Provision Of Services Research Articles

Preferences for Neurodevelopmental Follow-Up Care for Children: A Discrete Choice Experiment.

Identifying and addressing neurodevelopmental delays in children can be challenging for families and the healthcare system. Delays in accessing services and early interventions are common. The design and delivery of these services, and associated outcomes for children, may be improved if service provision aligns with families' needs and preferences for receiving care. The aim of this study is to identify families' preferences for neurodevelopmental follow-up care for children using an established methodology. We used a discrete choice experiment (DCE) to elicit families' preferences. We collected data from families and caregivers of children with neurodevelopmental needs. The DCE process included four stages. In stage 1, we identified attributes and levels to be included in the DCE using literature review, interviews, and expert advice. The finalised attributes were location, mode of follow-up, out-of-pocket cost per visit, mental health counselling for parents, receiving educational information, managing appointments, and waiting time. In stage 2, we generated choice tasks that contained two alternatives and a 'neither' option for respondents to choose from, using a Bayesian d-efficient design. These choice tasks were compiled in a survey that also included demographic questions. We conducted pre- and pilot tests to ensure the functionality of the survey and obtain priors. In stage 3, the DCE survey was administered online. We received 301 responses. In stage 4, the analysis was conducted using a latent class model. Additionally, we estimated the relative importance of attributes and performed a scenario analysis. Two latent classes were observed. More families with full-time employees, higher incomes, postgraduate degrees, and those living in metropolitan areas were in class 1 compared with class 2. Class 1 families preferred accessing local public health clinics, face-to-face follow-up, paying AUD100 to AUD500, mental health support, group educational activities, health service-initiated appointments, and waiting < 3 months. Class 2 families disliked city hospitals when compared with private, preferred paying AUD100 or no cost, and had similar preferences regarding mental health support and wait times as class 1. However, no significant differences were noted in follow-up modality, receiving educational information, and appointment management. The relative importance estimation suggested that location was most important for class 1 (28%), whereas for class 2, cost accounted for nearly half of the importance when selecting an alternative. The expected uptake of follow-up care, estimated under three different hypothetical scenarios, may increase by approximately 24% for class 2 if an 'ideal' scenario taking into account preferences was implemented. This study offers insights into aspects that may be prioritised by health services and policymakers to improve the design and delivery of neurodevelopmental follow-up care for children. The findings may enhance the organisation and functioning of existing care programmes; and therefore, improve the long-term outcomes of children with neurodevelopmental needs and their families.

Telepsychiatry Enables Better Mental Health Care Access in a Southern Philippines Hospital: a Mixed Methods Outcome Evaluation

The Philippines faces a significant unmet need for mental health care services, especially in remote and underserved areas with limited access to traditional in-person psychiatric services. Telepsychiatry offers a potential solution for bridging this gap and improving access to care. This study aimed to evaluate the telepsychiatry service in a Level 1 government hospital in southern Philippines and assess its feasibility for improving mental healthcare access. This evaluation study used a mixed-methods approach, including quantitative analysis of patient demographic data and psychiatric diagnoses retrieved from medical records (2018–2021), as well as qualitative in-depth interviews and focus group discussions with patients, guardians, and hospital staff. A SWOT (strengths, weaknesses, opportunities, threats) analysis was also conducted to assess areas for improvement. The majority of patients were between 18–35 yr old, male, and single. The most common diagnoses were schizophrenia spectrum and other psychotic disorders, followed by depressive and anxiety disorders. Key issues included medicine shortage, lack of communication, and poor Internet connectivity. However, stakeholders cited advantages such as access to free consultations, timely diagnosis, and potential for service scale- up. This study features telepsychiatry's potential for enabling better mental health care access in resource-constrained areas of the Philippines. It is the first to demonstrate telepsychiatry service provision from a specialist hospital to a Level 1 government hospital in the country. However, sustained multi-sector and multi-level coordination is crucial for long-term viability. Recommendations for enhancement and future research directions are provided.

The Culture of Non-Payment of Services in South Africa by Communities, Interplay the Provision of Quality Services by Local Municipalities

The culture of non-payment for municipal services in South Africa has been a persistent issue, significantly affecting the quality and sustainability of service delivery by local municipalities. This study explores the underlying causes of non-payment, its impact on the provision of services, and potential solutions to enhance compliance. By analysing the socio- economic and political factors contributing to this phenomenon, the study aims to provide a comprehensive understanding of the challenges faced by local municipalities and propose strategies to improve service delivery and financial sustainability.

Business Models of Public Smart Services for Sustainable Development

The smart city concept has entered the public debate over the last decade as a concept for the development of urban space for the efficiency, improvement and availability of public and private services and sustainability. The Business Models Canvas is most often used in the literature for the creation of business models of smart services. On the basis of the above, we investigated whether the Business Models Canvas is the most used tool for creating business models for public smart services in Slovakia and whether cities and municipalities need to evaluate their models for the provision of public smart services. However, there is no commonly used methodology for evaluating smart city business models to help both practitioners and researchers choose the best option. The goal of the research is to create a tool for evaluating business models of public smart services in smart cities. The base method used was the Delphi method, based on the previous primary (content) analysis process of the Business Model Canvas best practices. In total, 709 towns and villages participated in the primary research. Subsequently, the obtained data were evaluated and used for further research using the Delphi method, in which 28 experts participated. The research was carried out between 2020 and 2023 in Slovakia. Primary research confirmed that the Business Models Canvas is the most used tool for creating business models for public smart services in Slovakia and cities and municipalities need to evaluate their models for the provision of public smart services. Areas and basic building blocks were also identified for the design of the evaluation methodology of business models for public smart services. The proposal of the methodology for evaluating business smodels for public smart services in Slovakia was implemented using the Delphi method with the cooperation of 28 experts. Based on the results of the Delphi method, a methodological procedure for evaluating business models for public smart services was established. The methodology proposed in the paper is a simple, organized, flexible and transparent system that facilitates the work of evaluators of business models of public smart services and marketing.

Editorial: Enhancing Regional Resilience

Welcome to this special issue where we explore the role of hospitality services in sustaining communities especially in terms of enhancing regional resilience. In this issue, a range of topic areas are covered including service learning, operational risk management, hotel subscription models, staycations, virtual reality, cultural resilience, luxury transportation and Vanaprastha Tourism. With each of the research papers in this issue, the focus is on the provision of hospitality services and in particular the unique relationship between hosts and guests. The studies show that various factors need to come together for quality hospitality services to be delivered and that it is the interplay between hosts and guests that has important implications for organisations and associated communities. The studies highlight that hospitality is about creating spaces where a range of services are experienced, e.g., food, drink, accommodation, transportation, and entertainment. In turn, hospitality spaces are at the intersections of a range of issues such as social interactions, physical spaces, symbolic places, loyalty, transformation, embodiment, inclusivity, and resilience. These papers present insights into the importance of hospitality services to not only travellers and their experiences and memories but also to sustained social and economic activities of communities and their respective regions. They contribute significantly to understanding and knowledge of regional resilience and augment past, present and emerging discourses on the nature and role of hospitality and provision of hospitality services for enhancing regional and community resilience and sustainability. They generate ideas for policies, practices and future research. Individually and collectively, the insights provided by these papers lend opportunities for establishing resilient and sustainable hospitality operations into the future.

Enhancing community-oriented care: Implementation of social prescribing within a family health team.

High quality comprehensive primary care is essential for the health and well-being of individuals and communities, but the provision of health services is inadequate to fully address these needs. Social isolation and loneliness are associated with poor health outcomes and are increasingly prevalent among older adults. The St. Michael's Hospital Academic Family Health Team, a large interdisciplinary primary care organization that serves approximately 55,000 people in the downtown east of Toronto, Ontario, developed and implemented a social prescribing program to support socially isolated and lonely older adults. This article reports the development of that program-called SEED (Seniors, Equity, Engagement, and Dignity)-and describes opportunities and challenges and some preliminary results from the first year. By supporting people in new ways, this program aims to reduce loneliness and social isolation, increase capacity within the family health team, and support diverse older adults to live fulfilling lives.

Research Data Management (RDM) Skills Among Health Librarians in Nigeria: A Survey

ABSTRACT Research Data Management (RDM) skills encompass a set of abilities needed for RDM services. This study sought to assess the RDM skills of health librarians in Nigeria that can enable the provision of RDM services in health libraries. Employing the descriptive survey method, data was collected using a questionnaire adapted from Federer (2018). Data were analyzed using descriptive and inferential statistics. Among other findings, the results showed that, health librarians are inadequately skilled in RDM. Although they have adequate library and personal skills, these are not enough for rendering RDM services in health libraries in Nigeria.

The New Dimension of Surgery: Telesurgery and Surgical Nursing

In the recent COVID-19 pandemic, it has been observed that surgical patients have turned more towards telemedicine applications to meet their health care needs due to the fact that they cannot apply to hospitals unless they are mandatory and even the majority of non-urgent medical activities, including elective surgeries, are paused. Telesurgery, one of the telehealth concepts in the provision of health services, has emerged as a promising application known as remote surgery, which provides remote surgical care to patients. Today, telesurgical interventions performed away from patients using surgical robots, virtual reality applications, advanced computer and network technologies have become a rising trend in the field of surgery. It is obvious that telesurgery applications, which aim to provide high quality remote surgery with worldwide expertise, have some obstacles due to the fact that it is a very new technology. However, despite the obstacles, it is witnessed that telesurgical interventions are being successfully applied day by day thanks to different application methods. It is predicted that telesurgery, which is expected to reach and serve more patients in the future, will be more widely applied and developed with its high-speed advanced network connection, lower cost rates and reaching all over the world, even to space and the depths of the sea. When we look at the nursing practices in telesurgery, which is a new application area in the field of surgery, it is stated that positive results have been achieved, but the number of studies is still insufficient. Depending on the telesurgery technology, which is expected to develop rapidly in the coming years, it is thought that there will be a rapid increase in the number of studies on telesurgery in the field of surgical nursing. Therefore, in this review, it was aimed to clarify telesurgical interventions, which have been started to be applied by surgeons as a new trend in recent years and which is a very new and highly developed application area for nurses, and to examine the surgical nursing interventions applied in this field.

Evaluation of centralised and decentralised models of care during the 2020 Ebola Virus Disease outbreak in Equateur Province, Democratic Republic of the Congo: A brief report.

Traditionally in the Democratic Republic of the Congo (DRC), centralised Ebola treatment centres (ETCs) have been set exclusively for Ebola virus disease (EVD) case management during outbreaks. During the 2020 EVD outbreak in DRC's Equateur Province, existing health centres were equipped as decentralised treatment centres (DTC) to improve access for patients with suspected EVD. Between ETCs and DTCs, we compared the time from symptom onset to admission and diagnosis among patients with suspected EVD. This was a cohort study based on analysis of a line-list containing demographic and clinical information of patients with suspected EVD admitted to any EVD health facility during the outbreak. Of 2359 patients with suspected EVD, 363 (15%) were first admitted to a DTC. Of 1996 EVD-suspected patients initially admitted to an ETC, 72 (4%) were confirmed as EVD-positive. Of 363 EVD-suspected patients initially admitted to a DTC, 6 (2%) were confirmed and managed as EVD-positive in the DTC. Among all EVD-suspected patients, the median (interquartile range) duration between symptom onset and admission was 2 (1-4) days in a DTC compared to 4 (2-7) days in an ETC (p<0.001). Similarly, time from symptom onset to admission was significantly shorter among EVD-suspected patients ultimately diagnosed as EVD-negative. Since <5% of the EVD-suspected patients admitted were eventually diagnosed with EVD, there is a need for better screening to optimise resource utilization and outbreak control. Only one in seven EVD-suspected patients were admitted to a DTC first, as the DTCs were piloted in a limited and phased manner. However, there is a case to be made for considering decentralized care especially in remote and hard-to-reach areas in places like the DRC to facilitate early access to care, contain viral shedding by patients with EVD and ensure no disrupted provision of non-EVD services.

Social practices, gender, and materiality: Women's agency in bioenergy-dependent households and communities in the central Ethiopian Rift Valley

Current energy-related practices in bioenergy-dependent households and communities regularly reinforce social inequality and exacerbate environmental challenges. By investigating women's influence on rural energy service provision, this study sheds light on gendered practices and women's agency in a case study of three villages in central Ethiopia.Women's lives in these communities revolve around practices such as collecting wood and using fire for cooking, hygiene, or space heating. Energy-efficient technologies like cookstoves are peddled as solutions to the day-to-day challenges women face. While these can enhance health and well-being, a one-sided focus on technology overlooks the deep-seated social meanings that limit the agency of women. Energy research urgently needs to improve its understanding of how women may alter energy-related social practices, to avoid that technocratic approaches entrench the provision of energy services as a gendered female chore.This interdisciplinary research employs a Stock-Flow-Practice nexus perspective to analyse interlinkages between agency, practices, meanings, and the use of materials. Study results reveal that the agency of women to change their engagement in energy-related practices is curtailed by social prescriptions within the investigated households and communities. However, in households where women can garner higher levels of agency, they are able to shift how their households engage in practices.Our findings highlight the importance of understanding women's agency as unfolding through their engagement in social practices and reflecting negotiated social prescriptions. Policies and programmatic interventions towards sustainable and equitable energy transitions in bioenergy-dependent communities need to incorporate a practice-centred concept of agency to reach their goals.

Non-index hospital re-admissions after hospitalisation with acute myocardial infarction and geographic remoteness, New South Wales, 2005-2020: a retrospective cohort study.

To examine the frequency of re-admissions to non-index hospitals (hospitals other than the initial discharging hospital) within 30 days of admission with acute myocardial infarction in New South Wales; to examine the relationship between non-index hospital re-admissions and 30-day mortality. Retrospective cohort study; analysis of hospital admissions (Admitted Patient Data Collection) and mortality data (Registry of Births, Deaths and Marriages). Adults admitted to NSW hospitals with acute myocardial infarction re-admitted to any hospital within 30 days of discharge from the initial hospitalisation, 1 January 2005 - 31 December 2020. Proportion of re-admissions within 30 days of discharge to non-index hospitals, and associations of non-index hospital re-admissions with demographic and initial hospitalisation characteristics and with 30-day and 12-month mortality, each by residential remoteness category. Of 168 097 people with acute myocardial infarction discharged alive, 28 309 (16.8%) were re-admitted to hospital within 30 days of discharge, including 11 986 to non-index hospitals (42.3%); the proportion was larger for people from regional or remote areas (50.1%) than for people from major cities (38.3%). The odds of non-index hospital re-admission were higher for people with ST-elevation myocardial infarction, for people whose index admissions were to private hospitals, who were transferred between hospitals or had undergone revascularisation during the initial admission, were under 65 years of age, or had private health insurance; the influence of these factors was generally larger for people from regional or remote areas than for those from large cities. After adjustment for potential confounders, non-index hospital re-admission did not influence mortality among people from major cities (30-day: adjusted odds ratio [aOR], 1.09; 95% confidence interval [CI], 0.99-1.20; 12-month: aOR, 0.98, 95% CI, 0.93-1.03), but was associated with reduced mortality for people from regional or remote areas (30-day: aOR, 0.81; 95% CI, 0.70-0.95; 12-month: aOR, 0.88; 95% CI, 0.81-0.96). The geographically dispersed Australian population and the mixed public and private provision of specialist services means that re-admission to a non-index hospital can be unavoidable for people with acute myocardial infarction who are initially transferred to specialised facilities. Non-index hospital re-admission is associated with better mortality outcomes for people from regional or remote areas.

Skin health of Aboriginal children living in urban communities.

Skin concerns are frequent among urban-living Aboriginal children, yet specialist dermatology consultations are limited with studies highlighting the need for improved cultural security. Through newly established paediatric dermatology clinics at two urban Aboriginal Community Controlled Health Organisations (ACCHOs), we aimed to describe clinic and patient data, including disease frequencies and associations, to inform dermatology service provision and advocacy. A prospective cohort study of Aboriginal children and young people (CYP, 0-18 years) attending Aboriginal Health Practitioner (AHP) co-ordinated paediatric dermatology clinics at two urban ACCHOs. Data were collected from 32 clinics over 19 months, with 335 episodes of care and a mean attendance rate of 74%. From 78 new patients, 72 (92%) were recruited into the study, only one of whom had previously received dermatologist assessment. Eczema, tinea or acne accounted for 47% (34/72) of referrals, and 60% of patients received their first appointment within 4 weeks of referral. In 47/72 (65%) consultations, the GP referral and dermatologist diagnosis concurred. The most frequent diagnoses (primary or secondary) at first consultation were atopic dermatitis (26%, 19/72), dermatophyte infections (25%, 18/72), acne (21%, 15/72), bacterial skin infections (18%, 13/72) and post-inflammatory dyspigmentation (18%, 13/72). Three categories of the 2022 Australasian College of Dermatologists curriculum (infections, eczema/dermatitis, pigmentary disorders) accounted for 59% of all diagnoses. This study highlights the specialist dermatology needs of urban-living Aboriginal CYP. ACCHO-embedded dermatology clinics co-ordinated by AHPs demonstrated benefits for Aboriginal CYP in accessing care. Opportunities to embed dermatology practice within ACCHOs should be prioritised.

Water Security Characteristics of Existing Water Service Provision Systems in Informal Settlements within Nairobi County, Kenya

Water Security Characteristics of Existing Water Service Provision Systems in Informal Settlements within Nairobi County, Kenya

Predictive Models for Aggregate Available Capacity Prediction in Vehicle-to-Grid Applications

The integration of vehicle-to-grid (V2G) technology into smart energy management systems represents a significant advancement in the field of energy suppliers for Industry 4.0. V2G systems enable a bidirectional flow of energy between electric vehicles and the power grid and can provide ancillary services to the grid, such as peak shaving, load balancing, and emergency power supply during power outages, grid faults, or periods of high demand. In this context, reliable prediction of the availability of V2G as an energy source in the grid is fundamental in order to optimize both grid stability and economic returns. This requires both an accurate modeling framework that includes the integration and pre-processing of readily accessible data and a prediction phase over different time horizons for the provision of different time-scale ancillary services. In this research, we propose and compare two data-driven predictive modeling approaches to demonstrate their suitability for dealing with quasi-periodic time series, including those dealing with mobility data, meteorological and calendrical information, and renewable energy generation. These approaches utilize publicly available vehicle tracking data within the floating car data paradigm, information about meteorological conditions, and fuzzy weekend and holiday information to predict the available aggregate capacity with high precision over different time horizons. Two data-driven predictive modeling approaches are then applied to the selected data, and the performance is compared. The first approach is Hankel dynamic mode decomposition with control (HDMDc), a linear state-space representation technique, and the second is long short-term memory (LSTM), a deep learning method based on recurrent nonlinear neural networks. In particular, HDMDc performs well on predictions up to a time horizon of 4 h, demonstrating its effectiveness in capturing global dynamics over an entire year of data, including weekends, holidays, and different meteorological conditions. This capability, along with its state-space representation, enables the extraction of relationships among exogenous inputs and target variables. Consequently, HDMDc is applicable to V2G integration in complex environments such as smart grids, which include various energy suppliers, renewable energy sources, buildings, and mobility data.

Perception of healthcare workers and patients about the impact of health facility infrastructure on healthcare services in eThekwini Municipality, KwaZulu-Natal, South Africa

ABSTRACT Background: Although there are several health facilities with infrastructure to cater to healthcare services, there are still healthcare facilities with inadequate infrastructure in eThekwini Municipality, KwaZulu-Natal Province, South Africa, to provide comprehensive healthcare services. This study investigates the perceptions of healthcare workers and patients about the impact of health facility infrastructure on the provision of healthcare services in KwaZulu-Natal. Objectives: This study aims to determine the perception of healthcare workers and patients about the impact of health facility infrastructure on healthcare services at Goodwins Clinic in eThekwini Municipality, KwaZulu-Natal, South Africa. Method: This qualitative study applied a phenomenological design by conducting in-depth interviews with individual patients (n = 20) and healthcare workers (n = 10) purposively selected in 2022. Data were analysed using Colaizzi’s phenomenological analysis framework. Results: Participants reported that health facility infrastructure affects healthcare services. Furthermore, old facility structures, scattered structures and limited working spaces were found to be the leading factors affecting healthcare services in the facility. Conclusion: The facility’s structural design factors need to be considered to ensure that the health facility structure is adequate to deliver healthcare services and motivate radical transformation in measuring and managing healthcare facilities.

Views and practices on medical cannabis of unlicensed providers in Thailand: a qualitative study

Background Despite the legalization of cannabis use for medical purposes in Thailand in February 2019, illicit providers are still widespread and accessible. This study aimed to understand why people still chose to receive medical cannabis treatment or products from unlicensed or illegal providers. The practices of unlicensed or illegal providers in provision of medical cannabis products or treatment services were also examined. Methods Qualitative in-depth interviews were conducted among medical cannabis providers and users, including 36 unlicensed and 7 licensed providers and 25 users in 2019-2021. Snowball sampling was used to recruit participants until saturation of data was achieved. Interviews included open-ended questions about the providers’ practices and attitudes towards medical cannabis. Interviews were recorded and transcribed, and thematic analysis was performed. Results Overall, six reasons were identified to answer why unlicensed/illicit providers were still popular, including: 1) easy accessibility; 2) familiarity with the unlicensed providers before the legal scheme became available; 3) favorable characters (kind, supportive, non-judgmental) of unlicensed providers; 4) affordable treatment fees; 5) trust in the quality of the medicines; and 6) lack of knowledge and negative attitudes towards cannabis from healthcare professionals. Most providers started their career as medical cannabis providers by using it themselves or with their relatives and being satisfied with the results. They used cannabis products to treat all diseases, including skin, eyes, HIV/AIDS, non-communicable diseases and all kinds of cancers. Additionally, they believed that it was effective, with no or minimal adverse effects. Conclusions This study suggests that some patients will continue receiving medical cannabis treatment and products from unlicensed or illegal providers. More attention should be paid on increasing the capacity of medical cannabis service systems within public health hospitals, and the certification of unlicensed providers, so as to integrate them into a regulated system.

Acceptability and Feasibility of Provision of COVID-19 Services by Community Health Workers to Remote Gold Mining Communities in Suriname.

Gold mining communities in the Amazon region typically have limited access to public health services. In Suriname, the Ministry of Health Malaria Program (MoH-MP) works with community health workers (CHWs), people from mining communities without a formal medical degree, to provide malaria diagnostic and treatment services. During the COVID-19 pandemic, the MoH-MP trained 21 of these CHWs in COVID-19 outreach and testing, using rapid antigen tests for symptomatic persons in their communities; afterward, a mixed methods research approach was used to investigate whether including COVID-19 services in the tasks of the CHWs was feasible and accepted among gold mining populations. Also, CHWs took part in active case detection missions to proactively offer COVID-19 testing to all inhabitants of specific mining areas, regardless of symptoms. In the 6 months of field implementation (May-October 2022), 1,300 persons were tested for COVID-19, among whom 28.7% were women. Eight percent tested positive. Of the 312 asymptomatic persons tested, 2.2% tested positive. Qualitative semi-structured interviews with the CHWs and quantitative pre- and postintervention surveys revealed that the communities appreciated the nearby and free COVID-19 testing opportunity. The intervention motivated individuals who otherwise would not have been tested to test for COVID-19. Twenty-nine percent of those who had tested at least once for COVID-19 reported that their most recent test was conducted through the services of the CHWs. The results suggest that integrating COVID-19 testing into other CHW services can lower health access barriers in difficult-to-reach populations in remote communities.

Perception and coping mechanisms of patients with diabetes mellitus during the COVID-19 pandemic in Ibadan, Nigeria.

The 2019 coronavirus disease (COVID-19) ushered in a period of fear and uncertainty, resulting in structural instability across the globe. Vulnerable individuals, such as patients with diabetes mellitus, are predispose to have adverse effects and complications of COVID-19 when infected. We explored the perception of diabetes mellitus patients during the COVID-19 pandemic and their coping mechanisms at the University College Hospital, Ibadan. We employed an exploratory qualitative study design to explore diabetes mellitus patients' perceptions and coping mechanisms during the COVID-19 pandemic. A purposive sampling technique was used to recruit 32 participants (2 health professionals and 30 diabetes mellitus patients). In-depth interviews were used to collect the data from the participants. All the recorded audio data were transcribed verbatim and exported to NVivo software for thematic data analyses. Most diabetes mellitus patients were not fearful of the pandemic but were optimistic that it would not affect their health. Mechanisms such as the usage of herbal medicines and adherence to COVID-19 precautionary measures were noticed among patients. The study also revealed that the hospital's coping mechanism during the COVID-19 pandemic include prolonged appointments, limiting the number of patients attended per clinic day, and the provision of telehealth service. Patients in our study utilised negative coping mechanisms such as reduced drug dosages, subscriptions to cheaper drug brands, and reliance on religious institutions rather than a clinic for health instructions. The study has shown that diabetes mellitus patients were not fearful of the COVID-19 pandemic. The utilisation of telehealth, encouragement of daily monitoring of sugar levels, provision of avenues for a medication review, and adherence to the safety protocols were coping mechanisms employed by the health system and diabetes mellitus patients. We recommend that the government and other healthcare stakeholders reinforce the resilience of diabetes mellitus patients by alleviating their health burdens during the pandemic. This could be done by subsidizing the prices of drugs, tests, and consultation fees for patients with diabetes mellitus. Also, more efforts should be made to elevate the health system through the reduction in waiting and appointment times in the diabetes clinic and employing more health personnel in the clinic.

Situational Awareness and Safety: Using Weather Information to Inform Decision-Making in Antarctic Environments

Abstract To avoid hazards, manage risks, and successfully conduct their outdoor activities, people in Antarctica make weather-related decisions every day. Research on Antarctic weather information use and related decision-making, services, and user needs is limited. In a mixed-methods study, we explored how people use weather information to manage activities and weather in Antarctic regions. Survey (n = 62) and interview (n = 35) participants were deployed with National Antarctic Programs and tourism operators across a range of roles, activities, and locations. How and when weather information was used depended on people’s decision contexts, location, activities, previous experience and knowledge. Experienced participants used weather information, their experience, and local knowledge to form and maintain their situation awareness. Situation awareness influenced participant's decision-making, risk assessment, and planning processes and enabled people's adaptation to changing circumstances, hazards, and weather conditions. As a part of these processes, forecasts were used primarily for pre-activity planning and scheduling decisions. Tasks were prioritized and planned based on suitable weather conditions, experience, and safety. During activities, real-time weather data, personal observations, and experience were important for updating situation awareness, risk judgments, decision-making, and maintaining safety. Levels of weather service provision and training varied and were often not fit-for-purpose, which may adversely impact people's safety in Antarctic regions. Results contribute to our understanding of polar weather user needs, and how we may support people to develop the experience, knowledge, and non-technical skills necessary for identifying and avoiding hazards and safe, efficient, and successful outdoor activities.

Quality 4.0: the need for Tanzania's service organisation transit to Quality 4.0

PurposeQuality has always been a competitive advantage for every organisation that strives for customer satisfaction when offering services or products. Technological advancements during the industrial revolutions have enabled organisations to grub improvement and transition opportunities into a new paradigm in operating business processes. In light of the fourth industrial revolution (FIR), in which Quality 4.0 (Q4.0) leveraged its technologies, this study establishes the need for service organisations to transition to Q4.0. It unveils the awareness level within the organisation, the existing challenges and the benefits of transitioning to Q4.0.Design/methodology/approachThe data for this study was acquired through a survey methodology; it involved qualitative and quantitative methodologies and a mix of primary and secondary sources. The challenges and benefits regarding Q4.0 adoption were obtained from the relevant literature and used as a base of assessment in the selected service organisations. Minitab version 20 and SPSS 21.0 software packages analysed the gathered data.FindingsThe study found a high level of awareness regarding Q4.0 among the selected service organisations. Despite the high level of awareness, it was revealed that neither of the Q4.0-related technologies have been implemented nor in the process within the selected service industries. This is due to numerous challenges, including inadequate high-speed internet, a high cost of investment, inadequate skilled personnel and inadequate scepticalness to the implementation outcomes. Despite these challenges, leveraged technologies, potential benefits and Q4.0 awareness all demonstrate the need for Q4.0.Research limitations/implicationsThe study introduces the advent of the FIR and the disruptive nature of the associated technologies. It also unveils the potential of the contemporary technologies of the FIR that could elevate quality service provision to increase their competitiveness. Moreover, it also assists service organisations in planning and properly allocating their resources to ensure all the challenges are addressed in the Q4.0 adoption process. The study is limited in that it merely considers service organisations in Tanzania without categorising what type of service organisations were considered, i.e. banking, telecommunications, health, etc. thus generalising the findings.Originality/valueMuch has been discussed in the literature regarding Q4.0 in manufacturing organisations, focusing less on service organisations. This study uniquely assessed the need to transition to Q4.0 for service organisations, which has yet to be covered in the literature.