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Crimson Publishers High Impact Journals

All our scientific journals are open access and constantly updated to keep the knowledge flowing. Our articles are also met with the highest standards of publishing and go through a peer review before being considered for publishing. Crimson Publishing Group provides Journal publishing services in the diversified academic disciplines such as Science, Technology and Medicine available Online via Open Access ensuring the quality by reputed editors and high quality peer-reviewing. We strive towards betterment of societal conditions benefitting global humanity by advancing innovations in the fields of scientific research. We inspire upcoming researchers and scientists nurturing the essential temper and we are motivated to be significant role players for offering due recognition and rewards for their works.Our global Open Access platform makes sure that there are no barriers in sharing the knowledge and evolving through it.High Impact Journals

Journal of Materials Science

Research & Development in Material Science provides an international media for the publication of experimental and theoretical studies related to the load-bearing capacity of materials as influenced by their basic properties, processing history, microstructure and operating environment. RDMS is a relatively new scientific field which involves studying materials through the materials paradigm (synthesis, structure, properties and performance). It incorporates elements of physics and chemistry and is at the forefront of nanoscience and nanotechnology research. RDMS focuses on scientific and/or engineering factors affecting the relationships of materials, particularly appropriate for research and development in material science. RDMS is primarily interested in those contributions which bring new insights. Papers will be selected on the basis of the importance of the new knowledge they provide. The main theme of this journal is to spread the advanced research technologies in Materials Science and Engineering. RDMS journal cordially accepts all research papers, review articles, short communications, mini- reviews, opinions, letter to editors etc.

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Journal of Medical Sciences

Research in Medical & Engineering Sciences is a multidisciplinary study of research and information on the applications of Science and Engineering to medicine. This journal aims to associate both clinicians abreast and engineers latest innovations of technology to health care. This journal provides a forum for the publication of the latest inventions in the field of Medicine and engineering to reflect the essential multidisciplinary nature of the Medical & Engineering Sciences. Our Journal focus mainly encompasses the applications of the basic principles of Science and engineering to the development of medical devices and technology, with the ultimate aim of producing improvements in the quality of health care. It is a broad perspective on engineering and technology in the medical setting, including an understanding of the physiological processes, disability and underlying disease. This journal publishes Original Research papers, in-depth critical reviews, scientific papers and technical notes.

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Dairy and Veterinary Sciences journal

The APDV journal is a worldwide contributor to various research topics of veterinary science and its related subjects. It provides regular book reviews and a short communications section. This journal primarily includes topical reviews and commentaries on the features of dairy and veterinary fields. The APDV journal is the leading source for international reports on animal health programs and preventive veterinary medicine. This journal mainly focuses on the epidemiology of domestic and wild animals, costs of epidemic and endemic diseases in animals, the latest methods in veterinary epidemiology, disease control or relationships between veterinary medicine and animal production, and development of new techniques in diagnosing, recording, evaluating and controlling diseases in animal populations.

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Journal of Environmental Sciences

Environmental analysis and Ecology studies focuses on the emerging field of Environmental Ecology: the study of broad, consistent patterns in the ecological characteristics of organisms and ecosystems. EAES journal emphasizes on general ecological hypotheses, explored and tested using data of broad geographic, taxonomic, or temporal scope. A variety of approaches are represented; empirical studies documenting ecological and geographic patterns, theoretical studies as well as methodological studies of the tools used to study these problems. EAES publishes original papers concerned with environmental ecology concerning studies of plant communities, populations or individual species are accepted, as well as studies of the interactions between fungi or bacteria, plants and animals. This journal aims to bring important work using any ecological approach (including molecular techniques) to a wide international audience and publishes papers with strong and ecological potency that advances our understanding of ecological principles.

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Orthopedic Research journal

Orthopedic Research Online Journal is an international peer review journal, which aims at promoting the exchange and propagation of knowledge on problems related to orthopedics and their disorders. OPROJ accepts original research paperson clinical, medical or laboratory research related to Orthopaedics, Arthroscopy, Pediatric Orthopedics, Osteoarthropathy, Orthopedic Trauma, Osteoporosis and other related fields. We endeavor to improve the diagnostic, clinical, therapeutic and preventive skills and to guide clinical practice in the field of orthopedics. Our offer is encourage authors to share their ideas, research work, case studies, reviews, letters to editors and other type of articles on the latest updated technologies in orthopedics, which have overtaken the scientific world through this platform. All the articles will go through review process before getting published in our journal.

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Nursing Healthcare Open Access Journal

COJ Nursing & Healthcare is an open access journal, mainly publishing high quality original research and reviews, opinion, midwifery and health professional education. It also provides a forum for the publication of original papers of the highest standard that report research findings and research-based reviews and analysis of interest to an international readership of nurses, midwives, educators, administrators and researchers in all areas of nursing and health care sciences. It aims to contribute to the advancement of the science and practice of nursing and interrelated disciplines worldwide by the international dissemination of sound information based on rigorous methods of research. COJNH addresses the practice, research, and policy roles of nurses with baccalaureate and graduate degrees, the education and management concerns of the universities in which they are educated and the settings in which they practice. COJNH not only publishes original papers but also encourages thought-provoking articles representing research by some of the world’s leading nursing researchers.

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Open Access Journal of Sports Medicine

Research & Investigations in Sports Medicine is a practical review of current research and current practice in sports medicine and exercise physiology. Sports Medicine bridges the gap between science and practice by promoting exercise, health, scientific assessment, study and understanding of sports performance. RISM mainly focuses on sports injury prevention and treatment, exercise for health, drugs in sport and recommendations for training and nutrition. RISM Journal harnesses the tremendous scientific and clinical resources of sports medicine to develop articles reviewing recent and important advances in the field that have clinical relevance. The journal’s goal is to translate the latest research and advances in the field into information physicians can use in caring for their patients. RISM Journal cordially accepts all original research papers, review articles, short communications, mini- reviews, opinions, letter to editors, commentary, etc.

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International Journal of Forensic Sciences

Forensic Science & Addiction Research, a peer-reviewed scientific journal publishing with premium quality articles that aims to showcase advanced research in the field of forensic science, addiction research and other related areas. FSAR features original reviews, training and educational articles, special commentary and especially research articles that are meaningful to the treatment of alcohol, heroin, marijuana, and other drugs of dependence and includes forensic pathology, biochemistry, toxicology, biology (including the identification of hairs and serology, odontology, psychiatry, anthropology. The journal mainly focuses on recent advancements in forensic science and addiction research and welcomes researchers to publish their research work in our journal. FSAR’s main motto is to promote high quality research in the field of addiction worldwide through its publishing and other activities. It also to provides information about forensic science and addiction to readers. FSAR welcomes all types of articles like research, reviews, case reports, mini reviews, short communication, opinions etc.

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Textile Science Engineering Journal

Trends in Textile Engineering & Fashion Technology (TTEFT) is an international, open access, peer-reviewed journal that aims to bring out the most reliable and complete source of information on the innovations and current developments in the textile industry. The journals scope mainly includes findings from the textile raw materials, their processing to production of all kinds of textile fabric and yarns from textile fibers. TTEFT strongly desires to endow readers with information on recent advancements in fashion technology all over the globe. TTEFT will encourage interdisciplinary research which will share newly developed technology, theory and techniques in the fashion and textile industries in the field of fashion technology. This includes research in pattern cravings, fashion designing, apparel production, and manufacturing of technology and in textile engineering deals with all activities and methods which are involved in the process of textile manufacturing. TTEFT aims to publish information on innovations in textile processing and fashion technology in the form of manuscripts. TTEFT cordially accepts all original research papers, review articles, short communications, mini-reviews, opinions, letters to editors, commentary, etc.

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International Journal of Gerontology

Gerontology & Geriatrics studies is a multidisciplinary journal for the publication of work from all areas of bio gerontology, with an emphasis on studies focused at the systems level of investigation, such as whole organisms, immune, endocrine and cellular systems, as well as whole population studies. GGS welcomes researchers to publish their research work and wide variety of reviews, case reports, mini reviews, short communication, opinions etc. GGS publishes articles on the biological aspects of aging which covers biochemistry, biodemography, comparative and evolutionary biology, endocrinology, cellular and molecular biology, exercise sciences, genetics, immunology, morphology, neuroscience, nutrition, pathology, physiology and biological underpinnings of late life diseases. Basic aspects of regeneration in diverse investigatory biological systems as well as in the context of medical applications, which dealt with a special section that also contains information on technological advances for the elderly. GGS publishes international forum for the information that has clear and immediate applicability to health, care, and quality of life of the aged.

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Journal of Alternative and Complementary Medicine

Advances in Complementary & Alternative Medicine is an multidisciplinary journal which publishes original peer reviewed articles that complement or replace conventional therapies, with a specific emphasis on research that explores the biological mechanism of action, safety, efficacy, etc. ACAM authors to send papers that make substantial and scholarly contributions to the area of complementary medicine research. ACAM highlights scientific understanding of traditional medicine therapies, complementary & alternative medicine and their responsible integration with conventional health care. ACAM helps to spread innovative and expert findings in the fields of phytopharmacology and phytotoxicology as a reference source for researchers in these fields, with the aim to set international standards in their methodology. ACAM journal comprises of research results on phytotherapy (clinical trials), pharmacognosy, phytopharmacology, phytotoxicology and the standardization that has been obtained.

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International Journal of Agronomy

Modern Concepts & Developments in Agronomy strives hard to create a platform for students, scientists, academics, engineers all over the world to share, promote and discuss various topics, inventions and developments in different aspects of agriculture. The major aspect of the journal is to spread newfangled knowledge on agriculture and its development,by publishing high quality articles. The journal accepts the submission of original scientific papers, review articles, short communications and case studies. The journal welcomes all original trans-disciplinary and interdisciplinary papers along with reports focused on disciplinary studies that settle with the principles of agriculture. We also welcome authors to submit papers which take a critical approach on one or more aspects of agriculture, which include scientific papers, reviews, and overviews of agricultural findings.

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Journal of Pediatrics | Neonatology Open Access Journals

Novel Techniques in Nutrition and Food Science (NTNF) is an international, double blind peer-reviewed journal offering accessible and comprehensive knowledge of food and beverage along with nutritional research, clinical nutrition, animal nutrition and the basic science of nutrition. The nutritional information is gathered by performing well-controlled clinical studies that describe scientific mechanisms, efficacy and safety of dietary interventions in the context of disease prevention or a health benefit. The Journal recognizes the multidisciplinary nature of nutritional science and includes material from all of the specialties involved in nutrition research, including microbiology and cell biology and the emerging area of nutritional genomics and interactions between nutrients and non-nutrient food components on cells, organs, and body functions. Nutrition Journal aims to encourage scientists and physicians of all fields to publish results that challenge current models, lifestyle or dogmas. The journal welcomes various content like, research papers, review articles, mini reviews, opinions, short communications, conceptual papers etc., for the recent, ongoing and future research.

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Dentistry Open Access Journals | Crimson Publishers

Modern Research in Dentistry is an international, open access journal that publishes original papers, reviews, clinical studies, editorials, in all fields of dentistry, which include periodontal diseases, oral pathology, dental implants, oral and maxillofacial surgery.Studies that bring new techniques and knowledge on advanced health of individual or public health, also including the interactions between oral health and ill-health. The journal is committed to promoting the switch over and discussions of all the research areas that are relevant to dentistry in the form of invited reviews or systematic literature, prospective and clinical studies. MRD is a platform where researchers can access the content online due to our open access policy from any corner of the world without any charges. MRD publishes research work that is related to dentistry and which aids researchers to follow the current trend in dentistry.

https://crimsonpublishers.com/mrd/

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American Journal of Archaeology | Anthropology

Archaeology & anthropology is an international open access journal and forum for the publication of peer-reviewed original articles that synthesize the prehistory of an area of a time-horizon within a larger region, or describe technical advances of wide and general applications. AAOA provides in-depth, thoughtful development of data and concepts that are accessible to all archaeologists. The journal primarily focuses on prehistory, including the beginnings and early development of complex societies. AAOA is dedicated to publishing papers on humankind, encompassing the full range of anthropological consequences on human cultures and on other primate species. AAOA presents the results of research that include methodological and theoretical interface between archaeology and the anthropology. AAOA includes works that focus on understanding archaeological sites, their environmental context and particularly site formation processes about the analysis of sedimentary records that enhance our understanding of human activity in quaternary environments within its scope.

https://crimsonpublishers.com/aaoa/

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Assertiveness in Nursing _Crimson Publishers

Assertiveness in Nursing by Bushra Mushtaq in COJ Nursing & Healthcare

Introduction Assertiveness is essential to nursing profession in many ways. Nursing profession is the respectful profession which demands and shows respect for others. Assertive ways of communicating and putting one’s own concerns, ideas in front of others which help to the clients care as well as for nursing profession itself. Assertive nurse defends client in every aspects. It enhances honesty and dedication in nursing profession. Assertiveness is a broad term associated with the individual from hierarchical development of life. It adds to the quality of life by adding meaning and support to ones behaviour. It adds to the quality by adding meaning and support to ones behaviour .It is not only being confident about ones words but also about ones actions, doing and behaviour exhibited in every situation of life.

It is learned behaviour behaviour or mode of communicating feelings, ideas in a confident way without being aggressive on others. It depicts the confident behaviour in an individual within under estimating the others. Being assertive is beneficial to everyone. It can be defined simply, to convey one’s own point of view which affirms the right of the individual without violating the rights of the other person.

Assertiveness and Nursing are very closely related to each other. Nursing practise cannot be declared good if a nurse is not assertive. The assertiveness can be visualized in nursing care given by the nurse. Nurse has to be assertive enough in order to preserve rights of nurse as well as for clients who is seeking the nursing care.

Assertiveness by a nurse shows a behaviour that is based on certain principles like; equality, respect, responsibility, accountability. Being assertive, nurse is not being selfish rather it promotes the rights of the client, fairness and equality in job description and most important efficiency and effectiveness of nursing practice is being attained.

Nursing is a collaborative effort and teamwork with other nurses and that can be achieved ironically by assertiveness. Nurse play different roles in health care setting:

A. Individual to group member

B. Advocate to lawyer

C. Collaborator to team builder.

D. Leader to manager.

To perform all these roles effectively nurse has to be assertive.

The main aim of nursing care is to develop the effective nurseclient relationship, in order to achieve the client’s progress and nurse-client relationship, assertiveness is necessary. Assertive nurse is always confident, listens to others, always is clear to other, not confused with any issue and more over nurse is always assertive while hand-overing charge or duties to other health professionals.

Assertiveness in nursing is the important footstep in the ladder of professional progress. Assertiveness is a healthy behaviour and valuable component in nursing profession which are beneficial to nurse, client, other workers and community in large. Being assertive will also increase the visibility in nursing.

Conclusion From the very beginning the assertiveness training should be imparted to nurse students . A full assertive training programme should be included in the activity during nursing coarse. Being assertive from student period will increase truthfulness , confidence which are important during working as staff.

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Health Seeking Behavior among Mentally and Physically Ill Patients: A Comparative Study_Crimson Publishers

Health Seeking Behavior among Mentally and Physically Ill Patients: A Comparative Study by Naglaa M Gaber in COJ Nursing & Healthcare

Abstract Health-seeking behaviour has been defined as a sequence of remedial actions that individuals undertake to rectify perceived ill-health. Therefore, this study was to assess the barriers affecting seeking health care services as perceived by mentally and physically ill patients. A descriptive comparative design was utilized in this study. A sample of convenience of 100 patients (50 physically ill patients and 50 mentally ill patients) was recruited for the conduction of this study. Socio-demographic/medical data sheet, barriers affecting seeking health care services questionnaire were used for data collection. Findings of this study indicated that, near half of studied sample of patients with mental illness express severe level of difficulties in seeking health care services as compared to more than one third of patients with physical diseases. Meanwhile, more than one third of studied sample of patients with mental illness express moderate level of difficulties in seeking health care services as compared to two thirds of patients with physical diseases. To conclude no statistical difference was found between patients with mental illness and patients with physical disease in relation to barriers affecting seeking health care services. Further studies on a larger number of patients with different diagnoses from different geographical areas are recommended.

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An Examination of the Validity and Reliability of the Turkish Version of the Nurses’ Attitudes toward Obesity and Obese Patients (Natoops) Scale_Crimson Publishers

An Examination of the Validity and Reliability of the Turkish Version of the Nurses’ Attitudes toward Obesity and Obese Patients (Natoops) Scale by Tugba Menekli in COJ Nursing & Healthcare

Abstract Purpose: The aim of this study was to examine the validity and reliability of the Turkish version of the Nurses’ Attitudes toward Obesity and Obese Patients (NATOOPS) Scale, and to provide a scale to be used in this area in Turkey.

Method: Forward-backward translation of the NATOOPS from English to Turkish. The translated instrument administered 360 nurses working in the internal medicine and surgery clinics of a university hospital in Izmir, Turkey. The size of the sample was arranged so as to be ten times the number of items on the scale. A Nurses’ Identification Form and the NATOOP) Scale were used as instruments to collect data.

Result: Construct validity was tested by factor analysis. The Cronbachalpha coefficient the test-retest reliability coefficient and the item-total correlation were calculated. The scale was applied to 30 nurses twice, at the start and after two weeks. The views of 13 experts were sought on content validity, and their scores in the analysis were found to be compatible (KW=0.159, p=0.08). The Cronbachalpha coefficient obtained for the whole scale was 0.92. In the item analysis, the item-total correlation coefficient of items on the scale varied between 0.46 and 0.91, and no item was removed from the scale as a result. When test-retest was applied to test the invariability of the scale over time, a single factor was obtained explaining 74.17% of the total variance of the scale.

Conclusion: The results of the study showed the NATOOPS Scale was an instrument of high validity and reliability for Turkish society.

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cojnursinghealthcarecrimson · 2 months

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Prevalence of Skin Diseases in Rural Kashmir: A community Based Survey_Crismon Publishers

Prevalence of Skin Diseases in Rural Kashmir: A community Based Survey by Mohammad Sarwar Mir in COJ Nursing & Healthcare

Abstract Introduction: Skin diseases are one of the most common health problems. The objectives of this study are to determine the prevalence of skin diseases in a rural community. Methods: A community survey was conducted in a rural locality with 2000 inhabitants, to obtain socio-demographic data and identify individuals with skin diseases. Results: Of 600 individuals attending the health camps, had one or more Skin diseases. The overall prevalence of SDs was 22.5%.The most common SD categories were eczemas, fungal infection, pigment disorders and acne. The prevalence of the diseases was higher in females. The children were the most common group affected. Conclusion: This population-based study shows that Skin diseases are very common in a rural community. Targeted training should enable healthcare workers to prevent, accurately diagnose and manage these problems on site.

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Physical and Psychological Violence against Married Men in District Dir (Lower), Khyber Pukhtoonkhwa, Pakistan_ Crimson Publishers

Physical and Psychological Violence against Married Men in District Dir (Lower), Khyber Pukhtoonkhwa, Pakistan by Tazeen Saeed Ali in COJ Nursing & Healthcare

Introduction The World Health Organization [1] has defined violence as “the intentional use of physical force, threatened or actual, against oneself, another person, or against a group or community, that either results in, or has a high likelihood of resulting in injury, death, psychological harm, mal-development or deprivation’’ [1]. According to the WHO [1] typology of violence, there are mainly three types, such as, self-directed, interpersonal, and collective violence; these types are further divided into subtypes [1]. The current study focused on interpersonal (intimate partner or domestic) violence against married men. The Intimate Partner Violence (IPV) can be defined as the physical, psychological, or sexual harm by current/previous partner or spouse; domestic violence is used interchangeably with IPVs [2].

Violence against women is extensively studied in different parts of the western world and Asian countries; however, very few of the researchers have paid attention towards violence against men [3,4]; Hines et al. [5] it is commonly claimed that men are traditionally viewed as being physically stronger than women, therefore, they under-report their victimization due to barriers like embarrassment and masculine ego [6]. The fact that men are victims of IPV, from their female partners, has been identified for the last thirty years [5]; these victims often face the humiliation of being laughed at, accused, belittled, or ridiculed, due to which they do not report their victimization [6]. Studies have identified equal levels of exposure to intimate partner violence among men and women [7]; the rates and frequencies of violence enacted by women are often similar to that of their men partners [8]. Such symmetry signifies a weak association of gender with perpetration of IPV. However, men’s ego has been developed by the society in such a way that their reporting of violence is generally considered a social stigma. When men attempt to report DV against them, most of the times they are not trusted; instead, they are laughed at and ridiculed for the notion that they are beaten by their wives [9].

It is argued that violence is a human issue rather than a gender problem, and violence by women against men should not be ignored [10]. The Domestic Abuse Help Line for Men (DAHM) established in the United States in 2000 received 246 calls in 22months from male callers, in which 77% men themselves called and reported the violence meted out to them by their intimate partners. The rest of the 33% calls were either for their friends or family members. Physically aggressive behavior was frequently reported by 43.7% of the men. In addition, 41.8% of the men reported to have been pushed, 39.2% were kicked, 31% were grabbed, and 24.7% were reported as being punched by their intimate partners. Likewise, a Scottish study also reported the high prevalence of DV against men. This study included 190 interviews of 95 men and 95 women; it revealed that 50.6% of the men and 47.4% of the women reported experiencing of one to four violent events of IPV against themselves in the previous one year [11].

Similarly, a cross sectional study was conducted in Sweden about intimate partner violence (IPV). The investigators collected data from 173 men and 251 women, and concluded that more men (63.9%) than women (39.4%) reported being physically assaulted by their partners in the past one year [12]. A quantitative study was conducted in the United States to identify the help seeking experiences of men who sustain IPV.

The study sample consisted of 302 men, who reported a high magnitude of violence against them from their female partners. The findings of the study revealed that 100% of the women were reported by their men partners as having perpetrated psychological violence, out of which 98.7%, 90.4%, and 54% of women were reported for minor, severe, and very severe physical violence respectively. Contrary to the western studies, very little work has been done in the Asian countries for the identification of DV against men. Save Family Foundation conducted quantitative study about DV against men, which included a sample of 1650 Indian men? The percentages of violence against men by their female partners were reported as: 32.8% economical, 22.2% emotional, 25.2% physical, and 17.7% sexual violence [9]. The above studies show that worldwide DV against men is more prevalent than one would imagine, and, hence, needs to be explored further; so that effective measures can be taken to curb this social ill (Table 1).

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cojnursinghealthcarecrimson · 2 months

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Case Report: Approach to Tinea incognito_Crsimon Publishers

Case Report: Approach to Tinea incognito by Mehmet Ziya Gençer in COJ Nursing & Healthcare

Introduction Tinea incognito is a disease that gets the look of atipic form of mycotic infection, imitating many different dermatomes formed by misdiagnosing and giving improper topical, systemic steroids or immune suppressive therapy. Tinea incognito or steroid modified tinea is a dermatophytic infection in which topical or systemic steroids, administered as a result of dermatological misdiagnosis or pre existing pathologies, have modified the clinical appearance of the fungal infection, transforming the typical ring worm and mimicking other skin diseases [1,2].

In this case we demonstrate a patient who started topical corticosteroids application with misdiagnosis and after that insisting topical corticosteroids use on her treatment from doctors she see.

Case Forty-two-year-old female consulted to our clinic with severe itch, rash, redness that started at inguinal region and spreaded to belly region. Patients complaints is ongoing for 5months and she first admitted to the pharmacy and given herklobetazolpropiyonat cream for itching. Later while she was out of town prescribed same medicine to a family doctor. Patient stated that given cream reduced itching and after stop using medicine itches increased and worsened. Patient related rise of complaints with “unfinishing “treatment. Patient has requested the re-prescription of the same medicine from our clinic “to be able to continue treatment”. The patient has been informed and convinced to an examination. During examination erythematous papules and squamous plaques with unclear boundaries seen examination in the belly and around the inguinal region. From the anamnesis taken from the patient and clinical look disease thought as tinea incognita. Terbinafine 250mg/day, isoconazole cream (2times a day) and terbinafine spray (2times a day) started on her. In her supervision a week later lesions and complaints were seen reduced and totally disappeared in four weeks.

Conclusion Tinea incognito has been used to describe a dermatophyte infection modified by corticosteroid treatment. Lesions are often a typical appearing and the diagnosis can be delay edormissed [3]. The clinic of tinea incognito is quite typical. As a result of using cortices teroids, immune system suppressed and at the beginning clinical signs depends on dermatophyte infection to become indistinct, rash disappeared but fungal infection gradually spread. Patients forced to use drugs repeatedly, and this becomes avicious cycle. This clinic properties caused by steroids should be kept in mind by the family doctors, also society should made aware of the drawbacks of using unprescripted drugs.

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Patient Safety and the Significance of Human Factors Engineering Modality: A Review _Crimson Publishers

Patient Safety and the Significance of Human Factors Engineering Modality: A Review by Bashkin Osnat in COJ Nursing & Healthcare Journal

Abstract

The issue of patient safety and medical human error has been arousing growing concern around the world. Attempts to reduce the rate of human error present a great challenge, and there is an increased understanding that the issue of patient safety in healthcare systems is a complex one that requires in-depth analysis and understanding. Despite the many programs and interventions designed to reduce the rate of human medical errors, various publications that expose the extent of this phenomenon point to a high percentage of human errors that causes injury, and to the difficulties in improving patient safety. The understanding that the focus must be on prevention and the growing need for practical solutions have led to the involvement of disciplines such as human-factors engineering in an attempt to understand the root causes of safety problems and find ways to prevent them. Human-factors engineering is a proactive approach that may contribute to the planning of safe medical systems by taking into account the diverse needs, capabilities, and limitations of the human beings involved in these systems. This article reviews the benefits and challenges in applying the principles of human-factors engineering to promote patient safety, as well as the implications for policy in the field.

Introduction

In recent decades, the importance of preventing medical errors has become increasingly recognized in healthcare systems around the world. Attempts to reduce the proportion of human medical errors pose a major challenge, and diverse strategies are being developed and applied regularly to improve the quality of health care and medical services. At the same time, it is becoming increasingly clear that the issue of patient safety in healthcare systems is a complex one that requires in-depth analysis and understanding. There is some ambiguity regarding the effectiveness of the various strategies dealing with human medical errors, and about the ability to preserve positive outcomes of interventions over time. The current article reviews the topic of medical human error prevention and specifically the field of knowledge, known as human-factors engineering, which is proving its effectiveness in promoting safety in the medical world in recent years, but is not yet fully integrated into the healthcare system.

Human medical errors in recent decades

Despite the many programs and interventions designed to improve patient safety and reduce the rate of human medical errors committed in many healthcare systems, various publications that expose the extent of this phenomenon do not inspire hope. One of the first and best-known reports to reveal the alarming proportions of human medical error was published by the American Institute of Medicine (IOM) in 1999. This report, entitled “To Err is Human: Building a Safer Health System”, presented an assessment based on wide-ranging studies showing that between 44,000 and 98,000 people die in hospitals every year as a result of preventable medical errors [1].

The publication of the report caused a shake-up in the health system, and there were those who even claimed that these numbers were an underestimation of the real situation. This report led the American administration to realize the importance of the subject, and in the years following its publication, to invest considerable efforts to improve patient safety in the health systems. Some 15 years later, two major studies were published examining the changes in patient safety since the publication of the report. In 2015 the UK Health Fund published the report “Continuous Improvement of Patient Safety: The Case for Change in the NHS.” The report noted the many challenges that accompany the need for continuous improvement of the health system, including the fact that many health systems are not fundamentally designed to maintain patient safety. The report further stated that patient safety is still undergoing improvement through sporadic local initiatives and individual efforts. The report also described the current situation where most of the resources are invested in reporting and developing indices for health systems that help to learn from the past, but do not help predict the future and prevent errors [2].

At the same time, the National Patient Safety Foundation in the United States published a report entitled “Free from Harm: Accelerating Patient Safety Improvement Fifteen Years after ‘To Err Is Human’.” Like the UK Health Fund report, this report also noted difficulties in improving patient safety and described the complexity of the phenomenon. In addition, the US report noted the importance of the necessary transition from a reactive approach to a comprehensive proactive and systemic approach that places emphasis on a culture of safety [3]. A recently published study by Makary & Daniel [4], highlighted that the investigators in their study had reported an average of 251,454 deaths per year as a result of human error in the United States. This number was calculated by using findings of previous reports and extrapolating the findings to the total number of hospitalizations in the United States in 2013. To illustrate, the researchers noted that if human error were defined as a disease, it would be ranked as the third leading cause of death in the United States.

Prevention of medical errors

One of the main way to reduce the rate of medical human error is to place greater emphasis on developing prevention strategies, such as promoting an awareness about “almost adverse event (near miss)” and “potential adverse event” [5]. The awareness may be disseminate among the healthcare professionals and the patients via various health campaign medium and policy paper writing.

According to Bogner [6], “Almost adverse event” is an event without adverse consequences or an event that was stopped in time before leading to adverse consequences for the patient. “Potential adverse event” is a situation where there are failures in the environment, which might remain hidden over time and not cause any error, but under certain circumstances, could lead to an irregular occurrence with adverse consequences for the patient. Focusing on and investigating these types of events means transferring attention and resources from handling medical errors after they occur and cause the damage, to putting the emphasis on preventing the various causes of human medical error and handling safety problems before they occur and cause harm to the patient.

Effective coping with safety failures in medicine requires knowledge and skills in various fields such as cognitive psychology, organizational behavior, work research, ergonomics, and more. The understanding that it is essential to focus on prevention and the growing need for practical solutions to medical safety failures has led to the involvement of disciplines such as human-factors engineering in the attempt to understand the root causes of safety problems and seek ways to prevent them.

Human Factors Engineering in Patient Safety

Human-factors engineering offers a proactive approach to promoting patient safety in the healthcare system and puts the emphasis on prevention. This approach provides theories, research methods, and empirical data-based tools to implement interventions aimed at preventing human medical errors and promoting patient safety. Human-factors engineering is defined by the International Association for Ergonomics (IEA) as: “the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance.” Iea. cc International Ergonomics Association [7].

In this definition, “system” represents the physical, organizational, and cognitive elements with which humans interact [8]. Human-factors engineering may contribute to the safety planning of medical systems by taking into account the range of needs, capabilities, and limitations of the humans involved in these systems [9]. A system may be a technology, medical device, personnel, team, or organization, procedure, policy, or a physical environment, which must be adapted to human capabilities [8].

More than a decade ago, the Medical Institute and the National Academy of Engineering noted that human-factors engineering is an important tool in planning better health systems [8]. Subsequently, in 2009, a comprehensive report was written for the World Health Organization (WHO), which presented key issues where human and organizational factors may affected the patient safety. The report noted the major importance of understanding the broad range of human factors, such as characteristics of management, of individuals, and of staff, which may affect the behavior of medical team in terms of patient safety. In addition, the report included recommendations for the wider adoption of principles of humanfactors engineering to cope with patient safety problems in health systems [10]. The WHO had noted further the importance of human-factors engineering field in patient safety measure. This area shall be included as one of the key academic topics in patient safety programs taught in medical schools [11].

The advantages of applying human-engineering-based methodologies were presented in many studies, from improving work procedures through multi-stage task analysis and identification of potential failures [12] improving communication between medical care provider and patient, and among the medical staff, [13] adapting the physical medical environment to the patient and medical staff [14], improvement of diagnostic and medical decision-making procedures [12,15], to the ergonomic planning and design of medical systems [16] as well as many other subjects.

Challenges in implementing and assimilating humanfactors engineering in health system

Despite the international recommendations for employing human engineering principles to improve patient safety, this approach is actually implemented on a limited scale in health systems, and there is a great gap between the real and the ideal. Interventions and applications of the principles of human-factors engineering are carried out mainly through individual, small-scale local initiatives. There are several major challenges that make it difficult to implement human-factors engineering in health systems.

Most of these challenges are generally common to health systems around the world:

Integrating a culture of safety from a systemic perspective: Human-factors engineering is a systemic approach that does not focus on the search for blame and/or on analyzing cases of medical negligence. Instead, the human-factors engineering approach emphasizes the need to focus on prevention and inculcating a comprehensive culture of safety in the organization. Safety culture means perceptions, which are shared by the health care staff at all level, regarding the importance of various aspects of the work environment such as quality, safety, and service [17]. A culture of safety requires commitment at all level in the organization and an understanding that only a systemic vision - rather than focusing on the individual working in the system - can lead to a wide-ranging improvement in safety. Resistance to change may make it difficult to introduce a safety culture at the overall organizational level. Such resistance is more common in systems where there is greater involvement of the elements related to human behaviour, as in the medical system.

Commitment at the managerial level: As with any change at the organizational level, here, too, responsibility and commitment at the managerial level are necessary. Senior management who is actively engaged in developing a comprehensive patient safety policy, in process management while implementing proactive methodologies such as human-factors engineering, and in promoting interdisciplinary collaboration for comprehensive, in-depth handling of safety issues, will lead to a more active involvement of all medical staff and to a continuous improvement in patient safety. There must be a shift from a reactive policy that deals with human errors after they occur, to a proactive policy that prevents human error before causing serious harm to the patient.

Knowledge of human-factors engineering and its advantages in promoting patient safety: Many studies presented in this article and which appeared in recent years in the literature point to the importance of an in-depth investigation and understanding of human behaviours and human limitations. Understanding the complex characteristics of human errors and of the human factors involved in the medical environment, should be taught as early as in the basic courses of the medical and nursing professions. Specialized teaching programs that investigate human behaviour and its complexity, and discuss the risks and ways of dealing with them to students who, upon completing their studies, will be required to make quick decisions sometimes under conditions of stress and uncertainty [18], can contribute greatly to an advanced and more correct conception of patient safety among medical staff. In addition, workshops and training programs for health care staff at all levels of the organization, where new methodologies and approaches to prevent human error will be studied, can contribute greatly to the continuous incorporation of safety-promoting methods and work processes.

The complexity of the medical system and the difficulty in sustaining improvement in patient safety over time: According to one of the recognized researchers on human error, J. Reason (1990), the medical system is the most complex of all industrial systems [17]. This complexity is reflected in the technologies, procedures, and nature of the work, which is primarily to provide medical care to patients. The outcomes of medical treatment are not always clear and measurable; each patient arrives at the system with different characteristics, and his health and well-being are not always quantifiable. Like many complex systems, the medical system is characterized by workload, competing demands, high risks, time pressure, and very dynamic circumstances. These characteristics make it difficult to consistently implement methodologies to change work processes, procedures, and organizational environment. Due to the very dynamic circumstances, often, even if an intervention based on human engineering principles is successfully implemented, it is difficult to maintain the results of the intervention over time. The complexity of the medical system is unquestionably a major challenge for human-engineering experts [19]. Yet, redesign of medical systems with the diverse elements they contain, based on the principles of human-factors engineering, may contribute to understanding this complexity and help the effort to simplify it.

Implications for Health Policy

As noted, new findings reveal that various medical errors are considered the third most common cause of death in the USA [4]. These and other worrisome findings recently published, highlight the need for a comprehensive policy that must put the emphasis on implementing effective programs to prevent human medical error.

A first step in the healthcare policy requires a change in the priorities of decision makers and policymakers by giving top priority to dealing with human medical errors. Giving top priority would be expressed in actions such as investing resources in prevention rather than in defending error, increasing transparency, holding professional and public discourse on medical human errors, learning from other high-risk systems, and redesigning the medical working environments while taking into account various aspects of safety.

A second step in implementing such a policy requires a shift from investing resources in collecting and analyzing information about failures that have already occurred, together with the information about “near misses” and “potential adverse events”. This kind of shift requires a culture of transparency in the medical environment, encouraging medical teams to report on these events, and maintaining an open discourse as part of their daily work routine. It also requires investment of resources in developing a reporting system that would serve as a database for information related to safety problems, potential risks for human errors, and systemic failures that may lead to human medical errors. A reporting system that would allow medical professionals to report such data without fear from personal repercussions, would enable in-depth study and analysis of various factors, which cause medical human errors, and thus, learning practical lessons to prevent future undesirable events.

Following this, sharing information at the inter-institutional level could also contribute to learning and drawing practical conclusions, thus leading to improved patient safety on a large scale. Another step in changing the policy towards preventing human medical errors concerns the education and training of medical staff regarding patient safety issues. Such a step would include studying the subject of patient safety and prevention of medical human errors, in all its various aspects, in the earliest stages of medical and nursing studies. Likewise, training medical staff working in different medical environments to understand, prevent, and deal with factors that may lead to medical human errors, will lead to an increased awareness of the importance of the issue and increase collaboration in the application of proactive methodologies such as human-factors engineering in these environments. These are the first basic steps in transforming the health system from a defensive system that is not safe for neither the patient nor the caregiver, to a proactive system, whose central goal is maintaining the patient’s health and safety.

Conclusion

The issue of patient safety and medical human error is arousing growing concern around the world. Despite the development and implementation of many intervention programs in health systems, the phenomenon has not significantly decreased in scale. A thorough understanding of the complexity of the subject, a systemic view, and openness to methodologies taken from other fields, can be helpful in promoting patient safety consistently and continuously. The health system is a complex one with characteristics that distinguish it from other complex systems in industry. At the same time, applying principles of human-factors engineering has proven effective in many studies published in the medical literature. Despite the challenges inherent in implementing changes in the health system based on the principles of human-factors engineering, the medical system must promote this development. Cooperation of this kind could lead to a significant change in the treatment and prevention of medical human errors.

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cojnursinghealthcarecrimson · 10 months

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An Independent Review of Several Successful Hospital Incident Command System (HICS) Implementations and Lessons Learned _ Crimson Publishers

An Independent Review of Several Successful Hospital Incident Command System (HICS) Implementations and Lessons Learned by Julie Bulson in COJ Nursing & Healthcare

Abstract

US hospitals are required by Joint Commission to utilize a command structure that is compliant with the National Incident Management System (NIMS). Most utilized is the Hospital Incident Command System (HICS) which guides any disaster response. Further, hospitals are required to NIMS guidelines when responding to events that predicate the implementation of disaster plans or protocols - especially when hospital leaders will interact with local, state or federal authorities. These mandates have grown in depth and breadth since all first responder disciplines began to update their local policies, procedures, and education requirements in the post-9/11 preparedness environment.

This new environment includes ongoing federal grants designed to increase hospital preparedness and capacity, but with the fund are mandates requiring hospitals to educate staff members in NIMS education and its use. As a result, many hospitals have adopted HICS and NIMS as the general frameworks on which they build disaster plans, education sessions, and disaster drills. While federal and state officials continue to track compliance with federal requirements, there seems to be a gap in tracking use and effectiveness of HICS and NIMS in real-life incidents, whether planned or emergent. This article examines the real-life experiences of one 1,000+ bed Michigan hospital system that used HICS and NIMS during responses to a state funeral,a credible bomb threat, and a helicopter crash.

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cojnursinghealthcarecrimson · 2 years

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Work-Related Stress and Coping Profiles among Workers in Outer Garment Sector_ Crimson Publishers

Work-Related Stress and Coping Profiles among Workers in Outer Garment Sector by Ozlem Koseoglu ORNEK* in COJ Nursing & Healthcare_ Nursing Healthcare Open Access Journal

Abstract

Background: Garment sector has crucial working field in world. Work-related stress is common and alarming public health problem at workplace. It causes variety health and behavioural problems

Aim: The objective of this study is to define level of job level, work-related stress’ symptoms, social support and coping mechanisms of garment workers and to determine any related factors.

Method: This study is descriptive and cross-sectional. The study population comprised garment workers in the 16-65 age range. The data was collected by Assessment Form, The Brief Stress Coping Profile and Brief Job Stress Questionnaire.

Result: The study consisted of 719 workers. A clear majority of employees (54%) (388) were in the 25-44 age group and 12.5% (90) were in the 16-18 age group. The level of work-related stress was statistically higher among the workers who had chronic disease, low economic, education status and poor quality of sleep. Psychological and physical physiological reactions to stress were found higher among women workers and those with chronic disease. It also was seen that job stress scores had a meaningful relationship with “emotional expression involving others” (r =.20) and “Avoidance and suppression” coping profile (r =.16; p <.01).Psychological symptom scores were found to have a low level of meaningful relationship with “Seeking help for solution” (r =-.08), “changing point of view” (r=.13) and “emotional expression involving others” coping profiles (r=.21).

Conclusion: Work-related stress causes many health and behavioral problems. Work related reasons and coping profiles have powerful effects on stress.

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cojnursinghealthcarecrimson · 2 years

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Healthy Eating Concern (Orthorexia Nervosa) and Related Factors in Women_ Crimson Publishers

Healthy Eating Concern (Orthorexia Nervosa) and Related Factors in Women by Nilüfer ACAR TEK* in COJ Nursing & Healthcare

Abstract

Objective: This study was conducted in order to evaluate healthy eating obsession-orthorexia nervosa and related factors in women.

Method: The study was carried out 132 volunteer women aged between 20-54 years. Demographic characteristics, health information were taken and orthorexia nervosa-15 (ORTO-15) was applied by researcher with face to face method. Antropometric measurements were taken according to the rules. It was determinated that ORTO-15 score ≤40 is orthorexic and >40 is normal. Data was evaluated using chi-square, analysis of t-test and correlation analysis methods with SPSS16.0 program.

Result: It was found that 75.8% of women has less than 40 points from ORTO-15 test. There is a negative correlation between ORTO-15 score with age (r =-0.183), body weight (r=-0.206) and BMI (r=-0.199) (p<0.05). It was seen that obsessional concerns such as choosing healthy food and this dietary pattern to be associated with physical appearance are common in orthorexic individuals.

Conclusion: It was found that orthorexia tendency of women has higher. It has been observed that orthorexic tendencies are increased in individuals with high body weight and BMI values. Determination of obsessional concerns of orthorexic individuals will be useful in the classification of the disease and development of diagnostic criteria.

Introduction

As the importance of nutrition is emphasized in the prevention and treatment of diseases and improvement of health, awareness of healthy nutrition is increasing in society. In orthorexia nervosa, individuals adopt a nutritional style for purposes such as protecting and improvement of health, treating disease or losing weight. However, this nutrition style affects the life of individuals and also it may trigger nutritional deficiencies that threaten health and even causing eating behaviour disorders [1-3].

Orthorexic individuals usually prefer healthy and pure nutrients and they care the quality of food rather than amount [4,5]. In addition, they also show anxious behaviors about food preparation and cooking techniques and sterilization of cooker. They don’t consume food that is unfamiliar and unreliable [2]. Due to their obsession they often consume pure and additive-free foods, they tend to consume fruit and raw foods [6]. Orthorexic individuals who are struggling with healthy nutrition are often faced with severe weight loss and malnutrition as in other eating disorders [1,4-6]. But these individuals lose weight because of triying consume healthy foods and make their diet perfect mentally and not to look better like anorexia nervosa and bulimia nervosa [7]. However, negative feelings such as regret and wanting to be extremely weak are not observed [3].

Along with the increasing interest in orthorexia nervosa, the number of studies for determining the prevalence orthorexia nervosahas also been steadily increasing. The prevalence of orthorexic tendency varies between 41% and 60% in studies conducted in Europe [1,4,8,9]. Studies conducted in the United States indicated that the prevalence of orthorexia varies between 69% and 82.8% [10,11]. These studies showed that orthorexia tendencies are common. This study was planned and conducted to determine the tendency of orthorexia nervosa in women.

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cojnursinghealthcarecrimson · 2 years

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Cutaneous Polyarteritis Nodosa (cPAN) in ab 5 Years Old Girl_ Crimson Publishers

Cutaneous Polyarteritis Nodosa (cPAN) in ab 5 Years Old Girl by Maria Lubna Nazir* in COJ Nursing & Healthcare_ Nursing Healthcare Open Access Journal

Abstract Polyarteritis nodosa is a rare form of systemic vasculitis. Cutaneous polyarteritis nodosa (cPAN) is subtype of systemic PAN which predominantly affects the skin, extra-cutaneous findings include fever, malaise, myalgias, arthralgias, and neuropathy. The true incidence of cutaneous PAN is unknown. cPAN is recognized as a separate entity and is essentially a benign disorder which should be distinguished from systemic PAN, as the clinical course and management of the two conditions is different. In this case report, we have described a patient with fever and gangrene of both hands and feet. The patient underwent a very extensive workup in order to determine the cause of her condition, which finally turned out cPAN on skin biopsy.

Introduction Classic polyarteritis nodosa was the first systemic vasculitis to have been described. In 1866, Kussmaul and Maier [1] characterized this fatal condition which was originally called ‘‘periarteritis nodosa.’’ It was not until 1931 that Lindberg [2] first recognized PAN limited to skin. Systemic polyarteritis nodosa is rare, the true incidence of cutaneous PAN is unknown [3]. Although cutaneous polyarteritis nodosa (cPAN) predominantly affects the skin, extracutaneous findings include fever, malaise, myalgias, arthralgias, and neuropathy. cPAN is recognized as a separate entity but there are no diagnostic criteria for cPAN [4]. cPAN is essentially a benign disorder and should be distinguished from systemic PAN, as the clinical course and treatment of these two conditions is different from each other. To our knowledge, we report first case of childhood cPAN in Pakistan.

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cojnursinghealthcarecrimson · 2 years

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Failure to Prevent Violence against Women: The Social Costs and Consequences on Women’s Health_ Crimson Publishers

Failure to Prevent Violence against Women: The Social Costs and Consequences on Women’s Health by Maria Lucia Piga* in COJ Nursing & Healthcare_ Nursing Healthcare Open Access Journal

Abstract The World Health Organization identifies among the top ten causes of death, illness and disability for adult women on male aggression driving, while other international bodies regularly draw attention to this issue. So far little has been done by binding, until the approval of the Convention in Istanbul in 2011 (ratified in Italy in 2012, with the Law 119/2013). In particular the welfare systems do not implement measures and strategies where this priority receives integrated responses both social and health care. Furthermore, the complex nature of the problem and the extension in quantitative terms the phenomenon involves the difficulty of developing predictive tools that help to combat this problem by acting proactively. It is argued here that only by focusing on gender category analysis and its possible declinations explanatory you can respond effectively [1].

Introduction

In Italy the experience of the Centers anti-violence to more than twenty-five years since their establishment shows that much has been achieved, albeit with continuing territorial differences, in terms of system, confirming the view that a more holistic view of the problem could lead more extensively preventive practices and increased predictive sensibilities in an attempt to deal with the problem [2]. In addition to antiviolence Centers have been set up at the emergency departments Rose codes, sign of a more mature awareness that land consequences of violence not recognized from the earliest rumblings in the relationship with the partners are a major social cost, with short- and long-term health consequences [3].

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cojnursinghealthcarecrimson · 2 years

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Rapid Anxiety Reduction Tools for Nursing Staff, Faculty and Students_Crimson Publishers

Rapid Anxiety Reduction Tools for Nursing Staff, Faculty and Students by Anne M Devney* in COJ Nursing & Healthcare_ Nursing Healthcare Open Access Journal

Learning Objectives

A. Review use of mindfulness as a stress reduction technique.

B. Review rapid anxiety reduction techniques that faculty members can use.

C. Review those strategies.

In addition to selection of stress reduction techniques, the nurse and nurse educator might consider how use of these elements may help foster improved critical thinking. The National League for Nursing’s Guide for Teaching Thinking calls for exploring context, content and course of going forward. Reflection is a critical component of assessing the relevance of content and how to use the information to go forward. Using mindfulness can provide the nurse, nursing student, and nurse educator with means for enhancing critical thinking.

Mindfulness is defined as awareness of the present moment, being nonjudgmental, simply having a sense of who and where you are. Dr. Jon Kabat-Zinn, University of Massachusetts, developed a Mindfulness-Based Stress Reduction (MBSR) program several years ago. Program elements assist the individual to foster awareness of the present moment and uses techniques such as breathing, meditation, yoga, and a body-scan awareness exercise. Mindfulness increases awareness of one’s 5 senses, noticing landscapes of your mind without holding on or pushing out what one is feeling [1].

Research in use of Mindfulness-Based Stress Reduction is underway studying medical and nursing students with reports of participants feeling less anxiety and more calmness. Practitioners of mindfulness can use autogenic techniques incorporating progressive relaxation with meditation and guided imagery.

Psychological issues in the clinical and academic setting are well known and include stressors that may be too overwhelming, reducing students’ and clinicians’ performance. Physical signs such as tremors, agitation, poor concentration, problem-solving abilities, and lack of attention can result in poor task performance and a lack of confidence. Coping skills may be overwhelmed.

Techniques that can be used range from immediate to short term to longer term time frames. For example, if you have 1 minute, take a nice deep breath and feel the air moving in and out of your chest. Feel your body’s sensations, the air about you, listen to the sound of your breathing. If you have 2 minutes, breathe in to a count of 10, breathe out to a count of 10. Feel your chest rise & fall. As you exhale, feel your muscles relax down to your feet. If you have 3 or more minutes, tighten up your forehead to a count of 3. Relax to a count of 3. Tighten up your shoulders to a count of 3 and relax to a count of 3. Work progressively down the body with muscle groups. Feel those muscles tighten and relax [2].

Of course, the techniques listed above are simply suggestions especially with noted time constraints. Meditation and yoga techniques used over longer periods of time are very useful and have been proven to be very effective. Success of techniques vary with each individual; many people are hesitant to try some mindfulness techniques and feel as though they will not work. However, the time used to focus one’s attention to the present moment can be used to develop awareness of the context of the situation and encourage reflection of the meaning within that context. Such reflection itself may provide that individual with a pause that refreshes the thinking of the moment, possibly reducing anxiety and associated stressors.

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