Control Guidelines Research Articles

Internal Control and Administrative Management: an Empirical Study Applied to SMEs in the Canton of Manta-Ecuador

Objective: The objective of this research is to analyze the possible relationship between the components of internal control and the administrative management of SMEs located in the canton of Manta in the period 2019-2020. Theoretical Framework: This section presents the main concepts and theories that support the research. [List relevant theories, models, or frameworks] stand out, providing a solid foundation for understanding the context of the research. Methodology: A common framework emerges: the Committee of Sponsoring Organizations of the Treadway Commission (COSO) model as a strategy for organizational operations, aimed at achieving business goals. A sample of 213 individuals working in these organizations was used. One of the most important aspects in any company, regardless of its size or its obligation to keep accounting records, is internal control. Results and Discussion: Multiple linear regression analysis was performed, whose main findings allowed us to determine that there is a positive and statistically significant correlation between the components of these constructs. Implications of the Research: The implications of this research contribute to the design of methodologies and the establishment of strategic internal control tools, allowing managers and employees of SMEs to establish and comply with policies, processes, and undertake improvement actions necessary to improve the competitiveness of these types of companies in the short, medium, and long term. Originality/Value: Through this study, it was possible to determine that one of the fundamental aspects for the proper application of internal control is the level of education of the administrators of these institutions, who in some cases were unaware of internal control, but who applied certain control guidelines verbally and without written procedures, focusing more on the empirical.

The Compliance of Governance on Family Data Protection Regulation

Digital transformation has changed the way family data is managed and stored. The vulnerability of family data has become a serious concern due to the increase in data breach incidents. This research aims to analyze public compliance with family data protection regulations and the ideality of government governance regulations regarding family data protection regulations. This research uses normative legal research methods to analyze the comparison of family data privacy protection regulations between Indonesia and England. This research examines various legal guidelines and policies by applying legislative techniques and a conceptual approach. The legal system theory is used as an analytical framework to evaluate the effectiveness of regulations, law enforcement, and legal culture's influence on public compliance. Data was collected through a literature review of primary and secondary sources, including documents, archives, books, and scientific research findings. The research results show First, that family data protection regulations in England are first more standardized with a higher level of public compliance than in Indonesia. Secondly, Indonesia still faces challenges such as the weak bargaining position of data subjects, the absence of clear guidelines for data controllers, and the need for an independent oversight authority. This research recommends regulatory improvements, the establishment of competent authorities, and enhanced public education to strengthen Indonesia's personal data protection system, particularly family data.

Temporary recommendations of the russian association of functional diagnostics specialists on the registration of a conclusion based on the results of spirometry

The article presents concise guidelines for quality control and protocol development for spirometry, a routine test of lung function. Based on Russian methodological recommendations for spirometry, standards of the American Thoracic Society, and the European Respiratory Society, these guidelines cover all stages of spirometry, from patient preparation to result interpretation, aiming to ensure high quality and reliability of the tests performed. The importance of adhering to standards and quality control is emphasized to guarantee the accuracy and reliability of spirometry results. The guidelines provide criteria for the quality of individual attempts and the entire test, criteria for selecting the best attempt, and recommendations for assessing the severity of abnormalities. Examples of formulating spirometry protocols are also given. These recommendations are intended for physicians in functional diagnostics, pulmonologists, therapists, anesthesiologists, medical staff, and aim to standardize the formation of spirometry protocols.

Perceived Barriers and Facilitators of Behavioral-Health Modality Change Adoption During the COVID-19 Pandemic: A Systematic Review.

During the Coronavirus Disease 2019 pandemic, there was a surge in demand for mental health services worldwide, presenting challenges for healthcare institutions as they navigated changes in policy and safety regulations. In the United States, this resulted in many behavioral health modality changes to remain in compliance with the Center for Disease Control guidelines. A growing body of literature has documented these, yet few explored barriers and facilitators affecting the adoption of these modality delivery changes. The researchers conducted a systematic review using the PRISMA method, focusing on service delivery changes across healthcare systems in the United States from March 2020 to May 2022. The study objective was to identify barriers and facilitators affecting the adoption of changes to modality delivery of behavioral health services due to pandemic restrictions. This was a systematic review that utilized the PRISMA method. The researchers identified 445 initial articles from eight databases using predetermined keywords and implemented a three-round screening process to select the most pertinent articles for this review. The researchers used a thematic analysis focused on user-related, program-related, technology, and environment-related constructs relevant to engagement with digital mental health interventions, and also addressed provider and administrative-related barriers and facilitators of virtual behavioral health modality changes. Barriers and facilitators were operationalized using the Borghouts Model. This systematic review revealed several common barriers and facilitators, including underdeveloped technology infrastructure, privacy and confidentiality concerns, poor technology literacy, availability of diverse technology options, provider technology training, and ease of integration into everyday life. This review provides insights into barriers and facilitators of modality change adoption, which could inform the development and implementation of virtual mental healthcare services and may help optimize the application of these services by improving our understanding and ability to overcome barriers influencing their adoption.

Nursing practice of guidelines for prevention and control of vascular Catheter-Related bloodstream infections.

To apply the Ottawa Model of Research Use to translate the Guidelines for the Prevention and Control of Vascular Catheter-Associated Bloodstream Infections. The Ottawa model of research use is used to provide a framework and guidance. This study was organized by the Nursing Department of the Affiliated Hospital of Hebei Engineering University, and the Intravenous Therapy Group was responsible for the implementation of the study. The hospital's intravenous therapy administrators, members of the sedation team, and specialist nurses will be organized to evaluate the importance, exactness, and clinical practicability of 34 entries. Twelve clinical departments and IV therapy clinics with a high number of central venous catheters were used as sites for translating evidence from this project. The evidence-based team assessed the practice environment, potential practitioners, and clinical status of clinical translation of evidence through symposia, review of relevant systems, operational procedures, on-site inspections, and questionnaires. They compare evidence with existing processes and decide on change strategies. Before and after the application of the evidence, there was a significant increase in the knowledge, belief, and behavior of healthcare workers on CLABSI prevention and control, especially in the acquisition of related knowledge (χ2 = 26.648 p < 0.001). The associated implementation rate was also significantly improved, with a significant decrease in CLABSI incidence from 0.29 per 1000 to 0.11 per 1000 (χ2 = 8.625 p = 0.004). The assessment of the integration of issues showed that 8 aspects, including workflow, knowledge mastery, monitoring reports, and aseptic operations, do not meet the qualified standards. Through this clinical change, a perfect prevention and control system has been established, and the level of knowledge, belief, and behavior of medical staff in preventing CLABSI has been improved, while the incidence of CLABSI has been reduced.

Beyond CDC-Defined Surgical Site Infection: Factors Associated with Antibiotic Prescription After Breast Operation.

Background: Most studies on surgical site infections (SSIs) use the US Centers for Disease Control and Prevention (CDC) guidelines, which excludes inflammation or cellulitis without fever. The aim of this study was to evaluate antibiotic prescription trends in the post-operative period among patients undergoing breast operation. We explore the outcomes of patients receiving antibiotic agents outside of the CDC-defined SSI. Patients and Methods: A retrospective review of patients undergoing breast operation from January 2021 to May 2021 was conducted. Solely reconstructive and cosmetic cases were excluded. The primary outcome was the prevalence of antibiotic prescription in the absence of CDC-defined SSI, excluding routine prophylactic antibiotic agents, with analysis of associated factors. Results: A total of 754 breast surgical procedures were included. Seventy-seven patients (10.2%) were prescribed outpatient antibiotic agents. CDC-defined SSI occurred in 5.3% (n = 40), mostly involving tissue expander/implant-based reconstruction (47.5%, n = 19). However, 37 (4.9%) did not progress to meet the CDC criteria for SSI. Patients prescribed outpatient antibiotic agents without CDC-defined SSI did not have increased rates of diabetes mellitus, obesity, or current smoking. These patients were more likely to have a surgical drain (48.6% vs. 28.4%, p = 0.02), plastic surgery involvement (32.4% vs. 18.0%, p = 0.048), and a post-operative seroma (32.4% vs. 8.1%, p < 0.001) and or or cellulitis (18.9% vs. 0%, p < 0.001). Conclusion: Patients are prescribed antibiotic agents after breast operation based on clinical judgment for indications other than CDC-defined SSI. Post-operative wound morbidity including seroma and cellulitis could be contributing to these antibiotic prescriptions. Further study is needed to determine whether providers are preemptively treating SSIs appropriately or over-treating non-infectious wound complications.

Safety in Wearable Robotic Exoskeletons: Design, Control, and Testing Guidelines

Abstract Exoskeletons, wearable robotic devices designed to enhance human strength and endurance, find applications in various fields such as healthcare and industry; however, stringent safety measures should be adopted in such settings. This paper presents a comprehensive exploration of challenges associated with exoskeleton technology, ranging from mechanical issues to regulatory and ethical considerations. The enumerated challenges include joint hyper-extension or flexion, rapid or sudden motion, misalignment, fit, and comfort issues, mechanical failure, weight and mobility limitations, environmental challenges, power supply issues, high energy consumption and regeneration, fall risk or stability concerns, sensor failures, control algorithm malfunctions, machine-learning model challenges, communication disconnection, actuator malfunctions, unexpected human–robot interactions, and regulatory and ethical considerations. The paper outlines possible risks and suggests practical solutions based on design, control, and testing methods for each challenge. The objective is to offer a guideline for developers and users, emphasizing safety, reliability, and optimal performance in the ever-evolving landscape of exoskeleton technology. The guideline covers preoperation checks, user training, emergency response, real-time monitoring, and user interaction to ensure responsible innovation and user-centricity in exoskeleton development and deployment.

Foodservice strategies for reducing athlete illness at the Olympic and Paralympic Games.

In 2021, infection control guidelines, including those specific to feeding environments, were introduced by the International Olympic and Paralympic Committees to reduce virus transmission at the Tokyo 2020 Summer and Beijing 2022 Winter games. This observational cross-sectional study aimed to investigate caterers' compliance to these guidelines which included measures for personal hygiene, sanitisation, and physical distancing at these events. Expert sport dietitians attending Tokyo (n = 15) and Beijing (n = 7) games were surveyed to rate 11 COVID-19 countermeasures as fully (100%), partially or non-compliant at nine dining locations across both events. Descriptive analysis of each countermeasure based on observed compliance and location was conducted and reported as a proportion of the total responses. To better understand participant perspectives of the factors influencing compliance, open responses were systematically coded into themes and sub-themes by researchers through content analysis. Themes generated from participant comments were categorised based on their relevance to specific countermeasures and locations to identify commonalities and disparities in participant experiences, perceptions, and observations. All main dining halls at both events were observed as 100% compliant to countermeasures on more occasions compared with Tokyo's venues and satellite villages. However, Beijing's three main dining halls, showed a greater compliance compared with Tokyo's main dining hall, likely due to overcrowding in Tokyo. Comments suggested that smaller dining spaces, with overcrowding, may have contributed to reduced compliance to physical distancing measures. Food safety concerns were raised about gastrointestinal distress in Beijing due to food cross-contamination. Findings suggest that the food service environment may influence caterers' abilities to comply with foodservice safety and infection control guidelines. In the post-pandemic era, enhanced quality control and standardised risk mitigation strategies are needed to improve athletes' health at international sporting events.

Rapid response Task Force: addressing the detection of Aedes albopictus in Lisbon, Portugal

Abstract Issue The invasive Aedes albopictus mosquitoes are spreading in southern Europe and pose a heightened risk of mosquito-borne diseases, like Dengue and Chikungunya. On September 2023, A. albopictus was first identified in Lisbon through community-based surveillance and a multidisciplinary national Task Force (TF) was convened. Description of the problem The TF included experts in epidemiology, entomology, environmental health, laboratory diagnosis, prevention and control and communication. The objectives were to i) confirm A.albopictus presence in Lisbon and adjust the risk assessment, ii) raise awareness and prevent mosquitoes’ spread, iii) revise national guidelines on arboviruses surveillance and control. During September-December 2023, the National Network for Vectors Surveillance (REVIVE) and the Hygiene and Tropical Medicine Institute sampled mosquito-prone habitats within 2km-radius of the detection point using QGIS software. They used snowball sampling to identify any new foci. They placed ovitraps for ongoing surveillance and conducted morphological analysis and xenomonitoring for pathogen DNA and RNA detection at the national reference laboratory. Results By November 2023, A.albopictus was detected in two new foci. No mosquitoes tested positive for arboviruses, and no autochthonous cases of mosquito-borne diseases were identified. The TF developed national guidelines for vector prevention and control and awareness for arboviruses and trained municipality workers. To raise awareness, we communicated with experts and the public through existing channels and media. As of April 2024, no new foci have been detected. Lessons Community-based surveillance and REVIVE approach were crucial for invasive A.albopictus detection and monitoring in Lisbon. Rapid multidisciplinary TF coordination may have been key for timely vector control.

Spin Texture Engineering by a Temperature Gradient in Ultrathin CoFeB Film

Magnetic texture in a chiral material is touted as one of the next-generation nonvolatile computing elements. Thermal manipulation of magnetic textures attracts considerable attention and has promising applications. Here, the temperature-dependent magnetic properties of Ta/CoFeB/MgO thin film are studied experimentally and theoretically. We report the controllable spin texture distribution with a temperature gradient in the Ta/CoFeB/MgO thin film. The nucleation area could be generated at a certain location through the cooperation of heat and magnetic field. This method offers a way to realize spin texture injection at specific positions in magnetic thin films and devices. This work provides useful guidelines for the thermal control of the spintronic device operation.

From Traditional to Postmodern: Architectural Evolution and Implications for Cultural Preservation on Tha Phae Road, Chiang Mai, Thailand

This study examines the architectural heritage of Tha Phae Road in Chiang Mai, Thailand, which reflects the city’s cultural and economic development. The preservation of its historic character and cultural significance is of utmost importance as rapid urbanization and development threaten its potential loss. Using Grounded Theory, the study analyzes non-numerical data, including photographs and site investigations, to identify the area’s four main architectural styles: Modern, Postmodern, Traditional, and Traditional-Colonial, with Modern being the most prevalent. The Compound Annual Growth Rate (CAGR) is used to examine the distribution of styles over an 11-year period, revealing a decline in Traditional and Modern styles and a positive growth rate of Postmodern architecture. To preserve and enhance the area’s visual quality while allowing for new development, the study proposes a Façade Control Guideline and zoning regulations. These guidelines consider criteria such as the history and importance of Tha Phae Road, ensuring that any changes made to the area respect the overall scale and character of the street. This study’s findings have important implications for the development and preservation of Tha Phae Road’s identity and highlight the value of preserving the cultural heritage and visual quality of the area.

Prevalence and outcome of candidemia among paediatric cancer patients: A single centre experience from India

BackgroundCandida species are one of the leading causes of invasive fungal infections in pediatric patients with cancer, resulting in increased treatment related morbidity and mortality. There is limited data with respect to demography and outcomes of candidemia among children with cancer, especially from lower-middle income countries. MethodsIn this retrospective observational study conducted over a 4-year Period (January-2017 to December-2021), children less than 15 years with cancer, treated at a tertiary oncology centre in India and diagnosed with candidemia were included. Data with respect to risk factors, species types, treatment, complications and mortality was gathered. ResultsOne-hundred and ten children with candidemia were included. The most common underlying malignancy was acute leukemia seen in 72 (66%) patients. Seventy-five (68%) patients had neutropenia (<0.5 × 10^9/L) at the time of diagnosis of candidemia. In addition, 35 (32%) and 34 (30%) patients had prolonged exposure to steroids and antibiotics respectively. Non-albicans Candida species was isolated in majority (90%) of the cases. Fifty-seven patients required some form of modification of therapy for underlying malignancy. The 30-day mortality of the entire cohort was 36% and was 73% for patients admitted to the intensive care unit. On multivariate analysis, only prolonged use of antibiotics [odds ratio: 2.7(1.1-6.7); p = 0.027] was found to be significantly associated with worse 30-day mortality. ConclusionThe present study highlights the burden of candidemia among children with cancer. Despite prompt therapy, our cohort experienced increased mortality, primarily associated with prolonged antibiotic usage. These findings reinforce the critical importance of strict adherence to infection control guidelines and prudent antibiotic stewardship practices to improve patient outcomes.

RADIOGRAPHY CLINICAL EDUCATION AMIDST THE COVID-19 PANDEMIC: PERSPECTIVE OF RADIOGRAPHY STUDENTS INTERNATIONALLY

Purpose: The COVID-19 pandemic has signifi cantly impacted clinical practice. This study explored the impact of the pandemic on diagnostic radiography clinical education from the perspective of radiography students internationally. Materials and methods: A qualitative approach was used to gain insight into students' experience of clinical placement during the pandemic. A total of sixteen radiography students from six countries were recruited from an international Radiography summer research school. Qualitative data was gathered via three semi-structured focus groups (5-6 students per focus group). Data was analysed using Braun and Clark’s phases of thematic analysis. Results: Five key themes emerged in relation to clinical education during the COVID-19 pandemic, (i) unequal student access to personal protective equipment (PPE) (ii) challenges in achieving clinical learning outcomes (iii) impact of online education on clinical readiness (iv) emotional impact, and (v) coping strategies. Students indicated that they were particularly afraid of transmitting COVID-19 to their family and friends. Some students reported that they felt under pressure to receive COVID-19 vaccinations prior to clinical practice. Others reported confusion with respect to infection control guidelines and application of PPE. Conclusion: Student radiographers identifi ed key challenges which require consideration by educators to ensure students are appropriately prepared for and supported on clinical placement during a pandemic. Implications for practice: • The COVID-19 pandemic has impacted clinical education internationally and this study identifi es the implications for radiography students in terms of clinical readiness and their clinical placement experience. • Simulation-based in-person learning in the X-ray lab and PPE training were perceived by students to be important factors impacting clinical readiness.

Assessing effectiveness of cleaning and disinfection of equipment and environmental surfaces in cystic fibrosis clinics using an ATP assay.

Infection control guidelines for cystic fibrosis (CF) stress cleaning of environmental surfaces and patientcare equipment in CF clinics. This multicenter study measured cleanliness of frequently touched surfaces in CF clinics using an ATP bioluminescence assay to assess the effectiveness of cleaning/disinfection and the impact of feedback. Eight surfaces were tested across 19 clinics (10 pediatric, 9 adult) over 5 rounds of testing. Rounds 1 and 2 served as uncleaned baseline, and Round 3 occurring after routine cleaning. Rounds 4 and 5 were performed after feedback provided to staff and measured after cleaning. Pass rates defined as <250 relative light units were the primary outcome. Of the 750 tests performed, 72% of surfaces passed at baseline, and 79%, 83%, and 85% of surfaces passed in Rounds 3, 4, and 5, respectively. The overall pass-rate was significantly higher in adult compared to pediatric clinics (86% vs 71%; P < 0.001). In pediatric clinics, blood pressure equipment and computer keyboards in the pulmonary function lab consistently passed, but the exam room patient/visitor chairs consistently failed in all rounds. In adult clinics blood pressure equipment, keyboards in exam rooms and exam tables passed in all rounds and no surface consistently failed. We demonstrate the feasibility of an ATP bioluminescence assay to measure cleanliness of patient care equipment and surfaces in CF clinics. Pass rates improved after cleaning and feedback for certain surfaces. We found that surfaces are more challenging to keep clean in clinics taking care of younger patients.

Low body mass index patients have worse outcomes after mechanical thrombectomy

BackgroundThere is evidence that frailty is an independent predictor of worse outcomes after stroke. Similarly, although obesity is associated with a higher risk for stroke, there are multiple reports describing...

Smartphone application-based intervention to lower blood pressure: a systematic review and meta-analysis.

Nowadays, the mHealth market is flooded with smartphone applications (apps) lacking validation for blood pressure (BP)-lowering effects and BP measurement accuracy. This systematic review for Guidelines for BP control using digital technologies of the Japanese Society of Hypertension aimed to assess the validation studies of apps. We searched eligible studies in Ovid MEDLINE, Cochrane Library, and Ichushi, focusing on randomized controlled trials and observational studies comparing the effects of smartphone app-based interventions with non-digital healthcare. Random effects models of meta-analysis were employed to estimate the pooled effects of mean BP change and 95% confidence intervals (CIs). Out of 7385 studies screened, 76 studies with 46,459 participants were included. The interventions were significantly associated with a reduction in office systolic and diastolic BP at six months (systolic BP, -2.76 mmHg, 95% CI: -3.94 to -1.58; diastolic BP, -1.23 mmHg, -1.80 to -0.67). Normotensives saw a significant reduction in office systolic BP at three-month (-4.44 mmHg, -6.96 to -1.92), diminishing afterward (six-month, 0.86 mmHg, -2.81 to 4.52; twelve-month, 0.86 mmHg, -2.81 to 4.52). Conversely, hypertensive participants experienced a significant reduction in office systolic BP at both three- and six-month (three-month, -7.71 mmHg, -10.63 to -4.79; six-month, -1.88 mmHg, -3.41 to -0.35), albeit with limited evidence thereafter. A larger BP reduction was observed among participants using apps with wireless transmission of BP measurements (P = 0.047 for interaction), while there was no clear difference in BP reduction according to the presence of other functions. Smartphone app-based interventions may hold the potential to improve BP levels.

Etiology of Severely Dehydrating Diarrheal Illness in Infants and Young Children Residing in Low- and Middle-Income Countries.

Severe dehydration due to acute infectious diarrhea remains a leading cause of death among young children worldwide. Diarrhea with severe dehydration is a clinical syndrome with distinct management per the World Health Organization (WHO) Integrated Management of Childhood Illness (IMCI) and the WHO Global Task Force on Cholera Control (GTFCC) guidelines. We sought to characterize the pathogens causing severe dehydration using data from the Global Enteric Multicenter Study. We used the IMCI and GTFCC guidelines to define severe dehydration and quantitative polymerase chain reaction-based attribution models to assign the etiology of diarrhea associated with severe dehydration. The IMCI or GTFCC guidelines classified 2284 of the 5304 (43%) cases with moderate-to-severe diarrhea as having severe dehydration. In one-third of the cases with severe dehydration, no pathogens were attributed. The top pathogens attributed to children with guidelines-classified severe dehydration varied by age and were similar among those requiring intravenous hydration and hospitalization. Rotavirus (30.9%), Cryptosporidium (12.0%), and heat-stable (ST) enterotoxigenic Escherichia coli (ETEC) (10.3%) were the most common pathogens for ages 0-11 months, while Shigella/enteroinvasive E coli (EIEC) (25.8%), rotavirus (19.3%), and ST-ETEC (10.9%) were the most common for ages 12-23 months. Shigella/EIEC (25.9%), Vibrio cholerae (10.4%), and rotavirus (9.2%) were the most common among ages 24-59 months. The findings inform prioritization of pathogens, in addition to V cholerae, that cause severe dehydration for future preventive and treatment efforts. The schema for prioritization is driven primarily by age stratifications.

Automated quality control analysis for American College of Radiology (ACR) digital mammography (DM) phantom images.

To develop and validate an automated software analysis method for mammography image quality assessment of the American College of Radiology (ACR) digital mammography (DM) phantom images. Twenty-seven DICOM images were acquired using Fuji mammography systems. All images were evaluated by three expert medical physicists using the Royal Australian and New Zealand College of Radiologists (RANZCR) mammography quality control guideline. To enhance the robustness and sensitivity assessment of our algorithm, an additional set of 12 images from a Hologic mammography system was included to test various phantom positional adjustments. The software automatically chose multiple regions of interest (ROIs) for analysis. A template matching method was primarily used for image analysis, followed by an additional method that locates and scores each target object (speck groups, fibers, and masses). The software performance shows a good to excellent agreement with the average scoring of observers (intraclass correlation coefficient [ICC] of 0.75, 0.79, 0.82 for speck groups, fibers, and masses, respectively). No significant differences were found in the scoring of target objects between human observers and the software. Both methods achieved scores meeting the pass criteria for speck groups and masses. Expert observers allocated lower scores to fiber objects, with diameters less than 0.61mm, when compared to the software. The software was able to accurately score objects when the phantom position changed by up to 25mm laterally, up to 5 degrees rotation, and overhanging the chest wall edge by up to 15mm. Automated software analysis is a feasible method that may help improve the consistency and reproducibility of mammography image quality assessment with reduced reliance on human interaction and processing time.

Exploring barriers to and facilitators of infection prevention and control practices in the Pediatrics and Child Health Department of Tikur Anbessa Specialized Hospital, Ethiopia

BackgroundAdherence to infection prevention and control (IPC) standards and guidelines by healthcare workers is essential for reducing the spread of healthcare-associated infections (HAIs). However, IPC practices among healthcare workers in low- and middle-income countries (LMICs), including Ethiopia, are generally inadequate. This research aims to identify the barriers to and facilitators of IPC practices in the Pediatrics and Child Health Department of Tikur Anbessa Specialized Hospital (TASH) in Ethiopia.MethodsWe employed a rapid ethnographic assessment (REA) approach for this study, using focus group discussions (FGDs), in-depth interviews (IDIs), and observations to collect data. Participants were selected from the Pediatrics and Child Health Department of TASH, and data collection took place in March and April 2022. Two FGDs and eight IDIs were conducted in the participants’ workplace within the department. Unstructured guides were used to facilitate the FGDs and IDIs. Nvivo version 10 software was used for data organization and analysis. The data were coded deductively through thematic analysis to identify similar ideas and concepts, based on the Systems Engineering Initiative for Patient Safety (SEIPS) model.ResultA total of 23 healthcare workers participated, with 15 in FGDs and 8 in IDIs. The study identified several barriers to IPC practices, including nonadherence to IPC practice protocols, lack of pre-employment training, space constraints, insufficient maintenance and repair of equipment, limited management engagement and support, shortage of resources and budget, incidents of needle stick injuries and infections, high workloads for healthcare workers, shortages of personal protective equipment and water supply, and inadequate waste management. We also identified some facilitators, including the existence of an IPC team and committee, a health education schedule for patients and visitors, morning sessions for healthcare providers, and the presence of television screens in waiting areas. By addressing the identified barriers and leveraging the facilitators, department heads, IPC team leaders, and decision-makers can develop targeted strategies and interventions to improve infection control, reduce the spread of HAIs, and ultimately enhance the quality of healthcare services.ConclusionThis study explored several barriers that contribute to inappropriate and suboptimal IPC practices in the study area. These barriers create significant challenges for healthcare workers and hindering their ability to effectively implement IPC practices. The findings highlight the complex and multifaceted nature of the problems, which not only affect the current working environment but also compromise the overall quality of care. The hospital administrator should address these critical issues to improving IPC practices and ensuring a safer healthcare environment.

Evaluating the Efficacy of Cosmetic Product Safety Regulations in Malaysia: The Role of the National Pharmaceutical Regulatory Agency (NPRA) and Industry Compliance

Various legislative measures, such as the Sale of Drugs Act 1952, Control of Drugs and Cosmetics Regulations 1984, Poison Act 1952, Guidelines for Control of Cosmetic Products 2022, and other directives introduced by the NPRA in Malaysia, are intended to control the safety of cosmetic products. Despite these existing laws and directives, cosmetic products containing hazardous ingredients persist in the Malaysian market. NPRA reportedly received 1,041 complaints about cosmetic products in 2022, while its website also displays an annual increase in cases involving cosmetic products that contain hazardous ingredients. The persistent presence of harmful cosmetic products in the market highlights significant gaps in efforts to control hazardous cosmetic products. This study examined the efficacy of cosmetic product safety regulations in Malaysia, focusing on the role of the National Pharmaceutical Regulatory Agency (NPRA) and industry compliance. This qualitative study gathered data from library databases and conducted semi-structured interviews with NPRA officers, cosmetic manufacturers, and cosmetic industry experts. Findings suggest that despite the extensive nature of the regulatory framework, its implementation, which heavily relies on self-regulation and post-market surveillance, requires serious improvement. While some cosmetic producers adhere to Good Manufacturing Practice (GMP) standards, there are still persistent issues related to product notification, misuse of self-regulation, and inadequate penalties for non-compliance. Therefore, an intensive awareness campaign aimed at cosmetic manufacturers is necessary to ensure the production of safe cosmetic products. Consumers must play their role in helping the NPRA control the sale of hazardous cosmetic products by performing safety checks before purchasing them.