Practice Improvement Strategies Research Articles

Negative Brand Experiences and Purchase Intention of Green Wall Coating Brands: The Mediating Effect of Brand Identity

The purpose of this study was 1) to explore the impact of consumers' negative experiences with green wall coating brands on the brand identity of wall paint, 2) to analyze the effects of brand identity with green wall coating brands on purchase intentions, and 3) to test the mediating effect of green brand identity. Utilizing a quantitative research approach and simple random sampling technique, this study engaged 402 Chinese respondents aged 18 and older, all of whom had relevant purchase experiences with green wall coating products. The data collected were subjected to Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM) to assess model fit, as well as to establish the validity and reliability of the variables used in the study. The findings of this research revealed that all four dimensions of negative brand experience, which include negative functional experience (β =-0.189), negative emotional experience (β=-0.308), negative cognitive experience (β=-0.444), and negative social value experience (β=-0.134), have a negative impact on green brand identity. Additionally, the study confirmed a positive relationship between green brand identity and the intention to purchase green wall coating brands (β=0.655). Finally, the study established that green brand identity acts as a partial mediator between negative brand experiences (negative functional experience, negative emotional experience, negative cognitive experience, and social value negative experience) and the purchase intention of green wall coating brands (β3a=-0.124; β3b=-0.054; β3c=-0.126; β3d=-0.050). In light of these findings, this research provides specific and practical recommendations and improvement strategies for businesses within the green wall coating industry. These insights are aimed at enhancing their services and bolstering their competitive advantage.

What are the roles of positive psychological construct in blended learning contexts? Integrating academic buoyancy into the Community of Inquiry framework.

In the post-epidemic era, blended learning has become a social trend for the future of higher education, and scholars have endeavored to understand the factors that influence student learning in these blended communities. Communities of Inquiry is a conceptual framework that describes the components of blended learning environments, indicating teaching presence, social presence, and cognitive presence. However, the framework fails to adequately explore how individual learning motivational factors influence student learning. Therefore, this study extends the Community of Inquiry framework by drawing on a positive psychological construct-academic buoyancy to reveal the relationship between academic buoyancy and the three presences through empirical research. The theoretical model was validated by SPSS 26.0 and smartPLS4.0. To evaluate the measurement and structural models, structural equation modeling (SEM) was carried out using the partial least squares (PLS) method. (a) Teaching presence positively predicts academic buoyancy, and academic buoyancy positively predicts social presence and cognitive presence; (b) academic buoyancy mediates teaching presence and social presence, as well as teaching presence and cognitive presence; and (c) academic buoyancy acts as a chain mediator between teaching presence and cognitive presence through social presence. The results of this study fill a gap in the multiple roles of individual positive psychological construct-academic buoyancy in blended learning communities, extend the Community of Inquiry theoretical framework, and provide empirical evidence for blended learning quality and practical improvement strategies.

Practical Strategies for Improving the Quality of University Journals from the Perspective of Editors

With the deepening of academic research and exchanges, university journals, as crucial academic publishing platforms, play a significant role in the education sector, benefiting schools, teachers, and students alike. This paper delves into the quality connotation of university journals from the perspective of editors. Furthermore, it analyzes the current challenges in the publication and implementation of university journals, highlighting issues such as lack of distinctiveness and limited quality, which warrant further exploration and scrutiny. Finally, the research proposes a series of practical and effective improvement strategies. It aims to mobilize the efforts of all stakeholders, enhance team capabilities, and strengthen peer review processes to foster the advancement and enhancement of journal quality. Additionally, it aspires that the suggested methods will offer valuable insights to frontline educators and administrators.

Severe acute maternal morbidity reporting in Australia: Why is it so hard?

Adverse outcomes associated with pregnancy, including severe acute maternal morbidity (SAMM) and mortality, are internationally regarded as important indicators of quality of maternity services. Varied definitions and processes are barriers for SAMM recording, reporting and review. Identifying and documenting these cases of SAMM is a critical first step. Case reviews allow exploration of factors contributing to SAMM. Translation of the lessons learnt into practice improvement strategies and dissemination of this knowledge is essential for continual quality improvement. This review will outline the current status of SAMM review internationally and in Australia.

Analysis of Operational Problems and Improvement Measures for Biomass-Circulating Fluidized Bed Gasifiers

The advancement of biomass-circulating fluidized bed (CFB) gasification technology in China for commercialization and industrial application is still in its initial stages, characterized by extensive theoretical studies; however, there is limited documentation of its actual industrial operational characteristics. This study analyzes the operational challenges encountered in a 5 t/h biomass CFB gasifier at a rice factory in Jiangsu Province, China. It examines critical issues emerging during the gasifier system’s actual operational process, including the obstruction of the feeding system, the measurement of pressure at point blockages in the dense phase zone, loop seal blockages, bed inventory leakage of the blast cap on the air distribution plate, and gasification parameter fluctuations. Practical improvement strategies and implementation plans are proposed to address these operational concerns. The outcomes of this analysis serve as a reference for the design and operation of biomass CFB gasifiers. Furthermore, they provide crucial guidance for more extensive large-scale implementation of biomass CFB gasifiers.

Reexamining "psychosocial clearance": A procedural framework for psychosocial evaluation in liver transplantation.

Psychosocial and "nonmedical" phenomena are commonly encountered in liver transplantation (LT) evaluations. They are simultaneously crucial decision-making factors and some of the most difficult and controversial clinical matters clinicians confront. Epidemiology, societal trends, and the preponderance of psychological and behavioral factors underpinning common end-stage liver diseases ensure that LT teams will continue to encounter highly complex psychosocial patient presentations. Psychosocial policies, practices, and opinions vary widely among clinicians and LT centers. Liver clinicians already report insufficient psychosocial expertise, which creates a large gap between the stark need for psychosocial expansion, improvement, and innovation in LT and the lack of accompanying guidance on how to achieve it. While the clinical domains of an LT psychosocial evaluation have been well-described, few articles analyze the procedures by which teams determine candidates' "psychosocial clearance" and no conceptual frameworks exist. This article proposes a framework of core domains of psychosocial evaluation procedures, common pitfalls, and practical improvement strategies.

Combining Kano’s Model, IPA, and FMEA to Evaluate Service Quality Risk for Bus Service: Case of Bangkok Bus Service

Although the past research results have provided many effective tools for evaluating public bus service quality, they still lack the concept of risk. This study assessed the quality risk for city bus service by constructing a quality risk assessment model that integrated Kano’s model, IPA, and FMEA. The online questionnaire was distributed to commuters who use BMTA’s bus service in Bangkok with 429 samples. This study analyzed the service quality attributes of bus services via Kano’s model, an IPA, and an FMEA. For the results of Kano’s model, this study identified nine one-dimensional and three attractive attributes. The results of the IPA showed that the safety of boarding and disembarking from the bus, the cleanliness of vehicles, and the punctuality of buses according to the schedule were the top three attributes that had a large gap between importance and satisfaction. According to the results of the FMEA, the safety of boarding and disembarking from the bus, the cleanliness of vehicles, and the punctuality of buses according to the schedule were the top three attributes that had a high service quality risk and considered a priority improvement. These attributes belonged to interaction with passengers, tangible service equipment, and operating management support dimensions. Therefore, the government should take action and improve service quality to make Bangkok commuters consider switching from driving cars to using a bus. Finally, this study provides practical improvement strategies for managers to improve passenger experiences and enhance the quality of bus services.

A Team-Based Training for Continuous Glucose Monitoring in Diabetes Care: Mixed Methods Pilot Implementation Study in Primary Care Practices.

The American Academy of Family Physicians (AAFP) develops and maintains continuing medical education that is relevant to modern primary care practices. One continuing medical education modality is AAFP TIPS, which are comprised of resources designed for family medicine physicians and their care teams that aid in quick and accessible practice improvement strategies, with actionable steps. Evaluating physicians' use of and satisfaction with this modality's content and implementation strategies has not been prioritized previously. Continuous glucose monitoring (CGM) plays an increasing role in the treatment of diabetes; uptake occurs more rapidly in endocrinology settings than in primary care settings. To help address such differences in CGM uptake and diabetes care, AAFP TIPS on Continuous Glucose Monitoring (AAFP TIPS CGM) was developed, using published evidence and input from content experts (family medicine faculty; AAFP staff; and an advisory group comprised of other primary care physicians, patients, a pharmacist, and a primary care practice facilitator). A pilot implementation project was conducted in 3 primary care practices. To evaluate AAFP TIPS CGM in primary care practices, the research team assessed use of and satisfaction with the content and assessed barriers to and facilitators for strategy and workflow implementation. In total, 3 primary care practices participated in a mixed methods pilot implementation of AAFP TIPS CGM between June and October 2021. Practice champions at each site completed AAFP TIPS CGM and baseline practice surveys to evaluate practice characteristics and CGM prescribing. They conducted team trainings (via webinars or in person), with the goals of implementing CGM into practice and establishing or improving CGM workflows. Practice champions and team training participants completed posttraining surveys to evaluate the training, AAFP TIPS materials, and likelihood of implementing CGM. Interviews were conducted with 6 physicians, including practice champions, 2 months after team training. Satisfaction surveys were also distributed to those who completed the AAFP TIPS CGM course via the internet during the study period. Of the 3 practices, 2 conducted team trainings. The team training evaluation survey showed that practice staff understood their role in implementing CGM in practice (19/20, 95%), and most (11/20, 55%) did not have questions after the training. Insurance coverage for CGM was a remaining knowledge gap and potential barrier to implementing CGM in practice. Physicians and interdisciplinary care team members who took the AAFP TIPS CGM course via the internet, as well as those who attended in-person team training, expressed a high degree of satisfaction with the education, content, and applicability of the course. This pilot implementation of AAFP TIPS CGM offers pertinent and timely information for primary care practices that desire to initiate or expand CGM use to best meet the needs of their patients with diabetes.

Early Guided Palliative Care Communication for Patients With COVID-19 Receiving ECMO.

Extracorporeal membrane oxygenation (ECMO) combined with COVID-19 presents challenges (eg, isolation, anticipatory grief) for patients and families. To (1) describe characteristics and outcomes of patients with COVID-19 receiving ECMO, (2) develop a practice improvement strategy to implement early, semistructured palliative care communication in ECMO acknowledgment meetings with patients' families, and (3) examine family members' experiences as recorded in clinicians' notes during these meetings. Descriptive observation of guided, in-depth meetings with families of patients with COVID-19 receiving ECMO, as gathered from the electronic medical record of a large urban academic medical center. Most meetings were held within 3 days of initiation of ECMO. Forty-three patients received ECMO between March and October 2020. The mean patient age was 44 years; 63% of patients were Hispanic/Latino, 19% were Black, and 7% were White. Documentation of the ECMO acknowledgment meeting was completed for 60% of patients. Fifty-six percent of patients survived to hospital discharge. Family discussions revealed 7 common themes: hope, reliance on faith, multiple family members with COVID-19, helping children adjust to a new normal, visitation restrictions, gratitude for clinicians and care, and end-of-life discussions. Early and ongoing provision of palliative care is feasible and useful for highlighting a range of experiences related to COVID-19. Palliative care is also useful for educating patients and families on the benefits and limitations of ECMO therapy.

Integration of Substance Use Disorder Treatment Into a Traditional Community Mental Health Treatment System.

In response to the opioid crisis, Catholic Charities of Baltimore sought to integrate substance use disorder treatment into their outpatient community mental health clinics. The agency developed a systematic practice improvement strategy that included a competency-based curriculum and supervision plan for psychiatric providers and therapists. Psychiatric providers developed competency with medications used to treat substance use disorders, and therapists developed competency in therapeutic modalities to treat substance use disorders, all of which were gradually integrated into outpatient clinics. This column demonstrates that integration of substance use disorder treatment into outpatient community mental health care is feasible and beneficial.

Image and Speech Recognition Technology in the Development of an Elderly Care Robot: Practical Issues Review and Improvement Strategies.

As the world's population is aging and there is a shortage of sufficient caring manpower, the development of intelligent care robots is a feasible solution. At present, plenty of care robots have been developed, but humanized care robots that can suitably respond to the individual behaviors of elderly people, such as pose, expression, gaze, and speech are generally lacking. To achieve the interaction, the main objectives of this study are: (1) conducting a literature review and analyzing the status quo on the following four core tasks of image and speech recognition technology: human pose recognition, human facial expression recognition, eye gazing recognition, and Chinese speech recognition; (2) proposing improvement strategies for these tasks based on the results of the literature review. The results of the study on these improvement strategies will provide the basis for using human facial expression robots in elderly care.

A literature review of the research on students' evaluation of teaching in higher education.

Students’ evaluation of teaching is a teaching quality evaluation method and teacher performance evaluation tool commonly used in Chinese and foreign universities, and it is also a controversial hot issue in the field of teaching evaluation. At present, the research results of students’ evaluation of teaching in higher education are relatively rich, mainly focusing on reliability, validity and its influencing factors, construction of index system, problems in practical application and improvement strategies. The purpose of this article is to study the relevant research results of the current Chinese and foreign academic circles, in order to provide useful inspiration for the construction of the index system and practical application of the ideological and political theory course evaluation and teaching of Chinese college students.

A social ecological model (SEM) to exploring barriers of and facilitators to the implementation of opioid agonist treatment (OAT) programmes in prisons

Purpose Opioid agonist treatment (OAT) programmes in prisons play a significant role in preventing the human immunodeficiency virus (HIV). Despite its proven effectiveness, both the availability and coverage of prison OAT programmes remain low. This Indonesian study explores facilitators of, and barriers to, the delivery of methadone programmes in prisons using the social ecological model (SEM). Design/methodology/approach The study used a qualitative case study approach comprising two prisons with, and one prison without, methadone programmes. Purposive and snowball sampling was used to recruit study participants. In total, 57 in-depth interviews were conducted with prison governors, health-care staff, prison officers and prisoners. Data was analysed thematically. Findings The study findings identified facilitators of and barriers to the delivery of prison OAT programmes at all three levels of the SEM as follows: intrapersonal barriers including misperceptions relating to HIV transmission, the harm reduction role of OAT programmes, methadone dependency and withdrawal symptoms; interpersonal barriers such as inflexible OAT treatment processes and the wide availability of illicit drugs in prisons and; social-structural barriers, notably the general lack of resources. Research limitations/implications The findings highlight the importance of and overlap between, organisational and inter-personal, as well as intrapersonal factors. Such an approach is particularly important in the context of the implementation and delivery of methadone programmes in low/middle income countries, where the lack of resources is so significant. Practical implications Three main strategies for improvement were suggested as follows: the development of comprehensive education and training programmes for prisoners and all prison staff; the re-assessment of practices relating to the delivery of methadone, and a comprehensive review of harm reduction strategy in prisons, that should consider the role of prisoners’ families to increase support for prisoner participation; the re-assessment of prison policies to support the delivery of methadone programmes in prisons. Social implications The author suggests that ongoing international support and national drug policies are vital to the continuation and sustainability of methadone programmes in prisons. Originality/value This study contributes to the overall evidence base for OAT programmes in middle-income prison contexts.

"We are so close; yet too far": perceived barriers to smartphone-based telerehabilitation among healthcare providers and patients with Chronic Obstructive Pulmonary Disease in India

BackgroundTelerehabilitation is imperative and impending in the management of chronic obstructive pulmonary disease patients. However, its feasibility in low- and middle-income nations such as India remained unclear. ObjectiveTo assess the feasibility of administering a smartphone-based telerehabilitation program for chronic obstructive pulmonary disease patients in India. Material and methodAn online cross-sectional survey was administered to stakeholders of the telerehabilitation program: chronic obstructive pulmonary disease patients, health care professionals including pulmonary care physicians, rehabilitation nurses and physiotherapists. The survey sought to ascertain the causes, barriers, and facilitators associated with the implementation of smartphone-based telerehabilitation, as well as strategies for practice improvement. ResultsWhile 71% (n = 37/52) of the 52 healthcare professionals surveyed were aware of smartphone-based telerehabilitation, implementation was found to be extremely low (n = 4/37; 10%). The majority of patients with chronic obstructive pulmonary disease (n = 21/30; 70%) agreed to accept smartphone-based telerehabilitation as one of their treatment options. In India, challenges to efficient telerehabilitation implementation included a lack of infrastructure, perceived time consumption, a lack of expertise and training, organizational support, and perceived inefficacy. ConclusionWhile knowledge of smartphone-based telerehabilitation is high among healthcare professionals and chronic obstructive pulmonary disease patients, implementation of this novel intervention measure has been limited due to perceived constraints associated with smartphone-based telerehabilitation. Adapting national and organizational policies to support smartphone-based telerehabilitation services is critical during this decade of social isolation.

Exploring Strategies for Improving Green Open Spaces in Old Downtown Residential Communities from the Perspective of Public Health to Enhance the Health and Well-Being of the Aged.

Based on the trend of global aging, people are paying more and more attention to the health of the elderly and the improvement of green open spaces. However, few studies have focused on strategies to improve green spaces in response to this trend. Especially, with the outbreak of COVID-19, an urgent need to develop a sustainable system strategy to improve the health of the elderly in residential communities in old districts has emerged. Traditional improvement strategies based on current situation evaluation often focus on the most prominent practical problems. Therefore, the objective of this study was to provide theoretical research and practical improvement strategies for green open spaces in old downtown residential communities to improve the health and well-being of the elderly. In response to this problem, this research proposes an alternative method based on causality (FDM-DANP-mV model), by extracting 23 green open space elements that affect the health of the elderly and dividing them into three dimensions, to form a preliminary evaluation framework. On this basis, the more effective and feasible standard elements are screened out, and the influence relationship behind the elements is clarified. Then, the sustainable development strategy is systematically discussed in three practical cases. This allows for the analysis of the present situation to not only identify the current significant problems but also to capture the source of the influence behind the real problems based on the clarification of the dominant influence relationship. The actual value of this study is to provide a key design decision basis for the improvement of the green open spaces in old downtown residential communities, aiming at avoiding waste to the greatest extent under the premise of limited resources and gradually promoting the improvement of the urban built environment to promote the health and well-being of the elderly.

Biomass-Derived Carbon Materials for High-Performance Supercapacitors: Current Status and Perspective

Supercapacitors are electrochemical energy storage systems that depend on high-surface-area electrodes and can play a dominant role in areas that require high power delivery or uptake. And of various electrodes, biomass-derived carbonaceous electrodes have recently shown impressive promise in high-performance supercapacitors because of their widespread availability, renewable nature and low-cost electricity storage. Based on this, this review will discuss the current status of biomass-derived carbon materials in supercapacitors and highlight current research with a specific emphasis on the influences of structure and elemental doping on the electrochemical performance of corresponding carbon electrodes. This review will also discuss the gap between laboratory achievements and practical utilization in terms of these biomass-derived carbon materials and outline practical strategies for future improvement.

The Realistic Dilemma and Path Exploration of the Construction of Physical Education Teaching MOOCs Platform in Colleges and Universities

With the widespread application of artificial intelligence and big data technology, the era of higher education informatization has come. Physical education is an important means of cultivating higher education talents, and information-based teaching methods should be in the forefront of the development of the times. However, the construction of a sports MOOCs platform is not an overnight effort, especially in the absence of sports information-based talents. This article uses literature research methods and logical deductive research methods to systematically analyze the many difficulties faced by the construction of the physical education MOOCs platform in the current actual construction of colleges and universities. The research proposes the organic combination of MOOCs and traditional physical education to improve teachers’ teaching abilities and strengthening of student’s supervision and assessment system are practical improvement strategies.

The Future(s) of Pediatric Primary Care.

Pediatric primary care (PPC) arose in the early 20th century as the fusion of acute and chronic pediatric illness care with preventive elements borrowed from public and maternal and child health. Well-established and thriving by the 1930s, PPC saw major changes in childhood morbidity and mortality in the latter half of the 20th century with the recognition of the "new morbidity" of school, behavior, and social problems. At the same time, PPC experienced changes in its workforce, which became increasingly female and added nurse practitioners and physician assistants as practitioners. Independent practice, previously the dominant business model, decreased in prominence at the end of the 20th century as health systems bought practices and other sites morphed into federally qualified health centers. In the present century, electronic health records (EHRs) have brought profound changes in PPC workflows and practitioner experience. In addition, disruptive market competition such as retail clinics and corporate telemedicine providers coupled with changes in health insurance from fee-for-service to value-based payment further challenge the care model and economics of PPC. Finally, recognition of family social circumstances as major determinants of children's health presents another challenge to the status quo. As such, although one PPC future may resemble its present state, a more innovative future is likely to include clinics and practices more oriented toward and linked to communities and directed at the social determinants of health. In addition, the rise in physical, behavioral, and social problems in practice call for a growing focus on wellness, including sleep, nutrition, and activity, that promises to reorient the PPC future in productive new directions. The half-way technology of current EHR systems will ideally be spun into electronic hubs that facilitate teamwork between PPC, specialists, and community groups. Research and practice improvement strategies including involvement in "learning health systems" will be critical to making PPC effective in an evolving society. Although threatened by 21st century forces and hard-to-anticipate change, PPC is ideally positioned to build upon its core functions to create multidisciplinary teams that reach into the community, promoting a holistic wellness for children consistent with the broadest definition of health.

Predicting chiller system performance using ARIMA-regression models

A proper selection of predictor variables would enhance the exploratory analysis of time series models while prompting practical strategies to optimize chiller system performance. This study explores essential operating variables to predict the time series of the coefficient of performance (COP) of a chiller system expressed as the cooling capacity output divided by the total electric power input of all components. Based on a huge set of historical operating data, hybrid ARIMA-regression models were developed by fitting 14 predictor variables other than the past COP-related terms. The most significant variable influencing predictability involves the part load ratio (PLR) and its order-3 lag terms lasting for 45 min. The system COP fluctuation is mainly governed by the PLR variation due to operating unnecessary chillers and non-pair up operation of system components. When chiller sequencing is properly implemented, the PLRs shift up with tempered variation. The paired component combinations lower the system electric power to maximize the system COP. The annual average system COP increases to 3.5538 from 3.3212 with a predicted electricity saving of 8.2955%. The novelty of this study is to highlight which variables and component operating statuses help improve the predictability of time series models while prioritizing practical strategies for performance improvement.

Identifying priorities for practice improvement related to breastfeeding support in a neonatal intensive care unit (NICU) in Medellín, Colombia

PurposeTo identify priority areas and practice improvement strategies related to breastfeeding support, in a neonatal intensive care unit (NICU) in Colombia. MethodsAs part of a quality improvement initiative, this multi-method qualitative descriptive study involved 5 focus group interviews with NICU staff and 6 individual interviews with clinical leaders. Data were complemented by informal conversations with NICU staff and a document review of the hospital's breastfeeding policies and educational materials. Data were analyzed using qualitative content analysis. ResultsPriorities for practice improvement included (1) support for milk expression, (2) support for the transition to direct breastfeeding, and (3) creation of policies and tools related to breastfeeding. Findings highlighted ways in which resource limitations influence priority setting to favour the redistribution of existing assets and mobilization of local facilitators for breastfeeding support. ConclusionFindings will inform the development and implementation of future strategies to enhance breastfeeding support in this unit.