Search results for: antenatal care services

Authors: Sangeeta Girdhar, Amanat Grewal, Nahush Bansal

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Introduction: There is an increasing burden of hypertension in India. The morbidity and mortality arising from complications are mainly due to non-adherence to medication, unhealthy dietary habits, and lack of physical activity. Non-adherence is a well-recognised factor contributing to inadequate control of high blood pressure. Adherence to pharmacotherapy for hypertension varies from 43% to 88%. Non-adherence is influenced by various socio-demographic factors. Understanding these factors is useful in managing non-adherence. Therefore, the study was planned to determine adherence among hypertensives and factors associated with non-adherence to treatment. Methodology: A cross-sectional study was conducted at Urban Health Training Centre of Dayanand Medical College and Hospital Ludhiana. Patients attending the OPD over a period of 3 months were included in the study. Prior ethical approval was obtained, and informed consent was taken from subjects. A predesigned semi-structured questionnaire was applied, which included socio-demographic profile, treatment-seeking behaviour, adherence to the antihypertensive medication, lifestyle factors (intake of alcohol, smoking, consumption of junk food, high salt intake) contributing to the development of the disease. Reasons for non-adherence to the therapy were also explored. Data was entered into excel, and SPSS 26 version was used for analysis. Results: A total of 186 individuals were interviewed. Out of these, 113 females (60.8%) and 73 males (39.2%) participated in the study. Mean age of participants was 60.9 ± 10.7 years. Adherence to anti-hypertensive treatment was found in 68.3% of the participants. It was observed that adherence was more in literate individuals as compared to illiterate (p value- 0.78). Adherence was lower among smokers (33.3%) and alcohol consumers (53.8%) as compared to non-users (69.4% and 70.6%, respectively). The predominant reasons for skipping medications were discontinuing medication when feeling well, forgetfulness and unawareness. Conclusion: There is a need to generate awareness regarding the importance of adherence to therapy among patients. Intensive health education and counselling of the patients is the need of the hour.

Keywords: hypertension, anti-hypertensive, adherence, counselling

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Authors: Stephanie Boue, Nicolas Sierro, Julia Hoeng, Manuel C. Peitsch

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Systems biology relies on large numbers of data points and sophisticated methods to extract biologically meaningful signal and mechanistic understanding. For example, analyses of transcriptomics and proteomics data enable to gain insights into the molecular differences in tissues exposed to diverse stimuli or test items. Whereas the interpretation of endpoints specifically measuring a mechanism is relatively straightforward, the interpretation of big data is more complex and would benefit from comparing results obtained with diverse analysis methods. The sbv IMPROVER project was created to implement solutions to verify systems biology data, methods, and conclusions. Computational challenges leveraging the wisdom of the crowd allow benchmarking methods for specific tasks, such as signature extraction and/or samples classification. Four challenges have already been successfully conducted and confirmed that the aggregation of predictions often leads to better results than individual predictions and that methods perform best in specific contexts. Whenever the scientific question of interest does not have a gold standard, but may greatly benefit from the scientific community to come together and discuss their approaches and results, datathons are set up. The inaugural sbv IMPROVER datathon was held in Singapore on 23-24 September 2016. It allowed bioinformaticians and data scientists to consolidate their ideas and work on the most promising methods as teams, after having initially reflected on the problem on their own. The outcome is a set of visualization and analysis methods that will be shared with the scientific community via the Garuda platform, an open connectivity platform that provides a framework to navigate through different applications, databases and services in biology and medicine. We will present the results we obtained when analyzing data with our network-based method, and introduce a datathon that will take place in Japan to encourage the analysis of the same datasets with other methods to allow for the consolidation of conclusions.

Keywords: big data interpretation, datathon, systems toxicology, verification

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Authors: Helene Eller

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The aim of non-profit organizations (NPO) is to provide services and goods for its clientele, with profit being a minor objective. By having this definition as the basic purpose of doing business, it is obvious that the goal of an organisation is to serve several bottom lines and not only the financial one. This approach is underpinned by the non-distribution constraint which means that NPO are allowed to make profits to a certain extent, but not to distribute them. The advantage is that there are no single shareholders who might have an interest in the prosperity of the organisation: there is no pie to divide. The gained profits remain within the organisation and will be reinvested in purposeful projects. Good governance is mandatory to support the aim of NPOs. Looking for a measure of good governance the principals of corporate governance (CG) will come in mind. The purpose of CG is direction and control, and in the field of NPO, CG is enlarged to consider the relationship to all important stakeholders who have an impact on the organisation. The recognition of more relevant parties than the shareholder is the link to corporate social responsibility (CSR). It supports a broader view of the bottom line: It is no longer enough to know how profits are used but rather how they are made. Besides, CSR addresses the responsibility of organisations for their impact on society. When transferring the concept of CSR to the non-profit area it will become obvious that CSR with its distinctive features will match the aims of NPOs. As a consequence, NPOs who apply CG apply also CSR to a certain extent. The research is designed as a comprehensive theoretical and empirical analysis. First, the investigation focuses on the theoretical basis of both concepts. Second, the similarities and differences are outlined and as a result the interconnection of both concepts will show up. The contribution of this research is manifold: The interconnection of both concepts when applied to NPOs has not got any attention in science yet. CSR and governance as integrated concept provides a lot of advantages for NPOs compared to for-profit organisations which are in a steady justification to show the impact they might have on the society. NPOs, however, integrate economic and social aspects as starting point. For NPOs CG is not a mere concept of compliance but rather an enhanced concept integrating a lot of aspects of CSR. There is no “either-nor” between the concepts for NPOs.

Keywords: business ethics, corporate governance, corporate social responsibility, non-profit organisations

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Authors: Simont Toussi

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Cameroon and the Central African Republic arebound by the provisions of many regional and international charters, which condemn the manipulation of information, obstacles to access reliable information, or the limitation of freedoms of expression and opinion. These two countries also have constitutional guarantees for free speech and access to true and liable information. However, they are yet to define specific policies and regulations for access to information, disinformation, or misinformation. Yet, certain countries’ laws and regulations related to information and communication technologies, to criminal procedures, to terrorism, or intelligence services contain provisions that rather hider human rights by condemning false information. Like many other African countries, Cameroon and the Central African Republic face a profound democratic regression, and governments use multiple methods to stifle online discourse and digital rights. Despite the increased uptake of digital tools for political participation, there is a lack of interactivity and adoption of these tools. This enables a scarcity of information and creates room for the spreading of disinformation in the public space, hamperingdemocracy and the respect for human rights. This research aims to analyse the adequacy of stakeholders’ responses to disinformation in Cameroon and the Central African Republic in periods of political contestation, such as elections and anti-government protests, to highlight the nature, perpetrators, strategies, and channels of disinformation, as well as its effects on democratic actors, including civil society, bloggers, government critics, activists, and other human rights defenders. The study follows a qualitative method with literature review, content analysis, andkey informant’sinterviews with stakeholders’ representatives, emphasized crowdsourcing as a data and information collecting method in the two countries.

Keywords: disinformation, democracy, political manipulation, social media, media, fake news, central Africa, cameroon, misinformation, free speech

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Authors: Wilfred Elliam

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Background: Pain is a prevalent and debilitating symptom among breast cancer patients, impacting their quality of life and overall well-being. The experience of pain in this population is multifaceted, influenced by a combination of disease-related factors, treatment side effects, and individual characteristics. Despite advancements in cancer treatment and pain management, many breast cancer patients continue to suffer from chronic pain, which can persist long after the completion of treatment. Understanding the progression of pain in breast cancer patients over time and identifying its correlates is crucial for effective pain management and supportive care strategies. The purpose of this research is to understand the patterns and progression of pain experienced by breast cancer survivors over time. Methods: Data were collected from breast cancer patients at Hartford Hospital at four time points: baseline, 3, 6 and 12 weeks. Key variables measured include pain, body mass index (BMI), fatigue, musculoskeletal pain, sleep disturbance, and demographic variables (age, employment status, cancer stage, and ethnicity). Binomial generalized linear mixed models were used to examine changes in pain and symptoms over time. Results: A total of 100 breast cancer patients aged  18 years old were included in the analysis. We found that the effect of time on pain (p = 0.024), musculoskeletal pain (p= <0.001), fatigue (p= <0.001), and sleep disturbance (p-value = 0.013) were statistically significant with pain progression in breast cancer patients. Patients using aromatase inhibitors have worse fatigue (<0.05) and musculoskeletal pain (<0.001) compared to patients with Tamoxifen. Patients who are obese (<0.001) and overweight (<0.001) are more likely to report pain compared to patients with normal weight. Conclusion: This study revealed the complex interplay between various factors such as time, pain, sleep disturbance in breast cancer patient. Specifically, pain, musculoskeletal pain, sleep disturbance, fatigue exhibited significant changes across the measured time points, indicating a dynamic pain progression in these patients. The findings provide a foundation for future research and targeted interventions aimed at improving pain in breast cancer patient outcomes.

Keywords: breast cancer, chronic pain, pain management, quality of life

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Authors: Mequanint Birhan

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Modern urban environments present a dynamically growing field where, notwithstanding shared goals, several mutually conflicting interests frequently collide. However, it has a big impact on the city's socioeconomic standing, waiting lines and queues are common occurrences. This results in extremely long lines for both vehicles and people on incongruous routes, service coagulation, customer murmuring, unhappiness, complaints, and looking for other options sometimes illegally. The root cause of this is corruption, which leads to traffic jams, stopping, and packing vehicles beyond their safe carrying capacity, and violating the human rights and freedoms of passengers. This study focused on the optimizing time of passengers had to wait in public vehicle stations. This applied research employed both data gathering sources and mixed approaches, then 166 samples of key informants of transport station were taken by using the Slovin sampling formula. The length of time vehicles, including the drivers and auxiliary drivers ‘Weyala', had to wait was also studied. To maximize the service level at vehicle stations, a queuing model was subsequently devised ‘Menaharya’. Time, cost, and quality encompass performance, scope, and suitability for the intended purposes. The minimal response time for passengers and vehicles queuing to reach their final destination at the stations of the Tepi, Mizan, and Bonga towns was determined. A new bus station system was modeled and simulated by Arena simulation software in the chosen study area. 84% improvement on cost reduced by 56.25%, time 4hr to 1.5hr, quality, safety and designed load performance calculations employed. Stakeholders are asked to put the model into practice and monitor the results obtained.

Keywords: Arena 14 automatic rockwell, queue, transport services, vehicle stations

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Authors: Kerry Hull, Mark Wright

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This paper brings light to ethnobotanical medicines used by the Maya of Belize to treat snake bites. The varying ecological zones of Belize boast over fifty species of snakes, nine of which are poisonous and dangerous to humans. Two distinct Maya groups occupy neighboring regions of Belize, the Q’eqchi’ and the Mopan. With Western medical care often far from their villages, what traditional methods are used to treat poisonous snake bites? Based primarily on data gathered with native consultants during the authors’ fieldwork with both groups, this paper details the ethnobotanical resources used by the Q’eqchi’ and Mopan traditional healers. The Q’eqchi’ and Mopan most commonly rely on traditional ‘bush doctors’ (ilmaj in Mopan), both male and female, and specialized ‘snake doctors’ to heal bites from venomous snakes. First, this paper presents each plant employed by healers for bites for the nine poisonous snakes in Belize along with the specific botanical recipes and methods of application for each remedy. Individual chemical and therapeutic qualities of some of those plants are investigated in an effort to explain their possible medicinal value for different toxins or the symptoms caused by those toxins. In addition, this paper explores mythological associations with certain snakes that inform local understanding regarding which plants are considered efficacious in each case, arguing that numerous oral traditions (recorded by the authors) help to link botanical medicines to episodes within their mythic traditions. Finally, the use of plants to counteract snakebites brought about through sorcery is discussed inasmuch as some snakes are seen as ‘helpers’ of sorcerers. Snake bites given under these circumstances can only be cured by those who know both the proper corresponding plant(s) and ritual prayer(s). This paper provides detailed documentation of traditional ethnomedicines and practices from the dying art of traditional Maya healers and argues for multi-faceted diagnostic techniques to determine toxin severity, the presence or absence of sorcery, and the appropriate botanical remedy.

Keywords: ethnobotany, Maya, medicine, snake bites

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Authors: Cytha Nilam Chairani, Ditha Noviantika, Hidayati Amir, Nurul Khairiyah, Siti Rahmadita, Fadila Khairani

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Background: Dental caries is one of the most common diseases with high prevalence in children. The first permanent molar (FPM) has an essential role in establishing the occlusion. Nevertheless, FPM is very prone to caries because of various factors, such as their anatomical structure and early emergence in oral cavity. It is due to the little knowledge from parents and children regarding the timing of emergence of FPM in oral cavity which is still considered as primary teeth. Furthermore, the lack of knowledge from parents and children may affect their oral hygiene practice resulting to carious process. Objective: The aim of this study was to assess the status of FPM caries and its association with children’s oral hygiene practice in 9-12-year-old school children in Lubuk Kilangan Community Health Centre, Padang City. Methods: A cross-sectional study was performed in 50 school children (9-12 years old) using random sampling technique from two randomly selected schools in Lubuk Kilangan Community Health Centre, Padang City. A questionnaire was developed from other studies consisting of four closed ended questions regarding oral health practice. The data obtained were analyzed statistically using Mann-Whitney Test to assess the status of FPM caries and its association with children’s oral hygiene practice. Results: The results showed that 32% of children had FPMs sound and the remaining 68% had FPMs carious which were grouped into 1-2 FPMs carious (60%) and 3-4 FPMs carious (8%). The caries status of mandibular FPM (64%) was higher compared to maxillary FPM (10%). Conclusion: There was significant association in subject who did not visit dentist in the last 6 months which had more carious FPMs compared to subject who visited dentist (p < 0.05). There was no significant association between the status of FPM caries and knowledge of the timing eruption of FPM, oral hygiene instruction from parents and tooth brushing (p > 0.05).

Keywords: dental caries, children, first permanent molar, oral hygiene practice

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Authors: Said Benaissa, David Plets, Emmeric Tanghe, Jens Trogh, Luc Martens, Leen Vandaele, Annelies Van Nuffel, Frank A. M. Tuyttens, Bart Sonck, Wout Joseph

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The herd monitoring and managing - in particular the detection of ‘attention animals’ that require care, treatment or assistance is crucial for effective reproduction status, health, and overall well-being of dairy cows. In large sized farms, traditional methods based on direct observation or analysis of video recordings become labour-intensive and time-consuming. Thus, automatic monitoring systems using sensors have become increasingly important to continuously and accurately track the health status of dairy cows. Wireless sensor networks (WSNs) and internet-of-things (IoT) can be effectively used in health tracking of dairy cows to facilitate herd management and enhance the cow welfare. Since on-cow measuring devices are energy-constrained, a proper characterization of the off-body wireless channel between the on-cow sensor nodes and the back-end base station is required for a power-optimized deployment of these networks in barns. The aim of this study was to characterize the off-body wireless channel in indoor (barns) environment at 868 MHz using LoRa nodes. LoRa is an emerging wireless technology mainly targeted at WSNs and IoT networks. Both large scale fading (i.e., path loss) and temporal fading were investigated. The obtained path loss values as a function of the transmitter-receiver separation were well fitted by a lognormal path loss model. The path loss showed an additional increase of 4 dB when the wireless node was actually worn by the cow. The temporal fading due to movement of other cows was well described by Rician distributions with a K-factor of 8.5 dB. Based on this characterization, network planning and energy consumption optimization of the on-body wireless nodes could be performed, which enables the deployment of reliable dairy cow monitoring systems.

Keywords: channel, channel modelling, cow monitoring, dairy cows, health monitoring, IoT, LoRa, off-body propagation, PLF, propagation

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Authors: Roongtiwa Chobchuen, Angkana Srikhan, Pattra Wattanapan

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Background: Neurogenic bowel is common condition after spinal cord injury. Most of spinal cord injured patients have motor weakness, mobility impairment which leads to constipation. Moreover, the neural pathway involving bowel function is interrupted. Therefore, the bowel management program should be implemented in nursing care in the earliest time after the onset of the disease to prevent the morbidity and mortality. Objective: To study the outcome of bowel management program of the patients with spinal cord injury who admitted for rehabilitation program. Study design: Descriptive study. Setting: Rehabilitation ward in Srinagarind Hospital. Populations: patients with subacute to chronic spinal cord injury who admitted at rehabilitation ward, Srinagarind hospital, aged over 18 years old. Instrument: The neurogenic bowel dysfunction score (NBDS) was used to determine the severity of neurogenic bowel. Procedure and statistical analysis: All participants were asked to complete the demographic data; age gender, duration of disease, diagnosis. The individual bowel function was assessed using NBDS at admission. The patients and caregivers were trained by nurses about the bowel management program which consisted of diet modification, abdominal massage, digital stimulation, stool evacuation including medication and physical activity. The outcome of the bowel management program was assessed by NBDS at discharge. The chi-square test was used to detect the difference in severity of neurogenic bowel at admission and discharge. Results: Sixteen spinal cord injured patients were enrolled in the study (age 45 ± 17 years old, 69% were male). Most of them (50%) were tetraplegia. On the admission, 12.5%, 12.5%, 43.75% and 31.25% were categorized as very minor (NBDS 0-6), minor (NBDS 7-9), moderate (NBDS 10-13) and severe (NBDS 14+) respectively. The severity of neurogenic bowel was decreased significantly at discharge (56.25%, 18.755%, 18.75% and 6.25% for very minor, minor, moderate and severe group respectively; p < 0.001) compared with NBDS at admission. Conclusions: Implementation of the effective bowel program decrease the severity of the neurogenic bowel in patient with spinal cord injury.

Keywords: neurogenic bowel, NBDS, spinal cord injury, bowel program

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Authors: Ferdi Sönmez, Nihal Yorulmaz

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Decision making on the true planning of the public transportation systems to serve potential users is a must for metropolitan areas. To take attraction of travelers to projected modes of transport, adequately fair overall travel times should be provided. In this fashion, other benefits such as lower traffic congestion, road safety and lower noise and atmospheric pollution may be earned. The congestion which comes with increasing demand of public transportation is becoming a part of our lives and making residents’ life difficult. Hence, regulations should be done to reduce this congestion. To provide a constructive and balanced regulation in public transportation systems, right stations should be located in right places. In this study, it is aimed to design and implement a Decision Support System (DSS) Application to determine the optimal bus stop places for public transport in Istanbul which is one of the biggest and oldest cities in the world. Required information is gathered from IETT (Istanbul Electricity, Tram and Tunnel) Enterprises which manages all public transportation services in Istanbul Metropolitan Area. By using the most real-like values, cost assignments are made. The cost is calculated with the help of equations produced by bi-level optimization model. For this study, 300 buses, 300 drivers, 10 lines and 110 stops are used. The user cost of each station and the operator cost taken place in lines are calculated. Some components like cost, security and noise pollution are considered as significant factors affecting the solution of set covering problem which is mentioned for identifying and locating the minimum number of possible bus stops. Preliminary research and model development for this study refers to previously published article of the corresponding author. Model results are represented with the intent of decision support to the specialists on locating stops effectively.

Keywords: operator cost, bi-level optimization model, user cost, urban transportation

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Authors: Iruka C. Anugwo, Winston M. Shakantu

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The objective of this study is to uncover the basic business-forces that necessitated the survival and sustainable performance of the medium scale contractors in the South African construction market. This study is essential as it set to contribute towards long-term strategic solutions for combating the incessant failure of start-ups construction organizations within South African. The study used a qualitative research methodology; as the most appropriate approach to elicit and understand, and uncover the phenomena that are basic business-forces for the active contractors in the market. The study also adopted a phenomenological study approach; and in-depth interviews were conducted with 20 medium scale contractors in Port Elizabeth, South Africa, between months of August to October 2015. This allowed for an in-depth understanding of the critical and basic business-forces that influenced their survival and performance beyond the first five years of business operation. Findings of the study showed that for potential contractors (startups), to survival in the competitive business environment such as construction industry, they must possess the basic business-forces. These forces are educational knowledge in construction and business management related disciplines, adequate industrial experiences, competencies and capabilities to delivery excellent services and products as well as embracing the spirit of entrepreneurship. Convincingly, it can be concluded that the strategic approach to minimize the endless failure of startups construction businesses; the potential construction contractors must endeavoring to access and acquire the basic educationally knowledge, training and qualification; need to acquire industrial experiences in collaboration with required competencies, capabilities and entrepreneurship acumen. Without these basic business-forces as been discovered in this study, the majority of the contractors gaining entrance in the market will find it difficult to develop and grow a competitive and sustainable construction organization in South Africa.

Keywords: basic business-forces, medium scale contractors, South Africa, sustainable organisations

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Authors: C. B. Masera, M. Imprialou, L. Budd, C. Morton

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Even though signalised intersections are necessary for urban road traffic management, they can act as bottlenecks and disrupt traffic operations. Interrupted traffic flow causes congestion, delays, stop-and-go conditions (i.e. excessive acceleration/deceleration) and longer journey times. Vehicle and infrastructure connectivity offers the potential to provide improved new services with additional functions of assisting drivers. This paper focuses on one of the applications of vehicle-to-infrastructure communication namely Green Light Optimal Speed Advisory (GLOSA). To assess the effectiveness of GLOSA in the urban road network, an integrated microscopic traffic simulation framework is built into VISSIM software. Vehicle movements and vehicle-infrastructure communications are simulated through the interface of External Driver Model. A control algorithm is developed for recommending an optimal speed that is continuously updated in every time step for all vehicles approaching a signal-controlled point. This algorithm allows vehicles to pass a traffic signal without stopping or to minimise stopping times at a red phase. This study is performed with all connected vehicles at 100% penetration rate. Conventional vehicles are also simulated in the same network as a reference. A straight road segment composed of two opposite directions with two traffic lights per lane is studied. The simulation is implemented under 150 vehicles per hour and 200 per hour traffic volume conditions to identify how different traffic densities influence the benefits of GLOSA. The results indicate that traffic flow is improved by the application of GLOSA. According to this study, vehicles passed through the traffic lights more smoothly, and waiting times were reduced by up to 28 seconds. Average delays decreased for the entire network by 86.46% and 83.84% under traffic densities of 150 vehicles per hour per lane and 200 vehicles per hour per lane, respectively.

Keywords: connected vehicles, GLOSA, intelligent transport systems, vehicle-to-infrastructure communication

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Authors: Camila Plaza, Stefan Felder

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In October 2014, the TARMED reform was implemented in Switzerland. In an effort to even out the financial standing of general practitioners (including pediatricians) relative to that of specialists in the outpatient sector, the reform tackled two aspects: on the one hand, GPs would be able to bill an additional 9 CHF per patient, once per consult per day. This is referred to as the surcharge position. As a second measure, it reduced the fees for certain technical services targeted to specialists (e.g., imaging, surgical technical procedures, etc.). Given the fee-for-service reimbursement system in Switzerland, we predict that physicians reacted to the economic incentives of the reform by increasing the consults per patient and decreasing the average amount of time per consult. Within this framework, our treatment group is formed by GPs and our control group by those specialists who were not affected by the reform. Using monthly insurance claims panel data aggregated at the physician praxis level (provided by SASIS AG), for the period of January 2013-December 2015, we run difference in difference panel data models with physician and time fixed effects in order to test for the causal effects of the reform. We account for seasonality, and control for physician characteristics such as age, gender, specialty, and physician experience. Furthermore, we run the models on subgroups of physicians within our sample so as to account for heterogeneity and treatment intensities. Preliminary results support our hypothesis. We find evidence of an increase in consults per patients and a decrease in time per consult. Robustness checks do not significantly alter the results for our outcome variable of consults per patient. However, we do find a smaller effect of the reform for time per consult. Thus, the results of this paper could provide policymakers a better understanding of physician behavior and their sensitivity to financial incentives of reforms (both past and future) under the current reimbursement system.

Keywords: difference in differences, financial incentives, health reform, physician behavior

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Authors: Viktor R. Stoynov, Zlatka V. Valkova-Jarvis

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The intelligent management and optimisation of radio resource technologies will lead to a considerable improvement in the overall performance in Next Generation Networks (NGNs). Carrier Aggregation (CA) technology, also known as Spectrum Aggregation, enables more efficient use of the available spectrum by combining multiple Component Carriers (CCs) in a virtual wideband channel. LTE-A (Long Term Evolution–Advanced) CA technology can combine multiple adjacent or separate CCs in the same band or in different bands. In this way, increased data rates and dynamic load balancing can be achieved, resulting in a more reliable and efficient operation of mobile networks and the enabling of high bandwidth mobile services. In this paper, several distinct CA deployment strategies for the utilisation of spectrum bands are compared in indoor-outdoor scenarios, simulated via the recently-developed Realistic Indoor Environment Generator (RIEG). We analyse the performance of the User Equipment (UE) by integrating the average throughput, the level of fairness of radio resource allocation, and other parameters, into one summative assessment termed a Comparative Factor (CF). In addition, comparison of non-CA and CA indoor mobile networks is carried out under different load conditions: varying numbers and positions of UEs. The experimental results demonstrate that the CA technology can improve network performance, especially in the case of indoor scenarios. Additionally, we show that an increase of carrier frequency does not necessarily lead to improved CF values, due to high wall-penetration losses. The performance of users under bad-channel conditions, often located in the periphery of the cells, can be improved by intelligent CA location. Furthermore, a combination of such a deployment and effective radio resource allocation management with respect to user-fairness plays a crucial role in improving the performance of LTE-A networks.

Keywords: comparative factor, carrier aggregation, indoor mobile network, resource allocation

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Authors: Bsma Adel Bany Mohammad

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The University campuses are a small city containing basic city functions such as educational spaces, accommodations, services and transportation. They are spaces of functional and social life with different activities, different occupants. The campus designed and transformed like cities so both experienced and memorized in same way. Campus memory is the ability of individuals to maintain and reveal the spatial components of designed physical spaces, which form the understandings, experiences, sensations of the environment in all. ‘Cognitive mapping’ is used to decode the physical interaction and emotional relationship between individuals and the city; Cognitive maps are created graphically using geometric and verbal elements on paper by remembering the images of the Urban Environment. In this study, to determine the emotional urban identity belonging to Jordan University of science and technology Campus, architecture students Asked to identify the areas they interact with in the campus by drawing a cognitive map. ‘Campus memory items’ are identified by analyzing the cognitive maps of the campus, then the spatial identity result of such data. The analysis based on the five basic elements of Lynch: paths, districts, edges, nodes, and landmarks. As a result of this analysis, it found that Spatial Identity constructed by the shared elements of the maps. The memory of most students listed the gates structure- which is a large desirable structure, located at the main entrances within the campus defined as major landmarks, then the square spaces defined as nodes, in addition to both stairs and corridors defined as paths. Finally, the districts, edges of educational buildings and service spaces are listed correspondingly in cognitive maps. Findings suggest that the spatial identity of the campus design is related mainly to the gates structures, squares and stairs.

Keywords: cognitive maps, university campus, urban memory, identity

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Authors: Michael Campbell, Malaz Elsaddig, Kevin Jones

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Background: Despite encouraging progress, global maternal mortality has remained stubbornly high since the declaration of the Millennium development goals. Sub-Saharan Africa accounts for well over half of maternal deaths with Post-Partum Haemorrhage (PPH) being the lead cause. ‘In house’ simulation training delivered by local doctors may be a sustainable approach for improving emergency obstetric care. The aim of this study was to evaluate the use of a Train-the-Trainer (TtT) model in a rural Ugandan hospital to ascertain whether it can feasibly improve practitioners’ management of PPH. Methods: Three Ugandan doctors underwent a training course to enable them to design and deliver simulation training. These doctors used MamaNatalie® models to simulate PPH scenarios for midwives, nurses and medical students. The main outcome was improvement in participants’ knowledge and confidence, assessed using self-reported scores on a 10-point scale. Results: The TtT model produced significant improvements in the confidence and knowledge scores of the ten participants. The mean confidence score rose significantly (p=0.0005) from 6.4 to 8.6 following the simulation training. There was also a significant increase in the mean knowledge score from 7.2 to 9.0 (p=0.04). Medical students demonstrated the greatest overall increase in confidence scores whilst increases in knowledge scores were largest amongst nurses. Conclusions: This study demonstrates that a TtT model can be used in a low resource setting to improve healthcare professionals’ confidence and knowledge in managing obstetric emergencies. This Train-the-Trainer model represents a sustainable approach to addressing skill deficits in low resource settings. We believe that its expansion across healthcare institutions in Sub-Saharan Africa will help to reduce the region’s high maternal mortality rate and step closer to achieving the ambitions of the Millennium development goals.

Keywords: low resource setting, post-partum haemorrhage, simulation training, train the trainer

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Authors: John Olav Bjornestad, Bjorn Tore Johansen

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The number of people suffering from mental illnesses is increasing, and such illness is currently one of the major causes of disability and poor health. The reason for this is most likely a lack of physical activity. The purpose of this study was to discover if physical activity was an effective mode of treatment for psychiatric patients at an out-patient treatment facility. The study included an exploration of whether or not patients having physical activity included as an integral part of their treatment (to a greater degree than do patients who are physically inactive) would achieve 1) an improvement in their physical condition 2) a reduction in symptomatic pressure and 3) an increase in their health-related quality of life. The intervention period lasted a total of 12 weeks. The training group completed a minimum of 2 training sessions per week with an intensity of 60-75% of maximum heart rate. The participants’ health-related quality of life (SF-36), symptomatic pressure (SCL-90-R) and physical condition (UKK-walking test) were measured before and after intervention. Twenty participants were pre-tested, and out of this initial group, nine patients completed the intervention program and participated thereafter in post-testing. The results showed that participants on average improved their physical condition, reduced their symptomatic pressure and increased their health-related quality of life over the course of the intervention period. The training group experienced significant changes in their symptomatic pressure (the anxiety dimension) and health-related quality of life (the mental health dimension) from the pre-testing stage to the post-testing one. Furthermore, there was a significant connection between symptomatic pressure and health-related quality of life. The patients who were admitted to the psychiatric out-patient clinic were in a physical condition that was significantly poorer than that of persons of the same age in the remainder of the population. Experiences from the study and the relatively large defection from it demonstrate that there is a great need for close follow-up of psychiatric patients’ physical activity levels when physical activity and lifestyle changes are included as part of their treatment program.

Keywords: health-related quality, mental health, physical activity, physical condition

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Authors: Murat Erkoc, Kadir Ertogral

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Maintenance, repair and overhauling (MRO) of high cost equipment used in many industries such as transportation, military and construction are typically subject to regulations set by local governments or international agencies. Aircrafts are prime examples for this kind of equipment. Such equipment must be overhauled at certain intervals for continuing permission of use. As such, the overhaul must be completed by strict deadlines, which often times cannot be exceeded. Due to the fact that the overhaul is typically a long process, MRO companies carry so called rotable inventory for exchange of expensive modules in the overhaul process of the equipment so that the equipment continue its services with minimal interruption. The extracted module is overhauled and returned back to the inventory for future exchange, hence the name rotable inventory. However, since the rotable inventory and overhaul capacity are limited, it may be necessary to carry out some of the exchanges earlier than their deadlines in order to produce a feasible overhaul schedule. An early exchange results with a decrease in the equipment’s cycle time in between overhauls and as such, is not desired by the equipment operators. This study introduces an integer programming model for the optimal overhaul and exchange scheduling. We assume that there is certain number of rotables at hand at the beginning of the planning horizon for a single type module and there are multiple demands with known deadlines for the exchange of the modules. We consider an MRO system with identical parallel processing lines. The model minimizes total earliness by generating optimal overhaul start times for rotables on parallel processing lines and exchange timetables for orders. We develop a fast exact solution algorithm for the model. The algorithm employs full-delay scheduling approach with backward allocation and can easily be used for overhaul scheduling problems in various MRO settings with modular rotable items. The proposed procedure is demonstrated by a case study from the aerospace industry.

Keywords: rotable inventory, full-delay scheduling, maintenance, overhaul, total earliness

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Authors: Gulnaz Erkomaishvili

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Introduction. One of the most important issues of state economic policy in the 21st century is the problem of environmental protection. The Georgian government considers the green economy as one of the most important means of sustainable economic development and takes the initiative to implement voluntary measures to promote sustainable development. In this context, it is important to promote the development of ecosystem services, clean production, environmental education and green jobs.The development of the green economy significantly reduces the inefficient use of natural resources, waste generation, emissions into the atmosphere and the discharge of untreated water into bodies of water.It is, therefore, an important instrument in the environmental orientation of sustainable development. Objectives.The aim of the paper is to analyze the current status of the green economy in Georgia and identify effective ways to improve the environmental, economic policy of sustainable development. Methodologies: This paper uses general and specific methods, in particular, analysis, synthesis, induction, deduction, scientific abstraction, comparative and statistical methods, as well as experts’ evaluation. bibliographic research of scientific works and reports of organizations was conducted; Publications of the National Statistics Office of Georgia are used to determine the regularity between analytical and statistical estimations. Also, theoretical and applied research of international organizations and scientist-economists are used. Contributions: The country should implement such an economic policy that ensures the transition to a green economy, in particular, revising water, air and waste laws, strengthening existing environmental management tools and introcing new tools (including economic tools). Perfecting the regulatory legal framework of the environmental impact assessment system, which includes the harmonization of Georgian legislation with the requirements of the European Union. To ensure the protection and rational use of Georgia's forests, emphasis should be placed on sustainable forestry, protection and restoration of forests.

Keywords: green economy, environmental protection, environmental protection economic policy, environmental protection policy challanges

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Authors: Aisling De Paor

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Scientific and technological developments are driving genetics and genetic technologies into the public sphere. Scientists are making genetic discoveries as to the make up of the human body and the cause and effect of disease, diversity and disability amongst individuals. Technological innovation in the field of genetics is also advancing, with the development of genetic testing, and other emerging genetic technologies, including gene editing (which offers the potential for genetic modification). In addition to the benefits for medicine, health care and humanity, these genetic advances raise a range of ethical, legal and societal concerns. From an ethical perspective, such advances may, for example, change the concept of humans and what it means to be human. Science may take over in conceptualising human beings, which may push the boundaries of existing human rights. New genetic technologies, particularly gene editing techniques create the potential to stigmatise disability, by highlighting disability or genetic difference as something that should be eliminated or anticipated. From a disability perspective, use (and misuse) of genetic technologies raise concerns about discrimination and violations to the dignity and integrity of the individual. With an acknowledgement of the likely future orientation of genetic science, and in consideration of the intersection of genetics and disability, this paper highlights the main concerns raised as genetic science and technology advances (particularly with gene editing developments), and the consequences for disability and human rights. Through the use of traditional doctrinal legal methodologies, it investigates the use (and potential misuse) of gene editing as creating the potential for a unique form of discrimination and stigmatization to develop, as well as a potential gateway to a form of new, subtle eugenics. This article highlights the need to maintain caution as to the use, application and the consequences of genetic technologies. With a focus on the law and policy position in Europe, it examines the need to control and regulate these new technologies, particularly gene editing. In addition to considering the need for regulation, this paper highlights non-normative approaches to address this area, including awareness raising and education, public discussion and engagement with key stakeholders in the field and the development of a multifaceted genetics advisory network.

Keywords: disability, gene-editing, genetics, law, regulation

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Authors: Afaf Manzoor, Abdul Hameed

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Children with hearing impairment face several challenges in accessing primary and secondary education in general and higher education in particular in Pakistan. A large number of these children are excluded from formal education system through segregated special institutions. The enrollment rate of these children at school level is very low and it continues decreasing as they move on the ladder of education. Negligible number of students with hearing impairment gets any chance to be enrolled at tertiary or higher education institutes. The segregated system of education at primary and secondary level makes it even more difficult to adjust in an inclusive classroom at a higher level not only for students with hearing impairment but for their teachers and peers as well. A false belief of teachers and parents about low academic profile of students with hearing impairment is one of the major challenges to overcome for their participation at higher education. This case study was conducted to document an innovative step taken by the Department of Special Education Needs, University of Management & Technology, Lahore Pakistan. The prime objective of this study was to assess the satisfaction level of students with hearing impairment in BS 4 Years and MA Special Education programs at Lahore campus. Structured interviews were of 40 students with hearing impairment to assess the satisfaction on service delivery (admission process, classroom pedagogy, content, assessment/results, access to other services centers i.e. library, cafeteria, hostel, co-curricular activities) and campus life. Their peers without disabilities were also interviewed to assess their acceptance level. The findings of the study revealed positive results about their educational as well as social inclusion in the university. The students also shared their fears at the time of admission and how fear eventually faded out with the passage of time due to the proper academic support system. The findings of the study will be shared in detail with the audience during the presentation.

Keywords: students with hearing impairment, higher education, inclusive education, marginalization

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Authors: Jessica Leigh Thornton

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The South African Constitution outlines provisions for every detainee and sentenced prisoner in relation to the human rights recognized in the country since 1994; but currently, across the country, prisons have yet to meet many of these criteria. Consequently, their day-to-day lives are marked by extreme lack of privacy, high rates of infection, poor nutrition, and deleterious living conditions, which steadily erode prisoners’ mental and physical capacities rather than rehabilitating inmates so that they can effectively reintegrate into society. Even more so, policy reform, advocacy, security, and rehabilitation programs continue to be based on research and theories that were developed to explain the experiences of men, while female offenders are seen as the “special category” of inmates. Yet, the experiences of women and their pathways to incarceration are remarkably different from those of male offenders. Consequently, little is known about the profile, nature and contributing factors and experiences of female offenders which has impeded a comprehensive and integrated understanding of the subject of female criminality. The number of women globally in correctional centers has more than doubled over the past fifteen years (these increases vary from prison to prison and country to country). Yet, female offenders have largely been ignored in research even though the minority status of female offenders is a phenomenon that is not peculiar to South Africa as the number of women incarcerated has increased by 68% within the decade. Within South Africa, there have been minimal studies conducted on the gendered experience of offenders. While some studies have explored the pathways to female offending, gender-sensitive correctional programming for women that respond to their needs has been overlooked. This often leads to a neglect of the needs of female offenders, not only in terms of programs and services delivery to this minority group but also from a research perspective. In response, the aim of the proposed research is twofold: Firstly, the lived experiences and views of rehabilitation and reintegration of female offenders will be explored. Secondly, the various pathways into and out of recidivism amongst female offenders will be investigated regarding their inclusion in educational rehabilitation.

Keywords: female incarceration, educational rehabilitation, exclusion, experiences of female offenders

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Authors: Mohammad Julhas Sujan, Md. Ferdous Alam

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Maternal, neonatal, and child health (MNCH) holds one of the prime focuses in Bangladesh’s national healthcare system. To save the lives of mothers and children, knowing the stock of MNCH medicines in different healthcare facilities and when to replenish them are essential. A robust information system not only facilitates efficient management of the essential MNCH medicines but also helps effective allocation of scarce resources. In Bangladesh, Supply chain management of the 25-essential life-saving medicines are currently tracked and monitored via an electronic logistics management information system (eLMIS). Our aim was to conduct a cross-sectional study with a year (2020) worth of data from 24 districts of Bangladesh to evaluate how eLMIS is helping the Government and other stakeholders in efficient supply chain management. Data were collected from 4711 healthcare facilities ranging from primary to secondary levels within a district. About 90% (4143) are community clinics which are considered primary health care facilities in Bangladesh. After eLMIS implementation, the average reporting rate across the districts has been increased (> 97%). The month of stock (MOS) of zinc is an average 6 months compared to Inj. Magnesium Sulphate which will take 2.5 years to consume according to the current average monthly consumption (AMC). Due to first approaching expiry, Tab. Misoprostol, 7.1% Chlorhexidine and Inj. Oxytocin may become unusable. Moreover, Inj. Oxytocin is temperature sensitive and may reduce its efficacy if it is stocked for a longer period. In contrast, Zinc should be sufficiently stocked to prevent sporadic stockouts. To understand how data are collected, transmitted, processed, and aggregated for MNCH medicines in a faster and timely manner, an electronic logistics management information system (eLMIS) is necessary. We recommend the use of such a system in developing countries like Bangladesh for efficient supply chain management of essential MNCH medicines.

Keywords: adaption, eLMIS, MNCH, live-saving medicines

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Authors: Inaam Khalaf, Nadin M. Abdel Razeq, Hamza Alduraidi, Suhaila Halasa, Omayyah S. Nassar, Eman Al-Horani, Jumana Shehadeh, Anna Talal

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Background: Nursing researchers are responsible for generating knowledge that corresponds to national and global research priorities in order to promote, restore, and maintain the health of individuals and societies. The objectives of this scoping review of Jordanian literature are to assess the existing research on pediatric nursing in terms of evolution, authorship and collaborations, funding sources, methodologies, topics of research, and pediatric subjects' age groups so as to identify gaps in research. Methodology: A search was conducted using related keywords obtained from national and international databases. The reviewed literature included pediatric health articles published through December 2019 in English and Arabic, authored by nursing researchers. The investigators assessed the retrieved studies and extracted data using a data-mining checklist. Results: The review included 265 articles authored by Jordanian nursing researchers concerning children's health, published between 1987 and 2019; 95% were published between 2009 and 2019. The most commonly applied research methodology was the descriptive non-experimental method (76%). The main generic topics were health promotion and disease prevention (23%), chronic physical conditions (19%), mental health, behavioral disorders, and forensic issues (16%). Conclusion: The review findings identified a grave shortage of evidence concerning nursing care issues for children below five years of age, especially those between ages two and five years. The research priorities identified in this review resonate with those identified in international reports. Implications: Nursing researchers are encouraged to conduct more research targeting topics of national-level importance in collaboration with clinically involved nurses and international scholars.

Keywords: Jordan, scoping review, children health nursing, pediatric, adolescents

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Authors: Paul Kipchumba

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Kenya is an East African Country lying at the Equator. It had a population of 46 million in 2015 with an annual growth rate of 2.7%, making a population of at least 65 million in 2030. Kenya’s GDP in 2015 was about 63 billion USD with per capita GDP of about 1400 USD. The rural population is 74%, whereas urban population is 26%. Kenya grapples with not only access to energy but also with energy security. There is direct correlation between economic growth, population growth, and energy consumption. Kenya’s energy composition is at least 74.5% from renewable energy with hydro power and geothermal forming the bulk of it; 68% from wood fuel; 22% from petroleum; 9% from electricity; and 1% from coal and other sources. Wood fuel is used by majority of rural and poor urban population. Electricity is mostly used for lighting. As of March 2015 Kenya had installed electricity capacity of 2295 MW, making a per capital electricity consumption of 0.0499 KW. The overall retail cost of electricity in 2015 was 0.009915 USD/ KWh (KES 19.85/ KWh), for installed capacity over 10MW. The actual demand for electricity in 2015 was 3400 MW and the projected demand in 2030 is 18000 MW. Kenya is working on vision 2030 that aims at making it a prosperous middle income economy and targets 23 GW of generated electricity. However, cost and non-cost factors affect generation and consumption of electricity in Kenya. Kenya does not care more about CO2 emissions than on economic growth. Carbon emissions are most likely to be paid by future costs of carbon emissions and penalties imposed on local generating companies by sheer disregard of international law on C02 emissions and climate change. The study methodology was a simulated application of carbon tax on all carbon emitting sources of electricity generation. It should cost only USD 30/tCO2 tax on all emitting sources of electricity generation to have solar as the only source of electricity generation in Kenya. The country has the best evenly distributed global horizontal irradiation. Solar potential after accounting for technology efficiencies such as 14-16% for solar PV and 15-22% for solar thermal is 143.94 GW. Therefore, the paper recommends adoption of solar power for generating all electricity in Kenya in order to attain zero carbon electricity generation in the country.

Keywords: co2 emissions, cost factors, electricity generation, non-cost factors

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Authors: Apoorva Bamal, Agnieszka Indiana Olbert

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Floods are known to be one of the most devastating hydro-climatic events, impacting a wide range of stakeholders in terms of environmental, social and economic losses. With difference in inundation durations and level of impact, flood hazards are of different degrees and strength. Amongst various set of domains being impacted by floods, environmental degradation in terms of water quality deterioration is one of the majorly effected but less highlighted domains across the world. The degraded water quality is caused by numerous natural and anthropogenic factors that are both point and non-point sources of pollution. Therefore, it is essential to understand the nature and source of the water pollution due to flooding. The major impact of floods is not only on the physico-chemical water quality parameters, but also on the biological elements leading to a vivid influence on the aquatic ecosystem. This deteriorated water quality is impacting many water categories viz. agriculture, drinking water, aquatic habitat, and miscellaneous services requiring an appropriate water quality to survive. This study identifies, reviews, evaluates and assesses multiple researches done across the world to determine the impact of floods on water quality. With a detailed statistical analysis of top relevant researches, this study is a synopsis of the methods used in assessment of impact of floods on water quality in different geographies, and identifying the gaps for further abridgement. As per majority of the studies, different flood magnitudes have varied impact on the water quality parameters leading to either increased or decreased values as compared to the recommended values for various categories. There is also an evident shift of the biological elements in the impacted waters leading to a change in its phenology and inhabitants of the specified water body. This physical, chemical and biological water quality degradation by floods is dependent upon its duration, extent, magnitude and flow direction. Therefore, this research provides an overview into the multiple impacts of floods on water quality, along with a roadmap of way forward to an efficient and uniform linkage of floods and impacted water quality dynamics.

Keywords: floods, statistical analysis, water pollution, water quality

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Authors: Ruth Nsibirano

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Online mode of delivery in higher institutions of learning, popularly known in some circles as e-Learning or distance education is a new phenomenon that is steadily taking root in African universities but specifically at Makerere University. For slightly over a decade, the Department of Open and Distance Learning has been offering the first generation mode of distance education. In this, learning and teaching experiences were based on the use of hard copy materials circulated through postal services in a rather correspondence mode. There were more challenges to this including high dropout rates, limited support to the learners and sustainability issues. Fortunately, the Department was supported by the Norwegian Government through a NORHED grant to “leapfrog” to the fifth generation of distance education that makes more use of educational technologies and tools. The capacity of faculty staff was gradually enhanced through a series of training to handle the upgraded structure of fifth generation distance education. The trained staff was then tasked to develop modules befitting an online delivery mode, for use on the program. This paper will present attitudes, experiences of the course writers with a view of sharing the good practices that enabled them leap from e-faculty trainees to distinct online course writers. This perspective will hopefully serve as building blocks to enhance the capacity of other upcoming distance education programs in low capacity universities and also promote the uptake of e-Education on the continent and beyond. Methodologically the findings were collected through individual interviews with the 30 course writers. In addition, semi structured questionnaires were designed to collect data on the profile, challenges and lessons from the writers. Findings show that the attitudes of course writers on project supported activities are so much tagged to the returns from their committed efforts. In conclusion, therefore, it is strategically useful to assess and selectively choose which individual to nominate for involvement at the initial stages.

Keywords: distance education, online course content, staff attitudes, best practices in online learning

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Authors: Mohammed Alasel, Michael Keusgen

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Gold is a noble metal; in its nano-scale level (e.g. spherical nanoparticles), the conduction electrons are triggered to collectively oscillate with a resonant frequency when certain wavelengths of electromagnetic radiation interact with its surface; this phenomenon is known as surface plasmon resonance (SPR). SPR is responsible for giving the gold nanoparticles its intense red color depending mainly on its size, shape and distance between nanoparticles. A decreased distance between gold nanoparticles results in aggregation of them causing a change in color from red to blue. This aggregation enables gold nanoparticles to serve as a sensitive biosensoric indicator. In the proposed work, gold nanoparticles were modified with two proteins: i) Borrelia antigen, variable lipoprotein surface-exposed protein (VlsE), and ii) protein A. VlsE antigen induces a strong antibody response against Lyme disease and can be detected from early to late phase during the disease in humans infected with Borrelia. In addition, it shows low cross-reaction with the other non-pathogenic Borrelia strains. The high specificity of VlsE antigen to anti-Borrelia antibodies, combined simultaneously with the high specificity of protein A to the Fc region of all IgG human antibodies, was utilized to develop a rapid test for serological point of care diagnosis of borreliosis in human serum. Only in the presence of anti-Borrelia antibodies in the serum probe, an aggregation of gold nanoparticles can be observed, which is visible by a concentration-dependent colour shift from red (low IgG) to blue (high IgG). Experiments showed it is clearly possible to distinguish between positive and negative sera samples using a simple suspension of the two-protein modified gold nanoparticles in a very short time (30 minutes). The proposed work showed the potential of using such modified gold nanoparticles generally for serological diagnosis. Improved specificity and reduced assay time can be archived in applying increased salt concentrations combined with decreased pH values (pH 5).

Keywords: gold nanoparticles, gold aggregation, serological diagnosis, protein A, lyme borreliosis

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Authors: Bouami Hind, Millot Patrick

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The implementation of automated devices in life-critical systems such as hospitals can bring a new set of challenges related to automation malfunctions. While automation has been identified as great leverage for the medication dispensing system’s security and efficiency, it also increases the complexity of the organization. In particular, the installation and operation stage of automated devices can be complex when malfunctions related to automated systems occur. This paper aims to document operators’ situation awareness about the malfunctions of automated drug delivery systems (ADCs) during their implementation through Saint Brieuc hospital’s feedback. Our evaluation approach has been deployed in Saint Brieuc hospital center’s pharmacy, which has been equipped with automated nominative drug dispensing systems since January of 2021. The analysis of Saint Brieuc hospital center pharmacy’s automation revealed numerous malfunctions related to the implementation of Automated Delivery Cabinets. It appears that the targeted performance is not reached in the first year of implementation in this case study. Also, errors have been collected in patients' automated treatments’ production such as lack of drugs in pill boxes or nominative carnets, excess of drugs, wrong location of the drug, drug blister damaged, non-compliant sachet, or ticket errors. Saint Brieuc hospital center’s pharmacy is doing a tremendous job of setting up and monitoring performance indicators from the beginning of automation and throughout ADC’s operation to control ADC’s malfunctions and meet the performance targeted by the hospital. Health professionals, including pharmacists, biomedical engineers and directors of work, technical services and safety, are heavily involved in an automation project. This study highlights the importance of the evaluation of ADCs’ performance throughout the implementation process and the hospital’s team involvement in automation supervision and management.

Keywords: life-critical systems, situation awareness, automated delivery cabinets, implementation, risks and malfunctions

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