Notes

Comprehension of connection involving sophisticated nitrogen removal using extracellular polymeric materials portrayal inside a step-feed three-stage built-in anoxic/oxic biofilter method.
96). Confirmatory factor analysis confirmed the 6-factor solution and produced satisfactory discriminant validity and convergent validity indicators. The adapted scale was highly correlated with all dimensions of HEALTHQUAL, including continuous quality improvement (r ≥0.75, P < .001). In multiple linear regression, the 5 domains of HEALTHQUAL explained 59% of the variance in ADAPTED SERVQUAL (P < .001).

The study concluded that 8 items that make up a single factor (ie, sanitation and hygiene) and contribute most of the total variance satisfactorily fit into the SERVQUAL scale as additional indicators of health care quality.
The study concluded that 8 items that make up a single factor (ie, sanitation and hygiene) and contribute most of the total variance satisfactorily fit into the SERVQUAL scale as additional indicators of health care quality.
The passage of the Affordable Care Act has ignited a shift from the pay-for-performance model to value-based care with a particular relevance in critical care settings. Provider incentive programs are widely considered as a means to reward providers based on the achievement of preset quality metrics. This article aims to demonstrate the effects of a provider incentive program in the critical care delivery system in a large academic center in the Northeastern United States.

This article describes the results of a retrospective analysis of a performance-driven quality improvement initiative at a critical care facility of an academic medical center using a quasi-experimental pre-/posttest design. A set of quality measures was selected as outcome metrics. Selection criteria for the process measures are as follows (i) the metric goals should be influenced by the physician's input to a large degree; (ii) the measure must be transparent and accessible within the hospital-wide data reporting system; (iii) the meten financial incentive model in a critical care setting measured by outcome metrics dependent on physician input is successful with rigorous implementation and careful evaluation.
The use of a physician-driven financial incentive model in a critical care setting measured by outcome metrics dependent on physician input is successful with rigorous implementation and careful evaluation.
Defining quality in the health care context has proven difficult, with many organizations not able to clearly articulate their use of this term in a manner that is easily understood by their clinical staff. BL-918 This review seeks to investigate the literature to explore clinician engagement in quality including where engagement has been problematic, and if the reasons for this have been identified.

An integrative review of the literature was undertaken to determine whether evidence within the literature supports a hypothesis that there is a lack of understanding of and engagement in quality at an organizational level by health professionals. A search of the literature was conducted using EBSCO Academic Complete, CINAHL, and MEDLINE databases.

This article identified 18 studies where the understanding of quality by clinicians and their level of engagement with the process are investigated. We found that there has been no comprehensive study that explores the development of an agreed-upon definition and measur part by their own personal beliefs and values, in addition to their interpretation of their individual work/professional responsibilities.
Organizational justice (OJ) is important for organizational success; it reflects employee perceptions of fair treatment. OJ promotes employee retention and work engagement toward high performance. Organizational citizenship behavior (OCB) is a discretionary behavior, describing how employees contribute to a smoother organizational performance. OCB enhances employee satisfaction, quality of care, patients' satisfaction with hospital performance, and the use of best hospital practices. Moreover, OJ increases employee satisfaction and is perceived as a factor that encourages workers to go "above and beyond" their responsibilities, while avoiding OCB in the workplace may reduce awareness of justice. Previous efforts have shown that perceptions of a just workplace promoted OCB at different industrial companies. Still, few studies have investigated this relationship in hospitals.

This study addressed this gap by investigating the significant relationships of OJ and OCB in a large Jordanian hospital.

A fuzzy approach to Pearson's correlation was applied to test the formulated hypothesis, with an aim to better understand causal correlation of vague data.

A statistically significant, positive correlation existed between OJ and OCB. Maximum correlations existed between distributive justice and altruism, procedural justice, courtesy, and interactional or interpersonal justice and conscientiousness. This study showed that procedural justice was the best predictor of OCB.

This study revealed a correlation between OJ and OCB, reflecting the diversity of these correlation relationships, which can help decision makers to form their strategic plans.
This study revealed a correlation between OJ and OCB, reflecting the diversity of these correlation relationships, which can help decision makers to form their strategic plans.In the meantime, as COVID-19 has gone pandemic, social distancing has become inevitable; therefore, most in-person visits have been canceled to minimize the spread of the disease. This will greatly impact cleft palate patients as it will limit their chance to receive timely care and have persistent follow-up, and that could in turn delay its management so significantly that it could cause much more considerable complications. To mitigate the issue, it seems necessary to start integrating modern-day technologies into the everyday practice of physicians and to benefit from the opportunities it provides. Much of medical decision making is cognitive, and telemedicine can provide easy access to specialists who are not immediately available. With wide internet access, this task is more than feasible. Telemedicine and other modern facilities are very promising platforms that could fill the gap that has been made by social distancing. We tried to address some of these issues as well as give recommendations for possible solutions to each of them.An elongated styloid process (ESP) causes symptoms such as pharyngeal pain, swallowing pain, and discomfort during mouth opening. The main treatment is surgical resection of the ESP. The authors present a case of ESP with skeletal mandibular protrusion. Because mandibular setback by sagittal splitting ramus osteotomy (SSRO) may lead to deterioration of symptoms of ESP, resection of ESP and bilateral SSRO were performed simultaneously. The patient was a 50-year-old man who visited our department with chief complaints of mandibular protrusion and pain in the left pharynx on mouth opening and swallowing. A lateral cephalogram helped in diagnosis of skeletal mandibular protrusion. In addition, an approximately 42-mm left styloid process elongated inferomedially was observed. Left styloidectomy was first performed via the cervical approach, followed by SSRO. Occlusion, facial appearance, and preoperative symptoms due to the ESP improved after surgery. The cervical appearance was esthetically satisfactory. In a case of ESP with skeletal mandibular protrusion with potential aggravation of symptoms because of mandibular setback of the ESP, resection of the styloid process is necessary together with orthognathic surgery.Reconstruction of the antihelical area can be challenging because the cartilage can be easily exposed due to the thin overlying soft tissue, and it has a lack of tissue mobility. Skin graft can be hesitant to perform in antihelical defects where the bare cartilage is exposed.A 70-year-old male with squamous cell carcinoma of the antihelix of the left ear was referred to our department for surgical excision. Wide excision with tumor-free margins resulted in a defect of 2.0 × 1.0 cm with exposed bare cartilage. The authors covered the defect using adipoperichondrial turnover flap from cephalic portion of the earlobe followed by full thickness skin graft. The skin graft took well with no complication. Aesthetic result was satisfactory with no auricular deformity.This adipoperichondrial turnover flap is simple, easy, can be performed in one stage, and produces good esthetic results with no disfiguration of the ear shape.Assessment of stress and micromotions using finite element analysis along both the intraoral and the extraoral distractors devices used in the mandibular distraction of post temporomandibular joint ankylosis deformed mandible patients. The process of finite element analysis was carried out to assess distraction models. The first model was an extraoral mandibular distraction model and the second model was an intraoral mandibular distraction model. To analyze the stress state, 2 vertical loads were applied on the defective and normal side respectively by a 3D finite element ball model. The intraoral system observed lower stress (4.5 MPa) in the mandibular bone compared to the extra-oral system (11.5 MPa). The results revealed that the intraoral system observed higher stress on the distractor fixing points (392.21 MPa) compared to the extra-oral fixing points (12.62 MPa). The results revealed that the extra-oral system reflected higher displacement on the bone surrounding the screws of about 3720 μm compared to the intraoral system 1414.6 μm. Internal devices give better shielding to the bone and induce fewer stresses over the mandibular, so it is more advisable to be used. The external devices permit greater distraction length because the pins and the distractor main body are subjected to fewer stresses.
World scientists are using facial morphometry as a reconstructive option in the treatment of patients and ethnic differentiations. Hence, the authors aimed to study the naso-facial dimensions of northern population in Nigeria.

About 500 subjects (Igede, n = 260 and Idoma, n = 240) were recruited from schools in the Benue-Plateau valley in 2014-2015 academic session. Notable parameters measured using vernier caliper were upper facial length, lower facial length, total facial indices, nasal length, nasal width, and nasal indices. Also, stature was measured to the nearest centimeters with stadiometer.

Taller Idoma males than Igede males (169.25 ± 8.92, 167.13 ± 8.99), and taller Igede females than Idoma females (164.57 ± 8.77, 163.45 ± 8.94). The mean facial indices of Idoma subjects showed 97.89 ± 8.53 and 97.82 ± 8.11 with nasal indices of 77.77 ± 7.34 and 80.42 ± 7.53, whereas Igede subjects showed 96.88 ± 8.61 97.83 ± 8.36 with nasal indices of 75.59 ± 7.45 and 77.55 ± 0.21. Both ethnic groups showed dominance of the leptoprosopic face type and mesorrhine nose type. All R values appeared to be above 0.5% (P < 0.05), where Igede males and females were 0.72, 0.71 0.82, 0.81, and 0.69, 0.65 and 0.72, 0.73 for stature with total facial indices, and nasal indices respectively.

Facial and nasal types serve as good predictors of stature, important for dimorphic and ethnic classifications in time of forensic needs.
Facial and nasal types serve as good predictors of stature, important for dimorphic and ethnic classifications in time of forensic needs.
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