Facility Management Research Articles

Managers of Aged Care Residential Services in Australia 2006-2021: Transformation reform

Objectives: This article provides analyses of the number and characteristics of managers of aged care residential services in relation to number of aged people, residents of aged care facilities and people employed in them. Design: The research design follows specifications provided by the authors for tabulations prepared by the Australian Bureau of Statistics (ABS) from the censuses of population conducted by ABS in 2006 and 2021. Analyses undertaken by the authors show changes that have taken place in the number of managers of aged care residential facilities in relation to the number of aged people, residents of aged care facilities, and people employed in them. Further, the analyses examine changes in the demographic characteristics of managers, their working hours and income, over time. Findings: There was a substantial decline in the proportion of the growing number of people aged 70 years and over who lived in aged care residential services during the 15-year period. While there was a large increase in the number of employees and managers per resident, and a slight increase in the number of managers per employee. The proportion of female managers fell, and the average age of managers increased slightly. The proportion of managers at graduate level rose substantially. Although the average income of aged care residential services managers was similar to that in all industries in 2021, their increase was larger than in all industries during the 15-year period. Average hours worked remained similar over time. The proportion of Australia-born managers declined while that of managers born in Asia rose substantially, and the proportion of indigenous managers about doubled during the 15-year period. Implications: Relevance to those concerned with the evolving transformation of aged care in Australia and those interested with management training of the growing number of managers of aged care residential services.

Relocating a highly complex 5 million test per year hospital based laboratory - what you should know and what you should avoid

Abstract Introduction/Objective A highly complex hospital based laboratory performing 5 million test per year in New York City was commanded to relocate due to a clinical department need to expand. This presented a challenge regarding the obtention of a suitable new space within the existing facility, the architectural design to optimize the performance of both Anatomic and Clinical Pathology, the choice between acquirring brand new instrumentation versus relocation of the existing instruments. At the same time, we had to interact with hospital wide Facilities Management and Information Services/ Electronic Medical records. In addtion, for quality improvement and to alleviate the shortage of licensed technologist in our state, it was decided that a robotic line was to be implemented in the new facility. Methods/Case Report Several space options were assessed. Once the most suitable space was found a decision was made to move in two phases, Anatomic Pathology first, and subsequently Clinical Pathology. New work stations were purchased for Anatomic Pathology. New instruments were obtained for Chemistry, Immunology and Hematology. All instruments were validated.. Our laboratory information system had to be upgraded in order to support the robotic line, which is to be implemented after the Clinical Laboratory move. This will facilitate the expansion of in house provision of laboratory services to outpatient facilities / clinics expandin our outreach. The new space includes room to expand as well as abundant swing space. Our next phase includes the relocation of our Blood Bank and expansion of our Microbiology Services Results (if a Case Study enter NA) Due to delays in the obtention of the State Occupational permit the move was postponed several times. It was decided to move in two phases, once the permit was received. The Laboratory successfully moved in a two week period, and was fully operational overnight. Conclusion The Laboratory successfully moved in a two week period, and one week later we underwent a routine State inspection, in which the rigourous inspectos encountered very few deficiencies. The Laboratory is fully operational to the satisfaction of our clinical departmenst and preparing to the next phase including Blood bank and expanding our outreach program

Comparison of Intelligent Community Design from the Perspective of Modernization--Shenzhen and Singapore as examples

With the continuous advancement of modernization, globalization, and urbanization, smart communities have received widespread attention as an important part of modern urban development. Taking two typical cases, Shenzhen and Singapore, as objects, this study compares and analyzes the design and practice experiences of the two smart communities from the modernization perspective. By comparing the design and practice of the two smart communities in Shenzhen and Singapore, it explores the common features and differences of smart community construction in different modernization contexts and provides reference and inspiration for smart community construction in future cities. Through literature research and case studies, a comparative analysis is conducted to study the design concepts, practice methods, and effects of two smart communities in Shenzhen and Singapore. The results of the study show that Shenzhen focuses on innovation and cutting-edge technology, which improves the efficiency of community governance and the quality of life of residents;Singapore focuses on community autonomy, and through intelligent management and residents' cooperation, it has improved the level of community facility management and residents' participation.This study provides useful experience and enlightenment for the construction of other urban smart communities, and provides a reference for promoting the smooth progress of urban modernization.

Semantic Enrichment of Non-Graphical Data of a BIM Model of a Public Building from the Perspective of the Facility Manager

Building information modeling (BIM) is undeniably the most important trend in the digitization of the construction sector in recent years. BIM models currently being built are extremely geometrically rich, that is, they are modeled at a high level of detail in terms of geometry. Thanks to object-oriented programming paradigms, BIM models include high-level relationships to ensure interactions between objects, rapid view generation, and documentation. However, these models are not always equally rich in non-graphical data. This is true for parameters at the library object level, with which building object models are saturated, but also at the project, site, building, or floor levels according to the structure of the interoperable industry foundation classes (IFC) format. The current state of knowledge also lacks a clear methodology for inputting such data. For this reason, experimental work was undertaken on semantic enrichment in non-graphical data of a public building (a public kindergarten, Secemin, Poland), which has its BIM model at a high level of geometric detail but is poor in non-graphical data. As a result of the research and development work, all levels of the IFC structure were saturated with non-graphical data and validated, and the possibilities of their use were shown from the perspective of the facility manager. Documentation from the manager was used to achieve this goal, and selected analyses and simulations were performed on the enriched model. This article contributes to the discussion on semantic enrichment from CAD3D to BIM by presenting a detailed process for entering non-graphical data into a BIM model. The presented data entry method can be used by both modelers and facility managers. Thus, this paper fills an important research gap related to semantic enrichment in non-graphical data at different levels of the IFC structure.

Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol

Background Adequate antenatal care (ANC) and facility-based delivery are linked to improved maternal and neonatal outcomes. Adequate antenatal care attendance and facility birth rates are increasing in Ethiopia but remain well below national goals and global recommendations. Group ANC (G-ANC), when implemented at higher level facilities, is associated with improved quality and experience of ANC, and increased ANC retention and facility-based delivery. The objectives of the study are to assess the feasibility, acceptability, and impact of G-ANC implemented at lower-level facilities (health posts) on ANC continuation and facility-based delivery. Methods G-ANC will first be piloted in five purposively selected health posts. The study will then use a stepped-wedge design in 36 health posts under six health centers, with randomization of the order of the start of the intervention done at the health center level (clusters). The design will include three time periods: first is a six-month control period with no G-ANC implementation, followed by another six months period where G-ANC will be introduced in half (n=18) of the study health posts, then final six months where G-ANC will be implemented in the remaining 18 health posts. Quantitative and qualitative data collection approaches will be used. The study has “pause and reflect” points designed to iterate on the intervention before rolling out to the next set of sites. Qualitative research will be conducted using in-depth interviews with pregnant women, health care workers, facility managers, and regional health managers. 770 women will be enrolled across all phases. Conclusions The study will inform decision makers locally and globally on whether G-ANC is a feasible service delivery model at the health post level. Effectiveness of G-ANC at increasing ANC retention and facility-based delivery will be reported, as well as its acceptability to pregnant women and Health Extension Workers. Registration NCT05054491, ClinicalTrials.gov (September 23rd 2021).

Pay for a free service, access to cesarean section in the slums of Dakar

BackgroundIn sub-Saharan Africa, equitable access to cesarean section remains a major challenge for reducing maternal and neonatal mortality, particularly among disadvantaged populations. This situation is further exacerbated in slums, where women face significant financial barriers to accessing expensive healthcare services, such as cesarean. Within this context, this paper aims to study access to emergency cesarean services among women living in the slums of Dakar, considering the free cesarean policy implemented in Senegal since 2005.MethodQuantitative data were collected using a cross-sectional retrospective approach, from 18 health facility managers and 260 women living in slums in Dakar who had undergone cesarean delivery between July and December 2022. The surveys aimed to collect socio-demographic data on women and the costs they paid to have a cesarean section, as well as on the application of the policy of free caesarean sections by public health facilities. The data were processed using Stata.ResultsThe results indicated that poor women residing in Dakar slums do have access to emergency cesarean section services in public health facilities. However, a significant portion of these women come from impoverished households and lack higher education, making them more vulnerable to financial constraints when seeking a C-section. Despite cesarean sections being performed primarily based on medical necessity, regardless of the woman's economic status, ethnicity, or educational background, women often find themselves having to pay substantial amounts to undergo the procedure. This is particularly concerning, as cesarean sections are intended to be entirely free in public health facilities in Senegal. Health facility managers attribute this financial burden to the State, which recurrently delays reimbursements for cesarean sections, forcing them to charge women higher prices for the procedure.ConclusionA more rigorous enforcement of the policy for free cesarean section could greatly enhance access to this obstetric practice for women living in the slums of Dakar.

Evaluating the impacts of printing operations on indoor air quality in a printing press

Purpose Building operations and human activities indoors continuously affect air quality, contaminating the air and sometimes exceeding permissible limits which can be health threatening either in the short or long time. This implies a need for strict awareness and compliance with air quality standards, particularly in workplaces prone to air contaminants emissions. This study aims to evaluate printing-related pollutant concentrations and their effects on indoor air quality (IAQ). The study investigated a printing press's total volatile organic compounds (TVOC), particulate matter (PM), carbon monoxide and carbon dioxide emissions. Design/methodology/approach This study used mainly an experimental research design supported by physical assessment by identifying the major printing-related pollutants, assessing the existing situation and measuring pollutant concentration levels using literature reviews, walkthrough inspections and experiments, respectively. The measurements were conducted in two scenarios: with and without printing activities, and the results were compared with relevant standards and guidelines. Findings The outcomes indicate that TVOC concentration reaches 120 ppb during printing and binding activities, exceeding the 75 ppb acceptable limit based on the time-weighted average. The PM2.5 concentrations reach 49 µg/m3 and PM10 up to 150 µg/m3, exceeding acceptable levels given by the US Environmental Protection Agency (EPA), which are 35 µg/m3 and 150 µg/m3 for PM2.5 and PM10, respectively. These high concentrations of TVOC and PM indicate a significant risk to the health of building occupants, particularly those with respiratory conditions. PM concentrations do not exceed permissible levels when no printing or bookbinding occurs, suggesting that printing-related activities can contribute to elevated TVOC and PM concentrations. Social implications The social implication of the study lies in its ability to promote awareness among workers and improve their well-being which in turn relates to productivity. The study outcome could also encourage businesses to adopt more responsible environmental and social practices as part of corporate social responsibility practices. Originality/value The study's findings, which highlight the need for improved ventilation in printing halls, have the potential to significantly benefit building system designers, facility managers, policymakers and decision-makers. By providing information and theoretical support, the research can help integrate policies that regulate IAQ by reducing pollutant concentrations. This protects workers' health and helps update and enforce stricter IAQ regulations for industrial operations.

Smart retrofitting for office buildings: Comparison of decision-making criteria between developing and developed regions

Given the constantly evolving nature of modern infrastructure, retrofitting existing buildings with state-of-the-art smart technologies presents a pivotal opportunity, enabling promising advancements in sustainability, efficiency and adaptability. Focusing on Hong Kong and Sri Lanka, which are developed and developing regions respectively, this study investigates the decision-making criteria for selecting smart systems as retrofits for office buildings. Using the analytic network process (ANP), 24 expert interviews were conducted in Hong Kong and Sri Lanka to determine the importance weights of the decision-making criteria. The findings show varied importance weights for each criterion between the two regions, with Hong Kong emphasizing upfront financial considerations, specifically 'investment cost' while Sri Lanka emphasizing long-term operational sustainability, specifically 'recurring operation, maintenance and repair cost.' Despite these differences, there are similarities in the importance of core criteria such as 'reliability of retrofit option' and 'ability to increase returns.' The lack of focus on user-centric issues in Hong Kong and implementation of retrofit projects in Sri Lanka underscore the need for decision-makers to prioritize these aspects in future projects. The principal contribution of this study is in offering insights from a thorough analysis of the importance weights of the essential criteria in making decisions regarding smart retrofitting (SR). It is also beneficial to various stakeholders, including building owners and facility managers. The cross-region study approach, enabling the investigation on both developed and developing regions, further serves as a foundation for future research aiming to explore and analyze the influence of regional difference in decision-making for SR.

A multi-objective optimization and evaluation framework for LID facilities considering urban surface runoff and shallow groundwater regulation

Currently, the goals of sponge city construction mostly focus on urban surface water, with few considerations of groundwater indicators, and there is a lack of simulation methods that consider the interaction between surface water and groundwater under low impact development (LID) scenarios. Taking a sponge campus in Xi'an as the research object, this paper proposes a method to realize the interaction between surface water and groundwater at different spatial and temporal scales, so as to construct a SWMM-MODFLOW coupled numerical model to carry out the analysis of hydrological effect of sponge city comprehensively taking into account both surface water and groundwater. Simultaneously, the SWMM is coupled with the NSGA-III algorithm for multi-objective optimization of LID facility configurations, aiming to identify a globally optimal solution set for LID facility configurations under both long and short-duration rainfall scenarios. A novel framework for a comprehensive evaluation system of surface water-groundwater benefits is also developed to comprehensively assess LID facility optimization schemes that meet the goals of stormwater runoff infiltration and reduction, pollution interception and purification, and groundwater recharge conservation. The simulation results show that after optimization, the LID scheme has good surface runoff regulation effects and pollution reduction capabilities, reducing the runoff peak from 2.297 m3/s to 2.128 m3/s, significantly lowering the risk of inundation and effectively reducing the total suspended solids (SS) load by 42.38 kg at the outfall. Meanwhile, the groundwater recharge effect is particularly significant in September. Compared to the baseline scenario, the average groundwater levels from June to September were raised by 3.966 cm, 5.120 cm, 6.743 cm, and 7.639 cm, respectively. The maximum daily groundwater level rise reached 7.82 cm, while the average groundwater level for the whole year of 2023 increased by 2.61 cm. The maximum transport area of pollutants decreased from 2359.44 m2 to 1796.54 m2, and the maximum transport distance reduced from 79.985 m to 69.977 m. Additionally, the central concentration of pollutants also decreased. This optimization evaluation framework will aid decision-makers in selecting LID facility management strategies that balance the dual benefits of surface water runoff and groundwater regulation.

Decision trees for determining the fate of laboratory animals.

Facilities involved in laboratory animal research often face ethical challenges such as: what should I do with the animals that are no longer suitable for experimental purposes? One of the common answers to this question is to kill them. And while numerous scientifically justifiable reasons exist for killing laboratory animals, we must not overlook our ethical responsibility towards these sentient beings. Animal facility managers and scientists frequently find themselves in a moral dilemma, torn between furthering their research and addressing the well-being of experimental animals required for their studies. We elaborated a concept consisting of six decision trees and recommendations for making informed decisions about the need to kill laboratory animals in research facilities, considering legal and ethical considerations. The concept is based on the German regulatory perspective. However, the measures and decisions for animal welfare can be implemented in all laboratory animal facilities. These recommendations suggest several courses of action, including implementing consistent breeding plans, exploring alternative uses, reassigning surplus animals and their organs, and establishing appropriate housing capacity limits that ensure species-appropriate care. We encourage scientists and animal facility managers to develop and implement decision-making frameworks and procedures tailored to their specific facilities, in the hope that this work will promote a thoughtful and responsible approach to the complex challenges associated with the killing of laboratory animals, advancing scientific progress and the humane treatment of these animals.

An integrated active case detection and management of skin NTDs in yaws endemic health districts in Cameroon, Côte d'Ivoire and Ghana.

Integrated approaches to mapping skin Neglected Tropical Diseases (NTDs) may be cost-effective way to guide decisions on resource mobilization. Pilot studies have been carried out, but large-scale data covering multiple countries endemic for skin NTDs are lacking. Within the LAMP4YAWS project, we collected integrated data on the burden of multiple skin NTDs. From March 2021 to March 2023, integrated case searches for yaws alongside other skin conditions were performed in endemic health districts of yaws in Cameroon, Côte d'Ivoire, and Ghana. Integrated activities included training, social mobilization and active case detection. Initial screening involved a brief clinical examination of participants to determine if any skin conditions were suspected. Cases of skin NTDs were then referred to a health facility for appropriate management. Overall 61,080 individuals screened, 11,387 (18.6%) had skin lesions. The majority of individuals (>90%) examined were children aged 15 years old and under. The proportion of serologically confirmed yaws cases was 8.6% (18/210) in Cameroon, 6.8% (84/1232) in Côte d'Ivoire, and 26.8% (440/1643) in Ghana. Other skin conditions based on clinical examination included: scabies, Buruli ulcer, leprosy, lymphatic filariasis (lymphoedema and hydrocele), tungiasis, and fungal infections. The most common conditions were scabies and superficial fungal infections. In Cameroon, scabies and superficial fungal infections accounted for 5.1% (214/4204) and 88.7% (3730/4204) respectively, 25.2% (1285/5095) and 50.4% (2567/5095) in Côte d'Ivoire. In Ghana, 20% (419/2090) of individuals had scabies but superficial fungal infections were not routinely recorded and were reported in only 1.3% (28/2090). Other skin NTDs were less common across all three countries. This study confirms that integrated screening allows simultaneous detection of multiple skin NTDs, maximising use of scarce resources.

Assessment of female students' perception on access and utilization of water and sanitation facilities for menstruation management in higher education institutions in Uganda

AbstractThe main purpose of this study was to assess female students' perception of access and utilization of water and sanitation facilities for menstruation management in HEIs. A qualitative research design was embraced, and it was exploratory while gathering responses from the participating respondents using semi‐structured interviews, focus group discussions and observation from course coordinators from six faculties, students guild leadership, and selected university managers who were purposively selected and regarded to be more knowledgeable with university affairs as far as learners' social welfare was concerned. The study found that many students did not have adequate access to water and sanitation facilities for menstruation management. They also lack adequate menstrual hygiene management education and their rights to sanitation and water facilities for menstruation management in terms of the menstrual cycle, the importance of washing body parts, and the issue of stigma during the menstruation period. The study recommended that the Directorate of Gender at the university should review and work very closely with the Department of Estates and Works to improve the maintenance and provision of water and sanitation facilities for menstruation management.

Advancing Zebrafish Husbandry: Takeaways From the 2024 Husbandry Workshop and Husbandry Summit.

The 2024 Zebrafish Husbandry Workshop and Summit held during the World Aquaculture Society Meeting in San Antonio focused on key areas for improving zebrafish husbandry research. Discussions highlighted the need for comprehensive literature on husbandry, better communication and collaboration between researchers and facility staff, and the adoption of a standardized reference diet. Current literature lacks comprehensive data and often overlooks crucial factors such as housing density and space requirements for fish development. Collaborative efforts between researchers and facility managers are essential for acquiring accurate husbandry data and minimizing pathogen risks. Standardizing descriptive language and parameter lists in publications and enhancing communication between facilities can improve research quality. Action items proposed include better communication of incoming fish information, standardization of pathogen monitors, transparency in husbandry practices, and fostering a spirit of collaboration among organizations. The summit emphasized the importance of increased PI awareness about husbandry, testing existing standardized diets, forming consortia to oversee diet standardization, creating unified repositories and forums, and conducting evidence-based husbandry studies.

EXPLORING ISSUES AND ENHANCING SUSTAINABILITY: AFFORDABLE HOUSING DYNAMICS IN MALAYSIA

This study delves into the issues of affordable housing and elements influencing the sustainability of affordable housing, with a specific focus on the Malaysian context. The primary objective is to identify the issues associated with affordable housing in Malaysia, as well as to determine the elements crucial for enhancing sustainability in the housing sector. A quantitative method using a questionnaire survey was conducted involving three groups of respondents: building designers, facility managers, and GBI facilitators. The research employed the Kruskal Wallis statistical analysis method and Importance Index Calculation as the key methodologies. Two significant findings emerged from the study. Firstly, the issues related to ‘location and accessibility’ and ‘financing challenges’ were identified as critically important, shedding light on the obstacles faced in these domains. Secondly, the elements of ‘adaptability and upgradability’ and ‘location and accessibility’ were highlighted as pivotal contributors to the sustainability of affordable housing in Malaysia. These findings provided valuable insights for policymakers, urban planners, and stakeholders in addressing key issues and promoting sustainable practices in the realm of affordable housing.

BIM-based optimization approach to reduce life cycle costs by focusing on the integration of construction and operation phases in office-commercial buildings

This study investigates the application of Building Information Modeling (BIM) to reduce life cycle costs (LCC) by addressing critical nonconformances encountered during the construction and operational phases of buildings. The primary aim is to identify nonconformances that escalate operational costs and to evaluate how BIM can effectively reduce these costs. The research begins with a comprehensive review of existing literature and utilizes the Delphi method to identify four key nonconformances that most significantly impact operational expenses. To further analyze these issues, semi-structured interviews and the Non-dominated Sorting Genetic Algorithm II (NSGA-II) are employed to determine the cost ranges of components associated with these nonconformances in both the construction and operational phases. The study finds that BIM-based optimization can lead to substantial cost reductions, although there are limitations due to the lack of precise data on the operational phase of low-cost equipment. The key contribution of this research is the development of a framework that helps designers create more effective BIM models, enhancing facilities management (FM) and reducing LCC. The originality of this study lies in its integrated approach, combining BIM and optimization techniques to directly address operational cost issues, which provides a novel perspective on improving life cycle cost management in buildings. Future research should expand the dataset and explore a broader range of nonconformances to refine and extend the framework's applicability.

OPTIMIZATION OF HEAT CONSUMPTION IN CENTRAL HEATING SYSTEMS AT COMMERCIAL FACILITIES

Rising energy prices and stricter environmental regulations are exacerbating the problem of inefficient heat consumption in the commercial sector. Central heating systems of office buildings, shopping malls, and industrial complexes are often characterized by excessive thermal energy consumption, which leads to significant economic losses and a negative impact on the natural environment. The purpose of the study is to study the directions and trends of optimization in the field under consideration (taking into account modern technological capabilities, and economic factors). There are disagreements in the professional community about the priority of measures to improve energy efficiency: some experts prefer improving the thermal insulation of buildings, others — the introduction of intelligent control systems, and others — the integration of renewable energy sources. The present study demonstrates that the greatest effect is achieved with a systematic approach combining various initiatives. The conclusion is formulated that in the current conditions and the future, a comprehensive application of modern thermal insulation materials, highly efficient heating equipment, intelligent management mechanisms, and alternative energy sources is required. The article is of interest to engineers-designers of heating systems, energy managers of commercial facilities, specialists in energy efficiency of buildings, and heads of companies interested in optimizing operating costs and improving the environmental friendliness of their real estate.

Total quality management, supplier quality and operational efficiency in the public health sector in the Upper East Region of Ghana

The purpose of this study was to examine the role that Total Quality Management (TQM) plays in ensuring operational efficiency via supplier quality in public health sector in the Upper East Region. Specifically, the study examined the effect of TQM on supplier quality; effect of TQM on operational efficiency; effect of supplier quality on operational efficiency and finally assessed the mediating role that supplier quality plays in the relationship between TQM and operational efficiency within these health sectors in the Upper East region. Structured questionnaire was utilized to solicit primary data from the study’s respondents. The selection of 174 sampled respondents from the total population of 352 public health facilities were done using a simple random sampling procedure. Also, version 24 of the IBM SPSS software and the SmartPLS model was utilised to process the data. The demographic characteristics of the respondents were analysed with the help of descriptive tools such as means and standard deviation, while inferential statistical tools was employed in testing the cause-and-effect hypothesised relationships between the variables. The findings revealed that total quality management had a positive significant effect on supplier quality. Likewise, the objective two showed that total quality management had a positive statistically significant effect on operational efficiency. The third objective showed that supplier quality had a positive statistically significant effect on operational efficiency, and the fourth research objectives revealed a positive statistically significant mediating effect of supplier quality in the relationship between total quality management and operational efficiency. The study recommended that, management of health facilities within the Upper East region should emphasize on putting measures in place to ensure the improvement of their TQM practices to help set standard that will ensure that suppliers goods and services conform to quality standards

Hyperbaric Oxygen Therapy: An Evidence-Based Primer for Emergency Physicians

BackgroundHyperbaric medicine is a subspecialty that many emergency physicians may not encounter frequently in their daily practice. As such, we hope to provide a review, where we present an overview of hyperbaric oxygen therapy, complications from the therapy, and a description of how the treatments are administered. We also discuss seven emergency indications that may benefit from transfer to a hyperbaric facility for treatment. Objective of the ReviewOur aim is to provide an overview of hyperbaric oxygen therapy as it pertains to an emergency physician. We hope that this review will help emergency physicians identify conditions that may benefit from transfer to a hyperbaric facility. DiscussionWe discuss seven emergency conditions that may benefit from transfer to a hyperbaric facility for management – decompression sickness, arterial gas embolism, central retinal artery occlusion, carbon monoxide poisoning, crush injury, necrotizing soft tissue infection, and symptomatic anemia. We also describe special considerations for how to transfer patients needing evaluation by a hyperbaric physician. ConclusionsThis review aims to describe hyperbaric oxygen therapy, identify conditions that may benefit from treatment with hyperbaric oxygen, and discuss management of patients with those conditions as it pertains to an emergency physician.

Evaluating the effects, implementation experience and political economy of primary healthcare facility autonomy reforms within counties in Kenya: a mixed methods study protocol

IntroductionThere is a growing emphasis on improving primary healthcare (PHC) services and granting frontline service providers more decision-making autonomy. In October 2023, Kenya enacted legislation mandating nationwide facility autonomy. There...

Waste Governance and Empowerment: Evidence from Ponorogo, Indonesia

This research is a case study with a qualitative descriptive approach, aiming to describe and analyze Waste Governance on community empowerment in waste management in Ponorogo Regency, Indonesia. This research designs a recommendation model, taking into account empirical conditions in the field. Data collection in this study used interviews, observation, documentation, and focus group discussions. This research involved informants from various elements in Waste Governance, including government, community, industry, academics, mass media, NGOs/Communities, and regulators. This research stems from the low community empowerment in managing community-based waste management facilities in Ponorogo Regency, Indonesia. This condition is caused by the low participation and involvement of the community in various community empowerment programs in waste management, resulting in the community's role becoming less than optimal in Waste Governance. This study illustrates the weak aspects of Waste Governance in Ponorogo Regency, Indonesia, such as: weak collaboration between the community and academics in community empowerment in waste management, failure to accommodate waste governance in business, education, and environmental interests, and not maximizing the institutionalization of the waste management agenda through the Clean Friday Movement. This research recommends strengthening aspects of Waste Governance, namely encouraging local leadership as a driving force in waste governance. This aspect relates to the role of local leadership and community leaders in mobilizing various community-based waste management facilities. The results of this research are expected to contribute to developing Waste Governance theory, as well as provide practical benefits in the practice of Waste Governance in Indonesia.