Work Processes Research Articles

Barriers and facilitators to implement the redispensing of unused oral anticancer drugs in clinical care: A hybrid-effectiveness type I study

BackgroundMinimizing medication waste through the redispensing of oral anticancer drugs (OADs) that were unused by patients provides economic and environmental benefits, but this is not yet universally implemented in clinical care. Objective(S)To identify barriers and facilitators to the implementation of redispensing unused OADs in clinical care. MethodsA multicentre intervention study following a hybrid effectiveness-implementation type I design was conducted, consisting of semi-structured interviews with key stakeholders involved in the redispensing program: pharmacy employees, prescribing clinicians in oncology and haematology, patients who participated in redispensing and patients who declined trial participation. Questions encompassed experiences and suggestions for future implementation. The Consolidated Framework for Implementation Research (CFIR) guided data collection and categorisation of identified barriers and facilitators through thematic analysis. ResultsIn total, 35 interviews were conducted, identifying 15 themes encompassing barriers and facilitators, reflecting all CFIR domains. Facilitators encompassed: 1) convenient process requiring an acceptable time-investment; 2) support from project leaders and implementation champions; 3) being well-motivated by personal values and societal impact; 4) feeling ensured of medication quality upon redispensing; 5) endorsement by healthcare providers for patient participation; 6) clear and personal patient communication; 7) good visibility of intervention successes; and 8) implementation well supported through a collaborative network. Barriers encompassed: 1) unclear target population; 2) redispensing legally prohibited; 3) absence of financial compensation for pharmacies; 4) complexity arising from two parallel work processes; 5) widespread communication on adjustments within local teams challenging; 6) patient's low receptiveness due to burden of oncology treatment; and 7) lack of familiarization among pharmacy technicians. ConclusionsFacilitators for implementation of redispensing unused drugs mainly related to people's values, motivation, and societal demand, whereas barriers mainly encompassed practical issues, including knowledge, time, financial resources, and legal conditions. Strategies emphasizing the benefits of redispensing and further streamlining process compatibility could support implementation.

PRAKTIK BAIK PENGGUNAAN DANA ALOKASI UMUM DI KECAMATAN PAYAKUMBUH SELATAN

The The purpose of this study was to analyze the good practice of using the General Allocation Fund (DAU) in Payakumbuh Selatan Sub-district, Payakumbuh City. Data collection was conducted through semi-structured interviews. Data analysis was conducted using triangulation techniques, namely data reduction, data presentation, and conclusion drawing. The results of the study found that the realization of the use of DAU in the South Payakumbuh Sub-district showed very good performance, with a success rate of 95% in 2023. The process and all activities related to the use of DAU are carried out by the Budget User Authority (KPA), the Activity Technical Implementation Officer (PPTK), the Financial Administration Officer (PPK), the Treasurer, and several personnel who are assigned by each village. Employees in each kelurahan are assigned to succeed in the three focuses of the government through socialization related to stunting, technical guidance related to reducing inflation, and entrepreneurship training. There are several factors that inhibit the use of the DAU program, such as too high a comparison between the unit price listed in the Budget Implementation Document (DPA) and the real price in the field, the lack of personnel in several villages, and the existence of multiple positions that make the work process not optimal.

Measurement Method of Whole Mechanical Automatic Vertical Drilling Tools

The inaccurate positioning of a plat valve is a crucial factor affecting the efficiency and safety of drilling operations. Because of the complicated structure of vertical drilling, it is difficult to obtain the actual position of a plat valve during the working process. This work effectively addresses the challenge of accurately measuring the deflection angle of a plat valve in mechanical automatic vertical drilling. Initially, a comprehensive mathematical model was proposed for determining the angle range of the plat valve, which was founded on the thrust generated by vertical drilling. Furthermore, this work proposed a precise measurement methodology for acquiring the crucial parameters of the MVDT. The actual deviation angle range for the N-MVDT and O-MVDT vertical drilling was calculated using data obtained from measurements of the tools. At the same time, the influence of TID on the performance of the MVDT was determined. Then, a simulation was carried out to compare the calculation results. From this, it was determined that the deflection angle range of the O-MVDT at a higher rotational speed was [86°, 58°], and the deflection angle range of the N-MVDT was [−14°, 14°]. By comparing the two methods, the error in the angle range was derived. The error of the N-MVDT was less than 16.67%, and the error of O-MVDT was less than 9.43%, proving that the measurement method and the mathematical model can accurately estimate the deflection angle range of a plat valve for mechanical automatic vertical drilling. The experimental and mathematical model results consistently showed that the deflection angle φ of the N-MVDT was significantly smaller than that of the O-MVDT, so the TID significantly improved the stability of the MVDT.

Desenvolvendo o Conhecimento Pedagógico do Conteúdo de Botânica na Licenciatura: Uma Experiência Transformadora Durante o Ensino Remoto Emergencial

We share a transformative experience in the subject “Strategies and Resources for Teaching Botany” during a peculiar and challenging situation: Emergency Remote Teaching (2021). The context impacted the aims and the teaching strategies. However, through the interaction of teachers, monitors and students, the initial doubts and challenges were transformed into opportunities for innovation and improvements. We evaluate that the initial aims were achieved and that the subject contributed to the development of the Pedagogical Content Knowledge of Botany by the students, who were protagonists of their learning, mainly on the process of group work developed during the subject.

Managing SARS-CoV-2 transmission risk in workplace COVID-19 outbreaks.

A Coronavirus disease 2019 (COVID-19) workplace outbreak is a risk to the health of workers and business continuity. To minimise this risk, companies have implemented risk management measures (RMMs) designed to mitigate SARS-CoV-2 transmission within the workforce. The objective of this work was to gather insights into the application of RMMs in non-healthcare workplaces and to improve understanding of the practical barriers to their implementation. Data were collected using a pre-designed framework from 12 volunteer workplaces through discussions with staff responsible for site safety and during site visits to observe the RMMs and work processes. To evaluate ventilation effectiveness, measurements for carbon dioxide (CO2) were taken during the site visit and logged over an extended period in selected occupied areas. RMMs that were implemented well included working at home for office and other non-production staff, provision, and use of face coverings, provision for hand hygiene, and as methods became commonly available, carrying out testing for infected people. However, maintaining adequate physical distancing in many production areas proved difficult because established factory layouts cannot be easily changed and there is often a need for workers to be close to each other to communicate. A major shortcoming identified was the understanding and application of measures to improve workplace ventilation. Rapidly installing and/or upgrading mechanical ventilation systems during a pandemic may not be practical and ideally should be considered in building design. Measuring CO2 in occupied workspaces proved to be a useful tool for identifying areas with potentially inadequate ventilation. Preventing workplace attendance by identifying infected individuals is challenging, making effective RMMs crucial to mitigating virus transmission. The effectiveness of individual RMMs can be uncertain; therefore, it is necessary to adopt multilayered RMMs. Successful implementation relies on measures that are specific to individual workplaces, identified by accurate risk assessment, regularly reviewed for effectiveness, and worker compliance. Establishing suitable risk mitigation policies and providing staff supervision are vital to ensure the sustained and effective implementation of RMMs. For RMMs that require technical understanding, such as workplace ventilation systems, specialist support may be necessary to ensure effective implementation.

Empowerment Evaluation’s Practice and Principle Effects on Psychological Empowerment and Self-Determination Outcomes

This study contributed to a limited body of research on empowerment evaluation by examining its processes, principles, and outcomes. Objectives included: 1) determining implementation fidelity to the three empowerment evaluation models; 2) determining evidence of empowerment evaluation process principles; 3) determining whether empowerment evaluation outcome principles resulted from the evaluations reported on; and 4) determining whether variation in empowerment and self-determination was explained by the interaction between model fidelity and percentage of steps implemented, process principles in evidence, outcome principles in evidence, and evaluator characteristics. Results indicated individual empowerment and self-determination were likely outcomes of evaluations reported on; evidence of all ten empowerment evaluation principles indicated they were empowerment evaluations; evaluators adhered with fidelity to all three models, no model was privileged over another, and steps were chosen from across all three models. Empowerment and self-determination are more likely when empowerment evaluations are conducted by female evaluators living and working in an African country and SEEPPO was a successful first attempt at assessing the process and outcomes of empowerment evaluation work.

Improvement Proposal for Enhancing the Role of Dentists Within the Family Health Strategy Workframe

Objective: This research aimed to develop an improvement proposal for enhancing the role of dentists within the Family Health Strategy (FHS) framework in a municipality in the Vale do Itajaí region. Method: The methodology adopted in this study comprised exploratory, descriptive, and qualitative research. Data collection took place in a municipality with 18 primary health care units. The participants were 10 dentists working in these units, who responded to semi-structured interviews. Results and Discussion: Data were consolidated through content analysis, revealing four categories for discussion: 1) management and its implications on dental practice; 2) strategic planning as a tool for dental practice-related actions; 3) the impact of the COVID-19 pandemic and post-pandemic on the work process of dentists; and 4) the importance of more dental professionals within the FHS. Research Implications: the oral health management model of the study municipality was not well defined, there is a lack of epidemiological data, health indicators and the territorialization process in the territory assigned to each UBS, difficulty in communication and understanding as required of the coordinator in oral health. Originality/Value: The proposed flowchart for improving the dentist's role within the Family Health Strategy represents innovation in Primary Care.

Modelling and analysis of long floating hose string at different working states during the pumping ashore process

ABSTRACT During the pumping ashore process, a long floating hose string connects with the shoreline and the other end either free-floating or linking a Trailing Suction Hopper Dredger (TSHD), which suffered both motions of the TSHD and itself under the wind, wave and currents. It is necessary to evaluate the dynamics of the floating hose string to ensure its reliability because their deformation in waves matter the inside slurry flow transportation and may suffer unexpected damaged during the operation and even cause the project delay. Although the composite structure of the dredging hoses can refer to the floating hoses in offshore oil transportation, the bending stiffness, long-distance behaviour and coupling with the motions of the ship and the hose string bring new challenges for modelling and solving. In order to solve the problems, in this study, a numerical model of kilometres-long floating hose string with mechanical properties of the composite hose materials is established with single hose segment bending test data, macro model with lumped mass theory, dynamics of the hose string and coupling analysis with the ship motions. The dynamic performance of kilometres-long floating hoses during the free-floating state and connected TSHD for pumping state with different angles of wind, current, and wave are investigated. The analyses indicate that axial tensions and bending moments of the first 100 m and last 200 m of floating hose string should be noticed, and the amplitude of the tensions remain low and relatively stable when the 60° incoming wave to the ship, which is a better choice in practical operation. Finally, the effects of different sea conditions and lengths of hose string are carried out. The nonlinear geometry and forces of different lengths’ floating hoses during the pumping ashore process were obtained for practical operation reference. Results can help to evaluate long-distance floating hose motions under different sea conditions and provide practical operation suggestions for the working process.

Striking the balance: ethical challenges and social implications of AI-induced power shifts in healthcare organizations

AbstractThe emergence of new digital technologies in modern work organizations is also changing the way employees and employers communicate, design work processes and responsibilities, and delegate. This paper takes an interdisciplinary—namely sociological and philosophical—perspective on the use of AI in healthcare work organizations. Using this example, structural power relations in modern work organizations are first examined from a sociological perspective, and it is shown how these structural power relations, decision-making processes, and areas of responsibility shift when AI is used. In the subsequent ethical part, opportunities for a fairer organization of work, but also dangers due to possibly changed power relations are elaborated and evaluated by presenting a realistic scenario from everyday clinical practice. After combining a proceduralist account of organizational ethics with a virtue-ethical approach, it is argued that certain organizational and character dispositions are necessary for employers and employees to meet the challenge of changing structural power relations in the future. With the same goal, a summative sociological perspective discusses challenges to workplace co-determination.

A Pilot Study Evaluation of a Passive Shoulder Exoskeleton for a Drilling-fastening Task

Exoskeletons have been considered as a method to mitigate Work-related Musculoskeletal Disorders (WMSDs) in industry. However, it is still unclear how they affect work performance and processes that have accuracy and precision requirements (e.g., drilling, riveting, welding). In this study, the effect of a passive shoulder exoskeleton on a drilling-fastening task performance (the flushness and tilt angle of the fastener) and user perceptions (discomfort, fatigue, and workload) was examined. Participants ( n = 13) performed a drilling-fastening task with the exoskeleton present and absent. Results support that the exoskeleton did not influence the quality of the drilling task, perceived fatigue, or perceived workload. There were mixed results on perceived discomfort, with participants feeling less discomfort, similar discomfort, and greater discomfort based on the body location. This study provides added context for industry decision-making on using passive shoulder-support exoskeletons as a method to mitigate WMSDs.

How digital applications can facilitate knowledge sharing in health care

Purpose This paper focuses on knowledge sharing in health care. The aim of the paper is to further understand how digital applications can facilitate knowledge sharing between different care providers and health-care professionals. Design/methodology/approach The paper is based on a qualitative action case study, performed as a formative intervention study as a Change Laboratory, where a digital application concerning wound support was used. The Change Laboratory was used for knowledge sharing in the assessment and treatment process of wounds. The collected data was then thematically analyzed. Findings The findings show how digital applications can facilitate knowledge sharing, but also the need for complementary collaborative sessions. The main contribution is the rich description of how digital applications together with these sessions can facilitate knowledge sharing. Originality/value This paper shows that activities as collaborative sessions performed on the organizational level prove to support knowledge sharing and learning when a new digital application has been implemented in the work process. It also shows that these sessions contributed to identifying new knowledge that has potential for being included in the application and hence are important to keeping the application updated and relevant over time.

Factors Influencing Feeding Decisions in Children With Bronchiolitis on High-Flow Nasal Cannula.

High-flow nasal cannula (HFNC) is used in up to 50% of children admitted with bronchiolitis. Consensus recommendations for feeding these children have not been established, and there is variability in practice. We sought to identify factors influencing feeding decisions for general care patients admitted with bronchiolitis on HFNC from a national sample of interdisciplinary care team members. In this qualitative study, we conducted semi-structured virtual interviews with care team members involved in making feeding decisions at 10 US hospitals from June 2022 to March 2023. Eligible participants included 1 nurse, respiratory therapist, speech language pathologist, and physician from each site. Interviews were audio-recorded, transcribed, and conducted until reaching sufficiency. Three researchers analyzed transcript data using content analysis guided by the Systems Engineering Initiative for Patient Safety 2.0 model. We interviewed 29 participants, including 19 nurses, respiratory therapists, and speech language pathologists and 10 physicians. Participants identified 11 factors influencing feeding decisions related to hospital work systems and processes outlined in the Systems Engineering Initiative for Patient Safety model, including people (child and parent characteristics, care team experience), tools and technology (guideline, protocol, ordersets), organization (institutional culture, education), environment (time of day, care location), task (interventions to optimize feeding), and process (clinical assessment, feeding trial, communication). Our findings suggest that feeding decisions are driven by factors related to the child, care team experience, institutional tools, and culture. These key factors may inform local improvement efforts to decrease variation in feeding children with bronchiolitis requiring HFNC.

Sistem Informasi Perizinan Santri Online pada Pondok Pesantren Modern Darul Ihsan Berbasis Web

Scientific development today is developing very rapidly especially in the field of IT is a necessary area of society to maximum convenience and optimum results. In the neighborhood of the Modern Pondok Pesantren Darul Ihsan the licensing system is still done manually and is not computerized. Besides, the governor repeatedly applied for permission but not on the permission schedule. So from that, we need some kind of web-based online licensing system to help work the privacy and security parts. In this article, the author uses the Waterfall method, which is a method of developing a system or software where the work process of the system is run sequentially and systematically. This online licensing system is expected to help the central guardian in the license process and speed up the licencing process to make it easier.

Pedagogical Outdoor Project in Nature Sloyd

This study investigated the pedagogical value of a nature sloyd project. The assign­ment was to create the interior of and add decoration to one of the domed caves in a snow hotel dedicated to newlyweds. The theoreti­cal understanding that led to solve the design assignment was derived from experience-based teaching. The students were interviewed during the process, and three months later, the interviews emphasised the students’ experiences, cooperation, and learning and under­standing of significant subjects in the process. The Nordic context added value to the project. To support the interview data, the researcher’s memos and photos of the process were included in the analysis. The collected data were analysed in accordance with the constructing grounded theory method. The results show that feedback from supervisors and outsiders is important for maintaining motivation for a demanding outdoor project. They also show that the students were absorbed in the joy that various parts of the work process brought them, and it was new to them that ice can be processed with almost all types of tools found in a workshop for woodworking. Collaboration in lifting and constructing large structures using snow and ice made it possible for students to think in terms of a holistic design methodology. In such a way that the students reflected on didactic issues that may face them in their future profession as teachers. The results contribute to the understanding of the educational possibilities of pedagogical nature sloyd. Keywords: pedagogical value, sloyd, design art and crafts, nature sloyd

Work distribution for unzipping processes.

A simple zipper model is introduced, representing in a simplified way, e.g., the folded DNA double helix or hairpin structures in RNA. The double stranded hairpin is connected to a heat bath at temperature T and subject to an external force f, which couples to the free length L of the unzipped sequence. The leftmost zipped position can be seen as the position of a random walker in a special external field. Increasing the force leads to a zipping-unzipping first-order phase transition at a critical force f_{c}(T) in the thermodynamic limit of a very large chain. We compute analytically, as a function of temperature T and force f, the full distribution P(L) of free lengths in the thermodynamic limit and show that it is qualitatively very different for f<f_{c},f=f_{c}, and f>f_{c}. Next we consider quasistatic work processes where the force is incremented according to a linear protocol. Having obtained P(L) already allows us to derive an analytical expression for the work distribution P(W) in the zipped phase f<f_{c} for a long chain. We compute the large-deviation tails of the work distribution explicitly. This distribution can be interpreted as work distribution for an oscillatorylike model. Our analytical result for the work distribution is compared over a large range of the support down to probabilities as small as 10^{-200} with numerical simulations performed by applying sophisticated large-deviation algorithms.

Occupational safety management and human reliability testing during the operation of a plastic injection molding machine

Work safety is a key element in the design and maintenance of industrial workplaces and processes. This article examines occupational safety and the reliability of the human factor in the role of a plastic injection molding machine operator. Analyzing the work process and the dangerous, harmful, and burdensome factors present in the environment and workplace allowed for the identification of occupational hazards. Additionally, factors such as the frequency of threats, the likelihood of events, the possibility of avoiding and limiting damage, and the consequences of events were considered to conduct an occupational risk assessment according to the JSA (Job Safety Analysis) method. Following this, human reliability was assessed by determining the probability of operator errors using the TESEO and HEART methods. Finally, the possibility of using selected immersion techniques on the results of the research was discussed. The research methods and tools used in this study included a literature review and analysis, observation, interviews, and inference.

Quantitative analysis of energy transfer and separation in vortex tubes: Factors and empirical insights

As a device with a simple structure for energy separation, the low efficiency of the vortex tube is the primary obstacle hindering its widespread application. No existing energy separation theory has gained wide acceptance due to inconsistencies with actual processes. Therefore, drawing on prior studies concerning the flow field, the formation process of flow distribution is presented. Then a quantitative analysis of the energy transfer and separation processes in vortex tubes driven by velocity gradient, temperature gradient, and pressure gradient is proposed. The viscous shear work, heat transfer, and turbulent heat transfer processes were analyzed separately. It was found that the main factors of vortex tube energy separation originated from the expansion of the inlet nozzle and the turbulent heat transfer process. At the same time, the viscous shear work and heat transfer processes also have a specific effect on the energy separation, in which the heat transfer process suppressed the energy separation effect of the vortex tube. In addition, its empirical results indicate that interactions among the turbulent heat transfer process, frictional dissipation, angular momentum conservation, and heat transfer should be considered in further studies.

Numerical Investigation of the Effect of Intake Closing Timing on Flow Field and Combustion Process in an Elliptical Rotary Engine

Abstract The aim of this research is to investigate the effect of intake closing timing (ICT) on the flow field and combustion process in elliptical rotary engines. The model that can accurately describe the working process of the elliptical rotary engine was established, five kinds of ICTs were designed, and the influence of ICT on the flow field and combustion process was studied. The results show that the advance of the ICT can increase the intake mass flowrate and reduce the back flowrate, the volumetric efficiency is 86.1% at a 145-deg crank angle (°CA) before top dead center (BTDC), which is 7.6% higher than 125 °CA BTDC. The advance of the ICT improves the consumption speed, makes the combustion reaction more intense, and shortens the combustion time. When the ICT is 145 °CA BTDC, the crank angle when the burned mass fraction is 90% (CA90) is 19.4 °CA earlier than 125 °CA BTDC, the peak mass of hydroxy in a cylinder is 41.6% higher, and the peak pressure in a cylinder is 25.9% higher. With the advance of the ICT, the pressure and heat release in the cylinder are significantly increased, the peak temperature in the cylinder is increased, the rate of carbon monoxide generation is accelerated, and the mass of nitrogen oxide emission is significantly increased. However, advancing the ICT cannot improve the indicated thermal efficiency of the elliptical rotary engine. This analysis provides a comprehensive understanding of the ICT of elliptical rotary engines.

Starting continuous improvement; creating a common understanding of stroke care delivery in a general hospital

BackgroundContinuous improvement is based on fostering practitioners’ suggestions to modify their own work processes This improvement strategy is widely applied in healthcare but difficult to maintain. The cross-disciplinary nature of many care processes constitutes an extra impediment.MethodsThe study had an explorative design with a qualitative single-case approach. The case presents a project to improve the treatment of patients with thrombotic stroke. Data was obtained via hands on involvement, documents, observations, and interviews with participants in a cross-functional improvement group. A thematic analysis method was employed.ResultsThrough learning how tasks were carried out in other disciplines, the participants developed a common understanding of why it took so long to provide treatment to stroke patients. These insights were used to implement practical changes, leading to immediate improvements in stroke care delivery. The results were fed back so that successes became visible. Participants’ understandings of the local context enabled them to convince peers of the rationale of changes, setting in motion a permanent improvement structure. The participants considered that mapping and then assessing the entire workflow across disciplines were relevant methods for improving the quality of patient care.ConclusionStarting an improvement project in a cross disciplinary environment requires deep engagement on the part of professionals. A quintessential prerequisite is therefore the realization that the quality of care depends on cross-disciplinary cooperation. A facilitated learning arena needs to (1) create insights into each other’s colleagues’ tasks and process interdependencies, (2) increase understanding of how the distribution of tasks among specialist units affects the quality of care, and (3) frequently report and provide feedback on results to keep the process going.

Artificial intelligence in state and municipal management: challenges and prospects

Relevance. In the modern world, artificial intelligence (AI) is one of the fastest growing areas of information technology, which is increasingly penetrating into various spheres of human activity. In the context of public and municipal management, AI is a technology that is able to automate and optimize work processes, improve the quality of services provided to citizens, and increase the level of security and transparency of government work.The purpose is to analyze the possibilities and risks of using artificial intelligence in state and municipal management, as well as to determine the prospects for its development in this area.Objectives: to analyze the advantages of using artificial intelligence in state and municipal management; to study the risks and challenges associated with its implementation; to analyze trends in the development of artificial intelligence in this area, as well as to determine the prospects for its use.Methodology. Empirical, theoretical, statistical and graphical representation methods were used in the course of scientific research.Results. The study revealed the advantages of AI in public administration (improving efficiency, improving the quality of services, transparency, security); risks and challenges were studied (lack of infrastructure, risk of privacy violations, problems of transparency of algorithms, risk of discrimination); trends in the development of AI were analyzed (e-government, optimization of workflows, personalization of services, monitoring of social media, security); the prospects of using AI (smart cities, virtual assistants, hybrid systems, decision support, cooperation with business, international cooperation) have been identified.Conclusions. Artificial intelligence can significantly improve the efficiency and quality of public and municipal administration. However, for the successful implementation of AI, it is necessary to solve problems such as the lack of infrastructure and qualified specialists, ensuring data security, transparency of algorithms and compliance with the regulatory framework. To do this, it is necessary to conduct further research, develop integrated approaches and take into account world experience. The prospects for using AI include the creation of smart cities, the use of virtual assistants, hybrid systems, decision support systems, business cooperation and international cooperation.