National Facility Research Articles

A cluster source for photoelectron spectroscopy in VUV and X-ray ranges

A detailed description of a custom-made gas aggregation cluster source is given as well as of its coupling to permanent molecular beam end-stations of the beamlines DESIRS and PLEIADES at the French national facility synchrotron SOLEIL. Using (hydrated) hypoxanthine clusters as a case study, the production of clusters with different source parameters is discussed based on Vacuum Ultra-Violet (VUV) mass spectrometry. The ability of the cluster source to perform photoelectron spectroscopy is illustrated by photoelectron spectra obtained for valence and core shells.

A Sensing Device with the Optical Temperature Sensors-Based Quad-RX Module and a Security Module.

In this paper, we present a sensing device with the optical temperature sensors-based quad receiver (Quad-RX) module and a security module. In addition, in order to prevent cyberattacks on critical national infrastructures and key facilities, we implemented symmetric-key and secure hash algorithm-based hardware security modules in the key elements of the sensing device. A preliminary test was conducted prior to a field trial to verify the performance of the developed sensing device. The accuracy and stability of the sensing device were then verified for 1 month in a field test at facilities for energy storage systems and photovoltaic converters in sewage treatment plants.

A reproducible picture of open access health facility data in Africa andR tools to support improvement.

Background: Open data on the locations and services provided by health facilities have, in some countries, allowed the development of software tools contributing to COVID-19 response. The UN and WHO encourage countries to make health facility location data open, to encourage use and improvement. We provide a summary of open access health facility location data in Africa using re-useable R code. We aim to support data analysts developing software tools to address COVID-19 response in individual countries. In Africa there are currently three main sources of such open data; 1) direct from national ministries of health, 2) a database for sub-Saharan Africa collated and published by a team from KEMRI-Wellcome Trust Research Programme and now hosted by WHO, and 3) The Global Healthsites Mapping Project in collaboration with OpenStreetMap. Methods: We searched for and documented official national facility location data that were openly available. We developed re-useable open-source R code to summarise and visualise facility location data by country from the three sources. This re-useable code is used to provide a web user interface allowing data exploration through maps and plots of facility type. Results: Out of 52 African countries, seven currently provide an official open facility list that can be downloaded and analysed reproducibly. Considering all three sources, there are over 185,000 health facility locations available for Africa. However, there are differences and overlaps between sources and a lack of data on capacities and service provision. Conclusions: These summaries and software tools can be used to encourage greater use of existing health facility location data, incentivise further improvements in the provision of those data by national suppliers, and encourage collaboration within wider data communities. The tools are a part of the afrimapr project, actively developing R building blocks to facilitate the use of health data in Africa.

Beyond X-rays: an overview of emerging structural biology methods.

Structural biologists rely on X-ray crystallography as the main technique for determining the three-dimensional structures of macromolecules; however, in recent years, new methods that go beyond X-ray-based technologies are broadening the selection of tools to understand molecular structure and function. Simultaneously, national facilities are developing programming tools and maintaining personnel to aid novice structural biologists in de novo structure determination. The combination of X-ray free electron lasers (XFELs) and serial femtosecond crystallography (SFX) now enable time-resolved structure determination that allows for capture of dynamic processes, such as reaction mechanism and conformational flexibility. XFEL and SFX, along with microcrystal electron diffraction (MicroED), help side-step the need for large crystals for structural studies. Moreover, advances in cryogenic electron microscopy (cryo-EM) as a tool for structure determination is revolutionizing how difficult to crystallize macromolecules and/or complexes can be visualized at the atomic scale. This review aims to provide a broad overview of these new methods and to guide readers to more in-depth literature of these methods.

Large-scale testing facility for heavy haul track

Given the substantially increased demand for increased axle loads of heavy haul trains, there is an imperative need to develop sustainable track infrastructure. When subjected to heavy axle loading, ballast aggregates rapidly break down, compromising the particle friction and associated load bearing capacity. Therefore, understanding the deformation and degradation (breakage) of ballast subjected to various boundary and loading conditions is crucial for improved track design and performance monitoring. Ideally, field testing should be carried out in real-life tracks to avoid laboratory scale and boundary effects, but field tests are often expensive, time-consuming and may disrupt rail traffic, hence not always feasible. A prototype test facility that can simulate appropriate axle loading and boundary conditions for standard gauge heavy haul tracks is presented in this paper. In collaboration with more than a dozen Universities and Industry organisations, Australia's first and only National Facility for Heavy-haul Railroad Testing (NFHRT) has recently been constructed and is now fully operational. This new facility enables a real-size (1:1 scale) instrumented track section to be subjected to continuous cyclic loading simulated via two pairs of dynamic actuators in synchronized operation. The results of a typical test are presented in this paper including the measured track settlement and lateral deformation, transient vertical and lateral stresses, rail and sleeper accelerations, resilient modulus and breakage of ballast. The test results show that an average track settlement of about 14 mm and lateral displacements up to 9 mm are recorded after 500,000 load cycles. Subjected to a 25-tonne axle load, the maximum vertical stress measured at the sleeper-ballast interface is about 225 kPa and this attenuates with depth. The test results of this iconic facility are generally consistent with actual field measurements obtained in heavy-haul tracks located in the towns of Singleton and Bulli in the state of New South Wales, Australia.

Magnetic fields in the Milky Way from pulsar observations: effect of the correlation between thermal electrons and magnetic fields

ABSTRACTPulsars can act as an excellent probe of the Milky Way magnetic field. The average strength of the Galactic magnetic field component parallel to the line of sight can be estimated as $\langle B_\parallel \rangle = 1.232 \, \text{RM}/\text{DM}$, where RM and DM are the rotation and dispersion measure of the pulsar. However, this assumes that the thermal electron density and magnetic field of the interstellar medium are uncorrelated. Using numerical simulations and observations, we test the validity of this assumption. Based on magnetohydrodynamical simulations of driven turbulence, we show that the correlation between the thermal electron density and the small-scale magnetic field increases with increasing Mach number of the turbulence. We find that the assumption of uncorrelated thermal electron density and magnetic fields is valid only for subsonic and trans-sonic flows, but for supersonic turbulence, the field strength can be severely overestimated by using $1.232 \, \text{RM}/\text{DM}$. We then correlate existing pulsar observations from the Australia Telescope National Facility with regions of enhanced thermal electron density and magnetic fields probed by 12CO data of molecular clouds, magnetic fields from the Zeeman splitting of the 21 cm line, neutral hydrogen column density, and H α observations. Using these observational data, we show that the thermal electron density and magnetic fields are largely uncorrelated over kpc scales. Thus, we conclude that the relation $\langle B_\parallel \rangle = 1.232 \, \text{RM}/\text{DM}$ provides a good estimate of the magnetic field on Galactic scales, but might break down on sub-kpc scales.

Characterisation of the NPL Thermal Conductivity Reference Material Inconel 600

Due to the depletion of the thermal conductivity reference materials, the National Physical Laboratory (NPL) has certified a new thermal conductivity reference material, NPL code 2I09 that is based on Inconel 600. This batch of material has been thermally and electrically characterised over the temperature range 100 °C to 500 °C. The primary thermal conductivity measurements used to generate the certified values were carried out in the NPL Axial Heat Flow apparatus, which is a UK national standard measurement facility. It is based on a steady-state absolute technique and is suitable for measuring specimens with thermal conductivities in the range 10 W·m−1·K−1 to 240 W·m−1·K−1. Comparisons were made between the reference thermal conductivity values and the derived thermal conductivity values obtained from two indirect methods based upon electrical resistivity and thermal diffusivity measurements, respectively. The reference thermal conductivity values of NPL 2I09 compare with those calculated from the measurements of electrical resistivity within 2 % and those calculated from the measurements of thermal diffusivity, specific heat capacity, density and thermal expansion better than 4 %. In addition, the certified thermal conductivity values of the new batch of Inconel 600, the NPL code 2I09, were compared with the representative reference thermal conductivity values of Inconel 600 reported by J Clark and R Tye, and the agreement is within 2 %. The new reference material NPL 2I09 is available from NPL and can be used to calibrate or check apparatus that provides measurements of thermal conductivity which includes the range 14 W·m−1·K−1 to 22 W·m−1·K−1 covering the temperature range from 100 °C to 500 °C. The overall uncertainty on the certified values is estimated to be within ± 4.8 %, based on a standard uncertainty multiplied by a coverage factor k = 2, providing a level of confidence of approximately 95 %.

NHERI@UC San Diego 6-DOF Large High-Performance Outdoor Shake Table Facility

Since its commissioning in 2004, the UC San Diego Large High-Performance Outdoor Shake Table (LHPOST) has enabled the seismic testing of large structural, geostructural and soil-foundation-structural systems, with its ability to accurately reproduce far- and near-field ground motions. Thirty-four (34) landmark projects were conducted on the LHPOST as a national shared-use equipment facility part of the National Science Foundation (NSF) Network for Earthquake Engineering Simulation (NEES) and currently Natural Hazards Engineering Research Infrastructure (NHERI) programs, and an ISO/IEC Standard 17025:2005 accredited facility. The tallest structures ever tested on a shake table were conducted on the LHPOST, free from height restrictions. Experiments using the LHPOST generate essential knowledge that has greatly advanced seismic design practice and response predictive capabilities for structural, geostructural, and non-structural systems, leading to improved earthquake safety in the community overall. Indeed, the ability to test full-size structures has made it possible to physically validate the seismic performance of various systems that previously could only be studied at reduced scale or with computer models. However, the LHPOST's limitation of 1-DOF (uni-directional) input motion prevented the investigation of important aspects of the seismic response of 3-D structural systems. The LHPOST was originally conceived as a six degrees-of-freedom (6-DOF) shake table but built as a single degree-of-freedom (1-DOF) system due to budget limitations. The LHPOST is currently being upgraded to 6-DOF capabilities. The 6-DOF upgraded LHPOST (LHPOST6) will create a unique, large-scale, high-performance, experimental research facility that will enable research for the advancement of the science, technology, and practice in earthquake engineering. Testing of infrastructure at large scale under realistic multi-DOF seismic excitation is essential to fully understand the seismic response behavior of civil infrastructure systems. The upgraded 6-DOF capabilities will enable the development, calibration, and validation of predictive high-fidelity mathematical/computational models, and verifying effective methods for earthquake disaster mitigation and prevention. Research conducted using the LHPOST6 will improve design codes and construction standards and develop accurate decision-making tools necessary to build and maintain sustainable and disaster-resilient communities. Moreover, it will support the advancement of new and innovative materials, manufacturing methods, detailing, earthquake protective systems, seismic retrofit methods, and construction methods. This paper will provide a brief overview of the 1-DOF LHPOST and the impact of some past landmark projects. It will also describe the upgrade to 6-DOF and the new seismic research and testing that the LHPOST6 facility will enable.

Development of the voluntary health insurance market in Ukraine

This paper is aimed to study the development trends of the domestic voluntary health insurance market. The authors analyzed the current state of the domestic voluntary health insurance market by its types. In the study framework, the main tendencies were determined, while the relative ratios of voluntary health insurance market functioning were calculated. Health insurance has a great potential to be a promising source of additional funding for medicine in Ukraine. However, the systematization of scientific sources indicated that unresolved issues of further development of health insurance and the search for effective external funding sources for medicine in Ukraine, one of which may be the market of voluntary health insurance. This research’s urgency consists of insufficient healthcare budgetary funding and low healthcare quality, provoking external funding sources’ growth in national healthcare facilities such as voluntary health insurance. The study of the features of the voluntary health insurance market development was carried out in the following logical sequence: determining the relevance of the research topic; investigating the scientific background on the research topic; establishing the methodological basis; analyzing the indicators of voluntary medical insurance market development; considering the structure of health funding sources in Ukraine and some countries of Eastern Europe. The authors determined a need to develop voluntary health insurance in Ukraine as an external health funding source based on the findings. The conclusions and recommendations were formed. The study involved the methods of deduction and induction, analogy and comparative analysis, graphical method, method of statistical comparison. The research object is the voluntary health insurance market in Ukraine. The research period is 2012-2020. The obtained results indicated that the voluntary health insurance market is undoubtedly an essential component of the Ukrainian insurance market. The authors noted that it is an effective additional way for actual funding the social needs in medicine. Therefore, it calls for further in-depth study and more attention from the population. The results of this study could be helpful for scientists, health and insurance professionals.

ЕКОНОМЕТРИЧНА МОДЕЛЬ ОЦІНЮВАННЯ ДІЯЛЬНОСТІ ТУРИСТИЧНИХ ПІДПРИЄМСТВ

The work aims to develop an author's approach to modelling the performance of tourism enterprises using modern mathematical methods of multifactor modelling based on empirical data. To achieve this goal, the following tasks were set and solved: to generalize theoretical developments and practical approaches to evaluating the effectiveness of tourism enterprises at the regional and national levels; substantiate the methodological basis and choice of econometric tools for modelling the evaluation of the effectiveness of tourism enterprises, taking into account the available statistical base; to develop an econometric model for evaluating the effectiveness of tourism enterprises that would allow determining a system of indicators for assessing the impact of the effectiveness of tourism enterprises on the economic development of territories; to develop recommendations for the application of the author's model in the substantiation and management decisions in the process of forming the foundations of regional and national economic policy. The author's approach to assessing the impact of tourism enterprises on the processes of economic development of the regions is proposed in the article. In the process of econometric modelling, the method of analysis of canonical correlations was used, which allowed obtaining an analytical view of empirical relationships of sets of performance indicators of tourism enterprises and indicators of economic development of regions, which, in turn, allows to obtain a formalized interaction of tourism enterprises and region. to obtain a realistic estimate of the contribution of tourism enterprises to GRP generation. The canonical analysis of the interaction of indicators reflecting the economic performance of tourism enterprises in the regions of Ukraine and indicators of economic development of the regions showed that the most priority areas of tourism enterprises in the regions of Ukraine that contribute to the development of regions, territories and increase employment are revenues from tourism services in the form of sale of tourist vouchers to citizens of Ukraine abroad for the purpose of specialized tourism, leisure, recreation and children's tourism. The growth of the share of tourist services both in the structure of gross regional product and in the structure of consumption in the world should stimulate domestic tourist enterprises to work towards increasing those indicators of tourist activity that would increase their profitability and competitiveness in the distribution of tourist flows. with the state, national tourist facilities and tourist infrastructure, especially in regions with sufficient tourist potential and low level of its use, to ensure a high level of quality of tourist services in accordance with international standards, to develop tourist activities within Ukraine.

Telemedicine Implementation Challenges in Underserved Areas of the Philippines

During these difficult times of global pandemic, mobility restrictions and lockdowns were put in place to prevent an outbreak. However, patients with medical needs must deal with regular face-to-face consultations with physicians for their prescriptions and medications. It is important to review the various telemedicine research in the Philippines and abroad and how to formulate a national framework for telemedicine so the program can be implemented in the entire country. As a developing nation and an archipelago, the Philippines needs to work on massive infrastructure project for national broadband and health care facilities. The increase of medical professionals per 1000 of population and prevent them from migrations will help implement such innovation in medical field. A national policy to support the program in terms of funding and its transparency, establishment of processes and standards, and safeguarding digital information should be put in place. The country will need to address these gaps in technology and processes and encourage the population to partake in national health plans and initiatives to increase awareness and engagement of all stakeholders.

A Bi-level Programming Approach for Pre-positioning Emergency Warehouses

In some countries, regional authorities may attempt to rebalance the allocation of national facilities in benefit of their own region which, in turn, may cause disturbances in the central government’s decision-making proces. Regarding the hierarchical nature of these types of decisions, classical optimization models are not effective in decision-making and the use of multi-level programming can increase the efficiency of planning. Our paper aims to address the issue of a bi-level programming model to conduct the location analysis of emergency warehouses. A three-echelon relief supply chain is considered in which the relief network involves national and regional warehouses and demand cities. The upper-level model decides on the location of national warehouses, allocating them to regional warehouses. The lower-level model determines the location of regional warehouses and allocates them to demand points. The structure of both levels is based on the median location-allocation problem. Three solution approaches are presented based on the full enumeration and two types of nested evolutionarymethods (genetic and heuristic local search algorithms). For the model to be used in Iran, the efficiency of algorithms is analyzed for two sizes of problems. The obtained results show the proper functioning of the solution approaches.

The Art of Remote Sensing for Nuclear Medicine

Remote sensing can play crucial role in the evolving nuclear medicine sector in Egypt. As the number of national medical centers that use Positron Emission Tomography (PET)/ Computed Tomography (CT) scans and radioactive isotopes for diagnostics and therapeutic services of cancer patients, is increasing. Remote sensing also copes with the worldwide efforts of having specific cyclotron together with radio pharmacy and clinic on-site. The paper presents an integrated remote sensing solution for nuclear medicine facilities, to detect radiation exposure, and contamination in the production, diagnostic and therapeutic areas. The system allows economic and reliable autonomous monitoring, it helps reducing the cost, enhancing production quality, increasing number of treated patients, improving the patient remedy, assuring the staff safety, and complying with regulatory requirements. Four communication technologies ZigBee, Bluetooth, Wi-Fi, and Z-Wave, have been investigated, and compared in context of network parameters (data rate, coverage, power constrains and bandwidth) and success factors (cost, reliability, ease of deployment and security). The ZigBee technology seems to be the best candidate for the proposed system. Results demonstrate the feasibility of using remote sensing for nuclear medicine and promise the efficient performance of the national facilities.

A Study on Children's House Consignment Issues in the Social Service Agency Law

사회서비스원의 서비스가 기존 민간기관의 서비스와 어떻게 다를 수 있는지 극히 의문스럽다. 사회서비스원 설립에 따른 민간의 반발을 의식한 나머지 운영기관에 대한 독립채산제를 표방하고 있는데, 이는 기존 민간기관과 똑같이 서비스 단가 안에서만 운영을 하겠다는 것이다. 그렇다면 사회서비스원도 민간기관과 같은 조건에서 똑같이 경쟁을 하겠다는 것이라면 현재 운영 중인 민간기관과 무슨 차이가 있는가? 현재 어린이집위탁은 사회복지법인과 보육전문가에게 위탁 운영하는 형태로 운영되고 있다. 정부는 사회서비스원을 설치하여 첫째, 사회서비스원은 지방자치단체로부터 국‧공립 시설(어린이집 우선 위탁)을 위탁받아 운영하고 서비스 종사자들을 직접 고용하여 관리한다. 둘째, 신규 설치되는 국‧공립 시설, 위‧불법 발생 또는 평가 결과가 저조한 시설로 한다. 셋째, 시·도지사가 직접 사회서비스원을 설립·운영할 수 있도록 하고 지원조직으로 사회서비스지원단을 설치하도록 하여 사회서비스의 공공성 강화를 위한 기반을 마련하기 위해서라고 한다. 본 연구는 현재 운영 중인 위탁사무와 사회서비스원 법과 사회서비스원의 사업을 분석한다. 분석 결과, 사회서비스원이 설립되어 사회서비스를 직접 제공하는 경우 사회서비스 수요가 공공부문으로 편중될 우려가 있다. 또한 기존 민간 서비스 부문에 혼란이 초래될 우려가 있어 사회적 합의가 있어야 한다. 공공부문에서 사회서비스를 직접 제공함으로써 공공성을 제고한다는 것과는 별개로 공공부문이 사회서비스를 직접 제공함으로써 공공성을 제고할 수 있는 분야, 범위 및 우선순위 등에 대한 검토가 요구된다는 결론을 제시하였다.This study is one of the national tasks to promote the establishment of social service Agency in which the public sector directly operates service providers and employs workers to improve public service quality and strengthen job security. The main roles and functions of the social service Agency are as follows. First, the social service agency entrusts and operates national and public facilities (primary care for nurseries) from local governments, and directly employs and manages service workers. Second, the newly established national and public facilities, and the facilities with low occurrence of illegal and illegal results. Third, to establish a foundation for strengthening the publicity of social services by allowing the municipalities and provincial governors to directly establish and operate social service centers and to establish social service support groups as support organizations. This study analyzes the Law of Social Services Agency and the Business of Social Services Agency . As a result of analysis, if a social service Agency is established to provide social services directly, the demand for social services may be concentrated in the public sector. In addition, there is a risk of confusion in the existing private service sector, and social consensus should be reached. Apart from enhancing publicity by providing social services directly in the public sector, it is necessary to examine the areas, scopes and priorities that public sector can improve publicity by directly providing social services.

Fitness OSINT: Identifying and tracking military and security personnel with fitness applications for intelligence gathering purposes

The objective of this paper is to demonstrate the possibility of tracking and identifying military and other security personnel, operating in secretive or restricted areas. Such exposure might have dire consequences from the perspective of counterintelligence or physical security. Open Source Intelligence (OSINT) and Social Media Intelligence methods and techniques were employed to gather and analyse information on security and military personnel and expose their activities on-line. The case studies presented in the article exemplify utilisation of the new “Suunto” fitness application for open-source-based intelligence research. Despite general Operational Security rules that require all personal data such as names, pictures and habits to be kept discreet, open-source based research with one of the most popular fitness applications allowed the identification of military personnel and government agents operating in Afghanistan, Mali, Syria or working at national military facilities. In a single case, it took the author less than thirty minutes to identify personal details of a US Army soldier in Afghanistan and a Special Forces officer in one of the European countries and obtain their home addresses and pictures of them and their families. The results of the research show how OSINT techniques concerning fitness applications are useful both for intelligence and counterintelligence, specifically for malicious and terrorist purposes, and how necessary it is to make fitness and other, supposedly personal, activity private, especially for those who carry out sensitive missions and work in a restricted or secretive environment.

The essence and relationship between the concepts of "security forces" and "law enforcement forces"

The article examines the essence and differentiated concepts of "security forces" and "law enforcement forces" based on the analysis of the current legislation and the theory of national security. The problems of national security, which are one of the most important, complex and multifaceted and integral phenomena of social and political life, are investigated. National security theory is a meta-science that combines the applied aspects of social, military, humanities, technical, psychological, biological and other sciences to explore the nature, content, methods, forms and means of ensuring the security of the individual and social communities of different levels. Therefore, in the study of national security, many categories are used, including the following: security, national security, national interests, national security facilities, national security entities, security factors, threats, danger, national security system, national security principles, national security functions, etc. On the basis of the analysis of key norms of the Law of Ukraine "On National Security of Ukraine" it is concluded that the changed approach to the formation of key legal acts based on the change of the vector of formation of threats to national security and national interests. Such an approach is in line with current requirements because, as historical experience shows, focusing solely on the interests of the state, developing its economic and military potential and subordination to these goals of the interests of individuals, the emergence of internal conflicts, ultimately leads to a process of disintegration. It is noted that while the legislator even divides the security and defense sector of Ukraine into four interconnected components, the composition of the security and defense sector nevertheless lists the entities without belonging to any of the four components. Depending on functional function, the security forces should include: Ministry of Internal Affairs, Security Service of Ukraine, intelligence agencies, State Security Service of Ukraine, State Service for Special Communication and Information Protection of Ukraine, and Military Law Enforcement Service. In line with this goal, it should be noted that although the notion of "law enforcement is encompassed by a broader range of public relations, it includes not only activity in special circumstances, but also the day-to-day service of using the term" security force "in national security activities. moreover, the one defined at the legislative level is more relevant. The legislative definition of "security forces" prompts, at least, the start of a scientific search to clarify the passport of the specialty 21.07.05 - combat service of law enforcement forces and to make changes and additions to the List of scientific specialties.

Antibiotics (Macrolides and Lincosamides) Consumption Trends and Patterns in China's Healthcare Institutes. Based on a 3 Year Procurement Records, 2015-2017.

In this study, we investigated the trends and patterns of antibiotic consumption (macrolides and lincosamides) in China’s healthcare institutions from 2015 to 2017. The China Drug Supply Information Platform (CDSIP) was officially launched in 2015. We collected records from this national centralized bidding procurement system between 2015 and 2017. The use of J01F antibiotics (macrolides or lincosamides) was calculated in a defined daily dose per 1000 inhabitants per day (DID).Purchase data from 70,366 national medical facilities included in the CDSIP were collected. The procurement data of 66,007 medical facilities have not changed over 3 years. There is a slight decline in the consumption of J01F antibiotics, which decreased from 3.03 DID in 2015 to 2.91 DID in 2017. Azithromycin (20.6%) was the most commonly used antibiotic in 2017 among all classes, followed by clindamycin (17.9%) and erythromycin (13.7%). Parenteral antibiotics accounted for 32.0% of total antibiotic consumption and 59.6% of total antibiotics expenditure in 2017. The overall consumption of most antibiotics decreased slightly over the 3-yearstudy period. This may be owing to China’s health-related policies in the past few years. A gap still exists in antibiotic use between regions and dosage forms. Further studies are needed to optimize antibiotic prescribing and reduce antibiotic resistance.

Towards Universal Quality Health Care through an Independent Accreditation Agency: A Review

Background. Guaranteeing quality of health care services is part of the objectives of Republic Act No. 11223 or the Universal Health Care (UHC) Act of 2019. In assuring that quality services are delivered by health care providers, they must be accredited to participate in the National Health Insurance Program. The UHC Act mandates the Philippine Health Insurance Corporation (PhilHealth) to recognize third party mechanisms as basis of granting incentives for health facilities that deliver services of higher quality. This review aimed to identify lessons and experiences from literature that can be adopted and contextualized in the Philippine setting, for strategic policies on strengthening the national health facility accreditation system.
 Methods. A systematic review of literature was conducted to generate evidence-based recommendations from discussions on cross country experiences and local government initiatives towards improved accreditation system.
 Results. By virtue of the UHC Act, a form of strategic purchasing is further institutionalized through a rating system that incentivizes health facilities that provide better services in terms of quality, efficiency, and equity. It is imperative to consider the country’s previous and current gaps and challenges in accreditation and adopt the best practices of other countries, as appropriate to Philippine's local settings. A tool is proposed in creating a national hospital accreditation system using the domains of leadership and governance, financing and sustainability, standards development, program management, and continuing quality improvement.
 Conclusion and Recommendations. With the legitimacy of third party accreditation body mandated by the UHC Act, operationalization of the prescribed mechanisms and organizational structure must enjoin all pertinent stakeholders and be supported by sustainable funds and technical assistance by the government.

Multidisciplinary Management of Radiation-Induced Salivary Gland Carcinomas in the Modern Radiotherapy Era.

Simple SummaryEtiopathogenesis of salivary gland cancers [SGCs] is largely unknown, even if exposition to ionizing radiation is a recognized risk factor for SGCs development. To date, exhaustive data to guide clinicians in managing patients with radiation-induced [ri] SGCs are scarce and their treatment remains challenging. The purpose of this work is to describe and to analyze clinical and histopathological features, delivered treatments, and outcome of a series of patients with ri-SGCs treated at two Italian cancer referral sites. Given the rarity of ri-SGCs, this retrospective analysis conducted on a case series of 13 patients adds further knowledge to the paucity of literature. The management of these malignancies is extremely complex requiring a multidisciplinary treatment approach.Clinical data of ri-SGCs patients treated between 2015 and 2019 at a tertiary cancer center and a national hadron therapy facility were reviewed. Latent time (LT) from first RT to ri-SGCs diagnosis, overall (OS), and disease-free survival (DFS) were assessed. Thirteen patients developed 14 ri-SGCs (one patient had 2 synchronous ri-SCGs), after a median LT of 23 years (range 16–34). Parotid was the primary site in 8 cases (57%) and salivary duct carcinoma was the most frequent histotype (29%). Nine patients (69%) underwent surgery (Sx). Among them, 4 patients (31%) underwent Sx alone, 5 received post-operative treatments: 3 (23%) photon-based (X) reRT, one (8%) protons and carbon ions, one (8%) carbon ions only. One patient (8%) received definitive XRT. The remaining 3 patients (23%) received androgen deprivation therapy. With a median follow-up of 48 months (range 24–72), median OS and PFS were 74 and 24 months, respectively. In the subgroup of AR+ ri-SGCs, median PFS and OS were 12 and 74 months, respectively. Given the rarity of ri-SGCs, this work adds further knowledge to the paucity of literature. The management of these malignancies is extremely complex requiring a multidisciplinary treatment approach.

Gambaran Perilaku Pencarian Pengobatan Penyakit Tuberkulosis (TB) pada Masyarakat di Wilayah Kerja Puskesmas Uitao Kecamatan Semau Kabupaten Kupang

Treatment-seeking behavior can be seen as a reflection of the implementation of the national health system and access to health services. In the context of treatment-seeking behavior in Indonesia, the use of national health facilities. Health seeking behavior or health seeking behavior, most Indonesians will try to treat themselves first by using medicines bought at kiosks without a doctor's prescription or using traditional ingredients in the surrounding environment and even asking a traditional healer for help. If they are not successful then they go to a medical health service place, this is because Indonesia has sources of treatment covering three interconnected sectors, namely self-medication (self-medication), medical treatment and traditional medicine. However, treatment is not only conventional in nature, there are alternative treatments that are popular with the community, especially in countries rich in culture and beliefs such as Indonesia. type of research used in this research is descriptive research with a quantitative approach. This study uses a descriptive approach with the aim of describing the object of research or research results. the sampling technique using total sampling. a sample size of 209 respondents. The results showed that treatment-seeking behavior at health facilities was 41.2%, while other treatments were 58.8%. poor knowledge about TB 54.4% compared to respondents with good knowledge about TB 45.6%. positive attitude towards TB treatment was 38.2% smaller than negative attitude 61.8%. Good belief in TB treatment-seeking behavior was 36.8% smaller than bad belief about TB treatment 63.2%.