Port strategy and performance: empirical evidence from major container ports and implications for role of data analytics

Container ports operate in more challenging and volatile environments at present times. Events such as US-China trade tensions and the COVID-19 pandemic severely affect numerous container ports at various levels. Strategies pursued by container ports are key to port development and management amidst these challenges. Drawing on configuration theory, this research employs Fuzzy-set Qualitative Comparative Analysis to investigate the relation between port strategies and container throughput. The research contributes to the literature by proposing an approach to account for complexity of the port sector and offers insights into strategies adopted by major container ports. The research further identifies 10 port strategies and proposed indicators that can represent the essence of these strategies. Being able to represent strategies in a quantitative format is important for strategy analysis and performance evaluation. Results reveal that major container ports employ a combination of strategies which address both the supply and demand-side aspects of the port business. Growing digitalization and digitization coupled with advancements in information capture, diagnostics capabilities and predictive abilities means a greater role for data analytics to influence container port strategy and performance. Implications for port managers, policy makers and researchers from the perspective of port policy and management are proposed.

Reassures Me There Are People Around Who Care about Me: Analyzing Meanings of Support for People with Epilepsy

Aims The study aimed to examine the nature and outcomes of social support for the well-being and quality of life (QoL) of adults with epilepsy. Methods The Australian Epilepsy Longitudinal Survey's 5 th Wave included the Medical Outcomes Study Modified Social Support Survey on four dimensions of social support and the QOLIE-31. Both numerical data and open-ended responses were analyzed quantitatively and qualitatively. A mixed method was used where quantitative analysis used t -tests, analysis of variance and block recursive regression, and qualitative analysis identified themes. Results Three-hundred thirty-two people with epilepsy (PWE) participated. The quantitative component showed that for emotional/informational support being older and living alone were key factors. These as well as household income were important in tangible support. For affectionate support living alone and household income were factors, but only income was a factor for positive social interaction. In addition, only positive social interaction predicted increased QoL. In the qualitative component of the study both positive and negative supports were identified for the emotional/informational supports. Many reported the benefits of having information, although some reported failure to have their needs taken seriously by health professionals or epilepsy associations. Inability to drive was an important feature of negative tangible support as was finding some assistive services unaffordable. Reports of positive social interaction identified being accepted as a person with epilepsy that is the primary concern. Peer support plays a role here. Discussion The findings of factors affecting the four dimensions of support in this study have supported a number of studies. This includes the effects of positive social interaction on QoL. The qualitative analysis supports these results, but it also contributes to deeper understanding of support in the lives of PWE. Conclusion Social support is a particularly important issue for PWE. The results of this study demonstrate the complexities and benefits of obtaining the appropriate forms of support. This survey took place before the coronavirus disease 2019 pandemic and it may well be that this phenomenon affects PWE's support needs. Copyright © 2023. Indian Epilepsy Society. All rights reserved.

A Qualitative Analysis of Physician, Staff, and Patient Perspectives During the Discharge Process for Vascular Patients

Objectives: Evidence demonstrates that when hospitals focus on the discharge process patient safety improves and overall costs decline. Hospital discharge requires care coordination of multiple disciplines, often leading to fragmented care, and adverse outcomes after discharge include emergency department visits and hospital readmissions. The Re-Engineered Discharge (RED) process was developed as an evidence-based strategy to improve the hospital discharge. We evaluated perspectives and priorities of physicians, health care workers, and patients involved in the vascular discharge process using RED as a framework. Method(s): A single-center qualitative analysis using a semi-structured focus groups and an interview guide based on the RED process. Focus groups were Zoom platform recorded, transcribed into text files, independently coded, and analyzed with Dedoose qualitative software using a directed content analysis approach. Thematic concepts were created, and comparisons between groups were analyzed by coding frequency. Researchers independently thematically coded each transcript;prior to analysis, all redundancy of codes was resolved;and all team members agreed on text categorization and coding frequency. Result(s): Eight focus groups with 38 participants were performed. Participants included: physicians (n = 13), nursing and ancillary staff (n = 19), and patients/caregivers (n = 6). Transcript analyses revealed facilitators and barriers to discharge. Overarching themes identified from the qualitative analysis frequencies are displayed by stakeholder role (Fig 1). Themes identified with the greatest coding frequencies included helpfulness of discharge instructions, patient health literacy, patient medical complexity, poor interdisciplinary team communication, time constraints during discharge, technology literacy of patients, barriers to obtaining medications for patients, barriers to organizing outpatient services for health care workers, barriers for patients to obtain help after discharge, and the impact of COVID-19. Conclusion(s): These findings identify the need to strengthen efforts to overcome stakeholder barriers to improve patient safety at the interface of the hospital to create a well-organized discharge. Physicians were most concerned with low patient health literacy, patient understanding of discharge instructions, organizing outpatient services, and overall patient medical complexity hindering a smooth discharge. Health care staff identified time constraints, obtaining medications and, and inter-team communication as their greatest obstacles to an organized discharge. Patients found the complexity and amount of discharge instructions, the impact of COVID-19 on support systems, and technology utilization after discharge most challenging. Modifications to address individual stakeholder barriers within the discharge process are needed to develop a national standardized discharge specific for vascular surgery patients to improve patient safety and satisfaction. [Formula presented]Copyright © 2023

Governing systemic and cascading disaster risk in Indonesia: where do we stand and future outlook

PurposeThis paper aims to identify key factors for a contextualised Systemic Risk Governance (SRG) framework and subsequently explore how systemic risks can be managed and how local institutional mechanisms can be tweaked to deal with the complex Indonesian risk landscape.Design/methodology/approachUsing a case study from Palu triple-disasters in Central Sulawesi, Indonesia, the authors demonstrate how inland earthquakes in 2018 created cascading secondary hazards, namely tsunamis, liquefactions and landslides, caused unprecedented disasters for the communities and the nation. A qualitative analysis was conducted using the data collected through a long-term observation since 2002.FindingsThe authors argue that Indonesia has yet to incorporate an SRG approach in its responses to the Palu triple-disasters. Political will is required to adopt more appropriate risk governance modes that promote the systemic risk paradigm. Change needs to occur incrementally through hybrid governance arrangements ranging from formal/informal methods to self- and horizontal and vertical modes of governance deemed more realistic and feasible. The authors recommend that this be done by focusing on productive transition and local transformation.Originality/valueThere is growing awareness and recognition of the importance of systemic and cascading risks in disaster risk studies. However, there are still gaps between research, policy and practice. The current progress of disaster risk governance is not sufficient to achieve the Sendai Framework for Disaster Risk Reduction (2015–2030) unless there is an effective governing system in place at the local level that allow actors and institutions to simultaneously manage the interplays of multi-hazards, multi-temporal, multi-dimensions of vulnerabilities and residual risks. This paper contributes to these knowledge gaps.

DIBR–DOMBI–FUZZY MAIRCA Model for Strategy Selection in the System of Defense

Strategic management has applications in many areas of social life. One of the basic steps in the process of strategic management is formulating a strategy by choosing the optimal strategy. Improving the process of selecting the optimal strategy with MCDM methods and theories that treat uncertainty well in this process, as well as the application of other and different selection criteria, is the basic idea and goal of this research. The improvement of the process of the aforementioned selection in the defense system was carried out by applying a hybrid model of multicriteria decision-making based on methods defining interrelationships between ranked criteria (DIBR) and multiattributive ideal-real comparative analysis (MAIRCA) modified by triangular fuzzy numbers–"DIBR–DOMBI–Fuzzy MAIRCA model.” The DIBR method was used to determine the weight coefficients of the criteria, while the selection of the optimal strategy, from the set of offered methods, was carried out by the MAIRCA method. This was done in a fuzzy environment with the aim of better treatment of imprecise information and better translation of quantitative data into qualitative data. In the research, an analysis of the model's sensitivity to changes in weight coefficients was performed. Additionally, a comparison of the obtained results with the results obtained using other multicriteria decision-making methods was conducted, which validated the model and confirmed stable results. In the end, it was concluded that the proposed MCDM methodology can be used for choosing a strategy in the defense system, that the results of the MCDM model are stable and valid, and that the process has been improved by making the choice easier for decision makers and by defining new and more comprehensive criteria for selection.

Qualitative methods in a learning healthcare system: Balancing rigour and the need for rapid analysis and dissemination

Qualitative methods are used to capture stakeholder perspectives within learning healthcare systems (LHS), but there is a need to specify methods that balance rigour and pragmatic approaches to inform quality improvement (QI). Utilizing examples from two QI projects within the OTNY LHS, we illustrate methods and strategies that build team capacity and flexibility to respond to an evolving LHS. Method(s): Qualitative methods were tailored to fit each project's timelines and goals, to inform both practice and research. Tools to facilitate rapid cycle feedback included interview/focus group summary templates, aggregate summaries that synthesize findings by stakeholder group, case matrix templates for rapid extraction and systematic categorization of data along topic areas, and dissemination materials adapted for stakeholder audience and project phases. Strategies to maintain rigour included processes for data reduction and interpretation, a multi-disciplinary approach for analysis, frequent consensus-based meetings, data triangulation, and member checks. Result(s): Rapid cycle approaches yielded interim results that reshaped research questions or identified critical gaps. Case summary analysis exploring the impact of COVID-19 revealed limited information on telehealth challenges amongst OTNY participants, necessitating a shift in recruitment and interview focus. For another project, analytic methods were sequenced to rapidly inventory suggestions from interview summaries on how to enhance OTNY practice to better address racism, while subsequent thematic analysis of transcripts captured participants' experiences of racism for context. Challenges included concurrent alignment of data collection and analysis, tailoring summary templates to maximize utility for rapid analysis, and maintaining flexibility to respond to evolving findings and LHS stakeholder input. Conclusion(s): The diverse methods and strategies illustrated by these projects offer guidance for balancing.

International Students' Perceptions towards Their Learning Experience in an International Network Seminar in Japan: During and Post the COVID-19 Pandemic

The COVID-19 pandemic has struck educational experience systems around the globe. This paper investigates and evaluates the student participants' perceptions who joined the international exchange seminar on global citizenship and peace held at a University in Hiroshima, Japan. Approximately seventy students and faculty members from nine to ten different universities from around the globe joined this summer program in August 2021 (online) and 2022 (face-to-face). This study is a mixed-method study. The first part consists of a quantitative analysis of BEVI data obtained from the students in the seminar before COVID-19 and after. The research concludes that there are no changes in the effects of what students learn. The second part consists of qualitative data. The data shows the perceptions of students of online teaching versus hybrid teaching. It compares the differences in participants' perceptions reported in students' feedback on the programs during and post-COVID-19. Our results confirm prominent differences exist in the students' perceptions of their learning experience during the pre-pandemic and post-pandemic periods. The findings indicate based on lessons learned post-pandemic, universities need to strive and define the meaning and purpose of international seminars, which enable students to experience a high level of intercultural social interaction online and face-to-face. As the world becomes more interconnected, virtual environments, such as the ones presented within the International Seminar in Hiroshima, Japan, are vital to facilitating intercultural teaching environments and the implications within this paper indicate that these virtual mediums can promote inclusion, leading to a more sustainable world.

Verification and validation of a framework for collaborative BIM implementation, measurement and management (CIMM)

PurposeThe purpose of this research is to develop through a two-stage verification and validation process a novel implementation framework for collaborative BIM, utilising experts from academia and industry as well as a real-world case study project.Design/methodology/approachThe aim of this research was to build upon previous research findings by the authors in order to develop an implementation framework that stems from ousting the inefficiencies of current collaborative BIM practices. This is achieved by a more objectified and quantified approach towards seeking heightened transparency and objectivism of what is required through the implementation of BIM. The mixed research methods technique of both qualitative and quantitative data collection was utilised, with the structure consisting of a two-stage approach utilising the Delphi model for verification and validation. This was developed to test the novelty and beneficial structure hypothesis involving 15 core BIM experts from academia, construction and design with c. 22 years average experience. Validation was undertaken on a complex, high value real world building structures project in central London, inclusive of 8 core project BIM experts. The research utilised a developed solution that mirrored and provided a more holistic representation guiding the practitioners as a project team step by step through the determination of underpinning elements, which support the goal of enhanced information requirements as well as executing the prioritisation measurement tools as part of the framework. Data ascertained at the workshop case study prioritised areas of importance that are core in supporting the delivering of these enhanced information requirements at a project delivery level, which were in order of prioritisation determined by the project team (1) constraints (39.17%), (2) stakeholder requirements (35.78%), (3) coordination (existing asset) (15.86%), (4) exchange requirements (5.38%) and (5) level of information need (3.81%). Furthermore, risk mitigations for the top three priorities were focussed on early stakeholder engagement, appropriation of survey data collection, focus on quality of outputs and applying toolsets and processes with meaning and emphasis on the defined high-level requirements.FindingsFindings show that the framework and the developed solution translate the process methodology of the framework schema into a useable and beneficial tool that provides both qualitative and quantitative inputs and outputs. Furthermore, a collective agreement on the objectives, risk mitigations and assignment of tasks in order to achieve outcomes is presented, with evidence on numerical weightings and goal achievement.Research limitations/implicationsDue to the impacts of COVID-19 on physical engagements both the verification (electronic survey questionnaire) and validation (case study project) were undertaken remotely, using available technologies and web interfaces.Practical implicationsThe case study workshop was limited to one building structures project in central London of a value of c. £70 m design and build cost that the project team (participants) were actively engaged with.Social implicationsThe social impacts of this research has resulted in the review of existing systems, methods and approaches from a wider perspective of theoretical and applied environments, which led to the development of a novel approach and framework guided by an interactive and useable solution.Originality/valueAs shown within the core findings, experts across academia and industry (design and construction) confirmed that the framework methodology and application were 100% novel, and added a benefit to the existing collaborative BIM approach. Value added is that through objectifying, weighting/prioritizing and creating a discussion supported by qualitative and quantitative reasoning the focus on what collaborative BIM is to achieve is increased, and thus the likelihood of successful implementation.

Pandemic related mental health

OnTrackNY is a nationally recognized Coordinated Specialty Care model disseminated across New York state for young people experiencing early non-affective psychosis. OnTrackNY is a network of 22 teams located in licensed outpatient clinics, serving over 2500 individuals. OnTrackNY offers medication management, case management, individual and group cognitive behaviourally oriented therapy, family support and psychoeducation, supported employment and education, and peer support services. Teams receive training for implementation through an intermediary organization called OnTrack Central. OnTrackNY was selected as a regional hub of the National Institute of Mental Health Early Psychosis Intervention Network (EPINET), a national learning healthcare system (LHS) for young adults with early psychosis. This symposium will present the different ways in which EPINET OnTrackNY implemented systematic communitybased participatory processes to ensure robust stakeholder involvement to improve the quality of OnTrackNY care. Florence will present results of an assessment of stakeholder feedback experiences used to develop strategies for assertive outreach and engagement of program participants, families and providers. Bello will present on mechanisms for integrating of co-creation principles to design, develop and execute quality improvement projects in EPINET OnTrackNY. Stefancic will present on quality improvement projects that used rapid cycle qualitative methods, tools, and strategies to build team capacity and flexibility to respond to an LHS. Montague will present adaptations to OnTrackNY services during the COVID-19 pandemic using an implementation science framework. Finally, Patel will lead a discussion on the implications of involving individuals with lived experiences in all phases of the process to maximize learning in an LHS.

Isometric thumb extension exercise as part of a multimodal intervention for de Quervain's syndrome: A randomised feasibility trial

Introduction: de Quervain's syndrome is a painful condition commonly presented to hand therapists. Exercise is utilised as an intervention, but isometric exercise has not been investigated. We aimed to assess the feasibility and safety of isometric thumb extension exercise for de Quervain's syndrome and to explore differences between high-load and low-load isometric exercise. Method(s): This parallel-group randomised clinical feasibility trial included individuals with de Quervain's syndrome. All participants underwent a 2 week washout period where they received an orthosis, education, and range of motion exercises. Eligible participants were then randomised to receive high or low-load isometric thumb extension exercises, performed daily for 4 weeks. Feasibility and safety were assessed by recruitment and drop-out rates, adherence, adverse events, and participant feedback via semi-structured interviews. Secondary outcomes included patient-reported outcomes for pain and function, and blinded assessment of range of motion and strength. Result(s): Twenty-eight participants were randomised. There were no drop-outs after randomisation, and no serious adverse events. Adherence to exercise was 86.7%, with 84% of participants stating they would choose to participate again. There were clinically and statistically significant improvements in pain and function over time (p < 0.001) but not in range of motion or strength. There were no statistically significant between-group differences. Conclusion(s): Isometric thumb extension exercise within a multimodal approach appears a safe and feasible intervention for people with de Quervain's syndrome. A large multi-centre trial would be required to compare high- and low-load isometric exercises. Further research investigating exercise and multimodal interventions in this population is warranted.Copyright © The Author(s) 2023.

Implementation and sustainability of public health approaches for mental health and wellbeing in schools

Aims: With increasing prevalence of emotional difficulties in children and young people in England, there is a growing emphasis on prevention programs delivered in school settings. The Education for Wellbeing program is working with around 400 schools in England to evaluate five universal mental health and wellbeing interventions Here, we present an overview of the Education for Wellbeing program and describe patterns across different school settings in barriers and facilitators to sustaining intervention delivery Methods: This study draws on interviews with staff and pupils from eight schools over multiple timepoints, including during the COVID- 19 pandemic. Qualitative methods were used to cluster schools with similar 'journeys' over a three-year period in terms of staff members' experiences of intervention delivery and perceived barriers and facilitators to sustaining delivery Results: The analysis demonstrated patterns in schools' journeys over time, each underpinned by a range of barriers and facilitators to the sustainability of the interventions. Four clusters of schools were identified each representing one overarching pattern: 'Spreading and embedding', 'Trialled and moved on', 'Everything's changed', and 'Built into the curriculum for now' Conclusion(s): The variety in schools' experiences highlights the complexity of both school settings and the process of implementing and sustaining interventions. These findings suggest that the environment and conditions into which a public health intervention is placed may be as, if not more, important than the intervention itself, and provoke important questions regarding future research and intervention development.

Post-Lockdown Behaviors and Impacts of Avoiding COVID-19 in Individuals and Caregivers of Individuals at High-Risk of Severe COVID-19: A Qualitative Study

Objectives: Several populations are at greater risk of severe COVID-19 due to inadequate responses to COVID-19 vaccines. Many of these individuals, and their caregivers, continue practicing varying degrees of social isolation to avoid SARS-CoV-2 infection. Following the end of lockdowns, the behaviors and impacts of continued isolation on the quality-of-life of high-risk populations remain poorly understood. This study describes the main avoidance and protective behaviors and ongoing impacts experienced by adults and caregivers of adults at high-risk of severe COVID-19. Method(s): Four virtual focus groups (April-July 2022) were conducted with individuals at high-risk of severe COVID-19, or caregivers, recruited via a convenience sample from patient panels. A discussion guide of open-ended questions was prepared based on COVID-19 guidance documents and a literature review. For qualitative analyses, an inductive approach was used for behaviors, deductive for impacts. A pre-defined codebook was updated throughout as needed. Salient concepts were defined as those mentioned by >=30% of participants or in every focus-group session. Result(s): Fourteen participants were interviewed (12 patients, 2 caregivers). Participants highlighted continued behaviors greatly impacting their quality-of-life. Avoidance behaviors (staying home, avoiding bystanders, avoiding shopping facilities and gatherings, using delivery services, family protection [43%-64%]) and protective behaviors (masking [79%], vaccination [57%]) were reported. Negative impacts included family relationship impacts (71%), collapse of social relationships (57%), difficulties accessing healthcare (43%), anxiety, fear, loneliness and depression (36%-50%), and impacts on employment/finances (36%). Positive impacts included the advent of telehealth (57%) and recognizing family importance (36%). Lack of trust in authority (57%) and hoarding of medications (36%) were negative general impacts of the COVID-19 pandemic highlighted. Concepts reported by patients and caregivers were similar. Conclusion(s): Individuals at high-risk of severe COVID-19 and their caregivers maintained avoidance and protective behaviors similar to those reported during lockdowns. This study highlights the continued burden experienced by high-risk populations.Copyright © 2023

"Trying to Find People to Fit the Tech…”: A Qualitative Exploration of the Lessons Learnt Introducing Artificial Intelligence-Based Technology into English Social Care

Digital technology is expected to improve care and address significant service pressures within the National Health Service and social care though evidence on how their implementation might be optimised is lacking. This study explores how one such example, home-based sensors with artificial intelligence capabilities, was implemented in English social care to identify changes in behaviour that indicate the onset of potentially more serious issues. Its focus was staff perspectives on decision-making processes and implementation, to inform recommendations for others exploring the potential of new and emerging technology. Qualitative data were collected from 18 semistructured interviews conducted across three sites delivering social care, with senior decision makers, operational leads, and care staff. We identified several issues with the selection process and implementation of AI-based technology in social care, including a lack of consensus around what success would look like, problems identifying and evaluating alternatives, and technical challenges to implementation, as well as obstacles to developing a longer-term, more preventative approach in a system experienced as focused on responding to acute needs. Ultimately, the research confirmed a number of recognised implementation challenges associated with training, resource, and acceptability to staff and patients. It added particular insights around the anxieties experienced by frontline staff and the cultural shift required of preventative interventions in a system geared to meeting acute crises. That many barriers are familiar suggests a particular need to focus on helping policymakers/local leaders avoid similar pitfalls in the future.

Characterizing Surgical Provider Use of Telemedicine: Barriers and Facilitators to Utilization

Introduction: The use of telemedicine in surgical care quickly increased due to the COVID-19 pandemic. However, uptake among surgical specialties has not been consistent. We aimed to characterize surgical provider perceptions of barriers and facilitators to telemedicine use. Method(s): Surgeons and nurses within the gastrointestinal surgery division at a high-volume, tertiary care academic center were contacted for participation in this study. Individual semi-structured interviews explored barriers and facilitators to telemedicine use. Qualitative analysis was conducted by multiple coders using NVivo12 software. Result(s): Six surgeons and three nurses participated in this study. Among the 9 participants, 44% identified as female and 33% were over age 50. Three themes were identified as facilitators to provider utilization of telemedicine: increased accessibility for rural patients due to decreased travel time and cost, enhanced provider productivity from reduced transition time between visits, and the ability of video telemedicine to facilitate non-verbal communication and visual examination. Three themes were identified as barriers to provider utilization of telemedicine: unreliable broadband connection, negative impacts on workflow due to scheduling challenges and insufficient IT support, and the inability to conduct a physical exam and immediately manage certain complications. Conclusion(s): As telemedicine becomes highly integrated into routine care, best practice guidelines to surgeon-patient telemedicine encounters should be established. This will improve virtual communication and consistency across providers, as well as provider satisfaction with telemedicine. Future interventions should address concerns with workflow logistics and technical support by developing comprehensive training and troubleshooting strategies for healthcare providers.

Racial Diversity In Covid-19 Clinical Trails: A Mixed Quantitative And Qualitative Review

Introduction: Historically, clinical trial patient populations have lacked adequate diversity while studies have shown that differences exist in the biological response of different ethnicities to various healthcare interventions. Minority populations have suffered higher rates of Covid-19 infection, hospitalization, and mortality than their non-Hispanic white counterparts. It is vital that Covid-19 treatment research is appropriately diverse. This paper aims to define the demographic characteristics of COVID-19 therapeutic clinical trials to date. Method(s): A literature search initially returned 117 unique publications, 67 of which met the inclusion criteria and were analyzed. Main variables of interest were reporting of demographic data, percent white, Black, and Asian, and type of study. Statistical analysis was carried out via Stata software. Result(s): Among analyzed studies, 74.63% reported demographics. The demographic representation was 78.87%, 12.27% and 8.86% for white, Black, and Asian populations. Among vaccine related studies, the representation for Black, Asian, and Hispanic individuals was 5.01%, 6.40%, and 13.71%. A qualitative analysis of outlier studies with high (>30%) Black populations revealed that none were vaccine related, 1/3 were in hospitalized patients, and none were related to pharmacologic interventions. Of the studies with low levels (<2%) of Black patients, 4/6 were vaccine related, none were in hospitalized patients, and all were related to pharmacologic interventions. Conclusion(s): This analysis reveals concerning trends in therapeutic clinical trial enrollment to date. In the context of yet another health insult that disproportionately affects minority populations, America's scientific community is not doing enough to produce equitable scientific evidence on Covid-19 treatment.

Clinical identification and severity in patients with COVID-19

The clinical evaluation of the patient with COVID-19 allows better care, application of safety criteria and preventive measures. The disease progresses from mild to severe and critical. In this work, is evaluated in patients with COVID-19 clinical format to identify moderate to severe stages of the disease. Following a cohort of male and female patients over 18 years of age admitted to the Infectology Service of the General Hospital of Mexico. Each patient is studied using the"COVID-19 Infectology"clinical format and in the first 24 hours of admission, a real-time RT-PCR molecular test is performed for SARS-CoV-2 infection. 65 patients classified as severe COVID-19 were studied, the RT-PCR was positive in 60 patients and negative in 5, clinical data did not differ from the positive ones and the 5 negative were considered false negative cases of the molecular test. There were no differences between positives and negatives with Fisher's test, and no difference in age, comorbidities, or prognostic evaluation with Student's t test. The conclusion is that the clinical format"COVID-19 Infectology"allows to recognize the cases and identify those that are in a severe evolution.Copyright /© 2021 Sociedad Medica del Hospital General de Mexico. Published by Permanyer.

The Moderating Effects of Corporate Social Responsibility on Corporate Financial Performance: Evidence from OECD Countries

This study aims to investigate the nature and intensity of the changes in corporate financial performance due to the corporate social responsibility (CSR) disclosures as a result of certain relationships between corporate governance and company performance in the non-financial sector. This study selected 625 non-financial companies across six organizations for economic cooperations (OECD) countries' stock markets for the period of 10 years (2012–2021). For this qualitative study, corporate governance, financial performance, and corporate social responsibility score data were collected from the DataStream, a reliable database for examining the research on OECD countries' listed companies. For the data analysis we applied various statistical tools such as regression analysis and moderation analysis. The findings of the study show that all attributes of the corporate governance mechanism, except for audit board attendance, have significant positive impacts on financial performance indicators for all the selected OECD economies except the country France. France's code of corporate governance has a significant negative impact on return on asset (ROA) and return on equity (ROE) due to differences in cultural and operational norms of the country. The audit board attendance has no significant impact on ROA. Moreover, all the attributes except board size (BSIZ) have significant positive impacts on the earnings per share (EPS) in Spain, The United Kingdom (UK) and Belgium. The values obtained from the moderation effect show that Corporate social responsibility is the key factor in motivating corporate governance practices which eventually improves corporate financial performance. However, this study advocated the implications, Investors and stakeholders should consider both corporate governance and CSR disclosures when making investment decisions. Companies that prioritize both governance and CSR tend to have better financial performance and are more likely to mitigate risks. Moreover, the policy makers can improve the code of corporate governance in order to attain sustainable development in the stock market.

Remote care for chronic pain: A qualitative evaluation with managers, practitioners, and patients

The Covid-19 pandemic obliged many healthcare providers to transition rapidly to a remote-only model of care. Concerns have been expressed about patient access to remote services, their appropriateness for sensitive consultations and physical examinations. Pre-pandemic research into telemedicine showed evidence of its effectiveness, but patient, staff and service user perspectives on remote care approaches remain unclear. This study explored the experiences and perceptions of care among patients, practitioners and managers in a single United Kingdom chronic pain organisation whose services were delivered remotely (telephone and online) during the pandemic. Nineteen participants (seven patients, seven practitioners, five managers) took part in in-depth qualitative interviews, conducted via telephone or online. Transcripts were analysed thematically. Five service provider and four service user themes were generated. Service provider themes comprised "The change process," "Accessibility and efficiency," "Effective when remote: Contact, support and education," "Concerns about communication, connection and disembodied work," and "Supporting and sustaining the team." Patients' themes comprised "Preferences, expectations and acceptance of remote care," "Convenience and accessibility," "Sense of support" and "Delivery modality matters." The study provides evidence from the qualitative evaluation of a single remote only service of its benefits and limitations as perceived by stakeholders. Findings suggest that service providers could address limitations, and progress to a blended care package, based on for patient need and choice. Further attention could be paid to services delivered by telephone, and to staff communication skills, resources, time management and wellbeing needs.Copyright © Nova Science Publishers, Inc.

A mixed-method study on the barriers of industry 4.0 adoption in the Indonesian SMEs manufacturing supply chains

PurposeThis paper aims to investigate the adoption barriers of Industry 4.0 in the Indonesian manufacturing supply chains.Design/methodology/approachThe mixed method was deployed to validate the findings. First, the qualitative study was conducted based on the interviews. Then, the companies were approached using filter questions on the involvement in adopting industry 4.0 and its impact on the supply chain.FindingsBased on the qualitative study, nine main barriers were found in the thematic analysis. Thus, to get a consensus on the barriers in the industry, the barrier indicators were tested using a structural equation model retrieved from 173 small and medium Indonesian manufacturing firms. Results indicate that five main barriers (e.g. unclear Industry 4.0 policy, higher-risk investment, insecure data sharing, lack of expertise and lack of incentive) are confirmed as the adoption barriers.Practical implicationsThe successful adoption of supply chain integration with Industry 4.0 technology can strengthen the manufacturing sector and competitiveness. Therefore, this study can be a complimentary assessment to evaluate the Indonesia Industry 4.0 Readiness Index (INDI 4.0) and the effectiveness of the government support program.Originality/valueThe results can be used as the framework to foresee the successful implementation of smart manufacturing supply chain management and its integration. Therefore, the authors proposed the framework to foresee the successful implementation of smart manufacturing, supply chain management and integration.

Coagulation Parameters Changes Associated with Covid-19 Vaccination

A global spreading corona virus at 2019 (COVID-19) declared as emergent worldwide, due to its quick spreading and high rates of mortality that serious disruptions. The objective of this research is to explore further into effect of different types of covid-19 vaccinations (Pfizer, AstraZeneca and Sinopharm) on some coagulation parameters from random samples of students in college of pharmacy/ university of Ker-bala. A case-control study was carried out with Iraqis living in Kerbala city particularly college students in Kerbala University/ College of Pharmacy from 2021/1/16 to 2022/4/16. This study was done to encompass quantitative and qualitative analysis of covid 19 vaccination types and possible thrombosis that occur after vaccination. The enrolled sixty participants of male and female were aged 18years and above. A questionnaire was made questions pertaining age were inquired to make sure participants fulfilled the criteria for in-clusion, past medical history, previous infection with covid 19 were incorporated into the survey. The scien-tific and ethical committee provided their ethical approval in college of pharmacy at University of Kerbala. Our results in this study indicate significant differences in coagulation parameters readings of (Pt, Ptt) between vaccination groups and control by using ANOVA statistical analysis of SPSS. Our study showed that the difference between the vaccinated and unvaccinated groups was considerable (Pfizer, AstraZeneca & Sinopharm Covid 19 vaccines) and control group in thrombotic measurements time and platelet mean value. The most effective and economical method of preventing COVID-19 infection is still vaccination. A number of COVID-19 vaccines have been developed quickly, but more research needs to be done on any side effects that may appear.Copyright © 2023, Colegio de Farmaceuticos de la Provincia de Buenos Aires. All rights reserved.