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To Burn or Not To Burn: Causal effect of farm stubble burning on Air Quality.
Get PDFNational Capital Region of India (NCR) experiences adverse air quality during winters with Air Quality Index (AQI) at hazardous levels. Though various factors like industrial and automobile emissions, biomass burning, and firecrackers during festive season contribute to NCR’s adverse air quality, farm stubble burning in neighbouring agricultural regions of Punjab and Haryana is considered a prominent one. The motivation and consequences of farm-stubble burning in Punjab and Haryana have been extensively studied but the causal effect of this burning on air quality of Delhi has neither been rigorously analyzed nor the effects quantified. This study aims to bridge this gap by establishing causality between the two phenomenon using econometric methods and estimating the quantum of effect.
The study uses farm burning data and air quality data collected from satellite data using Google Earth Engine, and uses similarly collected vegetation cover data as an instrument for the IV identification strategy to establish causality. The results indicate that 1 standard deviation (approximately 332 thousand hectares) increase in farm-stubble results in an increase in Aerosol Optical Depth over NCR by 0.3 in the subsequent month and by 0.2 in the second month. Both results are significant at a confidence level of 99 percent
Comfortability in the Latino and Hispanic Community
Get PDFMany organizations often publicize their efforts to help particular communities but, how helpful are they to those who are their targets? For this reason this research focuses on the question of, how do programs create inclusivity and accessibility to the Hispanic community? This study focuses on five specific organizations that all commonly support the Hispanic Community in California, although some do go outside of the state due to extensions. In this study I have analyzed the content presented on each organization\u27s website and determined their accessibility and inclusivity within the Hispanic community. This research analyzes the websites content thoroughly through links provided, PDF’s and the language used etc. within the organization\u27s public image. In most cases organizations that pride themselves on being helpful within the Hispanic community often create difficult standards for their target community to qualify or even obtain information from them. The navigation of the website takes a large amount of time and is often not clear. This study will build on the connection between the Hispanic community and their needs for assistance, along with other research that highlights the importance of cultural competence in professional settings. The comfort level that is present when someone is at their most vulnerable state matters, and the ones who are present to help are a major part to the comfortability. All of this is essential because it is important to seek help when in need, and organizations offering help should strive to create this sense of comfort
Psychosocial and Spiritual Predictors of Mental Health Among Protestant Christian Latino Clergy
Get PDFResearch relating to the experiences of Protestant Christian Latino clergy in the United States is scarce. This study sought to explore the role of religion and spirituality on depression, burnout, and suicidality in Protestant Christian Latino clergy using multiple regression analysis. The study consisted of 212 Protestant Christian Latino clergy participants who completed an anonymous self-report questionnaire online that included measures for religious commitment and spiritual well-being, burnout, depression, and suicidality. Participants also completed a measure of ethnic/cultural identity and self-reported gender that were used as moderators in this study. The study revealed that stronger spiritual well-being-Daily (CSWS-Daily) and lower religious commitment (RCI) were related to lower levels of burnout while stronger levels of religious commitment and spiritual well-being-Ministry (CSWS-Ministry) were related to higher levels of depression. Additionally, the study found that the relationship between religious commitment, CSWS-Ministry, burnout, and depression was moderated at different levels of ethnic/cultural factors. Finally, the results indicate that gender moderated the relationship between religious commitment, spiritual well-being, and burnout but not depression. The results for suicidality were not statistically significant. The research results indicate that for Protestant Christian Latino clergy spiritual well-being and religious commitment are not the only predictors to consider when assessing for burnout and depression. Ethnic/cultural factors and gender are also important factors to consider when it comes to the well-being of Protestant Christian Latino/Hispanic clergy
WOMEN STRENGTH: USING PHOTOVOICE TO EXPLORE FEMALE CHINESE INTERNATIONAL STUDENTS’ EXPERIENCES
Get PDFFemale Chinese international students face discrimination and stereotypes in Western academia based on race and gender, yet they possess unique “Women Strength” characterized by agency, resilience, and self-advocacy. This study explores how these students navigate cultural differences and develop their strengths while studying in the U.S. Drawing upon “Women Strength” as a theoretical framework, including Community Cultural Wealth, Critical Feminist Theory- Chinese feminism, decolonial feminism, and transnational feminism, transformative agency, resilience theory, and self-advocacy theory, this research employs a qualitative approach, including Photovoice and autoethnography. Three research questions guide the study: 1) What cultural differences do female Chinese international students experience in the U.S. related to race and gender? 2) How do they navigate these cultural differences? 3) How do they develop agency, resilience, and self-advocacy, or “Women Strength,” in response to these challenges? Findings reveal participants’ cognitive awareness of cultural differences and their strategies for coping and finding purpose and joy in their U.S. experience. While social support plays a significant role in their lives, notably absent is support from universities, highlighting a need for institutional acknowledgment and tailored support. Recommendations include university stakeholders recognizing the unique needs of these students and fostering a supportive and inclusive environment. Additionally, students are encouraged to recognize their own strengths and seek peer support, while future research should continue exploring the experiences of female Chinese international students and other marginalized groups. This study contributes to a nuanced understanding of the challenges and strengths of female Chinese international students and informs interventions and policies to better support them in their academic journey
Implementing Joy in Practice and Addressing Nurse Burnout
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Background: This quality improvement project, a beacon of hope in the face of nurse burnout, examined its effects and how nurse leader engagement and the transformative Joy in Practice Initiative can promote wellness, joy in practice, and significantly improve patient outcomes. Problem: According to the Institute of Healthcare Improvements (IHI) 2019 National Forum on Quality Improvement in Healthcare (IHI, 2019), burnout can be characterized by depersonalization, emotional exhaustion, and lack of personal accomplishment. Since the COVID-19 pandemic, nurse burnout rates have been at an all-time high, posing a significant threat to patient care. This has revealed alarming results: Nurse burnout and compassion fatigue directly affect bedside staff and patients, resulting in a noticeable decline in the quality of care. The implications of this are profound, as it not only impacts the well-being of nurses but also jeopardizes the health and safety of patients (Archer, 2022).
Interventions: From April through June 2024, a twelve-week initiative was implemented to lessen the effects of nurse burnout and compassion fatigue in the workplace. Evidence-based interventions included nurse leader engagement, self-care practices, team engagement, positive reinforcement, and employee recognition.
Outcome Measures: A survey was performed pre- and post-implementation to assess reported levels of burnout. Quality metrics such as medication errors, falls, absenteeism, and workplace injuries were measured for effectiveness. This project aimed to decrease reported levels of nurse burnout by 20% of baseline scores, a significant step towards a healthier and more joyful nursing profession.
Results: Post-intervention results showed a 44% decrease in the overall burnout rate, a 32% reduction in depersonalization, and a 48% reduction in reduced personal achievement.
Conclusion: The implementation of the Joy in Practice Initiative was successful in reducing reported levels of burnout, improving workplace morale, and improving the overall quality of patient care.
Keywords: Nurse burnout, depersonalization, personal achievement, absenteeis
Improving Patient-Specific Mobility in the Telemetry Unit
Get PDFImproving Patient-Specific Mobility in the Telemetry Unit
Abstract
Problem: Prolonged immobilization has been proven to result in numerous adverse outcomes, including reduced ability to perform daily living activities, extended hospital stays, and increased need for rehabilitation discharge (Bergbower et al., 2020). Research reveals that only 5% of patients walk twice daily during hospitalization, and around 73% do not ambulate (Kalisch et al., 2013). In the telemetry unit, the inaccuracy of patients’ function assessment leads to the inability to optimize their mobility to meet daily activity goals.
Context: The patient-specific mobility improvement project addressed the critical quality gap of low mobility performance in the 6th-floor telemetry microsystem. Located in a 242-licensed-bed Northern California hospital, the 42-bed telemetry microsystem primarily cares for patients who require continuous cardiac monitoring due to a prior cardiac history or present diagnoses that may modify their baseline cardiac rhythms. The majority of the patient population is elderly with preexisting chronic conditions such as atrial fibrillation, residual stroke, congestive heart failure, and diabetes. To avoid additional decompensation, preserving functionality for this population should be a top focus. This project’s intervention attempted to educate staff on accurately assessing patients’ functional levels and enhancing mobility in the telemetry unit. The project aimed to improve patient-specific mobility metrics for all patients admitted in the telemetry unit from a baseline of 67.8% in 2023 to a target of above 70% by July 1st, 2024.
Measures: The project’s outcome measure was the percentage of expected bouts of activity that meet or exceed the patient’s CLOF-based mobility goal. This outcome was targeted at 70% or more. To evaluate the intervention, process measures included the percentage of staff who received education, the percentage of patients with CLOF scores correctly documented, and the percentage of expected activity bouts documented. These process measures were extracted from the EHR. The adverse event, such as mobility-related falls, was identified as the balancing measure.
Results: The project, which aimed to elevate the patient-specific mobility metric from a baseline of 67.8% to above 70% by August 1st, 2024, surpassed expectations, achieving an impressive 84.5%.
Conclusion: The patient-specific mobility improvement initiative effectively addressed the patients\u27 functional deterioration caused by prolonged immobilization in the 6th-floor telemetry microsystem using a series of targeted interventions and the dedication of a diverse team. This result demonstrated the effectiveness of a complete approach grounded in evidence-based practices and ongoing staff education. The formation of the Mobility Tiger team, which included a variety of stakeholders, demonstrated that frontline staff can lead and drive change. The telemetry unit\u27s experience is a model for other units pursuing similar initiatives to improve patient care and operational efficiency.
Keywords: patient-specific mobility, Mobility Tiger team, CLOF documentation, CLOF-based mobility goal, improving mobility in the telemetry unit, early mobility, improved care experience
Implementing the Fall TIPS Tool to Reduce Falls in Older Adults
Get PDFProblem: In many organizations, falls and associated major injuries create a large barrier to maintaining patient safety. Patient falls impact quality of care and create financial difficulty for all parties involved. It is important that prevention measures are effective and individualized.
Context: A significant increase in falls and major injuries have been documented in unit F1 of Facility A in Northern California. Current strategies to prevent falls have not been successful in reducing fall rates over the past year.
Interventions: The intervention to decrease falls on this unit is the Fall Tailoring Interventions for Patient Safety (TIPS) tool. The tool addresses individual fall risks for the patients, family members, and nurses to be aware of.
Measures: This project will be evaluated based on the following measures: the number of falls, the percentage of patients using the tool, and the number of sitters and restraint use. Information of these measures will be gathered from quality reports, room reviews or surveys, and electronic health record data.
Results: The results showed a shallow decline in the number of falls on the unit over the course of the project. Data collection began in March, but the tool was implemented in April where the unit had five falls. At the end of the project in June, there were two falls on the unit.
Conclusions: This fall prevention project decreased the incidence of patient falls. Collaboration and engagement will help improve safety and quality of care, leading to better outcomes for the patients and the organization as a whole
Improving Health Equity: Integrating Mental Health Services into Mobile Health Clinics for Unhoused and Low-income Populations in the United States
No full textMental health disparities among homeless and low-income populations in the United States highlight significant challenges in access and quality of care. This literature review explores the integration of mental health services into Mobile Health Clinics (MHCs) as a promising recommendation to address these disparities. I used various search engines, extracting 10 articles published from 2013 to 2023 focused on the U.S. MHCs show its effectiveness in improving healthcare access and quality of care, covering different services like mammography, reproductive health, COVID-19 testing, and diabetes care. Building on these successful models, this paper proposes extending MHCs to include mental health screenings, counseling, and psychiatric evaluations, emphasizing a patient-centered approach, community collaboration, and policy support to sustain these services. Despite challenges in funding sustainability and resource limitations, integrating mental health care into MHCs is a feasible way to improve public health outcomes and promote health equity among underserved populations. Future research and advocacy efforts are critical to advance this model and foster inclusive healthcare systems
Maternal Health Care in Rural South Africa: Risk Factors Impacting the High Maternal Mortality Rate
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Objective: This paper examines the barriers that inhibit woman from accessing comprehensive maternal health care services in rural areas of South Africa.
Methods: I used multiple databases (PubMed and Google Scholar) to extract literature that explored the factors pertaining to maternal health service delivery and utilization, disparities, and perspectives. I identified 10 articles that met the inclusion criteria and utilized a qualitative, quantitative or mixed methods approach.
Key Findings: A thematic analysis determined that inequities in maternal health care services, inconsistent leadership and resources in district hospitals and low maternal health literacy among women in rural areas played a significant role in access to quality maternal health care services.
Conclusion: The findings suggest that inequities in maternal health care such as limited hospital resources, deeply rooted cultural norms and varying hospital leadership act as barriers to access to comprehensive maternal health services in rural South Africa. Additionally, the research highlights there is lack of recent available data/research on this topic limiting the information that is available to make decisions to that can help contribute to lowering the high maternal mortality rate in rural South Africa
Partnering Across Professions: Public Health and Collaborative Courts Partnership to Increase Recovery Capital
No full textSubstance use disorder (SUD) has been steadily increasing over the past decade. The prevalence of SUD in the United States hit an all-time high of 48.7 million people struggling with SUD in 2022 (Tomko et al., 2022; United States (U.S.), 2023). State and federal policies have led to the criminalization of drug use, the dismantling of behavioral health systems, and mass incarceration of people with SUD. These policies have also created a cyclical cycle of failure and recidivism for people struggling with SUD. One intervention that has strived to rectify the mass incarceration of those struggling with SUD is the creation of collaborative courts. The goal of collaborative courts is to treat SUD creating therapeutic interventions away from incarceration into recovery. The collaborative courts have begun to use the recovery capital approach in assessing and building necessary tools to desist and promote long-term recovery. Recovery capital comprises 5 different categories, including personal, physical, community, cultural, and social, that all need to be developed to be for long-term recovery and desistance. However, the collaborative courts cannot do this alone. Public health can help support and partner with the courts to help fill the needs the collaborative courts struggle to address. In this paper, three strategies to support the development of recovery capital within a community are recommended, recovery-specific community needs assessments, harm reduction strategies, and addressing the stigmatization of SUD. Through this partnership, recovery capital will increase in the collaborative court clients and the surrounding community benefiting people in all stages of recovery