Designing a Questionnaire to Measure Factors Affecting Utilization of Services for Diabetics in Health Centers Based on Social Marketing Model

Background: The needs and demands of patients as one of the pillars of marketing in the health field require the right tools to identify consumers’ requests. Objectives: This study was conducted to develop a tool to evaluate services utilization behavior by type 2 diabetics in health centers based on a social marketing model (ie, 7 Ps). Methods: This study was conducted in two main stages. The first stage was performed with the aim of the initial design of the tool (ie, a questionnaire) through a literature review and professionals’ opinions. The second stage was performed to confirm the validity and reliability of the prepared questionnaire in the previous stage through calculating the impact score, content validity index (CVI), content validity ratio (CVR), and Cronbach’s alpha coefficient. The study participants included 8 academic and executive experts in the field of health and diabetes, 30 diabetic patients to calculate the impact score, and 50 patients with diabetes to calculate the Cronbach’s alpha through test-retest. The data were analyzed using SPSS software (version 18). Results: According to the results of the first stage of the study, a questionnaire with 46 items was designed. After determining the formal and content validity quantitatively and qualitatively, 8 items were deleted, and a questionnaire with 38 items was provided. Finally, the validity and reliability of the instrument were confirmed (CVI = 0.91; CVR = 0.92; intraclass correlation coefficient = 0.89; Cronbach’s alpha = 0.92). Conclusions: This questionnaire with confirmed validity and reliability helps analyze the diabetics’ behavior and specifies the reasons for the acceptance or rejection of the services of the diabetes unit by patients. Therefore, it can be used in health centers providing services for diabetics.

Prognostication of Traumatic Brain Injury using International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury score in Nepalese Cohort

Introduction: Traumatic brain injury disease of major importance globally. Prognostic models are useful for making decisions in the clinical practice. The aim of this study was to assess the accuracy of International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) score in predicting outcome in moderate to severe TBI at 3 months. Materials and Methods: All patients admitted to National Trauma Center, National Academy of Medical Sciences with moderate to severe traumatic brain injury from February 2020 to February 2021 were included in the study. IMPACT scores (core/extended core/ lab) were recorded separately at admission. Outcome was measured with Glasgow Outcome Scale (GOS) at the time of discharge and at six months. Correlation between observed and predicted outcomes was evaluated by Pearson’s correlation coefficient (r). Sensitivity and specificity were plotted in the receiver-operating characteristic (ROC) curve, and the area under the curve (AUC) was calculated to determine the discrimination ability of this prognostic model. Results: A total of 112 patients were enrolled in the study. Eighty (71.4 %) patients had moderate and 32 (28.57 %) had severe TBI. The median age was 33 years with male preponderance (M: F=4:1). Thirty three (29.5 %) patients died within 6 months of TBI, and 38 (33.9 %) patients had an unfavorable outcome. Pearson correlation coefficient showed good correlation between observed and predicted outcomes. Hosmer-Lemeshow test showed good model fit for IMPACT core, IMPACT extended and IMPACT lab in diagnosing mortality and unfavorable outcome in six months (p>0.05). The ROC curve indicated that all 3 models could accurately discriminate between favorable and unfavorable outcomes, as well as between survival and mortality (unfavorable outcome AUC= 0.905, 0.940, 0.955; mortality AUC= 0.875, 0.914, 0.917 respectively) in our patient population. Conclusion: The IMPACT score is a good prognostic model to predict 6-month outcomes in moderate to severe TBI at admission in Nepalese patient population. Among the three IMPACT models, IMPACT lab has the greatest discriminating ability.

Effect of Parental Socioeconomic Indicators on Oral Health Related Quality of Life of their Children in Riyadh, Saudi Arabia

Aim: There is scientific evidence that there is correlation between socioeconomic status and oral health integrity, more specifically children affected by dental caries have a reduced quality of life This research will thus shed light on the factors proving this correlation between the oral health related quality of life (OHRQoL) of their young children and parental socioeconomic status that is backed up by their occupation, income, and educational level. Materials and Methods: This is a descriptive cross-sectional study that collected the oral health information for children from their parents in different areas of Riyadh City. The study comprised parents from different areas in Riyadh City who were enrolled through simple random sampling technique. Sample Size of 350 was estimated using online Raosoft® sample size calculator based on acceptable margin error of 5%, confidence level of 95%. Results: overall ECOHIS score showed significant differences across the educational levels of mother (F=4.668, P = 0.003) and father (F=2.821, P = 0.039). However, child impact score (F=0.717, P = 0.581), family impact score (F=0.930, P = 0.447) and overall ECOHIS scores (F=0.900, P = 0.465) did not differ significantly across the various employment categories of mothers Conclusion: Parental socioeconomic conditions have a direct influence on OHRQoL of their children measured on ECOHIS. These factors should be attentively addressed when planning oral health promotion interventions for the Saudi Arabian population. Based on our study, these strategies should take into account socially and financially disadvantaged groups along with oral health behaviors and clinical variables. Keywords: oral health, socioeconomic status, caries

Impact of COVID-19 Pandemic on Anesthesia and Critical Care Residents in Spain

Background: The pandemic caused by coronavirus disease 2019 (COVID-19) has substantially changed the activity in Spanish healthcare centers. Residents who face pandemics are vulnerable physicians with different knowledge and experience. Objectives: This study aimed to determine the impact of COVID-19 pandemic on the Anesthesia and Critical Care residents and to establish its formative and personal consequences. Methods: A 35-question digital survey was developed, and was distributed among Anesthesia and Critical Care residents in Spain. The quantitative variable "Objective Formative Impact Score" (PIOF) was defined, being proportional to the impact on formative routines. Results: Several parameters were associated to a higher formative impact, such as the exposition to patients with COVID-19 (P = 0,020), an increase in the autonomy (P = 0,001), fear to contagion due to lack of protective equipment (P = 0,003), working in higher incidence areas (P < 0,001), being assigned to COVID-19 critical care units (P < 0,001), or to other departments different from Anesthesia and Critical Care. Residents experienced feelings of loneliness from the social distancing or ethical conflicts when working in suboptimal conditions. Conclusions: COVID-19 pandemic has had a major impact on Anesthesia and Critical Care residents both personally and formatively. The designed parameter PIOF brings an objective value about residents' formation.

CITIZEN PARTICIPATION & DIGITAL TOOLS TO IMPROVE PEDESTRIAN MOBILITY IN CITIES

In this work, we present a framework supported by mobile and web apps and able to propose personalized pedestrian routes that match user mobility profile considering mobility impediments factors. We explain how these later have been defined using a pedestrian-centric approach based on travel experiences as perceived in the field by senior citizens. Through workshops, six main factors that may influence pedestrian route choices were revealed: passability, obstacle in path, surface problem, security, sidewalk width, slope. These categories were used to build digital tools and guide a citizen participatory approach to collect geolocated points of obstacle documented with walkability information (picture, category, impact score, free comment). We also involved citizens to evaluate these information and especially senior referents for validation. Finally we present how we connect these points of obstacle with a pedestrian network based on OpenStreetMap to configure a routing cost function. The framework has been partially deployed in 2020 with limited people due to the pandemic. Nonetheless, we share lessons learned from interaction with citizens in the design of such a framework whose underlying workflow is reproducible. We plan to further assess its relevance and sustainability in the future.

Entrepreneurial Framework Conditions and Impact Scores of Small-Size Certified Benefit Corporations (CBCs). A Configurational Analysis of 17 Countries

The urgent need that the private sector generate positive social and environmental impacts in order to cope with the grand challenges faced by humanity and contribute to sustainable development, has ignited the need to understand the country conditions that could promote such an endeavor, especially for small firms who may have more difficulties and, among them, those that try to generate positive impacts for multiple stakeholders, such as Certified B Corporations (CBCs). To contribute to such understanding, we use fsQCA to identify the combinations of presence/absence of four entrepreneurial framework conditions (EFCs)—financing for entrepreneurs, taxes and bureaucracy, R&D transfer, and commercial and legal infrastructure—that are sufficient for the presence/absence of a high average impact score of small-size CBCs in the country. The analysis reveals that two combinations of the presence/absence of the considered EFCs are sufficient for the presence and another two are sufficient for the absence of that outcome. General patterns, specific combinations and the implications for policymakers, CBCs managers and future research are discussed.

Bibliometric Analysis on Port and Shipping Researches in Scope of Management Science

With the economic growth and prosperity, ports and shipping play an increasingly important role in the national economy and international trade. Numerous studies related to the field of port and shipping were conducted to propose some managerial insights. This paper uses the bibliometric method to analyze the research papers published from 2000 to 2019 on port and shipping in the field of management science. The number of published papers, impact score and cite score are identified as evaluation criteria to analyze the research contributions of researchers, affiliated institutions and countries/regions in the port and shipping field. At the same time, the importance of each keyword can be obtained by the bibliometric method, which may help new researchers grasp research hotspots and trends in related fields.

A neuropsychological study of chromatin disorders

AimsAnalyse neuropsychological assessment data collected from a chromatin disorder clinic to determine the neuropsychological profile associated with chromatin disorders. Assess for differences in neuropsychological profile by diagnostic group and gender. Hypothesis: A systematic neuropsychological review of chromatin disorders will reveal previously unknown patterns.BackgroundChromatin disorders (CD) are a group of genetic conditions that result in developmental delay and intellectual disability. Thus far the neuropsychological profile of CDs has been poorly studied.MethodCognitive functioning, adaptive behaviour, psychosocial difficulties and perceived impact on the family were systematically assessed in a cohort of 42 patients with CDs from November 2016 to February 2019. Cognitive functioning was assessed via Full-Scale Intelligence Quotient (FSIQ), adaptive behaviour was assessed via Vineland's Adaptive Behaviour Scores (VABS), anxiety and depression was assessed via the Revised Children's Anxiety and Depression Scale (RCADS) and communication skills were assessed via the Social Responsiveness Scale-2 (SRS-2). Family Impact Scale was used to assess for the perceived impact on the family. Mean scores for each neuropsychological domain were calculated firstly sorting patients by diagnosis, and then by gender. Unpaired t-tests were run to asses for statistically significant differences in mean scores by diagnosis and gender. Spearman's correlation was used to determine and potential correlations between FSIQ, VABS, RCADS and SRS-2 scores and Family Impact Score.ResultPatients with CDs were found generally to have mild intellectual disability (mean FSIQ = 64.57) and markedly deficient adaptive behaviour functioning (mean VABS = 50.19). Patients had a mean SRS-2 score of 70, indicative of high rates of autism spectrum disorder associated symptoms. RCADS and SRS-2 scores were negatively correlated with Family Impact Score with statistical significance (–0.562 and –0.429 Correlation coefficient for RCADS and SRS-2 respectively). Females had statistically significant average higher RCADS scores than males. CHARGE Syndrome was frequently an outlier having a mean higher FSIQ score, lower adaptive functioning and lower psychosocial impairment; however, these differences were not statistically significant.ConclusionAdaptive behaviour functioning of patients with CDs is lower than expected for their FSIQ. Females with chromatin disorders have higher levels of anxiety and depression than males however the reasons for this are unknown. The psychosocial challenges and family's impact should be considered in the clinical management of CDs. Further research with a larger data set is needed to identify the neuropsychological profiles of different CDs and to confirm whether the observed differences in CHARGE Syndrome are significant.