Access To Facilities Research Articles

Divers treated in Townsville, Australia: worse symptoms lead to poorer outcomes.

Hyperbaric oxygen treatment (HBOT) is considered definitive treatment for decompression illness. Delay to HBOT may be due to dive site remoteness and limited facility availability. Review of cases may help identify factors contributing to clinical outcomes. Injured divers treated in Townsville from November 2003 through December 2018 were identified. Information on demographics, initial disease severity, time to symptom onset post-dive, time to pre-HBOT oxygen therapy (in-water recompression or normobaric), time to HBOT, and clinical outcome was reviewed. Data were reported as median (interquartile range [IQR]) with Kruskal-Wallis and chi-square tests used to evaluate group differences. Significance was accepted at P < 0.05. A total of 306 divers (184 males, 122 females) were included with a median age of 29 (IQR 24, 35) years. Most divers had mild initial disease severity (n = 216, 70%). Time to symptom onset was 60 (10, 360) min, time to pre-HBOT oxygen therapy was 4:00 (00:30, 24:27) h:min, and time to start of HBOT was 38:51 (22:11, 69:15) h:min. Most divers (93%) had a good (no residual or minor residual symptoms) outcome and no treated diver died. Higher initial disease severity was significantly associated with shorter times to symptom onset, oxygen therapy, and HBOT, and with worse outcomes. The paucity of cases receiving HBOT with minimal delay precluded meaningful evaluation of the effect of delay to HBOT. Most divers had mild initial disease severity and a good outcome. Higher initial disease severity accelerated the speed of care obtained and was the only factor associated with poorer outcome.

The availability of essential medicines in public health facilities in Afghanistan: navigating socio-political and geographical challenges.

During the past two decades, the Afghan government, along with international community, has developed a system aimed at improving access to essential health services under Afghanistan's challenging socio-political and geographical circumstances. In 31 provinces, non-state actors competed for fixed-term contracts to implement a predefined package of health services. In three provinces, the government organised the provision of health services. An independent third party monitored service provision, including access to medicines. This study examines the availability of essential medicines in Afghanistan's public health facilities and how this is shaped by socio-political challenges, geographical barriers, and the organisation of the health system. Between March and July 2021, enumerators collected data at 885 health facilities across Afghanistan. For our analysis, we combined data about medicine availability and the functioning of the health system with publicly available information about geographical and socio-political factors, including security incidents. Using regression analysis, we identified facility, district, and province-level factors related to medicines availability in public health facilities. On average, 70% of 31 selected essential medicines were available in 2021. The availability of medicines varies significantly between provinces and was considerably higher in those where services were contracted out to non-state actors (n=34; 91%) compared to provinces where service provision was organised by the government (n=3; 9%). The most important drivers of variation in medicine availability included geographical barriers, securing and allocating funds on the provincial level, and organising and sustaining physical capacity on the facility level. Insecurity was not a key factor driving variation in medicine availability. Despite the socio-political challenges in 2021, the availability of essential medicines in public health facilities was relatively high. The results suggest that decentralized procurement of medicines by non-state actors and timely payment of funds contribute to medicines availability. Strategies to improve medicines availability should target hard-to-reach areas and lower-level facilities.

Exploring Customer Experience Drivers in Night Markets: Examining the Roles of Product Preference, Service Quality, and Facility Accessibility

This study investigates the critical factors shaping customer experiences in night markets, emphasizing product preferences, quality of services provided, and accessibility of facilities. As integral hubs of cultural exchange, community engagement, and tourism, night markets contribute significantly to local economies and cultural heritage preservation. However, research on customer experience in these dynamic environments remains limited. Using a structured questionnaire, data were collected from 201 night market visitors through a purposive sampling. The study utilized structural equation modeling (SEM) to assess the interconnections between the primary variables. The findings reveal that product preference has a substantial positive impact on customer experience (β = 0.465, p &lt; 0.001) along with service quality (β = 0.209, p &lt; 0.01) and facility accessibility (β = 0.585, p &lt; 0.001). Both service quality and facilities play pivotal roles in shaping customer satisfaction and experiences, either directly or indirectly. The results underscore the importance of tailored product offerings, consistent service quality, and well-maintained facilities for fostering satisfaction and loyalty. This study provides practical insights for vendors by emphasizing the value of understanding customer preferences, ensuring operational efficiency, and enhancing facility provisions. These findings contribute to theoretical frameworks on customer experience, enrich the knowledge base for night market operations, and offer actionable strategies for sustainable market development and customer engagement.

Unveiling the role of DHIS2 in enhancing data quality and accessibility in primary healthcare facilities: Evidence from Ethiopia.

The implementation of DHIS2 in healthcare systems has transformed data management practices worldwide. However, its specific impact on data quality, availability, and performance in Primary Health Unit (PHU) facilities in Ethiopia remains underexplored. Therefore, we investigated the contribution of DHIS2 to enhancing data quality, availability, and performance within PHU facilities in Ethiopia. We employed qualitative methods, specifically Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs), to gather insights from stakeholders, including healthcare providers and administrators at PHCUs across Ethiopia. Convenience sampling was used for FGDs, while purposive sampling targeted key informants with relevant expertise. Data were systematically analysed thematically, identifying patterns and themes related to DHIS2's impact on data management within PHUs. This approach offered a comprehensive understanding of the system's effectiveness and the factors influencing its implementation, highlighting both successes and challenges in integrating DHIS2 into healthcare practices. Participants from various regions reported significant enhancements in the timeliness, completeness, accuracy, and accessibility of health data following the implementation of DHIS2. While some concerns were raised regarding variations in reporting intervals, the consensus indicated marked improvements in data management processes. DHIS2 standardized data collection methods, enabling healthcare providers to input and access data in real-time. This advancement fostered greater accountability and transparency within the healthcare system. Additionally, unexpected benefits arose, including increased digital literacy among staff, equipping them with necessary skills for effective data management, and the creation of job opportunities, particularly for youth. Ultimately, DHIS2 emerged as a pivotal tool for enhancing data quality and promoting health service equity across Ethiopia. DHIS2 has significantly improved data quality and accessibility in Ethiopia, enhancing healthcare management and accountability across facilities. Healthcare providers should continue to leverage its robust features and prioritize ongoing staff training to improve digital literacy and data management skills. Establishing consistent reporting practices and regular audits will further maintain data integrity and foster a culture of accountability within the healthcare system.

Assessing the continuum of care in Sub-Saharan African hospitals performing surgery for breast cancer: a secondary analysis of the GlobalSurg 3 study

BackgroundWhile breast cancer incidence rates in Sub-Saharan Africa (SSA) are among the lowest worldwide, mortality rates remain among the highest, reflecting particularly poor survival. Only a few studies in SSA have investigated the capabilities of treatment services to adequately provide a continuum of care for breast cancer. Our aim was to assess the availability of diagnostic facilities and adjuvant therapies in hospitals performing breast cancer surgery in SSA.MethodsWe performed a secondary analysis of the GlobalSurg3 study data collected in the SSA region. The GlobalSurg 3 study is a multicenter, international, prospective, observational study of hospitals providing surgical services for cancer patients (including breast cancer) around the world. A total of 47 hospitals from 15 SSA countries and 43 cities were included between April 1, 2018, and Jan 31, 2019.ResultsOne-third of hospitals covered a population greater than two million (n = 17; 36.2%). Ultrasound was available in all hospitals; however, it was not consistently functional in 11 hospitals (23.4%). Only half of the included hospitals (n = 26, 55.3%) had access to a full-time pathologist, whilst the multidisciplinary team (MDT) approach was absent in 42.4% of hospitals. Radiotherapy equipment was only available in nine hospitals (19.1%). Only half of the hospitals (n = 25, 53.1%) had chemotherapy drugs available on site. In nine hospitals (19.1%), patients had to travel more than 50 km to access chemotherapy drugs.ConclusionsOutcomes for breast cancer patients in SSA cannot be improved without significant investments in pathology, surgical and oncological treatment pathways to provide timely diagnostic and effective treatment.

N-Bridged BODIPY Dimers: Exploring the Electron-Rich and Electron-Poor Coupling Limit via Pyrrole and Pyridine Annulation.

A facile access to N-heteroaryl-fused bis-BODIPY scaffolds has been developed. A BODIPY dimer with an α,α-amine linker serves as a starting material to obtain pyrrole- and pyridine-fused BODIPYs, either by direct oxidation or by oxidative condensation with an aldehyde building block. Both species mark antipodal conjugative coupling conditions that result in distinct spectral outcomes. In stark contrast to the pyrrole fusion, pyridine-coupled species show unique panchromatic absorption profiles.

Social sustainability in local communities in Norway: which factors are associated with people's satisfaction with their local community as a place to live now and in the future?

To investigate the associations between social sustainability factors and people's satisfaction with their local community as a place to live now and in the future. This study used data from the Norwegian County Public Health Survey conducted in Viken County, Norway, in 2021 (N = 97,323). The survey included questions concerning physical aspects (e.g. accessibility of services and facilities) and non-physical aspects (civic participation, social support, trust, safety, place attachment and well-being) of social sustainability in local communities. A new outcome variable was constructed to capture people's satisfaction with their local community as a place to live now and in the future. Hierarchical linear regression was applied to examine the relationships between physical and non-physical factors of social sustainability and this outcome. All included factors were significantly associated with people's satisfaction with their local community as a place to live now and in the future, but the magnitude and direction of these associations varied. Place attachment (β = 0.53), safety (β = 0.15) and well-being (β = 0.11) were the strongest indicators of people's satisfaction with their local community. Non-physical factors accounted for 41% of the variance in people's satisfaction, while physical factors accounted for 14%. Both physical and non-physical factors are essential for developing socially sustainable communities. This knowledge could be valuable for academics and policymakers, helping them better understand the complex relationships between various aspects of social sustainability and informing the development of socially sustainable local communities.

Inovasi Pelayanan Publik Bupati Ngantor Di Desa (BUNG DESA) Kabupaten Labuhanbatu Utara

Difficult road access and long travel distances in several areas of Labuhanbatu Utara Regency have become the main obstacles for the community in obtaining public services. In response to this issue, the Head of the Labuhanbatu Utara District launched an integrated service innovation through the "Bupati Ngantor di Desa" program. (Bung Desa). This program focuses on providing public services in one location for one day to improve community accessibility to government services. This article aims to analyze the effectiveness of the Bung Desa program as an innovation in improving the quality of public services in Labuhan Batu Utara Regency. This research uses a literature study method that includes searching for scientific references through Google Scholar and news sources related to the Bung Desa program. Relevant articles are classified based on publication year, keywords, and journal content, while news is categorized according to source, relevance, and publication time. The research results show that the Bung Desa program adopts the principles of New Public Management (NPM) and has had a positive impact. This innovation not only improves service accessibility even to remote villages but also encourages community participation in development. The success of this program is influenced by several factors, such as the awareness and capability of the apparatus, implementation regulations, and the availability of facilities and infrastructure. However, improving road infrastructure remains a priority to support smooth accessibility. In addition, the publication of schedules and activities of the Bung Desa program through official media, such as the local government website, needs to be improved to expand the reach of information to the public

Analisis Kebutuhan Sarana dan Prasarana untuk Mendukung Proses Pembelajaran di SMK Negeri 1 Surabaya

Vocational education, secondary school facilities and infrastructure play animportant role in the learning process. Management of facilities and infrastructure needs to be done well to achieve success and support the teaching and learning process in vocational schools. To achieve success, the learning process must be supported by the availability of adequate facilities and infrastructure as well as optimal managemet by referring to the management of facilities and infrastructure. This research aims to analyze the need for facilities and infrastructure to supportan optimal learning process at SMK Negeri 1 Surabaya. This article was written using qualitative approach. Through data collection through interviews, documentation, and supported by direct observation at SMK Negeri 1 Surabaya with an approach to he students. It can be concluded that the results of this research show that the dominant facilities and infrastructure at SMK Negeri 1 Surabaya have been utilized optimally. Things to support practice in vocational schools, such as computer labs, as well as studios and other equipment that supports the learning process, are said to be very adequate. Maintenance of facilities and infrastructure has also been carried out periodically. The available facilities and infrastructure greatly increase student enthusiasm for learning and achievement.onclusions.

The impact of COVID-19 on SME profitability: Insights from South Africa

This study aims to investigate the impact of COVID-19 on SME profitability, performance, and operational efficiency. The data were gathered using a structured questionnaire targeting SMEs affiliated with the Centre for Social Entrepreneurship (CSE), Productivity SA, Johannesburg Chamber of Commerce (JCCI), and Durban Chamber of Commerce and Industry (DCCI). A purposive sampling was utilized, specifically choosing SME owners or senior management representatives. The Krejcie &amp;amp;amp; Morgan formula was used to calculate a suitable sample size of 348, resulting in an 81% response rate with 282 participants successfully completing the questionnaire. The instruments’ dependability was validated by Cronbach’s alpha coefficients of 0.906 and 0.769 for the impact of COVID-19 on SMEs and profitability variables, respectively. The findings indicated that the average effect of COVID-19 on SME was 40.3546, with a standard deviation of 7.61450. The average profitability was 5.4921, with a standard deviation of 1.92297. An analysis using a one-sample t-test revealed that the influence of COVID-19 on SMEs did not show a statistically significant impact (p = 0.156). However, the effect on profitability was statistically significant (p = 0.001). These findings emphasize the diverse consequences of the pandemic on the functioning of SMEs, specifically pointing out considerable decreases in profitability. The study recommends that government agencies and financial institutions increase support for SMEs to help them recover from the profitability challenges brought on by the pandemic. Tailored financial relief programs, accessible credit facilities, and long-term recovery strategies should be implemented to cushion SMEs against future economic shocks.

Exploring the determinants of dietary nutrients intake among the rural households: a cross-sectional study in Jhargram district of West Bengal, India

In India, nutritional public health problems such as macronutrient malnutrition and diet-related non-communicable diseases are still persistent. Dietary assessment among the population is essential to understand the adequate consumption of nutrients in maintaining a balanced diet and most importantly to accomplish the Sustainable Development Goal-2, ‘End hunger, achieve food security and improved nutrition’, by 2030. Hence, an attempt was made in this paper to examine the nutrient consumption and compare it with the Recommended Dietary Allowances (RDAs)-given by Indian Council of Medical Research(ICMR)-2020 and also to assess the determinants of adequate intake of calorie and Protein among the rural households in Jhargram district of West Bengal, India. The study used primary data from a sample of 200 households collected during April–May, 2017. The daily intake of calorie and protein were calculated by following the RDAs by ICMR-2020 conversion table. Bivariate and multivariate logistic regression models were employed. Results found that the consumption of adequate calorie and protein intake was 30% and 40% respectively. Logistic regression found that age, gender of the household head, social category, size of household, major source of income, access to market, access to credit, type of house, monthly per-capita consumer expenditure and farm size were significantly associated with the consumption of calorie and protein. The study concludes the need to address the importance of socio-economic disparities in nutrient intake and accessibility of credit facilities to rural households. There is also a need for targeted interventions among female-headed households to foster balanced nutrition and avert malnutrition.

Performance of Agricultural Extension Workers in Pemalang District, Central Java, Indonesia

Agricultural extension plays an important role in the development of food agriculture, especially in efforts to increase production. This study describes the performance of agricultural extension in Pemalang Regency, Central Java on internal factors and available infrastructure. The analysis method used is a mixed method, which is a combination of descriptive statistics and simple triangulation. In Pemalang Regency, the overall performance of extension workers is 62.7% included in the sufficient category. The availability of facilities and infrastructure has no significant effect on the performance of extension workers. The results of multiple linear regression analysis found that the variables of education and the number of assisted farmers had a significant effect on the performance of extension workers, while the variables of age, working period, and regional distance did not have a significant effect on the performance of extension workers.

Benchmarking Values of Modulus of Rupture for Shells Used in Different Investment Casting Segments

Modulus of Rupture (MoR) is considered to be one of the most crucial properties of ceramic shells used in manufacturing investment castings. An industrial survey was conducted to get an insight into the availability of such facilities to measure this property even after guidelines about measurement as well as its relevance are very well established. However, benchmarking values of MoR especially for various segments including aerospace, automobile as well as chemical where investment castings are widely employed are not clearly traceable in the literature. The proposed research is mainly focused on the development of MoR testing machine as per established specific guidelines followed by benchmarking values of MoR for specific sectors mentioned above as these sectors use as much as 60% of total investment casting produced in India. Tested samples were specifically prepared to replicate the conditions that are followed in making of shells and samples were tested using a developed MoR machine. It was observed that values of MoR need to be 4.15–4.90 MPa for automobiles; 3.14–4.48 MPa for chemicals and 1.54–2.76 MPa for aerospace to avoid any unwanted effects of MoR on the quality of investment castings used in these segments.

FAKTOR-FAKTOR YANG MENGHAMBAT MASYARAKAT UNTUK BERJALAN KAKI DAERAH PERKOTAAN

Walking is very important in cities as it helps people to travel from one place to another. Urban areas in Bali are experiencing rapid development as tourism normalises, gradually entering a process of urban renewal. Improving the quality of the pedestrian environment is an important issue. The purpose of this research is to study how a person's physical condition, concepts, and activities affect their physical character and interest in walking. A quantitative method was used using randomly distributed open-ended questionnaires. Pedestrian criteria and facilities will be the source of data categorised in inhibiting pedestrians. A person who wants to walk should have good access and well-maintained facilities so that urban areas can be specialised for pedestrian paths.

Effect of branch girdling on the alternate bearing, yield, and fruit quality of grapefruit (Citrus paradisi Macf.)

Objective: The objective of this research was to evaluate the effect of girdling branches, application of gibberellic acid (GA3), and foliar urea on the alternating yield and quality of grapefruit (Citrus paradisi Macf) fruits. Design/methodology/approach: The experiment was carried out on trees during abundant harvest (“on” year) and trees with low harvest (“off” year). Foliar applications of GA3 and foliar urea were performed with a manual sprayer at a rate of 7 L tree-1 of solution. Branch girdling (5.0 mm wide) was performed on two-thirds of the secondary branches using a circular-edged knife to avoid damaging the xylem. The experimental design was completely randomized, with 24 factorial arrangements with 16 treatments and 3 repetitions. Each experimental unit was a tree to evaluate fruit yield and quality at the experiment's conclusion. Results: Branch girdling increased the diameter, the number of fruits, the yield, and the ºBrix-Acidity ratio of the juice. Foliar urea applications increased the percentage of juice but delayed ripening. The combination of branch girdling plus foliar urea applications increased fruit weight. The yield increase was attributed to the number of fruits rather than their weight. The treatments did not reduce alternate bearing. Limitations on study/implications: The commercial cultivation areas for the experiment were limited due to the availability of facilities for testing fruit quality. Findings/conclusions: To increase the size and number of fruits, with an increase in yield, branch girdling is an effective option. Furthermore, the application of foliar urea increases the percentage of juice and fruit weight, with a slight delay in maduration. However, the treatments did not reduce alternate bearing. Future research is required with other grapefruit varieties at different application times.

Predicting Depressive Symptoms Using GPS-Based Regional Data in Germany With the CORONA HEALTH App During the COVID-19 Pandemic: Cross-Sectional Study.

Numerous studies have been conducted to predict depressive symptoms using passive smartphone data, mostly integrating the GPS signal as a measure of mobility. Environmental factors have been identified as correlated with depressive symptoms in specialized studies both before and during the pandemic. This study combined a data-based approach using passive smartphone data to predict self-reported depressive symptoms with a wide range of GPS-based environmental factors as predictors. The CORONA HEALTH app was developed for the purpose of data collection, and this app enabled the collection of both survey and passive data via smartphone. After obtaining informed consent, we gathered GPS signals at the time of study participation and evaluated depressive symptoms in 249 Android users with the Patient Health Questionnaire-9. The only GPS-based data collected were the participants' location at the time of the questionnaire, which was used to assign participants to the nearest district for linking regional sociodemographic data. Data collection took place from July 2020 to February 2021, coinciding with the COVID-19 pandemic. Using GPS data, each dataset was linked to a wide variety of data on regional sociodemographic, geographic, and economic characteristics describing the respondent's environment, which were derived from a publicly accessible database from official German statistical offices. Moreover, pandemic-specific predictors such as the current pandemic phase or the number of new regional infections were matched via GPS. For the prediction of individual depressive symptoms, we compared 3 models (ie, ridge, lasso, and elastic net regression) and evaluated the models using 10-fold cross-validation. The final elastic net regression model showed the highest explained variance (R2=0.06) and reduced the dataset from 121 to 9 variables, the 3 main predictors being current COVID-19 infections in the respective district, the number of places in nursing homes, and the proportion of fathers receiving parental benefits. The number of places in nursing homes refers to the availability of care facilities for the elderly, which may indicate regional population characteristics that influence mental health. The proportion of fathers receiving parental benefits reflects family structure and work-life balance, which could impact stress and mental well-being during the pandemic. Passive data describing the environment contributed to the prediction of individual depressive symptoms and revealed regional risk and protective factors that may be of interest without their inclusion in routine assessments being costly.

Should newborn genetic testing for autism be introduced?

This manuscript provides a review of the potential role of newborn genetic testing for autism, and whether the state has an inherent responsibility to facilitate and subsidise this. This is...

Community disaster resilience assessment and external association characteristics analysis based on accessibility of service facilities: From the perspective of 15-minute life circle

Community disaster resilience assessment and external association characteristics analysis based on accessibility of service facilities: From the perspective of 15-minute life circle

Spatio-temporal analysis of pulmonary tuberculosis in Astambul District, South Kalimantan, Indonesia 2020-2021

Respiratory tuberculosis (TB) remains a significant global health concern and ranks among the top 10 leading causes of death worldwide, following human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Globally, it is estimated that 1.2 billion people are at risk of being infected with tuberculosis, and Indonesia is the country that contributes the third-highest number of TB cases worldwide, behind China and India. Tuberculosis is still a significant issue in South Kalimantan, notably in Banjar Regency. This study is a descriptive study that intends to identify respiratory TB clusters spatially and temporally in Astambul District during 2020–2021 with the SatScan application, which is visualized as a map of respiratory TB clusters using the Quantum GIS 3.28 application. Data on respiratory TB cases collected from the Banjar District Health Office were examined using retrospective space-time scan statistics, employing a Poisson probability model for analysis. This study found 4 respiratory TB clusters, and 2 of them had significant results, namely in 2020 (RR=6.90, p-value=0.000030) and 2021 (RR=5.27, p-value=0.00003). Factors that affect these clusters are population density, the physical condition of houses, humidity levels, and the availability of health facilities.

Service availability and readiness to provide maternal and newborn healthcare services in Kilimanjaro region, Tanzania: a cross sectional study

ObjectiveTo assess service availability and readiness of health facilities to provide maternal and newborn care in the Kilimanjaro region, northern Tanzania: a study conducted between August to October 2022.DesignThe study...