Articles de revues : « Knowledge Availability Systems Center »

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Lemos, Daniela Lucas da Silva, et Renato Rocha Souza. « Knowledge Organization Systems for the Representation of Multimedia Resources on the Web : A Comparative Analysis ». KNOWLEDGE ORGANIZATION 47, n^o 4 (2020) : 300–319. http://dx.doi.org/10.5771/0943-7444-2020-4-300.

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The lack of standardization in the production, organization and dissemination of information in documentation centers and institutions alike, as a result from the digitization of collections and their availability on the internet has called for integration efforts. The sheer availability of multimedia content has fostered the development of many distinct and, most of the time, independent metadata standards for its description. This study aims at presenting and comparing the existing standards of metadata, vocabularies and ontologies for multimedia annotation and also tries to offer a synthetic overview of its main strengths and weaknesses, aiding efforts for semantic integration and enhancing the findability of available multimedia resources on the web. We also aim at unveiling the characteristics that could, should and are perhaps not being highlighted in the characterization of multimedia resources.

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Metson, Ralph. « Image-Guided Sinus Surgery : Lessons Learned from the First 1000 Cases ». Otolaryngology–Head and Neck Surgery 128, n^o 1 (janvier 2003) : 8–13. http://dx.doi.org/10.1067/mhn.2003.40.

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OBJECTIVE: To study physician utilization and experience with image-guidance technology for sinus surgery. STUDY DESIGN AND SETTING: Retrospective review of the first 1000 image-guided sinus operations performed by 42 surgeons at an academic medical center. RESULTS: Utilization of image-guidance systems showed a dramatic increase in both number of cases performed and surgeons who used this equipment (70.6% and 92.8%, respectively) during the first 2 years of its availability. Surgical volume subsequently decreased by a mean of 9.3% per year, whereas the number of surgeons using this technology plateaued. The majority of surgeons continued to perform image-guided surgery throughout the study period for selected cases. The knowledge base gained from this experience can best be summarized as a series of lessons learned. CONCLUSION: It is likely that the availability and utilization of image-guidance systems for sinus surgery will continue to increase in the future. Physicians who learn to use this new technology must do so with an appreciation for both its potential benefits and pitfalls.

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Liu, Liu. « AI and big data-driven decision support for fostering student innovation in music education at private underground colleges ». Journal of Information Systems Engineering and Management 8, n^o 2 (28 octobre 2023) : 23646. http://dx.doi.org/10.55267/iadt.07.13840.

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This study investigates the transformative impact of AI-based Decision Support Systems (DSS) and Big Data Analytics (BDA) on student innovation and employability skills in an era of rapid technological advancement, with a focus on the mediating role of technological acceptance and the moderating role of resource availability. This study, which draws on a wide range of educational contexts and data sources, gives complete knowledge of the complex links between technology adoption, student results, and contextual factors. The results of this study show how AI-based DSS and BDA have a significant impact on musical education. These technological advancements enable tailored instruction and foster students' creative thinking. In order to prepare students for a work market that is rapidly changing, they act as a catalyst for improving employability skills. The study, however, emphasizes the complicated dynamics at work. Technological Acceptance emerges as a major mediating component, underlining the significance of students and instructors freely and effectively accepting technological tools. Furthermore, as a moderating factor, Resource Availability takes center stage, emphasizing the need for equitable access to educational resources to ensure that technology-driven advantages are accessible to all. The results of this study have broad repercussions. The adoption of AI and BDA by educational institutions is encouraged as transformative technologies for enhancing the learning process. Policymakers must create regulations that support equal access to technology and promote an innovative culture in the classroom. This study highlights for students how important it is to adopt new technologies, realizing how important they are in determining both their academic and career paths.

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Andrade, Manuel A., Susan A. O’Shaughnessy et Steven R. Evett. « ARSPivot, A Sensor-Based Decision Support Software for Variable-Rate Irrigation Center Pivot Systems : Part A. Development ». Transactions of the ASABE 63, n^o 5 (2020) : 1521–33. http://dx.doi.org/10.13031/trans.13907.

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HighlightsThe ARSPivot software seamlessly integrates site-specific irrigation scheduling methods with weather, plant, and soil water sensing systems in the operation of variable-rate irrigation (VRI) center pivot systems.ARSPivot embodies an Irrigation Scheduling Supervisory Control and Data Acquisition (ISSCADA) system that incorporates site-specific irrigation scheduling methods and automates the collection and processing of data obtained from sensing systems supporting them.ARSPivot incorporates a friendly graphical user interface (GUI) that assists in the process of setting up a computerized representation of a coupled ISSCADA VRI center pivot system and simplifies the review of irrigation prescriptions automatically generated based on sensor feedback.ARSPivot’s GUI includes a geographic information system (GIS) that relates sensed data and imported GIS data to specific field control zones.Abstract. The commercial availability of variable-rate irrigation (VRI) systems gives farmers access to unprecedented control of the irrigation water applied to their fields. To take full advantage of these systems, their operations must integrate site-specific irrigation scheduling methods that in turn should be supported by a network of sensing systems. An Irrigation Scheduling Supervisory Control and Data Acquisition (ISSCADA) system patented by scientists with the USDA-Agricultural Research Service (ARS) at Bushland, Texas, incorporates site-specific irrigation scheduling methods informed by weather, plant, and soil water sensing systems. This article introduces a software package, ARSPivot, developed to integrate the ISSCADA system into the operation of VRI center pivot systems. ARSPivot assists the operation and integration of a complex network of sensing systems, irrigation scheduling methods, and irrigation machinery to achieve this end. ARSPivot consists of two independent programs interacting through a client-server architecture. The client program is focused on automatically collecting and processing georeferenced data from sensing systems and communicating with a center pivot control panel, while the server program is focused on communicating with users through a friendly graphical user interface (GUI) involving a geographic information system (GIS). The GUI allows users to visualize and modify site-specific prescription maps automatically generated based on sensor-based irrigation scheduling methods, and to control and monitor the application of irrigation amounts specified in these recommended prescription maps using center pivots equipped for VRI zone control or VRI speed control. This article discusses the principles and design considerations followed in the development of ARSPivot and presents tools implemented in the software for the virtual design and physical operation of a coupled ISSCADA VRI center pivot system. This article also illustrates how the ISSCADA system and ARSPivot constitute a comprehensive sensor-based decision support system (DSS) for VRI management that is accessible to users without in-depth knowledge of sensing systems or irrigation scheduling methods. Keywords: Center pivot irrigation, Decision support system, Precision agriculture, Sensors, Site-specific irrigation scheduling, Software, Variable rate irrigation.n

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Al-Bugami, Abdullah, et Othman Aqeeli. « Requirements for Applying Knowledge Management to Improve Electronic Management in Educational Institutions in Light of Digital Transformation : An Analytical Study ». International Journal of Educational Sciences and Arts 3, n^o 4 (23 avril 2024) : 85–152. http://dx.doi.org/10.59992/ijesa.2024.v3n4p2.

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The study aimed to reveal the requirements for applying knowledge management to improve electronic management in educational institutions in light of digital transformation. The study followed the deductive approach and the descriptive analytical approach by referring to previous studies and deriving concepts related to knowledge management applications in the context of educational institutions, and analyzing statistical reports for the Information Technology Department at the Ministry of Education. The study concluded that to apply knowledge management (discovery, generation, sharing, implementation and sustainability) to improve electronic management in educational institutions: Organizational requirements: include strategic planning for the transformation process towards the digital world, leadership and administrative support, and the commitment of senior management to support... The electronic administration project and the flexible organizational structure were adopted, and legislative frameworks were established and updated in accordance with developments, and the material and technical requirements: such as infrastructure, the availability of programs and applications, the design of database system software such as “Oracle”, the presence of communication networks, service centers, and the availability of electronic means necessary to benefit from the services provided by the administration. Electronic and human requirements: educating and training employees to develop the skills of applications of knowledge management processes in electronic administration. Attracting the best qualified individuals in the fields of information systems and software, creating effective systems to retain, develop and motivate individuals, and financial requirements: providing financial support and security requirements: represented in information security, ensuring and protecting the database, and providing privacy and confidentiality to protect the information, and recommended the importance of achieving the requirements by relying on practical methods. Which requires the availability of leading expertise and specializations for digital transformation, and the use of knowledge management to manage the use and activation of technologies to provide opportunities for digital transformation.

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Al-Bugami, Abdullah, et Othman Aqeeli. « Requirements for Applying Knowledge Management to Improve Electronic Management in Educational Institutions in Light of Digital Transformation : An Analytical Study ». International Journal of Educational Sciences and Arts 3, n^o 4 (30 avril 2024) : 85–152. http://dx.doi.org/10.59992/ijesa.2024.v3n4p3.

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The study aimed to reveal the requirements for applying knowledge management to improve electronic management in educational institutions in light of digital transformation. The study followed the deductive approach and the descriptive analytical approach by referring to previous studies and deriving concepts related to knowledge management applications in the context of educational institutions, and analyzing statistical reports for the Information Technology Department at the Ministry of Education. The study concluded that to apply knowledge management (discovery, generation, sharing, implementation and sustainability) to improve electronic management in educational institutions: Organizational requirements: include strategic planning for the transformation process towards the digital world, leadership and administrative support, and the commitment of senior management to support... The electronic administration project and the flexible organizational structure were adopted, and legislative frameworks were established and updated in accordance with developments, and the material and technical requirements: such as infrastructure, the availability of programs and applications, the design of database system software such as “Oracle”, the presence of communication networks, service centers, and the availability of electronic means necessary to benefit from the services provided by the administration. Electronic and human requirements: educating and training employees to develop the skills of applications of knowledge management processes in electronic administration. Attracting the best qualified individuals in the fields of information systems and software, creating effective systems to retain, develop and motivate individuals, and financial requirements: providing financial support and security requirements: represented in information security, ensuring and protecting the database, and providing privacy and confidentiality to protect the information, and recommended the importance of achieving the requirements by relying on practical methods. Which requires the availability of leading expertise and specializations for digital transformation, and the use of knowledge management to manage the use and activation of technologies to provide opportunities for digital transformation.

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Shah, Aditya, John OHoro, Varun Shah, Taru Dutt, Sanjiv Shah et Rahul Kashyap. « India Antimicrobial Stewardship and Resistance (INTEREST) : A Needs Assessment Survey ». Infection Control & ; Hospital Epidemiology 41, S1 (octobre 2020) : s297—s298. http://dx.doi.org/10.1017/ice.2020.878.

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Background: The emergence and spread of antimicrobial resistance is a major problem in India with significant knowledge on whether this is a systems–based, prescriber and patient characteristic based or diagnostic technologies–based issue. Methods: An electronic survey was sent to select distribution list of intensive care units (ICU) and hospital inpatient (medicine ward) providers from India. Survey questions included antimicrobial clinical practice data, access to electronic medical records, microbiological diagnostic techniques, and access to microbiology data. The survey focused on antimicrobial prescription trends and their association with diagnostic techniques. Results: There were 90 responses from 18 states in 65 ZIP codes. They had median of 187.5 beds (IQR, 40–470). Representative responders had a median age of 40 years (IQR, 31–53). Among the responders, 73 (81%) were men. Of the 90 responses, 48 providers (52%) practiced solely in ICUs (medical and surgical) and 40 providers (45%) practiced solely on the medical ward or floor, with the rest practicing in other units. In total, 31 centers (34%) reported full access to electronic medical records, and 53 centers (59%) had access to wi-fi or Internet. Interestingly, 27 centers (30%) needed to use personal provider phone data for Internet access. Only 26 centers (29%) had electronic microbiological data. Also, 63 respondents (70%) agreed to de-escalation behavior after receiving microbiological data. In addition, 55 respondents (61%) agreed that patients have easy access to outpatient antibiotics without an appropriate prescription, over the counter. Furthermore, 58 responders (64%) said that antibiotic resistance was a major problem at their center, and 61 responders (68%) were familiar with antimicrobial stewardship programs. Among the centers, 69 (77%) had no access to formal infectious disease programs at their center. Only 27 centers (30%) had a formal Clostridium difficile–associated infection reporting and control program. Only 28 centers (31%) had a formal occupational health program. Conclusions: In a large-scale, semistructured, online survey, most issues related to easy availability of antibiotics and lack of “electronization” of medical and microbiological records. It was reassuring that most providers expressed knowledge of the existing antimicrobial stewardship program.Funding: NoneDisclosures: None

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Ahmed, Abdelrahman Mohamed. « Integrating ICT in Teaching and Learning at Sultan Qaboos University : Current Status and Future Recommendations ». International Journal of Information and Education Technology 10, n^o 12 (2020) : 897–904. http://dx.doi.org/10.18178/ijiet.2020.10.12.1476.

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The present study investigated the current status of integrating ICT into teaching and learning at Sultan Qaboos University (SQU). A sample of 220 faculty members from six different colleges and four administrators from the Center of Educational Technology (CET) and the Center for Information Systems (CIS) at SQU in Oman were chosen, and quantitative qualitative design using a semi-structured questionnaire, interviews and checklists was employed. The findings show that SQU had a high availability of ICT infrastructure in terms of hardware, software and support services, as well as adequate computer labs for educational purposes. However, the results also indicated that, although SQU provided a series of professional development workshops related to using ICT in teaching, few faculty members were interested. Furthermore, the finding indicated that, the degree of ICT integration into teaching at SQU was at a medium level. Given the importance of ICT integration in teaching and learning, it is recommended that SQU should recognise and acknowledge the faculty members’ role in ICT integration. Therefore, it should provide ways to support faculty members in developing their ICT skills and knowledge and increasing capability in performing their role.

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Asriani, Asriani, Lili Eky Nursia N, Kiswanto Kiswanto, T. Alamsyah T. Alamsyah et Ernawati Ernawati. « Analisis Hubungan Sanitasi Dasar Rumah dengan Resiko Kejadian Diare pada Balita ». Jurnal Syntax Admiration 5, n^o 7 (10 juillet 2024) : 2541–48. http://dx.doi.org/10.46799/jsa.v5i7.1242.

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Public health is affected by environmental health. Poor sanitation conditions will have a bad impact on human life, ranging from a decrease in the quality of the community's environment to the pollution of drinking water sources, which can lead to an increase in cases of diarrhea and other diseases. Clean water sources, healthy latrines, and standardized Wastewater Treatment Systems (SPAL) are essential. The purpose of this study is to analyze the relationship between basic sanitation conditions in households and the risk of diarrhea in toddlers. A quantitative method with a cross-sectional design was used in this study to identify the relationship between basic home sanitation, which includes the availability of clean water, the availability of healthy latrines, and the management of SPAL RT, and the possibility of diarrhea in toddlers. In this study, 63 samples of mothers from 74 populations had babies. To get information, questionnaires are distributed. The data were tested with chis-quare, and an error rate of 0.05% was taken into account. The results showed that the availability of clean water had a correlation with the possibility of diarrhea with a P_value of 0.004, the management of household waste sewers had a correlation with P_value 0.008, and the availability of good latrines had no correlation with the possibility of diarrhea with a P_value of 0.262. The results show that the Ujong Fatihah Health Center must continue to make efforts and socialization to increase public knowledge. Health staff must be educated by village officials on the importance of maintaining daily hygiene.

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Edmiston, Melissa, Solomon Atinbire, Ernest O. Mensah, Ernest Mensah, Bright Alomatu, Kofi Asemanyi Mensah et Stephanie Palmer. « Evaluating the availability and quality of services for lymphatic filariasis morbidity in Ghana ». PLOS Neglected Tropical Diseases 17, n^o 6 (12 juin 2023) : e0010805. http://dx.doi.org/10.1371/journal.pntd.0010805.

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Background and methodology In districts where lymphatic filariasis (LF) is endemic, the goal is to provide 100% geographical coverage of the essential package of care. Additionally, countries seeking elimination status must document the availability of services for lymphoedema and hydrocele in all endemic areas. To do this, the WHO recommends conducting assessments of the readiness and quality of services provided to identify service delivery and quality gaps. This study used the recommended WHO Direct Inspection Protocol (DIP), which consists of 14 core indicators related to LF case management, medicine and commodities, staff knowledge and patient tracking. The survey was administered in 156 health facilities across Ghana designated and trained to provide LF morbidity management services. Patient and health provider interviews were also conducted to assess challenges and feedback. Principal findings The highest performing indicators across the 156 surveyed facilities were related to staff knowledge; 96.6% of health workers correctly identified two or more signs and symptoms. The lowest scoring indicators concerned medication availability, with the two lowest scoring indicators in the survey being availability of antifungals (26.28%) and antiseptics (31.41%). Hospitals performed best with an overall score of 79.9%, followed by health centers (73%), clinics (67.1%) and CHPS compounds (66.8%). The most commonly reported challenge from health worker interviews was lack of medications and supplies, followed by a lack of training or poor motivation. Conclusions and significance The findings from this study can help the Ghana NTD Program identify areas of improvement as they seek to achieve LF elimination targets and continue to improve access to care for those with LF-related morbidity as part of overall health systems strengthening. Key recommendations include prioritizing refresher and MMDP training for health workers, ensuring reliable patient tracking systems, and integrating lymphatic filariasis morbidity management into the routine healthcare system to ensure medicine and commodity availably.

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Bavuso, K., G. Zuccotti, R. A. Rocha et S. A. Collins. « Lessons Learned for Collaborative Clinical Content Development ». Applied Clinical Informatics 04, n^o 02 (2013) : 304–16. http://dx.doi.org/10.4338/aci-2013-02-cr-0014.

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SummaryBackground: Site-specific content configuration of vendor-based Electronic Health Records (EHRs) is a vital step in the development of standardized and interoperable content that can be used for clinical decision-support, reporting, care coordination, and information exchange. The multi-site, multi-stakeholder Acute Care Documentation (ACD) project at Partners Healthcare Systems (PHS) aimed to develop highly structured clinical content with adequate breadth and depth to meet the needs of all types of acute care clinicians at two academic medical centers. The Knowledge Management (KM) team at PHS led the informatics and knowledge management effort for the project.Objectives: We aimed to evaluate the role, governance, and project management processes and resources for the KM team’s effort as part of the standardized clinical content creation.Methods: We employed the Center for Disease Control’s six step Program Evaluation Framework to guide our evaluation steps. We administered a forty-four question, open-ended, semi-structured voluntary survey to gather focused, credible evidence from members of the KM team. Qualitative open-coding was performed to identify themes for lessons learned and concluding recommendations.Results: Six surveys were completed. Qualitative data analysis informed five lessons learned and thirty specific recommendations associated with the lessons learned. The five lessons learned are: 1) Assess and meet knowledge needs and set expectations at the start of the project; 2) Define an accountable decision-making process; 3) Increase team meeting moderation skills; 4) Ensure adequate resources and competency training with online asynchronous collaboration tools; 5) Develop focused, goal-oriented teams and supportive, consultative service based teams.Conclusions: Knowledge management requirements for the development of standardized clinical content within a vendor-based EHR among multi-stakeholder teams and sites include: 1) assessing and meeting informatics knowledge needs, 2) setting expectations and standardizing the process for decision-making, and 3) ensuring the availability of adequate resources and competency training.Citation: Collins SA, Bavuso K, Zuccotti G, Rocha RA. Lessons learned for collaborative clinical content development Appl Clin Inf 2013; 4: 304–316http://dx.doi.org/10.4338/ACI-2013-02-CR-0014

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Poprawski, Dagmara Magdalena. « Budget poor, but outcomes rich : How to set up tele-assisted systems in a regional and rural cancer center. » Journal of Global Oncology 5, suppl (7 octobre 2019) : 4. http://dx.doi.org/10.1200/jgo.2019.5.suppl.4.

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4 Background: Tyranny of distance in Australia has motivated oncologists to try innovations in oncology care to improve cost efficiency, access, and compliance. This is often done with little budget availability as health funds are metrocentric. The aim is to bring novel approaches to utilisation of oncology care and show its applicability to most countries even with financial constraints. Methods: Mt Gambier Hospital is a regional hospital in South Eastern South Australia (SE SA). The data collected from clinics was commenced in January 2016, to gain knowledge of epidemiology of cancer in the region, and numbers of patients seen. Despite gold standard cancer care being performed in consultations which are face-to-face, we rolled out telemedicine consultations. We also, implemented a Survivorship Care Model, and entered into a Teletrials Project which sets up a regional trials centre with support from a tertiary hospital, Flinders Medical Centre. Results: Telemedicine has been made in Mt Gambier Hospital’s cancer service a part of every day practice to save patients from unnecessary travel. From January 2016, until May 2019, there were 812 consultations with nurse practitioner, 2542 consultations with consultant in clinic, and 246 telemedicine consultations. Survivorship clinic has been implemented according to South Australian Framework for Survivorship with no extra funding. Since 2017, 49 patients were seen with curative therapy. A re-alignment of appointment scheduling will see 6 patients in the next 2 months, thus increasing clinic potential. Teletrials Project was born from collaboration with Flinders Medical Centre, and gained funding by Beat Cancer South Australia. We are now entering into final stages of Governance agreement for our 1st trial, 18 months from commencing the project. Since then, we also got 2 more collaboration grants from Beat Cancer SA. Conclusions: With limited resources, regional cancer centres are able to maximise their patient outcomes by applying novel strategies. These novel ways of doing things, may be able to be implemented on either existing budgets or through collaboration with metropolitan cancer centres to attract financial grants to improve patient outcomes.

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Kopanieva, V. O., L. I. Kostenko, О. V. Novytskyi et V. A. Reznichenko. « The task of digital transformation of the scientific information environment ». PROBLEMS IN PROGRAMMING, n^o 1 (janvier 2023) : 03–10. http://dx.doi.org/10.15407/pp2023.01.003.

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The article discusses the issues of building interoperable scientific and informational structures based on the use of modern information technologies. Tasks related to the creation of theoretical and methodological foundations for the development of the Ukrainian fragment of the global digital interoperable environment of scientific knowledge are defined. The importance of permanent and unambiguous identification of digital resources to ensure their availability and reusability is noted. A synergistic approach to building an integrated digital environment of publishing houses and libraries is proposed. Attention is paid to the need to create a cooperative cataloging center in Ukraine to ensure one-time entry of scientific data and their subsequent multiple and multifaceted use by all interested institutions. The need for a fundamental solution to the problem of functional interaction of the conglomerate of scientific and information structures is emphasized, which will require the development of a new generation of information systems in which the problem of interoperability will be considered one of the main ones. Ukraine’s successes in creating electronic repositories are noted.

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Shah, Monika, Amit Kothari et Samir Patel. « A Comprehensive Survey on Energy Consumption Analysis for NoSQL ». Scalable Computing : Practice and Experience 23, n^o 1 (25 avril 2022) : 35–50. http://dx.doi.org/10.12694/scpe.v23i1.1971.

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During the last few years, we are witnessing increasing development in the Internet of Things (IoT) and big data. To address increasing workload complexity with better performance and to handle scalability issues of such applications, non-relational (NoSQL) has started taking the place of relational databases. With increasing load, it is challenging to maintain NoSQL’s performance, scalability, and availability without expanding the capacity of hosts and power budget of computing resources. Future scaling of data center capabilities depends on the improvement of server power efficiency. Considering the rise of energy costs and environmental sustainability, we can not ignore this high energy consumption caused by NoSQL. Despite the increasing popularity and share of NoSQL in the software market, little is still known about its energy footprint. To the best of our knowledge, there are no comprehensive studies that analyze the energy consumption by various modules of NoSQL. This article, therefore, conducts a comprehensive survey on the energy consumption analysis of NoSQL. There are limited proposals to reduce the energy consumption of NoSQL. This paper also provides a brief description of these little efforts on reducing the energy consumption of NoSQL. Based on the review, this paper discusses the research scope and opportunities for researchers to improve the energy conservation of NoSQL systems.

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Lee, Jinsu, et Eunji Lee. « Concerto : Dynamic Processor Scaling for Distributed Data Systems with Replication ». Applied Sciences 11, n^o 12 (21 juin 2021) : 5731. http://dx.doi.org/10.3390/app11125731.

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A surge of interest in data-intensive computing has led to a drastic increase in the demand for data centers. Given this growing popularity, data centers are becoming a primary contributor to the increased consumption of energy worldwide. To mitigate this problem, this paper revisits DVFS (Dynamic Voltage Frequency Scaling), a well-known technique to reduce the energy usage of processors, from the viewpoint of distributed systems. Distributed data systems typically adopt a replication facility to provide high availability and short latency. In this type of architecture, the replicas are maintained in an asynchronous manner, while the master synchronously operates via user requests. Based on this relaxation constraint of replica, we present a novel DVFS technique called Concerto, which intentionally scales down the frequency of processors operating for the replicas. This mechanism can achieve considerable energy savings without an increase in the user-perceived latency. We implemented Concerto on Redis 6.0.1, a commercial-level distributed key-value store, demonstrating that all associated performance issues were resolved. To prevent a delay in read queries assigned to the replicas, we offload the independent part of the read operation to the fast-running thread. We also empirically demonstrate that the decreased performance of the replica does not cause an increase of the replication lag because the inherent load unbalance between the master and replica hides the increased latency of the replica. Performance evaluations with micro and real-world benchmarks show that Redis saves 32% on average and up to 51% of energy with Concerto under various workloads, with minor performance losses in the replicas. Despite numerous studies of the energy saving in data centers, to the best of our best knowledge, Concerto is the first approach that considers clock-speed scaling at the aggregate level, exploiting heterogeneous performance constraints across data nodes.

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Zandiatashbar, Ahoura, et Shima Hamidi. « Impact of Transit Quality on Anchor-Mediated Knowledge Economies Across Large U.S. Cities ». Transportation Research Record : Journal of the Transportation Research Board 2676, n^o 4 (6 janvier 2022) : 763–75. http://dx.doi.org/10.1177/03611981211065440.

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Universities, medical centers, and headquarters are the driving forces behind cities’ innovation productivity and anchor-based urban revitalization efforts, such as innovation districts. As a result, there is increasing competition for corporate anchors, as well as emerging partnerships and conflicts. In each case, transit has a major role to play. Yet we know little about precisely how transit fits into the dynamics of anchor-based revitalization. To address this empirical gap, this study employed structural equation modeling to grasp both the direct and indirect impacts of transit on the knowledge-intensive firm location in 500 large U.S. cities. We conceptualized the indirect impact of transit as mediated by anchors with a composite value that we developed to quantitatively represent the presence and size of major innovation anchors in each city. According to our findings, the positive impact of transit on a city’s overall knowledge economy occurred through its role in supporting anchor institutions, a role that, in turn, significantly increased the likelihood of knowledge-based firms locating in the city. In short, transit quality was positively associated with larger and more established anchors, as well as the availability of more employees, which expands the city’s talent pool, a critical driver of knowledge-intensive employers’ location decisions. These findings call for greater attention to be paid to transit in cities’ anchor-based urban revitalization plans and to partnerships between cities, metropolitan organizations, and anchors in planning future transit systems.

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Rugchatjaroen, Krish. « Approach of Electronic Government to Closing the Gap between Public and Citizens ». Journal of Social and Development Sciences 5, n^o 3 (30 septembre 2014) : 130–37. http://dx.doi.org/10.22610/jsds.v5i3.813.

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Electronic government uses ICT to improve public activities, bringing also greater organizational efficiency and effectiveness. The aim of this research is to study electronic government in Thailand to move towards success. The questionnaire obtained information on the current status of electronic government in Thailand which intendeds to investigate factors relating to information technology by interviewing state employees in National Electronics and Computer Technology Center: NECTEC. The results reveal 6 conclusion based upon the following area of study; 1) Investment: budget allocations for the integration of ICT in the public sector by considering the national strategic plan and the ASEAN community strategies, to increase the competitiveness and investigate in infrastructure and logistics. 2) Officialsâ€™ knowledge and understanding: involving the full cooperation from government agencies workshops on the development of information systems for public sector officials to allow implementation of the projects to restructure more efficiently the form of electronic government. 3) Citizensâ€™ understanding: which investigated the public sectors acceptance of public participation and people-centered government services? There are wide gaps between those used in municipal and non-municipal area. 4) Networking: the form of networking through a collaborative network of TOT and CAT in the core layer, which makes the network redundancy and high availability. 5) Promoting: using website to promote activities and disseminate knowledge about technology in electronics and computer project or training. and 6) Policies: the manner the Ministry of Information and Communication Technology, allocates resources in their expansion of telecommunications infrastructure and communication channels and the way they encourage full access to ICT that will lead to close the gap.

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Scientific Council, National. « Excessive stress disrupts the development of brain architecture ». Journal of Children's Services 9, n^o 2 (10 juin 2014) : 143–53. http://dx.doi.org/10.1108/jcs-01-2014-0006.

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Purpose – Drawing on the scientific literature, the purpose of this paper is to elucidate the harmful effects of toxic stress on the developing brain. It explains how severe, chronic adversity during development, in the absence of responsive caregiving, can impair brain architecture. It also outlines policy implications for preventing or mitigating the effects of toxic stress in early childhood. Design/methodology/approach – The National Scientific Council on the Developing Child, based at the Center on the Developing Child at Harvard University, is a multidisciplinary, multiuniversity panel of scholars that seeks to bring science to bear on public decision making. Council members selected excessive stress as a topic meriting translation for a general audience and conducted extensive peer review in drafting the paper's key scientific concepts. Findings – The paper discusses how healthy development can be derailed by excessive or prolonged activation of the biological stress response systems and how that increases lifetime risk for certain behavioural and physiological disorders. It finds that supportive relationships with caregivers can help buffer the negative consequences of toxic stress. Social implications – The paper calls for improvements to family support programmes, mental health services, and the quality and availability of early care and education. Originality/value – This paper describes an original taxonomy of positive, tolerable, and toxic stress and demonstrates the need to translate scientific knowledge about the developing brain into actionable strategies for the prevention and treatment of the effects of adverse childhood experiences.

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Dupuy, P. M. M., M. Fernandino, H. F. F. Svendsen et R. Westra. « CO2 : One-Component Two-Phase System as Model Fluid for High-Pressure Hydrocarbon Systems ». SPE Journal 16, n^o 02 (23 décembre 2010) : 482–88. http://dx.doi.org/10.2118/139606-pa.

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Summary In the process of performing either scientific experiments or research and development related to the design and optimization of high-pressure liquid-from-gas separator units, both laboratory experiments and tests in prototypes are needed. In order to emulate the low interfacial tensions often experienced in high-pressure hydrocarbon systems, the use of carbon dioxide (CO2) as model fluid is studied. This paper describes how the CO2 system behaves at saturation conditions. It describes this system and compares it with traditional laboratory systems and real fluids (from the field). CO2 at saturation pressure under normal temperatures presents an interesting system with low interfacial tension, below 3 mN/m, while the liquid/gas-density ratio is approximately 3. The availability of the fluid (CO2) in research centers and academia is high. When planning a matrix of experiments as part of a database of reproducible laboratory fluids, the present system is an independent base vector ideal for studying the high-Weber/low-Reynolds-number regime. This paper shows how a dispersed CO2-droplet phase, representative of a hydrocarbon-gas/condensate system, can be achieved in the laboratory and used for studying collision outcomes. Results show that it is possible to obtain streams of droplets for droplet experiments. The mean diameter in the studied regime with the particular nozzle used was on the order of 100 µm, while the smallest droplets possible to track with the presented technique were approximately 40 µm. Droplet/wall-collision experiments were focused in this work. Both coalescence and bouncing were observed on both dry and wet walls. The absence of real fluid experiments at laboratory conditions generates a lack of basic knowledge about what is happening in real scrubbers. This system is proposed to be representative for a part of the flow-property region of interest in real gas/liquid scrubbers. This basic knowledge is fundamental when designing separation units at high pressures for gas-processing stages such as subsea gas-separation concepts.

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Olthof, A. W., R. K. Shiraliyeva, R. R. Aliyev, A. K. Mammadbayli, P. M. A. van Ooijen et J. C. de Groot. « NEURORADIOLOGY IN AZERBAIJAN AND THE NETHERLANDS : A HEALTHCARE ASSESSMENT FROM THE NEUROLOGIST’S PERSPECTIVE ». National Journal of Neurology 2018, Special (30 septembre 2018) : 61–70. http://dx.doi.org/10.61788/njn.spec.18.9.

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Background. Referring physicians are valuable sources of information for radiologist to improve quality in radiology. In different healthcare systems neuroradiology has developed differently. Healthcare in Azerbaijan is developing and investments take place both in infrastructure and knowledge. Tools to compare healthcare in Azerbaijan and western countries can help to guide these improvements by providing detailed information about a specific field resulting in a more focused approach. Methods. A survey covering the field of neuroradiology was developed, with a variety of items including the availability of equipment, the contentment with the radiological report, the experience of the neurologist, and factors omitting neurological imaging. Data was collected both in Azerbaijan and the Netherlands. Results. In both countries most neurologist do not receive formal neuroradiology training. The data demonstrate a higher availability of advanced computed tomography (CT) and magnetic resonance imaging (MRI) machines in the Netherlands compared with Azerbaijan, and a higher experience with requesting imaging and case reading for the Dutch respondents. The financial situation of the patient can be a reason for Azerbaijan neurologists to omit imaging (due to the establishment of CT and MRI in most cases in specialized and private centers). Conclusion. The presented survey allows comparison of neuroradiological healthcare between countries in general, and identification of required preconditions to improve collaboration between neurologists and radiologists. A future lower financial threshold for imaging and a future increase in availability of PACS (picture archiving and communication system) will facilitate the improvement of neuroradiological skills of Azerbaijan neurologists. Both Dutch and Azerbaijan neurologists consider weekly clinical neuroradiological conferences together with radiologists useful to improve their skills.

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B., Ajay Mallya, Praveen Kumar N. et Sridevi N. H. « Assessment of patient satisfaction of services in primary healthcare centers of Shivamogga : a cross-sectional study ». International Journal Of Community Medicine And Public Health 8, n^o 6 (25 mai 2021) : 3060. http://dx.doi.org/10.18203/2394-6040.ijcmph20212015.

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Background: India is the second most populous country in the world. Studies have shown that quality of primary health care in low to middle income countries is very poor. Patient’s perception of quality of health care service provided has strong relation with the utilization the services. Hence it’s important to monitor the health care delivery systems in the country to gain more knowledge about the health care delivery systems.Methods: A cross-sectional study was conducted in selected primary healthcare centres (PHCs) in Shimoga. 5 PHCs were selected by simple random sampling. 30 patients attending the facility were randomly chosen for exit interview. Data regarding patient’s perception of quality of health care provided by the facility was collected using a questionnaire.Results: Majority of the participants (68%) found the services provided by the facility to be satisfactory. Patients showed high satisfaction towards explanation provided the regarding problem by doctor (84%) and cleanliness of the facility (87.3%). Poor satisfaction was seen towards availability of medicines (54%) and behaviour of the paramedical staff (46%).Conclusions: There is a need to improve the quality of services provided by the primary healthcare centres to achieve better patient satisfaction and utilization.

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Rodrigues, Arthur de Souza, et Ediu Carlos Lopes Lemos. « Assessment of Groundwater Favorability in the Municipality of São Mateus-ES ». Revista de Gestão Social e Ambiental 18, n^o 2 (21 novembre 2023) : e04440. http://dx.doi.org/10.24857/rgsa.v18n2-004.

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Purpose: Make an assessment regarding the favorability of exploring groundwater in the municipality of São Mateus. Theoretical framework: Guaranteeing the availability of water regularly and with good quality for everyone, without threatening public health, remains a challenge for the semi-arid regions of the country, especially for diffuse communities in large centers, which do not have adequate water infrastructure. Method/design/approach: The methodology used in the research begins with a bibliographical review on the topic, as well as obtaining data relating to wells registered with SIAGAS E AGERH between the years 2019, 2020 and 2021; creation of cartographic products using ArcGisTM 10.1 software; characterization of aquifer systems in the region; definition of areas with greater favorability for the exploitation of groundwater, as well as the influence of the depth of drilled wells on the flow rates obtained. Results and conclusion: The three aquifer systems defined for the study area were characterized, namely the fractured, Barreiras and Coberturas. The Barreiras aquifer system has wells with higher flows. However, the importance of adequate planning and control by the public authorities regarding the exploitation of water in this system must be highlighted, as, as a result of intensive pumping, salt water can advance into the freshwater zone of the aquifer. Research implications: The advancement of studies regarding the availability and potential of groundwater contributes to the implementation of more efficient management of water resources, as well as promoting the expansion of specific knowledge on how reserves inherent to underground water dynamics are exploited locally. Originality/value: Trazer reflexões a partir da avaliação quanto a favorabilidade hídrica no município de São Mateus, de forma a garantir uma segurança hídrica tanto quantitativa, quanto qualitativa para as comunidades desta região, encontra-se em conformidade com uma das metas da Agenda 2030 para o Desenvolvimento Sustentável.

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Dusengimana, Jean-Marie Vianney, Jean de Dieu Uwihaye, Amanda Fata, David Tuyisenge, Aphrodis Ndayisaba, Vestine Rugema, Marie Louise Uwineza, Lawrence N. Shulman, Cyprien Shyirambere et Lydia E. Pace. « Abstract 1 : A Learning Collaborative Model to Empower Rural Rwandan Health Centers to Improve the Quality of Screening for Women’s Cancers ». Cancer Epidemiology, Biomarkers & ; Prevention 32, n^o 6_Supplement (1 juin 2023) : 1. http://dx.doi.org/10.1158/1538-7755.asgcr23-abstract-1.

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Abstract Purpose: Screening and early detection initiatives for breast and cervical cancer are public health priorities in sub-Saharan Africa, but sustainable strategies to monitor screening quality in rural health facilities are not well-described. We sought to empower rural primary care clinicians to monitor and improve screening quality and integrate quality improvement (QI) into routine practice through a learning collaborative in 8 health facilities participating in a breast and cervical cancer screening initiative in Burera district, Rwanda. We evaluated the model’s impact on participant knowledge/attitudes and QI projects’ success. Methods: Two-day didactic sessions in March 2022 addressed quality measurement and QI implementation. QI knowledge/attitudes were assessed before and after training using a brief written survey and compared using paired t-tests. Participants (all nurses) then identified a cancer screening problem at their health facility that could be solved using QI methods and planned projects. All health center (HC) trainees focused on increasing the proportion of eligible women screened for cervical cancer in their sectors, via educational campaigns. District hospital (DH) team members aimed to reduce missed referral visits. At subsequent meetings, teams discussed projects and next steps. Results: Three clinicians from each of 7 HCs and 2 from the DH (n=23) participated in training; 22 took pre- and post-training surveys. Baseline mean knowledge scores (66.5%,SD 11.8) improved following training (82.4%,SD 12.0,p<0.001). After training, 22(100%) reported interest in being more engaged in QI. In the 6 months following project implementation, HCs saw a 4.8-fold increase in the mean number of patients screened across 7 HCs (35.4,SD 17.1) compared to 6 months prior (7.5,SD 2.6). Efforts to reduce missed visits could not be assessed due to inability of the cancer screening electronic medical record to track patients across facilities. Conclusion: A learning collaborative model engaged rural primary care clinicians in evaluating and improving cancer screening practices. QI knowledge improved and HCs met initial project goals. Though projects focused on patient volume, future initiatives should examine other critical quality measures i.e., referral completion and time to cancer diagnosis. Improving data collection systems is essential to facilitate availability of follow-up data and patient tracking and empower clinicians to monitor care quality. Citation Format: Jean-Marie Vianney Dusengimana, Jean de Dieu Uwihaye, Amanda Fata, David Tuyisenge, Aphrodis Ndayisaba, Vestine Rugema, Marie Louise Uwineza, Lawrence N. Shulman, Cyprien Shyirambere, Lydia E. Pace. A Learning Collaborative Model to Empower Rural Rwandan Health Centers to Improve the Quality of Screening for Women’s Cancers [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 1.

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Klemp, Jennifer R., Carol Bush, Ashley Spaulding, Hope Krebill et Gary C. Doolittle. « Engaging a statewide network to expand survivorship care to rural and urban cancer survivors. » Journal of Clinical Oncology 34, n^o 3_suppl (20 janvier 2016) : 23. http://dx.doi.org/10.1200/jco.2016.34.3_suppl.23.

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23 Background: Advances have been made in elevating cancer survivorship as a public health priority and defining elements needed to deliver high-quality follow-up care to survivors. However, a lack of research on how best to care for survivors and the most effective and efficient strategies for delivering survivorship care in the community setting still exists. We report our assessment of the current state of practice, knowledge and professional development, and plan to increase access to care of urban and rural practices across the state of Kansas. Methods: In 2014, the Midwest Cancer Alliance (MCA), a membership-based outreach arm of The University of Kansas Cancer Center, convened an educational summit and survey to assess the survivorship landscape in Kansas. Post-summit, individual interviews were conducted. Survey and interviews included questions regarding health records, treatment summaries, survivorship care plans (SCP), availability of survivorship programs and resources, access to primary care and specialists, distress screening, community support, and educational needs. Results: Ten MCA member health systems were invited to participate and 7 indicated interest in participating in the project. Only one organization provided an SCP to survivors. Barriers included lack of an integrated approach and knowledge. A majority of survivorship care could be delivered close to home, however, services including fertility preservation, genetic counseling, oncology rehab, sexual health, and second opinions, required travel of more than 50 miles. Identified educational needs focused on comprehensive survivorship care across the health care team. Conclusions: Survivorship care remains fragmented across the state of Kansas. Based on this project, we have secured a CDC survivorship grant that will facilitate clinical and technical assistance related to process improvement and electronic health record integration focused on survivorship care and delivery of an SCP. Next steps include engaging primary care providers and survivors to assure the SCP meets the needs of stakeholders. This work will focus on a translational process to meet the growing needs of the survivors and complex health care organizations.

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Lin, Kuo-Ping, Chun-Min Yu et Kuen-Suan Chen. « Production data analysis system using novel process capability indices-based circular economy ». Industrial Management & ; Data Systems 119, n^o 8 (9 septembre 2019) : 1655–68. http://dx.doi.org/10.1108/imds-03-2019-0166.

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Purpose The purpose of this paper is to establish mechanisms for process improvement so that production efficiency and product quality can be expected, and create a sustainable development in terms of circular economy. Design/methodology/approach The authors obtain a critical value from statistical hypothesis testing, and thereby construct a process capability indices chart, which both lowers the chance of quality level misjudgment caused by sampling error and provides reference for the processes improvement in poor quality levels. The authors used the bottom bracket of bicycles as an example to demonstrate the model and methods proposed in this study. Findings This approach enables us to plot multiple quality characteristics, despite varying attributes and specifications, onto the same process capability analysis chart. And it therefore increases accuracy and precision to reduce rework and scrap rates (reduce), increase product availability, reduce maintenance frequency and increase reuse (reuse), increase the recycle rates of components (recycle) and lengthen service life, which will delay recovery time (recovery). Originality/value Parts manufacturers in the industry chain can upload their production data to the cloud platform. The quality control center of the bicycle manufacturer can utilized the production data analysis model to identify critical-to-quality characteristics. The platform also offers reference for improvement and adds the improvement achievements and experience to its knowledge management to provide the entire industry chain. Feedback is also given to the R&D department of the bicycle manufacturer as reference for more robust product designs, more reasonable tolerance designs, and selection criteria for better parts suppliers, thereby forming an intelligent manufacturing loop system.

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Sumbodo, B. Tresno, Sardi Sardi, Sunarya Sunarya et Hermawan Prasetyanto. « Penguatan Desa Wisata Berbasis Kampung Iklim : Menuju Terwujudnya Ketahanan Pangan di Desa Pandowoharjo Sleman Yogyakarta ». PATRIA 2, n^o 1 (11 avril 2020) : 69. http://dx.doi.org/10.24167/patria.v2i1.2589.

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Every household always hopes to have enough food available. While fertile agricultural land is decreasing, food needs increase with increasing population. The use of the yard is expected to help improve food availability for the community.In realizing a climate village tourism village in Pandowoharjo Village, a series of activity programs are designed to be carried out continuously for three years. In Year I of the program, community education activities focused on harvesting and using rainwater for vegetable cultivation in the yard. The design of rainwater harvesting facilities is carried out in the form of IPAH, infiltration wells and dead-end channels (Rorak) in six padukuhan which have been designated as the center of tourism village development namely: Brayut, Temon, Pajangan, Dukuh, Karangtanjung and Plalangan.This method of mentoring the PPDM scheme in Pandowoharjo was carried out in three stages, namely program socialization, training and implementation. The mentoring process is carried out with two approaches, namely theoretical training and skills improvement with practice in the field.The results of the activities in Year I of the PPDM program have benefited partners directly, including: a) Increasing number of people who understand, and have skills in responding to climate change; b) Number of facilities for IPAH, infiltration and rorak wells increased by 15 units; c) The number of people who harvest and utilize rainwater increases by 15KK; d) The number of members of the farmer group of women who use the yard for the cultivation of vegetables with vertikulture and hydroponic systems increases by 20 people.Some achievements that are non-physical such as: network of rainwater harvesters, improvement of knowledge and skills of community members, and pilot cooperation partnerships that integrate several productive economic business groups with BUMDes.

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Prihatini, Ike Johan, Sri Achadi Nugraheni et Sutopo Patria Jati. « Bottleneck Pelayanan Nifas pada Upaya Penurunan Risiko Kejadian Kematian Ibu di Wilayah Dinas Kesehatan Kota Semarang ». Jurnal Manajemen Kesehatan Indonesia 5, n^o 3 (31 décembre 2017) : 28–35. http://dx.doi.org/10.14710/jmki.5.3.2017.28-35.

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Maternal and child health was a priority of health program in Indonesia. Maternal Mortality Rate in Semarang was ranked second highest in Central Java. The highest proportion of maternal deaths occurred during puerperium. That’s indicates, there was a problem in a process of maternal health services during puerperium period in health facilities. This study was conducted to examine constraints on health systems that limit range of interventions or health services that were important for postpartum, bottlenecks related to postpartum services in Public Health Center (PHC), especially infrastructure, human resources, access to PHC, post partum visits (KF1 and KF3), as well as quality of post partum services on risk reduction of maternal mortality. This case study used a qualitative approach. Data collection through interviews to five midwives as main informants, 5 midwives coordinator and 5 heads of PHC as informant triangulation. Data analsyis used content analysis method, then assigned priority bottleneck through MCUA (Multiple Criteria Utility Assessment) techniques. WHO's scale-up BNA plan to analyze bottleneck causes. Results showed, there was a bottleneck on childbirth services in PHC. The causes of bottleneck risk reduction efforts of maternal mortality incidence in puerperium period has never been analyzed workload of health personnel in PHC, lack of monitoring and evaluation of an availability infrastructure facilities in PHC, there has not been regular training, especially on delivery until puerperium services, and PHC has not received more detailed and operational information about puerperium so their maternal knowledge about puerperium has not increased much and couldn’t raise mother's awareness to do so. Semarang Public Health Office (Dinas Kesehatan Kota Semarang) needs to conduct periodic monitoring and evaluation implementation of postpartum services and improve quality of childbirth services in PHC.Keywords: Bottleneck analysis, health services, post partum, Primary Health Care, Puskesmas, Maternal Mortality Rate

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Navis, MD, Allison, Mary Catherine George, PhD, Maya Scherer, MPH, Linda Weiss, PhD, Yosuke Chikamoto, PhD et Jessica Robinson-Papp, MS, MD. « What physicians need to implement safer opioid prescribing : A qualitative study ». Journal of Opioid Management 15, n^o 6 (1 novembre 2019) : 479–85. http://dx.doi.org/10.5055/jom.2019.0538.

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Introduction: In response to the US opioid epidemic, the Centers for Disease Control and Prevention issued a guideline (CDCG) for prescribing opioids for chronic pain. Successful implementation of the CDCG requires identification of the information, skills, and support physicians need to carry out its recommendations. However, such data are currently lacking.Methods: The authors performed one-on-one interviews with nine practicing physicians regarding their needs and perspectives for successful CDCG implementation, including the perceived barriers, focusing on communication strategies. Interviews were audio recorded, transcribed, and a thematic qualitative analysis was performed.Findings: Three major themes were identified: communication, knowledge, and information technology (IT). Physicians reported that open communication with patients about opioids was difficult and burdensome, but essential; they shared their communication strategies. Knowledge gaps included patient-specific topics (eg, availability of/insurance coverage for non-opioid treatments) and more general areas (eg, opioid dosing/equivalencies, prescribing naloxone). Finally, physicians discussed the importance of innovation in IT, focusing on the electronic medical record for decision support and to allow safer opioid prescribing within the time constraints of clinical practice.Discussion: These qualitative data document practical issues that should be considered in the development of implementation plans for safer opioid prescribing practices. Specifically, healthcare systems may need to provide opioid-relevant communication strategies and training, education on key topics such as naloxone prescribing, resources for referrals to appropriate nonpharmacologic treatments, and innovative IT solutions. Future research is needed to establish that such measures will be effective in producing better outcomes for patients on opioids for chronic pain.

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Wilson, Kate, Amir Juya, Ahmed Abade, Senga Sembuche, Devotha Leonard, Julie Harris, Samantha Perkins et al. « Evaluation of a New Field Epidemiology Training Program Intermediate Course to Strengthen Public Health Workforce Capacity in Tanzania ». Public Health Reports 136, n^o 5 (4 février 2021) : 575–83. http://dx.doi.org/10.1177/0033354920974663.

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Objectives Sub-Saharan Africa faces a shortage of skilled epidemiologists to prevent, detect, and respond to health threats. Tanzania has implemented one of the first Centers for Disease Control and Prevention Field Epidemiology Training Program (FETP) Intermediate courses in Africa. This course aims to strengthen health workforce capacity in surveillance system assessment, outbreak investigation, and evaluation, prioritizing HIV control. We conducted an outcome evaluation of this new course. Methods We used a pre/post evaluation design using data from 4 cohorts of trainees who took the FETP Intermediate course from 2017 to 2020. We conducted knowledge assessments before and after each cohort and combined those results. Outcomes included knowledge and self-rated competency and trends in integrated disease surveillance and response (IDSR) data. We collected data through tests, field assignments, exit interviews, and data audits. We compared the mean change in pre-/posttest scores using linear regression and 95% CIs. We used content analysis to summarize exit interviews. Results Fifty-three FETP trainees from 10 regions enrolled in the FETP Intermediate course, and 52 (99.0%) completed the course. We found substantial increases in mean knowledge (44.0 to 68.0 points) and self-rated competency (4.14 to 4.43) scores before and after the course. Trainees evaluated 52 surveillance systems and 52 district HIV care programs, and 39 (75.0%) trainees participated in outbreak investigations. From before to after cohort 1, timeliness and completeness of IDSR reports increased from 4.2% to 52.1% and from 27.4% to 76.5%, respectively. Course strengths were quality of instruction, individualized mentoring, and practical skills gained. Challenges were mentor availability, limited time for data analysis practice, and balancing work and field assignments. Conclusions The Tanzania FETP Intermediate course substantially improved trainee knowledge and helped to improve local data quality and reporting. This course is a promising model to strengthen subnational capacity to prevent, detect, and respond to public health threats in Africa.

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Mikulina, Maryna, et Igor Ryzhov. « Heuristic methods and pedagogical conditions for their implementation in the practice of the state security competency forming ». Information Security of the Person, Society, State. 2022. № 1–3 (34–36), n^o 34-36 (12 décembre 2022) : 91–103. http://dx.doi.org/10.51369/2707-7276-2022-(1-3)-11.

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The activity of the state in forming state security competence is the implementation of a system of means for anticipating and planning, organization, regulation, coordination, and monitoring activities of those authorized to introduce relevant competencies for the training courses of state security at different levels of the state security system. That is why the basic competencies of state security professionals are desirable, and for the managerial staff it is compulsory, firstly, they have to be able to creative and innovative in their activity, be open minded to promote new and diverse perspectives; secondly, critical thinking and problem-solving are indispensable skills, taking into account cause-effect relationships, understanding the relationships between systems and system elements; skillful, responsible thinking, which enables quick and objective determination of the problem and generate unique algorithms for solving it. In modern conditions, the center of gravity in the implementation of counterintelligence or anti-terrorist measures is shifting to the practices of social and informational counteraction and social prevention, and knowledge management requires new models of military and civil (hybrid) confrontation with new types of aggression where a significant proportion is intangible assets (socio-political, technological, informational, financial and others), which are a consequence of the effective use of intellectual capital of the state (social system). Accordingly, the role of effective management of intellectual resources is growing, since their availability and degree of development determine the ability of the national security system to innovation and progress in its development. The overwhelming majority of social systems managers do not tend to out-of-the-box thinking, but to formalized decision algorithms and are unable to find effective solutions due to the uncertainty and variability of conditions. That is why a prerequisite for the development and effective implementation of state security is the availability of specialists who are able not only to solve closed tasks, but also to perform creative tasks. Another problem-matter is the formation of pedagogical conditions to outline their professional competencies, which gives grounds to raise the issue of the need to form acmeological fundamentals of the state security system as a technology. The practice of using security forces shows a direct proportional dependence of the effectiveness of their operational-combat missions on the degree of readiness of the leadership and personnel. The degree of readiness is an integrated component of the status parameters, the main of which is the level of professional preparedness of the employee. The degree of readiness is an integrated component of the status parameters, the main of which is the level of professional preparedness of the employee. Therefore, the thesis that professionally trained personnel are and will be the system-forming element of the state security forces is and will be peremptory. The impact on the processes of formation of competence of state security specialists is regulatory, decisive for the ability of the system to perform key responsibilities – protection of the state from criminal encroachments. Key words: heuristics, educational process, theory of solving inventive problems, TRIZ-pedagogy, state security, algorithm of social management, competence, terrorism.

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Ellisman, Mark H., Gabriel E. Soto et Maryann E. Martone. « The merger of microscopy and advanced computing : A new frontier for the 21st century ». Proceedings, annual meeting, Electron Microscopy Society of America 52 (1994) : 10–11. http://dx.doi.org/10.1017/s0424820100167780.

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Establishing and maintaining state-of-the-art national resources such as HVEM, IVEM and supercomputing centers involves considerable initial cost and continued support of staff with special skills and knowledge. The increased availability of high performance computing and communications offers scientists the potential for effective remote interactive use of such centralized, specialized, and expensive facilities. Anticipating improvements in computing and communications infrastructure, a collaborative computational environment, or “Collaboratory for Microscopic Digital Anatomy” (CMDA), is being developed that will provide a researcher at a remote site distributed interaction with unique instrumentation for the acquisition and manipulation of biological images. The prototype outlined in figure 1 was developed at the San Diego Microscopy and Imaging Resource. The CDMA integrates remote interactive acquisition and analysis of 2- and 3-dimensional electron microscopic data from state-of-the-art digital image acquisition systems such as a computer-controled IVEM. A software system has been developed that provides interactive control of image acquisition from the IVEM from a remote laboratory (and eventually any laboratory on the Internet). Sophisticated software tools for image analysis, visualization, and data management of these digital images are also under development. The system design will provide transparent distribution of tasks that require extensive computation to high performance computers accessible on the network. These tasks include the derivation of 3-dimensional structure using electron microscope tomography, automatic feature extraction for serial section reconstructions as well as manipulation and exploration of 3-dimensional biological datasets.

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Ndagire, Emma, Yoshito Kawakatsu, Hadija Nalubwama, Jenifer Atala, Rachel Sarnacki, Jafesi Pulle, Rakeli Kyarimpa et al. « Examining the Ugandan health system’s readiness to deliver rheumatic heart disease-related services ». PLOS Neglected Tropical Diseases 15, n^o 2 (16 février 2021) : e0009164. http://dx.doi.org/10.1371/journal.pntd.0009164.

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Background In 2018, the World Health Assembly mandated Member States to take action on rheumatic heart disease (RHD), which persists in countries with weak health systems. We conducted an assessment of the current state of RHD-related healthcare in Uganda. Methodology/Principal findings This was a mixed-methods, deductive simultaneous design study conducted in four districts of Uganda. Using census sampling, we surveyed health facilities in each district using an RHD survey instrument that was modeled after the WHO SARA tool. We interviewed health workers with experience managing RHD, purposively sampling to ensure a range of qualification and geographic variation. Our final sample included 402 facilities and 36 health workers. We found major gaps in knowledge of clinical guidelines and availability of diagnostic tests. Antibiotics used in RHD prevention were widely available, but cardiovascular medications were scarce. Higher levels of service readiness were found among facilities in the western region (Mbarara district) and private facilities. Level III health centers were the most prepared for delivering secondary prevention. Health worker interviews revealed that limited awareness of RHD at the district level, lack of diagnostic tests and case management registries, and absence of clearly articulated RHD policies and budget prioritization were the main barriers to providing RHD-related healthcare. Conclusions/Significance Uganda’s readiness to implement the World Health Assembly RHD Resolution is low. The forthcoming national RHD strategy must focus on decentralizing RHD diagnosis and prevention to the district level, emphasizing specialized training of the primary healthcare workforce and strengthening supply chains of diagnostics and essential medicines.

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Shivgunde, Prashant P., et Archana D. Kodilkar. « Investigation of drug use at primary health centres in Nashik, Maharashtra, India ». International Journal of Research in Medical Sciences 8, n^o 1 (25 décembre 2019) : 290. http://dx.doi.org/10.18203/2320-6012.ijrms20195925.

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Background: By recognizing the need to promote rational utilization of medicines, the World Health Organization (WHO) in collaboration with the International Network for Rational Use of Drugs (INRUD) developed a set of core indicators. This study aimed to investigate drug use based on it.Methods: The study was performed in Primary Health Centers (PHC) in Nashik District, Maharashtra, India. Prescriptions data for the last one year from PHCs were sampled out retrospectively. Outpatients from PHCs were selected, observed and interviewed for the patient-care indicators, prospectively. Pharmacy personnel was interviewed for the facility-specific indicators. The data were analyzed; results and conclusions were drawn.Results: The average number of drugs per prescription was 3.48 (SD=0.36). The percentages of drugs prescribed by generic name and from Essential Drug List or formulary were 83.98% and 68.97% respectively. The percentages of encounters with antibiotics and injections were 60.33% and 50.83% respectively. The average consultation and dispensing times were 3.89 minutes and 58.28 seconds respectively. 98.19% of the prescribed drugs were actually dispensed. 67.27% of the dispensed drugs were labelled. The percentage of patients’ knowledge of the correct dosage was 87.78%. The percentage availability of the EDL or formulary was 100% and of the key drugs in the stock was 85.71%.Conclusions: The need for improvement in prescribing practices can be encouraged by devising strategies such as training to physicians, rewards systems, etc. There should be plans to increase staff members for a particular working period and to educate patients with healthcare, hygiene, medicines’ compliance and common diseases.

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Wasserman, Richard C., et Daria F. Ferro. « Using Electronic Health Record Data to Support Research and Quality Improvement : Practical Guidance from a Qualitative Investigation ». ACI Open 04, n^o 01 (janvier 2020) : e91-e101. http://dx.doi.org/10.1055/s-0040-1713421.

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Abstract Objective The aim of the study is to identify how academic health centers (AHCs) have established infrastructures to leverage electronic health record (EHR) data to support research and quality improvement (QI). Methods Phone interviews of 18 clinical informaticians with expertise gained over three decades at 24 AHCs were transcribed for qualitative analysis on three levels. In Level I, investigators independently used NVivo software to code and identify themes expressed in the transcripts. In Level II, investigators reexamined coded transcripts and notes and contextualized themes in the learning health system paradigm. In Level III, an informant subsample validated and supplemented findings. Results Level I analysis yielded six key “determinants”—Institutional Relationships, Resource Availability, Data Strategy, Response to Change, Leadership Support, and Degree of Mission Alignment—which, according to local context, affect use of EHR data for research and QI. Level II analysis contextualized these determinants in a practical frame of reference, yielding a model of learning health system maturation, over-arching key concepts, and self-assessment questions to guide AHC progress toward becoming a learning health system. Level III informants validated and supplemented findings. Discussion Drawn from the collective knowledge of experienced informatics professionals, the findings and tools described offer practical support to help clinical informaticians leverage EHR data for research and QI in AHCs. Conclusion The learning health system model builds on the tripartite AHC mission of research, education, and patient care. AHCs must deliberately transform into learning health systems to capitalize fully on EHR data as a staple of health learning.

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Shwetabh, Kumar, et Asha Ambhaikar. « Smart Health Monitoring System of Agricultural Machines : Deep Learning-based Optimization with IoT and AI ». BIO Web of Conferences 82 (2024) : 05007. http://dx.doi.org/10.1051/bioconf/20248205007.

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Implementing intelligent monitoring systems for Agricultural Machinery (AM) is hindered by the intricate and costly nature of the Internet of Things (IoT) sensor technologies. The heavy reliance on cloud and fog computing, the availability of network infrastructure, and the need for expert knowledge pose challenges in rural areas that lack network connectivity. Using edge devices, such as smartphones, which possess significant computational capabilities, is a potential solution that has not yet been fully realized in the commercial sphere. Furthermore, the increasing demand from users for economically viable and user-friendly technology serves as a driving force for transitioning away from expensive and intricate sensors towards more cost-effective alternatives. In the IoT era, there is anticipated to be a widespread network connection between a vast array of AM and service centers. Using smartphone applications has increased the potential for edge computation on smartphones to significantly aid in network traffic control. The development of an Artificial Intelligence (AI) - -based data analytic method poses a significant challenge due to the need to optimize for the limited computational capabilities of smartphones. However, the users’ demand for affordable technology renders it resistant to easy penetration. This paper uses IoT and AI to propose a Smart Health Monitoring System for Agricultural Machines with Deep Learning-based Optimization (SHMAM-DLO). This paper aims to propose a Fusion Genetic Algorithm (FGA) methodology and Artificial Neural Network (ANN) for optimization during monitoring the health of AM. The proposed approach enables cost-effective utilization of smartphone end devices by leveraging their built-in microphones instead of relying on expensive IoT sensors.

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Kushi, Lawrence H., Jeffrey S. Brown, Diana S. M. Buist, Jessica Chubak, V. Paul Doria-Rose et Kathleen M. Mazor. « Abstract IA23 : Opportunities and lessons learned from the Cancer Research Network ». Cancer Epidemiology, Biomarkers & ; Prevention 29, n^o 9_Supplement (1 septembre 2020) : IA23. http://dx.doi.org/10.1158/1538-7755.modpop19-ia23.

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Abstract Using health care systems data for research and care improvement is of intense interest. The now widespread availability of electronic health records (EHRs) holds great promise for population sciences cancer research. Founded in 1999, the Cancer Research Network (CRN) is a consortium of a dozen research groups affiliated with US integrated health care systems. CRN health care systems are pioneers in use of data systems to document and inform administrative and clinical aspects of health care. In addition to administrative (e.g., claims) data, the clinical databases of CRN health systems capture details of care that have generally not been available until the advent of EHRs. In most CRN health systems, such databases have been in use since at least the mid-1990s, with adoption of EHRs in the mid-2000s. CRN researchers developed the Virtual Data Warehouse (VDW) common data model to facilitate collaborative, multi-institution research. The VDW, with standardized data tables, variable names, and formats implemented at each participating research group, enables efficient multi-institution research collaborations. From a cancer research perspective, the VDW is also one of the only EHR-based common data models with tumor registry data of comparable quality to that of the SEER Program. Infusion medication data are also available in the VDW, and inclusion of results of clinical genetic and molecular tests is in development. The VDW is updated regularly, monthly or more frequently in most CRN institutions for most data domains. Advantages of conducting cancer research in the CRN setting include the ability to identify a “denominator” population, and the capture of primary and specialty care. Retention of health plan enrollees is high in CRN health systems, enabling longitudinal research. In most US health care settings, the population eligible to receive care cannot be identified, and data may be available for some, but not all, episodes of care. For example, tertiary-care cancer centers may have details on cancer treatment, but not information from primary care or other specialty care encounters. However, it is important to use caution because EHR data result from clinical encounters and associated activity and are not collected for research purposes; missingness is unlikely to be random and confounding by indication is an analytic and interpretational issue. Collaborative, efficient use of these data also requires navigating regulatory concerns. The federated nature of the VDW minimizes HIPAA-related privacy concerns, while agreed-upon human subjects and data use procedures facilitate collaborations. The CRN provides unparalleled opportunities for research across the full range of the cancer experience, from primary prevention to end of life, incorporating data from EHRs and other clinical and administrative databases. Use of these data and adherence to epidemiologic principles in the design of studies and their analysis and interpretation can greatly advance knowledge to decrease the burden of cancer. Citation Format: Lawrence H. Kushi, Jeffrey S. Brown, Diana S.M. Buist, Jessica Chubak, V. Paul Doria-Rose, Kathleen M. Mazor. Opportunities and lessons learned from the Cancer Research Network [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr IA23.

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Somerville, Mary M., Anita Mirjamdotter, Edmond Harjizi, Elham Sayyad-Abdi, Michele Gibney, Christine Bruce et Ian Stoodley. « Curating knowledge, creating change : : University Knowledge Center, Kosovo national transition ». IFLA Journal 46, n^o 2 (juin 2020) : 151–62. http://dx.doi.org/10.1177/0340035219883897.

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A collaborative system design initiative at the University for Business and Technology in Kosovo aims to make local knowledge visible and to enhance local knowledge creation, within the university and throughout the country. Since its inception in 2015, design activities aimed to activate systems through modeling the global knowledge landscape, technology enabled systems, and human activity processes. Within the framework of Informed Systems, application of Informed Learning Theory and Information Experience Design (IXD) guided prototyping systems that informed building an institutional repository named the UBT Knowledge Center. The knowledge vision anticipates that sustained curation, organization, discovery, access, and usage processes will accelerate academic engagement, national development, and global visibility, over time and with practice to further theory-to-practice and practice-to-theory.

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Lapeña, José Florencio F. « Impact, Not Just Impact Factor : Responding to the Manila Declaration on the Availability and Use of Health Research Information ». Philippine Journal of Otolaryngology-Head and Neck Surgery 30, n^o 2 (2 décembre 2015) : 4–5. http://dx.doi.org/10.32412/pjohns.v30i2.331.

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The journal impact factor is defined as “the average number of times (citable) articles from the journal published in the past two years have been cited in the JCR (journal citation report) year.”1 An impact factor of 1.5 means that on average, articles published 1-2 years ago have been cited one and a half times in journals included in the Web of Science. The impact factor has been used, misused and abused to rank journals within a discipline (and by inference, rank authors who are published in these journals), to evaluate the scholarly worth of a journal (and by extension, the worth of articles published in it), to decide institutional journal subscriptions, and to guide authors in choosing where to aim to submit articles to. But as has been eloquently pointed out by Amit Joshi2 the impact factor of a journal is not the same as its impact, or the impact of individual journal articles: A high impact factor journal may have zero impact in a remote Pacific island, just as a low impact (or no impact factor journal) may have very high impact in the country where it is read. More importantly, an article may achieve awesome impact, even if it is published in a low (or no) impact factor journal. “To achieve real impact, and not just impact factor,” the “Manila Declaration on the Availability and Use of Health Research Information in and for Low- and Middle-income Countries in the Asia Pacific Region” was launched at the 2015 Convention of the Asia Pacific Association of Medical Journal Editors (APAME 2015) held in Manila from 24 to 26 August 2015 in conjunction with the COHRED Global Forum on Research and Innovation for Health (FORUM 2015). It is concurrently published by Journals linked to APAME and listed in the Index Medicus of the South East Asia Region (IMSEAR) and the Western Pacific Region Index Medicus (WPRIM), and is published as a Special Announcement in this issue.3 It is also available online at http://www.wpro.who.int/entity/apame/publications/en/ at http://www.hifa2015.org/wp-content/uploads/Manila_Declaration_2015_FINAL_August_242.pdf and at http://www.equator-network.org/2015/08/28/the-manila-declaration/ The APAME 2015 convention in Manila was a meaningful and a memorable experience for the 500 editors, reviewers, authors, researchers, clinicians, scientists, students, librarians and publishers who joined us from all over the Philippines and around the world. Our participation in the New Leaders for Health Pre-Forum at the Philippine International Convention Center on August 22, our General Assembly and Joint Meeting with the Western Pacific Region Index Medicus and Index Medicus of the South East Asia Regions at the WHO Western Pacific Region Office on August 24, the Conjoint Sessions with the COHRED Global Forum on Research and Innovation for Health at the PICC from August 24-27 (broadcast on CNN Philippines), the APAME 2015 Convention at the Sofitel Philippine Plaza Hotel on August 25-26 (culminating in a HIFA Tweetchat), and 8th National Medical Writing Workshop and 1st Writeshop for Young Researchers at the Sofitel Philippine Plaza Hotel from August 27-28, comprised scientific sessions, workshops, discussions, special events and socials that were exemplary and inspiring. Through the Manila Declaration launched at the APAME 2015, we committed “ourselves and our journals to publishing innovative and solution-focused research in all healthcare and related fields … particularly health research applicable to low- and middle-income countries;” and committed “ourselves and our publishers to disseminating scientific, healthcare and medical knowledge fairly and impartially by developing and using … indices … databases … and open data systems.”3 Thus the response of the Philipp J Otolaryngol Head Neck Surg “to explore new paradigms, trends and innovations, especially with regard the social media… and “to consider the transition to a full open access model and adopting Creative Commons licenses.”4 With this issue, we begin that transition, by aligning our journal with the requirements for indexing in the Directory of Open Access Journals (DOAJ), “an online directory that indexes and provides access to high quality, open access, peer-reviewed journals.”5 An important part of this transition involves replacing the copyright transfer the Philippine Society of Otolaryngology Head and Neck Surgery requires of all authors published in our journal, with a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) or related license.6 We are also activating our Facebook, Twitter, and LinkedIn pages, and encourage published authors, reviewers, editors and readers to “like,” “tweet,” and comment on our published material and the discussions, blogs and microblogs that will arise from these. To this end, we will initiate the practice of posting “laymanized abstracts” of published scientific material on our social media sites, by requesting authors of articles accepted for publication to submit such abstracts. Meanwhile, we urgently need to improve our competencies in research, medical writing, and peer review – and this applies to young residents and senior consultants alike. While the quantity of manuscripts submitted to the journal has increased exponentially, the quality of these manuscripts leave much to be desired, as evinced by our tedious and thankless review and editing process. It is ironic that we are invited to speak on and conduct post-graduate courses and workshops in research, medical writing, peer review and editing by many other societies, colleges, academies, institutions, organizations and ministries around the country and abroad, but hardly within our very own Philippine Society of Otolaryngology Head and Neck Surgery. Be that as it may, our Fellows, Diplomates and Residents need regular medical writing and review workshops in order to improve the quality and impact of our journal articles, and consequently improve the impact of our journal. To this end, we all need to leave our comfort zones and welcome change. Pace Heraclitus, “no man steps in the same river twice, for it’s not the same river and he’s not the same man,” because “Παντα Ρει (Panta Rei)—All is Change.”7 These transitions will not come easily, nor will they happen overnight. But they are imperative if we are to uphold our commitment “to achieve real impact, and not just impact factor, as we advance free and open access to health information and publication that improves global health-related quality of life.”3

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Zulpikar, Firman, Abel Gandhy et Warsono El Kiyat. « PENINGKATAN AKSES PANGAN BAGI MASYARAKAT PERKOTAAN MELALUI PELATIHAN VERTICAL FARMING DAN PERTANIAN ORGANIK [IMPROVING FOOD ACCESS FOR A MARGINAL URBAN COMMUNITY THROUGH VERTICAL AND ORGANIC FARMING TRAINING] ». Jurnal Sinergitas PKM & ; CSR 4, n^o 2 (24 septembre 2020) : 115. http://dx.doi.org/10.19166/jspc.v4i2.1811.

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Housing and business centers are growing rapidly in the urban area. This causes agricultural land and other green lands increasingly narrow due to land conversion. One area affected by land conversion is Lengkong Kulon Village, Tangerang Regency, where most of the agricultural land has been turned into a residential area and business center. This condition has an impact on food availability which is getting lower and environmental quality is declining. To overcome these problems, Surya University, supported by the Ministry of Research, Technology, and Higher Education (Kemenristekdikti), organized community service activities by pioneering sustainable green villages and adequate nutrition through vertical farming. This program was implemented by the workshop and participatory community. The number of participants involved in this activity was more than 25 people from youth groups concerned about the environment, PKK members, and university students. This activity consisted of three stages: Community awareness building, Vertical and organic farming training, and Providing vertical farming equipment assistance packages. The result of this community service showed that participants knowledge about organic farming and vertical farming increased from 26% to 86% and from 11% to 72%, respectively. In addition, the level of community skills to apply organic farming systems also increased from 15% to 80%, and for vertical farming increased from 7% to 60%. This activity is expected to improve environmental conditions as well as food access for target communities through consumption of sufficients vegetables and fruits grown using the vertical farming system. Bahasa Indonesia Abstrak: Abstrak Pesatnya pembangunan komplek perumahan dan pusat bisnis di perkotaan telah menyebabkan semakin sempitnya lahan pertanian dan lahan hijau lainnya akibat alih fungsi lahan. Salah satu wilayah yang terkena dampak alih fungsi lahan adalah Kampung Lengkong Kulon, Desa Lengkong Kulon, Kabupaten Tangerang di mana sebagian besar lahan pertaniannya telah berubah menjadi kawasan perumahan dan pusat bisnis. Kondisi ini telah berimplikasi pada ketersediaan pangan yang semakin rendah serta kualitas lingkungan yang menurun. Untuk mengatasi permasalahan tersebut, Universitas Surya yang didukung oleh Kementristekdikti menyelenggarakan kegiatan pengabdian masyarakat dengan tema rintisan kampung hijau lestari dan cukup gizi melalui vertical farming. Program ini dilaksanakan menggunakan model workshop dan participatory community. Jumlah peserta yang terlibat dalam kegiatan ini yaitu lebih dari 25 orang, yang berasal dari kelompok pemuda peduli lingkungan, ibu-ibu PKK, anggota posyandu, serta kelompok mahasiswa. Tahapan kegiatan ini meliputi pembangunan kesadaran masyarakat (community awareness), pelatihan vertical farming dan pertanian organik, serta pemberian paket bantuan peralatan vertical farming. Hasil evaluasi pelatihan menunjukkan bahwa terjadi peningkatan pengetahuan masyarakat tentang pertanian organik dari semula hanya 26% menjadi 86%, sedangkan untuk vertical farming dari semula 11% meningkat menjadi 72%. Tingkat keterampilan masyarakat untuk menerapkan sistem pertanian organik juga meningkat dari semula hanya 15% menjadi 80%, sementara untuk untuk vertical farming dari semula 7% meningkat menjadi 60%. Kegiatan ini diharapkan dapat memperbaiki kondisi lingkungan serta adanya peningkatan akses pangan bagi masyarakat sasaran melalui konsumsi sayuran dan buahbuahan yang cukup, yang ditanam menggunakan sistem vertical farming.

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Gebreselassie, Lidetu. « Review on Dairy Production System, Constraints and Opportunities in Ethiopia ». Journal of Scientific and Innovative Research 8, n^o 4 (30 décembre 2019) : 108–11. http://dx.doi.org/10.31254/jsir.2019.8403.

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The objective of this paper was aimed to compile dairy cattle production system, main constraints and existing opportunities in Ethiopia. Based on their location the main milk production systems are namely as rural milk production, peri-urban and urban milk productions. Ethiopia has potential for dairy cattle production mainly to the reason of suitable environment and high cattle number that contains 59.5 million cattle populations. Even though Ethiopia has large dairy cattle population and favorable climatic conditions, self-sufficiency in milk production is low. The main constraints that affect milk production capacity of dairy cattle in Ethiopia includes feed shortage in terms of quality and quantity, high feed cost, land shortage and space limitation for farming of improved forage, insufficient veterinary services, diseases, water shortage, lack of market information, absence of improved breed in most parts of the country, poor artificial insemination service, lack of milk processing facilities, poor milk production potentials of local dairy cows, poor management of animals, adulteration, waste disposal, lack of market-oriented production. So, to solve the above-mentioned problems, it is very important to introduce improved forage, increase AI utilization efficiency, and improve the current condition of veterinary services. The finding of different authors conducted in different parts of the country indicated that the existence of large population of milk cows and diverse dairy animal’s genetic resources, fast growing population, change in living standard and income growth of people, rabid urbanization, growing demand and indigenous knowledge in the preservation of milk and milk products, availability of trained manpower, existence of research institutions and technologies, existence of service providers such as veterinary health and artificial insemination centers, development of infrastructural sector like road access, water supply, communication activities were the key opportunities to dairy production. Generally, the review highlighted that even dairy sector constrained by many factors there are still ample opportunities for dairying. Therefore, coordinated activities must be done by respective bodies to minimize the identified constraints which hinder dairy development.

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Hartaty, Ria, Sri Lestari Ramadhani Nasution, Ali Napiah Nasution et Ermi Girsang. « Affecting Factors BPJS Users on the Tiered Referral System in the Pokenjior Community Health Center, Padang Sidempuan City ». Budapest International Research and Critics Institute (BIRCI-Journal) : Humanities and Social Sciences 4, n^o 2 (22 avril 2021) : 1822–31. http://dx.doi.org/10.33258/birci.v4i2.1860.

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This study aims to determine the factors that influence BPJS users of the Tiered Referral System in the Work Area of Pokenjior Health Center, Padangsidimpuan City. This research is an analytical research type with explanatory research type. The populations in this study were all BPJS users or patients undergoing health services at the Pokenjior Public Health Center in Padang Sidempuan City with a sample of 98 patients participating in the Health BPJS. Data were collected using a questionnaire and analyzed using the Pearson Correlation test and multiple logistic regression tests. The results showed that there was an influence of BPJS user knowledge (p = 0.007), officer attitudes (p = 0.003), availability of infrastructure and human resources (p = 0.002), and referral information (p = 0.003) to the tiered referral system at Pokenjior Public Health Center. The results of multivariate analysis and modeling show that BPJS user knowledge, availability of infrastructure, and human resources and referral information are the dominant factors influencing the tiered referral system. Thus it was concluded that the knowledge factor of BPJS users, the availability of infrastructure and human resources as well as the referral information had a significant effect on the tiered referral system in Pokenjior Public Health Center, and the availability of infrastructure and human resources was the biggest or most dominant factor affecting the tiered referral system in the work area Pokenjior Public Health Center in Padangsidimpuan City

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Kusumawardani, Eva Flourentina, Meutia Paradhiba, Mardi Fadillah, Onetusfifsi Putra, Firman Firdauz Saputra, Perry Boy Chandra Siahaan, Rubi Rimonda, Laila Apriani Hasanah Harahap et Nasrianti Syam. « Gambaran Pelaksanaan Surveilans HIV di Dinas Kesehatan Provinsi Jawa Timur Tahun 2017 ». JOURNAL OF HEALTHCARE TECHNOLOGY AND MEDICINE 9, n^o 1 (19 avril 2023) : 741. http://dx.doi.org/10.33143/jhtm.v9i1.2977.

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Kasus HIV/AIDS terdapat hampir di semua negara di dunia tak terkecuali Indonesia. Penyakit ini telah menulari seluruh lapisan masyarakat termasuk bayi dan anak-anak. Perlu adanya kegiatan surveilans rutin untuk melakukan pencatatan dan pelaporan sehingga dapat memonitoring jumlah kasus pada periode waktu tertentu. Kegiatan surveilans HIV merupakan salah satu cara efektif untuk mengontrol penyebaran kasus HIV/AIDS. Tujuan penelitian: untuk memberikan gambaran evaluasi sistem surveilans HIV berdasarkan komponen sistem dan atribut surveilans di Dinas Kesehatan Provinsi Jawa Timur. Metode penelitian: jenis penelitian ini merupakan penelitian kualitatif dengan rancangan studi evaluasi. Pengumpulan data dilakukan dengan metode wawancara kepada petugas surveilans HIV di Dinas Kesehatan Provinsi Jawa Timur sejumlah 3 orang menggunakan kuesioner. Hasil penelitian: berdasarkan komponen sistem surveilans 66,7% petugas surveilans HIV memiliki tingkat Pendidikan S1 Kesehatan Masyarakat peminatan epidemiologi dan 33,3% adalah S2 Kesehatan Masyarakat. Pengumpulan, pengisian formulir hingga alur pelaporan dianggap mudah, dan tidak mengalami keterlambatan dalam proses input data ke aplikasi SIHA. Proses analisis hanya dilakukan ditingkat Dinas Kesehatan, sedangkan ditingkat Puskesmas tidak. Sistem surveilans HIV di Kabupaten/Kota di wilayah kerja Dinas Kesehatan Provinsi Jawa Timur masih memerlukan perbaikan dalam analisis, ketersediaan pedoman surveilans HIV, dan perlunya peningkatan pengetahuan petugas terkait surveilans HIV.Kata Kunci: Surveilans, HIV/AIDS, Komponen, SistemHIV/AIDS cases exist in almost every country worldwide, including Indonesia. This disease has affected all segments of society, including infants and children. Regular surveillance activities are needed to record and report cases, enabling the monitoring of the number of cases over specific periods of time. HIV surveillance is an effective method to control the spread of HIV/AIDS cases. The aim of this study was to provide an evaluation of the HIV surveillance system based on its components and surveillance attributes in the East Java Provincial Health Office. This qualitative study employed an evaluation study design. Data collection involved interviews with three HIV surveillance officers in the East Java Provincial Health Office, using a questionnaire. The results of the study revealed that 66.7% of the HIV surveillance officers possessed a bachelor's degree in Public Health with a specialization in epidemiology, while 33.3% held a master's degree in Public Health. The data collection, form completion, and reporting processes were considered easy, with no delays in inputting data into the SIHA application. The analysis process was only conducted at the Provincial Health Office level and not at the Primary Health Center level. The HIV surveillance system in the districts and cities within the jurisdiction of the East Java Provincial Health Office still requires improvement in terms of analysis, availability of HIV surveillance guidelines, and the need for increased knowledge among surveillance officers regarding HIV surveillance..Keywords: Surveillance, HIV/AIDS, Components, Systems

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Nelson, Joni D., et Irene M. Lubker. « Abstract 998 : Pursuing leadership in literacy to ameliorate head and neck cancer disparities ». Cancer Research 84, n^o 6_Supplement (22 mars 2024) : 998. http://dx.doi.org/10.1158/1538-7445.am2024-998.

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Abstract Overview of Proposed Research. Head and neck cancers are a deadly cancer that ranks among the six most common cancers worldwide. (American Cancer Society, 2021). Studies have shown greater disease burden among minority populations for head and neck cancer, higher mortality rates and lower oral cancer knowledge, but limited evidence has defined the underlying causes of late stage diagnoses and access to the healthcare system (Suzuki et al, 2019). More specifically, in comparison to the national rates, South Carolina is among the top ten for head and neck cancers (Community Outreach, Hollings Cancer Center, MUSC, 2019). Dental and primary care play a critical role delivering quality patient education, prevention, risk reduction and treatment regimes. However, there is a paucity of information published on the value of designing and implementing a health literacy program to prioritize head and neck cancer screening and prevention. Rural communities face unique challenges to achieving optimal oral health, impacted mainly by geographic location and socioeconomic status (IOM&NRC, 2011). More specifically, rural southern states such as SC continues to have a tremendous shortage of primary care providers. SC currently has 44 of 46 counties designated as geographic Primary Care and Dental Health Professional Shortage Areas and approximately 25% of SC citizenry are living in rural areas (HRSA, 2018). Because the vast majority of the state has challenges with availability of primary care and dental providers, this potentially exacerbates access to care inequities for rural and underserved minority populations. To enhance the quality and equity of oral cancer prevention in rural SC, it is critical that we prioritize strategies to elevate the significance of head and neck cancer risks. Therefore, the need to design and deliver innovative strategies to increase opportunities that intersect the healthcare system and community is inevitable. In this regard, we propose PULL A-HEAD, Pursuing Leadership in Literacy to Ameliorate HEAd and neck cancer Disparities. PULL A-HEAD is aimed to develop and implement a community-centered approach design for increasing the health literacy and efficacy of navigating the healthcare system for early detection of head and neck cancers. In this presentation we will share outcome and impact results of a community-centered, health literacy program in collaboration with our Regional Medical Library - Region 2 (RML2), National Library of Medicine partners at the Medical University of South Carolina. The program (i.e. PULL A-HEAD) will emphasize the delivery of health literacy education and health systems navigation tools to improve the early detection of head and neck cancers. Citation Format: Joni D. Nelson, Irene M. Lubker. Pursuing leadership in literacy to ameliorate head and neck cancer disparities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 998.

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De Leeuw, Jacqueline A., Hetty Woltjer et Rudolf B. Kool. « Identification of Factors Influencing the Adoption of Health Information Technology by Nurses Who Are Digitally Lagging : In-Depth Interview Study ». Journal of Medical Internet Research 22, n^o 8 (14 août 2020) : e15630. http://dx.doi.org/10.2196/15630.

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Background The introduction of health information technology (HIT) has drastically changed health care organizations and the way health care professionals work. Some health care professionals have trouble coping efficiently with the demands of HIT and the personal and professional changes it requires. Lagging in digital knowledge and skills hampers health care professionals from adhering to professional standards regarding the use of HIT and may cause professional performance problems, especially in the older professional population. It is important to gain more insight into the reasons and motivations behind the technology issues experienced by these professionals, as well as to explore what could be done to solve them. Objective Our primary research objective was to identify factors that influence the adoption of HIT in a sample of nurses who describe themselves as digitally lagging behind the majority of their colleagues in their workplaces. Furthermore, we aimed to formulate recommendations for practice and leadership on how to help and guide these nurses through ongoing digital transformations in their health care work settings. Methods In a Dutch university medical center, 10 face-to-face semi-structured interviews were performed with registered nurses (RN). Ammenwerth’s FITT-framework (fit between the Individual, Task, and Technology) was used to guide the interview topic list and to formulate themes to explore. Thematic analysis was used to analyze the interview data. The FITT-framework was also used to further interpret and clarify the interview findings. Results Analyses of the interview data uncovered 5 main categories and 12 subthemes. The main categories were: (1) experience with digital working, (2) perception and meaning, (3) barriers, (4) facilitators, and (5) future perspectives. All participants used electronic devices and digital systems, including the electronic health record. The latter was experienced by some as user-unfriendly, time-consuming, and not supportive in daily professional practice. Most of the interviewees described digital working as “no fun at all,” “working in a fake world,” “stressful,” and “annoying.” There was a lack of general digital knowledge and little or no formal basic digital training or education. A negative attitude toward computer use and a lack of digital skills contributed to feelings of increased incompetency and postponement or avoidance of the use of HIT, both privately and professionally. Learning conditions of digital training and education did not meet personal learning needs and learning styles. A positive impact was seen in the work environment when colleagues and nurse managers were aware and sensitive to the difficulties participants experienced in developing digital skills, and when there was continuous training on the job and peer support from digitally savvy colleagues. The availability of a digital play environment combined with learning on the job and support of knowledgeable peers was experienced as helpful and motivating by participants. Conclusions Nurses who are digitally lagging often have had insufficient and ineffective digital education. This leads to stress, frustration, feelings of incompetency, and postponement or avoidance of HIT use. A digital training approach tailored to the learning needs and styles of these nurses is needed, as well as an on-the-job training structure and adequate peer support. Hospital management and nurse leadership should be informed about the importance of the fit between technology, task, and the individual for adequate adoption of HIT.

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Baloian, Nelson, et José Pino. « Editorial introduction to J.UCS special issue Challenges for Smart Environments – Human-Centered Computing, Data Science, and Ambient Intelligence I ». JUCS - Journal of Universal Computer Science 27, n^o 11 (28 novembre 2021) : 1149–51. http://dx.doi.org/10.3897/jucs.76554.

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Modern technologies and various domains of human activities increasingly rely on data science to develop smarter and autonomous systems. This trend has already changed the whole landscape of the global economy becoming more AI-driven. Massive production of data by humans and machines, its availability for feasible processing with advent of deep learning infrastructures, combined with advancements in reliable information transfer capacities, open unbounded horizons for societal progress in close future. Quite naturally, this brings also new challenges for science and industry. In that context, Internet of things (IoT) is an enormously huge factory of monitoring and data generation. It enables countless devices to act as sensors which record and manipulate data, while requiring efficient algorithms to derive actionable knowledge. Billions of end-users equipped with smart mobile phones are also producing immensely large volumes of data, being it about user interaction or indirect telemetry such as location coordinates. Social networks represent another kind of data-intensive sources, with both structured and unstructured components, containing valuable information about world’s connectivity, dynamism, and more. Last but not least, to help businesses run smoothly, today’s cloud computing infrastructures and applications are also serviced and managed through measuring huge amounts of data to leverage in various predictive and automation tasks for healthy performance and permanent availability. Therefore, all these technology areas, experts and practitioners, are facing innovation challenges on building novel methodologies, accurate models, and systems for respective data-driven solutions which are effective and efficient. In view of the complexity of contemporary neural network architectures and models with millions of parameters they derive, one of such challenges is related to the concept of explainability of the machine learning models. It refers to the ability of the model to give information which can be interpreted by humans about the reasons for the decision made or recommendation released. These challenges can only be met with a mix of basic research, process modeling and simulation under uncertainty using qualitative and quantitative methods from the involved sciences, and taking into account international standards and adequate evaluation methods. Based on a successful funded collaboration between the American University of Armenia, the University of Duisburg-Essen and the University of Chile, in previous years a network was built, and in September 2020 a group of researchers gathered (although virtually) for the 2nd CODASSCA workshop on “Collaborative Technologies and Data Science in Smart City Applications”. This event has attracted 25 paper submissions which deal with the problems and challenges mentioned above. The studies are in specialized areas and disclose novel solutions and approaches based on existing theories suitably applied. The authors of the best papers published in the conference proceedings on Collaborative Technologies and Data Science in Artificial Intelligence Applications by Logos edition Berlin were invited to submit significantly extended and improved versions of their contributions to be considered for a journal special issue of J.UCS. There was also a J.UCS open call so that any author could submit papers on the highlighted subject. For this volume, we selected those dealing with more theoretical issues which were rigorously reviewed in three rounds and 6 papers nominated to be published. The editors would like to express their gratitude to J.UCS foundation for accepting the special issues in their journal, to the German Research Foundation (DFG), the German Academic Exchange Service (DAAD) and the universities and sponsors involved for funding the common activities and thank the editors of the CODASSCA2020 proceedings for their ongoing encouragement and support, the authors for their contributions, and the anonymous reviewers for their invaluable support. The paper “Incident Management for Explainable and Automated Root Cause Analysis in Cloud Data Centers” by Arnak Poghosyan, Ashot Harutyunyan, Naira Grigoryan, and Nicholas Kushmerick addresses an increasingly important problem towards autonomous or self-X systems, intelligent management of modern cloud environments with an emphasis on explainable AI. It demonstrates techniques and methods that greatly help in automated discovery of explicit conditions leading to data center incidents. The paper “Temporal Accelerators: Unleashing the Potential of Embedded FPGAs” by Christopher Cichiwskyj and Gregor Schiele presents an approach for executing computational tasks that can be split into sequential sub-tasks. It divides accelerators into multiple, smaller parts and uses the reconfiguration capabilities of the FPGA to execute the parts according to a task graph. That improves the energy consumption and the cost of using FPGAs in IoT devices. The paper “On Recurrent Neural Network based Theorem Prover for First Order Minimal Logic” by Ashot Baghdasaryan and Hovhannes Bolibekyan investigates using recurrent neural networks to determine the order of proof search in a sequent calculus for first-order minimal logic with a history mechanism. It demonstrates reduced durations in automated theorem proving systems.  The paper “Incremental Autoencoders for Text Streams Clustering in Social Networks” by Amal Rekik and Salma Jamoussi proposes a deep learning method to identify trending topics in a social network. It is built on detecting changes in streams of tweets. The method is experimentally validated to outperform relevant data stream algorithms in identifying “hot” topics. The paper “E-Capacity–Equivocation Region of Wiretap Channel” by Mariam Haroutunian studies a secure communication problem over the wiretap channel, where information transfer from the source to a legitimate receiver needs to be realized maximally secretly for an eavesdropper. This is an information-theoretic research which generalizes the capacity-equivocation region and secrecy-capacity function of the wiretap channel subject to error exponent criterion, thus deriving new and extended fundamental limits in reliable and secure communication in presence of a wiretapper. The paper “Leveraging Multifaceted Proximity Measures among Developers in Predicting Future Collaborations to Improve the Social Capital of Software Projects” by Amit Kumar and Sonali Agarwal targets improving the social capital of individual software developers and projects using machine learning. Authors’ approach applies network proximity and developer activity features to build a classifier for predicting the future collaborations among developers and generating relevant recommendations.

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MOOS, BERNHARD, DANIEL BEIMBORN, HEINZ-THEO WAGNER et TIM WEITZEL. « THE ROLE OF KNOWLEDGE MANAGEMENT SYSTEMS FOR INNOVATION : AN ABSORPTIVE CAPACITY PERSPECTIVE ». International Journal of Innovation Management 17, n^o 05 (octobre 2013) : 1350019. http://dx.doi.org/10.1142/s1363919613500199.

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What is the role of Knowledge Management Systems (KMS) for a firm's innovativeness and absorptive capacity (ACAP)? Research shows that a firm's capacity to acquire and utilise relevant knowledge, i.e., its absorptive capacity, is decisive for innovation success. We develop a theoretical model that links the availability and usage of KMS with a firm's ACAP and its organisational knowledge to explain its contribution for a firm's innovation success. Using data from 222 manufacturing firms, we can show that the availability of a KMS in a firm affects its innovation success by contributing to its ACAP. Looking at the impact of different knowledge types on innovativeness, the results show that only technological knowledge is a substantial determinant of innovation success but not market knowledge.

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Beaumont, Jon. « Knowledge Management : a Systems Case Study from Shearman & ; Sterling LLP ». Legal Information Management 17, n^o 4 (décembre 2017) : 220–28. http://dx.doi.org/10.1017/s1472669617000433.

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AbstractPre-2013, Shearman & Sterling employed only two full-time knowledge management (KM) professionals across the globe. As Jon Beaumont describes, there was no centralised method of storage or retrieval for knowledge and Attorneys would have to contend with searching the firm's Document Management System (DMS), SharePoint intranet, internal discussion boards or ten disparate knowledge systems for document and matter information. ‘Knowledge Center’ was launched in 2015, following two years of planning, aimed at consolidating firm systems and providing users with a single interface to access any required know-how. This article will touch upon the consolidation and migration of information, but focus predominantly on Knowledge Center itself, examining functionality, search, filtering and browse. Processes for better knowledge identification of both document and matter know-how, all of which have contributed to the success of Knowledge Center, shall also be considered.

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Samet, S., A. Chelbi et F. Hmida. « Repairable systems availability optimization under imperfect maintenance ». Bulletin of the Polish Academy of Sciences : Technical Sciences 57, n^o 3 (1 septembre 2009) : 249–56. http://dx.doi.org/10.2478/v10175-010-0126-z.

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Repairable systems availability optimization under imperfect maintenanceThis paper deals with the modeling of a preventive maintenance strategy applied to a single-unit system subject to random failures. According to this policy, the system is subjected to imperfect periodic preventive maintenance restoring it to ‘as good as new’ with probability p and leaving it at state ‘as bad as old’ with probability q. Imperfect repairs are performed following failures occurring between consecutive preventive maintenance actions, i.e the times between failures follow a decreasing quasi-renewal process with parametera. Considering the average durations of the preventive and corrective maintenance actions as well as their respective efficiency extents, a mathematical model is developed in order to study the evolution of the system stationary availability and determine the optimal PM period which maximizes it. The modeling of the imperfection of the corrective maintenance actions requires the knowledge of the quasi-renewal function. A new expression approximating this function is proposed for systems whose times to first failure follow a Gamma distribution. Numerical results are obtained and discussed.

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Pay, Dece Mery Natalia, Mindo Sinaga et Marthen R. Pelokilla. « Utilization of Health Operational Assistance (BOK) in Nutrition Services in Public Health Center ». Jurnal Kesehatan Masyarakat 12, n^o 2 (14 mars 2017) : 313–22. http://dx.doi.org/10.15294/kemas.v12i2.6045.

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Since BOK was launched in 2010, BOK utilization rate continued to increase while the NTT provincial nutrition service coverage did not increase, until 2013. This research aimed to analyze the relationship between the availability of operational funds, the availability of human resources, officers knowledge, infrastructure support, heads support and the appropriateness of fund utilization using BOK in nutritional services. This was a quantitative research which supported by a qualitative, cross-sectional design in 2015. The total sample of 250 health workers in 26 health centers of North Central Timor regency was included in this study. Data analysis was done using descriptive, bivariate and multivariate analyses. The results of the bivariate analysis using chi square test showed an association of (p <0.05) the availability of human resources (p = 0.017), officers knowledge (p = 0.000), infrastructure support (p = 0.004), heads support (p = 0.000) and the appropriateness of BOK fund utilization (p = 0.000) with the use of BOK in nutritional services. Meanwhile, the availability of operational funds is not associated with the use of BOK in nutritional services. Multivariate analysis showed that health centers with adequate human resources availability are seven times more likely to take advantage and make a good use of the nutritional services using BOK compared to health centers with the lack of human resources, after the infrastructure and head variable controlled. The government is required to provide adequate human resources, including financial administrative personnel and operational funding for health centers to optimize nutritional services. The government also needs to monitor the use of funds regularly and tiered to improve service coverage at the health center.

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Magfirah, Magfirah, A. Rizki Amelia Ap et Wardiah Hamzah. « Faktor yang berhubungan dengan Rujukan Pasien Peserta BPJS di Puskesmas Bangkala Kota Makassar Tahun 2023 ». JUMANTIK (Jurnal Ilmiah Penelitian Kesehatan) 9, n^o 1 (13 février 2024) : 83. http://dx.doi.org/10.30829/jumantik.v9i1.15481.

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The health service referral system is the organization of health services that regulates the delegation of duties and responsibilities of health services reciprocally both vertically and horizontally. The purpose of this study was to determine the factors related to patient referral participants (BPJS) at the Bangkala Health Center, Makassar City in 2023. . This type of research is a quantitative observational study using a cross sectional approach. The population in this study is the BPJS participant community who visited the Bangkala Health Center in Makassar City in the last month of 2022 with a total of 956 participants. The samples in this study were 282 samples. The sampling technique is using probability sampling method with accidental sampling technique. The results showed that there was no relationship with knowledge (p=0.873). Meanwhile, the variables significantly related to BPJS patient referrals were the availability of medicines (p=0.000) and the availability of medical devices (p=0.000). The conclusion from this study is that there is a relationship between the availability of medicines, the availability of medical devices and BPJS referrals. While the knowledge variable is not related to BPJS patient referrals.

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