: Introduction Th e concept of the quality of healthcare services is constantly evolving and transforming depending on the interest in it and the level of involvement of medical sta ff and patients. Aim To assess patient satisfaction with the quality of health services in private practice condition. Methods 105 (n=105) subjects participated in the study, and it was conducted by an anonymous survey of the clinic which o ff ers medical services, tests, and diagnostic procedures in the fi elds of gynecology, internal medicine, surgery, radiology, urology, and neurology. Th e research was conducted among patients who used the health services of a private practice institution from January to September 2022. Th e patient questionnaire consisted of 14 questions. Five questions related to identifying the sociodemographic characteristics of the respondents, and 9 questions were research questions of the Lickert type. For this purpose, the standardized Laschinger HCAHPS ( Hospital Consumer Assessment of Healthcare Providers and Systems ) questionnaire on patient satisfaction with the quality of healthcare services was used. Di ff erences in numerical variables were tested by Student’s t-test or analysis of variance (ANOVA). All P values are two-sided (p<0.05). Th e statistical program MedCalc Statistical Software version 18.2.1 was used for statistical analysis. Results Th e research was conducted on 105 patients, 28% of whom were male and 72% female. Most patients were in the age group of 61 to 70 years (30%). Patients are satis fi ed with the quality of healthcare services. Th e highest average score for reception and waiting time (4.9), the lowest score for being informed about upcoming interventions and treatments and professional approach (4.68). Conclusion Patients show a high degree of satisfaction with the general services provided.
The article presents an approach aimed at automatically deriving the initial conceptual database model from a set of business process models. The approach proposes the incremental synthesis of the target model by iteratively composing the partial conceptual database models that are derived from the models contained in the source set. The approach is implemented by the AMADEOS tool, which is the first online web-based tool enabling the automatic derivation of the conceptual database model from a set of business process models. The experimental evaluation proves that the implemented approach enables effective automatic derivation of the initial conceptual database model.
This paper proposes a novel circuit configuration for a high-voltage direct-current circuit breaker (HVDCCB) test bench that differs significantly from conventional test benches. The proposed test bench consists of a modular multilevel cascaded converter (MMCC) that is based on H-bridge cells, an output inductor, and an auxiliary capacitor bank. The proposed test bench is capable of generating controllable output currents up to several kiloamperes and output voltages up to several hundred kilovolts because each MMCC cell is operated by phase-shifted pulse-width-modulated (PSPWM) signals. Consequently, the proposed test bench can simulate a wide range of fault conditions within hardware limitations to test different HVDCCB types with various current and voltage ratings. The flexibility of the proposed test bench is complemented by a longer service lifetime with inherent circuit protection in the case of operational failure of the HVDCCB. The concept of the proposed test bench is verified experimentally on a downscaled test bench that consists of nine H-bridge cells and operates at an equivalent switching frequency of $\mathrm {92.5 kHz }$ .
Modern technologies, in addition to making people's lives easier, faster and better, enable the combination of different technologies to develop solutions to various problems. Global warming is one of the biggest and most dangerous problems facing planet earth. If global warming were presented as a coin, then air pollution and climate change would be two sides of the same coin. Climate change is primarily a problem that has arisen due to the large amount of carbon dioxide (CO2 ) in the atmosphere. Carbon overload occurs mainly due to the combustion of fossil fuels such as coal, oil and gas, or the cutting and burning of forests. There are other harmful gases but CO2 stands out because it poses the greatest risk of irreversible change if it continues to accumulate in the atmosphere. This paper presents a number of different solutions by combining modern technologies for the problem of CO2 emissions globally, where Bosnia and Herzegovina is particularly singled out as one of the countries with the most polluted air in Europe and with the highest mortality rate associated with air pollution. Smart cities use digital technologies, aim to improve the quality of human life and to enable the protection of the environment. The concept of a smart city is described as a set of modern technologies, examples of leading smart cities in the world are given, as well as the advantages of implementing such a solution.
Digital technologies change the way how manufacturing firms create offers for customers. These new technologies transform traditional Product-Service Systems into Digital Product-Service Systems. This paper investigates the use of digital technologies for the creation of new products and smart services in manufacturing firms. Additionally, this paper investigates the service orientation in Product-Service Systems. The data for this research were collected at the end of 2021 through the ASAP Service Management Forum in the manufacturing sector of the Republic of Serbia. The empirical results indicate that more than 60% of manufacturing firms use digital technologies for the creation of new products and less than 50% for the creation of new smart services. Moreover, results indicated that most services are product-oriented with 25% of share in a sample, followed by results-oriented services with 20% of share in a sample and use-oriented services with 11% of share in the total sample.
Speech is a way of communication formed by rhythmic units of syllables, words and sentences, and as such is inherent in man, the only being whose organs and psyche are trained for this process. Delayed speech is defined as a phenomenon in which a child does not start speaking on time, or there are errors in the speech pattern that are not appropriate in relation to a given age. It is known that significant risk factors for the development of delayed speech in preschool children are physical, and most often social and emotional in nature. For the normal development of speech, it is necessary that the child is in a human environment, and therefore the circle of people with whom children come into contact should always be expanded. The aim of this study is to review the existing literature on studies examining the impact of social isolation during the COVID-19 pandemic on preschool children, as well as the speech and language development in preschool children. The recent pandemic of corona virus infection (COVID-19) has led to a state of emergency, quarantine, closure of public institutions, and preschools, kindergartens and schools in 172 countries. These epidemiological measures have led to social isolation and the need for children to learn from home, which has manifested itself in the emergence of difficulties in the development of speech and language. Research has shown that during the pandemic, children spent significantly more time watching television and computer screens than before pandemic, and less in play and physical activity.
Introduction. Cardiac magnetic resonance imaging (CMR) is considered the reference diagnostic method for quantifying right ventricular size and function, and pulmonary regurgitation in patients with tetralogy of Fallot surgery. The aim of this paper is to confirm the importance of magnetic resonance continuous postoperative monitoring of right and left heart function parameters as a diagnostic method that provides the most precise and accurate assessment. Methods. The prospective observational study included subjects with TOF surgery who were diagnosed with residual morphological and/or functional disorders on control postoperative echocardiographic examinations. All subjects underwent magnetic resonance imaging of the heart on a 1.5 T scanner with dedicated coils for the heart surface according to the standard protocol for a period of one year from the beginning of the study. Criteria for exclusion from the study were: significant residual pulmonary stenosis, condition after pulmonary valve replacement, existence of residual shunt lesions, contraindications for cardiac magnetic resonance imaging (pacemaker, ICD, claustrophobia). Depending on the time elapsed since the tetralogy of Fallot surgery, the subjects were divided into groups: more than 15 years, 11-15 years, 6-10 years, less than 5 years. Results. The study included 131 subjects with an average age of 24.18 ± 11.57 years with complete correction of TOF. Intergroup differences in values of right ventricular end-diastolic volume, right ventricular ejection fraction, and left ventricular ejection fraction were demonstrated, but there was no statistically significant intergroup difference in values of pulmonary regurgitation fraction. The negative interaction of the right and left ventricles intensifies during the years of follow-up of patients after TOF surgery, which is especially true fifteen years after surgery. Conclusion. CMR has the most significant role in research efforts aimed at improving the outcomes of operated patients with tetralogy of Fallot.
Introduction. According to the data of the World Health Organization (WHO), mental illnesses are on the rise. The World Health Report estimates that today about 1 billion people suffer from mental and behavioral disorders or psychosocial problems such as those related to alcohol and drug abuse. Stigmatization of the mentally ill is one of the burning social problems of those people, and the attitudes and behavior of nurses/technicians significantly affect the self-stigmatization of patients, and thus their condition and recovery. The main aim of this study was to assess attitudes of nurses and nursing students towards patients with mental illnesses. Method. The research conducted is a cross-sectional study. The study covered two countries, Bosnia and Herzegovina and Serbia. In June and July 2018, 200 nurses and nursing students from the second to the fourth year of study were surveyed. Data were collected with original anonymous questionnaires, which was made for the purpose of this research. Results. Seventy percent of nurses believe that people with mental illness are discriminated against in our society, while there are statistically significant differences between respondents in relation to demographic characteristics (ch2 = 10.217; p = 0.037). Nurses working in psychiatric wards show a lower level of stigmatization compared to nurses working in other wards (ch2 = 25.553; p = 0.001). Nursing students have more negative attitudes towards mentally ill people compared to nurses (ch2 = 13.471; p = 0.009). Nurses from Serbia show a higher level of tolerance towards people with mental disabilities compared to nurses from Bosnia and Herzegovina (ch2 = 16.115; p = 0.003). Conclusion. The results of the research show that stigmatization of patients with mental illness still exists among health professionals. Undergraduate and continuing medical education of nurses should include more content related to access to the patient with mental disorders, communication skills in psychiatry, mental health promotion and prevention of stigmatization.
Introduction. Visual-motor integration (VMI) is defined as the degree to which visual perception (VP) and finger-hand movements are well coordinated. The VMI consists of two components: VP and motor coordination (MC). The main goal of our research was to determine whether there are differences in age and gender categories in VMI, VP and MC scores, as well as whether there is a correlation between VMI and school success of younger school-aged children. Methods. Out of 103 student respondents, 52 were female (50.5%), aged 6 to 11 years (8.05 ± 1.44 years), divided into two groups according to age: 6-8 years (first, second and third grade) and 9-11 years (fourth to fifth grade). Data on the level of VMI were obtained by applying the following tests: Beery-Buktenica Developmental Test of VMI, VP test and MC test. Results. In the older age group of subjects, a significant difference was observed in the mean values of the score on the VMI (12.67 ± 1.92), VP (23.69 ± 3.21) and MC (24.34 ± 3.23) tests comparing to the younger group of subjects (9.98 ± 2.12; 20.80 ± 3.2; 19.65 ± 3.82) (p < 0.001), while the difference in the mean values of scores in relation to gender was not observed. A significant, positive and strong correlation was observed between the scores on the VMI, VP and MC test with the success of second to fifth grade students (p < 0.050). Conclusion. Given such a strong correlation between VMI and the success of younger students, we conclude that it is important that VMI disabilities are identified in time, so that these students can be referred for further assessment and receive the necessary support.
Introduction. The patient and his safety should be at the center of quality health care, which is a challenge for every health system. Adverse patient outcomes (APO) are defined as damage caused by a drug or other intervention in a primary, secondary or tertiary health care facility, which results in a complication of the primary or the emergence of a new disease or injury. The aim of our study was to determine how frequent the APO are, and to determine the differences between nurses and doctors in the frequency, causes and attitudes towards APO. Methods. This cross-sectional study included 100 health professionals, nurses and medical doctors employed at the primary and secondary level of health care. The research was conducted in the period from May to October 2020. The questionnaire was partially taken from a general questionnaire offered on the website of the Agency for Healthcare Research and Quality and the standardized Perceived stress scale was used to measure the degree of subjective stress. Results. Forty-four health professionals (44%) experienced adverse patient outcomes in their career, doctors (52%) significantly more often than nurses (36%) (p = 0.039). More than a half of respondents (52.3%) declared that APO happens few times a month. Seventy percent of the respondents blame their own stress burden as the main factor associated with APO. Doctors more often than nurses (69.2%) blame problems in communication between health professionals as the main cause of APO (27.8%) (p = 0.046). Conclusion. For doctors, the main cause of APO is problem in communication, while nurses more often think that patient safety is priority when compared to doctors. Almost two thirds of respondents blame their own stress burden as a factor associated with APO.
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