Search results for: agency effectiveness

Authors: F. Fatoye, C. E. Mbada, T. Gebrye, A. O. Ogunsola, C. Fatoye, O. Oyewole

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Musculoskeletal disorders (MSDs) such as low back pain (LBP), cervical spondylosis (CSPD), sprain, osteoarthritis (OA), and post immobilization stiffness (PIS) have a major impact on individuals, health systems and society in terms of morbidity, long-term disability, and economics. This study estimated the direct and indirect costs of common MSDs in Osun State, Nigeria. A review of medical charts for adult patients attending Physiotherapy Outpatient Clinic at the Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria between 2009 and 2018 was carried out. The occupational class of the patients was determined using the International Labour Classification (ILO). The direct and indirect costs were estimated using a cost-of-illness approach. Physiotherapy related health resource use, and costs of the common MSDs, including consultation fee, total fee charge per session, costs of consumables were estimated. Data were summarised using descriptive statistics mean and standard deviation (SD). Overall, 1582 (Male = 47.5%, Female = 52.5%) patients with MSDs population with a mean age of 47.8 ± 25.7 years participated in this study. The mean (SD) direct costs estimate for LBP, CSPD, PIS, sprain, OA, and other conditions were $18.35 ($17.33), $34.76 ($17.33), $32.13 ($28.37), $35.14 ($44.16), $37.19 ($41.68), and $15.74 ($13.96), respectively. The mean (SD) indirect costs estimate of LBP, CSPD, PIS, sprain, OA, and other MSD conditions were $73.42 ($43.54), $140.57 ($69.31), $128.52 ($113.46), sprain $140.57 ($69.31), $148.77 ($166.71), and $62.98 ($55.84), respectively. Musculoskeletal disorders contribute a substantial economic burden to individuals with the condition and society. The unacceptable economic loss of MSDs should be reduced using appropriate strategies. Further research is required to determine the clinical and cost effectiveness of strategies to improve health outcomes of patients with MSDs. The findings of the present study may assist health policy and decision makers to understand the economic burden of MSDs and facilitate efficient allocation of healthcare resources to alleviate the burden associated with these conditions in Nigeria.

Keywords: economic burden, low back pain, musculoskeletal disorders, real-world

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Authors: Ganeshkumar, Ashika, Valavan, Ramesh, Thangam, Chirayu

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MSCs are found in much higher concentration in the Wharton’s jelly compared to the umbilical cord blood, which is a rich source of hematopoietic stem cells. Umbilical cord tissue is collected at the time of birth; it is processed and stored in liquid nitrogen for future therapeutical purpose. The source of contamination might be either from vaginal tract of mother or from hospital environment or from personal handling during cord tissue sample collection. If the sample were contaminated, decontamination procedure will be done with 70% ethanol (1 minute) in order to avoid sample rejection. Ethanol is effective against a wide range of bacteria, protozoa and fungi and has low toxicity to humans. Among the 1954 samples taken for the study, 24 samples were found to be contaminated with microorganism. The organisms isolated from the positive samples were found to be E. coli, Stenotrophomonas maltophilia, Pseudomonas aueroginosa, Enterococcus fecalis, Acinetobacter bowmani, Staphylococcus epidermidis, Enterobacter cloacae, and Proteus mirabilis. Among these organisms 70% ethanol successfully eliminated E. coli, Enterococcus fecalis, Acinetobacter bowmani, Staphylococcus epidermidis, and Proteus mirabilis. 70% ethanol was unsuccessful in eliminating Stenotrophomonas maltophilia, Pseudomonas aueroginosa, and Enterobacter cloacae. Stenotrophomonas maltophilia and Pseudomonas aueroginosa have the ability to form biofilm that make them resistant to alcohol. Biofilm act as protective layer for bacteria and which protects them from host defense and antibiotic wash. Finally it was found 70% ethanol wash saved 58.3% cord tissue samples from rejection and it is ineffective against 41% of the samples. The contamination rate can be reduced by maintaining proper aseptic techniques during sample collection and processing.

Keywords: umblical cord tissue, decontamination, 70% ethanol effectiveness, contamination

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Authors: Ibrahim Turfanda, Soniya Rai, Karan Vadher

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Objectives— The study aims to compare real-world adherence to and persistence with dulaglutide and liraglutide in patients with type 2 diabetes (T2D) initiating treatment in UAE. Methods— This was a retrospective, non-interventional study (observation period: 01 March 2017–31 August 2019) using the UAE Dubai e-Claims database. Included: adult patients initiating dulaglutide/liraglutide 01 September 2017–31 August 2018 (index period) with: ≥1 claim for T2D in the 6 months before index date (ID); ≥1 claim for dulaglutide/liraglutide during index period; and continuous medical enrolment for ≥6 months before and ≥12 months after ID. Key endpoints, assessed 3/6/12 months after ID: adherence to treatment (proportion of days covered [PDC; PDC ≥80% considered ‘adherent’], per-group mean±standard deviation [SD] PDC); and persistence (number of continuous therapy days from ID until discontinuation [i.e., >45 days gap] or end of observation period). Patients initiating dulaglutide/liraglutide were propensity score matched (1:1) based on baseline characteristics. Between-group comparison of adherence was analysed using the McNemar test (α=0.025). Persistence was analysed using Kaplan–Meier estimates with log-rank tests (α=0.025) for between-group comparisons. This study presents 12-month outcomes. Results— Following propensity score matching, 263 patients were included in each group. Mean±SD PDC for all patients at 12 months was significantly higher in the dulaglutide versus the liraglutide group (dulaglutide=0.48±0.30, liraglutide=0.39±0.28, p=0.0002). The proportion of adherent patients favored dulaglutide (dulaglutide=20.2%, liraglutide=12.9%, p=0.0302), as did the probability of being adherent to treatment (odds ratio [97.5% CI]: 1.70 [0.99, 2.91]; p=0.03). Proportion of persistent patients also favoured dulaglutide (dulaglutide=15.2%, liraglutide=9.1%, p=0.0528), as did the probability of discontinuing treatment 12 months after ID (p=0.027). Conclusions— Based on the UAE Dubai e-Claims database data, dulaglutide initiators exhibited significantly greater adherence in terms of mean PDC versus liraglutide initiators. The proportion of adherent patients and the probability of being adherent favored the dulaglutide group, as did treatment persistence.

Keywords: adherence, dulaglutide, effectiveness, liraglutide, persistence

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Authors: Eleanor K. P. Kwan

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English academic writing, it has been argued, is an acquired language even for English speakers. For research students whose English is not their first language, however, the acquisition process is often more challenging. Instead of hoping that students would acquire the conventions themselves through extensive reading, there is a need for the explicit teaching of linguistic conventions in academic writing, as explicit teaching could help students to be more aware of the different generic conventions in different disciplines in science. This paper presents an interuniversity effort to develop an online academic writing resource for research students in five subdisciplines in engineering, upon the completion of the needs analysis which indicates that students and faculty members are more concerned about students’ ability to organize an extended text than about grammatical accuracy per se. In particular, this paper focuses on the materials developed for thesis writing (also called dissertation writing in some tertiary institutions), as theses form an essential graduation requirement for all research students and this genre is also expected to demonstrate the writer’s competence in research and contributions to the research community. Drawing on Swalesian move analysis of research articles, this online resource includes authentic materials written by students and faculty members from the participating institutes. Highlight will be given to several aspects and challenges of developing this online resource. First, as the online resource aims at moving beyond providing instructions on academic writing, a range of interactive activities need to be designed to engage the users, which is one feature which differentiates this online resource from other equally informative websites on academic writing. Second, it will also include discussion on divergent textual practices in different subdisciplines, which help to illustrate different practices among these subdisciplines. Third, since theses, probably one of the most extended texts a research student will complete, require effective use of signposting devices to facility readers’ understanding, this online resource will also provide both explanation and activities on different components that contribute to text coherence. Finally results from piloting will also be included to shed light on the effectiveness of the materials, which could be useful for future development.

Keywords: academic writing, English for academic purposes, online language learning materials, scientific writing

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Authors: Virginia Chambers, Kamryn York, Mark Marnich

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T.I.M.E. for STEM (Transforming Integrative Maker Education for STEM learning) focuses on improving the quality and effectiveness of STEM education for pre-service teachers through a focus on the integration of maker space pedagogy. This National Science Foundation-funded project primarily focuses on undergraduate pre-service teaching students majoring in elementary education. The study contributes to the knowledge about teaching and learning by developing, implementing, and assessing faculty development, interactive instruction, and STEM lesson plan development. This project offers a valuable opportunity to improve STEM thinking skills by formally integrating STEM concepts throughout the pre-service teacher curriculum using an interdisciplinary approach. T.I.M.E. for STEM utilizes a maker space laboratory at Point Park University in Pittsburgh, PA, USA. However, the project design is such that other institutions of higher education can replicate the program with or without a physical maker space lab as the project’s findings and “maker mindset” are employed. Utilizing qualitative research methodology, the project investigates the following research question: What do pre-service teachers (education students) and faculty members identify as areas of pedagogical growth in STEM learning and teaching in a makerspace environment? This research highlights the impact of makerspace pedagogy on improving STEM education learning outcomes through an interdisciplinary constructivist approach. The project is expected to have a multiplier effect as it impacts STEM disciplinary and higher education faculty, pre-service teachers, and teacher preparation programs at other universities that benefit from what is learned at Point Park University. Ultimately, the future elementary students of the well-prepared pre-service teachers steeped in maker pedagogy and STEM content will have the potential to develop higher-level thinking skills and improve their mathematics and scientific achievement, which are essential for the 21st century STEM workforce.

Keywords: maker education, STEM learning, teacher education, elementary education

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Authors: M. A. Ojo, E. O. Ogbole, A. O. Ojo

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This study analysed improved household solid waste management system in Minna metropolis, Niger state. Multi-staged sampling technique was used to administer 155 questionnaires to respondents, where Minna was divided into two income groups A and B based on the quality of the respondent’s houses. Primary data was collected with the aid of structured questionnaires and analysed using descriptive statistics to obtain results for the socioeconomic characteristics of respondents, types of waste generated and methods of disposing solid waste, the level of awareness and reliability of waste disposal methods as well as the willingness of households to pay for solid waste management in the area. The results revealed that majority of the household heads in the study area were male, 94.20% of the household heads fell between the ages of 21 and 50 and also that 96.80% of them had one form of formal education or the other. The results also revealed that 47.10% and 43.20% of the households generated food wastes and polymers respectively as a major constituent of waste disposed. The results of this study went further to reveal that 81.90% of the household heads were aware of the use of collection cans as a method of waste disposal while only 32.90% of them considered the method highly reliable. Multiple regression was used to determine the factors affecting the willingness of households to pay for waste disposal in the study area. The results showed that 76.10% of the respondents were willing to pay for solid waste management which indicates that households in Minna are concerned and willing to cater for their immediate environment. The multiple regression results revealed that age, income, environmental awareness and household expenditure have a positive and statistically significant relationship with the willingness of households to pay for waste disposal in the area while household size has a negative and statistically significant relationship with households’ willingness to pay. Based on these findings, it was recommended that more waste management services be made readily available to residents of Minna, waste collection service should be privatised to increase their effectiveness through increased competition and also that community participatory approach be used to create more environmental awareness amongst residents.

Keywords: household, solid waste, management, WTP

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Authors: Ebipatei Victoria Tunyan, T. A. Cao, Cheol Young Ock

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Detecting subjectively biased statements is a vital task. This is because this kind of bias, when present in the text or other forms of information dissemination media such as news, social media, scientific texts, and encyclopedias, can weaken trust in the information and stir conflicts amongst consumers. Subjective bias detection is also critical for many Natural Language Processing (NLP) tasks like sentiment analysis, opinion identification, and bias neutralization. Having a system that can adequately detect subjectivity in text will boost research in the above-mentioned areas significantly. It can also come in handy for platforms like Wikipedia, where the use of neutral language is of importance. The goal of this work is to identify the subjectively biased language in text on a sentence level. With machine learning, we can solve complex AI problems, making it a good fit for the problem of subjective bias detection. A key step in this approach is to train a classifier based on BERT (Bidirectional Encoder Representations from Transformers) as upstream model. BERT by itself can be used as a classifier; however, in this study, we use BERT as data preprocessor as well as an embedding generator for a Bi-LSTM (Bidirectional Long Short-Term Memory) network incorporated with attention mechanism. This approach produces a deeper and better classifier. We evaluate the effectiveness of our model using the Wiki Neutrality Corpus (WNC), which was compiled from Wikipedia edits that removed various biased instances from sentences as a benchmark dataset, with which we also compare our model to existing approaches. Experimental analysis indicates an improved performance, as our model achieved state-of-the-art accuracy in detecting subjective bias. This study focuses on the English language, but the model can be fine-tuned to accommodate other languages.

Keywords: subjective bias detection, machine learning, BERT–BiLSTM–Attention, text classification, natural language processing

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Authors: Sherly M. A., Subhankar Karmakar, Terence Chan, Christian Rau

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Floods are one of the most frequent natural disasters, causing widespread devastation, economic damage and threat to human lives. Hydrologic impacts of climate change and intensification of urbanization are two root causes of increased flood occurrences, and recent research trends are oriented towards understanding these aspects. Due to rapid urbanization, population of cities across the world has increased exponentially leading to improperly planned developments. Climate change due to natural and anthropogenic activities on our environment has resulted in spatiotemporal changes in rainfall patterns. The combined effect of both aggravates the vulnerability of urban populations to floods. In this context, an efficient and effective flood risk management with its core component as flood risk mapping is essential in prevention and mitigation of flood disasters. Urban flood risk mapping involves zoning of an urban region based on its flood risk, which depicts the spatiotemporal pattern of frequency and severity of hazards, exposure to hazards, and degree of vulnerability of the population in terms of socio-economic, environmental and infrastructural aspects. Although vulnerability is a key component of risk, its assessment and mapping is often less advanced than hazard mapping and quantification. A synergic effort from technical experts and social scientists is vital for the effectiveness of flood risk management programs. Despite an increasing volume of quality research conducted on urban flood risk, a comprehensive multidisciplinary approach towards flood risk mapping still remains neglected due to which many of the input parameters and definitions of flood risk concepts are imprecise. Thus, the objectives of this review are to introduce and precisely define the relevant input parameters, concepts and terms in urban flood risk mapping, along with its methodology, current status and limitations. The review also aims at providing thought-provoking insights to potential future researchers and flood management professionals.

Keywords: flood risk, flood hazard, flood vulnerability, flood modeling, urban flooding, urban flood risk mapping

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Authors: Kalayanee Senasu

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This research investigates the influences of different factors on the happiness of Thai people, including both general factors and sustainable ones. Additionally, this study also monitors Thai people’s happiness via Thai Happiness Index developed in 2017. Besides reflecting happiness level of Thai people, this index also identifies related important issues. The data were collected by both secondary related data and primary survey data collected by interviewed questionnaires. The research data were from stratified multi-stage sampling in region, province, district, and enumeration area, and simple random sampling in each enumeration area. The research data cover 20 provinces, including Bangkok and 4-5 provinces in each region of the North, Northeastern, Central, and South. There were 4,960 usable respondents who were at least 15 years old. Statistical analyses included both descriptive and inferential statistics, including hierarchical regression and one-way ANOVA. The Alkire and Foster method was adopted to develop and calculate the Thai happiness index. The results reveal that the quality of household economy plays the most important role in predicting happiness. The results also indicate that quality of family, quality of health, and effectiveness of public administration in the provincial level have positive effects on happiness at about similar levels. For the socio-economic factors, the results reveal that age, education level, and household revenue have significant effects on happiness. For computing Thai happiness index (THaI), the result reveals the 2018 THaI value is 0.556. When people are divided into four groups depending upon their degree of happiness, it is found that a total of 21.1% of population are happy, with 6.0% called deeply happy and 15.1% called extensively happy. A total of 78.9% of population are not-yet-happy, with 31.8% called narrowly happy, and 47.1% called unhappy. A group of happy population reflects the happiness index THaI valued of 0.789, which is much higher than the THaI valued of 0.494 of the not-yet-happy population. Overall Thai people have higher happiness compared to 2017 when the happiness index was 0.506.

Keywords: happiness, quality of life, sustainability, Thai Happiness Index

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Authors: Batool Ismaeel, Umair Farooq, Saad Mushtaq

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Construction projects in the oil industry can be very complex, having unknown outcomes and uncertainties that cannot be easily predicted. Each project has its unique risks generated by a number of factors which, if not controlled, will impact the successful completion of the project mainly in terms of schedule, cost, quality, and safety. This paper highlights the historic risks associated with projects in the south and east region of Kuwait Oil Company (KOC) collated from the company’s lessons learned database. Starting from Contract Award through to handover of the project to the Asset owner, the gaps in project execution in terms of managing risk will be brought to discussion and where a well-defined systematic approach in project risk management reflecting many claims, change of scope, exceeding budget, delays in engineering phase as well as in the procurement and fabrication of long lead items should be adopted. This study focuses on a proposed feasible approach in risk management for engineering, procurement and construction (EPC) level projects including the various stakeholders involved in executing the works from International to local contractors and vendors in KOC. The proposed approach covers the areas categorized into organizational, design, procurement, construction, pre-commissioning, commissioning and project management in which the risks are identified and require management and mitigation. With the effective deployment and implementation of the proposed risk management system and the consideration of it as a vital key in achieving the project’s target, the outcomes will be more predictable in the future, and the risk triggers will be managed and controlled. The correct resources can be allocated on a timely basis for the company for avoiding any unpredictable outcomes during the execution of the project. It is recommended in this paper to apply this risk management approach as an integral part of project management and investigate further in the future, the effectiveness of this proposed system for newly awarded projects and compare the same with those projects of similar budget/complexity that have not applied this approach to risk management.

Keywords: construction, project completion, risk management, uncertainties

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Authors: Akhigbe Mark, Abang Roger, Mwoltu Nanaribet, Edet Blessing

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Introduction.: The introduction of pre- exposure prophylaxis (PrEP) as a biomedical prevention method for HIV/AIDS has been around for more than a decade since the first confirmed evidence of its effectiveness when used daily as an oral pill. It is now a very valuable addition for people who are at higher risk of contracting HIV. Although globalacceptanceof PrEP hasincreased, PrEP is still highly concentrated in a small number of countries and within a small sub-population, with Kenya and South Africa accounting for only 19% of people who have received PrEP in Africa region, there is still a significant regionGap in PrEP availability and use, with only 28% of the target of 3 million in low-and middle countries currently using PrEP. Description: The purpose of this study is to find out if serum creatinine could be used as an incentive to improve PrEP uptake among Key population.Numerous approaches to increasing the uptake ofPrEP as a prevention mechanism for HIV in KPs has beenemployed, and one of them is serum creatinine. This approach is a biomarker of renal function, which was used in study as an incentive to increase PrEP uptake among key population groups (female sex workers, men who have sex with men, persons who inject drugs, transgender) in 3 states from South-South Nigeria. Whole blood samples are collected from clients, analysis of the samples is done using the clinical chemistry analyzer before they are initiated onto PrEP. Lessons learned and Recommendations: Secondary data was extracted from 3 states of HALG Implementing facilities in Southern part of Nigeria, PrEP uptake before and afterthe introduction of serum creatinine between March 2020 and August 2020 among key populationsin Nigeria. A total of 5664 patients were initiated on PrEP before, and after the introduction of serum creatinine, the PrEP uptake rate before (March 2020 to May 2020) introduction of serum creatinine accounted for only 5% of the total onset, and after (June 2020 to August 2020) introduction of serum creatinine, the uptake rate accounted for 95% of the total onset. These finding shows that increased uptake of PrEP before/after serum creatineindicates that serum creatine may be an effective stimulus for promoting PrEP in key populations.

Keywords: serum creatinine, incentives, PrEP, key populations, Nigeria

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Authors: Zarish Jawad, Nikita Chugh, Karina Dadar

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Introduction: This paper aims to identify barriers indigenous women face in accessing prenatal care in Canada. It explores the differences in prenatal care received between indigenous and non-indigenous women. The objective is to look at changes or programs in Canada's healthcare system to reduce barriers to accessing safe prenatal care for indigenous women. Methods: A literature search of 12 papers was conducted using the following databases: PubMed, Medline, OVID, Google Scholar, and ScienceDirect. The studies included were written in English only, including indigenous females between the age of 19-35, and review articles were excluded. Participants in the studies examined did not have any severe underlying medical conditions for the duration of the study, and study designs included in the review are prospective cohort, cross-sectional, case report, and case-control studies. Results: Among all the barriers Indigenous women face in accessing prenatal care, the three most significant barriers Indigenous women face include a lack of culturally safe prenatal care, lack of services in the Indigenous community, proximity of prenatal facilities to Indigenous communities and costs of transportation. Discussion: The study found three significant barriers indigenous women face in accessing prenatal care in Canada; the geographical distribution of healthcare facilities, distrust between patients and healthcare professionals, and cultural sensitivity. Some of the suggested solutions include building more birthing and prenatal care facilities in rural areas for indigenous women, educating healthcare professionals on culturally sensitive healthcare, and involving indigenous people in the decision-making process to reduce distrust and power imbalances. Conclusion: The involvement of indigenous women and community leaders is important in making decisions regarding the implementation of effective healthcare and prenatal programs for indigenous women. However, further research is required to understand the effectiveness of the solutions and the barriers that make prenatal care less accessible for indigenous women in Canada.

Keywords: indigenous, maternal health, prenatal care, barriers

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Authors: Hamidreza Mansouri

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In the construction industry, the lifespan of a metal structure is directly related to the quality of welding. In most metal structures, the welded area is considered critical and is one of the most important factors in design. To date, many fracture incidents caused by these types of cracks have occurred. Various methods exist to increase the lifespan of welds to prevent failure in the welded area. Among these methods, the application of ultrasonic peening, in addition to the stress relief process, can manually and more precisely adjust the geometry of the weld toe and prevent stress concentration in this part. This research examined Gas Tungsten Arc Welding (GTAW) on common structural steels and 316 stainless steel, which require precise welding, to predict the optimal condition. The GTAW method was used to create residual stress; two samples underwent ultrasonic stress relief, and for comparison, two samples underwent thermal stress relief. Also, no treatment was considered for two samples. The residual stress of all six pieces was measured by X-Ray Diffraction (XRD) method. Then, the two ultrasonically stress-relieved samples and two untreated samples were exposed to a corrosive environment to initiate cracking and determine the effectiveness of the ultrasonic stress relief method. Thus, the residual stress caused by GTAW in the samples decreased by 3.42% with thermal treatment and by 7.69% with ultrasonic peening. Furthermore, the results show that the untreated sample developed cracks after 740 hours, while the ultrasonically stress-relieved piece showed no cracks. Given the high costs of welding and post-welding zone modification processes, finding an economical, effective, and comprehensive method that has the least limitations alongside a broad spectrum of usage is of great importance. Therefore, the impact of various ultrasonic peening stress relief parameters and the selection of the best stress relief parameter to achieve the longest lifespan for the weld area is highly significant.

Keywords: GTAW welding, stress corrosion cracking(SCC), thermal method, ultrasonic peening.

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Authors: Shem Ikoojo Ayegba, Ye Qi

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Public-private partnerships (PPPs) can potentially be a transformative mechanism for advancing affordable housing in Nigeria., considering the current housing deficit between 17 – 24 million. Nevertheless, their effectiveness is marred by persistent unethical practices such as corruption and the utilization of subpar materials. Through a comprehensive mixed-methods approach, this study delves into the ethical quandaries within Nigerian housing construction and their cascading effects on the success of PPPs. Semi-structured interviews encompassing seasoned construction professionals and an in-depth content analysis of ongoing housing policies and projects in Nigeria reveal a culture of corruption across the value chain. This malaise is exacerbated by glaring deficiencies in oversight and a lack of transparent practices. A robust statistical survey involving diverse professionals, including engineers, architects, and project managers, echoes these findings, emphasizing that a frail institutional framework facilitates the persistence of substandard material use, professional negligence, and rampant bribery. Such compromised construction standards place residents in potential jeopardy and impede the achievement of broader sustainability objectives. This study propounds a suite of policy interventions to pave the way for thriving affordable housing PPPs: initiating transparent bidding processes, establishing non-negotiable quality benchmarks for construction materials, and incorporating independent third-party audits throughout the building phase. Furthermore, cultivating a culture of professional integrity through targeted ethics training for all construction personnel is imperative. This research furnishes pragmatic strategies that can radically enhance the potency of housing PPPs, thereby ensuring safe, durable, and affordable housing solutions for Nigeria's underserved populace.

Keywords: public-private partnerships, affordable housing, unethical practicies, housing policies, construction ethics

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Authors: L. Sun, T. Hargreaves, Z. Ahmad

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Newly-qualified Foundation Year 1 doctors in the United Kingdom are frequently expected to perform practical skills involving the upper limb in clinical practice (for example, venipuncture, cannulation, and blood gas sampling). However, a move towards systems-based undergraduate medical education in the United Kingdom often precludes or limits dedicated time to anatomy teaching with cadavers or prosections, favouring only applied anatomy in the context of pathology. The authors hypothesised that detailed anatomical knowledge may consequently be adversely affected, particularly with respect to long-term retention. A simple picture quiz and accompanying questionnaire testing the identification of 7 upper limb surface landmarks was distributed to a total of 98 final year medical students from two universities - one with a systems-based curriculum, and one with a dedicated longitudinal dissection-based anatomy module in the first year of study. Students with access to dissection and prosection-based anatomy teaching performed more strongly, with a significantly higher rate of correct identification of all but one of the landmarks. Furthermore, it was notable that none of the students who had previously undertaken a systems-based course scored full marks, compared with 20% of those who had participated in the more dedicated anatomy course. This data suggests that a traditional, dissection-based approach to undergraduate anatomy teaching is superior to modern system-based curricula, in terms of aiding long-term retention of anatomical knowledge pertinent to newly-qualified doctors. The authors express concern that this deficit in proficiency could be detrimental to patient care in clinical practice, and propose that, where dissection-led anatomy teaching is not available, further anatomy revision modules are implemented throughout undergraduate education to aid knowledge retention and support clinical excellence.

Keywords: dissection, education, surface anatomy, upper limb

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Authors: Laïd Boukraâ

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Complementary and Alternative Medicine is an inclusive term that describes treatments, therapies, and modalities that are not accepted as components of mainstream education or practice, but that are performed on patients by some practitioners. While these treatments and therapies often form part of post-graduate education, study and writing, they are generally viewed as alternatives or complementary to more universally accepted treatments. Ancient civilizations used bee products and medicinal plants, but modern civilization and ‘education’ have seriously lessened our natural instinctive ability and capability. Despite the fact that the modern Western establishment appears to like to relegate apitherapy and aromatherapy to the status of 'folklore' or 'old wives' tales', they contain a vast spread of pharmacologically-active ingredients and each one has its own unique combination and properties. They are classified in modern herbal medicine according to their spheres of action. Bee products and medicinal plants are well-known natural product for their healing properties and their increasing popularity recently as they are widely used in wound healing. Honey not only has antibacterial properties which can help as an antibacterial agent but also has chemical properties which may further help in the wound healing process. A formulation with honey as its main component was produced into a honey gel. This new formulation has enhanced texture and is more user friendly for usage as well. This new formulation would be better than other formulas as it is hundred percent consisting of natural products and has been made into a better formulation. In vitro assay, animal model study and clinical trials have shown the effectiveness of LEADERMAX for the treatment of diabetic foot, burns, leg ulcer and bed sores. This one hundred percent natural product could be the best alternative to conventional products for wound and burn management. The advantages of the formulation are: 100% natural, affordable, easy to use, strong power of absorption, dry surface on the wound making a film, will not stick to the wound bed; helps relieve wound pain, inflammation, edema and bruising while improving comfort.

Keywords: bed sore bee products, burns, diabetic foot, medicinal plants, leg ulcer, wounds

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Authors: Mohd Imtiaz S, Saurabh Jain, Pothiraj K.

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In today’s highly competitive passenger vehicle market, comfortable driving experience is one of the key parameters significantly weighed by the customer. Smooth ride and handling of the vehicle with exceptionally reliable wheel end solution is a paramount requirement in passenger Sports Utility Vehicle (SUV) vehicles subjected to challenging terrains and loads with rigid rear drive axle configuration. Traditional wheel-end bearing systems in passenger segment rigid rear drive axle utilizes the semi-floating layout, which imparts vertical bending loads and torsion to the axle shafts. The wheel-end bearing is usually a Single or Double Row Deep-Groove Ball Bearing (DRDGBB) or Double Row Angular Contact Ball Bearing (DRACBB). This solution is cost effective and simple in architecture. However, it lacks effectiveness against the heavy loads subjected to a SUV vehicle, especially the axial trust at high-speed cornering. This paper describes the solution of Double Row Taper Roller Bearing (DRTRB) wheel-end for a SUV vehicle in the rigid rear drive axle and improvement in terms of maximizing its load carrying capacity along with better reliability in terms of axial thrust in high-speed cornering. It describes the advantage of geometry of DRTRB over DRDGBB and DRACBB highlighting contact and load flow. The paper also highlights the vehicle level considerations affecting the B10 life of the bearing system for better selection of the DRTRB wheel-ends systems. This paper also describes real time vehicle level results along with theoretical improvements.

Keywords: axial thrust, b10 life, deep-groove ball bearing, taper roller bearing, semi-floating layout.

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Authors: Mansoureh Karimollahi, Mehriar Adrmohammadi, Mohsen Mohammadi

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Introduction: Patient satisfaction with nursing care is considered as an important indicator of the quality and effectiveness of the health care system, and improving the quality of care is not possible without paying attention to the opinions and expectations of patients. Considering that the scales for assessing satisfaction with nursing care in our country are not comprehensive and measure very few areas, therefore, in this study, psychometrically, the Persian version of the Newcastle Nursing Care Satisfaction Scale was used in patients hospitalized in the wards. Internal medicine and general surgery were discussed. Methods: This cross-sectional study was conducted on 200 patients admitted to the surgery and internal departments of hospitals affiliated to Ardabil University of Medical Sciences. The Newcastle nursing care satisfaction scale was used for the first time in Iran in comparison with the good nursing care scale from the patients' point of view to evaluate the criterion validity. The Newcastle nursing care satisfaction scale was used after translation, validity, and reliability. Results: The level of satisfaction of patients and the experience of patients with nursing care was at a favorable level, respectively, with an average of 111.8 ± 14.2 and 69.07 ± 14.8. Total CVI was estimated at 0.96 for the experience section, 0.95 for the satisfaction section, and 0.96 for the whole scale. The index (CVR) was also 0.95 for the experience section, 0.95 for the satisfaction section, and 0.95 for the whole scale. Criterion validity was also estimated using 0.725 correlation. The validity of the construct was also confirmed using the goodness of fit index (X2=1932/05, p=0.013, KMO=0.913). Convergent validity was estimated at 0.99 in the experience subscale and 0.98 in the satisfaction subscale. . The overall reliability in the experience subscale and satisfaction subscale was 94%, 92%, and 98%, respectively, which indicated the acceptable reliability of the questionnaire. Conclusion: The Persian version of the Newcastle nursing care satisfaction scale as a comprehensive tool that can be easily completed by patients and is easy to interpret, has good validity and reliability and can be used in patient care centers, in departments Surgery, and internal medicine are recommended.

Keywords: psychometrics, Newcastle nursing care satisfaction scale, nursing care satisfaction, general surgery department

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Authors: Chitra Rajagopal, Indra Deo Kumar, Ila Chauhan, Ruchi Joshi, Binoy Bhargavan

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Reliability and safety are essential for the success of mission-critical and safety-critical defense systems. Humans are part of the entire life cycle of defense systems development and deployment. The majority of industrial accidents or disasters are attributed to human errors. Therefore, considerations of human performance and human reliability are critical in all complex systems, including defense systems. Defense systems are operating from the ground, naval and aerial platforms in diverse conditions impose unique physical and psychological challenges to the human operators. Some of the safety and mission-critical defense systems with human-machine interactions are fighter planes, submarines, warships, combat vehicles, aerial and naval platforms based missiles, etc. Human roles and responsibilities are also going through a transition due to the infusion of artificial intelligence and cyber technologies. Human operators, not accustomed to such challenges, are more likely to commit errors, which may lead to accidents or loss events. In such a scenario, it is imperative to understand the human factors in defense systems for better systems performance, safety, and cost-effectiveness. A case study using Task Analysis (TA) based methodology for assessment and reduction of human errors in the Air and Missile Defense System in the context of emerging technologies were presented. Action-oriented task analysis techniques such as Hierarchical Task Analysis (HTA) and Operator Action Event Tree (OAET) along with Critical Action and Decision Event Tree (CADET) for cognitive task analysis was used. Human factors assessment based on the task analysis helps in realizing safe and reliable defense systems. These techniques helped in the identification of human errors during different phases of Air and Missile Defence operations, leading to meet the requirement of a safe, reliable and cost-effective mission.

Keywords: defence systems, reliability, risk, safety

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Authors: Mohammed Shaath

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Aims Technological advancements in teaching and learning have made significant improvements over the past decade and have been incorporated in institutions to aid the learner’s experience. This review aims to assess whether Technology Enhanced Learning (TEL) pedagogy is more effective at improving students’ attitude and knowledge retention in orthodontic training than traditional methods. Methodology The searches comprised Systematic Reviews (SRs) related to the comparison of TEL and traditional teaching methods from the following databases: PubMed, SCOPUS, Medline, and Embase. One researcher performed the screening, data extraction, and analysis and assessed the risk of bias and quality using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2). Kirkpatrick’s 4-level evaluation model was used to evaluate the educational values. Results A sum of 34 SRs was identified after the removal of duplications and irrelevant SRs; 4 fit the inclusion criteria. On Level 1, students showed positivity to TEL methods, although acknowledging that the harder the platforms to use, the less favourable. Nonetheless, the students still showed high levels of acceptability. Level 2 showed there is no significant overall advantage of increased knowledge when it comes to TEL methods. One SR showed that certain aspects of study within orthodontics deliver a statistical improvement with TEL. Level 3 was the least reported on. Results showed that if left without time restrictions, TEL methods may be advantageous. Level 4 shows that both methods are equally as effective, but TEL has the potential to overtake traditional methods in the future as a form of active, student-centered approach. Conclusion TEL has a high level of acceptability and potential to improve learning in orthodontics. Current reviews have potential to be improved, but the biggest aspect that needs to be addressed is the primary study, which shows a lower level of evidence and heterogeneity in their results. As it stands, the replacement of traditional methods with TEL cannot be fully supported in an evidence-based manner. The potential of TEL methods has been recognized and is already starting to show some evidence of the ability to be more effective in some aspects of learning to cater for a more technology savvy generation.

Keywords: TEL, orthodontic, teaching, traditional

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Authors: Hi̇lal Surat

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People who want to get rid of stress and intensive working tempo for a while head for recreation operations in order to get rest and have fun. Therefore, planning recreation operation makes contributions to social, physiological, economic and psychological development of an individual and the community in a way that the needs of people meet regularly and constantly. The rapid increase of world population rate makes necessary of benefit from natural or man-made resources in a multiple way. Dams and reservoirs which are built near urban area with the aim of electrical energy conversion and agricultural irrigation are considered as natural area providing various opportunities such as recreation operations. Dams have a great importance regarding to protection and improvement of water resources and coming into service of community. There should be a priority to protect these water resources, which are essential for nature and living organisms. It should be taken into consideration that these water resources are the most important input in the area and have high nature value to make sustainability of recreation effectiveness. The Deriner reservoir that has been built yet near the province of Artvin with natural and cultural properties is considered as an alternative option for meeting the needs of people for sportive and recreation activities and as a potential for planning of water-based recreation activities. Hence, in this study, activities that meet the expectations of people who get benefit from the area considering to natural, cultural and sportive recreation opportunities will be developed. In the first place, planning criteria for some sportive and water-based recreation operations will be defined in order to use the area for recreation and sportive activities and these criteria will be a base for a macro planning work within the holistic perspective of natural, cultural, and economical structure of the area. After this time, necessities of local people and evaluation of reservoir recreational potential will be determined, end then different socio-economic groups according to their in-come, age groups will be chosen and the questionnaire which has already prepared will be done these groups, as a result of these questionnaire recreational activities in water necessities will determine and we are going to develop different suggestion for this reservoir.

Keywords: dam, dam lakes, Deriner, recreation, water based activities

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Authors: María García-García, Esther Simancas-González, Said Balhadj, Carmen Silva-Robles, Driss Ferhane

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Cooperation between the territories on both sides of the Strait of Gibraltar is an urgent reality. the south of Spain and northern Morocco share a common historical past and belong to a very similar geographical and ecological area. Economic, social and cultural relations make cooperation between the two countries’ (Spain and Morocco) a priority for the EU and both countries governments. Likewise, deepened changes happened in production systems and consumption patterns had seriously damaged and weakened the craftwork sector. The promotion of local crafts, and its economic value, and the cooperation with the north of Morocco has been an important issue for the Andalusian government in recent years. The main aim of this work is to understand the strengths and weaknesses of the Tangier - Tetuan region craftworks sector in order to develop accurate communication and promotion plans. From the knowledge of the real identity, the sector could be repositioned. Promotion and communication could be a spur to traditional sectors, such as crafts. Competitiveness requires "the culture of communication, the cooperation between different companies to build powerful territory brands and maintain the establishment confidence and effectiveness relationships among agencies and organizations". The lack of previous literature addressing how Tangier craftwork promote and communicate its value to their stakeholders, has conducted the study to an exploratory approach with a double dimension: internal, Tangier craftwork sector image, and external, Andalusia image of the sector in Tangier. Different interviews were conducted with Andalusian partners involved in the artisanal sector (9 master craftsmen and 3 institutions) and focus groups with 9 Tangiers craftsmen were developed. The result of these interviews and expert groups are reflected in a SWOT analysis which reveals a handcraft industry with a worrying wide-spread and undifferentiated identity and reluctance to innovation and new technologies.

Keywords: communication management, image, Moroccan crafts, Spain-Morocco cooperation

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Authors: Taha Benarbia

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The advent of automated and connected vehicles has revolutionized the transportation industry, presenting new opportunities for enhancing the efficiency, safety, and sustainability of our transportation networks. This paper explores the integration of automated and connected vehicles into a smart transportation framework, leveraging the power of deep learning techniques to optimize the overall network performance. The first aspect addressed in this paper is the deployment of automated vehicles (AVs) within the transportation system. AVs offer numerous advantages, such as reduced congestion, improved fuel efficiency, and increased safety through advanced sensing and decisionmaking capabilities. The paper delves into the technical aspects of AVs, including their perception, planning, and control systems, highlighting the role of deep learning algorithms in enabling intelligent and reliable AV operations. Furthermore, the paper investigates the potential of connected vehicles (CVs) in creating a seamless communication network between vehicles, infrastructure, and traffic management systems. By harnessing real-time data exchange, CVs enable proactive traffic management, adaptive signal control, and effective route planning. Deep learning techniques play a pivotal role in extracting meaningful insights from the vast amount of data generated by CVs, empowering transportation authorities to make informed decisions for optimizing network performance. The integration of deep learning with automated and connected vehicles paves the way for advanced transportation network optimization. Deep learning algorithms can analyze complex transportation data, including traffic patterns, demand forecasting, and dynamic congestion scenarios, to optimize routing, reduce travel times, and enhance overall system efficiency. The paper presents case studies and simulations demonstrating the effectiveness of deep learning-based approaches in achieving significant improvements in network performance metrics

Keywords: automated vehicles, connected vehicles, deep learning, smart transportation network

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Authors: Ravi Kant, Banshi D. Gupta

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The unbridled application of insecticides to enhance agricultural yield has become a matter of grave concern to both the environment and the human health and, thus pose a potential threat to sustainable development. Fenitrothion is an extensively used organophosphate insecticide whose residues are reported to be extremely toxic for birds, humans and aquatic life. A sensitive, swift and accurate detection protocol for fenitrothion is, thus, highly demanded. In this work, we report an SPR based fiber optic sensor for the detection of fenitrothion, where a nanocomposite arrangement of Ta2O5 and reduced graphene oxide (rGO) (Ta₂O₅: rGO) decorated on silver coated unclad core region of an optical fiber forms the sensing channel. A nanocomposite arrangement synergistically integrates the properties of involved components and consequently furnishes a conducive framework for sensing applications. The modification of the dielectric function of the sensing layer on exposure to fenitrothion solutions of diverse concentration forms the sensing mechanism. This modification is reflected in terms of the shift in resonance wavelength. Experimental variables such as the concentration of rGO in the nanocomposite configuration, dip time of silver coated fiber optic probe for deposition of sensing layer and influence of pH on the performance of the sensor have been optimized to extract the best performance of the sensor. SPR studies on the optimized sensing probe reveal the high sensitivity, wide operating range and good reproducibility of the fabricated sensor, which unveil the promising utility of Ta₂O₅: rGO nanocomposite framework for developing an efficient detection methodology for fenitrothion. FOSPR approach in cooperation with nanomaterials projects the present work as a beneficial approach for fenitrothion detection by imparting numerous useful advantages such as sensitivity, selectivity, compactness and cost-effectiveness.

Keywords: surface plasmon resonance, optical fiber, sensor, fenitrothion

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Authors: Victor N. Anisimov, Igor E. Serov, Ksenia M. Kolkova, Natalia V. Galkina

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The problem of memorability of the advertising content is closely connected with the key issues of neuromarketing. The memorability of the advertising content contributes to the marketing effectiveness of the promoted product. Significant directions of studying the phenomenon of memorability are the memorability of the brand (detected through the memorability of the logo) and the memorability of the product offer (detected through the memorization of dynamic audiovisual advertising content - commercial). The aim of this work is to reveal the predictors of memorization of static and dynamic audiovisual stimuli (logos and commercials). An important direction of the research was revealing differences in psychophysiological correlates of memorability between static and dynamic audiovisual stimuli. We assumed that static and dynamic images are perceived in different ways and may have a difference in the memorization process. Objective methods of recording psychophysiological parameters while watching static and dynamic audiovisual materials are well suited to achieve the aim. The electroencephalography (EEG) method was performed with the aim of identifying correlates of the memorability of various stimuli in the electrical activity of the cerebral cortex. All stimuli (in the groups of statics and dynamics separately) were divided into 2 groups – remembered and not remembered based on the results of the questioning method. The questionnaires were filled out by survey participants after viewing the stimuli not immediately, but after a time interval (for detecting stimuli recorded through long-term memorization). Using statistical method, we developed the classifier (statistical model) that predicts which group (remembered or not remembered) stimuli gets, based on psychophysiological perception. The result of the statistical model was compared with the results of the questionnaire. Conclusions: Predictors of the memorability of static and dynamic stimuli have been identified, which allows prediction of which stimuli will have a higher probability of remembering. Further developments of this study will be the creation of stimulus memory model with the possibility of recognizing the stimulus as previously seen or new. Thus, in the process of remembering the stimulus, it is planned to take into account the stimulus recognition factor, which is one of the most important tasks for neuromarketing.

Keywords: memory, commercials, neuromarketing, EEG, branding

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Authors: Lok Yi Joyce Poon

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China's mobile payment market has boomed in the past few years. WeChat (Chinese name as Weixin) owned by Tencent is known as the fastest growing all-in-one social messaging platforms. The company has launched the WeChat Pay in 2013, in which users can link their credit card to their user account and make payments within the app’s built in digital wallet. WeChat Payment is a one-stop payment tool that can provide a seamless online experience for the shoppers to transfer money between WeChat users (peer-to-peer) and make payments online by scanning a QR code, a prominent facilitator for transactions in WeChat, to complete the payment with the app without directing the users to the external websites. The aims of this study are to examine the effectiveness of WeChat mobile payment in China as well as the impacts of the China teen’s online purchasing behavior since the establishment of WeChat Payment. The research method of this study is conducted by both online survey on Sojump, a popular online survey platform in China. A total of 120 respondents among 18 to 25 teens in China completed the survey. Data sources included participants’ response to an end-of-session questionnaire, encompassing with the types of multiple choice, open-ended questions. To have an in-depth analysis, a face-to-face interview with a Chinese teen who is a frequent user of the WeChat Pay. The main finding of the study shows that the majority of the teenagers frequently use the WeChat payment tool because of its convenience, user-friendliness and the scenarios offered within the WeChat Wallet. The respondents claimed that they will settle the bills in their daily lives via WeChat Pay. However, the respondents in the age group of 40 or above will not use the WeChat Pay due to the security concern and they do not see the app as a platform for commercial activities like online shopping. Throughout the study, it is recommended WeChat should put more efforts on the security issue and improve the payment technology by adopting the near-field communication terminals instead of requiring users to scan QR codes before they complete the transaction.

Keywords: digital wallet, mobile payment, online purchasing behavior, WeChat Pay

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Authors: Lucas Paganin, Viliam Makis

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With the advent of globalization, the market competition has become a major issue for most companies. One of the main strategies to overcome this situation is the quality improvement of the product at a lower cost to meet customers’ expectations. In order to achieve the desired quality of products, it is important to control the process to meet the specifications, and to implement the optimal maintenance policy for the machines and the production lines. Thus, the overall objective is to reduce process variation and the production and maintenance costs. In this paper, an integrated model involving Statistical Process Control (SPC) and maintenance is developed to achieve this goal. Therefore, the main focus of this paper is to develop the jointly optimal maintenance and statistical process control policy minimizing the total long run expected average cost per unit time. In our model, the production process can go out of control due to either the deterioration of equipment or other assignable causes. The equipment is also subject to failures in any of the operating states due to deterioration and aging. Hence, the process mean is controlled by an Xbar control chart using equidistant sampling epochs. We assume that the machine inspection epochs are the times when the control chart signals an out-of-control condition, considering both true and false alarms. At these times, the production process will be stopped, and an investigation will be conducted not only to determine whether it is a true or false alarm, but also to identify the causes of the true alarm, whether it was caused by the change in the machine setting, by other assignable causes, or by both. If the system is out of control, the proper actions will be taken to bring it back to the in-control state. At these epochs, a maintenance action can be taken, which can be no action, or preventive replacement of the unit. When the equipment is in the failure state, a corrective maintenance action is performed, which can be minimal repair or replacement of the machine and the process is brought to the in-control state. SMDP framework is used to formulate and solve the joint control problem. Numerical example is developed to demonstrate the effectiveness of the control policy.

Keywords: maintenance, semi-Markov decision process, statistical process control, Xbar control chart

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Authors: Nagendra P. Luitel, Mark J. D. Jordans

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Globally, there is a significant gap between the number of individuals in need of mental health care and those who actually receive treatment. The evidence is accumulating that mental health services can be delivered effectively by primary health care workers through community-based programs and task-sharing approaches. Changing the role of specialist mental health workers from service delivery to building clinical capacity of the primary health care (PHC) workers could help in reducing treatment gap in low and middle-income countries (LMICs). We developed a comprehensive mental health care plan in 2012 and evaluated its feasibility and effectiveness over the past three years. Initially, a mixed method formative study was conducted for the development of mental health care plan (MHCP). Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from beneficiaries (n=135) during the pilot-testing phase. Repeated community survey (N=2040); facility detection survey (N=4704) and the cohort study (N=576) were conducted for evaluation of the MHCP. The resulting MHCP consists of twelve packages divided over the community, health facility, and healthcare organization platforms. Detection of mental health problems increased significantly after introducing MHCP. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Currently, MHCP has been implemented in the entire Chitwan district where over 1400 people (438 people with depression, 406 people with psychosis, 181 people with epilepsy, 360 people with alcohol use disorder and 51 others) have received mental health services from trained health workers. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers, high drop-out rates and continue the supply of medicines. The results indicated that involvement of PHC workers in detection and management of mental health problems is an effective strategy to minimize treatment gap on mental health care in Nepal.

Keywords: mental health, Nepal, primary care, treatment gap

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Authors: Rahul Paul, Peter Mctaggart, Luke Skinner

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Maintaining public safety and network reliability are the core objectives of all electricity distributors globally. For many electricity distributors, managing vegetation clearances from their above ground assets (poles and conductors) is the most important and costly risk mitigation control employed to meet these objectives. Light Detection And Ranging (LiDAR) is widely used by utilities as a cost-effective method to inspect their spatially-distributed assets at scale, often captured using high powered LiDAR scanners attached to fixed wing or rotary aircraft. The resulting 3D point cloud model is used by these utilities to perform engineering grade measurements that guide the prioritisation of vegetation cutting programs. Advances in computer vision and machine-learning approaches are increasingly applied to increase automation and reduce inspection costs and time; however, real-world LiDAR capture variables (e.g., aircraft speed and height) create complexity, noise, and missing data, reducing the effectiveness of these approaches. This paper proposes a method for identifying each conductor from LiDAR data via clustering methods that can precisely reconstruct conductors in complex real-world configurations in the presence of high levels of noise. It proposes 3D catenary models for individual clusters fitted to the captured LiDAR data points using a least square method. An iterative learning process is used to identify potential conductor models between pole pairs. The proposed method identifies the optimum parameters of the catenary function and then fits the LiDAR points to reconstruct the conductors.

Keywords: point cloud, LİDAR data, machine learning, computer vision, catenary curve, vegetation management, utility industry

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Authors: Sunny Deo, Eve Barnes, Peter Arnold-Smith

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Introduction: Healthcare technology is a rapidly expanding field in healthcare, with enthusiasts suggesting a revolution in the quality and efficiency of healthcare delivery based on the utilisation of better e-healthcare, including the move to paperless healthcare. The role and use of computers and programmes for healthcare have been increasing over the past 50 years. Despite this, there is no standardised method of assessing the quality of hardware and software utilised by frontline healthcare workers. Methods and subjects: Based on standard Patient Related Outcome Measures, a questionnaire was devised with the aim of providing quantitative and qualitative data on clinicians’ perspectives of their hospital’s Information Technology (IT). The survey was distributed via the Institution’s Intranet to all contracted doctors, and the survey's qualitative results were analysed. Qualitative opinions were grouped as positive, neutral, or negative and further sub-grouped into speed/usability, software/hardware, integration, IT staffing, clinical risk, and wellbeing. Analysis was undertaken on the basis of doctor seniority and by specialty. Results: There were 196 responses, with 51% from senior doctors (consultant grades) and the rest from junior grades, with the largest group of respondents 52% coming from medicine specialties. Differences in the proportion of principle and sub-groups were noted by seniority and specialty. Negative themes were by far the commonest stated opinion type, occurring in almost 2/3’s of responses (63%), while positive comments occurred less than 1 in 10 (8%). Conclusions: This survey confirms strongly negative attitudes to the current state of electronic documentation and IT in a large single-centre cohort of hospital-based frontline physicians after two decades of so-called progress to a paperless healthcare system. Greater use would provide further insights and potentially optimise the focus of development and delivery to improve the quality and effectiveness of IT for clinicians and their patients.

Keywords: information technology, electronic patient records, digitisation, paperless healthcare

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