kerälä Tiina , Palomäki Outi , Kankkunen Päivi , Juurinen Leena , Uotila Jukka , Palomäki Ari 
Published: September 2016

AbstractIntroductionGestational diabetes mellitus (GDM) is an indicator of future cardiovascular disease. We investigated whether sensitive biomarkers of increased cardiovascular risk differ between women with and without a history of GDM few years after pregnancy, and whether obesity affects the results.Material and methodsWe studied two cohorts – 120 women with a history of GDM and 120 controls, on average 3.7 years after delivery. Circulating concentrations of oxidized low‐density lipoprotein (oxLDL) were determined by ELISA. The homeostasis model assessment of insulin resistance (HOMA‐IR) index was used to estimate insulin resistance. Central blood pressure (cBP) was measured noninvasively from a radial artery pulse wave. The primary outcomes were possible differences in oxLDL, HOMA‐IR or cBP between the groups. Secondly, we investigated the influence of obesity on the results, also using adjusted multiple linear regression analyses.ResultsOxLDL concentrations or cBP did not differ between the two cohorts, but HOMA‐IR was significantly higher in women with previous GDM than in controls, 1.3 ± 0.9 (SD) and 1.1 ± 0.9, respectively (p = 0.022). In subgroup analyses, HOMA‐IR (p < 0.001), systolic (p < 0.001) and diastolic (p < 0.001) cBP were significantly higher in obese subgroups compared with non‐obese ones. Body mass index was an important determinant of HOMA‐IR and cBP in multiple linear regression analyses.ConclusionsOver 3 years after delivery, women with GDM were still more insulin‐resistant than controls. Obesity turned out to be a more important determinant of insulin resistance and cBP compared with GDM.
Cross‐linking in children with keratoconus: a systematic review and meta‐analysis
Authors: McAnena Lisa , Doyle Frank , O'Keefe Michael 
Published: September 2016

AbstractKeratoconus can behave more aggressively in pediatric than in adult patients. We systematically reviewed the literature to determine the effectiveness of corneal collagen cross‐linking (CXL) in children. For this study, MEDLINE® and Cochrane databases were searched for all studies examining the effects of standard, trans‐epithelial or accelerated CXL protocols in patients age 18 years or younger. Primary outcomes were; uncorrected visual acuity (UCVA) and maximum keratometry (Kmax) and secondary outcomes were; best‐corrected visual acuity (BCVA), mean refractive spherical equivalent (MRSE), central corneal thickness (CCT) and endothelial cell density (ECD). Standardized mean differences (SMD) and 95% confidence intervals were calculated, comparing baseline values with those at 6, 12 and 24 months. A total of 13 papers, published between May 2011 and December 2014 examining 490 eyes of 401 patients with a mean age of 15.25 (±1.5) years, were included in the qualitative analysis in this review. Nine papers were included in the meta‐analysis, showing significant improvement in UCVA and BCVA and stable Kmax at 12 months, and stable UCVA, improved BCVA and improved Kmax at 24 months in the standard protocol group UCVA, BCVA and KMax were stable at 12 months in the trans‐epithelial group. Mean refractive spherical equivalent (MRSE), CCT and ECD remained stable in both groups. In conclusion it was found that standard CXL may be effective in halting progression of keratoconus in pediatric patients at 1 year. However, larger, more long‐term studies are required to ascertain its effectiveness.