Administrative Challenges Research Articles

Rescaling Food Insecurity

Abstract Food provisioning represents a major everyday challenge for migrant shelter administrators, workers, and volunteers, yet very little is known about the specific conditions and challenges faced by these spaces. While there is a small body of scholarly work about food in shelters from the perspective of people on the move, most of this literature is based on state-run shelters in the Global North, and there is little understanding of the challenges and conditions faced by non-state shelters in general, and by shelters in the Global South in particular. This article represents an opening for exploring these issues. Drawing on a day-long workshop conducted between a team of researchers and representatives of five migrant shelters in the Mexico City metropolitan area, the article discusses the theoretical and practical stakes of ensuring food security for migrant populations and suggests that we rescale food security to address these spaces and their struggles.

Improving door-to-analgesia timing in musculoskeletal injuries in an academic emergency department in India: a quality improvement project

IntroductionPain, more frequently due to musculoskeletal injuries, is a prevalent concern in emergency departments (EDs). Timely analgesic administration is paramount in the acute setting of ED. Despite its importance, many...

The Impact of Administrative Burdens in Ghana’s LEAP Cash Transfer Programme: Insights for Enhancing Well-being

This article reports experiences and challenges connected with Ghana’s Livelihood Empowerment Against Poverty (LEAP) programme and its implications for grant access and impacts on recipients’ well-being. Engaging with the administrative burden’s framework, we find that inadequate information; transport, timing and financial barriers to accessing payments; irregularity of payments; electronic payment difficulties; gift giving to programme administrators; and lack of access to complementary services are the key administrative challenges watering down the LEAP impacts on recipients’ well-being. We recommend establishing an appropriate information delivery system, feedback and monitoring mechanisms, providing other productivity-enhancing services to complement the LEAP grant, strengthening the local implementation structures and payment procedures and reducing travel costs and waiting time for service delivery.

Flimm: Foreground traffic aware data migration manager for distributed storage system

Currently, decentralized distributed storage system is widely used in various scenarios, because decentralized data placement algorithms observably improve scalability and robustness of distributed storage system. However, storage system applied with decentralized data placement algorithm suffers from uncontrollable data migration during expanding the clusters, which lead to dramatic fluctuation of performance. To maintain reliability and stability of storage system, administrators are under great pressure to migrate data during expansion or contraction. Not only the urgent time constraints to expansion but also low interference to foreground application are required during data migration period. It is a difficult challenge for in-experienced administrators to tackle.To address this challenge, this paper introduces Flimm, a fast and low-interference data migration manager that is aware of storage resource utilization and performs data migration with low interference to foreground applications. Flimm mitigates interference by scheduling a subset of migration tasks with careful consideration. Moreover, Flimm adapts to varying foreground application workloads through adaptive migration speed control, providing administrators with convenient and secure parameters for tuning. In our experiments, Flimm demonstrated a 1.2x acceleration in migration speed and achieved a 20% reduction in interference.

Real-World Efficacy of Ensitrelvir in Hospitalized Patients With COVID-19 in Japan: A Retrospective Observational Study.

The coronavirus disease 2019 (COVID-19) pandemic necessitates continuously evaluating antiviral treatments, especially for high-risk groups, including older individuals. This study aimed to compare the efficacy of three antiviral drugs, including remdesivir, molnupiravir, and ensitrelvir, in hospitalized patients as measured by our own institution's antigen test, focusing on outcomes, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen levels, hospitalization duration, and fever resolution. This retrospective observational study was conducted at Yoshida Hospital, Asahikawa City, Japan, enrolling 154 patients who received antiviral treatment upon COVID-19 diagnosis from July 1, 2022, to September 15, 2023. The diagnosis was confirmed by proprietary antigen tests or loop-mediated isothermal amplification assays. Patients who received treatment outside the hospital or with consistently negative antigen results were excluded. Drug administration was determined by attending physicians, considering oral administration challenges and renal dysfunction. The data were statistically analyzed using an unpaired two-tailed Student's t-test and one-way analysis of variance complemented by the Tukey post-hoc test for detailed group comparisons. No significant differences were observed in the initial antigen levels among the treatment groups. By day 10, the ensitrelvir group showed lower antigen levels than the other groups, but not significantly. The ensitrelvir group had a higher antigen-negative conversion rate and a significantly shorter hospital stay than the molnupiravir group. However, no significant differences were noted in the fever resolution time among the groups. This study suggests the potential benefits of ensitrelvir in reducing antigen levels and hospitalization duration. However, the overall efficacy of the antiviral agents for symptomatic relief appears similar. These findings underscore the need for further research to optimize COVID-19 management by considering personalized treatment approaches and long-term outcomes.

A framework for the biophysical screening of antibody mutations targeting solvent-accessible hydrophobic and electrostatic patches for enhanced viscosity profiles

The formulation of high-concentration monoclonal antibody (mAb) solutions in low dose volumes for autoinjector devices poses challenges in manufacturability and patient administration due to elevated solution viscosity. Often many therapeutically potent mAbs are discovered, but their commercial development is stalled by unfavourable developability challenges. In this work, we present a systematic experimental framework for the computational screening of molecular descriptors to guide the design of 24 mutants with modified viscosity profiles accompanied by experimental evaluation. Our experimental observations using a model anti-IL8 mAb and eight engineered mutant variants reveal that viscosity reduction is influenced by the location of hydrophobic interactions, while targeting positively charged patches significantly increases viscosity in comparison to wild-type anti-IL-8 mAb. We conclude that most predicted in silico physicochemical properties exhibit poor correlation with measured experimental parameters for antibodies with suboptimal developability characteristics, emphasizing the need for comprehensive case-by-case evaluation of mAbs. This framework combining molecular design and triage via computational predictions with experimental evaluation aids the agile and rational design of mAbs with tailored solution viscosities, ensuring improved manufacturability and patient convenience in self-administration scenarios.

Analysis of a European general wildlife health surveillance program: Chances, challenges and recommendations.

In a One Health perspective general wildlife health surveillance (GWHS) gains importance worldwide, as pathogen transmission among wildlife, domestic animals and humans raises health, conservation and economic concerns. However, GWHS programs operate in the face of legal, geographical, financial, or administrative challenges. The present study uses a multi-tiered approach to understand the current characteristics, strengths and gaps of a European GWHS that operates in a fragmented legislative and multi-stakeholder environment. The aim is to support the implementation or improvement of other GWHS systems by managers, surveillance experts, and administrations. To assess the current state of wildlife health investigations and trends within the GWHS, we retrospectively analyzed 20 years of wildlife diagnostic data to explore alterations in annual case numbers, diagnosed diseases, and submitter types, conducted an online survey and phone interviews with official field partners (hunting administrators, game wardens and hunters) to assess their case submission criteria as well as their needs for post-mortem investigations, and performed in-house time estimations of post-mortem investigations to conduct a time-per-task analysis. Firstly, we found that infectious disease dynamics, the level of public awareness for specific diseases, research activities and increasing population sizes of in depth-monitored protected species, together with biogeographical and political boundaries all impacted case numbers and can present unexpected challenges to a GWHS. Secondly, we found that even a seemingly comprehensive GWHS can feature pronounced information gaps, with underrepresentation of common or easily recognizable diseases, blind spots in non-hunted species and only a fraction of discovered carcasses being submitted. Thirdly, we found that substantial amounts of wildlife health data may be available at local hunting administrations or disease specialist centers, but outside the reach of the GWHS and its processes. In conclusion, we recommend that fragmented and federalist GWHS programs like the one addressed require a central, consistent and accessible collection of wildlife health data. Also, considering the growing role of citizen observers in environmental research, we recommend using online reporting systems to harness decentrally available information and fill wildlife health information gaps.

Construction and Application of a Prediction Model for Students’ Satisfaction in Chinese-Foreign Cooperatively-Run Educational Programmes Based on Machine Learning

The increasing popularity of educational programs by Chinese and foreign partners in China's universities presents challenges in administration due to differences in organization, social expectations, and academic requirements. This study presents a prediction model using Machine Learning techniques to assess student satisfaction levels. The Gradient Boosting Machine (GBM) framework, enabled by Principal Component Analysis (PCA), was used to collect data from 1,237 students. The approach was compared to other ML models like Random Forest, Linear Regression, Naïve Bayes, and Support Vector Machine and trained and validated using 5-fold cross-validation. The PCA+GBM model scored most effectively of significant metrics, with 93% accuracy, 92% precision, 91% recall, and 91.5% F1-score. Policymakers and educational administrators can use the outcomes as an incentive to enhance the strategy and standard of Higher Education (HE) that are run in collaboration between China and foreign countries.

Development and evaluation of hot-melt–extruded diquafosol tetrasodium formulations for ophthalmic inserts: A design of experiments approach

This study aimed to develop, optimize, and evaluate hot-melt–extruded ophthalmic inserts capable of sustained release of diquafosol tetrasodium (DQS) via a design of experiments approach. DQS, a tear stimulant for dry eye management, faces challenges of frequent administration and low bioavailability. The developed insert uses biodegradable polymers in varied proportions to achieve sustained release. Optimized through mixture design, the insert completely dissolved within 24 h and maintained a stable drug content, thickness, and surface pH over three months at room temperature. In vitro corneal permeation studies on excised rabbit corneas demonstrated increased bioavailability, suggesting a reduced dosing frequency compared with conventional eye drops. Therefore, this insert has potential to enhance treatment outcomes by improving patient compliance and providing sustained drug effects.

Optimization of pediatric vaccines distribution network configuration under uncertainty

Millions of young people are not immunized in low income (LI) and lower middle income (LMI) countries because of low vaccine availability resulting from inefficiencies in cold supply chains. We create supply chain network design and distribution models to address the unique characteristics and challenges facing vaccine supply chains in LI and LMI countries. The models capture the uncertainties of demand for vaccinations and the resulting impacts on immunization, the unique challenges of vaccine administration (such as open vial wastage), the interactions between technological improvements of vaccines and immunizations, and the trade-offs between immunization coverage rates and available resources. The objective is to maximize both the percentage of fully immunized children and the vaccine availability in clinics. Our research examines how these two metrics are affected by three factors: number of tiers in the supply chain, vaccine vial size, and new vaccine technologies. We tested the model using Niger’s Expanded Program on Immunization, which is sponsored by the World Health Organization. We make many observations and recommendations to help LMI countries increase their immunization coverage.

Nanoparticle aggregation and electro-osmotic propulsion in peristaltic transport of third-grade nanofluids through porous tube

In the modern era, the utilization of electro-kinetic-driven microfluidic pumping procedures spans various biomedical and physiological domains. The present study introduces a mathematical framework for characterizing the hemodynamics of peristaltic blood flow within a porous tube infused with ZrO2 nanoparticles. This model delves into the interactions between buoyancy, electro-osmotic forces, and aggregated nanoparticles to discern their influence on blood flow. We employ a third-grade fluid model to elucidate the rheological behavior of the pseudoplastic fluid which refers to its response to applied shear stress, specifically the relationship between shear rate and viscosity. The collective influence of accommodating heat convection, joule heating and aggregated nanoparticles contributes to the thermal behavior of fluids. The distribution of electric potential within the electric double layer (EDL) is predicted by solving the Poisson–Boltzmann equation. The rescaled equations are simplified using the lubrication and Debye-Hückel models as the underlying frameworks. The novel homotopy perturbation method is employed to obtain solutions for the finalized non-linear partial differential equation. Theoretical assessment of hemodynamic impacts involves plotting graphical configurations for various emerging parameters. As electro-osmotic parameter increase, the bloodstream encounters greater impedance, thereby enhancing the effectiveness of electro-osmotic assistance. Concurrently, elevated convective heat markedly reduces the rate of heat transfer, potentially resulting in a drop in blood temperature. It is important to note that maximum shear stress occurs when the artery is positioned horizontally, underscoring the significant impact of arterial alignment on wall shear stress. Skin friction intensifies with the increasing wall permeability as aggregated nanofluids pass through the arterial conduit. Therefore, aggregation of nanoparticles into the bloodstream yields a broader spectrum of distinctive physiological features. In summary, these findings enable more effective tool and device designs for addressing medication administration challenges and electro-therapies.

Perspectives on telehealth implementation in Australia: An exploratory qualitative study with practice managers and general practitioners

BackgroundThere is a lack of understanding regarding the impact of telehealth on clinical delivery and the feasibility of sustained implementation by health services. The COVID-19 pandemic provided an ideal opportunity to identify factors related to the implementation of telehealth. This study assessed factors that influenced telehealth implementation during COVID-19 in the Western region of Victoria, Australia, from the perspectives of practice managers and general practitioners (GPs). MethodsEmploying a qualitative approach, we conducted semi-structured interviews with 14 GPs and 11 practice managers across metropolitan and rural settings in the Western region of Victoria, Australia. Interviews were conducted between December 2021 to June 2022, which included periods during and beyond the peak of the COVID-19 pandemic. Themes were synthesised using the Consolidated Framework for Implementation Research, which comprised five domains: innovation, inner setting, outer setting, individuals and implementation process. An additional domain related to billing and finances was added. ResultsThe innovation domain revealed that telehealth was identified by both stakeholder groups as a critical tool for improving healthcare access for vulnerable patients. GPs highlighted the role of telehealth in follow-up care and the need for extended telephone consultation services. For the implementation process, both stakeholder groups identified a shift in attitudes among GPs from reluctance to acceptance of telehealth. In terms of outer setting, constant changes in regulations posed challenges to administrative staff. Practice managers faced difficulties in acquiring information on changes, but those with robust professional networks were well supported. Initial loss of incentive funding and government-imposed billing methods posed hurdles for clinics. Both stakeholder groups highlighted the need for education around videoconference and a standardised telehealth platform. ConclusionEvolving telehealth regulations during the emergence of COVID-19 posed financial, operational and administrative challenges to primary care clinics. To ensure sustainability, policymakers should improve stakeholder communication, set interoperability standards, and ensure sustainable funding for telehealth.

Trainee advocacy for medical education on the care of people with intellectual and/or developmental disabilities: a sequential mixed methods analysis

BackgroundMedical trainees (medical students, residents, and fellows) are playing an active role in the development of new curricular initiatives; however, examinations of their advocacy efforts are rarely reported. The purpose of this study was to understand the experiences of trainees advocating for improved medical education on the care of people with intellectual and/or developmental disabilities.MethodsIn 2022–23, the authors conducted an explanatory, sequential, mixed methods study using a constructivist paradigm to analyze the experiences of trainee advocates. They used descriptive statistics to analyze quantitative data collected through surveys. Participant interviews then yielded qualitative data that they examined using team-based deductive and inductive thematic analysis. The authors applied Kern’s six-step approach to curriculum development as a framework for analyzing and reporting results.ResultsA total of 24 participants completed the surveys, of whom 12 volunteered to be interviewed. Most survey participants were medical students who reported successful advocacy efforts despite administrative challenges. Several themes were identified that mapped to Steps 2, 4, and 5 of the Kern framework: “Utilizing Trainee Feedback” related to Needs Assessment of Targeted Learners (Kern Step 2); “Inclusion” related to Educational Strategies (Kern Step 4); and “Obstacles”, “Catalysts”, and “Sustainability” related to Curriculum Implementation (Kern Step 5).ConclusionsTrainee advocates are influencing the development and implementation of medical education related to the care of people with intellectual and/or developmental disabilities. Their successes are influenced by engaged mentors, patient partners, and receptive institutions and their experiences provide a novel insight into the process of trainee-driven curriculum advocacy.

Empowering Local Communities Through Zakat to Achieve Sustainable Development Goals

The Prosperous Village Livestock Program at LAZNAS Nurul Hayat Kediri City serves as a model for utilizing zakat to bolster local communities towards sustainable development goals. This qualitative case study employs document analysis, interviews, and field observations to delve into the efficacy of this program. Despite challenges in zakat fund administration and economic limitations, findings indicate its effectiveness in community empowerment through livestock company financing, training, and social network enhancement. This study uniquely focuses on zakat-driven empowerment to combat poverty and foster sustainable development at the grassroots level. By addressing the research problem of how zakat can be leveraged for long-term community development, it fills a critical gap in existing literature. Phenomenologically, the subject of this study encompasses individuals involved in or affected by the Prosperous Village Livestock Program, while the object is the empowerment process facilitated by zakat utilization.

Healthcare Virtual Assistant using Generative AI

Abstract: Documentation is a clumsy task for the front- desk staff. They've to fill in patient data, schedule appointments, and attend to patient queries. Even healthcare providers must enter EHR data, which takes a lot of time, and they end up spending lesser time with their patients. In the evolving landscape of healthcare administration, the burden of administrative tasks continues to challenge healthcare professionals and institutions. However, with generative AI, doctors can produce clones of patient data and automate form- filling tasks. It can also be integrated with EHR for documentation work. This project introduces a result — a generative artificial intelligence (AI) system designed to ease administrative burdens and enhance operating efficiency. By employing the power of AI, this web- grounded platform aims to streamline administrative processes, automate routine tasks, and facilitate absolute communication between patients, medical staff, and administrative personnel. The proposed website leverages advanced generative AI approaches to tackle crucial administrative challenges. Through natural language processing (NLP) and image analysis, the system interprets unstructured data such as medical notes, images, and documents. It enables automated documentation generation, medical coding and billing, appointment scheduling, and patient inquiries through a responsive and user-friendly interface

First Person: Learning to have difficult conversations as a school leader

One of the greatest challenges for school administrators is navigating the difficult conversations that come with the territory of the role. Maury Grebenau shares his own path as an administrator who feared such conversations to someone who embraces them.

Challenges to the sustainability of Irish post-primary school leadership: the role of distributed leadership

PurposeThere is currently a shortage of applications for the role of principal. There are a range of factors contributing to this, one of which may be the considerable levels of stress and burnout reported by principals and deputy principals. Distributed leadership may offer some solutions to this challenge. This study aimed to explore the lived experiences of distributed leadership from a role sustainability perspective of school principals and deputy principals.Design/methodology/approachThis paper follows a qualitative interpretivist approach based upon 15 semi-structured interviews with principals and deputy principals working in Irish post-primary schools. Data were analysed via thematic analysis.FindingsResults indicate challenges to the sustainability of the role of senior school leaders comprising administrative overload, policy proliferation and challenges due to the complexity and breadth of the role of these school leaders. It was reported that engagement with distributed leadership could aid the sustainability of participants in their roles and the importance of focusing on well-being practices was also highlighted.Practical implicationsRecommendations include the need to reconsider policy proliferation and the need to reconceptualise school leadership. Further consideration regarding how distributed leadership can aid the sustainability of the role of senior school leaders, without adversely contributing to the already busy role of schoolteachers is also recommended.Originality/valueThe findings of this study are valuable as they reflect previous findings relating to the current challenges to sustainable school leadership as well as highlight distributed leadership as a potential aid to mitigate against these challenges.

Transoceanic ships as a source of alien dinoflagellate invasions of inland freshwater ecosystems

Ships' ballast water and sediments have long been linked to the global transport and expansion of invasive species and thus have become a hot research topic and administrative challenge in the past decades. The relevant concerns, however, have been mainly about the ocean-to-ocean invasion and sampling practices have been almost exclusively conducted onboard. We examined and compared the dinoflagellate cysts assemblages in 49 sediment samples collected from ballast tanks of international and domestic routes ships, washing basins associated with a ship-repair yard, Jiangyin Port (PS), and the nearby area of Yangtze River (YR) during 2017–2018. A total of 43 dinoflagellates were fully identified to species level by metabarcoding, single-cyst PCR-based sequencing, cyst germination and phylogenetic analyses, including 12 species never reported from waters of China, 14 HABs-causing, 9 toxic, and 10 not strictly marine species. Our metabarcoding and single-cyst sequencing also detected many OTUs and cysts of dinoflagellates that could not be fully identified, indicating ballast tank sediments being a risky repository of currently unrecognizable invasive species. Particularly important, 10 brackish and fresh water species of dinoflagellate cysts (such as Tyrannodinium edax) were detected from the transoceanic ships, indicating these species may function as alien species potentially invading the inland rivers and adjacent lakes if these ships conduct deballast and other practices in fresh waterbodies. Significantly higher numbers of reads and OTUs of dinoflagellates in the ballast tanks and washing basins than that in PS and YR indicate a risk of releasing cysts by ships and the associated ship-repair yards to the surrounding waters. Phylogenetic analyses revealed high intra-species genetic diversity for multiple cyst species from different ballast tanks. Our work provides novel insights into the risk of bio-invasion to fresh waters conveyed in ship's ballast tank sediments and washing basins of shipyards.

Revitalizing motivation for healthcare office workers: An Analysis of Job Diagnostic Survey Through the Lens of Hackman and Oldham's Model

The unprecedented nature of technological advancements, emphasis on the need for superior patient care, and evolving workplace dynamics lead to the need for revitalizing various factors that improve motivation for healthcare workers. The study aims to comprehend motivation for healthcare workers through the intricate lens of the Hackman and Oldham model by conducting a job diagnostic survey. Healthcare is a crucial industry where timely delivery of patient care is prioritized, workers often aim to exceed expectations and stay motivated. The conceptual framework of Hackman and Oldham provides insight into understanding the motivational factors of the job design, employee satisfaction in their role, and channel efforts into improving the same. A key application of the survey can be identifying areas of focus and improvement that can significantly improve motivation levels for employees thereby improving their performance and reshaping the healthcare workforce. A novel approach to research has been adopted, as previous studies have extensively focused on health care workers; however, most have overlooked the challenges healthcare office workers face to support the physicians and nurses at hospitals. The originality of the study stems from this finding as healthcare administrative workers face unique challenges that may be absent in other industries, and with the current nature of jobs post the pandemic, employers have found difficulty in retaining talent, keeping workers motivated, and empowering them to perform. This study will lead to both empirical and practical implications, aims to provide insight to future researchers as well as organizational leaders to acknowledge the newer dynamics of the workplace where healthcare office workers face many struggles in their workplace like long hours of working, stressful work environment, and constant pressure to perform as their performance is directly related to patient care and often involves saving lives, leading to lack of work-life balance; and how motivation resolves these issues. The study is performed on healthcare office workers in a North Texas Hospital and Healthcare organization, by surveying them with the Hackman and Oldham instrument to grasp their motivation levels and provide suggestions to the leadership to assist employees to stay motivated and focused.

Case Study in Network Security System Using Random Port Knocking Method on The Principles of Availability, Confidentiality and Integrity

Preventing unidentified individuals from misusing their access to information is a major concern when it comes to data security. Network administrators are charged with working harder to be able to secure the computer network they manage. The utilization of right method is a challenge for network administrators to protect computer network from intruders. The RPK method is one of solution to overcome this problem. This research aims to implement RPK method on the principles of availability, confidentiality, and integrity which have not been explored by previous studies. The network system configuration stage involved installing Debian 9, NMAP, Hydra, RPK, cloud server, remote admin, and attacker. The network security system's performance was tested, revealing a 99.97% availability rate and 100% confidentiality. The system's integrity was assessed, with an average response time of 0.22 seconds and 100% blocking accuracy. The test results indicate that the system's network security performance, using the RPK method, capable of protecting server attacks and effectively upholding security stability.