Improve Quality Indicators Research Articles

Mastering granular activated carbon filtration to remove organic micropollutants, antibiotic resistance and metals for municipal wastewater reuse

GAC filtration of municipal wastewater was optimized and intensified, making its implementation and operation directly after secondary clarification possible and relevant. GAC was first selected based on laboratory tests. Performances on organic micropollutants were linked to the repartition of BET surface between micropores and meso/macropores. At pilot scale, in order to limit the impact of head loss, downflow declogging sequences (DCS) were implemented and upflow filtration tested. 6 to 12 DCS per day led to a 4.7–5.5-fold increase of particles retention capacity between backwashes (cycle duration of 20–120 h), and upflow operations improved head loss evolution profile with only a slight GAC (<15 %) expansion. DCS allows backwash frequency reduction, enabling significant water savings. Both adaptations maintained high organic micropollutants removals compared to a review of 16 GAC studies at pilot or full-scale, results being in the upper range. A specific dose of 2.0–2.5 g GAC/gC was necessary to obtain an average removal of pharmaceuticals and benzotriazole of 80 % at 20 min contact time, which is comparable to PAC and low granulometry GAC. Higher doses are needed for PFAS but >80 % removals are achievable. Particles, TKN, particulate phosphorus and organic matter are well removed by GAC filtration in both configurations. Biological activity is observed through nitrogen transformation in the GAC bed. Heavy metals are greatly removed in GAC filtration, in particular Cd, Cu, Ni and Pb, probably through biosorption onto the biofilm, developed within the GAC bed. For wastewater reuse applications, GAC filtration has an added value through physicochemical quality improvement and fecal contamination indicators removal of 1 log, facilitating the implementation and optimizing the design of a post-disinfection. Antibiotic resistant bacteria and antibiotic resistance genes are also partially retained in GAC filtration. Finally, biological wastewater treatments combined to GAC filtration is a good solution to effectively treat organic micropollutants together with heavy metals and preparing post-disinfection for reuse.

Effect of Early Multiprofessional Mobilization on Quality Indicators of Intensive Care in a Less Economically Developed Country: An Action on “Rehabilitation 2030” in Brazil

ObjectiveTo investigate the effects of implementing early multiprofessional mobilization on quality indicators of intensive care in Brazil. DesignThis is a retrospective cohort study. SettingA Brazilian educational and research-intensive care unit (ICU). ParticipantsA total of 1047 patients were hospitalized from May 2016 to April 2018. InterventionsImplementation of early multiprofessional mobilization using the MobilizAÇÃO Program (MAP). Main Outcome MeasuresClinical, ventilation and safety quality indicators, and physical function before (preprogram period) and after (postprogram period) the MAP. ResultsThere was a reduction in sedation time (4 vs 1d), hospital stay (21 vs 14d) and ICU stay (14 vs 7d), mechanical ventilation (8 vs 4d), hospital death rate (46% vs 26%) (P<.001), and ICU readmission (21% vs 16%; P=.030) from pre to post MAP. Successful weaning (42% vs 55%) and discharge rate (50% vs 71%) (P<.001) increased after MAP. No differences were found to safety quality indicators between periods. After MAP, complex physical functions assessed using the Manchester Mobility Score (MMS) were more frequent. The in-bed intervention was a predictor for readmission (P=.009; R²=0.689) and death (P=.035; R²=0.217), while walking was a predictor for successful weaning (P=.030; R²=0.907) and discharge (P=.033; R²=0.373). The postprogram period was associated with the MMS at ICU discharge (P<.001; R²=0.40). ConclusionsEarly mobilization implementation through changes in low mobility culture and multiprofessional actions improved quality indicators, including clinical, ventilation, and physical functional quality, without compromising patient safety in the ICU.

ANZACS-QI Heart Failure Registry: a new approach using age-stratified sampling of hospital discharges to guide quality improvement (ANZACS-QI 79).

Heart failure is a major healthcare problem in New Zealand. The Acute Decompensated Heart Failure (ADHF) Registry was introduced in 2015, and has identified the need for quality improvement strategies to improve care of patients hospitalised with heart failure. In this paper, we describe the implementation of the revised ANZACS-QI Heart Failure Registry, which has a primary aim to support evidence-based management of and quality improvement measures for patients who are hospitalised with heart failure in New Zealand. Taking the learnings from the initial experience with the ADHF Registry, the revised ANZACS-QI Heart Failure Registry i) utilises age-stratified sampling of hospital discharge coding to identify a representative heart failure cohort, ii) utilises existing ANZACS-QI infrastructure for data-linkage to reduce the burden of manual data entry, iii) receives governance from the Heart Failure Working Group, and iv) focusses on established quality improvement indicators for heart failure management.

O-151 Endometrial preparation using CONCEIVF algorithm with intrauterine and sub-endometrial endosera administration for enhanced pregnancy rates in women with thin endometrium

Abstract Study question Could personalized regenerative medicine based strategies promote endometrial growth and receptivity in women with refractory thin endometrium resulting in successful implantation and live births? Summary answer Personalized regenerative medicine based strategies remarkably promote endometrial growth and receptivity in women with refractory thin endometrium resulting in successful implantation and live births What is known already Thin endometrium (&amp;lt;7mm) is considered sub-optimal for embryo transfer and associated with reduced pregnancy chances. Regenerative medicine based strategies utilizing stem cells, growth factors alone or in combination for endometrial regeneration have been proposed as futuristic clinical therapies. Data-intensive biomedical technologies in research studies reveals that humans vary widely at genetic, biochemical, physiological, exposure and behavioral levels, especially with respect to disease processes and treatment responsiveness. Hence there is a need to deeply ‘personalize,’ interventional strategies at clinical and dosage level for individual patients. Study design, size, duration In this self- controlled study, 60 women with history of more than 3 failed IVF cycles due to persistent refractory thin endometrium (&amp;lt;7mm) were enrolled between July 21-December 23. 42 women were treated with intrauterine administration of Endosera and 18 patients were treated with sub-endometrial administration of Endosera as suggested by CONCEIVF - Proprietary Algorithm from Seragen.. Endosera is Autologous platelet derived implantation friendly anti-inflammatory cytokines and concentrated growth factors and progenitor cells. Participants/materials, setting, methods CONCEIVF-Algorithm classifies patients (High, Moderate, Poor responders) based on age, BMI, clinical history, guiding standardized dosage routines for proliferative, secretory, implantation phases including CD 33/CD34 cells minimal threshold, are specified. Intrauterine Endosera administration, 2 or 3 times from menstrual cycle day 5 during FET, precedes embryo transfer. Sub-endometrial administration involves Endosera with endothelial progenitor cell support on cycle days 5-7, followed by embryo transfer two days after the final Endosera infusion in the subsequent cycle. Main results and the role of chance Clinical pregnancy rate was 77%(46/60), no pregnancy in 10 patients accounting for 17%. 50% (30/60) delivered healthy babies and 17%(10/60) of uneventful pregnancies are progressing. 3 patients (5%) had miscarriage between 6-8 weeks. Improvement in endometrium thickness (EMT) was 90% with mean difference of 1.9mm improvement in 54 patients. No adverse effects reported. 33 patients out of 42 conceived and 6 out of 42 patients did not conceive and 3 out of 42 patients are yet to undergo embryo transfer in the intra-uterine group. 13 patients out of 18 conceived and 4 out of 18 patients did not conceive and 1 out of 18 patient is yet to undergo embryo transfer in the sub-endometrial group. Live birth rate and on-going pregnancies are indicators of overall endometrial quality (thickness and receptivity) improvement and validates that personalization helps to achieve maximum success rate. 15 out of 60 patients who were referred to surrogacy have conceived. In women with a history of cycle cancellations due to thin endometrium, CONCEIVF algorithm recommended personalized Endosera dosages resulted in improved endometrial thickness, clinical pregnancy and live birth. Personalization holds the key for precision because now two patients are alike! Limitations, reasons for caution This prospective self-control study, contains small sample size and lacks randomized controlgroup. Our results are encouraging but large cohort of patients is needed to establish efficacy. of protocols and positive patient predictors score to strengthen Conceivf personalized recommendations. Wider implications of the findings Despite global rise in FET for diverse indications, ongoing efforts to find the optimal endometrial preparation protocol persist. Our personalized approach achieved cumulative 74% pregnancy rate (40/54 ETs done), inspiring planned randomized trials to validate results and help women with resistant thin endometrium to conceive without surrogacy. Trial registration number Not applicable

Enhancing Urban Living Convenience through Plot Patterns: A Quantitative Morphological Study

Enhancing Urban Living Convenience through Plot Patterns: A Quantitative Morphological Study

Surgical Service Utilization and In-Patient Satisfaction in Surgical Service.

The patient satisfaction study is an important and commonly used valid indicator for service quality improvement in healthcare institutions. The aim of this study was to assess the service utilization and patient satisfaction in patients admitted under surgical service in Bir Hospital. A prospective cross sectional analytical study was conducted in Bir Hospital, National Academy of Medical Sciences from February 2021 till June 2023. The patient satisfaction data was collected using the SAPS scale after obtaining ethical clearance from the Institutional Review Board. Data were entered and analyzed in Statistical Package for the Social Sciences version 20.0. There were 152 patients included in the study categorized into conservative treatment group, elective surgery group and emergency surgery group. 32.9%(50) patients were "very satisfied", 62.5%(95) patients were "satisfied", 2.6%(4) were "neither satisfied nor dissatisfied" and 2%(3) were "dissatisfied" with the effect of their treatment/care. The mean satisfaction score in conservative treatment group was 22.13 ±2.53 as compared to the mean satisfaction in elective surgery group which was 21.11± 2.55 (P=0.036) and the mean satisfaction score in emergency surgery group which was 21.66 ±2.68 (P=0.64). The mean score and proportion of patient satisfaction regarding service utilization in patients admitted under surgical service were high with satisfaction score higher in emergency surgery group among the operative groups in Bir Hospital, National Academy of Medical Sciences.

The influence of reed nanocellulose on the quality indicators of paper-basis for wallpapers

Improving the production technology of products with improved quality indicators and with less impact on the environment remains an urgent scientific and practical problem of paper industry enterprises. This refers to the technology for the production of paper-bases for wallpaper using environmentally safe chemical additives, in particular nanocellulose (NC), which was obtained by acid hydrolysis from reed cellulose. The production of cellulose was carried out in two stages - extraction from reed stalks with a solution of alkali and an organosolvent method of cooking in a solution of peracetic acid. The obtained organosolvent cellulose contained the remains of lignin and mineral substances, which allows it to be used for the preparation of NC. As a result of the hydrolysis of organosolvent cellulose, a time-stable NC suspension was extracted, the properties of which were investigated by scanning electron microscopy (morphological changes in the structure of reed cellulose-containing materials), atomic force microscopy (determination of topographic characteristics of NC), analysis of electronic absorption spectra (transparency of NC films). It was established that reed NC films had nanoparticles with a cross-sectional size of 5-25 nm, density up to 1.52 g/cm3, transparency up to 81.6 %, tensile strength up to 65 MPa. For the production of castings of paper-bases for wallpaper samples, sulfated pine bleached cellulose and polyester synthetic fiber were used, to the fibrous mass of which were added the following chemical additives: alkyl ketene dimer, reed NC, binder, and optical brightener. It has been shown that the use of nanocellulose at a rate of 0.35 % to 1.0 % of the paper mass leads to a significant improvement in the physical and mechanical quality indicators of the paper base for wallpaper. It was established that the replacement of 50 % of the synthetic chemical auxiliary substance alkyl ketene dimer with nanocellulose or additional application of nanocellulose at a rate of 0.5 g/m2 on the surface of the casting with 0.7 % alkyl ketene dimer allows to obtain paper that meets the requirements of the standard. The obtained results indicate the prospects of using reed nanocellulose for the production of other mass types of paper and cardboard.

Delayed vs Early Admission to Intensive Care: A Retrospective Review of Outcomes and Clinical Indicators of Deterioration Following Trauma.

Unplanned admission to an intensive care unit (ICU) is a trauma quality improvement indicator associated with increased morbidity, mortality, and hospital resource usage. We identified demographics, injuries, and other clinical factors between early ICU admission, <72hrs after admission (EAd), and delayed admission, >72hrs (DelAd) from a medical/surgical floor. 146 trauma patients admitted to ICU at a level 1 trauma center from January 2020 to March 2023 met inclusion criteria and were divided into EAd and DelAd. No statistical differences in injury mechanism or severity were observed. Delayed admission demonstrated higher mortality (P = .001), more frequent decline in GCS (P = .045), and initiation of anticoagulation (P = .002). Abnormal EKG, orthopedic surgery during admission, and home anticoagulant and antidepressant use were statistically significant in identifying patients requiring early ICU admission.

ТЕХНОЛОГИЯ ПРОИЗВОДСТВА ПРЯНИКА С ДОБАВЛЕНИЕМ ПОРОШКА ИЗ КЕДРОВОГО ЖМЫХА

The objective of the study is to analyze the use of cedar cake powder in different percentage additives to wheat flour (second grade) in laboratory experiment variants; to use of the optimal dosage of cedar cake powder for enrichment of cedar gingerbread and improvement of the quality of this flour confectionery product; to improve production technology. The object of the study is samples of cedar gingerbread pro-ducts obtained by adding cedar cake powder (5; 10; 15 %) to second-grade wheat flour. To perform the study, well-known organoleptic and physicochemical methods for studying raw materials and finished products were used. The safety of raw materials was controlled by TR CU 021/2011 "On the safety of food products". The choice of the control – Dnieper gingerbread, is associated with the use of second-grade flour in its recipe and its low calorie content. Laboratory studies and their testing were carried out in 2023 at the Department of Technology of Bakery, Confectionery and Pasta Production of Krasnoyarsk State Agrarian University. The finished flour confectionery product – cedar gingerbread was tested using stan¬dard methods in accordance with GOST R 58233-2-18; GOST 15810-2014. The cedar gingerbread sample with 15 % additive can be considered enriched, possessing improved quality indicators. The advantage of quality assessment is the pleasant smell (aroma) of cedar nut and an increased mass fraction of fat – 1.90 %. Organoleptic and physicochemical indicators and increased nutritional value of the enriched cedar gingerbread sample allow us to give an "excellent" rating on the rating scale (29.8 points). The generally accepted technology for the production of raw unglazed gingerbread was used. In the technology for ma¬king cedar gingerbread, the dough kneading stage was improved. Flour, cedar cake powder, soda and ammonium dissolved in water were added to the finished syrup. Profitability was 19 %. The production of cedar gingerbread is possible to expand the range and increase the production of flour confectionery products for all groups of the population.

Improvement of the quality of pork meat during salting due to the use of starter bacterial cultures

The influence of the starter cultures, such as Lactobacillus rhamnosus, L. plantarum, Kocuria rosea, Staphylococcus carnosus, L. plantarum, L. rhamnosus and L. paracasei, on the functional-technological and physicochemical characteristics of the pork meat during the salting is investigated in this paper. It has been proven that the use of these starter cultures in the technology of raw ba-lik products makes it possible to obtain finished products with improved quality indicators, which is promising in the food industry. It had been shown that in the pork meat samples with the starter cultures, the acidity from 5.74 pH units is more intensively decreased – to 5.52 pH units compared to the control sample (up to 5.64 pH units). Using the starter cultures based on nitrite-reducing microorganisms for the salting in 72 hours positively influenced the formation of the required colour characteristics. It had been established that the moisture-binding capacity and plasticity of the pork meat samples with the starter cultures are characterised by the increased indicators compared with the control sample – by 4.73% and 7.73% and by 2.19 cm2.g, respectively. The difference in the volatile fatty acids content in the pork meat samples with the starter cultures compared with the control sample is 22 and 33%, respectively, in 72 hours of salting. The obtained results can be used in the enterprises of the meat processing industry to produce fermented meat products, particularly raw dried logs.

Global-PPS targets for antimicrobial stewardship in paediatric patients at hospitals in Sanandaj, Western Iran, compared with Southeast Asian and European hospitals

Point prevalence surveys (PPS) provide valuable data on patterns of hospital antimicrobial administration. To identify quality improvement indicators, we evaluated antimicrobial prescribing patterns in children and neonates admitted to three referral centres in Sanandaj, Western Iran, and compared these with Southeast Asian and European paediatric benchmark data. The standardised Global-PPS was performed to assess antimicrobial use in Southeast Asia, including Sanandaj and European hospitals, in 2019. Of the 4118, 2915, and 443 paediatric patients enrolled in Southeast Asian, European and Sanandaj hospitals, 2342 (56.9%), 833 (28.6%) and 332 (74.9%), respectively, received at least one antimicrobial in 2019. The most administered antibiotics in neonates were ampicillin in Southeast Asia (30.3%) and Sanandaj (41.5%, often in combination with cefotaxime (29.0%)), compared with amoxicillin in Europe (20.0%). In children, ceftriaxone was most prescribed in Sanandaj (62.4%) and Southeast Asia (20.5%) as opposed to amoxicillin (11.8%) in Europe. Twice as many Watch antibiotics (83.0%) were prescribed on paediatric wards in Sanandaj compared with European paediatric wards (41.1%). All antimicrobials in Sanandaj hospitals were prescribed empirically, and prolonged surgical prophylaxis was common (75.5%). The high prevalence of antibiotic prescribing, high empirical therapies, and poor outcomes for antibiotic quality indicators strongly suggest the urgent need for an antibiotic stewardship program in Sanandaj hospitals, where improved diagnostic laboratory capacity and reconsideration of training may be good targets for intervention in their hospitals.

Application of whey protein hydrolysate as a technological additive in the sour cream production

In the context of economic sanctions, the problem of supplying food additives, including stabilizers and thickeners, which are important in the production of fermented milk products, remains relevant for many enterprises; the development of a fermented milk product – sour cream, using whey protein hydrolysate as a technological additive is relevant. The purpose of the research was to study the effect of whey protein hydrolysate on the technological process of manufacturing a fermented milk product, sour cream, and the quality indicators of the final product. The results of the acidity study showed that in the experimental samples, the ripening process occurred faster than in the control sample. Based on the results of the research, it can be concluded that whey protein hydrolysate can be used as a technological additive in the production of fermented milk products to improve quality indicators.

Influence of vertical shaft machine parameters on increasing productivity of the processed product

In this article, the influence of the force pulling the base plate of the vertical shaft machine up along the chain on the pair of compression shafts and the dependence of the moisture squeezed from the semi-finished product being processed on the diameter of the shafts are experimentally studied. The scientific novelty of the research is the development of an improved experimental design of a vertical type shaft machine that flattens the folded areas of wet semi-finished products and compresses excess moisture. The practical significance of the results of the research is explained by the development of an improved vertical type shaft machine for the mechanical processing of the semi-finished products with improved quality indicators of semi-finished products, energy saving, increasing productivity. In experimental studies, a regression equation was developed that determines the amount of excess liquid squeezed out of the semi-finished product during vertical transmission, depending on the diameter of the compression shafts, traction force and transmission speed. Based on the obtained results, graphs were constructed and analyzed. Currently, worldwide attention is being paid to improving the quality of leather products by using energy and resource-saving technologies. As can be seen from the above review, the quality of the processed material is influenced by many parameters of technological machines. Therefore, we believe that an experimental study of the parameters of a vertical roller machine on the properties of the processed leather semi-finished product is relevant.

Ұқсастық пайдалану шартында екі тактілі қозғалтқышты жасау саласындағы эксперименттік зерттеу

The article applies to similar conditions of use and the creation of a competitive two-stroke engine. Currently, there are prerequisites for creating an effective two-stroke engine, such as direct-flow scavenging, a valve-slotted gas distribution system with a multi-valve mechanism, hydraulic valve control, a diesel cycle with a high compression ratio, etc. To implement a set of promising technical solutions, a design basis is required, on the basis of which a two-stroke engine can be configured. As such, a crank-yoke kinematic mechanism for converting motion was chosen. The mechanism unloads the piston from lateral forces and allows the cylinder to be isolated from the oil sump, using the sub-piston volume as a purge pump. This required the development and research of a cylinder-piston group based on solid lubricant. The sliding bearing has also been improved with improved quality indicators based on the use of thermally conductive and antifriction materials of copper and graphite.

ОПРЕДЕЛЕНИЕ ЭНЕРГОЕМКОСТИ ПРОЦЕССА ИЗМЕЛЬЧЕНИЯ РЕЗАНИЕМ В ИЗМЕЛЬЧИТЕЛЕ КОРМОВ

The relevance of the study is due to the need to reduce energy intensity and loss of nutritional value of feed while simultaneously improving quality indicators during the grinding process. The work was carried out with the aim of theoretical studies of the design and technological parameters of the feed chopper and determining the energy consumption of the grinding process by cutting. The scientific novelty of the research lies in the mathematical models for determining the cutting work and the total drive power of the feed chopper. When carrying out the research, the general scientific principles of the theory of elasticity, the theory of shells, and fracture mechanics were used, and the physical, mechanical and technological properties of feed of plant origin were also taken into account. A device is proposed, the design of which has the following advantages: a uniform supply of material to the cutting zone (to the knives) is ensured due to the working chamber in the form of a truncated cone, which leads to a consistent reduction in the size of the feed to those established by zootechnical requirements and improves its quality; the ability to change the angle of inclination of the rotary counter-cutting knives, which provides adjustment of the intensity of the grinding process; reduction in the energy intensity of grinding due to the free movement of crushed feed into the unloading chamber and the original shape of the tosser blade. Analytical expressions were obtained to determine the cutting work on each row of knives for one knife in a row, the total work of all knives per revolution, as well as the required power for the rotor drive. As a result of the research, it was established that the energy intensity of the grinding process is determined as the sum of the costs of cutting, acceleration of the material and idling of the rotor. The total power required to drive the chopper depends on the number, geometric characteristics of the chopper and counter-cutting knives, the rotor speed, and the properties of the material being crushed.

Study of correlations between yield and grain quality indicators of varieties and breeding lines of Triticum aestivum L.

Purpose. To determine the correlations between yield and grain quality indicators of varieties and breeding lines of winter bread wheat. Methods. The study was conducted under the conditions of the V. M. Remeslo Myronivka Institute of Wheat NAAS of Ukraine (MIW) during 2019/20–2021/22. Ten new varieties and four breeding lines of winter bread wheat of Myronivka breeding were evaluated. Grain quality indicators were determined in the grain quality laboratory of MIW according to conventional techniques. Pearson’s correlation coefficients (r) were calculated to establish correlations. Results. Correlations with different direction and strength were found between yield and quality indicators of winter bread wheat grain (–0.32 &lt; r &lt; 0.61). During the research years, reliable direct correlation coefficients were obtained between yield and the 1000 kernel weight indicator (r = 0.17–0.46). Also, a reliable linear dependence (r = 0.13–0.61) of yield with water absorption capacity of flour, test weight, grain vitreous, with protein and wet gluten content, but only under certain hydrothermal growing conditions. The varieties and breeding lines of winter bread wheat were identified which, during the years of research, showed stable direct correlations between yield and the indicators of 1000 kernel weight, grain vitreous, protein content, wet gluten content, sedimentation value, dough elasticity index, deformation energy, dough tenacity, water absorption capacity of flour. Conclusion. The selected varieties and breeding lines of winter bread wheat can be used in the breeding process as sources for combining high yield with certain improved quality indicators in one genotype to create competitive varieties.

Quality in special education from teacher perspectives

ABSTRACT In this study, we aimed to determine the quality indicators in separate special education schools that only educate individuals with special needs from the perspectives of teachers. We collected data from 82 special education teachers included by maximum diversity sampling using a semi-structured interview form. We conducted a content analysis using the MAXQDA qualitative data analysis program. As a result of the study, we identified six main themes as quality indicators in separate special education schools. These were teacher and administrator qualifications, school environment (social and physical), curriculum and educational process, family interest and attitude, policies and practices, and child-related factors. Moreover, several factors such as teachers with degrees in special education, materials, social perspective, evidence-based practices, family support, and individualised education programs were found to play an important role as quality indicators in separate special education schools. Improvements in quality indicators in separate special education schools can contribute to student outcomes.

Radiographers’ perceptions on the quality of managing general radiographic paediatric examinations through the use of a reflective tool

Introduction Paediatric patients are a vulnerable population that require additional care by healthcare professionals. Quality managing these examinations ensures that effective and quality care is provided to individual patients, whilst encouraging consistency within the medical imaging department. This study explored radiographers’ perspectives on quality management strategies of general radiographic paediatric examinations using a paediatric imaging reflective checklist. Methods A quantitative descriptive research design with qualitative questions was used through a purposive sampling method from both public and private Australian diagnostic imaging qualified radiographers who had experience in paediatric imaging examinations. The paediatric imaging service reflective tool consisted of 65 items in total. Data analysis entailed Microsoft Excel version 16.16.6 and Jamovi version 2.3.21 for the closed-ended questions and for the open-ended responses a thematic analysis. Results The participation rate was 13.2% and the most significant findings were: lead shielding was still being used at their organisation, despite recent recommendations to suspend its use; access to paediatric patient related information resources is limited; there was no involvement of families and communities regarding policy development or quality improvement measures as advocated in literature; and there was a need for enhanced specialised paediatric education, training and protocols. Conclusion Using the paediatric patient-centred imaging reflective checklist, radiographers had an opportunity to identify quality improvement indicators as well as issues that could further enhance best practice principles. Further studies could inform on the validity of this reflective tool.

ОДЕРЖАННЯ НАФТОВИХ БІТУМІВ ОКИСНЕННЯМ ГУДРОНУ ІЗ СУМІШІ СХІДНОУКРАЇНСЬКИХ НАФТ

The study results of the process obtaining of petroleum bitumen with improved quality indicators are described. The method of mixing the tar of paraffinic oils with the residue and the distillation of Orkhiv oil with subsequent oxidation of this mixture was used. To conduct the research, tar extracted from Western Ukrainian paraffinic oils was used. The influence of temperature, oxidation duration and air consumption on the operational properties of oxidized petroleum bitumens were determined. Samples of the obtained oxidized petroleum bitumen were analyzed with the determination of ductility (at 25 0C), penetration (at 25 0C) and softening point (ring-and-ball method). We established that the bitumen with improved operational properties obtained from the residue of paraffinic oils with the addition of residue from the distillation of Orkhiv oil to the raw materials can be used for laying asphalt pavement.

Impact of the role of cardiology pharmacy specialist on the improvement of quality indicators among patients with heart failure and reduced ejection fraction

Abstract Background 2021 European Society of Cardiology quality indicators (QIs) for the care and outcomes of adults contains a domain for patients with heart failure with reduced ejection fraction (HFrEF) for initial treatment of guideline-directed medical therapy (GDMT) which includes beta-blocker (BB), angiotensin-converting enzyme inhibitor (ACEI) or angiotensin-neprilysin receptors inhibitors (ARNI), mineralocorticoid receptor antagonist (MRA), and sodium-glucose transporter-2 inhibitor (SGLT2i). The QIs for the individual GDMT is estimated by finding the proportion of patients with HFrEF who are prescribed each therapy in the absence of any contraindication. Purpose To identify the role of the board certified cardiology pharmacist (BCCP) on improving the quality indicators regarding the prescribing of GDMT among patients with HFrEF during hospitalization and before discharge. Methods A cross-sectional study was conducted at the cardiac care unit in a single heart center in Iraq between January 2021 to February 2023. Among the multidisciplinary team member at this unit is a BCCP who suggests optimization of medical therapy based on the recommendations of updated European or American guidelines for the management of different cardiovascular diseases including HFrEF. The suggestion then discussed with the cardiologists for agreement. The study included the medical records for patients with HFrEF and BCCP interventions whether the interventions regarding GDMT or other medical therapy interventions. Data were reviewed and were analyzed to identify the specific interventions related to the initiation of one or more GDMT in each patients. Results Among 164 patients with HFrEF with BCCP interventions, there were 102 (62%) patients who were eligible for one or more of the GDMTs prescription which was suggested by BCCP. The most GDMT initiated was MRA 53 (43%) among 123 interventions and in 53 (52%) of 102 patients (Figure 1). QIs were improved (100%) for BB, ACEI/ARNI, MRA, and SGLT2i among eligible patients as shown in table 1. Conclusions The role of BCCP is essential among heart team for improving QIs related to the GDMT prescription among patients with HFrEF based on the recommendations of the updated guidelines. BCCP mainly improved the QIs for the prescription of MRA.Frequency of GDMT Initiation by BCCPGDMT Initiation Reflecting Improved QIs