Delivery Practices Research Articles

A conceptual framework of decentralized blockchain integrated system based on building information modeling to steering digital administration of disputes in the IPD contracts

PurposeIn the construction industry, various parties are involved in a project. Consequently, claims and disputes are inevitable in this industry. This paper aims to develop Integrated project delivery (IPD) practices including early involvement of stakeholders and multiparty contracts which its combination with advanced technologies such as blockchain can lead to better dispute management and improve the whole construction process.Design/methodology/approachBased on literature review, the alternative dispute resolution (ADR) for IPD contacts were identified, and three formats of IPD contracts were selected, and the dispute resolution process of them has been analyzed. Then, based on blockchain review, a conceptual blockchain-based dispute management (BDM) model was generated for ADR in IPD. Model validation was done by an interview. Experts were asked to compare the BDM model with the traditional system regarding the ADR duration.FindingsAnalyses of the collected data from the experts demonstrated that the BDM model has better function in terms of time and cost for ADR process when the project is facing serious and considerable number of disputes. The relation between blockchain technology (BCT) and building information modeling (BIM) has been examined through a framework, and the ability of the proposed model for administrating dispute resolution process has been verified using four different scenarios of construction claims that show the system can run successfully.OriginalityThe current study proposes a truthful model, reliable framework to address the problem of project dispute management in IPD contracts. The system combines the ability to being unchangeable and the reliability characteristics of BCT with informative and automation aspects of BIM together to improve dispute resolution issue in the IPD system.

Designing an optimal model of blood logistics management with the possibility of return in the three-level blood transfusion network

BackgroundInventory managers in the blood supply chain always endeavor to provide their clients with prompt and appropriate responses. On the other hand, timely and regular blood deliveries to consumers are essential since ineffective delivery and transportation practices promote shortages, returns, blood loss. The paper attempted to develop an extensive and integrated optimal model of blood transfusion network logistics management by blood type to reduce the cost of losses, returns, and blood shortages given the relevance of this for the blood transfusion network.MethodsThe regional blood transfusion network in Khorasan Razavi, which contains one main base, six central bases, and 54 hospitals, should be constructed using the optimal model for blood inventory management and distribution. A reusable simulation process was used to identify the optimal behavior for the inventory of all participants in the region (central bases as suppliers and hospitals as consumers), and the demand of hospitals as consumers has been calculated using artificial neural networks. This will lead to a significant reduction of returned blood units by consumers, optimal management of suppliers’ and consumers’ inventory to prevent waste and shortages. The routing method was used to proceed with the designed model and look into the optimal strategy to distribute blood requested by the consumers. with the aim of reducing the cost and increasing the speed of transportation.ResultsThe model’s solution allowed for the estimation of the amount of consumers’ demand, the optimal amount of target stock, the central bases and hospitals’ reorder points, as well as the method of distributing blood from the supplier to its consumers. Implementing the model leads to outcomes such as reducing the time of blood transfer from the central bases to their consumers, increasing the speed of blood delivery to the consumers, increasing the average stock of blood in the central bases, reducing the accumulation of distribution machines at the location of the central bases, the amount of stock, the method for requesting, consuming, and storing blood, and the performance of the central bases’ consumers all affect how much control they have over them.

Fertility and Reproductive Health: A Qualitative Study of Homeless Migrants in Delhi

Homelessness gives rise to a diverse kind of vulnerability which affect different sections of the population distinctly. Scholars have reported that the homeless are more prone to health issues than the general population. This article focuses on the reproductive health and fertility outcomes of two homeless ethnic populations in Delhi, who were migrants and belonged to scheduled caste groups. It was found that their culture played an important role in their reproductive decisions and health service-seeking behavior. The results showed that the participants were vulnerable due to gaps in Antenatal Care-seeking behavior, lack of support during admission and in the intrapartum phase, and traditional practice of home deliveries. It was observed that homelessness left fewer choices of space for women to deliver their children, especially in the case of the expectant women who either wanted to avoid institutional delivery or missed the window to go back to their native homes. Findings from the research indicate that there is an urgent need to understand and address the requirements of women in the homeless population and integrate them into the mainstream health system through infrastructural and support services.

Physician perceptions of barriers to infection prevention and control in labor and delivery.

To learn about the perceptions of healthcare personnel (HCP) on the barriers they encounter when performing infection prevention and control (IPC) practices in labor and delivery to help inform future IPC resources tailored to this setting. Qualitative focus groups. Labor and delivery units in acute-care settings. A convenience sample of labor and delivery HCP attending the Infectious Diseases Society for Obstetrics and Gynecology 2022 Annual Meeting. Two focus groups, each lasting 45 minutes, were conducted by a team from the Centers for Disease Control and Prevention. A standardized script facilitated discussion around performing IPC practices during labor and delivery. Coding was performed by 3 reviewers using an immersion-crystallization technique. In total, 18 conference attendees participated in the focus groups: 67% obstetrician-gynecologists, 17% infectious disease physicians, 11% medical students, and 6% an obstetric anesthesiologist. Participants described the difficulty of consistently performing IPC practices in this setting because they often respond to emergencies, are an entry point to the hospital, and frequently encounter bodily fluids. They also described that IPC training and education is not specific to labor and delivery, and personal protective equipment is difficult to locate when needed. Participants observed a lack of standardization of IPC protocols in their setting and felt that healthcare for women and pregnant people is not prioritized on a larger scale and within their hospitals. This study identified barriers to consistently implementing IPC practices in the labor and delivery setting. These barriers should be addressed through targeted interventions and the development of obstetric-specific IPC resources.

In-situ coordination assembly of polyphenol with cage-like Prussian blue as an ecofriendly nanocarrier for site-specific pesticide delivery and sustained pest control

In sustainable agricultural production, an efficient and environmental-friendly nanoplatform for precise pesticide delivery is considerably desirable to enhance efficacy and minimize ecological side effects. In this study, a pH-responsive nanohybrid named EB@HMPB@TA was designed using hollow mesoporous Prussian blue (HMPB) coordinated with tannin (TA) for targeted delivery of emamectin benzoate (EB). Results demonstrated that the cage-like HMPB nanoparticles possessed a remarkable loading capacity for EB, reaching up to 63.7%. Through a coordination assembly process, an in-situ Fe3+-chelated TA coating was formed on the surface of EB@HMPB to obtain EB@HMPB@TA. Notably, EB@HMPB@TA appreciably improved the foliar affinity of EB. Moreover, under UV-light irradiation, the degradation rate of EB loaded in the HMPB@TA nanocarriers decreased by 47% compared to EB alone, thus reducing the loss of EB. Additionally, the release ratio of EB@HMPB@TA at pH = 8.5 was 9.47-fold higher than that at neutral pH over 48 h. This pH-dependent release feature held great potential for targeting lepidopteran pests, which own a unique alkaline gut environment. Importantly, compared to commercial EB suspension concentrate, EB@HMPB@TA exhibited potent insecticidal activity against three target pests. Safety evaluations conducted on both HK-2 cells in vitro and maize crops demonstrated the relative safety of EB@HMPB@TA. Consequently, EB@HMPB@TA offered a new approach for accurate pesticide delivery, facilitating efficient and eco-friendly pest control practices and holding tremendous potential for sustainable agricultural production, which aligns with the principles of cleaner production in agriculture.

Anesthesia practice for Cesarean delivery in Japan: a retrospective cohort study.

General anesthesia for Cesarean delivery affects maternal and neonatal outcomes. We aimed to evaluate temporal trends in anesthesia management for Cesarean deliveries over 16years and analyze interinstitutional variations in general anesthesia use in Japan. In this retrospective cohort study, we obtained patient data from the nationwide health insurance claims database containing data for ten million individuals. We included patients who underwent Cesarean delivery between 1 January 2005 and 31 August 2021. The primary outcome was the use of general anesthesia. We evaluated institutional variations in general anesthesia use in medical facilities using two-level hierarchical logistic regression analyses with median odds ratios and intraclass correlation coefficients. The cohort included 86,793 patients who underwent 102,617 Cesarean deliveries at 2,496 institutions. General anesthesia was used in 3.7% (95% confidence interval [CI], 3.6 to 3.9) of all Cesarean deliveries. The temporal trend in the use of general anesthesia decreased gradually from 10.8% in 2005 to 2.9% in 2021 (P for trend <0.001). The adjusted median odds ratio for medical facilities was 6.1 (95% CI, 5.9 to 6.7), and the intraclass correlation coefficient was 0.52 (95% CI, 0.51 to 0.55). Although the rate of general anesthesia use for Cesarean delivery in Japan decreased gradually from 2005 to 2021, general anesthesia was used in 3.7% of all Cesarean deliveries. The use of general anesthesia varied significantly across institutions, and 52% of the overall variations in general anesthesia practice can be explained by differences between facilities.

Perinatal Outcomes at Rural Hospitals That Participated in the Rural Surgical and Obstetrical Networks (RSON) of British Columbia (2016–2021)

BackgroundThe goal of the Rural Surgical and Obstetrical Networks (RSON) of British Columbia was to support safe and appropriate surgery, operative birth, and perinatal care closer to home for rural communities. Family physicians with enhanced obstetrical and/or surgical skills provide cesarean delivery and family practice anesthetists manage anesthesia for labour pain and operative births at RSON-supported hospitals, with the involvement of a local specialist at one site. ObjectivesThe objectives of the study were to: (1) compare perinatal outcomes at hospitals participating in the RSON initiative with outcomes at referral hospitals and (2) examine temporal changes in the proportion of childbearing people who resided in RSON communities and gave birth locally. MethodsPoisson regression analysis was used to model the effect of hospital type (RSON vs. referral) on perinatal outcomes. We restricted the analysis to singleton births and controlled for differences in maternal characteristics, obstetric history, and pregnancy complications. ResultsChildbearing people who gave birth at RSON-supported hospitals (n = 3498) had a 10% lower incidence of adverse maternal–newborn outcomes compared to those who gave birth at referral hospitals (n = 14 772), after controlling for referral bias. We found a small increase (3.2 %) in the proportion of local births over the study period. ConclusionFindings provide evidence that childbearing people can safely give birth at smaller rural hospitals in British Columbia and that investments in rural hospitals contribute to service stability. Stabilizing local birth services in rural communities benefits the whole region because it reduces surgical overload in regional referral centres.

Gaps in care planning and delivery for patients with liver cancer: Baseline assessment for implementation of 4R Oncology model.

381 Background: Liver cancer is a complex disease, requiring detailed care planning, patient engagement and delivery of comprehensive care, including supportive and health maintenance care. The 4R Oncology Model for patient facing care planning, patient self-management and team based delivery of complex care has the potential to address these needs. 4R (Right Info/Care/Patient/Time) significantly improves patient self-management and optimizes delivery of supportive and health maintenance care in breast and lung cancer (Trosman JCOOP 2021; Liu JCOOP 2022). The impact of 4R in liver cancer has not been examined. Ochsner Health’s multi-disciplinary live cancer team is implementing and evaluating 4R. Here we describe the baseline assessment of provider practices and patient experience of care planning and delivery of supportive and health maintenance care. Methods: Surveys of providers and patients on current care planning and delivery in liver cancer were conducted Oct 2022 – Jan 2023. We used 3 metrics of care planning and 3 metrics of care delivery (Table). Results: Survey response rates: providers 55% (33/60), patients 45% (27/60). Providers included physicians, advance practitioners, nurses and navigators from Hepatology, Transplant, Interventional Radiology and Medical Oncology. Patients were 56% female, 63% white, 37% black, 56% &lt; 30k income. In care planning, patient experience was reported at a similar rate as provider practices for informed on goal of care, but significantly higher than providers for informed on next steps in care and receiving a detailed care plan (Table). In care delivery, patient experience and provider referral practices for social and supportive care were similarly low. Rates of patients’ receiving primary care and substance abuse assistance were significantly higher than respective rates of provider referrals. Among providers, 73% give patients a verbal care plan and 27% a hand written plan. The current process to create care plans is satisfactory to 54% of providers. Conclusions: We found substantial gaps in care planning and referrals to supportive and health maintenance care. Higher rates of patients reporting receipt of care planning and services suggest that many patients may resort to their own devices in these aspects of care. Ochsner Health aims to address these gaps by implementing the 4R Oncology model in liver cancer and will share results when available.[Table: see text]

Utilization of the medical oncology pager and call center: Characterizing forgotten pillars of telemedicine in the digital era.

518 Background: Oncology has entered the digital era, accompanied by changes in patient interactions and expectations involving telemedicine. While much emphasis is appropriately placed on digital interactions with patients, little is known about modern non-digital interactions with patients in oncology practices. Methods: We analyzed Medical Oncology Pager (MOP) data from 7/1/18 – 4/14/23, during which patients had access to the electronic health record and messaging capabilities. The MOP for Mayo Clinic (Rochester) is covered by the medical oncology fellows, including after hours (6PM – 7AM). It covers consults and direct patient calls after hours and during weekends, in addition to critical results back up and inpatient oncology matters at all times. We also analyzed Medical Oncology Call Center (MOCC) data since 6/1/22, which takes inbound patient calls during working hours (7AM – 6PM) and is staffed by appointment office employees. Results: The MOP received a total of 17,679 pages during the analyzed period for a mean of 10.1 pages per day. Of these, 6,319 pages occurred after hours. The most after-hours pages were received on Fridays (n=1,091) and the least on Sundays (n=701); of those years with fully available data, 2022 had the highest volume (n=1,405) (Table 1). When comparing the MOP activity pre-pandemic (7/1/18 – 3/10/20) and intra-pandemic (3/11/20 – 4/14/23), the mean number of after-hours pages per day was relatively stable with 3.47 pre-pandemic and 3.69 intra-pandemic. Since 6/1/22, the MOCC has averaged 6,464 inbound calls per month during working hours, each of which had an average talk time of approximately five minutes. The majority of inbound calls occur on Monday mornings between 9 – 11AM, with over 6,500 recorded throughout the previous year. Conclusions: Telemedicine is multi-faceted, comprised of both digital and non-digital patient interactions. We show that many oncology patients utilize telephone communication with the healthcare system despite increased availability of digital capabilities. These data have implications for addressing the digital divide for those with limited digital access, serving older patient populations unfamiliar with digital technologies, healthcare navigation, trainee responsibilities, and resource allocation. Further work and standardization in non-digital telemedicine is necessary as it remains a pillar of modern healthcare delivery and oncology practices.[Table: see text]

Effect of Room Service on Patient’s Macronutrient Consumption Level

Food service in hospital is aimed at providing high-quality meals and ensuring nutrition intake for patients. However, this aspect of healthcare faces numerous challenges, including high levels of food waste and patient dissatisfaction, often attributed to conventional food delivery practices in hospitals. The consumption of energy and macronutrients, including carbohydrate, protein, and fat, contribute greatly for hospitalized patients. Therefore, this study tried to implement a room service-like method in the food service system. This research was conducted in Class 1 and 2 of the inpatient wards of “Waled” Public Hospital, using a static pre-experimental design with two groups. Each group consisted of 38 patients selected from quota sampling. The control group followed the conventional food service method, while treatment group was given a room service approach. The treatment group was provided with a list of three menu options for each of the nine mealtimes, allowing them to choose their preferred food by sending a short message at the designated meal hour. Ordering times were specified as follows: 05:15 to 07:00 for breakfast, 10:00 to 12:00 for lunch, and 15:00 to 17:00 for dinner. Foods were prepared within 45 minutes after the order was placed. T-test analysis showed a distinct trend in the levels of energy, carbohydrates, proteins, and fats consumption between the control and treatment groups. The correlation between group variables and the level of energy consumption reached 15%, while the correlation between group variables and the level of protein consumption was 14%.

‘Customer is king’: gig work in a small South African city and the varieties of digital control and workers’ responses

The digital revolution typified by pervasive intrusion of digital technology into our everyday practices raises questions concerning the impact on the organisation of work and workers’ experiences. Drawing from workers’ subjective views, this article examines how the intervention of digital technology in the gig food delivery sector in Kimberley, South Africa, shapes the organisation of work and patterns of workers’ experiences and responses. The article, informed by labour process theory, highlights the platforms’ diverse business models and how they embrace digital technology informs the nature of the labour process, employment relations and workers’ response. For example, the ‘paradoxical’ nature of customer rating systems, and a culture of tipping, which, while allowing workers to ‘extract surplus value outside the direct control of the platforms’ serves to control and manage workers’ performance. This individualisation of income determination further isolates workers from each other and ‘undermines their sense of collective solidarity’. This affirms the on-going importance of human interaction in the digital labour process and the ways in which these technologies intersect with racial inequalities, perpetuating discriminatory service delivery practices. The organisation of gig delivery work is not just about controlling the labour process to maximise capital accumulation. It is embedded in practices aimed at (re)configuring both the workers and societal norms, values and culture, and, in the process, produce new traditions of work and worker subjectivities. However, workers do not blindly surrender to this logic but have the capacity to subvert this by forging means which propels them to exercise some form of control in how their work is organised.

Food safety knowledge, attitudes, and practices among online food delivery services during COVID-19 pandemic in Jabodetabek area, Indonesia

The coronavirus 2 (SARS-CoV-2) in some countries including Indonesia, has changed consumer behavior in accessing their food from direct buying from food services (i.e. food groceries, restaurants, cafes) to online buying by using an application from their smartphone. By using online food delivery services, knowledge, attitude, and practices of food handlers (FH) and food delivery workers (FDW) contributed to food safety. This study aimed to predict the food safety practices of FH and FDW by conducting a survey on their knowledge and attitude on food safety in Jakarta-Bogor-Depok-TangerangBekasi (Jabodetabek) area, Indonesia. The FDW were from Gofood, Grabfood, Shopeefood, and Kulina. The questionnaire was distributed via social media, ecommerce sites, and messenger applications to 675 respondents. The survey contained 36 questions and the data were analyzed by using the partial least squares structural equation modeling (PLS-SEM) technique. This study revealed that knowledge (β = 0.311 for FH; β = 0.136 for FDW; p &lt; 0.05) and attitude (β = 0.417 for FH; β = 0.342 for FDW; p &lt; 0.05) were positively correlated to good food safety practices. The study also indicated that attitude was the main variable in predicting the practices of FH and FDW. Overall, the structural model for FH has a better prediction (R² = 0.374) than that for FDW (R² = 0.165). There were gaps in food safety practices between FH and FDW that could contribute to achieving safe foods. Comprehensive knowledge through food safety campaigns, food safety training, and food safety culture for FH and especially FDW could be a strategy to strengthen food safety.

Surgical waitlist management: Perspectives from surgeons on surgical prioritization at a paediatric hospital.

Globally exacerbated surgical waitlists have provided the opportunity to reflect on prioritization and resource allocation decisions. The unique circumstances of paediatric surgery and consequences of surgical delay prompted the study reported in this paper. As part of a larger project to attend to prioritization in our surgical waitlists, we conducted a Quality Improvement study, the purpose of which is to understand surgeon's perspectives regarding the ethical and practical realities of surgical prioritization at our institution. The study comprises semi-structured interviews with nine full-time paediatric surgeons from a variety of subspecialties conducted at our institution, which is a tertiary paediatric hospital with ten surgical subspecialties in a publicly funded healthcare system. Participants articulated how they prioritize their waitlists, and how they understand ethical prioritization. These findings resonate with the growing public concern for ethical practice in healthcare delivery and transparency in prioritization and resource allocation practices. Specifically, more transparency, consistency, and support is required in prioritization practices. This work highlights the importance of institutional dialogue regarding surgical case prioritization. Because quality improvement work is necessarily site-specific, concrete generalizations cannot be offered. However, the insights gleaned from these interviews and the process by which they were gleaned are a valuable knowledge-sharing resource for any institution that is interested in ongoing quality improvement work. The objectives here were to clarify the goals of prioritization within the institution, improve prioritization practices, and make them more ethical and transparent.

Using good delivery practices and maternal experience and satisfaction

Objetivo: Descrever a utilização das boas práticas de atenção ao parto e nascimento e o grau de satisfação e experiência de puérperas com o parto. Métodos: Estudo transversal, realizado no período de julho de 2017 a janeiro de 2018, em uma maternidade em Fortaleza, Ceará. Utilizou-se o Questionário de Experiência e Satisfação com o Parto e questionário para avaliação dos dados sociodemográficos e obstétricos. Os dados foram analisados no software Statistical Package for the Social Science. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultados: Participaram 237 puérperas com média de idade de 26 anos. 168 (70,9%) mulheres estiveram bastante satisfeitas com a estrutura da instituição, 119 (50,2%) com os cuidados profissionais prestados e 160 (67,5%) com o trabalho de parto e parto. Dentre os fatores que estiveram associados à experiência positiva com o parto, destaca-se a realização do contato pele a pele, o estímulo ao aleitamento materno e a utilização dos métodos não farmacológicos de alívio da dor. Conclusão: Para uma experiência mais positiva de parto, ressalta-se a importância de abordagens humanizadas que incentivem práticas como contato pele a pele e início precoce do aleitamento materno, além de garantir que profissionais de saúde forneçam cuidados holísticos.

Infant mortality before and during COVID-19 pandemic in a district of Istanbul

Objective: The infant mortality rate is one of the most important indicators providing information on maternal and infant health. It can be affected by changes of social and environmental factors. The aim of this study is to evaluate infant mortality in 2019 and 2020 years at the local level, considering the beginning of the pandemic period. Methods: The population of this cross-sectional study are infants registered in a district of Istanbul in 2019 and 2020. Infant mortality rates before and during the COVID-19 pandemic were calculated. Antenatal healthcare and delivery practices in addition to the underlying risk factors for infant deaths were identified and compared by the year of mortality. All study data were collected from the district health information system. Results: Fifty-one infant deaths included in the study were residents of the district. Infant mortality rates were calculated as 4.8 and 5.1 per thousand live births for the years 2019 and 2020. Neonatal mortality rates were 3.9 and 2.7; postneonatal mortality rates were 0.9 and 2.4 per thousand live births, respectively by the years. No statistically significant difference was found between maternal and infant characteristics of the two years. The number of pregnancy follow-up records was significantly higher for the infants that died in 2020 compared to 2019. Yet, there wasn’t any difference in number of prenatal physician visits. Conclusion: Increase in the infant mortality rate during the pandemic compared to the pre-pandemic period is due to postneonatal mortality. The increase in postneonatal mortality is related to deaths caused by infections. This finding should be investigated with the healthcare accessibility and other characteristics of the infants. Our experience during the study revealed a room for improvement in access to data on always-important public health indicators, which would support evidence-based decision-making even in difficult times.

Temperature Elevation during Semen Delivery Deteriorates Boar Sperm Quality by Promoting Apoptosis.

Semen delivery practice is crucial to the efficiency of artificial insemination using high-quality boar sperm. The present study aimed to evaluate the effect of a common semen delivery method, a Styrofoam box, under elevated temperatures on boar sperm quality and functionality and to investigate the underlying molecular responses of sperm to the temperature rise. Three pooled semen samples from 10 Duroc boars (3 ejaculates per boar) were used in this study. Each pooled semen sample was divided into two aliquots. One aliquot was stored at a constant 17 °C as the control group. Another one was packaged in a well-sealed Styrofoam box and placed in an incubator at 37 °C for 24 h to simulate semen delivery on hot summer days and subsequently transferred to a refrigerator at 17 °C for 3 days. The semen temperature was continuously monitored. The semen temperature was 17 °C at 0 h of storage and reached 20 °C at 5 h, 30 °C at 14 h, and 37 °C at 24 h. For each time point, sperm quality and functionality, apoptotic changes, expression levels of phosphorylated AMPK, and heat shock proteins HSP70 and HSP90 were determined by CASA, flow cytometry, and Western blotting. The results showed that elevated temperature during delivery significantly deteriorated boar sperm quality and functionality after 14 h of delivery. Storage back to 17 °C did not recover sperm motility. An increased temperature during delivery apparently promoted the conversion of sperm early apoptosis to late apoptosis, showing a significant increase in the expression levels of Bax and Caspase 3. The levels of phosphorylated AMPK were greatly induced by the temperature rise to 20 °C during delivery but reduced thereafter. With the temperature elevation, expression levels of HSP70 and HSP90 were notably increased. Our results indicate that a temperature increase during semen delivery greatly damages sperm quality and functionality by promoting sperm apoptosis. HSP70 and HSP90 could participate in boar sperm resistance to temperature changes by being associated with AMPK activation and anti-apoptotic processes.

Consensus on telepractice service delivery practices with vulnerable families: a Delphi study

ABSTRACT Objective: In recent years family services have been required to rapidly employ telehealth without access to a reliable and contemporary evidence-base for implementation. This study explores expert views on systems and practices that facilitate telehealth in the delivery of family support services to vulnerable families. Method: Using the Delphi survey method, an inventory comprising 124 telepractices was presented to an initial panel of telepractice researchers and practitioners (N = 23) for ratings across three survey rounds. The panel was asked to provide feedback and suggestions for further inclusions, leading to an additional 29 items. Results: Results indicate 119 telepractice strategies were endorsed as essential and/or feasible for family services. These strategies were spread across five domains including practices prior to service delivery, practices during telepractice, practices when working with group programs, practices when working with culturally and linguistically diverse communities, and support for practitioners. Discussion: Practices that facilitate organisational support for practitioners, flexible service modality, and equitable access and privacy attracted the strongest endorsement. The findings support a hybrid model of service delivery in family services.

Practice of non-institutional delivery and its associated factors among women who gave birth in Southern Ethiopia, 2022

BackgroundNon-institutional delivery is one of the major reasons that results in high mortality rates for a mother and her neonate. The World Health Organization estimates that only 43% of mothers have access to skilled delivery services. A recent Ethiopian Mini Demographic Survey indicated that more than half of Ethiopian women have given birth non-institutionally. This shows that maternal health remains a major public health challenge in Ethiopia, irrespective of the government’s measures for institutional delivery. So, the aim of this study was to assess the practice of non-institutional delivery and its associated factors among women who gave birth in the study area.MethodsA community-based cross-sectional study was carried out on 260 study participants from June 1 to July 1, 2022, in Boloso Bombe Woreda. Data collection was done using a structured questionnaire, and systematic sampling techniques were used to select the study subjects. The data was entered into the EPI data version 3.1 and analyzed using SPSS version 25. The adjusted odds ratio, along with 95% confidence intervals, was used, and the level of statistical significance was declared at a P-value of 0.05.ResultOut of 260 women interviewed, 252 (97%) pregnant women participated in the interview. The prevalence of non-institutional delivery among study participants was 68.7% (95% CI: 63.1–72.9). Mothers who were a daily laborer [AOR = 6.6;95%CI(3.6(1.2–11.2), last pregnancy planned [AOR = 0.4; 95%CI (0.4(0.2–0.8)), an absence of antenatal care contacting history [AOR = 3.3; 95%CI (1.3–8.6)], respondents’ knowledge on the labor complication [AOR = 3; (95%CI); 3.5(2.2–6.1)], and place of first delivery [AOR = 8.7 95%CI(3.2–23)] were factors that significantly associated with practice of non-institutional delivery.ConclusionThis study indicated that the majority of study participants practiced non-institutional delivery in this study area. Thus, we strongly recommend that all responsible bodies take immediate action, such as community health education on pregnancy-related complications, encouraging ANC visits, and raising awareness of the advantages of preventing non-institutional delivery in order to reduce non-institutional pregnancy practices and improve the factors identified.

Green products wrapped and delivered: consumer’s preference for sustainable e-commerce practices

ABSTRACT With the rapidly growing online sales, e-commerce firms in emerging economies like India risk unsustainable practices such as the relentless consumption of goods, increased plastic and paper packaging, or inefficient delivery options that increase fuel consumption. To maintain a favorable corporate image amongst consumers, online firms possibly adopt various mechanisms to signal consumers’ adoption of sustainable practices. Such practices by firms may involve implementing sustainability practices in doorstep delivery, packaging, and product selection to influence consumers’ buying preferences. This research uses a structured survey approach to explore the impact of three sustainable practices implemented by an e-commerce firm on the consumer’s intention to purchase from such a firm. Using a dual theory perspective of the theory of consumption value (TCV) and the theory of planned behavior (TPB), the study demonstrates the impact of the belief of environmental risks on consumers’ intentions to purchase from such e-commerce firms with sustainable practices. The data findings from 301 Indian e-commerce consumers suggest that consumers with a higher belief of environmental risks display a higher degree of tolerance for the inconvenience of order delivery and sustainable product purchase intentions, further influencing their intentions to purchase from e-commerce firms with sustainable practices. However, the preference for sustainable packaging does not impact intentions to purchase from e-commerce firms with sustainable practices. The study discusses the implications for online e-commerce retailers and policymakers and informs online e-commerce consumers’ choices.

Gaining Competitive Advantage in Higher Education Management: Exploring Strategic Management Practices at the University for Development Studies (UDS), Tamale, Ghana

In recent times, gaining competitive advantage in higher education management has received the deserved attention from School Managers and Scholars globally. However, in Ghana, much has not been done beyond benchmarking, and gaps still exist both in literature and practice in the area of inimitable strategies employed by public universities in the quest to gain competitive advantage. This study investigated strategy formulation and implementation at the University for Development Studies within the context of quality higher education management. Specifically, the study examined internal stakeholders’ expectations of strategic management practices in quality higher education delivery using questionnaires, interview and focus group guides to collect primary data from students, principal officers and members of staff who were randomly and purposively selected. The findings revealed that internal stakeholders expect management to have a clear vision and mission for the university which should incorporate the interests of all relevant groups, especially those of students. The findings further revealed that the quality of strategic plans, policies, projects, and decisions of management to a large extent determined teaching, learning and research outcomes. To this effect, the UDS’ Pedagogy of the Third Trimester Field Practical Programme (TTFPP) makes the university unique.