Client Assessment Research Articles

Effect of Digital Credit on the Financial Health of Youth Borrowers in Kibera, Nairobi County

The increased advancements in technological integration within the financial sector has led to development of new credit platforms which improve access to borrowing among the youth. Further, with proliferation of digital lending platforms which provide unsecured loans has led to a debt chokehold among the youth. This has resulted in poor financial health among the youth. Hence it’s vital to understand how various digital credit platforms have contributed to financial health of borrowers and help in advancing policy and practical solutions. The general objective of the study was to analyze the effect of digital credit on the financial health of youth borrowers in Kibera, Nairobi County. The study specifically analysed the effects of mobile network operator facilitated digital credit, commercial bank-based digital credit and fintech based digital credit on the financial health of youth borrowers in Kibera, Nairobi County. The study employed a correlational research design. The population of interest was youth borrowers who live and work in Kibera, Nairobi County. The sampling frame was active users of digital credit who are between 18 and 35 years, residing in Kibera. The list was obtained from the Independent Electoral and Boundaries Commission’s voter register for Kibera Ward. A stratified sampling technique was used to select the respondents. The sample size was 399 respondents. Data was collected using structured questionnaires. SPSS was used to aid in the data analysis. A descriptive statistical technique of analysis was used and entailed the determination of the mean and frequency distribution of the datasets. Further inferential analysis was conducted using both correlation and regression analysis. The data was presented in tables and figures. The study results shows that mobile network operator facilitated digital credit, Bank-facilitated digital credit and fintech facilitated digital credit has a positive and significant effect on youth’s financial health in Kibera Ward. The study recommends that mobile money operators that provide digital loans reduce their operation rates considering they have high interest rates for the small loans they offer. The study also calls for the development of progressive peer to peer regulations that would improve the penetration of these loan devices. The study recommends improved client assessment to increase borrower’s ability to access funds without long-term history. The study recommends that the firms make attempts to guarantee interoperability between devices as this would significantly improve access for borrowers with older phones.

Barriers to and strategies for early implementation of pharmacy-delivered HIV PrEP services in Kenya: An analysis of routine data.

For individuals who face challenges accessing clinic-based HIV pre-exposure prophylaxis (PrEP), differentiated service delivery models are needed to expand access and reach. During a pilot study testing a novel pharmacy-delivered oral PrEP model in Kenya, we used routine programmatic data to identify early implementation barriers and actions that providers and study staff took in response to the barriers. We trained pharmacy providers at five private pharmacies in Kisumu and Kiambu Counties to initiate and continue clients at risk of HIV acquisition on PrEP for a fee of 300 KES per visit (∼$3 USD) using a prescribing checklist with remote clinician oversight. Research assistants stationed at the pharmacies completed weekly observation reports of pharmacy-delivered PrEP services using a structured template. We analyzed reports from the first 6 month of implementation using content analysis and identified multi-level early implementation barriers and actions taken to address these. We then organized the identified barriers and actions according to the Consolidated Framework for Implementation Research (CFIR). From November 2020 to May 2021, research assistants completed 74 observation reports (∼18/pharmacy). During this period, pharmacy providers screened 496 potential PrEP clients, identified 425 as eligible for pharmacy-delivered PrEP services, and initiated 230 (54%) on PrEP; 125 of 197 (63%) clients eligible for PrEP continuation refilled PrEP. We identified the following early implementation barriers to pharmacy-delivered PrEP services (by CFIR domain): high costs to clients (intervention characteristics), client discomfort discussing sexual behaviors and HIV testing with providers (outer setting), provider frustrations that PrEP delivery was time-consuming and disruptive to their workflow (inner setting), and provider hesitancy to deliver PrEP due to concerns about encouraging sexual promiscuity (characteristics of individuals). To help address these, pharmacy providers implemented a self-screening option for behavioral HIV risk assessment for prospective PrEP clients, allowed flexible appointment scheduling, and conducted pharmacy PrEP trainings for newly hired staff. Our study provides insight into early barriers to implementing pharmacy-delivered PrEP services in Kenya and potential actions to mitigate these barriers. It also demonstrates how routine programmatic data can be used to understand the early implementation process.

A study to assess the intervention on patients with osteoarthritis

Effectiveness of Nursing Care on Patients with Osteoarthritis .Osteoarthritis (OA) is a condition that results in joint inflammation. It’s caused by the wear and tear of cartilage, the tissue protecting the ends of your bones and joints. OA is the most common form of arthritis and is degenerative, getting worse with age. Without treatment, chronic pain from OA can lead to other complications and can significantly affect your quality of life. Assess the intervention on patients with osteoarthritis (10) was evaluated using a descriptive study methodology. A simple sampling approach was adopted in this investigation. There are three sections to the checklist. Part 1 contains data on demographic characteristics such peer group, faith, employment, learning, salary, and behaviors. Portion 2 consists of a ranking scale to keep track of the patient’s fitness. There were a total of ten variables. The observational checklist to determine the efficiency of nursing intervention of clients with osteoarthritis in part three. There are a total of ten variables. The descriptive numerical study technique to determine t-test,mean, standard deviation, % of the score in this study. Conclusion: From the intervention revealed that 6(60%) is were behind fitness complaint an no one in worthy fitness complaint beginning the assessment of clients with Osteoarthritis after comprehensive nursing care as per protocol showed that majority 7(70%) patients with Osteoarthritis client in worthy health state. A p<0.05 significant development in wellbeing, after the intervention for Osteoarthritis client.

Using Active Learning Strategies to Strengthen Cultural and Linguistic Diversity Training in Communication Sciences and Disorders Programs.

Training in cultural competence is an accreditation requirement for graduate programs in Communication Sciences and Disorders (CSD; Council on Academic Accreditation in Audiology and Speech-Language Pathology, 2020). Cultural and linguistic diversity (CLD) instruction within CSD programs and current instructional models may not provide students with effective training in this area (Hammond et al., 2009; Higby et al., 2021; Stockman et al., 2008). In this paper, we present active learning as an instructional approach that may provide students with stronger training in the assessment and treatment of individuals with unfamiliar cultural and linguistic backgrounds. Active learning emphasizes the creation of a supportive classroom environment, teaching skills rather than content, and fostering metacognition in students (Bransford et al., 2000; Gooblar, 2019). We propose a three-part pedagogical model for using active learning strategies to improve clinical training in assessment and treatment of clients with CLD backgrounds. This pedagogical model encourages instructors to set the scene for learning, present a problem to solve, and build in reflection and generalization. Active learning approaches, as described in the model, are ideal for teaching clinical problem-solving across populations while reflecting on one's lived experience and positionality. Sample materials for readers to create their own lesson plans using the model are provided and reviewed.

A Truthful and Reliable Incentive Mechanism for Federated Learning Based on Reputation Mechanism and Reverse Auction

As a distributed machine learning paradigm, federated learning (FL) enables participating clients to share only model gradients instead of local data and achieves the secure sharing of private data. However, the lack of clients’ willingness to participate in FL and the malicious influence of unreliable clients both seriously degrade the performance of FL. The current research on the incentive mechanism of FL lacks the accurate assessment of clients’ truthfulness and reliability, and the incentive mechanism based on untruthful and unreliable clients is unreliable and inefficient. To solve this problem, we propose an incentive mechanism based on the reputation mechanism and reverse auction to achieve a more truthful, more reliable, and more efficient FL. First, we introduce the reputation mechanism to measure clients’ truthfulness and reliability through multiple reputation evaluations and design a reliable client selection scheme. Then the reverse auction is introduced to select the optimal clients that maximize the social surplus while satisfying individual rationality, incentive compatibility, and weak budget balance. Extensive experimental results demonstrate that this incentive mechanism can motivate more clients with high-quality data and high reputations to participate in FL with less cost, which increases the FL tasks’ economic benefit by 31% and improves the accuracy from 0.9356 to 0.9813, and then promote the efficient and stable development of the FL service trading market.

Empathy Competencies and Behaviors in Professional Communication Interactions: Self Versus Client Assessments

Empathy is an important competence for communication professionals. This article investigates two aspects of empathy in an educational setting: the validity of self versus other assessments and the manifestation of empathy in communicative behaviors. Communication students were given a mediating role in discussions with two clients and their empathy was measured using self-ratings and client assessments. Videos of highest- and lowest-rated students were analyzed to identify empathy-related behaviors. No correlation was found between self-rated empathy and clients’ assessments. Several verbal and nonverbal behaviors corresponded to empathy: body language, an other-orientation in asking questions, paraphrasing, and a solution orientation.

Client's Assessment on the Accessibility, User-friendliness, and Relevance of E-Resources of a Public Library in the Philippines

Client's Assessment on the Accessibility, User-friendliness, and Relevance of E-Resources of a Public Library in the Philippines

Implementation Strategy Fidelity and Organizational Outcomes in a Randomized Trial: Implications for Reentry from Corrections to Community Treatment

Background: This study examined fidelity of implementation strategies used in an organizational process improvement intervention (OPII) designed to improve evidence-based practices related to assessments for drug-involved clients exiting incarceration. Leadership was studied as a moderating factor between fidelity and outcomes. Methods: A mixed-method cluster randomized design was used to randomize 21 sites to early- or delayed-start within 9 research centers. Parent study protocol was reviewed to develop fidelity constructs (i.e., responsiveness, dose, quality, adherence). Outcomes were site-level success in achieving goals and objectives completed during the OPII (e.g., percent goals achieved). Correlations, analyses of covariance, regressions and moderation analyses were performed. Qualitative interviews assessed facilitators/barriers to implementation. Results: Fidelity constructs related to outcomes. No differences were found in fidelity by early or delayed condition. At low levels of leadership, high staff responsiveness (i.e., engagement in the OPII) related to poorer outcome. Conclusions: It is important to consider contextual factors (e.g., leadership) that may influence implementation strategy fidelity when deploying evidence-based practices. Findings are relevant to researchers, clinicians, administrators and policy makers, and suggest that goal completion during implementation of evidence-based practices requires monitoring of leadership competence, fidelity to implementation strategies (i.e., staff responsiveness to strategies) and attendance to goal importance.

Therapist’s interventions immediately after exceeding the client’s therapeutic zone of proximal development: A comparative case study

Objective When therapists’ proposals are too demanding exceeding clients’ readiness to move into change, clients may resist advancing. We aimed to understand how a therapist behaved immediately after the client resisted advancing into change within Cognitive–Behavioral Therapy. Methods We analyzed a recovered and an unrecovered case, both with Major Depression, and followed by the same therapist. Through the Therapeutic Collaboration Coding System, we analyzed 407 exchanges of interest. Results In both cases, clients resisted more in advancing at intermediate sessions, mainly by the therapist’s challenges to raise insight and debate cognitive beliefs in the recovered case, and to seek experiential meanings in the unrecovered case. Immediately after clients resisted advancing, the therapist tended to insist on challenging them in the same direction. In the recovered case, the therapist did so continually throughout the therapy, sometimes balancing between insisting or stepping back. In the unrecovered case, the therapist insisted on challenging, but mostly at the final session. Occasionally, the therapist insisted on challenging, and clients resisted over consecutive exchanges. Conclusion: Our results reinforce that to enact progress and change clients need to be pushed into change, however it requires therapists’ skillful assessment of clients’ tolerance to move in time.

Nursing Care of Patients With Ineffective Airway Clearance Problems

Bronchial asthma is a condition in which the airways narrow due to hypersensitivity to certain stimuli, which causes inflammation. Eucalyptus is a plant that is often used as a drug by inhalation because it contains terpenes, porphyrin derivatives, and other phenolic compounds for pharmacological activity. Eucalyptus can be inhaled to produce local or systemic effects through inhalation by inhalation using a vapor, nebulizer, or aerosol spray. This study aims to carry out nursing assessments for clients who experience asthma, establish nursing diagnoses for clients who experience asthma, develop nursing plans for clients who experience asthma, carry out nursing actions for clients who experience asthma, carry out nursing evaluations for clients who experience asthma, perform discussion of the results of the application of eucalyptus aromatherapy to clients who experience asthma. The research method was carried out qualitatively with a content analysis approach to patients directly. The results obtained prove that there is an effective effect in administering simple steam aromatherapy eucalyptus inhalation therapy to asthma sufferers.

Echoing Mechanism of Juvenile Delinquency Prevention and Occupational Therapy Education Guidance Based on Artificial Intelligence.

In this paper, in-depth research and analysis of juvenile delinquency prevention and occupational therapy education guidance using artificial intelligence are conducted, and its response mechanism is designed in this way. Two crime type prediction algorithms based on time-crime type count vectorization and dense neural network and crime type prediction based on the fusion of dense neural network and long- and short-term memory neural network are proposed. The outputs of both are fed into a new neural network for training to achieve the fusion of the two neural networks. Among them, the use of the dense neural network can effectively fit the relationship between the constructed features and crime types. The behavioral manifestations and causes of the formation of deviant behavior in adolescents are discussed. They can only read numerical data, but there is a lot of information in the textual data that is closely related to the training effect. When experimenting, it is necessary to extract knowledge and build applications. The practical work with adolescents with deviant behaviors is again carried out from group work and casework, respectively, with problem diagnosis, needs assessment, and service plan development for specific clients, to carry out relevant practical service work. The causes of juvenile delinquency in the Internet culture are discussed in terms of the Internet environment, juvenile use of the Internet, Internet supervision, and crime prevention education, respectively. The fourth chapter focuses on the analysis of the prevention and control measures for juvenile delinquency in cyberculture. In response to the above-mentioned causes of juvenile delinquency in cyberculture, the prevention and control measures are discussed in four aspects, namely, strengthening the construction of cyberculture and building a healthy cyber environment, strengthening the capacity building of guiding juveniles to use cyber correctly, building a prevention and supervision system to promote the improvement of the legal system, and improving and innovating the crime prevention education in the cyber era.

NURSING CARE OF ACUTE PAIN IN CLIENTS WITH ACUTE MYOCARDIAL INFARCTION IN THE ICCU ROOM, DR. SOEGIRI HOSPITALS LAMONGAN

Introduction: Severe pain in the center of the chest is found in acute myocardial infarction (AMI) clients. Chest pain is described as pressing, usually radiating to the jaw or teeth, shoulders, arms, and/or back. Purpose: to report a case study on nursing care of clients with acute pain in AMI clients in the ICCU Room of Dr. Soegiri Hospitals Lamongan. Methods: research using case studies. The sample used was one IMA client with acute pain. Data collection was obtained through interviews, observations, physical examinations and documentation studies. Result: the case shows that there are several gaps between the client's facts and the literature review. For the assessment of AMI clients in general there is no gap, nursing diagnoses lead to a priority, namely acute pain, with priority nursing actions taken, namely providing analgesic therapy and advising clients to perform distraction and relaxation techniques. Evaluation of the nursing diagnosis of acute pain, the problem was partially resolved on the third day. Conclusion: AMI clients in their care must be more careful in assessing and prioritizing patient needs, seriousness in implementation to avoid complications that may occur.

Which therapist perceptions best predict client outcomes? A naturalistic examination.

Examining associations between therapists' perceptions of therapy sessions and client-reported outcomes in naturalistic settings (real-life therapy settings) can provide valuable guidance for the assessment, treatment, and monitoring of clients. This study included data of 1334 sessions from 127 clients (86 individual and 41 couple cases) and 15 therapists, collected at a therapy training center. Clients reported their personal functioning and individual symptoms before each session. Therapists rated clients' participation, receptivity, session progress, goal progress, and therapeutic alliance at the end of each therapy session. Multilevel Structural Equation Modeling analyses revealed that therapist-rated client participation and goal progress predicted better personal functioning, beyond clients' previous personal functioning scores. In contrast, none of therapist-rated session variables predicted clients' individual symptoms, beyond previous symptom scores. Power analyses suggested sufficient statistical power to detect small effect sizes. Findings of the current study have clinical implications for treatment planning and progress monitoring.

Keep an Eye on Chalazion

Nurse practitioners routinely encounter patients presenting with chalazion or meibomian cyst in primary care. This report describes the pathogenesis, assessment, and treatment of chalazion. Differential diagnosis and management strategies are discussed, with attention to more serious diagnoses, such as sebaceous cell carcinoma. Many malignancies can conceal as benign or inflammatory lesions, making diagnoses difficult and leading to higher morbidity and mortality. A vigilant history and physical examination will aid in early assessment and referral of clients with new or suspicious lesions warranting further investigation.

Basic Health Care Provision Fund Scheme: Assessment of Clients' Satisfaction at Primary Health Care Facilities after Two Years of Implementation in Nigeria's Federal Capital Territory

Basic Health Care Provision Fund Scheme: Assessment of Clients' Satisfaction at Primary Health Care Facilities after Two Years of Implementation in Nigeria's Federal Capital Territory

Needs Assessment of Clients Accessing a Community Mental Health Crisis Stabilization Unit.

This study aimed to examine the needs of clients accessing a community mental health crisis stabilization unit (CSU) in Winnipeg, Canada.Sociodemographics, service connections, and need were assessed among CSU clients. The Camberwell Assessment of Need Short Appraisal Schedule - Patient (CANSAS-P) was administered to differentiate need domains that were met and unmet. An ordinal regression examined sociodemographics and level of total unmet need; client characteristics were correlated with unmet need.In total,271 questionnaires were analyzed. On average, respondents had 6.2 areas of unmet need, with "psychosocial distress" (n = 186, 68.6%), "safety to self" (n = 140, 51.7%), "company" (n = 139, 51.3%), and "physical health" (n = 124, 45.8%) being reported most often. Higher level of unmet need was predicted by disability income and absence of income.Overall,CSU clients had high rates of unmet need reflecting important determinants of health. This information can inform community mental health crisis service delivery to positively impact mental health recovery.

International Delphi Recommendations for Pediatric Lower Limb Neurological Test Protocols for Muscle Strength, Reflexes, and Tactile Sensitivity.

To gain consensus from physical therapists on pediatric lower limb neurological tests of muscle strength, tactile sensitivity, and reflexes. A Delphi technique was used for 2 sequential questionnaire rounds to gain consensus from a panel of pediatric physical therapists (n = 28). Physical therapists rated their agreement to items from statements on pediatric lower limb neurological tests, their protocols, and interpretation using a 6-point Likert scale. Ninety percent of items gained consensus: 80% on pediatric lower limb neurological tests, 88% on test protocols, and 92% on test interpretation. Fifty-one percent of items had high agreement and high importance. There is variability in pediatric neurological tests used, their protocols, and interpretation. Identification of items with high agreement and importance is the first step to develop a standardized lower limb neurological assessment for pediatric clients of varying ages and diagnoses.

Enhancing referral processes within an integrated fall prevention pathway for older people: a mixed-methods study

ObjectivesMultifactorial interventions, which involve assessing an individual’s risk of falling and providing treatment or onward referral, require coordination across settings. Using a mixed-methods design, we aimed to develop a process...

An assessment of client and clinician satisfaction in veterinary teleconsultation compared to in-person consultations

PICO question
 Compared to in-person veterinary consultations, does teleconsultation lead to similar levels of client and clinician satisfaction?
 
 Clinical bottom line
 Category of research question
 Qualitative assessment
 The number and type of study designs reviewed
 Eight studies were critically appraised. There were six cross-sectional studies, one randomised controlled clinical trial, and one case report
 Strength of evidence
 Weak
 Outcomes reported
 All eight studies provided weak evidence of similar levels of clinician and / or client satisfaction
 Conclusion
 Teleconsultation can lead to similar levels of client and clinician satisfaction when compared to in-person consultations. However, the evidence is weak due to the subjectivity and varied methods of measuring satisfaction. Furthermore, the current applicability of veterinary teleconsultation is still very limited to certain select scenarios in which it is appropriate (e.g., emergency, triage, remote locations, non-complicated routine postoperative checks, nutrition and behavioural consults)
 
 How to apply this evidence in practice
 The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
 Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
 

Description of Nursing Implementation with Main Nursing Problem on Child Diarrhea of The Regional Hospital in Besuki Residency

Diarrhea are one of the diseases that causes the death of children number two in 2016 and has the main causative factors, namely groups of viruses, bacteria and parasites. The purpose of this study was to find out a description of nursing implementation in diarrhea children aged 0-18 years in the area of Besuki residency which is famous for its agro-cultural with high mortality problems in children. This research method was descriptive with a retrospective approach and use a purposive sampling technique. The sample in the study was 199 diarrhea children aged 0-18 years of the regional hospital in the area of Besuki residency. Data collection tools in this study is using checklist sheets. The result of the study showed diarrhea nursing problems that often arise with observational nursing action, namely pulse strength monitoring, number of frequencies, monitoring a number of respiratory. Observation has influence which is high enough to detect changes in life support systems. Vital signs are a statistical measure, especially for clients who are medically unstable, can know the baseline data to determine the stress response of physiology or psychology, concerning factors related to the existing disease and to assess the client's response to the conversion given by health workers. Observation is a basic method of assessment and assessment for clients to find out clinical signs in establishing a diagnosis of disease and for planning appropriate medical therapy.