State Of Selangor In Malaysia Research Articles

Effect of the COVID-19 Pandemic and Subsequent Social Distancing on Individual's Mental Health

The COVID-19 coronavirus, an infectious disease originating in Wuhan, has become an outbreak worldwide, leading to unprecedented measures restricting social and physical activities in many countries. The subsequent social distancing of COVID-19 has significantly resulted in many psychological consequences. The current study examines the impact of social distancing during the COVID-19 pandemic on the mental health symptoms of Selangor State, Malaysia residents. An online survey was conducted through social media platforms targeting residents of Selangor State in Malaysia. A convenience sampling method was led to include 258 respondents in the study. The questionnaire on the symptoms of mental health related to fear of COVID-19 included 13 items developed from the existing studies. The results showed that symptoms of mental health problems related to fear of COVID-19 are negatively associated with the likelihood of social interaction. The overall score of symptoms of mental health related to the fear of COVID-19 showed moderate symptoms of mental problems related to the fear of COVID-19. The factor of age was also associated with higher symptomatology of mental health problems related to fear of COVID-19. Thus, related measures and guidelines must consider the mental well-being of the at-risk person as the pandemic continues. The current study’s findings contribute to the knowledge gaps in behavioural health during biological disasters. It also provides a reference for professionals and policymakers to develop programs and measures to handle the psychosocial status of the affected people.

Mosque based sustainable financing model for micro enterprises using cash Waqf in Selangor state of Malaysia

Micro enterprises are emerging as an important sector in the economic system of Malaysia by contributing significantly to Gross Domestic Product (GDP) and providing employment opportunities to millions of workers in the country. Despite its importance in contributing towards the enhancement of the well-being of society and the continuous efforts from the government, micro-enterprises in Malaysia, are struggling with several issues. The majority of them are facing difficulties in obtaining financing for high risk. Hence, they face issues in obtaining financing from financial institutions which seek collateral and charge interest or fixed profit rate. Hence, this study proposes a mosque-based sustainable model for financing micro-enterprises using cash waqf with a significant feature of involving mosque-based administration committees (AJK) to intermediate between the Waqf Corporation of Selangor (PWS) (Waqf assets managing body of State Islamic Religious Council of Selangor (MAIS)) as Mutawalli of waqf and micro enterprises at village level. This study proposed a model for the Selangor state as the case study that may help address the financing constraints of micro-enterprises and further improve the well-being of Muslim society by better usage of cash waqf. IIUC Business Review Vol. 7-8, Dec. 2018-19 pp. 9-30

Managing Coopetition in Business Ecosystem - A study of the Printing Industry in Malaysia

Coopetition involves multidisciplinary actors in a competition and cooperation phenomenon simultaneously. There is a large research gap on how a coopetition process is established and managed in a business ecosystem. Through the in-depth analysis of a single printing business ecosystem in Malaysia, this paper finds coopetition is common as the way of doing business among the micro, small and medium sized firms in one industrial park growing into a popular printing ecosystem in Selangor state of Malaysia. This paper identifies the sources of coopetition, challenges faced by different firms in the same industry and the mechanism of these firms surviving in this business ecosystem. Through a case study, our findings showed that informal cooperation more likely than a structured coopetition to achieve short-term success yet a long term resilience for small medium enterprises. The possible tension in coopetition is reduced when trust and friendliness is available to maintain the business ecosystem position. The interchangeable supplier-customer relationships facilities value co-creation through exchange of resources and capabilities in the geographic, technological and market overlap business ecosystem. The paper suggests the coopetition strategy is the base strategy to build competitiveness of individual firm located in a business ecosystem.

Parents’ knowledge and awareness towards hand foot mouth disease in Malaysia: A survey in Selangor

BackgroundOutbreaks of hand foot mouth disease (HFMD) is endemic in Malaysia and causes outbreaks and deaths amongst young children. The aim of this study was to assess the knowledge and awareness towards HFMD and their associated determinants among parents in Malaysia. MethodsA community-based cross-sectional study was conducted between January and March 2020 in Selangor state of Malaysia using a self-administered survey. The validated questionnaires were distributed to parents with children attending kindergartens in the nine districts of Selangor through multistage sampling. Logistic regression was used to estimate the differences in knowledge and awareness between groups and to identify their associated variables. ResultsWe received 690 participant responses of which 485 were included in the final analysis. We found that only 34.4% of parents had good knowledge and 78.1% had good awareness of HFMD. The multivariate analysis found that those who were working in the private sectors had lower odds of having good knowledge compared to those who were working in the public sectors, adjusted odds ratio (aOR): 0.59; 95%CI: 0.36–0.97. Compared to Malay, Malaysian Chinese and Malaysian Indian had lower odds of having good awareness with aOR: 0.48; 95%CI: 0.29–0.81 and aOR: 0.44; 95%CI: 0.23–0.83, respectively. ConclusionAlthough parents' awareness was relatively high, they have poor knowledge on HFMD in particular to identify the symptoms of severe cases, basic treatment and preventive measures of HFMD. HFMD information needs to be communicated in a simplified language including in online communications to improve parents’ knowledge and awareness of HFMD.

FACTORS THAT AFFECTING COLLABORATION AMONG PHYSICIANS USING HEALTHCARE INFORMATION SYSTEM IN DEVELOPING COUNTRIES

To analyze and propose the factors that affect the current levels of collaboration which exist among physicians in sharing healthcare information in the selected hospitals in developing countries using HISs. A quantitative method of enquiry was used for this study in the two public hospitals in Selangor state in Malaysia, by using questionnaire instrument. The responses received and analyzed using Statistical Package for the Social Science (SPSS).Using the descriptive statistics (e.g., percentage, standard deviations, and means), and five point Likert scales in order to describe the features of data collection to analyze the factors that affect the collaboration among physicians in the selected hospitals. The result of the analysis showed the current level of collaboration among physicians within the hospitals with regard sharing information using HIS, which was very weak according to many factors. An analysis of the seven kinds of collaboration that exists among physicians was conducted and a mean score of 2.6130 was obtained reflecting minimal collaboration which in other words can be regarded as weak collaboration. The lack of collaboration was found to be as a result of lack of information distribution systems alongside the independent information technology support. In this study it was also found that collaboration occurred only in the form of regular verbal meetings with no form of data sharing through the use of the system. Low rating was also recorded for collaboration among physicians in terms of information sharing among hospitals for the purpose of improving medical research as well as medical activities. This implies the absence of an efficient information system which enhances data sharing within the hospitals and with other hospitals. Furthermore, the results imply that the real- time sharing of new activity in the hospital and with other hospitals through an information system is yet to be achieved. ©2018JASET, International Scholars and Researchers Association

Factors Influencing Domestic Tourist Preference of Holiday Destination in Malaysia During theCovid-19 Pandemic: A Conceptual Framework

The COVID-19 global pandemic has negatively impacted local tourism industries worldwide, including in Malaysia where the tourism industry contributes significantly to the country’s economic income and employment opportunities. While sector has received regulatory financial assistance to sustain their business and retain employees, more market measures are needed to promote domestic tourism as the main vehicle for filling the tourist income gap from the decline in inbound international tourist arrivals. Similar previous studies were focused on business-as-usual conditions with unrestricted international travel, however there is a research gap focusing on tourism in Malaysia under current conditions of recovery from the impact of the COVID-19 pandemic. The purpose of this paper is to propose a conceptual framework to investigate affordability, quality of service, health and safety compliance and access to facilities and amenities and to better understand how these factors influence domestic tourist preference of holiday destination in Malaysia during the pandemic. A sample of 384 respondents from the Federal Territories of Kuala Lumpur and Putrajaya and the state of Selangor in Malaysia will be selected by using random sampling technique. Regression analysis will be conducted to assess the research hypothesis

Industry 4.0 and Business Policy Development: Strategic Imperatives for SME Performance

Industry 4.0 presents companies with new prospects to renovate industrial manufacturing processes and increase value creation, has promised several optimizing strategies for improved business performance. The purpose of this research is to examine the relationship between innovation capability and employee capability on organizational performance among Small and Medium Scale industries entrepreneurs. Following a positivist research philosophy with a quantitative, cross-sectional descriptive study design, the study addressed three direct and two indirect relationships in the model. The research followed the expectation Resource-Based View Theory to test the theoretical model. Following stratified random sampling, this research using 384 SME entrepreneurs from the Selangor state of Malaysia. The study applied Smart PLS-SEM to analyze the data. The results show that SME firms' innovation capability and employee capability positively correlate with business performance. The study also shows the partial mediation effect of technology change on innovation capability and business performance and employee capability and business performance. Research extends practical and theoretical implications to the stakeholders of SMEs and businesses.JEL Classification: L25, L26, L29How to Cite:Govindarajo, N. S., Kumar M, D., Shaikh, E., Kumar, M., & Kumar, P. (2021). Industry 4.0 and Business Policy Development: Strategic Imperatives for SME Performance. Etikonomi, 20(2), 213 – xx. https://doi.org/10.15408/etk.v20i2.20143.

Clinical and epidemiological characteristics of patients seeking COVID-19 testing in a private centre in Malaysia: Is there a role for private healthcare in battling the outbreak?

ObjectiveThis cross-sectional observational study summarized the baseline characteristics of subjects who underwent COVID-19 molecular testing in a private medical centre located in the state of Selangor in Malaysia between 1 Oct 2020 and 31 Jan 2021. We compared the baseline characteristics between subjects who were tested positive and negative of SARS-CoV-2 infection, and identified risk factors which may be predictive of SARS-CoV-2 positivity.Methods and findingsA total of 36603 subjects who were tested for COVID-19 infection via molecular assays at Sunway Medical Centre between Oct 1, 2020 and Jan 31, 2021, and consented to participate in this observation study were included for analysis. Descriptive statistics was used to summarize the study cohort, whereas logistic regression analysis was used to identify risk factors associated with SARS-CoV-2 positivity. Among the reasons listed for COVID-19 screening were those who needed clearance for travelling, clearance to return to work, or clearance prior to hospital admission. They accounted for 67.7% of tested subjects, followed by the self-referred group (27.3%). Most of the confirmed cases were asymptomatic (62.6%), had no travel history (99.6%), and had neither exposure to SARS-CoV-2 confirmed cases (61.9%) nor exposure to patients under investigation (82.7%) and disease clusters (89.2%). Those who presented with loss of smell or taste (OR: 26.91; 95% CI: 14.81–48.92, p<0.001), fever (OR:3.97; 95% CI: 2.54–6.20, p<0.001), running nose (OR: 1.75; 95% CI:1.10–2.79, p = 0.019) or other symptoms (OR: 5.63; 95% CI:1.68–18.91, p = 0.005) were significantly associated with SARS-CoV-2 positivity in the multivariate logistic regression analysis.ConclusionOur study showed that majority of patients seeking COVID-19 testing in a private healthcare setting were mainly asymptomatic with low epidemiological risk. Consequently, the average positivity rate was 1.2% compared to the national cumulative positivity rate of 4.65%. Consistent with other studies, we found that loss of smell or taste, fever and running nose were associated with SARS-CoV-2 positivity. We believe that strengthening the capacity of private health institutions is important in the national battle against the COVID-19 pandemic, emphasizing the importance of public-private partnership to improve the quality of clinical care.

Chaos Theory Modelling for Temperature Time Series at Malaysian High Population Area during Dry Season

The aim of this study is to model the temperature time series at Malaysian high population area during dry season through chaos theory. The selected high population area is Shah Alam located in Selangor state of Malaysia. Chaos theory modelling is categorized into two parts namely analysis and prediction. Analysis by the phase space plot showed that the nature of the observed temperature time series is chaos. Hence, the time series is predicted via the chaotic model. Results from the chaotic model showed that the temperature time series is well predicted with Pearson correlation coefficient near to 1. The result is compared with the traditional method of autoregressive linear model. Based on the computed values of average absolute error, root mean squared error and Pearson correlation coefficient, the chaotic model is found better in predicting temperature time series at Shah Alam area during dry season. This indicates that the chaos theory is applicable for temperature time series at Malaysian high population area. This finding is expected to facilitate stakeholders such as Malaysian Meteorological Department and Department of Environment Malaysia in managing temperature and climate change problem.

Getting Young Drivers to Buckle Up: Exploring the Factors Influencing Seat Belt Use by Young Drivers in Malaysia

Many car drivers in Malaysia, especially young drivers, ignore the importance of wearing seat belts. This questionnaire study employed an extended version of the theory of planned behaviour (TPB) by including habit as a new construct to explain the factors influencing the behavioural intention and expectation of young Malaysian drivers to use seat belts. A total of 398 young drivers from the state of Selangor in Malaysia participated in this study. Analyses used a covariance-based structural equation modelling (CB-SEM) approach. The results showed that the variance, which indicates the intention of young Malaysian drivers to use seat belts (R2 = 0.76), is influenced by drivers’ habits and three basic constructs of the TPB (attitude, subjective norms, and perceived behavioural control). The basic TPB constructs have a direct and positive impact on the intention of young Malaysian drivers to use seat belts. Drivers’ habits have a positive and direct influence on their intention to use seat belts, and an indirect influence via the attitude and perceived behaviour control constructs. Drivers’ habits do not influence subjective norms. The authors recommend implementing effective measures to encourage Malaysian drivers to use seat belts and ensure sustainable traffic safety.

Energy use pattern analysis of rockmelon (Cucumis melo) production in Malaysia: a case study

Preservation of energy resources for crop production is a crucial act in an endeavour to make agriculture more sustainable. In response to that matter, this study aims to analyse and evaluate energy use pattern and its economic in rockmelon (Cucumis melo) production in Malaysian farms. Face-to-face interviews with the sampled farmers were employed to collect the data through a case study in Klang district, Selangor state of Malaysia. The collected data was then analysed using mathematical operations and spreadsheet software. The results indicated that the total energy inputs in rockmelon were 4475.62 MJ/ha. The highest portion, which accounted for 73.29% of the total energy inputs were consumed by fertilizers, while the lowest portion was used for seed (0.01%). The total energy inputs were formed from 85.12% indirect energy and 14.88% direct energy; and 85% non-renewable energy and 15% renewable energy. The net energy and energy productivity values were 11332.85 MJ/ha and 2.81 kg/MJ, respectively. The farmers gained 29.94% profit margin from their farms business. The ratio of energy output -inputs in rockmelon production was 5.34. As the ratio was much greater than 1, thus, conclusively, the energy inputs used by the farmers in the process of rockmelon production was highly efficient.

COMPARATIVE ANALYSIS OF ZAKAT DISTRIBUTION PROGRAM IN RIAU PROVINCE IN INDONESIA AND SELANGOR STATE IN MALAYSIA IN REDUCING POVERTY: A DYNAMIC ANALYSIS MODEL

This study is a comparative study between Riau Province in Indonesia and Selangor State in Malaysia with the aim of assessing differences in the zakat distribution program in reducing poverty in both regions, using the Tawhidi String Relationship (TSR) theory with a circular causation approach and a dynamic analysis model. The results of the study found that there were differences in the management of zakat in the two regions, differences in the effect of reducing poverty, differences in the amount of zakat collected and differences in the distribution of zakat funds. Research recommendation is Riau Province should unite the management of zakat in one institution to concentrated zakat funds and the distribution of zakat has a stronger multiplier effect in reducing poverty.

COMPARATIVE ANALYSIS OF ZAKAT DISTRIBUTION PROGRAM IN RIAU PROVINCE IN INDONESIA AND SELANGOR STATE IN MALAYSIA IN REDUCING POVERTY: A DYNAMIC ANALYSIS MODEL

This study is a comparative study between Riau Province in Indonesia and Selangor State in Malaysia with the aim of assessing differences in the zakat distribution program in reducing poverty in both regions, using the Tawhidi String Relationship (TSR) theory with a circular causation approach and a dynamic analysis model. The results of the study found that there were differences in the management of zakat in the two regions, differences in the effect of reducing poverty, differences in the amount of zakat collected and differences in the distribution of zakat funds. Research recommendation is Riau Province should unite the management of zakat in one institution to concentrated zakat funds and the distribution of zakat has a stronger multiplier effect in reducing poverty.

Prescribing patterns of antihypertensive medications and blood pressure control among hypertensive patients in a primary care setting in Malaysia

Aims: This study aims to describe the prescribing patterns of antihypertensive medications and short term outcomes of these patients, defined as repeat blood pressure measurements by a medical professional within 6 months, in a primary care facility in Puchong, located within the state of Selangor in Malaysia. Methods: This study was a cross-sectional, retrospective analysis of patients with essential hypertension, aged 18 and above, with blood pressure recorded at least twice within a 6-month period in an urban primary care clinic in Malaysia. Patients with history of co-morbidities were excluded. The prescribing patterns of antihypertensive medications and proportion of patients who achieved blood pressure control of less than 140/90 mmHg were ascertained. Results: A total of 200 prescriptions were analysed, including 52.5% females taking a mean of 1.7 (0.7) antihypertensive medications with a mean age of 57.9 (12.4) years. Most of the patients were prescribed either a single medication (n=90, 45.0%) or two medications (n=90; 45.0%) to control their blood pressure. Only 20 patients (10.0%) were prescribed three antihypertensive medications. A total of 127 (63.5%) patients met the blood pressure target of less than 140/90 mmHg. All participants exhibited a significant drop in systolic blood pressure, reducing from 143.0 (16.0) mmHg at baseline to 135.3 (14.8) mmHg at the end of 6 months (p&lt;0.001). Diastolic blood pressure also decreased significantly from 83.5 (11.7) mmHg at baseline to 79.0 (10.2) mmHg at the end of 6 months (p&lt;0.001). The choice of antihypertensive medications by the prescribers was compliant with the hypertension guidelines of Malaysia. Conclusion: The most commonly prescribed antihypertensive class was calcium channel blockers. Significant reduction in blood pressure was observed in patients from baseline to the follow-up visit. Further research of larger sample size and longer monitoring period is necessary to provide more robust epidemiology and drug utilisation data.

Visual Impairment among Older Adults in Selangor State of Malaysia: The Grand Challenge Project

Visual Impairment among Older Adults in Selangor State of Malaysia: The Grand Challenge Project

Knowledge and awareness of hepatitis B among households in Malaysia: a community-based cross-sectional survey

BackgroundHepatitis B (HepB) is a major public health concern in Malaysia yet little is known about knowledge and awareness of this infection in the country. Such information is essential for designing effective intervention strategies for HepB prevention and control. The aim of this study was to characterize knowledge and awareness regarding HepB in Malaysia and to identify their associated sociodemographic determinants.MethodsA community-based cross-sectional survey was conducted between January and May 2016 in Selangor state of Malaysia. A two-stage cluster random sampling design was used and one adult member of selected households was interviewed face-to-face. Logistic regression was used to estimate the differences in knowledge and awareness between groups.ResultsA total of 764 households completed the interviews and were included in the final analysis. Only 36.9 and 38.8% of the participants had good knowledge and awareness, respectively. The factors associated with good knowledge were being in the 35–44 year age group, Malay ethnicity, high educational attainment and high family income. Being Chinese, being older and having high educational attainment were determinants of having good awareness towards HepB. Participants who had good knowledge were 2.5 times more likely to also have good awareness (OR: 2.41, 95% CI: 1.78–3.26, p < 0.001).ConclusionsThis study reveals a low level of knowledge and awareness of HepB among households in Malaysia. This finding highlights the need to improve public knowledge and awareness through well-designed programs targeting vulnerable groups in order to reduce hepatitis B virus transmission and achieve the governmental target of eliminating viral hepatitis as a public health concern by 2030.

Detection of a Borrelia sp. From Ixodes granulatus Ticks Collected From Rodents in Malaysia.

The Borrelia genus consists of spirochete bacteria known to cause Lyme disease (LD) and relapsing fever in humans. Borrelia pathogens are commonly transmitted via arthropod vectors such as ticks, mites, or lice. Here, we report the molecular screening of LD group Borrelia sp. from ticks (Acari: Ixodidae) collected from rodents trapped in recreational forests and a semiurban residential area in the Selangor state in Malaysia. Of 156 adult ticks surveyed, 72 ticks were determined as positive for Borrelia sp. by polymerase chain reaction (PCR). All Borrelia PCR-positive ticks belonged to the Ixodes granulatus Supino species. Borrelia sp. was not detected in other tick species examined, including Dermacentor sp. and Amblyomma sp. ticks. Thirteen Borrelia PCR-positive tick samples were selected for further sequence analyses. Phylogenetic analyses of partial flaB gene sequences revealed that the Borrelia sp. were closely related to the LD group borreliae, Borrelia yangtzensis; a novel Borrelia genospecies reported in East Asian countries including Japan, Taiwan, and China. To our knowledge, this is the first report of Borrelia sp. related to Borrelia yangtzensis detected in Malaysia and Southeast Asia. The zoonotic potential of the Borrelia sp. reported here merits further investigation, as it may explain the previously reported serological evidence for borrelial infections in Malaysia.

Social Support and Social Participation among Urban Community in Malaysia

Social participation in community is important in improving the wellbeing of life in city. The elements of social participation in this study relates to knowledge and intellectual, social concerns, sports and recreation, environmental sustainability which are important in encouraging local communities to conduct various activities that can lead to wellbeing of life. This survey study utilized questionnaire as the instrument for this study which involved a total of 2502 samples from various ethnicities that were randomly selected from 6 municipalities in Selangor state in Malaysia. The pilot study for all items in the whole construct was at high level of reliability with the Cronbach Alpha value between 0.803 and 0.946. The findings reveal that family support and local community support were at moderate levels. This suggests that families and communities in the area provide encouragement to participate in activities towards improving wellbeing of life in city. Nevertheless, peer support and social media support are only at moderate level where peers and social media-based activities are still not fully utilized in developing a wellbeing community. This aspect should be addressed by the local authorities in improving the quality of life in the city.

Dental Home Visits for Caries Prevention Among Preschool Children: Protocol for a Cost-Effectiveness Analysis on a Randomized Control Trial.

BackgroundIn 2012, nearly 4000 children in Malaysia were referred to hospital pediatric dental services due to dental caries. Recent research has reported the effectiveness of dental home visits in preventing caries development in young children. Dental home visits (DHVs) are described as an ongoing relationship between the dentist and their patients, providing all aspects of a preventive oral health care program in the presence of the parents at home.ObjectiveThe objective of this study is to evaluate the cost-effectiveness of dental home visits and oral health information, in the form of educational leaflets, in preventing new caries development in young children, compared to those receiving only educational leaflets over a period of two years. Cost-effectiveness analysis will be used to evaluate the cost-effectiveness of dental home visits.MethodsThis is a collaborative project with the Oral Health Division of the Ministry of Health Malaysia. The Oral Health Division will provide access to a subsample from the National Oral Health of Preschoolers Survey which was carried out in 2015. The population of interest is children aged 5 and 6 years from kindergartens in the Selangor state of Malaysia. The study adopted a societal perspective for cost-effectiveness analysis and all types of resources that are of value to society will be included in analyzing the costs; such as cost to the patient, cost to the provider or institution, and indirect costs because of loss of productivity.ResultsThe trial has been approved by the International Medical University Malaysia’s Joint Research and Ethics Committee (Project ID: IMU R157-2014 [File III – 2016]). This trial is currently recruiting participants.ConclusionsThe number of young children in Malaysia who have been referred to the hospital children’s dentistry service for severe caries is disturbing. The cost of dental treatment in young children is high due to the severity of the caries which require an aggressive treatment, and the need for general anesthesia or sedation. This study will provide information on the cost and effectiveness of DHVs in caries prevention of young children in Malaysia.Registered Report IdentifierRR1-10.2196/10053

FACTORS THAT AFFECTING COLLABORATION AMONG PHYSICIANS USING HEALTHCARE INFORMATION SYSTEM IN DEVELOPING COUNTRIES

The analyse and propose the factors that affect the current levels of collaboration which exist among physicians in sharing healthcare information in the selected hospitals in developing countries using HISs , A quantitative method of enquiry was used for this study in the two public hospitals in Selangor state in Malaysia, by using questionnaire instrument. The responses received and analysed using Statistical Package for the Social Science (SPSS). Using the descriptive statistics (e.g., percentage, standard deviations, and means), and five point Likert scales in order to describe the features of data collection to analyse the factors that affect the collaboration among physicians in the selected hospitals.&#x0D; The result of the analysis showed the current level of collaboration among physicians within the hospitals with regard sharing information using HIS, which was very weak according to many factors. An analysis of the seven kinds of collaboration that exists among physicians was conducted and a mean score of 2.6130 was obtained reflecting minimal collaboration which in other words can be regarded as weak collaboration. The lack of collaboration was found to be as a result of lack of information distribution systems alongside the independent information technology support. In this study it was also found that collaboration occurred only in the form of regular verbal meetings with no form of data sharing through the use of the system. Low rating was also recorded for collaboration among physicians in terms of information sharing among hospitals for the purpose of improving medical research as well as medical activities.&#x0D; This implies the absence of an efficient information system which enhances data sharing within the hospitals and with other hospitals. Furthermore, the results imply that the real-time sharing of new activity in the hospital and with other hospitals through an information system is yet to be achieved.