Point Of Delivery Research Articles

Hybrid Search with Graph Neural Networks for Constraint-Based Navigation Planning [Extended Abstract

Route planning for autonomous vehicles is a challenging task, especially in dense road networks with multiple delivery points. Additional external constraints can quickly add overhead to this already-difficult problem that often requires prompt, on-the-fly decisions. This work introduces a hybrid method combining machine learning and Constraint Programming (CP) to improve search performance. A new message passing-based graph neural network tailored to constraint solving and global search is defined. Once trained, a single neural network inference is enough to guide CP search while ensuring solution optimality. Large-scale experiments using real road networks from cities worldwide are presented. The hybrid method is effective in solving complex routing problems, addressing larger problems than those used for model training.

Optimization of scheduling scheme for self-driving vehicles by simulation algorithm.

As a new logistics technology, self-driving electric vehicles not only improve freight efficiency but also promote energy saving and emissions reductions. Aiming at logistics technologies based on self-driving electric vehicles, planning the vehicle scheduling scheme as a whole reduces energy consumption and improves economic and environmental benefits. Targeting an actual freight problem based on a two-way single-lane road connecting the pickup and delivery points and including electric charging stations, this paper proposes a method for optimizing the scheduling scenario and parameters of self-driving vehicles through computer simulations. An optimization model based on dynamic programming is established, and an optimization simulation algorithm is designed to solve the model, effectively solving the overall planning problem of vehicle scheduling. The experimental results show that the model and algorithm have good universality. After specifying an appropriate road length, total number of vehicles, number of spare vehicle batteries, duration of freight transportation, and other necessary information, the simulation algorithm is executed and the optimal scheduling scheme and the total amount of freight transported are output. The efficiency of the algorithm is extremely high, requiring only 1.5 s to complete the whole simulation process of scheduling 150 vehicles for 1000 h over a road with a length of 10 km.

A multi-depot vehicle routing problem with time windows, split pickup and split delivery for surplus food recovery and redistribution

The problem faced by the food banks operating on the front-end model is the collection of surplus food from donation points and re-distribution of it to the demand points using a fleet of vehicles available at different volunteer locations/depots within specified time windows. Further, due to the limited vehicle capacity, demand splitting is allowed at the pickup as well and delivery points. Therefore, this problem can be seen as a rich variant of the vehicle routing problem (VRP) and named as a multi-depot VRP with time windows, split pickup and split delivery (MDVRP-TW-SP-SD). The problem is to determine the optimal number of vehicles from each depot to be hired and their optimal routes (sequence for visiting pickup and demand nodes) such that the total cost of hiring the vehicles, routing cost and penalty for unmet demand are minimized and it is formulated as a mixed-integer programming problem. To the best of our knowledge, this is the first attempt to formulate the MDVRP-TW-SP-SD. To efficiently and effectively solve the problem, an elitist GA and a GA hybridized with the local search are proposed. The performance of the proposed algorithms is tested through extensive computational experiments carried out on 180 modified benchmark problem instances from the literature. The results of computational experiments show the superiority of the GA hybridized with 3-opt local search. A case of the Robin Hood Army operating in the Lucknow city of India is also presented to demonstrate the applicability of the proposed model to practice.

Where There Is A Will, There Is A Way: Enhancing Contraceptive Uptake In Pakistan.

To assess the contribution of a series of interventions on contraceptive uptake and reduction in unmet need in areas covered by the Family Advancement for Life and Health project. The study was conducted from 2008-09 to 2011-12 in 14 districts across Pakistan. The sample comprised all urban and rural households in each district. A total or 40 blocks/villages were selected, with 13 households selected per block/village. Within each household, all married women of reproductive age 15-49 years were interviewed, and their husbands who were present at the time were also interviewed to a maximum of 5 per block. Baseline data was collected in 2008-09, while end line data was collected in 2010-11. Change in family planning uptake attributed to the project interventions were estimated. Besides, a situation analysis of service delivery points was also conducted. Data was analysed using SPSS 21. The panel comprised 5,304 women and 950 husbands. Interventions with the most robust effects were LHWs' home visits, attending women's group meetings, and watching family planning messages on television (p<0.05). The greatest changes were observed in Khyber Pakhtunkhwa province, in urban areas and among younger women (p<0.05). Investing in public-sector services does pay off in terms of meeting family planning needs, and so do better, wider and clearer communication.

A mathematical optimization model for cluster-based single-depot location-routing e-commerce logistics problems

This study proposes a mathematical optimization model for a two-echelon location-routing problem in the last-mile delivery e-commerce environment. The e-commerce firm delivers each customer’s demand at home or through delivery points. Customers could be unavailable when the vehicle arrives at their homes. In this case, the vehicle must visit the allocated delivery points for the unavailable customer. There are several scenarios from all-present to all-absent customers. A mathematical model is proposed with six inequalities to reduce the model’s complexity. In addition, two scenario reduction methods are introduced to deal with the exponential growth of the number of scenarios. We generate twelve numerical instances to evaluate the performance of the model, the scenario reduction methods, and the proposed inequalities. The model produces valid solutions. Also, the scenario reduction methods are helpful for decision-makers in the e-commerce context by reducing the number of scenarios and decreasing the complexity of managing unavailable customer scenarios.

How can we deliver on the promise of precision medicine in oncology and beyond? A practical roadmap for action.

Precision medicine (PM) is a form of personalized medicine that recognizes that individuals with the same condition may have different underlying factors and uses molecular information to provide tailored treatments. This approach can improve treatment outcomes and transform lives through favorable risk/benefit ratios, avoidance of ineffective interventions, and possible cost savings, as evidenced in the field of lung cancer and other oncology/therapeutic settings, including cardiac disease, diabetes, and rare diseases. However, the potential benefits of PM have yet to be fully realized. There are many barriers to the implementation of PM in clinical practice, including fragmentation of the PM landscape, siloed approaches to address shared challenges, unwarranted variation in availability and access to PM, lack of standardization, and limited understanding of patients'experience and needs throughout the PM pathway. We believe that a diverse, intersectoral multistakeholder collaboration, with three main pillars of activity: generation of data to demonstrate the benefit of PM, education to support informed decision-making, and addressing barriers across the patient pathway, is necessary to reach the shared goal of making PM an accessible and sustainable reality. Besides healthcare providers, researchers, policymakers/regulators/payers, and industry representatives, patients in particular must be equal partners and should be central to the PM approach-from early research through to clinical trials and approval of new treatments-to ensure it represents their entire experience and identifies barriers, solutions, and opportunities at the point of delivery. We propose a practical and iterative roadmap to advance PM and call for all stakeholders across the healthcare system to employ a collaborative, cocreated, patient-centered methodology to close gaps and fully realize the potential of PM.

Abstract 28: Design Workshops: Participatory Co-Design and Iterative Adaptation of Cervical Cancer Screening Implementation Plans in Peru

Abstract Purpose: In many countries, implementation planning for delivery of cancer screening services functions as a ‘top-down’ process, often resulting in fragmentation and bottlenecks at points of service delivery. Participatory engagement of health system planners and actors from across cancer screening and treatment continuum involved with implementation, planning, and adaptation is hypothesized to lead to plans that have a higher likelihood of adoption and sustainability. We tested the feasibility of conducting a 4-day series of participatory ‘design workshops’ for implementation of the recently initiated HPV screening program in the DIRIS Lima Norte (DLN) region of Peru. Methods: The workshop agendas were co-designed by the Peruvian Ministry of Health (MINSA) and the National Cancer Institute (NCI) using principles of participatory action research, implementation science, and systems thinking. The workshop objectives were to clarify the goals and processes of the HPV cervical screening program and reflect on the initial implementation experience. Workshop design was attentive to a) building trust among the health system planners and actors, b) surfacing misconceptions and process bottlenecks, c) equitable representation of perspectives on the process from all levels of the screening system, and d) shared decision-making in actions to improve the system. Results: Through real-time participatory reflection and process mapping of the screening program, context-specific challenges were rapidly identified. The process maps helped participants gain a shared understanding of the complexity of the screening system and quickly identified how one part of the system can create barriers for proximal and distal parts of the system. Participants mentioned feeling detached from the distal barriers before the workshops but now understood their role in the decision-making and problem-solving processes and demonstrated a willingness to work with the regional director to implement process improvements in the system, specifically to ensure women testing positive received the appropriate follow-up care. Conclusion: Rapid embedded implementation research using facilitated workshops with broad health system representation to reflect on the processes and procedures was an acceptable quality improvement activity. MINSA plans to replicate this experience in other regions and to continue to create a culture of trust and establishment of learning health systems. Citation Format: Fatou Jallow, Andrea Matos Orbegozo, Maria Del Carmen Caruhapoma, Víctor A. Palacios, Milagros Montes, Carlos Santos, Margarita Correa-Mendez, Aubrey Villalobos, Alejandro Salicrup, Jose Jeronimo, Laura Nervi, Patti Gravitt, Julia Gage. Design Workshops: Participatory Co-Design and Iterative Adaptation of Cervical Cancer Screening Implementation Plans in Peru [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 28.

Vaccine wastage in Ghana, Mozambique, and Pakistan: An assessment of wastage rates for four vaccines and the context, causes, drivers, and knowledge, attitudes and practices for vaccine wastage

Vaccine procurement costs comprise a significant share of immunization program costs in low- and middle-income countries, yet not all procured vaccines are administered. Vaccine wastage occurs due to vial breakage, excessive heat or freezing, expiration, or when not all doses in a multidose vial are used. Better estimates of vaccine wastage rates and their causes could support improved management of vaccine stocks and reduce procurement costs. This study examined aspects of wastage for four vaccines at service delivery points in Ghana (n = 48), Mozambique (n = 36), and Pakistan (n = 46). We used prospective data from daily and monthly vaccine usage data entry forms, along with cross-sectional surveys, and in-depth interviews. The analysis found that estimated monthly proportional open-vial wastage rates for vaccines in single-dose vials (SDV) or in multi-dose vials (MDV) that can be kept refrigerated up to four weeks after opening ranged from 0.08 % to 3 %. For MDV where remaining doses are discarded within six hours after opening, the mean wastage rates ranged from 5 % to 33 %, with rates being highest for measles containing vaccine. Despite national-level guidance to open a vaccine vial even when only one child is present, vaccines in MDV that are discarded within six hours of opening are sometimes offered less frequently than vaccines in SDV or in MDV where remaining doses can be used for up to 4 weeks. This practice can lead to missed opportunities for vaccination. While closed-vial wastage at service delivery points (SDPs) was relatively rare, individual instances can result in large losses, suggesting that monitoring closed-vial wastage should not be neglected. Health workers reported insufficient knowledge of vaccine wastage tracking and reporting methods. Improving reporting forms would facilitate more accurate reporting of all causes of wastage, as would additional training and supportive supervision. Globally, decreasing doses per vial could reduce open-vial wastage.

Игровое моделирование выбора стратегии развития системы пунктов выдачи заказов интернет-магазинов

The article focuses on the problem of choosing the optimal strategy for the development of the system of Internet order pick–up points in the context of the dynamics of solvent demand and competition of Internet stores for the market of consumer goods. A game model of the situation of choosing a strategy for the development of a system of base-level delivery points is constructed, which allows quantifying the usefulness of each of the strategies in accordance with the possible values of the number of orders and the value of the average check. From a mathematical point of view, the constructed game model belongs to the class of games with a generalized player «Nature». A study of the game model of choosing a strategy for the development of the system of order pick-up points of Internet stores based on the use of several criteria used in information situations of complete uncertainty. The obtained results of game modeling have received a meaningful interpretation in terms of the economic situation under consideration. From a methodological point of view, the constructed game model can be used as a new component of the content of applied mathematical training of a graduate of the University of Economics.

A new truck-drone routing problem for parcel delivery by considering energy consumption and altitude.

The high population density in metropolitan areas, high-rise buildings, and changes in people's lifestyles have completely changed the way postal packages are delivered. People no longer go to the ground floor to receive a postal package. In the meantime, the delivery of postal packages through the balconies and windows of the units on the upper floors of the buildings will gradually become inevitable. Hence, a new Vehicle Routing Problem with Drone mathematical model has been developed with the objective of minimizing total delivery time and with the ability to deliver postal packages in the path of drones at different heights. In addition, the drone's energy consumption is computed by taking into account wind speed, the weight of the postal parcel, the weight of the drone's body, and other factors in the drone's path. A two-phase algorithm based on the nearest neighborhood and local search is presented to solve the developed mathematical model in different instances. Several small-sized test problems are designed and solved, and the performance of the heuristic approach is evaluated compared to the outputs of the CPLEX solver. Finally, the proposed model is implemented on a real-world scale to demonstrate the efficacy and applicability of the proposed model as well as the heuristic approach. The results show that the model successfully finds the optimal planning of the delivery routes, especially when we deal with delivery points at different heights.

Reducing the environmental impact of mask inductions in children: A quality improvement report.

Inhalational anesthetic agents are potent greenhouse gases with global warming potential that far exceed that of carbon dioxide. Traditionally, pediatric inhalation inductions are achieved with a volatile anesthetic delivered to the patient in oxygen and nitrous oxide at high fresh gas flows. While contemporary volatile anesthetics and anesthesia machines allow for a more environmentally conscious induction, practice has not changed. We aimed to reduce the environmental impact of our inhalation inductions by decreasing the use of nitrous oxide and fresh gas flows. Through a series of four plan-do-study-act cycles, the improvement team used content experts to demonstrate the environmental impact of the current inductions and to provide practical ways to reduce this, by focusing on nitrous oxide use and fresh gas flows, with visual reminders introduced at point of delivery. The primary measures were the percentage of inhalation inductions that used nitrous oxide and the maximum fresh gas flows/kg during the induction period. Statistical process control charts were used to measure improvement over time. 33 285 inhalation inductions were included over a 20-month period. nitrous oxide use decreased from 80% to <20% and maximum fresh gas flows/kg decreased from a rate of 0.53 L/min/kg to 0.38 L/min/kg, an overall reduction of 28%. Reduction in fresh gas flows was greatest in the lightest weight groups. Induction times and behaviors remained unchanged over the duration of this project. Our quality improvement group decreased the environmental impact of inhalation inductions and created cultural change within our department to sustain change and foster the pursuit of future environmental efforts.

Mail to One or Mail to All? An Experiment (Sub)Sampling Drop Point Units in a Self-Administered Address-Based Sampling Frame Survey

Practitioners utilizing an address-based sampling frame for a self-administered, mail contact survey must decide on how to handle drop points, which are single delivery points or receptacles that service multiple households. A variety of strategies have been adopted, including sampling all units at the drop point or subsampling just one (or a portion) of them. This paper reports results from an experiment fielded during the 2021 Healthy Chicago Survey aimed at providing insight into whether there are any substantive differences between these approaches. We find that a subsampling strategy in which a single mailing is sent produces a roughly 3 percentage point higher response rate relative to a strategy sending multiple mailings concurrently to the drop point. While base-weighted distributions of gender and age differed enough to be statistically significant, there were no noteworthy differences across other demographics or across the base-weighted distributions of select key health outcomes measured by the survey. Taken together, these results provide some evidence that a “mail to one” drop point strategy is more efficient than a “mail to all” drop point strategy.

A Novel Two-Phase Approach for Optimization of the Last-Mile Delivery Problem with Service Options

As the growth of e-commerce continues to accelerate, there is a need for new and innovative strategies in last-mile delivery to meet the changing demands of customers. The main objective of this study is to address this need by optimizing the last-mile delivery problem with service options (LMDPSOs) through a novel two-phase approach that considers various delivery options such as home delivery, self-pickup, and delivery at different prices. This original approach enables simultaneous optimization of the selection of the most appropriate pickup and delivery points and determination of the most efficient vehicle routing. The LMDPSOs reduces overall costs, minimizes environmental impact, and considers customer satisfaction levels by determining the most appropriate trips according to the available service options. This research employs a two-phase methodology for decision making. The first phase determines the value of the proposed locations through a novel multi-criteria decision-making (MCDM) approach that incorporates sustainability criteria. In the second phase, a tailored mathematical model is proposed for vehicle routing with service options. The model is coded in the CPLEXsoftware version 12.6 in various dimensions. We evaluate the potential and advantages of diverse delivery choices, illustrating that aggregating orders at pickup and delivery points can reduce delivery costs and minimize environmental impact. Additionally, this paper directs managers in selecting the most appropriate delivery method for last-mile delivery, considering environmental, social, and economic factors.

A continent-wide effort and solidarity at curbing COVID-19 pandemic: the Africa task force for novel coronavirus (AFTCOR) infection prevention and control technical working group’s experience

A continent-wide Africa Task Force for Coronavirus with its six technical working groups was formed to prepare adequately and respond to the novel Coronavirus disease (COVID-19) outbreak in Africa. This research in practice article aimed to describe how the infection prevention and control (IPC) technical working group (TWG) supported Africa Centre for Disease Control and Prevention (Africa CDC) in preparedness and response to COVID-19 on the continent. To effectively address the multifaceted IPC TWG mandate of organizing training and implementing rigorous IPC measures at healthcare service delivery points, the working group was sub-divided into four sub-groups—Guidelines, Training, Research, and Logistics. The action framework was used to describe the experiences of each subgroup. The guidelines subgroup developed 14 guidance documents and two advisories; all of which were published in English. In addition, five of these documents were translated and published in Arabic, while three others were translated and published in French and Portuguese. Challenges faced in the guidelines subgroup included the primary development of the Africa CDC website in English, and the need to revise previously issued guidelines. The training subgroup engaged the Infection Control Africa Network as technical experts to carry out in-person training of IPC focal persons and port health personnel across the African continent. Challenges faced included the difficulty in conducting face-to-face IPC training and onsite technical support due to the lockdown. The research subgroup developed an interactive COVID-19 Research Tracker on the Africa CDC website and conducted a context-based operation and implementation research. The lack of understanding of Africa CDC’s capacity to lead her own research was the major challenge faced by the research subgroup. The logistics subgroup assisted African Union (AU) member states to identify their IPC supply needs through capacity building for IPC quantification. A notable challenge faced by the logistics subgroup was the initial lack of experts on IPC logistics and quantifications, which was later addressed by the recruitment of professionals. In conclusion, IPC cannot be built overnight nor can it be promoted abruptly during outbreaks of diseases. Thus, the Africa CDC should build strong national IPC programmes and support such programmes with trained and competent professionals.

A novel conflict free routing with multi pickup delivery tasks for autonomous vehicles

PurposeThis study aims to propose a novel method for the conflict detection and eradication of autonomous vehicles which has predetermined routes to establish multi pickup and delivery tasks according to task priorities and vehicle capacity status on each pickup and delivery nodes in assembly cells in the automotive production.Design/methodology/approachIn the designed system, the routing of autonomous vehicles (AVs) and scheduling of pickup and delivery tasks are established in production logistics. Gantt chart is created according to vehicle routes, and conflicts are detected using the proposed conflict-sweep algorithm. The proposed conflict-solving algorithm eliminates conflicts on intersections and roads by considering vehicle routes and task priorities.FindingsIn many production systems, there is a need to obtain flexible routes in each pickup delivery task group that changes during day, week, etc. Proposed system provides remarkable advantages in obtaining conflict-free routes for pre-scheduled multi transport tasks of vehicles by considering efficiency in production systems.Originality/valueA novel method is proposed for the conflict detection and eradication of AVs. Proposed system eliminates conflicts on intersections and roads by considering pre-planned vehicle routes for a fleet of heterogeneous AVs. Unlike most of the other conflict-free algorithms, in which conflicts are solved between two points, proposed system also considers multi pickup and delivery points for AVs. This is pioneering paper that addresses conflict-free route planning with backhauls and scheduling of multi pickup and delivery tasks for AVs.

Inter-basin surface water transfers database for public water supplies in conterminous United States, 1986–2015

The manipulation of water resources is a common human solution to water-related problems. Of particular interest because of impacts on both source and destination is the anthropogenic movement of water from one basin to another, or inter-basin transfers (IBTs). In the United States, IBTs occur widely in both wet and dry regions, but IBT data are not collated and served in a coordinated way. Thus researchers wishing to account for transfers between basins have faced difficulty in doing so. Here we present the outcome of a systematic investigation into inter-basin surface water transfers connected with public water supplies in the conterminous United States (CONUS), 1986 to 2015. The present open-access geodatabase includes transfer volumes collected, evaluated, and compiled from disparate sources. We provide an updated snapshot of CONUS IBTs at a higher spatial resolution of points of withdrawal and delivery than previous datasets. This paper puts the national inter-basin transfer data in context, and shows how we acquired, structured, and validated the locations and volumes of surface water transfers in public water systems.

Socioeconomic Inequalities in Novel NSCLC Treatments During the Era of Tumor Biomarker-Guided Therapy: A Population-Based Cohort Study in a Publicly Funded Health Care System

IntroductionSocioeconomic inequalities in the utilization of conventional NSCLC treatments are well documented. Nevertheless, it is not known whether these inequalities are also observed with novel anticancer therapies. This study evaluated associations between deprivation and utilization of novel anticancer therapies targeting tumor biology, the immune system, or both, within the English national publicly funded health care system. MethodsA retrospective analysis of 90,785 patients diagnosed with having a histologically confirmed stage IV NSCLC from January 1, 2012, to December 31, 2017, sourced from the English national population-based cancer registry and linked Systemic Anti-Cancer Therapy database, was undertaken. Multivariable logistic regression evaluated the likelihood of novel anticancer therapy utilization by deprivation category of area of residence at diagnosis (measured by quintiles of the income domain of the index of multiple deprivation). ResultsMultivariable analyses revealed marked treatment inequalities by deprivation. Patients residing in the most deprived areas were more than half as likely to use any novel therapy (multivariable OR [mvOR] = 0.45, 95% confidence interval [CI]: 0.41–0.49) compared with patients residing in the most affluent areas. Deprivation associations with treatment utilization were slightly stronger with targeted treatments ([most versus least deprived] mvOR = 0.39, 95% CI: 0.35–0.43) than immune checkpoint inhibitors (mvOR = 0.58, 95% CI: 0.51–0.66). ConclusionsThere are marked socioeconomic inequalities in NSCLC novel treatment utilization, even in the English National Health Service where treatment is free at the point of delivery. These findings have important implications for equitable delivery of drugs, which have transformed outcomes in metastatic lung cancer. Further work exploring the underlying causes is now needed.

Readiness of health facilities to manage individuals infected with COVID-19, Uganda, June 2021

BackgroundThe COVID-19 pandemic overwhelmed the capacity of health facilities globally, emphasizing the need for readiness to respond to rapid increases in cases. The first wave of COVID-19 in Uganda peaked in late 2020 and demonstrated challenges with facility readiness to manage cases. The second wave began in May 2021. In June 2021, we assessed the readiness of health facilities in Uganda to manage the second wave of COVID-19.MethodsReferral hospitals managed severe COVID-19 patients, while lower-level health facilities screened, isolated, and managed mild cases. We assessed 17 of 20 referral hospitals in Uganda and 71 of 3,107 lower-level health facilities, selected using multistage sampling. We interviewed health facility heads in person about case management, coordination and communication and reporting, and preparation for the surge of COVID-19 during first and the start of the second waves of COVID-19, inspected COVID-19 treatment units (CTUs) and other service delivery points. We used an observational checklist to evaluate capacity in infection prevention, medicines, personal protective equipment (PPE), and CTU surge capacity. We used the “ReadyScore” criteria to classify readiness levels as > 80% (‘ready’), 40–80% (‘work to do’), and < 40% (‘not ready’) and tailored the assessments to the health facility level. Scores for the lower-level health facilities were weighted to approximate representativeness for their health facility type in Uganda.ResultsThe median (interquartile range (IQR)) readiness scores were: 39% (IQR: 30, 51%) for all health facilities, 63% (IQR: 56, 75%) for referral hospitals, and 32% (IQR: 24, 37%) for lower-level facilities. Of 17 referral facilities, two (12%) were ‘ready’ and 15 (88%) were in the “work to do” category. Fourteen (82%) had an inadequate supply of medicines, 12 (71%) lacked adequate supply of oxygen, and 11 (65%) lacked space to expand their CTU. Fifty-five (77%) lower-level health facilities were “not ready,” and 16 (23%) were in the “work to do” category. Seventy (99%) lower-level health facilities lacked medicines, 65 (92%) lacked PPE, and 53 (73%) lacked an emergency plan for COVID-19.ConclusionFew health facilities were ready to manage the second wave of COVID-19 in Uganda during June 2021. Significant gaps existed for essential medicines, PPE, oxygen, and space to expand CTUs. The Uganda Ministry of Health utilized our findings to set up additional COVID-19 wards in hospitals and deliver medicines and PPE to referral hospitals. Adequate readiness for future waves of COVID-19 requires additional support and action in Uganda.

Role of community pharmacy and pharmacists in self-care in Brazil

Global healthcare systems, including the National Health System in Brazil – one of the largest public models in the world –, continue to evolve, as well as populations' health needs, currently shaped on individuals feeling a greater desire to manage their own health. Self-care practices are part of several public policies and clinical guidelines in Brazil including the National Policy on Complementary and Integrative Practices, the National AIDS Control Program, the National Policy for Women's Health, and the Guidelines for Care of People with Chronic Diseases. There are over 100,700 community pharmacies, in the country (89.2% privately owned) employing 234,300 pharmacists, representing an important delivery point for self-care, as they are the first point of access to care for most patients. Self-medication is a common practice in Brazil (prevalence rates of self-medication ranging from 16.1% to 35.0%), especially with non-prescription/over-the-counter medicinal products (65.0%). In fact, these products represent over 25% of volume marketed of medicines, summing revenues of USD 1.9 billion per year. Studies demonstrated a positive budget impact as important savings for the National Health System due to reductions of unnecessary medical appointments and loss of working days. In addition to minor ailments management, other self-care services provided by community pharmacies that are frequently sought by Brazilian citizens (20–25% of cases) are smoking cessation and weight management (costs per service ranging from around USD 5.00–12.00). However, pharmacy services are not yet as fully integrated in Brazil to the same extent as in other countries. Barriers such as standardization of processes (from services' design, implementation, and evaluation in practice), pharmacist remuneration for the provision of services and the amount to be charged for the service are still a matter of controversy. For more rapid and sustainable advances in these practices, communication among various stakeholders, professional practice and healthcare regulations, standardization of services and financing of self-care (both publicly and privately) are urgently needed. This paper provides an overview of some self-care services provided by community pharmacies in Brazil and call attention to the ongoing challenges to move the National Health system forward.

Direct gas heating in linear concentrating solar collectors for power and industrial process heat production: Applications and challenges

AbstractParabolic trough collectors and linear Fresnel collectors are mature technologies for power production, and they are being recently applied to provide solar heat for industrial needs. Conventionally, they use a liquid as heat transfer fluid, either thermal oil or water, to carry heat from the receivers up to the point of conversion or delivery. Although liquids offer excellent thermal properties, they show technical limitations, besides environmental concerns, which have encouraged the research on alternative solutions. This work reviews the main research works on the use of gases as heat transfer fluid in linear concentrating collectors, including solar power and heat production, highlighting the potential applications and technical challenges. The review indicates: first, gases offer potential to replace liquids, and second, there is a need for more research and development to define the best technical compromises to reach practical application in every sector.This article is categorized under: Sustainable Energy &gt; Solar Energy Energy and Power Systems &gt; Energy Infrastructure