Objective Of Project Research Articles

PROJECT MANAGEMENT APPROACH IN HEALTHCARE SERVICES

Objective: This study investigates the terms project, project management, and project management cycle, focusing on the project management approach in healthcare services. It aims to emphasize the importance and necessity of project management in healthcare, contributing to the development of a project management culture within the healthcare sector. Theoretical Framework: Projects are generally a set of activities or efforts planned and implemented to achieve a specific goal or objective. Businesses often need to operate within a specific project or plan to reach their goals. The same applies to healthcare services. Today, it is crucial for healthcare institutions to achieve their strategic objectives by utilizing their limited resources most effectively. Therefore, healthcare institutions must continuously strive to manage their resources in alignment with their strategic goals. By adopting an effective resource management strategy, healthcare institutions can enhance the quality of patient care, patient satisfaction, operational efficiency, and cost optimization. Project management consists of specific phases: initiation, planning, execution, monitoring and control, and closure. Each phase is essential for the project's successful progress. Project management is a vital management system in healthcare institutions that reduces uncertainties and ensures the successful completion of projects. Planning and monitoring all phases of projects from start to finish allow for early detection and correction of errors and problems. Method: This study on project management in healthcare services uses document analysis as a qualitative data analysis method. It compiles and evaluates existing knowledge and data on project management in healthcare services. Research Implications: The results and recommendations of this study can increase awareness of project management in healthcare services and help manage practices in this field more effectively.

Distinct sources of uncertainty in simulations of the ocean biological carbon pump at different depths

Model uncertainty in simulating the biological carbon pump was quantified and partitioned using 14 models from the Coupled Model Intercomparison Project Phase 6. Uncertainty increases with depth. On the global scale, uncertainty in carbon export dominates above 900 m and uncertainty in transfer efficiency below. Reducing model uncertainty in carbon export and transfer efficiency offers similar benefits for understanding century-scale carbon sequestration and climate. These models produce three different qualitative patterns in transfer efficiency: one where it is globally homogenous and two opposite latitudinal patterns due to different model structures and parameters. The exponent b of the Martin curve, which has long been used to compare different representations of transfer efficiency, is shown here to underestimate uncertainty in transfer efficiency. This highlights the importance of using vertical profiles of carbon flux rather than the single exponent b in model validation and intercomparison exercises.

Identifying strategies and related principles supporting a co-design approach in an assistive device service delivery and research platform.

Possibilities Project Plus (PPPlus) is a free assistive device (AD) marketplace and research platform for persons with disabilities. The overall aim of PPPlus is to increase access to ADs through an integration of service, research and education. To maximize positive outcomes and reflect community needs a co-design approach informed by guiding principles of Integrated Knowledge Translation (IKT) was adopted, with examination of methods related to Experience Based Co-design. The integrated nature of PPPlus benefits from the use of specific engagement strategies that align with IKT principles to meet project objectives. The extent to which partnership and engagement strategies are specified in the rehabilitation research literature vary greatly and studies that provide information on specific strategies used to operationalize principles are limited. The objective of this manuscript is to provide a description of the co-design approach and the specific strategies that strive to achieve meaningful user engagement. By reflecting on these processes we also report on limitations and strategies for improvement. The co-design approach is highlighted through specific project activities including a representative governance structure, ongoing environmental scan and iterative Health Equity Impact Assessments (HEIA). The inherent engagement strategies that align with IKT and co-design principles are described. The most impactful engagement strategies included early engagement of partners throughout all phases, ensuring project relevance across partners through alignment of objectives with complementary aims, using HEIAs to promote equitable outcomes from diverse stakeholders, the representative governance structure beyond individuals with disabilities and caregivers, and the use of experiences and stories to inform development. This examination of specific strategies related to co-design focused on partnership engagement and informed targets for enhancement of the PPPlus initiative. These include being more intentional in developing a more rigorous process for evaluation that includes an assessment of strategies and their impact-especially as related to partner engagement. In addition, ongoing and enhanced efforts will focus on developing knowledge products that bring to life the most salient experience-based user stories emerging from the environmental scan with these being used to drive distinct co-creation events as well as serve other knowledge mobilization purposes (i.e., supporting policy change).

Public-Private partnership frameworks for financing affordable housing: Lessons and models

The pressing need for affordable housing in both developed and developing countries has prompted governments to explore innovative financing mechanisms, with Public-Private Partnerships (PPPs) emerging as a viable solution. This paper examines the frameworks, lessons, and models of PPPs for financing affordable housing, aiming to provide insights into their effectiveness and scalability. PPPs combine the resources, expertise, and efficiencies of both the public and private sectors to address the housing affordability crisis. By leveraging the strengths of each sector, PPPs aim to reduce financial burdens on governments while ensuring the delivery of quality housing solutions. This review outlines the various PPP models, including build-operate-transfer (BOT), design-build-finance-operate (DBFO), and lease-develop-operate (LDO), highlighting their structural differences and application contexts. Key components of successful PPP frameworks include clear regulatory environments, transparent procurement processes, risk-sharing mechanisms, and robust stakeholder engagement. Regulatory frameworks that support PPPs play a critical role in providing legal certainty and fostering investor confidence. Transparent procurement processes ensure fairness and competitiveness, while effective risk-sharing mechanisms distribute financial, construction, and operational risks appropriately between public and private partners. Engaging stakeholders, including communities and civil society, is essential for aligning project objectives with local needs and ensuring social acceptance. Case studies from various regions illustrate the practical application and outcomes of PPP frameworks. In the United Kingdom, the Affordable Homes Programme (AHP) has effectively utilized PPPs to deliver thousands of affordable housing units, demonstrating the benefits of strong regulatory support and private sector participation. Singapore's Housing and Development Board (HDB) employs PPP models to maintain high housing standards while ensuring affordability through extensive government subsidies and private sector involvement. In South Africa, the Social Housing Regulatory Authority (SHRA) leverages PPPs to develop rental housing for low- and moderate-income households, highlighting the importance of government incentives and capacity-building initiatives. The review concludes that PPP frameworks, when effectively designed and implemented, can significantly enhance the availability of affordable housing. Lessons learned from successful models emphasize the need for supportive policies, transparent processes, and inclusive stakeholder engagement. Policymakers and practitioners can draw on these insights to develop tailored PPP approaches that address specific housing challenges and contribute to sustainable urban development. Keywords: Public-Private Partnership: Frameworks, Financing, Affordable Housing, Models.

Incorporating Diversity, Equity, and Inclusion Within Community Health Nursing Simulation.

Undergraduate nursing institutions face difficulties providing learners with community and public health nursing clinical opportunities. An opportunity existed to improve a senior-level undergraduate community and public health nursing course by developing alternative clinical teaching-learning experiences that promote diversity, equity, and inclusion. Utilizing theory and evidence-based practice, a simulation emulating a community home health visitation allowed learners to function as members of a health care team who provide care for a family in their home setting. The results indicate that all learners met project objectives, and 88% of learners reported increased self-efficacy related to the project's topics after implementation. Learner reflections offered their perception of the experience. A community and public health nursing teaching-learning project provided learners with clinical hours by completing a simulation learning experience incorporating diversity, equity, and inclusion through exposure to patient inequities within the lesbian, gay, bisexual, transgender, queer (LGBTQ+) community. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Climatology, trends, and future projections of aerosol optical depth over the Middle East and North Africa region in CMIP6 models

This study assesses the aerosol optical depth (AOD) from historical simulations (2003–2014) and future climate scenarios (2015–2100) of the Coupled Model Intercomparison Project Phase 6 (CMIP6) over the Middle East and North Africa (MENA) region. Multi-model mean (MME) AOD statistics are generated as the average of those from the five best-performing CMIP6 models, which reproduce observational climate statistics. These models were selected based on the validation of various climate metrics, including strong pattern correlations with observations (>0.8). The resulting MME reproduces the observed AOD seasonal cycle well. The observed positive trends (summer and annual) over the Arabian Peninsula (AP) and negative trends (winter) over North Africa are well captured by MME, as regional meteorological drivers associated with observed AOD trends, with few discrepancies. Crucially, the MME fails to capture the AOD trends over North West Africa (NWA). For MENA and NWA regions, two high-emission scenarios, SSP370 and SSP585, project a continuous rise in the annual mean AOD until the end of the century. In contrast, the low-emission scenarios, SSP126 and SSP245, project a decreasing AOD trend. Interestingly, the projected future AOD area-averaged over the AP region varies significantly across all four scenarios in time. Notably, a substantial decrease of about 8–10% in the AOD is projected by the SSP126, SSP245, and SSP585 scenarios at the end of the century (2080–2100) relative to the current period. This projected decrease in annual-mean AOD, including the frequency of extreme AOD years under SSP585, is potentially associated with a concurrent increase in annual-mean rainfall over the AP.

A Comprehensive Evaluation of Black Carbon in Snow and Its Radiative Forcing in CMIP5 and CMIP6 Models Based on Global Field Observations

AbstractBlack carbon in snow (BCS) is a crucial parameter in Earth System modeling, as it influences global radiative balance. Here, simulated BCS from Coupled Model Intercomparison Project Phase 5 and 6 (CMIP5 and CMIP6) that provided BCS as a model output were evaluated. In comparison with global BCS observations, CMIP5/6 models successfully reproduced long‐term historical trends linked to human activities, but struggled capturing decadal variability caused by natural climate variability. CMIP6 models NorESM2‐MM, NorESM2‐LM, and TaiESM1 yielded the most accurate simulations of BCS concentration with modest overestimation of <50%, while the four CESM2 models underestimated concentrations by up to ∼80%. These errors effectively balanced for the CMIP6 multi‐model ensemble mean (MME), which had a relative error (RE) of −37%. However, the CMIP5 MME was less reliable due to extreme overestimation by up to 8,000% in the three MIROC models. The significant BCS concentration errors in the MIROC and CESM2 models were linked mainly to errors in handling of BC in snow processes. Conversely, marked improvements in NorESM, the only common to both CMIP5 and CMIP6, were due to improved simulation of black carbon deposition. BCS errors significantly impacted radiative forcing estimates, particularly at the poles, where model errors reached several thousandfold. CMIP6 exhibited superior results compared to CMIP5, achieving global MME RE of −33% in radiative forcing estimates. However, it's worth noting BCS output is currently limited, with only seven models available for each of CMIP5 and CMIP6 here. Additional models simulating BCS are desirable in the next CMIP generations.

Assessing the Potential Impacts of Climate Change on Drought in Uzbekistan: Findings from RCP and SSP Scenarios

Future climate change and its impact on drought is critical for Uzbekistan, located in Central Asia, the world’s largest arid zone. This study examines the evolving intensity of climate change and drought events using multi-model ensembles (MMEs) derived from the Coupled Model Intercomparison Project Phase 5 and 6 (CMIP5 and CMIP6) simulated under the Representative Concentration Pathway and Shared Socioeconomic Pathway (RCP and SSP) scenarios. The projections show different rates of increase in temperature and precipitation under the RCPs and SSPs. Projected temperature increases are expected to reach up to 2–2.5 °C under SSP1-2.6, SSP2-4.5, and SSP3-7.0, by mid-century. By 2080–2099, an increase is projected of 2–3 °C in monthly mean temperatures throughout the year (SSP1-2.6), and a more pronounced increase in summer up to 3–4 °C (SSP2-4.5) and 4–6 °C (SSP3-7.0), with a marked contrast in conditions between the mountainous and desert regions of Uzbekistan. Regional changes in precipitation over the study periods show relatively little variability, except for FD, where notable trends are found. Under SSP1-2.6 and SSP2-4.5, the increase in precipitation is relatively modest, whereas the changes in SSP3-7.0 are more substantial, with some regions experiencing variations of up to 10–20 mm per period. The Standardized Precipitation Evapotranspiration Index (SPEI), calculated based on the projected temperature and precipitation, provides an estimate of future drought trends. Our results show increasing aridity under all scenarios by mid-century, with longer-term projections indicating stabilization around different SPEI values by 2100: RCP2.6 and SSP1-1.9 stabilize around −1.0; RCP4.5, RCP6.0, SSP2-4.5, and SSP3-7.0 stabilize around −1.5; while RCP8.5 and SSP5-8.5 scenarios project values of −2 or less by 2100. Notable differences in the SPEI index are found between lowland and foothill regions. In view of Uzbekistan’s heavy reliance on agriculture and irrigation, which are the sectors that are expected to be mostly affected by climate change, our study provides a scientific basis for informed policy decision-making. This includes various aspects such as planning and management water resources, as well as the broader socioeconomic development of the country.

Projection of Compound Wind and Precipitation Extreme Events in the Iberian Peninsula Based on CMIP6

This study aims to investigate the potential changes in the co-occurrence of strong precipitation and wind events over the Iberian Peninsula using simulations from the Coupled Model Intercomparison Project (CMIP) Phase 6 under two scenarios (SSP2 − 4.5 and SSP5 − 8.5). Projected changes indicate a significant regional variability during all seasons. In winter, the western regions are projected to experience an increase in compound events as the century progresses under both scenarios, with a significantly larger area being affected by the end of the century. In spring, summer, and autumn, a general decline in the occurrence of these events is anticipated throughout the century, accompanied by a reduction in the area affected by them. However, in the northwesternmost area (Galicia), an increase in the occurrence of compound events is expected during the spring towards the end of the century, particularly under the SSP5-8.5 scenario.

How Do CMIP6 HighResMIP Models Perform in Simulating Precipitation Extremes over East Africa?

This work assesses the ability of nine Coupled Model Intercomparison Project phase 6 (CMIP6) High-Resolution Model Intercomparison Project (HighResMIP) models and their ensemble mean to reproduce precipitation extremes over East Africa for the period 1995–2014. The model datasets are assessed against two observation datasets: CHIRPS and GPCC. The precipitation indices considered are CDD, CWD, R1mm, R10mm, R20mm, SDII, R95p, PRCPTOT, and Rx1day. The overall results show that HighResMIP models reproduce annual variability fairly well; however, certain consistent biases are found across HighResMIP models, which tend to overestimate CWD and R1mm and underestimate CDD and SDII. The HighResMIP models are ranked using the Taylor diagram and Taylor Skill Score. The results show that the models reasonably simulate indices, such as PRCPTOT, R1mm, R10mm, R95p, and CDD; however, the simulation of SDII CWD, SDII, and R20mm is generally poor. They are CMCC-CM2-VHR4, HadGEM31-MM, HadGEM3-GC31-HM, and GFDL-CM4. Conversely, MPI-ESM1-2-XR and MPI-ESM1-2-HR show remarkable performance in simulating the OND season while underestimating the MAM season. A comparative analysis demonstrates that the MME has better accuracy than the individual models in the simulation of the various indices. The findings of the present study are important to establish the ability of HighResMIP data to reproduce extreme precipitation events over East Africa and, thus, help in decision making. However, caution should be exercised in the interpretation of the findings based on individual CMIP6 models over East Africa given the overall weakness observed in reproducing mean precipitation.

Standardized reporting of spine and sacroiliac joints in axial spondyloarthritis MRI: from the ESSR-Arthritis Subcommittee.

Apply a modified Delphi-based approach and produce a practical, radiology-specific set of definitions for interpretation and standardization of the multiple MRI findings in axial spondyloarthritis (ax-SpA), specifically to aid the general radiologist with a musculoskeletal interest, working with gold standard basic MRI protocols. We report the results of a modified Delphi-based consensus of 35 experts from 13 countries in the Arthritis Subcommittee of the European Society of Musculoskeletal Radiology (ESSR). Seventeen definitions were created (i.e., nine for the spine and eight for the sacroiliac joint) and two Delphi rounds were conducted on an electronic database, collated and revised by the project leader with agreement. Group leads were appointed for each definition following the first round. Final definitions included only those that reached a consensus > 80%; if > 50% agreed on exclusion consensus, definitions were excluded. Final results have been shared during the Arthritis meeting at the Annual ESSR Congress. Fourteen definitions, eight for the spine and six for the sacroiliac joint were agreed for standardized reporting. Andersson's, anterior corner sclerotic and costovertebral joint inflammatory lesions of the spine, with active and non-active erosions, and fat metaplasia of the sacroiliac joint reaching the highest consensus (≥ 95%). More than 50% of the experts agreed to exclude joint space inflammation in the sacroiliac joint and tissue backfill. Syndesmophytes reached 76% agreement. Agreed definitions by expert radiologists using a modified Delphi process, should allow standardized actionable radiology reports and clarity in reporting terminology of ax-SpA. The proposed definitions will support reporting from musculoskeletal and general radiologists working with gold-standard basic MRI, improve confidence in lesion assessment, and standardize terminology to provide actionable reports on MRI in patients with ax-SpA. Experts applied a modified Delphi method to optimize the definitions of MRI findings of ax-SpA. After two Delphi rounds and one in-person meeting, fourteen definitions reached the agreement threshold. These consensus-based definitions will aid in actionable reporting specifically for the general radiologist with a musculoskeletal interest.

Integrated approach of predicting rock stability in high mountain valley underground caverns

High mountain valleys are characterized by the development of intricate ground stress fields due to geological processes such as tectonic stress, river erosion, and rock weathering. These processes introduce considerable stability concerns in the surrounding rock formations for underground engineering projects in these regions, highlighting the imperative need for rigorous stability assessments during the design phase to ensure construction safety. This paper introduces an innovative approach for the pre-evaluation of the stability of surrounding rocks in underground caverns situated within high mountain valleys. The methodology comprises several pivotal steps. Initially, we conduct inverse calculations of the ground stress field in complex geological terrains, combining field monitoring and numerical simulations. Subsequently, we ascertain stress-strength ratios of the surrounding rocks using various rock strength criteria. To assess the stability characteristics of the surrounding rocks in the 1# spillway cave within our project area, we employ numerical simulations to compute stress-strength ratios based on different rock strength criteria. Furthermore, we undertake a comparative analysis, utilizing data from the 5# Underground Laboratory (Lab 5) of Jinping II Hydropower Station, aligning the chosen rock strength criterion with the damage characteristics of Lab 5′s surrounding rocks. This analysis serves as the cornerstone for evaluating other mechanical responses of the surrounding rocks, thereby validating the pre-evaluation methodology. Our pre-evaluation method takes into account the intricate geological evolution processes specific to high mountain valleys. It also considers the influence of the initial geostress field within the geological range of underground caverns. This comprehensive approach provides a robust foundation for the analysis and assessment of the stability of surrounding rocks, especially in high mountain valley areas, during the design phase of underground engineering projects. The insights derived from this analysis hold substantial practical significance for the effective guidance of such projects.

Enhancing resilience: Integrating future flood modeling and socio-economic analysis in the face of climate change impacts

As climate change intensifies, future floods will become more severe in some areas with geographic variation, necessitating that local and regional governments implement systems to provide information for climate adaptation, particularly for vulnerable populations. Therefore, we aimed to develop a methodology to identify areas that are at an increased risk from future floods and independently socially vulnerable. In this study, 100-year recurrence interval flood extents and depths were estimated using an ensemble of six independent Coupled Model Intercomparison Project Phase 6 climate models for a past and future period under the highest-emissions climate scenario. The flood inundation results were related to social vulnerability for two selected study areas in the Mississippi River Basin. The range of flood extents and depths for both time periods were estimated, and differences were evaluated to determine the effects from climate change. To identify at-risk areas, the relationship between the spatial distribution of flood depths and vulnerability was then assessed. Finally, an analysis of the current and future damages on infrastructure from flooding on residential housing was performed to determine whether damages are correlated with higher vulnerability areas. Results show in every flooding scenario, flood extents and depths are increasing in the future compared with the past, ranging from an increase of 6 to 76 km2 in extent across both locations. A statistically significant relationship between spatial clusters of flooding and of vulnerability was found. The infrastructure analysis found that residential structures in the most vulnerable census tracts are 6 to 59 times more likely to experience moderate damage compared with the least vulnerable tracts depending on scenario. Overall, a framework was established to holistically understand the hydrologic and socioeconomic impacts of climate change, and a methodology was developed to use for allocating resources at the local scale.

Future warming of the Gulf of Oman: SST trends under contrasting climate scenarios by 2050

This study investigated potential changes in sea surface temperature (SST) within the Gulf of Oman over the next three decades (2020–2050) under contrasting climate scenarios. Monthly SST data from three Coupled Model Intercomparison Project Phase 6 (CMIP6) models were obtained from the Earth System Grid Federation (ESGF) database for a defined spatial grid (0.5° x 0.5°) encompassing the Gulf of Oman. Future changes (2020–2050) in SST were analyzed under two contrasting Shared socioeconomic Pathways (SSPs): SSP245 (optimistic) and SSP585 (pessimistic).A time series analysis employing a weighted average approach across all three models was conducted. This analysis revealed a projected increase in SST for most seasons and months, except for summer. Further trend analysis was performed using the non-parametric Mann-Kendall test and Sen's slope estimator. This analysis indicated a moderate warming trend in the Gulf of Oman's SST over the next 30 years, with an average increase of approximately 1°C. Spatial analysis of SST was also conducted, identifying minimum and maximum temperature values in shallow regions, the Strait of Hormuz, and its connection to the Persian Gulf. The findings of this study suggest a potential for significant warming in the Gulf of Oman over the coming decades, with implications for regional marine ecosystems and weather patterns. Understanding these projected changes is crucial for informing adaptation strategies and mitigating the potential negative impacts of climate change in the region.

All-cause 30-day mortality associated with hysterectomy in Sweden from 2015 to 2021 using data from the Swedish perioperative register

ObjectiveHysterectomy is one of the most common gynaecological procedures. All-cause mortality within 30 days is an important indicator of care quality.The primary objectives of this quality project were to study all-cause 30-day mortality following hysterectomy in Sweden and the impact of age, ASA class, and malignant indication on outcomes. Population and methodsAll hysterectomy procedures documented in the Swedish Perioperative Register (SPOR) were included from 2015 to 01-01 until 2021-12-31. Patient demographics and perioperative observations were collected and analysed. Main outcome measureAll-cause 30-day mortality. ResultsThe study cohort consisted of 25,391 patients with a mean age of 55.0 ± 13.8, and 54 % of patients were ASA I-II. All-cause 30-day mortality was low: only 1 patient died within the first 24 h, and 23 deaths were noted within 30 days among 25,391 procedures studied; equal to a perioperative mortality rate (POMR) 0.09 %. Higher age, higher ASA class, malignant indication, and combined general and neuraxial anaesthesia increased numerical POMR. Elderly (>65-years) and ASA III-IV were associated with significant increased un- and adjusted Odds Ratio for death within 30-days at 4.3 (95%CI 1.3–14.3, p = 0.02) and 15.3 (95%CI 4.8–84.4, p = 0.001) respectively. ConclusionsAll-cause 30-day mortality associated with hysterectomy in Sweden during recent years is low with a POMR of 0.09 %. Higher age and more pronounced higher ASA class increased the odds ratio for all-cause 30-day mortality. Further efforts to optimise the perioperative care of elderly and frail patients are important.

Amplification of temperature extremes in Arabian Peninsula under warmer worlds

The Paris Agreement and the Special Report on Global Warming of 1.5 °C from the Intergovernmental Panel on Climate Change (IPCC) highlighted the potential risks of climate change across different global warming levels (GWLs). The increasing occurrence of extreme high-temperature events is linked to a warmer climate that is particularly prevalent in the Arabian Peninsula (AP). This study investigates future changes in temperatures and related extremes over AP, under four GWLs, such as 1.5 °C, 2.0 °C, 3.0 °C, and 4.0 °C, with three different Shared Socioeconomic Pathways (SSPs: SSP1-2.6, SSP2-4.5, and SSP5-8.5). The study uses high-resolution datasets of 27 models from the NASA Earth Exchange Global Daily Downscaled Projections of the Coupled Model Intercomparison Project Phase 6 (NEX-GDDP-CMIP6). The results showed that the NEX-GDDP-CMIP6 individual models and their multi-model means reasonably captured the extreme temperature events. The summer maximum and winter minimum temperatures are projected to increase by 0.11–0.67 °C and 0.09–0.70 °C per decade under the selected SSPs. Likewise, the projected temperature extremes exhibit significant warming with varying degrees across the GWLs under the selected SSPs. The warm temperature extremes are projected to increase, while the cold extremes are projected to decrease under all GWLs and the selected SSPs. Overall, the findings provide a comprehensive assessment of temperature changes over AP in response to global warming, which can be helpful in the development of climate adaptation and mitigation strategies.

Importance of key stakeholder communication in the implementation of an in-hospital digital medical translation application for heart surgery patients: a qualitative study

Abstract Background/Introduction The scientific and clinical communities are inundated with health applications designed for testing and/or implementation to support and enhance clinical practice. However, there is a deficiency in studies concentrating on vital factors such as stakeholder involvement to ensure the successful implementation of such applications. Purpose The purpose of this study was to investigate the experiences of key stakeholders involved in the process leading to the implementation of a digital medical translation tool designed for in-hospital use with heart surgery patients who speak minority languages. Methods In-depth interviews were conducted using a semi-structured interview guide through digital (i.e., Zoom) interviews in June 2023. The data collected was analyzed using NVivo software, following Braun and Clarke´s six-step thematic analysis process. Results Five stakeholders participated in the interviews, including representatives from the Regional Health Authorities Information Technology partner and the project leader, and representatives from the company responsible for the digital medical translation tool. All with major stakes in such an in-hospital application implementation process. Four main themes with corresponding quotations emerged from the analysis, pointing to the need for: i) Qualified stakeholders: Stakeholders who possessed the knowledge of "what to do and when" played a crucial role in the process. ii) Communication between stakeholders: Effective communication between stakeholders was deemed essential for optimizing the process at the required pace, with an emphasis on collaborative efforts by "working as partners to enhance services for minority-speaking patients". iii) Requirement specification for procurement: The importance of "detailed and clear quality requirements in the procurement process to select the best clinical translation tool", was highlighted. iv) Clinical practice foundation: "Expert nurses from the hospital setting and medical doctor from the company adjusted the translation tool" was pointed to as necessary to suit clinical practice needs. Conclusions Key stakeholders involved in the implementation of a medical translation tool for minority-speaking patients within a hospital setting pointed to four vital aspects for successfully implementing a digital medical translation tool in-hospital care. Effective communication among stakeholders was seen to inspire and improve the working process. Having qualified stakeholders was vital for ensuring quality requirements and establishing a solid clinical foundation during the application implementation.

Unusually low dust activity in North Africa in June 2023: Causes, impacts and future projections

Dust activity during the pre-monsoon season in Africa has an impact on the monsoon circulation and the Atlantic hurricane season. During early June 2023 the atmosphere was relatively clear over West Africa and the eastern tropical Atlantic, in contrast with the dustier June 2020. The negative phase of the North Atlantic Oscillation suppressed dust lifting, with an equatorward shifted African Easterly Jet limiting its downstream advection. On the other hand, dust accumulated in the atmosphere over northeastern Africa, with the negative dust aerosol optical depth (DAOD) anomalies over western Africa and the positive anomalies over eastern Africa more than two standard deviations away from the climatological mean. The lack of dust led to an up to 55 W m−2 increase in the surface downward shortwave radiation flux and a 35 W m−2 decrease in the longwave flux, and is in line with the record-breaking sea surface temperatures over the eastern tropical Atlantic and the active start to the Atlantic hurricane season. In order to explore future projections of DAOD, a multi-model ensemble (MME) is constructed from 29 models that integrate the sixth phase of the Coupled Model Intercomparison Project (CMIP6). It captures the positive trend in the June DAOD over the eastern tropical Atlantic during 1980–2014, although the amplitude is roughly a factor of six smaller than the 0.0017 year−1 in the reanalysis dataset. The CMIP6 MME projects a further increase in DAOD in the region at a rate of up to 0.0003 year−1 in the most extreme climate change scenario for 2066–2100, which is comparable to that seen during the historical period, even though the mean values are projected to decrease by 0.03–0.06. While lower dust loadings may lead to improved air quality, they will likely further fuel pre-season and early season storms in the North Atlantic, which have become more frequent in recent decades.

Medication Adherence in Adults with Chronic Diseases in Primary Healthcare: A Quality Improvement Project.

(1) Background: Medication adherence is influenced by a variety of intricate factors, presenting hurdles for nurses working to improve it among adults with chronic conditions. Pinpointing the reasons for non-adherence is crucial for customizing interventions. The objective of this quality improvement project was to improve medication adherence among adults with chronic diseases in primary healthcare by promoting evidence-based practices, identifying barriers and facilitators to compliance, and developing strategies to ensure optimal adherence through engaging the nursing team, enhancing knowledge, and evaluating the effectiveness of the implemented strategies. (2) Methods: This study was a quality improvement project that utilized the JBI Evidence Implementation framework, the Practical Application of Clinical Evidence System, and the Getting Research into Practice audit tool across three phases: (i) forming a project team and conducting a baseline audit, (ii) offering feedback via the GRiP tool, and (iii) conducting a follow-up audit to assess best practice outcomes. The study was conducted between September 2021 and March 2022 in the community care unit of Algarve Regional Health Administration, targeting adults with chronic illnesses. (3) Results: A total of 148 individuals were audited, including 8 nurses, 70 baseline patients, and 70 post-implementation patients. Initial compliance with key best practices was low, with several criteria at 0% compliance at baseline. Post-intervention, we observed significant improvements; compliance with key best practices improved dramatically, with many reaching 100%. Notable improvements included enhanced patient education on medication management, regular medication adherence assessments, and increased engagement of healthcare professionals in adherence activities. (4) Conclusions: This quality improvement project demonstrated that structured, evidence-based interventions could significantly enhance medication adherence among adults with chronic diseases. The success of the project highlights the potential of similar strategies to be applied broadly in primary healthcare settings to improve health outcomes.

Árvores sobreviventes ao bombardeamento atómico de Hiroshima

The objective of this article is to publicize the social action project EC-614 of the University of Costa Rica “Trees of peace surviving the Hiroshima atomic bomb: Phase 1: establishment of seedlings in Costa Rica”, as well as the impact it has had especially in public libraries and as a contribution to the fulfillment of objective 16, “Peace, justice and solid institutions”, of the United Nations 2030 Agenda. Therefore, a contextualization of libraries as peace-promoting entities is carried out and the project, its genesis and significance are described. Likewise, the conclusions and learning that have been obtained so far with the development of this collaborative project between the School of Biology and the School of Library and Information Sciences of the University of Costa Rica are presented.