Emergency-department accesses in home care paediatric patients: Occurrence and risks of use in a six-year retrospective investigation in Northern Italy

Objective To assess the determinants of ED use in paediatric patients enrolled in an Integrated Paediatric Home Care (IPHC) program. Methods A retrospective study was conducted using administrative databases on a cohort of patients enrolled in an IPHC program between January 1st, 2012, and December 31st, 2017, in Northern Italy. ED visits that occurred during the IPHC program were considered. Data were collected considering sociodemographic, clinical and organizational variables. A multivariable stepwise logistic regression analysis was performed. The dependent variable to identify possible associations was ED visit. Results A total of 463 ED visits occurred in 465 children, with an incidence rate of 1. The risk of ED visits significantly increased among children involved in the IPHC program after hospital discharge (OR 1.94). Additionally, the risk of ED visits increased significantly as the duration of IPHC increased (OR 5.80 between 101 and 200 days, to OR 7.84 between 201 and 300 days, OR 12.54 between 301 and 400 days and OR 18.67 to more than 400 days). Conclusion The overall results represent a practical perspective to contribute improving both the service quality of IPHC and reducing low acuity and improper ED use.

Has Clinical and Epidemiological Varicella Burden Changed over Time in Children? Overview on Hospitalizations, Comorbidities and Costs from 2010 to 2017 in Italy

According to WHO estimates, varicella disease is responsible of a worldwide significant burden in terms of hospitalizations, complications, and deaths, with more than 90% of cases under 12 years old. This study aims at evaluating the clinical, epidemiological, and economic burden of varicella in Ligurian children, about comorbidities, organizational variables, and vaccination coverages from 2010 to 2017, in terms of Emergency Department accesses and hospitalizations. The overall hospitalization rate was 179.76 (per 100,000 inhab.), with a gradual but significant decline since 2015, when universal varicella vaccination was introduced in Liguria (p < 0.0001). The risk of being hospitalized for complicated varicella in subjects with at least one comorbidity was significantly higher than in subjects without comorbidities (p = 0.0016). The economic analysis showed higher costs in subjects with complicated varicella who were 0–3 years old. This age group showed higher costs also considering extra-hospital costs for both outpatient procedures and pharmaceutical costs (p < 0.0001). The results confirm the relevant burden of varicella, especially in the 0–3 age group and in children with comorbidities. Thus, vaccination with the achievement of adequate vaccination coverages is confirmed to be a necessary control strategy to reduce hospitalizations and associated complications with important economic benefits.

Green Warehousing: Exploration of Organisational Variables Fostering the Adoption of Energy-Efficient Material Handling Equipment

The lithium-ion battery (LIB) represents a useful lever for reducing material handling equipment’s (MHE) environmental impact. The exploitation of opportunity charging might improve LIB adoption, which is still prevented by the high investment cost. Since opportunity charging is affected by the system organization, the relationship between LIB and organizational variables is a meaningful work direction to reduce warehouses’ environmental impact, which is underrepresented by the current literature. The present paper aims at filling this gap by investigating the implications of organisational variables on LIB adoption in warehouses where handling activities are performed with forklift trucks. Based on an in-depth review of the literature and semi-structured interviews, the research presents an input-process-output model linking organisational variables and LIB forklift related costs with an application to a real case. This paper is original as it extends findings from the research fields of production and mobility to the warehouse arena, and it opens room for further research on warehouse sustainability. The paper also offers insights to warehouse managers making decisions about LIB adoption for their electric forklift fleets. This is particularly meaningful to reduce warehouse environmental impact, since MHE power source significantly contributes to greenhouse gases emissions.

Impact of Some Demographic and Organizational Variables on Grade Eight Science Students’ Performance

This study examined the impact of some demographic and organizational variables (gender, school type, and parental involvement) on the performance of Grade 8 students in the 2015 Trends in International Mathematics and Science Study (TIMSS) assessment in Abu Dhabi, Emirate. The study employed a mixed-method design to determine if, and to what extent, these factors affected how the students performed in the assessment. The population for the present study comprised male and female students from 68 public and private schools (35 all-boys and 33 all-girls schools). The study sample consisted of 3400 students (1750 boys and 1650 girls) and 40 parents who were put in 4 focus groups and interviewed to triangulate the results of the quantitative data. The results of the 2015 TIMSS assessment showed that demographic factors, gender, and parental involvement had no significant effect on the students’ performance. However, the type of school (private or public) was found to be statistically significant in predicting students’ performance, as private school students performed better than their public-school counterparts. The findings of the qualitative data were aligned with the results of quantitative data to some extent. The overall findings were then discussed in the context of the recent Science Education reform initiated by the United Arab Emirates’ Ministry of Education. Keywords: TIMSS, science achievement, gender, region, school type, parental involvement

The Effect of Innovation and Participation as Workplace Values on Job Satisfaction and the Mediating Effect of Psychological Ownership

Job satisfaction is an important construct in the organizational behavior domain because it affects several organizational variables, such as performance, organizational citizenship behavior, and organizational commitment. This study investigates the effect of innovation and participation as workplace values on job satisfaction and the mediating role of psychological ownership. Participants ( N = 316) were adults working at different hotels in Antalya, Turkey. The results show innovation and participation as workplace values manifest their effects on job satisfaction through psychological ownership. Moreover, psychological ownership, along with participation, is one of the best estimators of job satisfaction, while participation is the best estimator of psychological ownership among studied variables.

Predictors of Burnout Among Physicians: Evidence From a National Study in Portugal

The aims of this research on burnout among physicians were threefold, (1) to characterize the burnout symptoms’ prevalence among Portuguese physicians, (2) to test the hypothesis that organizational demands and resources add, on top of other factors, to the explanatory level of burnout; and (3) to explore the predictors of organizational demands and resources. Data collection was conducted online at the national level in Portugal, with 9,176 complete replies and a response rate of 21%. Predictors stemming from theoretical models of an intra-individual, occupational, organizational, and socio-psychological nature were measured using an online/paper survey. Results were analyzed through a significantly modified version of the Maslach Burnout Inventory (MBI) after transformations to address the fit of this measure in this sample. Results show that 66% of physicians have high levels of emotional exhaustion, 33% high levels of depersonalization, and 39% high levels of decrease of personal accomplishment. Moreover, a first set of hierarchical multiple regression models with burnout symptoms reveals that organizational resources, demands of the relationship with the patients and of work schedule are consistently important predictors of emotional exhaustion and depersonalization on top of other theoretically relevant predictors. A second set of regression models with the organizational-level variables shows that, aside from organizational variables, other context variables, like procedural justice and teamwork, have the most substantial predictive value. These results highlight the importance of recognizing physicians’ burnout as a phenomenon that is predicted by a wide variety of factors, but also the importance of attending to the particular role of circumstancial factors that may be addressed in future interventions.

Organizational and patient-level predictors for reaching key risk factor targets in cardiac rehabilitation after myocardial infarction – the perfect-CR study

Background The benefits of specific cardiac rehabilitation (CR) programme components on patient outcomes after myocardial infarction (MI) remain unclear, as does their relative predictive strength compared to patient-level predictors. Purpose To identify CR organizational and patient-level predictors for reaching risk factor targets at one-year post-MI. Methods This was an observational survey- and registry-based study. Data on CR organization at all 78 CR centres in Sweden was collected in 2016 and merged with individual patient data from nationwide registries (n=7549, median age 64 years, 24% females). Cross-validation resampled orthogonal partial least squares discriminant analysis identified predictors for reaching treatment targets for low-density lipoprotein-cholesterol (LDL-C&lt;1.8 mmol/L), blood pressure (BP&lt;140/90 mmHg) and smoking abstinence (yes/no). Predictors with Variables of Importance for the Projection (VIP) value &gt;0.8 and 95% confidence intervals (CI) excluding zero, were considered meaningful. Results Of the 71 analysed organizational variables, 36 were identified as meaningful predictors for reaching LDL-C and 35 for BP targets (Figure 1). The strongest predictors (VIP [95% CI]) for LDL-C and BP were: offering psychosocial management at initial CR assessment 2.09 [1.70–2.49]; 2.34 [1.90–2.78], having a CR team psychologist 1.59 [1.28–1.91]; 2.00 [1.46–2.55], having extended CR centre opening hours 2.17 [1.95–2.40]; 1.51 [1.03–2.00], staff reporting satisfaction with CR centre facilities 1.55 [1.07–2.04]; 1.96 [1.64–2.28], having a medical director 1.71 [1.45–1.97]; 1.47 [1.07–1.87], nurses using protocols for antihypertensive and/or lipid lowering medication adjustment 1.58 [1.35–1.81]; 1.56 [1.03–2.08], having operational team meetings 1.36 [1.08–1.64]; 1.34 [0.99–1.70], and using audit data for quality improvement 1.00 [0.79–1.20]; 1.27 [0.99–1.56]. Offering pre-exercise-based CR (exCR) assessment and different modes of exCR were predictors for reaching both targets. The strongest patient-level predictor of reaching LDL-C target was low baseline LDL-C 3.90 [3.25–4.56], and for BP it was having no history of hypertension 2.93 [2.74–3.12]. Second, participation in exCR was the strongest predictor for both outcomes 1.60 [0.83–2.37]; 1.50 [1.15–1.86]. For smoking abstinence, 5 organizational variables were identified as meaningful predictors, the strongest being prescription of varenicline by the centre physicians 1.98 [0.13–3.84] (Figure 2). The strongest patient-level predictors were exCR participation 2.51 [2.24–2.79] and socioeconomic status variables e.g., income 1.67 [1.28–2.06], living with partner 1.47 [0.84–2.09] and education 0.80 [0.48–1.12]. Conclusion The study identified multiple CR organizational and patient-level predictors for reaching key risk factor targets one-year post-MI. The results might contribute to defining the optimal composition of comprehensive CR programmes. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): 1) The Swedish Research Council for Health, Working Life and Welfare (FORTE)2) The Swedish Heart and Lung Foundation (Hjärt Lung Fonden)

Influence of Organization and Leadership on Lecturer Performance

This study aims to determine and analyze the influence of organization and leadership on lecturer performance. Based on the results of the discussion and testing, it can be concluded several things related to this research as follows: Simultaneously the variables of the school committee, organization, and leadership, simultaneously have a positive and significant effect on the performance of Lecturers of the Faculty of Economics, Sisingamangaraja XII University Tapanuli, marked by Fcount = 29.324 and Ftable = 2.87 in this case Fcount is greater than Ftable and the significant value is 0.00 less than the alpha value of 0.05. Partially, the school committee variable has no significant effect on the performance of the Lecturer of the Faculty of Economics at Sisingamangaraja XII Tapanuli University which is indicated by the tcount value for the school committee variable ( 1.180) is smaller than ttable(3.18) or sig value (0.246) is greater than alpha (0.025). Partially, organizational variables have a positive and significant effect on the performance of Lecturers of the Faculty of Economics, Sisingamangaraja University XII Tapanuli which is indicated by the tcount value for the organizational variable (6.096) which is greater than ttable (3.18) or the sig value (0.000) is smaller than alpha (0.025). ). Partially, the leadership variable has a positive and significant effect on the performance of the Lecturer of the Faculty of Economics, Sisingamangaraja XII Tapanuli University, which is indicated by the t-count value for the leadership variable (4.081) which is greater than ttable (3.18) or the sig (0.000) value is smaller than alpha (0.025). The R2 value obtained is 0.710 or 71.0% which shows the ability of the school committee, organization, and leadership variables in explaining the variations that occur in Lecturer Performance is 71.0%, while the remaining 29.0% is explained by other variables that not included in the model, for example curriculum, lecturer certification, school facilities and others