Poor Record Research Articles

Factors Affecting Fund Management among Village Community Banks (VICOBAs); a Case of Registered VICOBAs in Iringa Municipality

The primary objective of this study was to assess the factors affecting fund management among Village Community Banks (VICOBAs), focusing on registered VICOBAs in Iringa Municipality under Iringa municipal council. Specifically, the study aimed to investigate the impact of timely loan repayment, financial record keeping, and the economic activities of groups of VICOBA on fund management. The research targeted a population of 104 accountants and treasurers from 104 registered VICOBAs in Iringa Municipality, and a sample size of 83 accountants and treasurers from 83 registered VICOBAs were selected for the study. A cross-sectional research design was employed, where a quantitative approach was applied to collect data. Simple random sampling and convenience sampling were used to select accountants and treasurers from those 83 registered VICOBAs from 18 wards within Iringa Municipality. Data was analysed by using descriptive statistics and regression analysis so as to determine the relationship between fund management among VICOBAs as dependent variable to timely loan repayment, financial records keeping and economic activities of the groups of VICOBAs in Iringa municipality as independent variables. The results revealed that there was a positive relationship between all independent variables and the dependent variable, which is fund management among registered VICOBAs. Furthermore, the results revealed that lack of timely loan repayment, poor financial records keeping, and poor performance of economic activities of the groups led to poor fund management among registered VICOBAs in Iringa municipality. Based on the study findings, it is concluded that the lack of timely loan repayment, poor financial record keeping, and poor performance of economic activities of the groups significantly contribute to poor funds management within VICOBAs in Iringa Municipality. The researcher made several recommendations whereby among the recommendations was that VICOBAs should prioritise the provision of collateral security for loans to mitigate the risks associated with untimely loan repayment

Advancement of the Electrochemical Performance of Stainless-Steel EEG Electrodes by Functionalizing with Carbon Nanotubes and Antibiofouling Molecules

Understanding brain function and neurological disorders are essential to develop therapeutic strategies such as neuropharmacological medications and implantable biomedical tools to treat brain-related disorders. Implantable neural electrodes can deliver in-depth knowledge of brain activity and disorders by recording real-time brain signals. Epilepsy is an electrophysiological brain disorder caused by genetic factors or a brain injury. Electroencephalography (EEG) is a standard technique that provides more specific information about epilepsy. Both invasive and non-invasive EEG electrodes are used to study epilepsy and possess high temporal resolution. Invasive EEG electrodes are useful for localizing the brain's regions where epilepsy arises. EEG electrodes are mainly metal-based electrodes. Stainless steel, platinum, gold, tin, and silver are commonly used metals. Electrode material plays a critical role in the accuracy of the brain signal measurements and consistent performance in chronic applications. Stainless steel EEG electrodes are successfully used in EEG signal monitoring in vivo; however, stainless steel can undergo chloride-induced corrosion and biofouling over time. Corrosion and biofouling can negatively affect the impedance of the EEG electrodes resulting in poor signal recording and inconsistent performance. The current study reports the advancement of the performance of stainless-steel EEG electrodes by functionalizing with vertically aligned carbon nanotubes (CNTs) and zwitterionic phenyl phosphorylcholine (PPC) molecules. CNTs are conductive and biocompatible nanomaterial which have been successfully used for neural interfacing applications. The results show that the electrochemical performance of the EEG electrodes was significantly improved after functionalization with vertically aligned CNTs. Electrochemically grafting of zwitterionic PPC molecules onto CNTs further improved electrochemical performance and introduced anti-biofouling properties.

Clinical validation of a wearable respiratory rate device: A brief report.

Respiratory rate (RR) is used for the diagnosis and management of medical conditions and can predict clinical changes. Heavy workload, understaffing, and errors related to poor recording make it underutilized. Wearable devices may facilitate its use. RR measurements using a wearable photoplethysmography-based monitor were compared with medical grade devices in complementary clinical scenarios: Study one included a comparison to a capnograph in 35 healthy volunteers; Study two included a comparison to a ventilator monitor in 18 ventilated patients; and Study three included a comparison to capnograph in 92 COVID-19 patients with active pulmonary disease. Pearson's correlations and Bland-Altman analysis were used to assess the accuracy and agreement between the measurement techniques, including stratification for Body Mass Index (BMI) and skin tone. Statistical significance was set at p ≤ 0.05. High correlation was found in all studies (r = 0.991, 0.884, and 0.888, respectively, p < 0.001 for all). 95% LOA of ±2.3, 1.7-(-1.6), and ±3.9 with a bias of < 0.1 breaths per minute was found in Bland-Altman analysis in studies 1,2, and 3, respectively. In all, high accordance was found in all sub-groups. RR measurements using the wearable monitor were highly-correlated with medical-grade devices in various clinical settings. ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT03603860.

OBJECT-ORIENTED PARTS INVENTORY INFORMATION SYSTEM MODELING USING UNIFIED MODELING LANGUAGE

The availability of spare parts in a vehicle service workshop needs to be correctly recorded and recorded, making it easier for workshop owners to ensure the complete availability of vehicle spare parts. From the results of the author's observations, the Rizki Prima workshop has several obstacles in recording the availability of spare parts where the business processes being carried out are still a hassle for the employees working in the workshop. The problem often occurs when recording is the incompleteness of data related to incoming and outgoing goods. So the recording made in the ledger needs to be more accurate and requires a relatively long time to search one by one in the register if the workshop owner needs it. As a result of poor recording of goods, it is difficult for the owner to order goods again, worried that duplicating data will record incoming goods. The above problems are the basis for the authors to conduct research by utilizing information systems and modeling with an object-oriented approach using a unified modeling language to design a spare parts inventory information system according to user needs. To provide an overview of the Rizki Prima workshop transforming from conventional spare parts data recording to digital spare parts recording. The above problems are the basis for the authors to conduct research by utilizing information systems and modeling with an object-oriented approach using a unified modeling language to design a spare parts inventory information system according to user needs. To provide an overview of the Rizki Prima workshop transforming from conventional spare parts data recording to digital spare parts recording. The above problems are the basis for the authors to conduct research by utilizing information systems and modeling with an object-oriented approach using a unified modeling language to design a spare parts inventory information system according to user needs. To provide an overview of the Rizki Prima workshop transforming from conventional spare parts data recording to digital spare parts recording. KEYWORDS: Modeling, Information Systems, Spare Parts Inventory, Availability, Unified Modeling Language

Improving data quality from routine clinical appointments-Development of a minimum dataset for traumatic dental injuries in children and adolescents.

It is currently difficult to evaluate the success or not of treatment for dental injuries due to poor recording of diagnostic and treatment codes in clinical dentistry. A minimum dataset comprises a standardised minimum set of outcomes along with a specified outcome measurement instrument, to allow aggregated use of data from routine clinical care appointments. This study aimed to determine which outcomes should be included in a minimum dataset for traumatic dental injuries (TDI). This is a three-stage sequential, mixed-methods study, using evidence-based best practice for dataset development. Normalisation process theory informed the development of the study protocols. In Stage 1, semi-structured interviews with patients and their parent or guardian were undertaken to identify outcomes of importance to patients. In Stage 2, an online Delphi survey was undertaken to identify outcomes of importance to clinicians. In Stage 3, a National Consensus Meeting was undertaken involving patient representatives, clinicians and other stakeholders, to agree which outcomes should be included in the minimum dataset. Stage 1: Eleven participants were recruited, five children and six parents. Two key themes emerged from the analysis-communication and aesthetics. In Stage 2, 34 dentists were recruited, and 32 completed both rounds of the survey (97% retention). Most outcomes were deemed by participants to be of 'critical importance', with three outcomes deemed 'important' and none to be 'of limited importance'. In Stage 3, 15 participants took part in the consensus meeting. Participants agreed that the dataset should comprise a list of clinician-important outcomes (pulp healing, periodontal healing, discolouration, tooth loss) and a list of patient-important outcomes (communication, aesthetics, pain, quality of life). A Minimum Dataset for TDI has been developed using a robust and transparent methodology.

First Fossil Record of Trichomanes sensu lato (Hymenophyllaceae) from the Mid-Cretaceous Kachin Amber, Myanmar.

Hymenophyllaceae (filmy ferns), with ca. 430 species, are the most species-rich family of early diverging leptosporangiate ferns but have a poor fossil record dating back to the Late Triassic period. Traditionally, Hymenophyllaceae comprise two species-rich genera or clades: Hymenophyllum (hymenophylloids) and Trichomanes sensu lato (s.l.) (trichomanoids). Unequivocal fossils of Hymenophyllum have been reported from the Early Cretaceous of central Mongolia and the early Eocene of Okanogan Highlands, Washington, USA. However, despite being a highly diversified lineage with an estimated 184 extant species, Trichomanes s.l. lack a definitive fossil record, which severely affects the reliability of the molecular dating of this group. Here, we report the first unequivocal fossil record of Trichomanes s.l. as T. angustum comb. nov. on the basis of fertile material with tubular involucres and long exserted receptacles from the mid-Cretaceous Kachin amber, Myanmar. This species was previously tentatively assigned to Hymenophyllites due to a lack of fertile evidence. Inferred to be an epiphytic fern, T. angustum further enriches the species diversity of the epiphytic palaeocommunities in the mid-Cretaceous Kachin amber, which are mainly composed of Porellalean leafy liverworts and Dicranalean and Hypnodendralean mosses. Fossil records indicate that Hymenophyllaceae probably originated in the tropical Pangea at the latest in the Triassic when all continents were coalesced into a single landmass and had already accumulated some notable diversity in low-middle latitude areas of Laurasia by the mid-Cretaceous period.

Foreign language provision in English primary schools: making evidence-based pedagogical choices

Fluency in more than one language is generally accepted as being advantageous in our modern global age. However, in addition to the obvious personal, social, cultural and economic benefits of being bilingual, it has been claimed that bilingualism enhances cognitive development in a range of areas relevant to educational outcomes. Given the poor track record of teaching children foreign languages in England, schools that are not required to follow the National Curriculum are understandably keen to investigate innovative methods for teaching languages, with the aim of not only enhancing language learning but also of stimulating heightened cognitive functioning. Our purpose in writing this paper is to arm education professionals with a critical awareness of the evidence supporting the bilingual advantage and innovative but unproven foreign language taster courses, in order to support them in making evidence-based pedagogical choices. We explain how young children effortlessly learn their first language(s) and argue that it is unrealistic to expect this process to be replicated in the foreign-language-learning classroom. We then review some of the evidence supporting the so-called ‘bilingual advantage’ and argue that the advantage is found in only specific, as yet undetermined, narrow circumstances and not in the bilingual population as a whole. We scrutinize the suitability of unproven foreign language taster courses for young children and argue that their claims are unlikely to be justified. Finally, we provide some objective criteria to help schools, from early years settings to the end of primary, to judge the efficacy of novel ways of teaching languages before adopting them.

The earliest-diverging avemetatarsalian: a new osteoderm-bearing taxon from the Triassic (?Earliest Late Triassic) of Madagascar and the composition of avemetatarsalian assemblages prior to the radiation of dinosaurs

AbstractUnderstanding the evolution of the earliest avemetatarsalian (bird-line) archosaurs and inferring the morphology of the last common ancestor of Archosauria are hampered by a poor fossil record in critical temporal intervals. Here we describe an early-diverging avemetatarsalian from the ?Earliest Late Triassic (~235 Ma) ‘basal Isalo II’/Makay Formation of Madagascar, which helps bridge these gaps. This taxon, Mambachiton fiandohana gen. et sp. nov., is represented by well-preserved postcranial material and possibly a postfrontal bone. Features of the neck region include anteroposteriorly elongated vertebrae with laterally expanded dorsal ends of the neural spines with three pairs of osteoderms per cervical vertebra, lying dorsal to those vertebrae. Inclusion of Mambachiton in a phylogenetic analysis of archosauromorphs recovers it at the base of Avemetatarsalia, outside of the aphanosaur + ornithodiran clade. This new specimen indicates that osteoderms were present in the earliest avemetatarsalians, but were lost in more crownward lineages. The plesiomorphic morphology of the taxon also underscores the difficulty of identifying early avemetatarsalians from incomplete skeletons. This early-diverging avemetatarsalian occurring together with a lagerpetid and silesaurid in the ‘basal Isalo II’/Makay Formation of Madagascar documents the co-occurrence of multiple non-dinosaurian avemetatarsalian clades in Gondwana near the Middle–Late Triassic transition. Translated abstract (Malagasy and French) is provided in the Supplementary information.

Depositional and tectonic influences on preservation of Milankovitch record during long-term global cooling: Middle and Upper Ordovician convergent foreland, eastern USA

Influences of depositional setting and tectonics on recording Milankovitch (orbital) signals within evolving Ordovician foreland successions during arc-continent collision are poorly documented. To address this, we analyzed downhole gamma ray vs depth time series from three wells on the Central Appalachian foreland, eastern USA for evidence of Milankovitch forcing during the 25 Myr duration Middle and Upper Ordovician Darriwilian to Katian interval. Relatively slowly accumulating Darriwillian sabkha anhydritic dolomites (up to 450 m thick), are dominated by eccentricity and obliquity forcing whereas Darriwillian to Sandbian restricted inner ramp carbonates (350 m thick) show eccentricity forcing only as do the overlying basal Katian (80 m thick) mid-ramp units. Rapidly accumulating lower Katian deeper ramp, shale-prone sediments (400 to 500 m thick) and upper Katian peritidal siliciclastic units (∼300–550 m thick) show a full suite of short eccentricity, obliquity and precession forcing. Best recording of the astronomical signal occurred during Katian rapid tectonic subsidence whereas a much poorer record was preserved during the Darriwilian-Sandbian. Milankovitch forcing of climate influenced input of siliciclastics as well as controlling sea-level fluctuations and position of storm wave-base. Initially sea level changes may have been driven by greenhouse aquifer eustasy but following later Darriwilian cooling, glacio-eustasy was dominant.

Partisans like any other? How populist supporters assess the economy when their party is in office

AbstractPopulist supporters have been found to take cues from populist incumbents. Yet, little is known about how they incorporate party cues in their political beliefs when populists are in office. This research note argues that (1) citizens who identify with populist parties engage in partisan motivated reasoning – that is, they are driven by the desire to be consistent with their partisan allegiances – and that (2) they engage in partisan motivated reasoning more intensely than their non-populist counterparts because populist party cues strongly prompt them to process biased information. Drawing on data from the European Social Survey, it is evidenced that populist supporters express much warmer economic views when their parties hold power. Warm economic views are also found to increase significantly more in accordance with strength of partisanship and exposure to political information for populist supporters than for non-populist supporters when their respective parties govern. Results highlight a mechanism by which populist incumbents are likely to remain attractive despite their poor economic record. They have implications for our understanding of the mainstreaming of populist parties in Europe.

A mid-Cambrian tunicate and the deep origin of the ascidiacean body plan

Tunicates are an evolutionarily significant subphylum of marine chordates, with their phylogenetic position as the sister-group to Vertebrata making them key to unraveling our own deep time origin. Tunicates greatly vary with regards to morphology, ecology, and life cycle, but little is known about the early evolution of the group, e.g. whether their last common ancestor lived freely in the water column or attached to the seafloor. Additionally, tunicates have a poor fossil record, which includes only one taxon with preserved soft-tissues. Here we describe Megasiphon thylakos nov., a 500-million-year-old tunicate from the Marjum Formation of Utah, which features a barrel-shaped body with two long siphons and prominent longitudinal muscles. The ascidiacean-like body of this new species suggests two alternative hypotheses for early tunicate evolution. The most likely scenario posits M. thylakos belongs to stem-group Tunicata, suggesting that a biphasic life cycle, with a planktonic larva and a sessile epibenthic adult, is ancestral for this entire subphylum. Alternatively, a position within the crown-group indicates that the divergence between appendicularians and all other tunicates occurred 50 million years earlier than currently estimated based on molecular clocks. Ultimately, M. thylakos demonstrates that fundamental components of the modern tunicate body plan were already established shortly after the Cambrian Explosion.

Interrogating the Political Economy of Age

AbstractThis article considers the argument by Tim Vlandas, in this issue, that an ageing electorate may undermine democracies’ ability to make the right economic choices. Vlandas suggests that the emergence of gerontocratic politics may give rise to ‘gerontonomia’: an economy run for the old, at the expense of younger generations and of future prosperity. However, evidence from the UK suggests a more mixed picture. Age‐based voting patterns have been consequential around single issues, not least the 2016 Brexit referendum. However, voters’ interests in broad economic policy models are not easily reducible to age dynamics, and intergenerational politics are filtered through a set of normative and affective considerations beyond straightforward self‐interest. Moreover, since the rational interests of different age groups do not speak for themselves, cueing by political elites is potentially significant and may be contributing to older voters’ relative tolerance of a poor economic record.

The Future of Behavioral Health: Can Private Equity and Telehealth Improve Access?

Treatment of mental illness in the United States is woefully inadequate. One-third of adults report having a mental health condition or substance use disorder, but less than half receive treatment for their condition.Access is the problem. The U.S. is short on mental health professionals: more psychiatrists are needed and psychologists and social workers are overextended. Proposed solutions are to (1) increase reimbursement rates for psychiatrists and other mental health practitioners, and (2) use a wider range of providers, including nurses and family support specialists-all good ideas. My focus however is on two other forces that are moving into the behavioral health area, offering both financing and technologies to extend the reach of mental health services-private equity and telemental health.First, private equity firms see high demand in this market.Behavioral health is desperately needed but is highly fragmented and lacking in innovation.Private equity is attracted to outpatient programs that target specific conditions that have evidence-based clinical models-programs aimed at addiction, eating disorders, and autism; these areas require less capital. Federal and state reimbursement is available, some regulations have been relaxed to allow remote prescribing of medicine; and innovative telehealth tools can be used.The problem is that private equity has a poor track record in both nursing home care and behavioral care for teens. The private equity model and its financial incentives are at odds with good care.Second, telemental health tools, already in use because of the need during the pandemic, appear attractive.These tools require less capital to treat a higher volume of patients and promise much improved access to mental health treatment for populations that could not get such care because of travel distance, costs, and time limitations.The problem is that the telemental health tools have yet to be subjected to evidence-based testing.My goal in this article is to test whether these two developments - private equity and telemental health -can improve access for patients at an acceptable level of quality. I conclude that both have substantial problems and I offer a range of regulatory approaches to control patient abuses and poor quality.

THE ROLE OF THE DARMSTADT CONCERTINO IN THE COMPOSITIONAL OUTPUT OF ZDZISAW SZOSTAK

Both in academic publications and in the music press, little attention has been paid to the figure of Zdzisaw Szostak a conductor and a composer, who spent most of his professional life at the d Philharmonic and the Academy of Music in d. Prof. Szostak was seen by the musical community mainly through the prism of his great achievements in the field of film music. The artists later autonomous works had to contend against the success and recognition of his previous compositions. In the article, however, the author focuses on a specific autonomous work by Szostak the Darmstadt Concertino for violin, piano and orchestra, with the title clearly associated with the important 20th century centre of European avant-garde. The resulting connotation seemed particularly interesting due to Szostaks reluctance to radical compositional means used by artists associated with the famous Internationale Ferienkurse fr Neue Musik. The intriguing contradiction encoded in the title and the rudimentary knowledge of the work led the author to investigate its history based on the collected sources. These were limited to a piano reduction assembled in parts, some orchestral voices and completely amateur, poor quality recording. The only possible way to obtain information about the genesis of the piece was interviewing soloists, the violinist ukasz Baszczyk and the pianist Mariusz Drzewicki. The musicians participated in the premiere performance, which was conducted in Darmstadt in November 1998 by Zdzisaw Szostak himself. The concert crowned the celebration of the sixth edition of the Polish Music and Culture Week in Darmstadt organised by the German Chopin Society.

The 4IR-Health Service Delivery Nexus

The delivery of quality healthcare services to citizens is not only a constitutional right, but also the task and obligation of every government. However, bribery, lack of financial accountability and counterfeit drugs, a shortage of human resources, poor hygiene and ineffective infection control measures, and poor medical record keeping have been identified as major challenges for the implementation of a successful public healthcare system. Fraudulent orders, tender irregularities, fiscal dumping, and over-pricing have also been identified as additional challenges. Due to the lack of quality healthcare services, people have lost trust and hope in the African National Congress (ANC). The paper found that to deliver adequate healthcare services, government needs to establish mechanisms that promote efficiency, quality, transparency, and safety. AI is a mechanism that can increase transparency, efficiency, and detect diseases before they become critical. The paper adopted a qualitative research methodology with an exploratory approach.

REVIEW THE ASSESSMENT OF EFFECTS OF LOST TIME INJURIES IN AN INDUSTRIAL SYSTEM BY USING AN EXPLANATORY PROGRAM

Health and safety problem can be described by statistics it can only be understood by knowing and feeling the pain, suffering, and depression. Health and safety has a legal responsibility to protect it for everyone who can affect in the workplace. This includes manufacturers, suppliers, designers and controllers of work places and employees. Work injury is one of the major problems in manufacturing and production systems industries; it is reduced production efficiency and affects the cost. To gain flexibility from a traditional manufacturing system and production efficiency, this paper is about the application of estimating technology to preview and synthesis of Lost Time of Work Injuries in industry systems aims to provide a safe working environment for all employees to achieve safe workplaces, safe systems of work, and safety understanding within our workforce. Our industry oftenhas a poor record in dealing with modern and development techniques. Thus, as one of the targets, this leads to perform a helpful program plane to provide guidelines of management, employees to eliminate hazards, given the enormous cost of occupational personal damage in industry and to develop safe work methods work site. This work proposed a general methodology for constructing an explanatory software system to review and analysis workers injuries in a work site. The program language used is Axes, which suitable to shows categories of incidences and estimates costs to workers, employers and society of workplace injuries and work-related ill health. Data of the system was collected in the State Company for Woolen Industries in Al-Kadhumiaa in Iraq.The resulting is to provide a simple obvious outline system to evaluate lost time injury and the net-costs on safety interfering at the company level to reduce occupational morbidity and generating a helpful system to estimate of the total costs to employers and workers of workplace accidents and work-related ill health.

Teachers’ Professional Development and Instructional Supervision as Contributory Factor to Job Performance in Ogun State Secondary Schools, Nigeria

Evident complacency of teachers as indicated by absenteeism, poor student grade return, poor record keeping, and laziness at work among others are clear indicting evidence that teachers’ job performances call for questioning. The purpose of the study is to investigate the contribution of professional development and instructional supervision to teachers’ job performance in Ogun State secondary schools. The study adopted descriptive survey research. The population comprised of teachers in Ogun state public secondary schools with 208 samples selected through a multi-stage sampling technique. Three adopted questionnaires (Instructional supervision scale, 0.88; Teachers Professional Development scale, 0.82; job performance scale, 0.74) were revalidated and used for data collection. Data collected were analyzed using simple percentage and multiple regression analysis (MRA). Findings show that there is a significant relationship among the variables of the study (professional development and instructional supervision, r = 262, P &lt; 0.05; professional development and job performance, r = .182, P &lt; 0.05; job performance and instructional supervision r = 078, P &lt; 0.05). It also shows that professional development and instructional supervision have a significant contribution to teachers’ job performance in Ogun state secondary schools (F = 1.550, p &lt; 0.05). It also shows a significant contribution of professional development to teachers’ job performance (F (1,205) = 1.257, P &lt; 0.05) while instructional supervision also contributed significantly to teachers’ job performance (F(1,205) = 1.257, P &lt; 0.05). It is concluded that teachers will continue to improve their job performance once they are given the right training and are well-supervised. The study recommends that adequate and timely training should be provided to teachers based on their needs to enhance their job performance.

An Exploratory Study on Management Competence for Better Work Practices of The Traditional Metal Fabrication Industry in Kumasi, Ghana

One of the identifiable resources that an industry can utilize as a driver for survival is managerial competence. Although literature is replete with evidence on this subject matter, no research work has been conducted on the relationship between managerial competence and performance of the traditional metal fabrication industries in Ghana. To address this information gap, this study explored the work place practices of three traditional metal craft industries in Kumasi, Ghana with managerial competence as a moderating factor. An inductive research approach based on qualitative research methodology was adopted. The target population was 300 people of which a sample size of 171 respondents was selected. Data were collected through the use of questionnaire designed with open and close-ended responses as well as personal observations conducted using a well-designed observation guide with clear attributes and angles of observation. The results showed that all the study participants interviewed exhibited various levels of operational competence of knowledge, technical skills, experience and character attitude needed to enhance the performance and day-to-day administration of their work. They also had good conflict resolution abilities and good decision-making skills, as well as an excellent apprenticeship system embodied in a succession plan. On the other hand, the study identified several factors that impacted negatively on the operations of their work including the inability to create a conducive work environment for high performance, poor equipment and tool maintenance culture, lack of proper PPEs, poor record keeping, poor innovation and creativity skills, and nonexistence of a system for the acquisition and utilization of modern equipment and technology. These limitations suggest lack of management competence. The study considers this as quite worrisome and recommends for the needed support from both governmental and NGOs, to safeguard the survival of the metal craft industry in Ghana.

Feasibility of implementing public-private mix approach for tuberculosis case management in Pokhara Metropolitan City of western Nepal: a qualitative study.

The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public health care providers in the fight against tuberculosis using international health care standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. We conducted key informant interviews with 20 participants, 14 of whom were from private clinics, polyclinics, and hospitals where the PPM approach was used, two from government hospitals, and four from policymakers. All data were audio-recorded, transcribed, and translated into English. The transcripts of the interviews were manually organized, and themes were generated and categorized into 1. TB case detection, 2. patient-related barriers, and 3. health-system-related barriers. A total of 20 respondents participated in the study. Barriers to PPM were identified into following three themes: (1) Obstacles related to TB case detection, (2) Obstacles related to patients, and (3) Obstacles related to health-care system. PPM implementation was challenged by following sub-themes that included staff turnover, low private sector participation in workshops, a lack of trainings, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. Government stakeholders can significantly benefit by applying a proactive role working with the private in monitoring and supervision. The joint efforts with private sector can then enable all stakeholders to follow the government policy, practice and protocols in case finding, holding and other preventive approaches. Future research are essential in exploring how PPM could be optimized.

Artificial intelligence–enabled tools in cardiovascular medicine: A survey of current use, perceptions, and challenges

Numerous artificial intelligence (AI)-enabled tools for cardiovascular diseases have been published, with a high impact on public health. However, few have been adopted into, or have meaningfully affected, routine clinical care. To evaluate current awareness, perceptions, and clinical use of AI-enabled digital health tools for patients with cardiovascular disease, and challenges to adoption. This mixed-methods study included interviews with 12 cardiologists and 8 health information technology (IT) administrators, and a follow-on survey of 90 cardiologists and 30 IT administrators. We identified 5 major challenges: (1) limited knowledge, (2) insufficient usability, (3) cost constraints, (4) poor electronic health record interoperability, and (5) lack of trust. A minority of cardiologists were using AI tools; more were prepared to implement AI tools, but their sophistication level varied greatly. Most respondents believe in the potential of AI-enabled tools to improve care quality and efficiency, but they identified several fundamental barriers to wide-scale adoption.