Staff Volunteers Research Articles

Can We Harness the Business Paradigm of Value Creation to Support Quality Improvement Projects? [31G

INTRODUCTION: Quality improvement projects are generally not reimbursed by payers and often rely on engaged staff and physician volunteers. Physicians typically receive no training in business strategy. We hypothesized that adopting a paradigm of value creation has the potential to support QI projects and thereby enhance patient outcomes in a financially sustainable way. METHODS: Childbirth is the most common indication for hospital admission in the US. We identified pain points for insurance companies and hospitals that coincided with existing quality improvement initiatives. A decrease in the cesarean rate was chosen as a potentially modifiable target that would create a compelling value proposition for payers. A labor support app was then designed with content curated to support a QI initiative to decrease the NTSV cesarean rate. A business plan was built around the app and tested for viability in the investor community, with hospital administrators, insurance- and employer representatives. RESULTS: We partnered with Penny Simkin, to provide labor support content. Labor support has been shown to decrease cesarean birth. The app format allows for easy access by patients and their care team. Every cesarean avoided results in cost savings for payers, favoring payment of the app. This was highly acceptable to hospitals administrators, insurance and employer representatives. The business plan won first place in the business plan competition, indicating a high level of support of the local business community. CONCLUSION: Approaching clinical problems with a perspective of value creation to payers has the potential to create financially viable solutions and improve care for our patients.

Turning aspirations for inclusion into action

The American Chemical Society core values reflect the fundamental beliefs of the society and guide the activities of our volunteer members and staff to achieve our mission and vision. In short, they are why we do what we do. The conundrum, though, lies in the development and implementation of what we do in order to turn these tenets into practical and effective actions to support, promote, and enhance both ACS and the greater chemistry enterprise. If ACS governance could devise a straightforward program to ensure that ACS at all levels would achieve its laudable aspirations, the result would be fantastic. But doing so is difficult, if not impossible. We are all in this together, and all our efforts must be marshaled if we are to make progress, particularly if we are to make fundamental cultural changes. We want to focus here on our core value of diversity, inclusion, and respect.

The influence of staff turnover on work motivation and job performance of employees in it sector – the results of empirical research

Voluntary staff turnover is becoming increasingly common, especially in the IT sector. It can impact job performance and the factors which shape it, such as work motivation. Given this fact, the aim of this paper is to empirically verify the impact of voluntary staff turnover on job performance and work motivation of employees in the IT sector and to verify whether voluntary staff turnover can be a moderator of the relationship between work motivation and job performance of employees in the IT sector. The formulated research hypotheses were verified on a sample of 151 employees from organisations within the IT sector in Poland. To verify the impact of voluntary staff turnover on work motivation and job performance, a correlation analysis was conducted. In order to verify the moderation effect, a regression analysis with a moderator was used. The results of the research reveal that voluntary staff turnover has a negative impact on the job performance of employees from the IT sector. Moreover, voluntar staff turnover is a moderator for the relationship between work motivation and job performance of employees from the IT sector and has a negative impact on this relationship, which means that an increase in voluntary staff turnover reduces the positive impact of work motivation on job performance for employees from the IT sector. In this way, it has been proven that – in terms of impact of work motivation on job performance – the phenomenon of voluntary staff turnover is a negative one, although it is common among employees from the IT sector.

Dementia Cafés as Hubs to Promote Community-Integrated Care for Dementia through Enhancement of the Competence of Citizen Volunteer Staff Using a New Assessment Tool

Introduction: Dementia cafés have recently been attracting attention. The increased involvement of citizen volunteers and the competence of dementia café staff could enhance the potential of dementia cafés. The aim of the present study was to examine enhancement of the competence of citizen volunteers using a new assessment tool. Methods: This cross-sectional analysis included 433 dementia café staff members, including medical and care professionals and citizen volunteers. A 20-item dementia café staff self-assessment (DCSA) instrument was newly developed. After confirmation of the reliability and validity of the instrument, DCSA scores among citizen volunteers were evaluated. Results: DCSA showed very good psychometric properties. The mean (±SD) DCSA score was significantly higher for café staff with a medical and care professional background (n = 267) than for citizen volunteers (n = 166) (2.2±0.5 vs. 1.7±0.7, respectively; p < 0.001). The DCSA scores of citizen volunteers became significantly higher with increasing attendance (minimum: n = 24; 1.3±0.7; intermediate: n = 65; 1.6±0.6; and frequent: n = 77; 1.8±0.7; p < 0.01). Conclusion: Assessment of the competence of dementia café staff using the DCSA revealed the potential of citizen volunteers. This tool could also enhance the potential of dementia cafés.

Effective Staff Relationships as An Impetus for Growth in 21st Century Church

Effective staff relationships is a stimulus to church developmental growth in all facets of church life. It is expedient that each church and religious organizations should imbibe because of its benefits that cannot be overemphasized. This paper considers the necessity of staff relationships for growth in the 21 st Century church by exploring into the biblical perspective of staff relationships. The necessity of staff relationships was also consider, such as it enhances mutual encouragement both personal and spiritual; it facilitates and improve the workforce; it promotes growth in all facets; teamwork, delegation and supervision are enhanced; it is problem-solving; it is enjoyable and broaden staff understanding, and building a Christlike attitude and relationships are not exempted. The possible challenges in staff relationships were also considered, such as staining, denting and destroying each other reputation and integrity. Mistrust and lack of sincere commitment among staff members. Inattentive to staff voices, preferential treatment and rivalry. Lack of recognition, motivation and appreciation of staff. The unconducive atmosphere and lack of openness and the spirit of cooperation. Excessive use of power and social stratification; and unforgiving spirit. The paper concludes that staff relationships are inevitable in contemporary churches and religious organizations. Healthy staff relationships should be built and encouraged for efficiency, growth, productivity and fulfilment of the primary purpose of multi-staff both between the volunteer staff members, non-ministerial staff and ministerial staff. Keywords: Effective, Staff Relationships, Impetus, Growth DOI: 10.7176/JPCR/48-02 Publication date: March 31 st 2020

A Linked Community and Health Facility Intervention to Improve Newborn Health in Cambodia: the NICCI Stepped-Wedge Cluster-Randomized Controlled Trial.

Background: Newborn mortality in Cambodia remains high, with sepsis and complications of delayed care-seeking important contributing factors. Intervention study objectives were to improve infection control behavior by staff in health centers; improve referral of sick newborns; increase recognition of danger signs, and prompt care-seeking at an appropriate health facility; and appropriate referral for sick newborns by mothers and families of newborn infants. Methods: The stepped-wedge cluster-randomized controlled trial took place in rural Cambodia from February 2015 to November 2016. Sixteen clusters consisted of public health center catchment areas serving the community. The intervention included health center staff training and home visits to mothers by community health volunteers within 24 h of birth and on days 3 and 7 after delivery, including assessment of newborns for danger signs and counselling mothers. The trial participants included women who had recently delivered a newborn who were visited in their homes in the first week, as well as health center staff and community volunteers who were trained in newborn care. Women in their last trimester of pregnancy greater than 18 years of age were recruited and were blinded to their group assignment. Mothers and caregivers (2494) received counseling on handwashing practices, breastfeeding, newborn danger signs, and prompt, appropriate referral to facilities. Results: Health center staff in the intervention group had increased likelihood of hand washing at recommended key moments when compared with the control group, increased knowledge of danger signs, and higher recall of at least three hygiene messages. Of mother/caregiver participants at 14 days after delivery, women in the intervention group were much more likely to know at least three danger signs and to have received messages on care-seeking compared with controls. Conclusions: The intervention improved factors understood to be associated with newborn survival and health. Well-designed training, followed by regular supervision, enhanced the knowledge and self-reported behavior of health staff and health volunteers, as well as mothers’ own knowledge of newborn danger signs. However, further improvement in newborn care, including care-seeking for illness and handwashing among mothers and families, will require additional involvement from broader stakeholders in the community.

The Swedish Malaise Trap Project: A 15 Year Retrospective on a Countrywide Insect Inventory.

The Swedish Malaise Trap Project (SMTP) is one of the most ambitious insect inventories ever attempted. The project was designed to target poorly known insect groups across a diverse range of habitats in Sweden. The field campaign involved the deployment of 73 Malaise traps at 55 localities across the country for three years (2003-2006). Over the past 15 years, the collected material has been hand sorted by trained technicians into over 300 taxonomic fractions suitable for expert attention. The resulting collection is a tremendous asset for entomologists around the world, especially as we now face a desperate need for baseline data to evaluate phenomena like insect decline and climate change. Here, we describe the history, organisation, methodology and logistics of the SMTP, focusing on the rationale for the decisions taken and the lessons learned along the way. The SMTP represents one of the early instances of community science applied to large-scale inventory work, with a heavy reliance on volunteers in both the field and the laboratory. We give estimates of both staff effort and volunteer effort involved. The project has been funded by the Swedish Taxonomy Initiative; in total, the inventory has cost less than 30 million SEK (approximately 3.1 million USD). Based on a subset of the samples, we characterise the size and taxonomic composition of the SMTP material. Several different extrapolation methods suggest that the material comprises around 20 million specimens in total. The material is dominated by Diptera (75% of the specimens) and Hymenoptera (15% of specimens). Amongst the Diptera, the dominant groups are Chironomidae (37% of specimens), Sciaridae (15%), Phoridae (13%), Cecidomyiidae (9.5%) and Mycetophilidae (9.4%). Within Hymenoptera, the major groups are Ichneumonidae (44% of specimens), Diaprioidea (19%), Braconidae (9.6%), Platygastroidea (8.5%) and Chalcidoidea (7.9%). The taxonomic composition varies with latitude and season. Several Diptera and Hymenoptera groups are more common in non-summer samples (collected from September to April) and in the North, while others show the opposite pattern. About 1% of the total material has been processed and identified by experts so far. This material represents over 4,000 species. One third of these had not been recorded from Sweden before and almost 700 of them are new to science. These results reveal the large amounts of taxonomic work still needed on Palaearctic insect faunas. Based on the SMTP experiences, we discuss aspects of planning and conducting future large-scale insect inventory projects using mainly traditional approaches in relation to more recent approaches that rely on molecular techniques.

A Letter from the Editor

A Letter from the Editor Su Cho Dear Reader, You are about to dive into an issue that holds the work of countless editors, writers, readers, artists, volunteer staff, and many others. I would like to acknowledge those whose contributions often go unnoticed: the administrative staff, the university's student organization, the printing office, the mailing office, and the endless hands the issue passes through before becoming the artifact you're holding now. We were kept conscious of the complex production process as 44.1 was assembled remotely in the midst of the COVID-19 pandemic. Cream City Review would not be entering its forty-fifth year of publishing if not for a lineage of dedicated editors who made sure to leave an impression on our literary journal that would last long after their tenure here. These impressions are what keeps Cream City Review alive and growing. It is because of this dedication that we can present this issue to you, the reader, today. You may have noticed that we look a little different this year. The cover art, titled "She Who Sends and Receives" by Suiko McCall, symbolizes our process, this issue a beacon of receiving and sending out light to be discovered. The works in here reflect our growth, our continued discovery. We have seen glimpses of the brilliant worlds our authors created here and stretched [End Page 6] our imagination. We hope that you, too, will be challenged. Here, the ordinary becomes inexplicable, inexplicable events cascade into self-discovery, where we encounter the things we cannot bear to say. Or did we simply imagine it? Thank you for supporting us and our authors; much joy and care went into crafting this issue, and we hope you can find something in it that makes an impression on you. We hope you can find something here to get lost in, a bit of reprieve from wherever you are now. [End Page 7] Copyright © 2020 University of Wisconsin Board of Regents

Trends in the Staff's Perception of Patient Safety Culture in Romanian Hospitals.

Introduction. The IRIS-2 project (2019) expanded the application of the HSOPSC in Romanian hospitals, yet applied, for the first time in the country, in 2014 (IRIS-1). The aim is an update on patient safety culture for staff, by geographic region and overall, by year of survey. Materials and methods. A cross-sectional study was carried out in voluntary staff in four hospitals in four regions (n. 1,121 staff) and compared with a previous study based on six hospitals in four regions (n. 969 staff). The instrument was the Romanian version of the HSOPSC with 31 items and 9 dimensions. Statistics to analyze trend were computed using “R”. Results No significant differences between the proportion of positive response (PPRs) by dimension were observed in IRIS-2 with respect to IRIS-1, with two exceptions: significantly lower PPR for “teamwork across hospital units“ (65% versus 73%) and significantly higher PPR for “frequency of events reporting” (65% versus 59%). Four dimensions were well developed and five dimensions needed to be improved. The poorest PPRs were for the “teamwork across hospital units”, the “frequency of event reporting” and the “non punitive response to error” dimensions. Besides, one outcome indicator changed through time: the proportion of the staff who did not report any event was significantly lower (64% versus 73%) and the proportion of the staff who reported “1-2 events” was significantly higher (21% versus 15%). Conclusion. Despite some small progress related to the frequency of events reporting, there is room for further patient safety culture improvement.

The characteristics of the patients in mass public shootings among coup attempt in Turkey: A single-center hospital response.

Turkey is an experienced country for both military and civilian mass casualties that arise from explosions and shootings by various terrorist groups. In this study, we aimed to investigate the characteristics of patient flow admitted to our hospital caused by primarily gunshot wounds during the coup attempts on the 15th of July. This descriptive, retrospective study included a total of 50 patients who were injured during a coup attempt on the date of July 15, 2016, and admitted to our emergency department (ED). Demographic characteristics, anatomical injury sites, postoperative clinical outcomes, and hospitalization settings were recorded. The Glasgow Coma Scale (GCS), Trauma and Injury Severity Score (TRISS), Abbreviated Injury Scale (AIS), Revised Trauma Score (RTS) and Injury Severity Score (ISS) were used to measure the severity of injuries. A total of 63 medical personnel voluntarily reached the ED within two hours. Extremity injuries were the most common injuries. The mean RTS, GCS, and TRISS scores did not differ significantly between the patients discharged from the ED and the patients who were hospitalized (p>0.05). However, there was a statistically significant difference in the ISS scores (p<0.001, independent t-test). There was no statistically significant difference in the GCS and RTS scores between the discharged and hospitalized patients, although the ISS scores were higher in hospitalized patients (p>0.05 and p<0.001, respectively). A total of 33 patients (66%) were admitted to the hospital for follow-up and/or surgical intervention. Five (10%) of the patients were hospitalized for more than 14 days. The management of each disaster is unique. Armed conflicts result in gunshot wounds, and preparations must be focused on surge capacity and a prolonged hospital stay of the patients. In our study, the length of stay in the hospital decreased after the arrival of volunteer staff to the ED, but we should note that the ISS increased. Hospital disaster plans should be reorganized not only for ED but also for the whole hospital.

ORGANIZATIONAL AND OLDER ADULT VOLUNTEER PERSPECTIVES ON ROLE CONFLICT MANAGEMENT STRATEGIES

Older adults are increasingly occupying multiple life roles, including working, caregiving, and volunteering, creating the opportunity for role conflict. Such conflict occurs when stress and strain created by the demands of multiple life roles outstrips an individual’s resources to successfully manage such demands. A two-phase research study was recently completed with 1,697 RSVP volunteers drawn from 55 RSVP program sites across the country (Phase I) with a follow-up survey of RSVP programs conducted with 17 sites (Phase II). Grounded in role theory, the Phase I volunteer survey explored role conflict in addition to self-reported strategies used to mitigate the experience of role conflict. The Phase II program survey gathered responses from volunteer managers and staff about the strategies used by their older adult volunteers to avoid and address role conflict. Based on findings from both surveys, caregivers engaged the following strategies in order to minimize role conflict: obtaining respite care, and volunteering alongside their care recipient. Worker-specific strategies focused largely on time management and included volunteering during off-work hours and completing time-limited volunteer assignments. While a high level of convergence was noted between volunteer manager and volunteer perspectives, two themes emerged from the volunteer survey that were not identified in program survey responses: seeking volunteer opportunities that leverage similar skills and experiences across roles and seeking volunteer opportunities that provide a different experience from that of other roles. Implications for future research and volunteer management strategies will be discussed.

CULTURAL MOTIVATION TO VOLUNTEER AMONG OLDER JEWISH ADULTS: AN EXPLORATORY STUDY

The physical, mental, and social benefits for older adults who volunteer are well-documented. Absent from this area of research however, is an understanding of volunteer motivation and experiences among culturally diverse older adults. This study addresses this research gap by exploring the volunteer pathways, motivations, and experiences of Jewish older adults in Vancouver, BC, Canada. The Jewish community is notable for possessing high levels of social capital, indicated by close community ties and the large number of faith and culturally based organizations, including community centres, day schools, seniors’ centres, and family service agencies, which provide many opportunities for older adults to volunteer. Despite this, they remain an understudied population. Semi-structured qualitative interviews were conducted with twenty-one older adult volunteers (age 55+), and two paid volunteer staff in the Jewish community. Theoretical concepts including social capital, generativity, and the life course perspective on aging were used to guide interview questions. Data analysis revealed three themes related to cultural motivation to volunteer: 1.) A desire to support the current and future generations of the Jewish community, 2.) To satisfy the “Jewish ethic” of giving back, and 3.) Experiences of discrimination (anti-Semitism) over the life course. Participants frequently volunteered for organizations that supported the infrastructure of the Jewish community. Findings indicate how cultural experiences and values may influence the decision to volunteer and the types of volunteer roles taken on by older adults. Further, they suggest the ways in which cultural and religious generativity may be expressed through volunteerism, a previously unexplored concept.

Preface

It is my great pleasure to present the proceedings of the “International Conference on Advances in Materials and Manufacturing Engineering (ICAMME-2019)”. This conference is organized by the School of Mechanical Engineering of Kalinga Institute of Industrial Technology (KIIT), Deemed to be University, Bhubaneswar. We were honored to have Prof. Mustafizur Rahman from National University of Singapore, Prof. D K Pratihar from IIT Kharagpur, Prof. Md. Mamun Habib from BRAC University, Bangladesh, Prof. Brij Kumar Dhindaw from IIT Bhubaneswar, Dr. Debasish Deb (Executive Director) from Hindustan Aeronautical Limited (HAL) and Prof. Biswanath Doloi from Jadavpur University as Key Note Speakers on this special occasion.We have received good number of research papers and after peer review 47 papers were accepted for IOP Conference Series: Materials Science and Engineering. These papers were presented in different categories of oral sessions. ICAMME-2019 covered four major areas namely Smart and Advanced Materials, Advanced Manufacturing, Design and Industrial Engineering, Thermal and fluid Engineering of Mechanical Engineering which are directly linked to socially useful research. The emerging areas like Advanced machining methods, automation, 3-D printing, robotics, waste management, biofuels, Nano-materials, PCM & smart materials, Supply chain management, which directly meets the needs of society in the form of design, planning and processing of various components.As the convener of the conference, I extend my gratitude to our honorable Founder Prof. A. Samanta, KIIT and KISS, Prof. Ved Prakash, Chancellor, KIIT, Prof. S. K. Acharya, Pro-Chancellor, KIIT, Prof. H. K. Mohanty, Vice-Chancellor, KIIT, Prof. SasmitaSamanta, Registrar, KIIT, Prof. R. Kodali, Pro-Vice Chancellor, KIIT, Prof. A. K. Sahoo, Dean, SME, KIIT, Prof. P. C. Mishra, Assoc. Dean, SME, KIIT, for their continuous support and guidance throughout the planning and execution stages of ICAMME. I would like to thank technical program committee, organizing committee, faculty, staff and student volunteers of KIIT, SME for their dedicated support. Special gratitude is paid here to the Springer, for the Technical Sponsorship, Silver sponsor: GAIL, BBSR.Finally I would like to thank all the authors, volunteers and persons who directly or indirectly contributed to the conference. Without their cooperation and full support, this conference would not have been possible.

2898. Achieving Hepatitis C SVR12 of 95% in Mono-Infected Patients with Severe Comorbidities Using Volunteer Staff and Minimal Clinic Visits and Phlebotomy

BackgroundHCV is the most common chronic bloodborne infection in the United States with an estimated 3.5 million infected. With direct-acting antivirals, cure can be achieved in 8 to 12 weeks. To achieve WHO elimination targets by 2030 (>90% reduction in incidence) requires increased detection, access to care, and simpler treatment protocols that patients, challenged by substance use and mental health disorders, can readily complete.MethodsIn 2016, Wake County, NC began HCV testing at 32 sites finding prevalence >10% at 5 shelters and drug treatment centers. An adapted simplified HCV treatment protocol, used in the high prevalence settings of Ukraine and Burma, was implemented at the Open Door Clinic – a free clinic for uninsured persons living in poverty in Wake County. After initially using genotype-specific therapy, we switched to pan-genotypic sofosbuvir/velapatisvir (SOF/VEL) for 12 weeks. Clinic visits were limited to pre-treatment and 12 weeks after treatment completion. Patients were contacted weekly via text to check on their health and adherence.ResultsThirty HCV mono-infected patients have initiated treatment including 9 women. 21 were infected by IDU, 5 by transfusion, 3 by sex with an infected partner, and 5 have unknown risk. In genotype (GT) testing 22 have GT1, 3 GT 2, and 4 GT3. Major comorbidities include 24 with current or recent IDU, alcohol dependency, psychotic depression or schizophrenia, or missing all medical appointments other than the HCV. Twenty-seven of 30 have completed their prescribed course of HCV therapy and 20 have achieved an SVR at 12 weeks. The 1 patient who failed was admitted to the hospital 4 times in the first 6 weeks of treatment and did not take his medication consistently. An additional 2 remain on treatment and 6 are awaiting results of testing done at 12 weeks post-therapy completion. One patient died within 2 weeks of initiating therapy due to a perforated duodenal ulcer.ConclusionUsing targeted on-site HCV testing, we identified high prevalence sites. Implementing a simplified HCV treatment program reduces patient and clinic burden and resulted in 95% achieving SVR12 despite severe comorbidities. Expansion of this program to other clinics in Wake County is underway.Disclosures All Authors: No reported Disclosures.

Process evaluation of a community mobilization intervention for preventing men’s partner violence use in peri-urban South Africa

Intimate partner violence (IPV) is experienced by one-third of women globally, yet few programs attempt to shift men’s IPV perpetration. Community mobilization is a potential strategy for reducing men’s IPV perpetration, but this has rarely been examined globally. We conducted a mixed-methods process evaluation alongside a trial testing community mobilization in peri-urban South Africa. We used in-depth interviews (n=114), participant observation (160 h), and monitoring and evaluation data to assess program delivery. Qualitative data (verbatim transcripts and observation notes) were managed in Dedoose using thematic coding and quantitative data were descriptively analyzed using Stata13. We learned that outreach elements of community mobilization were implemented with high fidelity, but that critical reflection and local advocacy were difficult to achieve. The context of a peri-urban settlement (characterized by poor infrastructure, migrancy, low education, social marginalization, and high levels of violence) severely limited intervention delivery, as did lack of institutional support for staff and activist volunteers. That community mobilization was poorly implemented may explain null trial findings; in the larger trial, the intervention failed to measurably reduce men’s IPV perpetration. Designing community mobilization for resource-constrained settings may require additional financial, infrastructural, organizational, or political support to effectively engage community members and reduce IPV.

Newborn Infection Control and Care Initiative for Health Facilities to Accelerate Reduction of Newborn Mortality (NICCI): Results of a Stepped Wedge Cluster-Randomized Controlled Trial

Objectives: The intervention study objectives were to improve infection control behavior by staff in health centers; improve referral of sick newborns, increase recognition of danger signs, and prompt care seeking at appropriate health facility; and appropriate referral for sick newborns by mothers and families of newborn infants Methods: The stepped wedge cluster randomized controlled trial in 16 Health Centers (HC) took place from February 2015 and November 2016. Each cluster was one HC its catchment area. Eligible HCs were those with greater than 20 birth deliveries per month. Eligible participants in each cluster included women in their last trimester of pregnancy who were healthy and able to participate in the intervention activities, such as home visits and data collection, could adhere to the study protocol, and were greater than 18 years of age. Participants enrolled in the study who met all inclusion criteria were blinded to their group assignment and interviewed by the study during the last trimester of her pregnancy (enrollment), the 14th day after delivery, and on the 28th day after delivery. The study team was not blinded to group assignment. At the HCs, the intervention included training on hand washing, infection prevention control, newborn danger signs, breastfeeding, and newborn care. Health workers were trained to conduct home visits within 24 hours of birth and on days 3 and 7 after delivery, including assessment of newborns for danger signs, counselling mothers at home visits, and use of equipment (e.g. thermometers). At home visits, mothers and caregivers received counseling on hygiene and handwashing practices, breastfeeding, newborn danger signs, and prompt, appropriate referral to facilities. Results: HC staff in the intervention group had 14.6 times (7.73-31.47; p<0.0001) the likelihood of hand washing at the recommended key moments when compared to the control group, and 98% of HC staff in the intervention group knew six danger signs compared to 15% in the control group (p<0.0001), while 95% recalled at least three hygiene messages compared to 54% in the control group (p<0.0001). 60.58% of VHSG volunteers in the intervention group knew at least six danger signs compared to 2.11% of VHSG in the control group (p<0.0001). Of 2,494 mother participants in the trial, at 14th days after delivery, women in the intervention group were more than twice as likely to know at least 3 danger signs compared to women in the control group (OR=2.35, p=0.0104), with no effect on care seeking behavior. However, 35.01% of mothers in the intervention group received messages on care seeking from VHSG volunteers compared to 5.35% in the control group (p<0.0001). Conclusions: Well-designed training followed by regular supervision improved the knowledge and self-reported behavior of HC staff and VHSG volunteers as well as mothers' knowledge of newborn danger signs. However, further improvement in hygiene behavior among mothers and families will require involvement from broader stakeholders in the community. Trial Registration Number: ClinicalTrials.gov, Identifier: NCT02271737 Funding Statement: United States Agency for International Development under prime agreement number AID-OAAA-A-11-00012 with the National Academy of Sciences (NAS). Declaration of Interests: All authors declare that there are no conflicts of interest. Ethics Approval Statement: The trial protocol was approved by the National Ethics Committee Health Research of the Cambodia Ministry of Health and by the Institutional Review Boards of Tulane University.

Affecting care: Maggie's Centres and the orchestration of architectural atmospheres

This article presents research on the architecture of Maggie's Centres, a series of buildings for those with cancer, their families and friends. In particular, we explore the way in which their architectural atmospheres are spoken of by architects who have designed individual Maggie's Centres, in interviews with staff members and volunteers in the buildings and in focus groups with visitors to their sites. We bring together qualitative research from two separate projects, and present findings from interviews, across the UK and internationally, with 66 visitors, 22 staff members and 7 architects of Maggie's Centres. How our research participants discussed the atmospheres of their Maggie's Centres is broken down into an analysis of, respectively, how building materials are used in these buildings; how colour and light are experienced in the buildings, and how the shape of the buildings in themselves affect the ways in which people use the spaces. These separate aspects of the buildings combine to become what can be described as the generators of architectural atmospheres. We discuss how architects, staff members, volunteers and visitors translated their intuition of intangible atmospheres into a recognition of architectural qualities, and linked these to questions of care. Maggie's Centres, we argue, are emotionally charged buildings that shape the ways in which care is staged, practiced and experienced in everyday ways, through the orchestration of architectural atmospheres. We use the example of Maggie's Centres as a comparison with how social scientists have characterised the design of mainstream hospital settings, in order to draw out the implications for questions of healing and recovery from illness, and how buildings may hold the potential to affect care.

23 The Implementation of a Hospital “Buddy Walking Programme” to Improve Access to Mobility for Acute Hospital in-Patients

Abstract Background An acute hospital admission often means that patient’s mobility can decline if not maintained and encouraged throughout their inpatient stay. The “Buddy Walking Programme” is a joint initiative between the physiotherapy department, nursing department and hospital volunteers. The aim of this research was to implement a hospital “Buddy Walking Programme” within a teaching hospital in Cork to allow the provision of accompanied walking sessions by members of the hospital’s volunteer team. Methods Ward based physiotherapy staff and nursing staff identify suitable patients and add their bed number and mobility status to a list each morning. Patients are identified who are independently mobile or can safely mobilise with the supervision of one person, with or without a mobility aid and who are cognitively capable of simple commands. Physiotherapists and nursing staff are made aware of the programme at induction. Volunteers partake in an educational session and manual handling training prior to offering supervised walking sessions. Results A standard operating procedure has been developed for the “Buddy Walking Programme”. Training has been rolled out hospital wide amongst nursing staff, physiotherapy staff and hospital volunteers. Conclusion This programme will help encourage a culture of physical activity within the hospital in-patient setting and improve mobility levels. Further research is warranted to explore the beliefs and perceptions of hospital staff and volunteers regarding the initiative and to examine barriers and facilitators to the programme.

A qualitative assessment of disease surveillance activities in a resource-limited environment: Perceptions and opinions of volunteer staff working in Northern Uganda.

Annually, groups of health professionals from high-income countries are drawn to work in low- and middle-income countries (LMICs) through timed engagements intended to improve the well-being of people in most disadvantaged communities. The existing evidence on understanding volunteer experience in LMICs often focuses on activities within the medical discipline; whereas little research has been conducted on the experiences of volunteers in other disciplines. This paper focuses on understanding veterinary and public health professional's experiences conducting disease surveillance work in Northern Uganda. Forty US-based health care professionals were recruited to complete multiple-choice and open-ended questions to understand prior and current experiences working in resource-limited settings. Responses were coded using NVivo 10®, qualitative analysis package. Of the 44 volunteers, 50% completed the questionnaire. Responses were largely positive towards surveillance activities; they reported personal and professional gains, new cultural experiences and mutual learning environment with local colleagues. Nevertheless, respondents highlighted challenges during various stages of program implementation-some difficulty with program logistics, inadequacy of preparation materials, in addition to concerns inherent to working in a resource-limited environment. This assessment suggests that international volunteer work could positively influence programmatic outcomes, personal experiences, furthering health organizational goals, often achieved in a limited time-frame. To maximize volunteer impact, these assessments are critical and suggest that volunteer and institutional capacities should be seriously considered when planning placement as it can influence programmatic decision-making, gauge training needs and volunteer readiness.

Üniversite Öğrencilerinin ve Çalışanlarının Güneşten Koruma Davranışının Değerlendirilmesi: Anket Çalışması

Objective: We aims of our study are as follows: 1) to determine the data and socio-demographic characteristics related to sun protective behavior during the summer months in the population who came for education and work from every region of the country, 2) to compare sun protective behaviors and intentional sun exposure factors in the highly educated population (college graduate or university students) as well as intentional sun exposure factors. We intend to reflect in this study the use of sunscreen cream and the knowledge and behavior about sun protection methods of the students of University (SU) and hospital personnel working in University Faculty of Medicine Research and Training Hospital(SURTH). Material and methods: The study was held on the subjects consisting of student and staff volunteers of SU and SURTH. One thousand three hundred eighty-nine (69.2%) of these volunteers were students in SU, 616 (30.7%) of them were staff working in SURTH. Results The study was conducted on 2005 individuals with face-to-face interviews. Of the participants, 53.4% (n = 1070) were male and 46.6% (n = 935) were female. Conclusion The incidence of malignant melanoma and other skin cancers is increasing. We believe that the researches and warnings were still inadequate on these issues. The behaviors of protection from the sun were not caused because they want to be healthy, they were caused to avoid the inconvenience due to the sun while driving and playing sports.