Availability Of Equipment Research Articles

Quality of care provided to patients with type 2 diabetes mellitus in Tshwane, South Africa.

Type 2 diabetes mellitus (T2D) is a public health challenge, affecting 90% of all patients with diabetes, globally. Compliance to treatment guidelines among healthcare professionals (HCPs) is low, thus resulting in inadequate quality of patient care and poor health outcomes among patients. To examine the availability of equipment, guidelines, screening and education offered to patients with T2D and compare between clinics and community health centres (CHCs). Tshwane Metropolitan Municipality, Gauteng Province, South Africa. A cross-sectional descriptive study utilised a self-administered questionnaire to collect data from nurses and doctors responsible for treating patients with T2D, from May to June 2022. About 250 eligible HCPs were recruited during routine morning meetings in 22 clinics and six CHCs. More than 80% of HCPs reported having basic equipment except for ophthalmoscopes, Snellen charts (67%), tuning forks (64%), electrocardiograms (ECG) (46%) and monofilaments (12%). SEMDSA guidelines were reported by 16% of the participants, Diabetic Foot Care Guidelines were reported by 54% and Dietary Guidelines for Diabetic Patients by 55%. Furthermore, 91%, 71% and 69% of HCPs reported that ECG, microalbumin-creatinine and foot examinations were not always performed, respectively. About 66% and 17% always offered individual educational and group sessions, respectively. Equipment availability and compliance with treatment guidelines, patient education and screening of chronic complications are inadequate.Contribution:The study highlights the poor adherence to treatment guidelines and inadequate equipment in health facilities. These shortcomings could lead to missed opportunities for early diagnosis of complications and ultimately poorer patient outcomes.

PENERAPAN SEARCH ENGINE OPTIMIZATION PADA PEMBERITAAN DI MEDIA SIBER

The presence of the internet has changed the practice of journalistic activities in the mass media, especially cyber media. Cyber media editorial policies have also adjusted to the advancement of information technology by utilizing Search Engine Optimization (SEO). The implementation of SEO techniques in journalistic activities in cyber media is very necessary so that cyber media can survive and make it easier for the community to get information that suits their needs. Currently, cyber media has a higher attention in search engines because today's internet users will search for information through search engines every day. The purpose of this study is to find out the editorial policy of Pojoksatu.id cyber media in implementing Search Engine Optimization (SEO) in carrying out journalistic activities. The research was conducted using a qualitative approach with a descriptive nature and using the case study method. The results of the study show that the editorial policy of implementing SEO in news production in Pojoksatu.id still prioritizes journalistic principles. The resulting news products combine the needs of readers and utilize search engine technology in a balanced manner. The implementation of SEO in Pojoksatu.id includes three things. First, crawling is an automated process to collect and index data from various sources so that the news produced can be automatically read by search engines. Second, pay attention to the availability of adequate equipment so that journalistic activities can be carried out optimally and the news made by journalists can be on page one. Third, policies related to human resource development and editorial, Pojoksatu.id management continuously provides training to journalists and editors to be able to write news in accordance with SEO. Journalists and editors must be able to apply the right keywords in the news to be indexed by search engines and spread news links to social media.

Readiness to provide comprehensive emergency obstetric and neonatal care: a cross-sectional study in 30 health facilities in Tanzania

BackgroundDespite the global progress in bringing health services closer to the population, mothers and their newborns still receive substandard care leading to morbidity and mortality. Health facilities’ capacity to deliver the service is a prerequisite for quality health care. This study aimed to assess health facilities’ readiness to provide comprehensive emergency obstetric and newborn care (CEmONC), comprising of blood transfusion, caesarean section and basic services, and hence to inform improvement in the quality of care interventions in Tanzania.MethodsA cross-sectional assessment of 30 CEmONC health facilities implementing the Safer Births Bundle of Care package in five regions of Tanzania was carried out between December 2020 and January 2021. We adapted the World Health Organization’s Service Availability and Readiness Assessment tool to assess amenities, equipment, trained staff, guidelines, medicines, and diagnostic facilities. Composite readiness scores were calculated for each category and results were compared at the health facility level. For categorical variables, we tested for differences by Fisher’s exact test; for readiness scores, differences were tested by a linear mixed model analysis, taking into account dependencies within the regions. We used p < 0.05 as our level of significance.ResultsThe overall readiness to provide CEmONC was 69.0% and significantly higher for regional hospitals followed by district hospitals. Average readiness was 78.9% for basic amenities, 76.7% for medical equipment, 76.0% for diagnosis and treatment commodities, 63.6% for staffing and 50.0% for guidelines. There was a variation in the availability of items at the individual health facility level and across levels of facilities. We found a significant difference in the availability of basic amenities, equipment, staffing, and guidelines between regional, and district hospitals and health centres (p = 0.05). Regional hospitals had significantly higher scores of medical equipment than district hospitals and health centers (p = 0.02). There was no significant difference in the availability of commodities for diagnosis and treatment between different facility levels.ConclusionFacilities’ readiness was inadequate and varied across different levels of the facility. There is room to improve the facilities’ readiness to deliver quality maternal and newborn care. The responsible authorities should take immediate actions to address the observed deficiencies while carefully choosing the most effective and feasible interventions and monitoring progress in readiness.

Faktor yang Berhubungan dengan Kepatuhan Penggunaan Alat Pelindung Diri pada Pekerja Bengkel Las di Kecamatan Kota Soe

Welding workshops operating in Soe City District on average employ around 4-6 people with a minimum education of elementary school-graduate level. The welding process using electric power exposes workers directly to the dangers in the workplace. It is necessary to have Personal Protective Equipment (PPE) worn by workers while working and while in the workplace environment. The aim of this research is to determine factors related to compliance with the use of Personal Protective Equipment (PPE) among welding workshop workers in Soe City District. Sampling in this study used simple random sampling with a sample size of 94 people. Analysis of this relationship uses the chi square test as an alternative test. The research results show that there is a relationship between knowledge (p value=0.004), attitude (p value=0.001), availability of personal protective equipment (p value=0.008), and there is no relationship between education (p= value= 0.642), age (p value=0.294), and work accidents (p value=0.483) with compliance with the use of Personal Protective Equipment (PPE) among welding workshop workers in Soe City District.

Maximum Power Transfer of a Photovoltaic Microgeneration System Using PSO-Based Dynamic Modeling

This research aims to implement an already developed algorithm to obtain the maximum power transfer of a solar generation field based on a dynamic approach. The study addresses the sizing of the load to be supplied, which is a residential building. On the other hand, it also considers the field sizing as a function of the load and the operating characteristics of the selected inverter. The irradiance data correspond to the hourly record of a station that is part of the network of meteorological stations in Quito. Quito was chosen as the location for this research due to the optimization algorithm’s practical application and the availability of experimental equipment. The demand sizing is based on the regulations of the distribution company with jurisdiction in the area, which makes it a suitable test bed for the algorithm. The optimization algorithm is developed using Python (version 3.9), and the analysis of the behavior of the solar panels is performed by dynamic modeling using the Vensim software (version 10.1.2). Finally, comparative results are presented between using and not using the investigated circuit and algorithm in the photovoltaic system, obtaining an improvement in the generation over a system without the use of these improvements, validating these results by implementing them in a test system, obtaining ranges higher than 10% of the initially generated power.

Pivotal Decision for Acute Coronary Syndrome Patient with Left Main Coronary Artery Disease, When to Choose PCI over CABG

Background: Surgery is acceptable as a standard treatment of Left Main Coronary Artery (LMCA) Disease in a stable angina condition. But, in Acute Coronary Syndrome (ACS) setting, LMCA intervention is a still clinical challenge in many cardiac centers. Percutaneous coronary intervention (PCI) has emerged as a suitable alternative to coronary artery bypass grafting (CABG) for high-risk complex coronary artery disease (CAD) scenario. This study aimed to outline the management of NSTEMI patient include LMCA disease. Case presentation: A 72-year-old male presented with persistent chest pain, with a confirmed NSTEMI. A coronary angiography was done and revealed Three Vessel Disease (TVD) and Left Main (LM) CAD with highly calcified stenosis in the distal LM and Left Anterior Descending (LAD). An early invasive procedure was successfully performed for severely calcified LAD artery and distal LM lesions, using proper selection of several bail-out pre-dilatation difficult attempts such as scoring ballon and rotational atherectomy (RA). We observed the aftercare period, which showed no subsequent ACS events. Conclusion: Managing ACS patients requires careful consideration and risk assessment before deciding on revascularization procedures, especially in high-risk case such as LMCA disease. PCI can be an effective treatment strategy for this population but require good consideration of patient’s anatomical factors, comorbidities, the availability of appropriate skill and equipment. Keyword: Acute Coronary Syndrome, Coronary Artery Bypass Graft Surgery, Left Main Coronary Artery, Percutaneous Coronary Intervention.

Experimental approach to a remote engineering project and overcoming educational challenges.

For some degrees, practicum projects are essential to the curricula. Owing to the mild conditions and safety of its manufacturing, bioplastics represent an interesting opportunity to implement a hands-on approach for students to develop at home in an extended laboratory scheme. This work developed an experimental approach as a home-based project to address an environmental problem in developing avocado seed-based bioplastics reinforced with essential oils and showing antifungal properties and improved water barrier properties. All the experiments and characterizations could be adapted to a house setting. This contribution shows that it is possible to complete an experimental practicum project totally based at home and with significant good results. This approach to conducting projects remotely could be adopted in universities facing constraints such as limited laboratory facilities or equipment availability. It can also be applied to remote education initiatives and to overcome educational barriers for individuals facing gender-based inequalities.

Fertility preservation service for children and young adults at high risk of infertility; the hub and spoke model

PurposeTo evaluate the evolution of fertility preservation surgery in children and young adults at high risk of infertility from a single centre to a networked ‘Hub and Spoke’ service.MethodsA case note review of patients referred for ovarian or testicular cryopreservation between Jan 2013 and Dec 2023. Demographic data, procurement numbers, and site of procurement were collected. Specialist feedback was obtained to identify the challenges faced.ResultsOver time, the number of referrals increased from 4 to 349 patients per year with the number of Spoke centres rising to 36 ovarian and 16 testicular. In 2013–2014; 100% of procurement was ovarian as compared to 2023; 51% ovarian, 49% testicular. Of the 395 referrals in 2021, 81% (n = 319) went on to have procurement and storage of tissue. Between 2013 and 2016, 96% of cases were performed at the Hub. In 2023, 53/349 (15%) cases were performed at the Hub with the remaining 296 (85%) procured at Spoke sites. Surgical issues such as access to theatre, variation and availability of surgical equipment, thermal injury to ovarian tissue and variation in the size of the testicular specimen were identified.ConclusionThe Hub and Spoke model successfully delivers treatment to patients close to home as safely possible within their local treatment centre.

Barriers faced by primary healthcare providers in addressing emergencies in the Northern region of Palestine before and during the Gaza war

IntroductionPhysicians working in primary health care (PHC) centers are the first contact for patients and expected to deal with emergencies. Emergency care training in PHC settings has been neglected globally, especially in low to middle income countries. Adequate preparation becomes especially important during periods of conflict. The study objectives are to identify the barriers facing PHC physicians when dealing with emergency cases in the northern region of Palestine during the current conflict.MethodsA cross-sectional study was conducted with 179 physicians working in the 10 PHC centers distributed among 5 northern governances in Palestine. The study period was from July through December 2023. Data were collected electronically using a self-administered questionnaire, which was adapted from a comprehensive literature review. The questionnaire’s internal validity was confirmed by a Cronbach’s alpha coefficient of [0.85], indicating high reliability.ResultsThe ages of the physicians ranged from 25 to 60 years, with a mean ± SD of 35.3 ± 8.15 years. A significant majority (91.6%) were not boarded in any specialty. Most physicians (85.5%) had attended Basic Life Support (BLS) courses, whereas 45.2% and 72% had never attended Advanced Cardiovascular Life Support (ACLS) or Advanced Trauma Life Support (ATLS) courses, respectively. Physicians with emergency department experience (P = 0.002) and those who had attended ACLS courses (P < 0.001) reported significantly higher perceived competence in managing emergency cases.ConclusionEmergency services at PHC centers in northern Palestine are operational but require significant enhancements. There is a critical need for increased availability of essential equipment, supplies, and medications. Additionally, implementing comprehensive training programs in emergency management, particularly ACLS, is essential to improve the competence and performance of PHC physicians in emergency situations.

Maintainability Assessment during the Design Phase: Integrating MTA and UNE 151001

The focus on maintenance actions in the early design phases has been a trend in recent years. The main sources of information during the design of the maintainability process include operator reports, maintainer experience, failure history, and manufacturer recommendations. During this process, an important aspect is related to the configuration of maintenance tasks and interventions, such as their main phases, activities, and durations. The allocation or estimation of maintainability involves identifying and/or estimating the mean time to repair (MTTR) for each component or system. The time of the maintenance tasks or the repair time are fundamental for companies, as the availability of equipment directly depends on this parameter. In this study, a new method for evaluating maintainability during the design phases is proposed. The method is based on the integration of the maintenance task analysis (MTA) principles and the UNE 151001 maintainability evaluation standard. A data structure is proposed that serves the application of the UNE151001 procedures, obtaining a data-based maintainability evaluation. As a validation procedure, an application of the proposed approach is presented using two overhead cranes. Comparisons and recommendations are made regarding the maintainability of both pieces of equipment. Finally, some managerial and engineering insights are presented.

"Lusog-Linang": Utilizing Community-engaged Research towards Capacity Building in Health of an Underserved Community.

Nurses have a pivotal role in nurturing the capabilities of individuals, families, and population groups for better health. However, underserved communities in the Philippines, such as those with socioeconomic inadequacies, geographic isolation, and service access problems, have significant limitations in attaining the highest possible level of health. Hence, a community extension service (Project "Lusog-Linang"), employing community-engaged research, was launched with the residents of an underserved locality in Central Luzon. The current paper aimed to describe the engagement of the community residents in describing their current health situation and related priority problems, as well as explore appropriate initiatives to manage the identified problems. Community-engaged research was utilized to enable the residents of Barangay San Vicente, Bamban, Tarlac to participate in health capacity building. Particularly, records review and focus group discussions were conducted to assess the community's health needs and to identify the residents' perceived problems. The findings were presented in a community assembly, where residents further discussed their priority health concerns and potential interventions to address them. Quantitative data were summarized through descriptive statistics, while qualitative information was synthesized via content analysis. The priority community health problems included healthcare inaccessibility (trained staff, health equipment, and facility access), food insecurity, water supply limitations, and environmental sanitation. Moreover, there was inadequate knowledge and skills among the residents in health promotion, disease prevention, and illness management. While Barangay San Vicente had limited socioeconomic resources to optimize their health capacities, the sense of community among the residents is a vital resource towards empowering them to improve their health. The results could be utilized as a launching pad for developing appropriate health programs for the residents of Barangay San Vicente. Hence, the next steps in Project "Lusog-Linang" should include the identification and training of core group members toward community mobilization, and further exploring collaborative and sustainable partnerships across organizations to ensure that the community will have long-term solutions to their problems. Consequently, this project could guide public health workers in ensuring the active involvement and participation of the community members in managing their own health.

Quality of work life and associated factors among health professionals working at private and government health institutions in Awi zone, Amhara regional state, Ethiopia, 2022: a comparative cross-sectional study.

Quality of work-life issues significantly impact the economic, physical, and psychological well-being of health professionals and their families. Enhancing QWL aims to foster a conducive environment and improve work performance. This study evaluated the quality of work life of health professionals in government and private health institutions in the Awi zone, Ethiopia. A comparative cross-sectional approach was employed, with study participants selected via the lottery method in 2022. Socio-demographic and organizational-related data were collected, coded, cleaned, and entered into Epi-Data version 3.1, then analyzed using SPSS version 27. Candidate variables were selected using bivariable logistic regression (p < 0.20). We used multivariable logistic regression to identify factors associated with quality of work life, presenting AOR with a 95% CI at a 5% significance level. The study included 385 private health professionals and 395 government health professionals, with response rates of 90.38 and 92.72%, respectively. Overall quality of work-life satisfaction was 53.08% (95% CI: 49.2-57.0), with private health institution workers reporting satisfaction at 42.3% (95% CI: 37.4-47.30) and government health professionals at 63.54% (95% CI: 58.78-68.31). The difference between the two groups was 21.2% (95% CI: 14.3, 27.9). Factors significantly associated with quality of work life included type of health institutions (AOR = 2.272; 1.684, 3.065), family size (AOR = 1.536; 1.122, 2.103), personnel protective equipment (AOR = 1.369; 1.006, 1.863), eye protection (AOR = 2.090; 1.514, 2.885), engineering control (AOR = 1.563; 1.140, 2.143), and accessibility of alcohol (AOR = 1.714; 1.219, 2.410). Health professionals in private health institutions exhibited lower quality of work-life satisfaction than government health institutions. Quality of work life was significantly associated with the type of health institutions, family size, availability of personal protective equipment, eye protection, engineering control, and accessibility of alcohol. Regular monitoring and evaluation of the quality of work life, ensuring the availability of appropriate personal protective equipment, and providing sufficient materials and equipment for both groups were recommended based on the findings.

Treatment of choledocholithiasis: a review of clinical trials and current clinical guidelines

The review provides an analysis of clinical studies and current clinical guidelines from the MEDLINE database on the PubMed platform regarding the treatment of choledocholithiasis. Choledocholithiasis occurs in almost 20 % of patients with gallstone disease and is characterized by frequent dangerous complications, in particular, bile duct obstruction, cholangitis, and biliary pancreatitis. Therefore, common bile duct exploration is an important component of surgical treatment for gallstone disease, but discussions about the optimal treatment for choledocholithiasis have been ongoing for many years. Currently, there is no generally accepted standard of treatment, and various methods and approaches to the staging and sequence of surgical interventions on the gallbladder and common bile duct are used. In recent years, the leading methods of choledocholithiasis treatment are minimally invasive endoscopic and/or laparoscopic interventions, which have almost completely replaced open surgeries. For common bile duct exploration and normalization of biliary excretion, endoscopic transpapillary (retrograde) access is used mostly, which is characterized by a high risk of post-procedural immediate and long-term complications. Endoscopic management of common bile duct stones requires an additional intervention — laparoscopic cholecystectomy, which is most often performed at the second stage or simultaneously with endoscopic intervention. The optimal staging and sequencing of interventions requires further research. A good alternative to endoscopic interventions on common bile duct is its laparoscopic exploration through the cystic duct or by choledochotomy (antegrade), which can be performed simultaneously with cholecystectomy. However, this technique has not yet been widely adopted, and immediate and long-term results are conflicting that require further research into the effectiveness and safety of the method. The effectiveness of surgical treatment for choledocholithiasis depends not only on the individual characteristics of a patient, including biliary anatomy, the form and severity of the disease, but also on the local experience and availability of appropriate equipment, which must be taken into account when planning treatment.

Investigating the Challenges, Successes, and Strategies of Implementing Advanced Neonatal Care Interventions in Low-Resource Settings: A Clinical Study.

Neonatal care interventions are crucial for reducing infant mortality rates, particularly in low-resource settings where access to advanced medical facilities is limited. Implementing these interventions poses significant challenges due to resource constraints and infrastructural limitations. This clinical study investigated the challenges, successes, and strategies involved in implementing advanced neonatal care interventions in a low-resource setting. A retrospective analysis was conducted on the data collected from a neonatal care unit in a resource-limited area over a period of two years. The study assessed the availability of medical equipment, healthcare personnel training, and the efficacy of interventions in improving neonatal health outcomes. The analysis revealed that despite resource constraints, significant strides were made in implementing advanced neonatal care interventions. Availability of essential medical equipment increased by 30%, and healthcare personnel received targeted training programs resulting in a 25% improvement in neonatal survival rates. Strategies such as task-shifting and community outreach programs played a pivotal role in overcoming infrastructural limitations. Implementing advanced neonatal care interventions in low-resource settings is challenging but feasible with targeted strategies. While resource constraints remain a barrier, innovative approaches such as task-shifting and community involvement can significantly improve neonatal health outcomes. Continued investment in infrastructure, training, and community engagement is essential for sustainable progress in reducing neonatal mortality rates in resource-limited areas.

Interoperable square‐circular coupled coils for wireless electric vehicle battery charging system with different misalignments

AbstractA substantial interest in inductive power transfer (IPT) is due to its straight forwardness and dependability in charging electric vehicle (EV) batteries for researchers. The mutual inductance (MI) plays a critical role in the IPT system as it enables efficient power transfer. Therefore, it is imperative to examine the MI between the two coils that are connected through inductive coupling. This work investigates the MI and efficiency of connected coils in interoperable conditions. The transmitter coil is arranged in the shape of a square (TxS), whereas the reception coil is arranged in the shape of a circle (RxC). A concise and user‐friendly collection of design guidelines for S‐S compensated resonant inductive power transfer (SS‐RIPT) systems the design concepts efficiently mitigate the possibility of systematically and unambiguously setting the specifications for a given load profile. A 3.6‐kW setup has been constructed and validated by finite element analysis and experimental testing, following the design specifications. The availability of suitable testing equipment in the laboratory influenced the choice of a resonance frequency and output voltage for a 3.6 kW system.

Multidisciplinary Cancer Treatment Capacity in Ukraine During the War

PURPOSE Assessment of cancer diagnostic and treatment capacity is crucial to optimizing cancer care, especially in the setting of limited resources, including as a result of war. We assessed personnel, equipment, and treatment availability during Russia's full-scale invasion of Ukraine to define gaps that could then be addressed with tailored strategies. METHODS An online survey designed in collaboration with oncology specialists from the National Cancer Institute in Ukraine was distributed to oncologists in Ukraine through oncology-related social media. Data were analysed using descriptive statistics. RESULTS 192 physicians from all regions of Ukraine, including 53 (23.6%) medical oncologists, 89 (46.4%) surgical oncologists, and 32 (16.7%) radiation oncologists completed the survey. The average number of medical oncologists per regional cancer centre was 4.7 compared to 2.5 seen as the optimal number. The average number of nurses trained in chemotherapy administration was 6.4 compared to the desired number of 8.6. The average number of chemotherapy infusion machines was 8.2 compared to 17.7 desired. On average, 5.7 ports were put in per month compared to 22.1 desired. Average number of infusion chairs was 6.4 compared to 16.3 desired, while the number of inpatient chemotherapy beds was 26.8 compared to 34.0 perceived as the optimal number. The reported average number of surgical oncologists was 12.1 with an optimal average of 6.0. The average number of surgical beds was 52.8 v 60.7 desired. The average and optimal numbers of the following were fairly close: surgical oncology trainees (2.1 v 2.6), operating room nurses (4.1 v 4.3), anesthesiologists (4.4 v 4.2), operating rooms (3.6 v 3.4), anaesthesia machines (4.4 v 4.0), average surgeries per week (21.5 v 21.8). The average number of radiation oncologists was 7.9 compared to 8.5 optimal numbers. For other metrics, average and optimal numbers were somewhat close: number of radiation therapy laboratory technicians (7.9 v 8.5), medical physicists (3.8 v 4.8), dosimetrists (1.5 v 2.1), Cobalt 60 machines (0.9 v 1.1), brachytherapy machines (1.1 v 1.7). CONCLUSION We identified important equipment and personnel gaps in oncology care in Ukraine. Results are limited by the decreased number of respondents from areas directly affected by active hostilities.

Pediatric Difficult Airway Management: Assessment and Intervention

Background: Pediatric airways exemplify the adage that children are not merely small adults. Their airway anatomical differences are markedly different than that of an adult system and with evidently variable physiology. Small fully oxygenated children can desaturate to a level of 0 in by multitudes faster rate than a full-size adult. Narrowing of an airway vastly changes resistance flows in comparison to adults leading to greater volatility and fluidity of an airway status. The airway may be difficult to visually examine or obtain either through innate challenges given its differing height and anterior displacement, or due to additional factors including clefts, congenital changes, stenoses, or mandibular hypoplasia. Rapid and efficient evaluation of the airway for appropriate airway securement involves coordination of different experts and specialized equipment. Otolaryngology is often not involved until difficult situations are deemed untenable with intensive care or anesthesia. Enabling appropriate resource access and timeliness allows for improved patient care and time allocation. At the Children’s Hospital of Michigan, the operating rooms hold the vast number of specific airway equipment needed for pediatric airway evaluation and intervention escalation. This equipment is not centralized and is stored in a multitude of locations, the reliability of which is dependent on stocking experience. Multiple airway emergencies had occurred over several years. These resulted in unsatisfactory outcomes despite prompt responses, appropriate staffing, and decision making. Efforts were centralized in a means to assess access and expediency of airway management with progression to the current system. Methods: Root cause analysis was performed of the reported sentinel airway events. Anesthesia, Emergency Department, and Otolaryngology teams assessed cases for areas of potential failure and improvement. Equipment availability and readiness efficiency were deemed one of the most variable. Additionally, knowledge of predeterminate difficult airways and associated details was deemed vital to allow for appropriate planning and intervention enaction. A multidisciplinary team was tasked with creating centralized difficulty airway carts. These were then stocked with means of airways assessment and intervention within a centralized unit. Communication was enhanced with the creation of automated difficult airway warnings within the electronic health record. A standardized difficult airway note was then created to allow for quick and accessible means of reviewing prior airway assessments. Results: This system has now been implanted within the Children’s Hospital of Michigan. Airway response readiness has improved and multiple emergent airways have been attended and with successful intervention. Handoff of difficult airway informatics has improved with greater understanding between disciplines regarding necessary interventions, precautions, and escalation algorithms. Conclusion: A centralized system of airway assessment and intervention aids in pediatric airway management. Standardized means of communicating airway difficulty improves communication and patient handoffs.

ІНКЛЮЗІЯ В УКРАЇНІ: СУЧАСНІ ВИКЛИКИ

The article is devoted to a theoretical and practical analysis of the problem of inclusion: formation and development, features of educational inclusion, and mechanisms of implementation of inclusive higher education. Based on the analysis of regulatory documents and scientific research, the authors determine the most significant stages of the formation and development of inclusion in Ukraine. The requirements for specialists needed by the modern domestic education system have been analyzed. The article emphasizes the trends in the process of invalidation of the population of Ukraine. The authors determine the expediency and necessity of wide implementation of educational inclusion in the system of higher education, in particular: ensuring free access of all higher education applicants to educational and methodical materials and creating the necessary special units. On the basis of the analysis of the results of the conducted survey, the possible ways of solving the current problems of educational inclusion in the higher education system are substantiated and characterized: support of the teaching staff in the organization of an inclusive educational environment in the institution of higher education; support for education seekers who belong to the category of persons with special needs; financing and implementation of regulated and guaranteed mechanisms for financial support of higher education institutions; technical and methodological support of the educational process. Also, emphasis is placed on electronic inclusion, which is interpreted as a social movement aimed at overcoming the digital divide among different categories of the population. It was found that the appropriate level of organization of an inclusive educational environment is observed in institutions of general secondary education. Instead, HEIs need more active involvement of specialists, technical equipment and financial support for effective educational inclusion. An important factor is the availability of computer equipment: ensuring access to free or low-cost computers, in particular through the implementation of special target programs, charity projects, etc. It is also relevant to search and exchange data to diversify the ways of obtaining education for persons with special educational paths, to ensure effective interpersonal communication despite temporal and spatial boundaries.

Workshop Response Time at the Emergency Room Lubuk Pakam Health Center

Higher level of achievement of the community in the local area, this is also a service in the area which is a world-class public and individual service, at the same time prioritized in promotion and prevention efforts. Decree of the Minister of Health Number 129 of 2008 concerning Minimum Service Standards in Emergency Installations, Response Time, also known as "emergency service response time", is the time needed by patients from the time they arrive at the Emergency Installation until they are given first aid in minutes. The maximum response time is five minutes. The results of the study showed that the number of qualified nurses, the availability of medical equipment, and emergency room employees are the main factors affecting response time. An important factor in evaluating the quality of health services is patient satisfaction, which is measured by how patients act after receiving health services. Patient satisfaction also depends on how well the service offers patient expectations. Patient service has a significant impact on patient satisfaction and is an important component in the Puskesmas system that must always be evaluated. The experience and ability of a doctor in handling emergency patients quickly and accurately correlates with patient satisfaction. Patients who receive good health services will indirectly promote and recommend the health facility to their families.

Laboratory Facilities as Predictors of Academic Performance among Maritime Students

This study investigates the influence of laboratory facilities on maritime students' learning and extent of delivery of instruction at the Merchant Marine Academy of Caraga Inc. It emphasizes the need for improvements to align with industry requirements and prepare students for future challenges. The research examines the impact of specific facilities like the seamanship lab, bridge simulator, and chart room. The researchers used a quantitative approach to gather data from maritime students and instructors through surveys. The analysis focused on the serviceability of the labs in terms of equipment availability, maintenance, and safety standards. The justification for the research is further supported by the findings, which indicate that most facilities are in good working order, with serviceability ranging from 77% to 87%. Interestingly, the study highlights that instructor expertise is just as important as the facilities themselves. It emphasizes that instructor experience and teaching methods significantly impact student learning, suggesting a need for investment in instructor development alongside improvements to the laboratories. In conclusion, the abstract justifies the research by demonstrating that laboratory facilities are important for maritime student learning and that there is a need for improvement in order to prepare students for the challenges of the maritime industry. The abstract outlines a methodology to investigate this and presents preliminary findings that justify further research.