Search results for: healthcare access and efficiency

Authors: Ignatio Madanhire, Charles Mbohwa

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Efficiency in manufacturing is critical in raising the value of exports so as to gainfully trade on the regional and international markets. There seems to be increasing popularity of continuous improvement strategies availed to manufacturing entities, but this research study established that there has not been a similar popularity accorded to the Six Sigma methodology. Thus this work was conducted to investigate the applicability, effectiveness, usefulness, application and suitability of the Six Sigma methodology as a competitiveness option for discrete manufacturing entity. Development of Six-sigma center in the country with continuous improvement information would go a long way in benefiting the entire industry

Keywords: discrete manufacturing, six-sigma, continuous improvement, efficiency, competitiveness

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Authors: S. I. Mwasha, Z. Robinson, M. Musgrave

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Communities, especially in the global south, have been reported to have low adaptive capacity to cope with climate change impacts. As an attempt to improve adaptive capacity, most studies have focused on understanding the access of the household resources which can contribute to resilience against changes. However, little attention has been shown in uncovering how the household resources could be used and their implications to resilience against weather related shocks. By using a case study qualitative study, this project analyzed the trends in livelihoods practices and their implication to social equity. The study was done in three different villages within Kilimanjaro region. Each in different agro ecological zone. Two focus group discussions in two agro-ecological zones were done, one for women and another one for men except in the third zone where focus group participant were combined together (due to unforeseen circumstances). In the focus group discussion, several participatory rural appraisal tools were used to understand trend in crops and animal production and the use in which it is made: climate trends, soil fertility, trees and other livelihoods resources. Data were analyzed using thematic network analysis. Using an amalgam of magnitude (to note weather comments made were positive or negative) and descriptive coding (to note the topic), six basic themes were identified under social equity: individual ownership, family ownership, love and respect, women no education, women access to education as well as women access to loans. The results implied that despite mum and dad in the family providing labor in the agro pastoral activities, there were separations on who own what, as well as individual obligations in the family. Dad owned mostly income creating crops and mum, food crops. therefore, men controlled the economy which made some of them become arrogant and spend money to meet their interests sometimes not taking care of the family. Separation in ownership was reported to contribute to conflicts in the household as well as causing controversy on the use income is spent. Men were reported to use income to promote matriarchy system. However, as women were capacitated through access to education and loans they become closer to their husband and get access to own and plan the income together for the interest of the family. Joint ownership and planning on the household resources were reported to be important if families have to better adapt to climate change. The aim of this study is not to show women empowerment and joint ownership and planning as only remedy for low adaptive capacity. There is the need to understand other practices that either directly or indirectly impacts environmental integrity, food security and economic development for household resilience against changing climate.

Keywords: adaptive capacity, climate change, resilience, women empowerment

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Authors: Ali W. N. Alattabi, Clare B. Harris, Rafid M. Alkhaddar, Montserrat Ortoneda, David A. Phipps, Ali Alzeyadi, Khalid S. Hashim

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This study was performed to optimise the hydraulic retention time (HRT) and study its effects on the sludge characteristics and the effluent quality in an aerobic suspension sequencing batch reactor (ASSBR) treating synthetic wastewater. The results showed that increasing the HRT from 6 h to 12 h significantly improved the COD and Nitrate removal efficiency; it was increased from 78.7% - 75.7% to 94.7% – 97% for COD and Nitrate respectively. However, increasing the HRT from 12 h to 18 h reduced the COD and Nitrate removal efficiency from 94.7% - 97% to 91.1% – 94.4% respectively. Moreover, Increasing the HRT from 18 h to 24 h did not affect the COD and Nitrate removal efficiency. Sludge volume index (SVI) was used to monitor the sludge settling performance. The results showed a direct relationship between the HRT and SVI value. Increasing the HRT from 6 h to 12 h led to decrease the SVI value from 123 ml/g to 82.5 ml/g, and then it remained constant despite of increasing the HRT from 12 h to 18 h and to 24 h. The results obtained from this study showed that the HRT of 12 h was better for COD and Nitrate removal and a good settling performance occurred during that range.

Keywords: COD, hydraulic retention time, nitrate, sequencing batch reactor, sludge characteristics

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Authors: Vladimir Siska, Lukas Kober

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Introduction: The research deals with the work satisfaction of nurses working in healthcare institutions in the Slovak Republic, and factors influencing it. Employers should create working conditions that are consonant with the requirements of their employees and make the most of motivation strategies to help them answer to the employess' needs in concordance with various needs and motivation process theories. Methodology: In our research, we aimed to investigate the level of work satisfaction in nurses by carrying out a quantitative analysis using the standardized McCloskey/Mueller Satisfaction scale questionnaire. We used the descriptive positioning characteristics (average, median and variability, standard deviation, minimum and maximum) to process the collected data and, to verify our hypotheses; we employed the double-selection Student T-test, Mann-Whitney U test, and a one-way analysis of variance (One-way ANOVA). Results: Nurses´satisfaction with external rewards is influenced by their age, years of experience, and level of completed education, with all of the abovementioned factors also impacting on the nurses' satisfaction with their work schedule. The type of founding authority of the healthcare institution also constitutes an influence on the nurses' satisfaction concerning relationships in the workplace. Conclusion: The feelling of work dissatisfaction can influence employees in many ways, e.g., it can take the form of burn-out syndrome, absenteeism, or increased fluctuation. Therefore, it is important to pay increased attention to all employees of an organisation, regardless of their position.

Keywords: motivation, nurse, work satisfaction, McCloskey/Mueller satisfaction scale

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Authors: Mera Ababneh, Sayer Al-Azzam, Karem Alzoubi, Abeer Rababa'h

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Background: Medication errors are among the most common medical errors. Their occurrences result in patient’s mortality, morbidity, and additional healthcare costs. Continuous monitoring and detection is required. Objectives: The aim of this study was to compare medication errors in outpatient’s prescriptions in two different hospitals (paper system vs. electronic system). Methods: This was a cross sectional observational study conducted in two major hospitals; King Abdullah University Hospital (KAUH) and Princess Bassma Teaching Hospital (PBTH) over three months period. Data collection was conducted by two trained pharmacists at each site. During the study period, medication prescriptions and dispensing procedures were screened for medication errors in both participating centers by two trained pharmacist. Results: In the electronic prescription hospital, 2500 prescriptions were screened in which 631 medication errors were detected. Prescription errors were 231 (36.6%), and dispensing errors were 400 (63.4%) of all errors. On the other side, analysis of 2500 prescriptions in paper-based hospital revealed 3714 medication errors, of which 288 (7.8%) were prescription errors, and 3426 (92.2%) were dispensing errors. A significant number of 2496 (67.2%) were inadequately and/or inappropriately labeled. Conclusion: This study provides insight for healthcare policy makers, professionals, and administrators to invest in advanced technology systems, education, and epidemiological surveillance programs to minimize medication errors.

Keywords: medication errors, prescription errors, dispensing errors, electronic prescription, handwritten prescription

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Authors: Nana Benma Osei

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Patient discharge can be a hectic process. Patients are sometimes sent to the wrong location or forgotten in lounges in the waiting room. This ends up compromising patient care because the delay in picking the patients can affect how they adhere to medication. Patients may fail to take their medication, and this will lead to negative outcomes. The situation highlights the demands of modern-day healthcare, and the use of technology can help in reducing such challenges and in enhancing the patient’s experience, leading to greater satisfaction with the care provided. The paper contains the proposed changes to a healthcare facility by introducing the clinical decision support system, which will be needed to improve coordination and communication during patient discharge. This will be done under Kurt Lewin’s Change Management Model, which recognizes the different phases in the change process. A pilot program is proposed initially before the program can be implemented in the entire organization. This allows for the identification of challenges and ways of managing them. The paper anticipates some of the possible challenges that may arise during implementation, and a multi-disciplinary approach is considered the most effective. Opposition to the change is likely to arise because staff members may lack information on how the changes will affect them and the skills they will need to learn to use the new system. Training will occur before the technology can be implemented. Every member will go for training, and adequate time is allocated for training purposes. A comparison of data will determine whether the project has succeeded.

Keywords: patient discharge, clinical decision support system, communication, collaboration

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Authors: Mesfin Nigussie

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The objectives of the study were to identify factors affecting rural households’ willingness to install biogas plant and amount willingness to pay in order to examine determinants of effective demand for biogas technology. A multistage sampling technique was employed to select 120 respondents for the study. The binary probit regression model was employed to identify factors affecting rural households’ decision to install biogas technology. The probit model result revealed that household size, total household income, access to extension services related to biogas, access to credit service, proximity to water sources, perception of households about the quality of biogas, perception index about attributes of biogas, perception of households about installation cost of biogas and availability of energy source were statistically significant in determining household’s decision to install biogas. Tobit model was employed to examine determinants of rural household’s amount of willingness to pay. Based on the model result, age of the household head, total annual income of the household, access to extension service and availability of other energy source were significant variables that influence willingness to pay. Providing due considerations for extension services, availability of credit or subsidy, improving the quality of biogas technology design and minimizing cost of installation by using locally available materials are the main suggestions of this research that help to create effective demand for biogas technology.

Keywords: biogas technology, effective demand, probit model, tobit model, willingnes to pay

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Authors: J. Milton, C. Uzoigwe, O. Ayeko, B. Offorha, K. Anderson, R. G. Middleton

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Background: We used the UK National Hip Fracture database to determine the effect of institution hip fracture case volume on hip fracture healthcare outcomes in 2019. Using logistic regression for each healthcare outcome, we compared the best performing 50 units with the poorest performing 50 units in order to determine if the unit volume was associated with performance for each particular outcome. Method: We analysed 175 institutions treating a total of 67,673 patients over the course of a year. Results: The number of hip fractures seen per unit ranged between 86 and 952. Larger units tendered to perform health assessments more consistently and mobilise patients more expeditiously post-operatively. Patients treated at large institutions had shorter lengths of stay. With regard to most other outcomes, there was no association between unit case volume and performance, notably compliance with the Best Practice Tariff, time to surgery, proportion of eligible patients undergoing total hip arthroplasty, length of stay, delirium risk, and pressure sore risk assessments. Conclusion: There is no relationship between unit volume and the majority of health care outcomes. It would seem that larger institutions tend to perform better at parameters that are dependent upon personnel numbers. However, where the outcome is contingent, even partially, on physical infrastructure capacity, there was no difference between larger and smaller units.

Keywords: institution volume, mortality, neck of femur fractures, osteoporosis

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Authors: Iris Xiaohong Quan, Sharon Qi, Kelly Tianqin Shi

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This study focuses on the critical role of insurance policies in a world grappling with increasing mental health challenges, as they significantly influence the dynamics of healthcare businesses and entrepreneurial ventures. The paper utilizes the mental health sector as a case to examine the impact of insurance policies on healthcare service providers, entrepreneurs, and individuals seeking mental health support. This paper addressed the following research questions: To what extent do changes in insurance reimbursement policies affect the accessibility and affordability of mental health services for patients, and how does this impact the overall demand for such services? What are the barriers and opportunities that mental health entrepreneurs face and what strategies and adaptations do mental health businesses employ when navigating the evolving landscape of insurance reimbursement policies? How do changes in insurance reimbursement policies, specifically related to mental health services, influence the financial viability and sustainability of mental health clinics and private practices? Employing a self-designed survey aimed at autism spectrum disorder (ASD) treatment companies, alongside two in-depth case studies and an analysis of pertinent insurance policies and documents, this research aims to elucidate the multifaceted influence of insurance policies on the mental health industry. The findings from this study reveal how insurance policies shape the landscape of mental health businesses and their operations. A total of 821 autism treatment organizations or offices were contacted by telephone between November 1, 2019, and January 31, 2020. About half of the offices (53.33%) were established in the past five years, and 80% were established in the past 15 years. There is a significant increase in the establishment of ABA service centers in the recent two decades as a result of autism insurance reform, the increasing social awareness of ASD, and the redefinition of autism. In addition, almost half of the ABA service providers we surveyed had a patient size ranging from 20 to 50 in the year when the residence state passed the legislation for autism insurance coverage. On average, an ABA service provider works with 5.3 insurance companies. This research find that insurance is the main source of revenue for most ABA service providers. However, our survey reveals that clients’ out of pocket payment has been the second main revenue sources. Despite the changes of regulations and insurance policies in all states, clients still have to pay a fraction of, if not all, the ABA treatment service fees out of pocket. This research shows that some ABA service providers seek federal and government funds and grants to support their services and businesses. Our further analysis with the in-depth case studies and other secondary data also indicate the rise of entrepreneurial startups in the mental health industry. Overall, this research sheds light on both the challenges and opportunities presented by insurance policies in the mental health sector, offering insights into the new industry landscape.

Keywords: entrepreneurship, healthcare policy, insurance policy, mental health industry

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Authors: Kubra Akbayrak

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In parallel with increasing inclusive practice for pupils with vision impairments, the role of specialist teachers who have specialized in the area of vision impairment has dramatically changed in recent years. This study, therefore, aims to provide a holistic perspective towards the distinctive role of specialist teachers of pupils with vision impairments in different educational settings (including mainstream settings, special school settings, etc.) in Turkey and England. Within the scope of the study, semi-structured interviews have been conducted with 17 specialist teachers in Turkey and 14 specialist teachers in England in order to reveal the perception of specialist teachers regarding their roles in different educational settings as well as their perception towards their pre-service training. As this study is a part of an ongoing PhD research, the qualitative data through semi-structured interviews will be analyzed through using Bronfenbrenner’s ecological systems theory as a theoretical framework in order to provide a holistic view regarding the role of specialist teachers particularly in facilitating curriculum access for pupils with vision impairments in England and Turkey. However, the initial findings broadly illustrate that specialist teachers who work in special school settings have different understanding regarding their roles compared to specialist teachers who work in mainstream settings in relation to promoting independence for pupils with vision impairments. The initial findings also imply that specialist teachers in England and Turkey have different perception about their roles in relation to providing specialist advice and guidance for families of pupils. With the completion of the analysis of the study, it is hoped that the findings will provide an insight into the role of specialist teachers in order to provide implication for programmes which prepare specialist teachers of pupils with vision impairments.

Keywords: curriculum access, pupils with vision impairments, specialist teachers, special education

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Authors: Zaman Jawahar, Anne Rouve-Khiev, Elizabeth Hoban, Joanne Williams

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Ensuring access to timely obstetric care is essential to prevent maternal deaths. Geographical barriers pose significant challenges for women accessing quality reproductive and maternal health services in rural Cambodia. This policy brief affirms the need to address the issue of transportation and cost (direct and indirect) as critical barriers to accessing reproductive and maternal health (RMH) services in four provinces in Northeast Cambodia (Kratie, Ratanak Kiri, Mondul Kiri, Stung Treng). A systemic search of the literature identified 1,116 articles, and only ten articles from low-and-middle-income countries met the inclusion criteria. The ten articles reported on transportation and cost related to accessing RMH services. In addition, research findings from Partnering to Save Lives (PSL) studies in the four provinces were included in the analysis. Thematic data analysis using the information in the ten articles and PSL research findings was conducted, and the findings are presented in this paper. The key findings are the critical barriers to accessing RMH services in the four provinces because women experience: 1) difficulties finding affordable transportation; 2) lack of available and accessible transportation; 3) greater distance and traveling time to services; 4) poor geographical terrain and; 5) higher opportunity costs. Distance and poverty pose a double burden for the women accessing RMH services making a facility-based delivery less feasible compared to home delivery. Furthermore, indirect and hidden costs associated with institutional delivery may have an impact on women’s decision to seek RMH care. Existing health financing schemes in Cambodia such as the Health Equity Fund (HEF) and the Voucher Scheme contributed to the solution but have also shown some limitations. These schemes contribute to improving access to RMH services for the poorest group, but the barrier of transportation costs remains. In conclusion, initiatives that are proven to be effective in the Cambodian context should continue or be expanded in conjunction with the HEF, and special consideration should be given to communities living in geographically remote regions and difficult to access areas. The following strategies are recommended: 1) maintain and further strengthen transportation support in the HEF scheme; 2) expand community-based initiatives such as Community Managed Health Equity Funds and Village Saving Loans Associations; 3) establish maternity waiting homes; and 4) include antenatal and postnatal care in the provision of integrated outreach services. This policy brief can be used to inform key policymakers and provide evidence that can assist them to develop strategies to increase poor women’s access to RMH services in low-income settings, taking into consideration the geographic distance and other indirect costs associated with a facility-based delivery.

Keywords: access, barriers, northeast Cambodia, reproductive and maternal health service, transportation and cost

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Authors: Lawan Ja’afar Tahir

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This research work centered on the problem of free Arms flow around the Nigeria and Chad Border. The whole of the northeastern Nigerian region has been devastated by the crisis of insecurity facilitated by more than a decade of insurgency. One of the major issues of concern to security experts and personnel in the country is how the insurgents are getting access to weapons, which gave them more strength to fight the war for this long period, which has become so difficult to overcome. Among the possible avenues that continue to strengthen the enemies is the easy access to the arms flow from the neighboring countries, especially the Republic of Chad, which borders Nigeria to the east, where Boko Haram gained firm roots. This paper, therefore, looked at the nature of the waterway of the Nigeria/Chad Border, which has become a source of strength to the insurgents as the flow of weapons is one of the cheapest things on the Border. The availability of such arms flow has also led to the People abandoning their lands and economic and commercial activities, especially those settlements between the Border of these two countries. For more than eight years now, they have suspended their livelihood activities, roads were blocked and chances of survival in the rural areas were minimal due to the frequent attacks carried out by the insurgents. However, this research looks at the causes of the arms flow along the Border of these neighboring countries, the extent of damage done as a result of the availability of the weapons, and how far the Nigerian government has gone in curtailing the menace of the flow of dangerous weapons into the country. The research looked at the ways arm dealers are conniving with settlers along the border as well as the various ways they followed to reach their target. The work provided suggestion as to how the fragile Border should be managed with the view to reduce the influx of arms without control, which, according to this research, is the central factor that continues to unleash and give terror groups the opportunity to destroy people for more than a decade.

Keywords: border, insecurity, weapons, management

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Authors: Miriam Schiff, Hadas Rosenne, Ran Nir-Paz, Shiri Shinan Altman

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To examine (1) the level, predictors, and subjective perception of professional quality of life (PRoQL), posttraumatic growth, roles, task changes during the pandemic, and perceived preparedness for the next pandemic. These variables were added as part of an international study on social workers in healthcare stress, resilience, and perceived preparedness we took part in, along with Australia, Canada, China, Hong Kong, Singapore, and Taiwan. (2) The extent to which background variables, rate of exposure to the virus, working in COVID wards, profession, personal resilience, and resistance to organizational change predict posttraumatic growth, perceived preparedness, and PRoQL (the latter was examined among social workers only). (3) The teams' perceptions of how the pandemic impacted them at the personal, professional, and organizational levels and what assisted them. Methodologies: Mixed quantitative and qualitative methods were used. 1039 hospital healthcare workers from various professions participated in the quantitative study while 32 participated in in-depth interviews. The same methods were used in six other countries. Findings: The level of PRoQL was moderate, with higher burnout and secondary traumatization level than during routine times. Differences between countries in the level of PRoQL were found as well. Perceived preparedness for the next pandemic at the personal level was moderate and similar among the different health professions. Higher exposure to the virus was associated with lower perceived preparedness of the hospitals. Compared to other professions, doctors and nurses perceived hospitals as significantly less prepared for the next pandemic. The preparedness of the State of Israel for the next pandemic is perceived as low by all healthcare professionals. A moderate level of posttraumatic growth was found. Staff who worked at the COVID ward reported a greater level of growth. Doctors reported the lowest level of growth. The staff's resilience was high, with no differences among professions or levels of exposure. Working in the COVID ward and resilience predicted better preparedness, while resistance to organizational change predicted worse preparedness. Findings from the qualitative part of the study revealed that healthcare workers reported challenges at the personal, professional and organizational level during the different waves of the pandemic. They also report on internal and external resources they either owned or obtained during that period. Conclusion: Exposure to the COVID-19 virus is associated with secondary traumatization on one hand and personal posttraumatic growth on the other hand. Personal and professional discoveries and a sense of mission helped cope with the pandemic that was perceived as a historical event, war, or mass casualty event. Personal resilience, along with the support of colleagues, family, and direct management, were seen as significant components of coping. Hospitals should plan ahead and improve their preparedness to the next pandemic.

Keywords: covid-19, health-care, social workers, burnout, preparedness, international perspective

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Authors: Jainendra Singh, Zaheeruddin

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A typical wireless sensor networks (WSNs) consists of several tiny and low-power sensors which use radio frequency to perform distributed sensing tasks. The longevity of wireless sensor networks (WSNs) is a major issue that impacts the application of such networks. While routing protocols are striving to save energy by acting on sensor nodes, recent studies show that network lifetime can be enhanced by further involving sink mobility. A common approach for energy efficiency is partitioning the network into clusters with correlated data, where the representative nodes simply transmit or average measurements inside the cluster. In this paper, we propose an energy- efficient homogenous clustering (EHC) technique. In this technique, the decision of each sensor is based on their residual energy and an estimate of how many of its neighboring cluster heads (CHs) will benefit from it being a CH. We, also explore the routing algorithm in clustered WSNs. We show that the proposed schemes significantly outperform current approaches in terms of packet delay, hop count and energy consumption of WSNs.

Keywords: wireless sensor network, energy efficiency, clustering, routing

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Authors: Hesham Kozou

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Sensorineural hearing loss (SNHL) poses a significant challenge due to limited access to the inner ear for therapies. Emerging treatments such as regenerative, genetic, and pharmacotherapies offer hope for addressing this condition. This study aims to highlight the potential of cochlear implants and emerging therapies in managing sensorineural hearing loss by improving access to the inner ear. The study is conducted through a review of relevant literature and research articles in the field of cochlear implants and emerging therapies for hearing loss. It outlines how advancements in cochlear implant technologies, electrodes, and surgical techniques can facilitate the delivery of therapies to the inner ear, potentially revolutionizing the treatment of sensorineural hearing loss. The study underscores the potential of cochlear implants and emerging therapies in revolutionizing the treatment landscape for sensorineural hearing loss, emphasizing the feasibility of curing this condition by leveraging technological advancements.

Keywords: therapies for hearing loss management, future of CI as a cochlear delivery channel, regenerative, genetic and pharmacotherapeutic management of hearing loss

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Authors: Wint Wint Thu, Htet Ko Ko Win, Myat Mon San, Zaw Lin Tun, Nandar Than Aye, Khin Nyein Myat, Hayman Nyo Oo, Nay Aung Lin, Kusum Thapa, Kyaw Htet Aung

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Background: In Myanmar, the intense political instability happened to start in Feb-2021, while the COVID-19 pandemic waves are also threatening the public health system, which subsequently led to severe health sector crisis, including difficulties in accessing maternal and newborn health care for vulnerable women and children. The Remote Pregnant and Newborn Care (RPNC) uses a telehealth approach United States Agency for International Development (USAID)-funded Essential Health Project. Implementation: The Remote Pregnant and Newborn Care (RPNC) service has adapted to the MNCH needs of vulnerable pregnant women and was implemented to mitigate the risk of limited access to essential quality MNH care in Yangon, Myanmar, under women, and the project trained 13 service providers on a telehealth care package for pregnancy and newborn developed Jhpiego to ensure understanding of evidence-based MNCH care practices. The phone numbers of the pregnant women were gathered through the preexisting and functioning community volunteers, who reach the most vulnerable pregnant women in the project's targeted area. A total of 212 pregnant women have been reached by service providers for RPNC during the implementation period. The trained service providers offer quality antenatal and postnatal care, including newborn care, via telephone calls. It includes 24/7 incoming calls and time-allotted outgoing calls to the pregnant women during antenatal and postnatal periods, including the newborn care. The required data were collected daily in time with the calls, and the quality of the medical services is made assured with the track of the calls, ensuring data privacy and patient confidentiality. Lessons learned: The key lessons are 1) cost-effectiveness: RPNC service could reduce out of pocket expenditure of pregnant women as it only costs 1.6 United States dollars (USD) per one telehealth call while it costs 8 to 10 USD per one time in-person care service at private service providers, including transportation cost, 2) network of care: telehealth call could not replace the in-person antenatal and postnatal care services, and integration of telehealth calls with in-person care by local healthcare providers with the support of the community is crucial for accessibility to essential MNH services by poor and vulnerable women, and 3) sharing information on health access points: most of the women seem to have financial barriers in accessing private health facilities while public health system collapse and telehealthcare could provide information on low-cost facilities and connect women to relevant health facilities. These key lessons are important for future efforts regarding the implementation of remote pregnancy and newborn care in Myanmar, especially during the political crisis and COVID-19 pandemic situation.

Keywords: telehealth, accessibility, maternal care, newborn care

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Authors: Milad Keshvardoost, Amir Khanlari, Nader Khalesi

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Background: Any firm in the pharmaceutical industry requires efficient and effective management information systems (MIS) to support managerial functions. Purpose: The aim of this study is to investigate the impact of Task-Technology Fit on user effectiveness, efficiency, and creativity in Iranian pharmaceutical companies. Methodology: 345 reliable and validate questionnaires were distributed among selected samples, through the cluster method, to Information system users of eight leading Iranian pharmaceutical companies, based on the likert scale. The proposed model of the article is based on a model with Task technology fit, on user performance with the definition of efficiency, effectiveness, and creativity through mediation effects of perceived usefulness and ease of use. Results: This study confirmed that TTF with definitions of adequacy and compatibility has positive impacts on user performance Conclusion: We concluded that pharmaceutical users of IS, utilizing a system with a precise and intense observation of users' demands, may make facilitation for them to design an exclusive IS framework.

Keywords: information systems, user performance, pharmaceuticals, task technology fit

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Authors: Djamila Nebbali, Rezki Nebbali, Ahmed Ouibrahim

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This study focuses on the cooling of a photovoltaic panel (PV). Indeed, the cooling improves the conversion capacity of this one and maintains, under extreme conditions of air temperature, the panel temperature at an appreciable level which avoids the altering. To do this, a fan provides forced circulation of air. Because the fan is supplied by the panel, it is necessary to determine the optimum operating point that unites efficiency of the PV with the consumption of the fan. For this matter, numerical simulations are performed at varying mass flow rates of air, under two extreme air temperatures (50°C, 25°C) and a fixed solar radiation (1000 W.m2) in a case of no wind.

Keywords: energy conversion, efficiency, balance energy, solar cell

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Authors: Thamer Kubat, Riadh Al-Mahaidi, Ahmad Shayan

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The alkali-aggregate reaction (AAR) in concrete has a negative influence on the mechanical properties and durability of concrete. Confinement by carbon fibre-reinforced polymer (CFRP) is an effective method of treatment for some AAR-affected elements. Eighteen reinforced columns affected by different levels of expansion due to AAR were confined using CFRP to evaluate the effect of expansion level on confinement efficiency. Strength and strain capacities (axial and circumferential) were measured using photogrammetry under uniaxial compressive loading to evaluate the efficiency of CFRP wrapping for the rehabilitation of affected columns. In relation to uniaxial compression capacity, the results indicated that the confinement of AAR-affected columns by one layer of CFRP is sufficient to reach and exceed the load capacity of unaffected sound columns. Parallel to the experimental study, finite element (FE) modeling using ATENA software was employed to predict the behavior of CFRP-confined damaged concrete and determine the possibility of using the model in a parametric study by simulating the number of CFRP layers. A comparison of the experimental results with the results of the theoretical models showed that FE modeling could be used for the prediction of the behavior of confined AAR-damaged concrete.

Keywords: carbon fiber reinforced polymer (CFRP), finite element (FE), ATENA, confinement efficiency

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Authors: M. Sharifi, M. Mirzaii, F. Bolourinovin, H. Yousefnia, M. Akbari, K. Yousefi-Mojir

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A multilayer passive shield composed of low-activity lead (Pb), copper (Cu), tin (Sn) and iron (Fe) was designed and manufactured for a coaxial HPGe detector placed at a surface laboratory for reducing background radiation and radiation dose to the personnel. The performance of the shield was evaluated and efficiency curves of the detector were plotted by using of the various standard sources in different distances. Monte Carlo simulations and a set of TLD chips were used for dose estimation in two distances of 20 and 40 cm. The results show that the shield reduced background spectrum and the personnel dose more than 95%.

Keywords: HPGe shield, background count, personnel dose, efficiency curve

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Authors: Jenny Ringblom, Marie Proczkowska, Laura Korhonen, Ingrid Wåhlin

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Background: Emergence delirium is a well-known behaviour of perceptual disturbances that may occur after general anaesthesia in children. Children with emergence delirium are often confused; they cry, are involuntarily physically active and are almost impossible to console. The prevalence varies considerably between about 13% and 53%. Research has mainly focused on how different medication accents affect the incidence of emergence delirium, but less is known about parents’ experiences of emergence delirium during the recovery process. Aim: The aim of this study was to describe parents’ experiences and reflections during their child's emergence delirium behaviour when recovering from anaesthesia. Method: The study has a qualitative design, and the data has been analyzed using thematic analysis. A total of 16 parents were interviewed at two county hospitals in Sweden. Results: When the parents reunited with their child at the recovering unit, they felt as if they were encountering an incomprehensible scenario. When watching their child demonstrating emergence delirium, they experienced fear and insecurity and had feelings of powerlessness and guilt. Information and previous experience turned out to offer relief and being seen by the healthcare staff when they, in their vulnerability, failed to reach or console their child gave hope and energy. Conclusion: Emergence delirium must be extensively considered in children undergoing general anaesthesia. Healthcare staff needs to be aware of the parental difficulties it may cause. There is also important to know what parents experience as relieving, such as receiving information and when staff members are being available, responsive and supportive during the wake-up period.

Keywords: emergence delirium, experiences, pediatrics, parents, postoperative care

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Authors: Samia Jamshed Nauman Majeed

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Purpose: Globally, the pandemic of COVID -19 has created a massive distraction for educational reforms influencing learning options, education access, and outcomes of students in more than 190 countries which has carved marks in history. To explore the challenges and complications confronted by students and faculty members while ensuring access to online education, qualitative research was conducted. Methodology: For this purpose, a series of focus group discussions were conducted in different regions of Pakistan, which revealed interesting findings shared by Panelists, which include Vice-Chancellors, Rectors, and Deans of different private and public sector universities of Pakistan. The qualitative research aims to explore the challenges and success factors of online educations by students with diverse backgrounds of higher education institutions to maximize student educational outcomes. Findings: The findings revealed several challenges and opportunities when it comes to online education for students of higher education institutions. Simultaneously, the researchers discovered the key success factors necessary for online education. Lastly, the paper presents the research limitations and future research recommendations to streamline online education in a better way ensuring the students' success. Originality: The pandemic has forced the closure of social, business, and educational activities, which has drastically influence the quality of education with its subsequent impact on the economy. In response, numerous universities across the globe are forced to suspend their educational activities by closing the universities. Though online education has been adopted worldwide by the universities, which brought numerous issues for academia, particularly for underdeveloped countries, and Pakistani higher education reforms are no exception to this.

Keywords: online education, higher education institutions, COVID-19, challenges, key success factors

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Authors: Okoro Ngozi Priscilla

Abstract:

Education is the bedrock of development in every nation of the world, and it is very useful in ensuring quality of life for every individual and a better world for the people. Education, therefore, is the basic instrument of economic growth and technological advancement in any society. It is in recognition of this fact that the Nigerian government commits immense resources to ensuring that its citizens acquire education and also policies are being made to ensure the accessibility of education, qualitative higher education is highly recognized as a vital driving force for the socio-economic growth and technological development of nations yet the problem of access to University education in the country persists and therefore brought about the introduction of Open and Distance Learning (ODL) which has as its main objective, the attainment of mass literacy and providing opportunities for those who could not gain admission through designated entrance examination agencies as well as those who could not afford to leave their job to attend a full-time educational programme. Open and distance learning seeks to improve skilled manpower and also improve the skills for those already at work.

Keywords: accessibility, open and distant learning programme, fulltime educational programme, distance learning

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Authors: Keshek M.H, Mohamed M.A, El-Shafey M.A

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The aim of this research was increasing the productivity of solar distillation. In order to reach this aim, a solar distiller was created with three glass sides sloping 30o at the horizontal level, and the experiments were carried out on the solar distillation unit during the period from 24th August, 2016 till 24th May, 2017 at the Agricultural Engineering and Bio Systems Department, Faculty of Agriculture, Menoufia University. Three gap lengths were used between the water level and the inner glass cover, those were 3, 6, and 9 cm. As the result of change the gap length between the water level and the inner glass cover the total volume of basins were changed from 15.5, 13, and 11 L, respectively. The total basin volume was divided to three sections, to investigate the effect of water volume. The three water volumes were 100%, 75%, and 50%. Every section was supplied with one, two, or three heaters. The one heater power was 15 W. The results showed that, by increasing the distance between the basins edge and the inner edge of the glass cover, an increase occurs in the percentage of temperature difference with maximum value was 52% at distance 9 cm from each edge, an increase occurs in the productivity with maximum productivity was 3.3 L/m2 at distance 9 cm from each edge and an increase occurs in the efficiency with maximum efficiency was 70% at distance 9 cm from each edge.

Keywords: distillation, solar energy, still productivity, efficiency

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Authors: Isao Tomita

Abstract:

We develop a periodically-poled LiNbO3 (PPLN) device for highly-efficient third-harmonic generation (THG), where the THG efficiency is enhanced with a cavity. THG can usually be produced via χ(3)-nonlinear materials by optical pumping with very high pump-power. Instead, we here propose THG by moderate-power pumping through a specially-designed PPLN device containing only χ(2)-nonlinearity, where sum-frequency generation in the χ(2) process is employed for the mixing of a pump beam and a second-harmonic-generation (SHG) beam produced from the pump beam. The cavity is designed to increase the SHG power with dichroic mirrors attached to both ends of the device that perfectly reflect the SHG beam back to the device and yet let the pump and THG beams pass through the mirrors. This brings about a THG-power enhancement because of THG power proportional to the enhanced SHG power. We examine the THG-efficiency dependence on the mirror reflectance and show that very high THG-efficiency is obtained at moderate pump-power when compared with that of a cavity-free PPLN device.

Keywords: cavity, periodically-poled LiNbO₃, sum-frequency generation, third-harmonic generation

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Authors: Walid Moudani

Abstract:

The healthcare environment is generally perceived as being information rich yet knowledge poor. However, there is a lack of effective analysis tools to discover hidden relationships and trends in data. In fact, valuable knowledge can be discovered from application of data mining techniques in healthcare system. In this study, a proficient methodology for the extraction of significant patterns from the coronary heart disease warehouses for heart attack prediction, which unfortunately continues to be a leading cause of mortality in the whole world, has been presented. For this purpose, we propose to enumerate dynamically the optimal subsets of the reduced features of high interest by using rough sets technique associated to dynamic programming. Therefore, we propose to validate the classification using Random Forest (RF) decision tree to identify the risky heart disease cases. This work is based on a large amount of data collected from several clinical institutions based on the medical profile of patient. Moreover, the experts’ knowledge in this field has been taken into consideration in order to define the disease, its risk factors, and to establish significant knowledge relationships among the medical factors. A computer-aided system is developed for this purpose based on a population of 525 adults. The performance of the proposed model is analyzed and evaluated based on set of benchmark techniques applied in this classification problem.

Keywords: multi-classifier decisions tree, features reduction, dynamic programming, rough sets

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Authors: Cheng-Chi Yu, Chi-Shiun Chiou

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This study developed a plug-in hybrid powertrain system which consisted of two continuous variable transmissions. By matching between the engine, motor, generator, and dual continuous variable transmissions, this integrated power system can take advantages of the components. The hybrid vehicle can be driven by the internal combustion engine, or electric motor alone, or by these two power sources together when the vehicle is driven in hard acceleration or high load. The energy management of this integrated hybrid system controls the power systems based on rule-based control strategy to achieve better fuel economy. When the vehicle driving power demand is low, the internal combustion engine is operating in the low efficiency region, so the internal combustion engine is shut down, and the vehicle is driven by motor only. When the vehicle driving power demand is high, internal combustion engine would operate in the high efficiency region; then the vehicle could be driven by internal combustion engine. This strategy would operate internal combustion engine only in optimal efficiency region to improve the fuel economy. In this research, the vehicle simulation model was built in MATLAB/ Simulink environment. The analysis results showed that the power coupled efficiency of the hybrid powertrain system with dual continuous variable transmissions was better than that of the Honda hybrid system on the market.

Keywords: plug-in hybrid power system, fuel economy, performance, continuously variable transmission

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Authors: Adiba Matin, Daniel Cabrera, Javiera Bellolio, Jasmine Stewart, Dana Gerberi (librarian), Nathan Cummins, Fernanda Bellolio

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OBJECTIVES: Artificial intelligence (AI) tools are becoming more prevalent in healthcare settings, particularly for diagnostic and therapeutic recommendations, with an expected surge in the incoming years. The bedside use of this technology for clinicians opens the possibility of disagreements between the recommendations from AI algorithms and clinicians’ judgment. There is a paucity in the literature analyzing nature and possible outcomes of these potential conflicts, particularly related to ethical considerations. The goal of this scoping review is to identify, analyze and classify current themes and potential strategies addressing ethical conflicts originating from the conflict between AI and human recommendations. METHODS: A protocol was written prior to the initiation of the study. Relevant literature was searched by a medical librarian for the terms of artificial intelligence, healthcare and liability, ethics, or conflict. Search was run in 2021 in Ovid Cochrane Central Register of Controlled Trials, Embase, Medline, IEEE Xplore, Scopus, and Web of Science Core Collection. Articles describing the role of AI in healthcare that mentioned conflict between humans and AI were included in the primary search. Two investigators working independently and in duplicate screened titles and abstracts and reviewed full-text of potentially eligible studies. Data was abstracted into tables and reported by themes. We followed methodological guidelines for Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). RESULTS: Of 6846 titles and abstracts, 225 full texts were selected, and 48 articles included in this review. 23 articles were included as original research and review papers. 25 were included as editorials and commentaries with similar themes. There was a lack of consensus in the included articles on who would be held liable for mistakes incurred by following AI recommendations. It appears that there is a dichotomy of the perceived ethical consequences depending on if the negative outcome is a result of a human versus AI conflict or secondary to a deviation from standard of care. Themes identified included transparency versus opacity of recommendations, data bias, liability of outcomes, regulatory framework, and the overall scope of artificial intelligence in healthcare. A relevant issue identified was the concern by clinicians of the “black box” nature of these recommendations and the ability to judge appropriateness of AI guidance. CONCLUSION AI clinical tools are being rapidly developed and adopted, and the use of this technology will create conflicts between AI algorithms and healthcare workers with various outcomes. In turn, these conflicts may have legal, and ethical considerations. There is limited consensus about the focus of ethical and liability for outcomes originated from disagreements. This scoping review identified the importance of framing the problem in terms of conflict between standard of care or not, and informed by the themes of transparency/opacity, data bias, legal liability, absent regulatory frameworks and understanding of the technology. Finally, limited recommendations to mitigate ethical conflicts between AI and humans have been identified. Further work is necessary in this field.

Keywords: ethics, artificial intelligence, emergency medicine, review

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Authors: Irma Andriani, Ita Djuwita, Komar Sumantadinata, Alimuddin

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The recent study has been conducted to develop testicular germ cell transplantation as a tool for preservation and propagation of male germ-plasm from endangered fish species, as well as to produce surrogate broodstock of commercially valuable fish. Giant gourami testis had been used as a model for donor and Nile tilapia larvae as recipient. We developed testicular cell xenotransplantation by optimizing the timing of intraperitoneal cell transplantation to recipient larvae aged 1, 3, 5 and 7 days post hatching (dph). Freshly isolated testis of giant gourami weighing 600–800 g were minced in dissociation medium and then incubated for 3 hours in room temperature to collect monodisperce cell suspension. Donor cells labeled with PKH 26 were transplanted into the peritoneal cavity of Nile tilapia larvae using glass micropipettes. Parameters observed were survival rate of Nile tilapia larvae at 24 hours post transplantation (pt) and colonization efficiency of donor cells at 2 and 3 months pt. The incorporated donor cells were observed under fluorescent microscope. The result showed that the lowest survival rate at 24 hours pt was 1 dph larvae (82.74±6.76%) and the highest survival rate were 3 and 5 dph larvae (95.00±5.00% and 95.00±2.50%, respectively). The highest colonization efficiency was on 3 dph larvae (61.1±34.71%) and the lowest colonization efficiency was on 7 dph larvae (19.43±17.33%). In conclusion, 3 dph Nile tilapia larvae was the best recipient for giant gourami testicular germ cells xenotransplantation.

Keywords: xenotransplantation, testicular germ cell, giant gourami, Nile tilapia, colonization efficiency

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Authors: Syed Asif Ali Naqvi, Muhammad Azeem Tufail

Abstract:

Inadequate sanitation causes direct costs of treating illnesses and loss of income through reduced productivity. This study estimated the economic cost of health (ECH) due to poor sanitation and factors determining the lack of access to latrine for the rural, backward hamlets and slums of district Faisalabad, Pakistan. Cross sectional data were collected and analyzed for the study. As the population under study was homogenous in nature, it is why a simple random sampling technique was used for the collection of data. Data of 440 households from 4 tehsils were gathered. The ordinary least square (OLS) model was used for health cost analysis, and the Probit regression model was employed for determining the factors responsible for inaccess to toilets. The results of the study showed that condition of toilets, situation of sewerage system, access to adequate sanitation, Cholera, diarrhea and dysentery, Water and Sanitation Agency (WASA) maintenance, source of medical treatment can plausibly have a significant connection with the dependent variable. Outcomes of the second model showed that the variables of education, family system, age, and type of dwelling have positive and significant sway with the dependent variable. Variable of age depicted an insignificant association with access to toilets. Variable of monetary expenses would negatively influence the dependent variable. Findings revealed the fact, health risks are often exacerbated by inadequate sanitation, and ultimately, the cost on health also surges. Public and community toilets for youths and social campaigning are suggested for public policy.

Keywords: sanitation, toilet, economic cost of health, water, Punjab

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