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1.
Radiotherapy and Oncology ; 170:S303-S304, 2022.
Article in English | EMBASE | ID: covidwho-1967488

ABSTRACT

Hypofractionation has shown to be beneficial in the management of a wide range of cancers1,2 including other advantages such as cost savings3. Trials over the last decade4,5,6 have demonstrated the advantages of hypofractionation compared with a standard radiotherapy regimen3. Covid-19 significantly impacted the way in which cancer patients7 are managed and even though the use of hypofractionation is well established in some cancer types;the application thereof during the pandemic has been widely expanded to minimise treatment time8. Even though the treatment outcomes have been well defined, there is limited evidence to suggest changes in patient care. Some oncology centres advocated for a reduced contact time between patient and staff9. Hypofractionation in an ageing population is particularly advantageous in allowing people to receive treatment in a shorter time demonstrating treatment outcomes similar to younger age groups10 however;greater consideration should be given to performance status and comorbidities associated with these treatment outcomes11. Fractionation schedules which allow delivery in less fractions, can be highly effective with limited treatment-related toxicity. Studies have shown that the late consequences of radiotherapy in these patient groups are seldom an issue even with larger fraction s12. However more recent studies suggest that a reduction in treatment time should not be the only reason for selecting this approach. Moderate hypofractionation should therefore be considered for those patient who are younger and who might experience long terms effects13. More studies are now investigating the tolerability of ultra-hypofractionated radiotherapy in an attempt to improve the therapeutic gain, suggesting that these approaches are well-tolerated and showed no statistical difference in toxicity14. Hypofractionation in radiotherapy may be a good alternative to conventional fractionation however patience care remains paramount in the management of all toxicities related the radiotherapy delivery. There is no evidence to suggest the patient care of these patients have changed, however the tolerability and outcomes of this method of delivery requires constant review. Patient care needs to consider the site of treatment, age of the patient, performance status, and tolerability. A model of shared decision making in managing care is advocated with greater emphasis on selfcare.

2.
Gastroenterology ; 162(7):S-489-S-490, 2022.
Article in English | EMBASE | ID: covidwho-1967324

ABSTRACT

INTRODUCTION There is a paucity of literature evaluating the COVID-19 pandemic's impact on GI fellowship match and fellow recruitment. With the emergence of the COVID- 19 pandemic and institution of travel bans and social distancing, a complete shift towards video conference interview (VCI) was instituted. VCI makes the interview process costeffective and saves time, while potentially increasing existing implicit biases, and creating new biases based on technology. It remains unclear, however, if this had any impact on fellowship programs matching with trainees from outside institutions. One particular concern is whether programs and applicants would prefer to train at their local institutions where they are well-acquainted with the training program, city, and available resources. The objective of our study is to evaluate the impact of VCI on GI trainees' fellowship match rate at their local institutions for the appointment year 2021. METHODS We performed a crosssectional study of all the GI fellowship programs in the United States. Each programs' website was reviewed to identify current fellows' characteristics including where they did their internal medicine residency training. Programs were excluded if there was insufficient information on their website regarding their fellows' prior training experience. Statistical analysis was performed using SPSS 25. RESULTS We identified a total of 212 US-based GI fellowship programs, 87 of the programs met the exclusion criteria. A total of 125 fellowship programs with 440 fellows were included in the analysis, encompassing 75.3% of the total number of first-year fellows who matched in 2021. A Mann-Whitney test was performed to compare the percentage of residents who matched at their local institution for fellowship training pre-COVID/before the initiation of VCI (class of 2022/2023) and post-COVID (class of 2024). There was no statistically significant difference between the two groups: class of 2022/2023 (Mdn=37.5%) and class of 2024 (Mdn=33.3%), U=7245.5, z=-1.001, p= 0.317(Figure 1). DISCUSSION Our study provides crucial information to GI fellowship applicants and fellowship programs, highlighting that employing VCI during the pandemic did not significantly impact GI fellowship applicants' match at either their local program or outside institutions. Moreover, the cost savings from reduced travel and lodging is beneficial to the applicant and may encourage the applicant to apply to more programs than previously feasible. These findings suggest that applicants continue to rank programs where they believe they will receive the best training. GI programs may have also implemented changes including video tours and more comprehensive program presentations that help applicants understand the programs' strengths and weaknesses, as well as available resources which could impact training without their physical presence.(Figure Presented)

3.
Journal of Facilities Management ; 20(4):586-605, 2022.
Article in English | ProQuest Central | ID: covidwho-1961337

ABSTRACT

Purpose>The high consumption of energy by buildings may have enhanced land degradation, flooding, air pollution and many other hazardous environmental issues. However, green practices in buildings have been proved as one of the successful technologies to mitigate these issues. Past studies have shown lax green practices in Nigerian buildings. Concerning public hospital buildings, this is yet to be explored. Therefore, this paper aims to investigate the barriers to green practices and proffer possible policy solutions to promote hospital green buildings.Design/methodology/approach>In attaining these objectives, the view of hospital building contractors, design team, hospital management and policymakers in the relevant ministries/agencies was engaged via virtual interviews. The collated data were analysed and presented in the thematic pattern.Findings>Findings show that green building construction is extremely low in Nigeria, but the worst hit is the health-care buildings across the states. Government/policy-related, organisational/leadership-related, financial-related, technical-related, design team-related and stakeholders’ behaviour-related barriers emerged as the main six themes of barriers affecting public hospital green buildings implementation initiatives. Findings show that proffering possible policies to addressing these barriers may improve public hospital green construction across the states.Research limitations/implications>This paper is limited to barriers to green buildings implementation in public hospitals in Nigeria, and data collection was through virtual interviews but does not affect the strength of the findings. Thus, this paper suggests that the sub-themes and variables/items that emerged from the collated data as presented in Figure 1 can be further developed quantitatively via questionnaire survey to validate and improve the reliability of results from this paper.Practical implications>As part of this study’s implications, suggestions from this paper will stir up policymakers’ decisions, to be tailored towards achieving green buildings implementation initiatives in Nigerian public hospitals.Originality/value>To the best of the authors’ knowledge, this paper is probably the first that attempted to investigate the barriers to green buildings implementation in public hospitals in Nigeria.

4.
Webology ; 19(2):3952-3969, 2022.
Article in English | ProQuest Central | ID: covidwho-1958084

ABSTRACT

This paper discusses the influence of various revenue streams (government grants, student fees, internally generated revenue, and endowment trust funds) on the financial sustainability of Kenyan public universities from the perspective of resource dependency theory. A longitudinal survey research approach was used and the final sample consisted of 31 public chartered universities in Kenya that had operated continuously for more than five years as of 2015. Panel data were extracted from the annual financial statements of these universities and other secondary data sources for the period from 2015 to 2020. A random effects regression model was applied to determine the correlation between the different revenue streams and financial sustainability. This study found that both government grants and student fees have significant relationships with the current ratio. By contrast, internally generated revenue and endowment trust funds have insignificant relationships with the current ratio. Not only do this study's findings contribute to existing empirical literature, but the results will also be beneficial to multiple stakeholders, such as university management, stakeholders, and researchers.

5.
BJU International ; 129:74-75, 2022.
Article in English | EMBASE | ID: covidwho-1956726

ABSTRACT

Introduction & Objectives: Double J ureteric stents are commonly used in acute and elective urology practice. Ureteric stents with external strings offer an alternative solution to extraction compared to the standard of requiring cystoscopy and stent removal at an additional cost. Our aim was to review the usage of double J stents on extraction strings in our institution and whether this was increasing over time and the potential cost savings. Methods: All ureteric stent insertions in Auckland Hospital between 2015 and 2019 (5 years) were reviewed from the hospital stent register. Results: A total of 4016 ureteric stents were inserted over 5 years. Of the total number of stents inserted 33.2% were stents on strings, with a significant increase in the trend towards stent on strings per year (Cochran-Armitage test p<0.0001). Procedures for stone disease were the most common indication for stent insertion making up 66% of all cases. 45% of stents inserted in management of stone disease were stents on strings. The number of stents on strings and total number of stents inserted for ureteric calculi increased each year. If a Covid test cost and subsequent flexible cystoscopy removal of ureteric stent was applied to stent on strings in our study period, a cost saving of $1.15 million would be seen, and is an important consideration for future practice worldwide. Conclusions: The use of stents on strings appears to be higher in our centre than previously reported in the literature. This is likely to be associated with reduced patient discomfort from stent removal and significantly reduced stent removal costs with implications for future planning and resource distribution in our centre. Potential risks associated with stents on strings - in particular stent dislodgement - need to be considered, and consideration given to case selection and patient counselling.

6.
Croatian Operational Research Review ; 13(1):99-111, 2022.
Article in English | ProQuest Central | ID: covidwho-1955178

ABSTRACT

Goods from warehouses must be scheduled in advance, prepared, routed, and delivered to shops. At least three systems directly interact within such a process: warehouse workforce scheduling, delivery scheduling, and routing system. Ideally, the whole problem with the preceding inventory management (restocking) would be solved in one optimization pass. In order to make the problem simpler, we first decompose the total problem by isolating the delivery scheduling. Then we connect the optimization model to the rest of the system by workload balancing goal that is a surrogate of coordination and criterion for the system robustness. This paper presents the practical application of top-down discrete optimization that streamlines operations and enables better reactivity to changes in circumstances. We search for repetitive weekly delivery patterns that balance the daily warehouse and transportation utilization in the absence of capacity constraints. Delivery patterns are optimized for the quality criteria regarding specific store-warehouse pair types, with a special focus on fresh food delivery that aims at reducing inventory write-offs due to aging. The previous setup included semi-manual scheduling based on templates, historical prototypes, and domain knowledge. We have found that the system augmented with the new automated delivery scheduling system brings an improvement of 3% in the performance measure as well as speed in adjusting to the changes, such was the case with changes in policies during COVID-19 lockdowns.

7.
International Journal of Agricultural and Biological Engineering ; 15(3):55-61, 2022.
Article in English | ProQuest Central | ID: covidwho-1934919

ABSTRACT

Food security is one of the key global challenges in this century. In Singapore, our research team has been using novel aeroponic technology to produce fresh vegetables since 1997. Aeroponic systems allow for year-round production of not only tropical, but also sub-tropical and temperate fresh vegetables, by simply cooling the roots suspended in aeroponic systems while the aerial parts grow under tropical ambient environments. It has also been used to investigate the impacts of root-zone CO2 on vegetables by enriching root-zone CO2 while their aerial portions were subjected to constant atmospheric CO2. To compensate for the lack of available land, Singapore also needs to develop a farming system that can increase productivity per unit land area by many-fold. Over the past 10 years, my research team has established a commercially viable LED integrated vertical aeroponic farming system to grow different leafy vegetables under different LED spectra, intensities, and durations in the tropical greenhouse. The results demonstrate that it is possible to increase shoot production and rate of shoot production of leafy vegetables by increasing light intensity and extending the photoperiod under effective LED lighting. Furthermore, temperate vegetable crops such as lettuce were able to acclimate to high light intensity under supplementary LED lights to natural sunlight in the greenhouse. Supplementary LED lightings promote both leaf initiation and expansion with increased photo synthetic pigments, higher Cyt b6f and Rubisco protein contents on a per area basis and thus improve photosynthetic capacity and enhance productivity. Plants sense and respond to changes in their immediate environments (microclimate), manipulating the root zone temperature (RZT) and water supply will impact not only their growth and development but also their nutritional quality. Our on-going research aims to investigate if the nutritional quality of leafy vegetables could be improved under suboptimal RZT and mild water deficit through deficit irrigation. If substantial energy and water savings in urban farming can be achieved without substantial yield penalty but with higher nutritional quality, the amount of water and energy saved can bring substantial benefits to society.

8.
Sustainability ; 14(13):8079, 2022.
Article in English | ProQuest Central | ID: covidwho-1934253

ABSTRACT

The present study examines the impact of monetary benefits on hotel loyalty programs in a pandemic situation, and the relationship between monetary benefits and multidimensional loyalty aspects. Since 2020, international hotel suppliers have focused on monetary investments and promotions through hotel loyalty programs that have seen extraordinary results in the Korean market. Feedback from the market raises questions as to whether these results are caused by true loyalty or economic sensitivity caused by a recession. Thus, it is necessary to investigate this phenomenon from a relationship perspective. In this research, negative switching barrier facets were given a moderating role with multidimensional loyalty factors consisting of attitudinal loyalty, behavioral loyalty, and composite loyalty. A quantitative method was used, in which consumers in Korea were surveyed via an online questionnaire. In total, 494 responses from consumers were analyzed. Notably, negative switching barriers were found to have a negative moderating effect on the relationship between monetary benefits and attitudinal loyalty. This result implies that although the customer is economically sensitive during a recession, monetary benefits and the market situation can cause fatigue that potentially produces obstacles to long-term relationships with the customer. The results of this study highlight the hotel suppliers involved in monetary competition during a pandemic situation and the need to develop solid long-term relationships through customer loyalty strategies.

9.
Sustainability ; 14(13):7759, 2022.
Article in English | ProQuest Central | ID: covidwho-1934229

ABSTRACT

The issuance of consumption coupons during the epidemic period to stimulate the economy must take full account of the level of probabilistic consumption and inventory optimization. In this paper, an improved minimum-cost maximum-flow model is constructed to dynamically adjust the inventory capacity of node enterprises with the change of probabilistic consumption level, and three scenarios are simulated by numerical assumptions. The results show that: (1) The model can better solve the problem of consumption coupons, probabilistic consumption and inventory optimization;(2) Consumer welfare remains unchanged, the largest number of government consumption coupons is issued, and the number of enterprise inventories reaches the lowest;(3) Enterprise inventories are minimized with different decisions on consumer probability consumption, and the government’s issuance of consumption coupons and the satisfaction of consumer demand have reached a dynamic balance. Corresponding suggestions are put forward, hoping to better help the government to implement the consumption coupons policy to stimulate the economy.

10.
Journal of Financial Counseling and Planning ; 33(2):160-170, 2022.
Article in English | ProQuest Central | ID: covidwho-1933446

ABSTRACT

When the COVID-19 pandemic caused businesses to close and triggered high unemployment in 2020, millions of unbanked U.S. households, those without a bank account, had to wait for weeks and months for their stimulus checks to arrive. The delayed delivery of stimulus checks issued by the Coronavirus Aid, Relief, and Economic Security (CARES) Act sheds light on the critical role that safe, affordable financial services and products play in people’s ability to cope with financial shocks. Dialogues over banking practices have been framed with a banked-unbanked dichotomous framework that masks more nuanced understandings of households’ financial realities, including the underbanked, who use a bank account and alternative financial services simultaneously. Using data from the 2015 National Financial Capability Study, this study identifies and compares predictors of being underbanked and unbanked, respectively. We found that the underbanked group is a sizable, distinctively different group. Income volatility and welfare benefit receipt are both associated with being underbanked rather than unbanked. Our findings call for expanding the current, limited framework to gain more complete, nuanced understandings of banking practices.

11.
BMJ : British Medical Journal (Online) ; 378, 2022.
Article in English | ProQuest Central | ID: covidwho-1932676

ABSTRACT

Health services in England have been tasked with treating more patients at home, to cope with growing demand for beds—Jo Best asks how this will work

12.
Obstetrics and Gynecology ; 139(SUPPL 1):20S, 2022.
Article in English | EMBASE | ID: covidwho-1925546

ABSTRACT

INTRODUCTION: The COVID-19 pandemic shifted many inperson activities to virtual settings. Given nationwide travel restrictions and recommendations from the Association of American Medical Colleges, subspecialty program directors for obstetrics and gynecology conducted interviews using a virtual platform for 2020. The impact of virtual interviews (VI) on a candidates' ability to effectively create a rank list is unknown. The primary objective was to evaluate obstetrics and gynecology subspecialty fellowship applicants' perspectives regarding the effectiveness of VI for creating a rank list. Secondary outcomes included perceived advantages and disadvantages of the process, including preference of interview type, cost, and time savings. METHODS: This was a cross-sectional electronic survey administered to a convenience sample of obstetrics and gynecology subspecialty applicants. This institutional review board-exempt survey was administered via REDCap. Descriptive statistics were used. RESULTS: Response rate was 158 of 330 (48%). Nearly all (99%) applicants cited cost savings as a distinct advantage of VI. Overall, 82% percent of respondents felt confident in making their rank list based on the VI, and 92% were “very satisfied” or “somewhat satisfied” with the process. Most respondents (91%) preferred Zoom to other virtual platforms. Of those who expressed an interview style preference (in-person versus VI), 44% of respondents preferred VI;33% had no preference or were not sure. CONCLUSION: The majority of applicants to obstetrics and gynecology subspecialty fellowships felt confident to create a rank list based on VI. This study indicates that the virtual format is suitable for fellowship interviews and can be utilized beyond the pandemic to improve equity and diversity in the applicant pool.

13.
International Conference on Tourism Research ; : 568-576,XVIII, 2022.
Article in English | ProQuest Central | ID: covidwho-1918899

ABSTRACT

The debate concerning e-Commerce adoption is an evolving one that in the context of the current COVID-19 Pandemic has come centre stage. Although the shift towards e-Commerce platforms has been an increasing trend in recent years, Curtin (2020) states the current pandemic has accelerated consumers' shifts toward e-Commerce by five years. As store closures and new enforcements became a reality, it forced many companies to pivot their online strategies overnight (Shadler et al, 2020). Since its inception in the late 90's, e-Commerce adoption and research has championed the rise and the significant benefits of e-Commerce. Industries as diverse as financial, retail, manufacturing, and hospitality (Josanov, 2011;Kremez et al, 2019;Helper and MacDuffie, 2000;Hua, 2016) have embraced e-Commerce. By contrast, research into the use and level of adoption by Agri-food businesses indicates that this sector has not kept pace with this digital revolution. This is surprising given the importance of this sector worldwide. Indeed, it is one of the most important indigenous industries in Ireland in terms of employment, economic output, and export performance. However, there is scarce research found in the case for Irish Agri-food e-Commerce development, with limited industry reports available. Previous research elsewhere called for government support to encourage the move to online territory (Sparkes and Thomas, 2001;Sturiale and Scuderi, 2016), and the onset of COVID-19 furthered this. Numerous support agencies expanded on their current offerings in relation to digital support, although little is known around Agri-food businesses adoption of these. For this reason, this paper intends to add to the limited studies surrounding this important indigenous industry in Ireland within the widely dynamic topic of eCommerce platforms. The focus of this paper is directed toward the adoption and integration of these online platforms during COVID-19, the benefits and challenges faced, the role of support agencies and further support suggested by SMEs through survey data. This study has both an academic and industry focus and hence aims to improve our understanding of online activity and digital support within this sector.

14.
Pakistan Journal of Medical Sciences Quarterly ; 38(5):1216, 2022.
Article in English | ProQuest Central | ID: covidwho-1918690

ABSTRACT

Objectives: To study the effects of melatonin in preventing neonatal neuronal apoptosis induced by maternal hypothyroidism. Methods: Twelve healthy female Wistar rats, 12-16 weeks, were divided equally into three groups. Group-A was labelled as control. Group-B was made hypothyroid by giving 15mg/kg of propylthiouracyl (PTU) daily whereas Group-C was given PTU along with melatonin (10mg of melatonin/kg/day) in drinking water. After one week of treatment, the female rats were allowed to mate and conceive. The treatment of all groups continued throughout the period of pregnancy and lactation. After delivery, a total of 30 pups, 10 from each group, were labelled and sacrificed on 22nd day of life. The serum levels of TSH, T3 and T4 of the pups were measured. The brains were extracted from the skull and homogenized for isolation of mitochondria to determine the levels of cytochrome c oxidase and for isolation of RNAs to measure the levels of gene expressions of caspases 3, 9 and 8. Results: Group-B pups showed a significant increase in serum levels of TSH (21 ± 3.7 mg/dl), and gene expression levels of caspase 3 (0.85±0.02) and 9 (0.69±0.02) where as in Group-C, there was visible reduction in concentration of TSH (15 ± 2.4 mg/dl), caspase 3 (0.50±0.02) and 9 (0.25±0.01) expressions. Increase in cytochrome c oxidase enzyme concentration (3.416 ± 0.001) in Group-B was the result of mitochondrial outer membrane rupture, causing decrease in the number of neurons by accelerating apoptosis. A decrease in its level in Group-C (2.100 ± 0.001) indicated inhibition of apoptosis. Conclusion: Intake of melatonin during pregnancy and lactation protected the brains of offspring from extensive apoptosis during maternal hypothyroidism.

15.
Value in Health ; 25(7):S533, 2022.
Article in English | EMBASE | ID: covidwho-1914760

ABSTRACT

Objectives: To review US payer policies and rationale for coverage of approved digital therapeutics (DTx) in order to better understand the likely evolution of payer management and future outlook for DTx with anticipated future growth in the space. Methods: Information on coverage and management of FDA approved prescription DTx from top 20 largest US public and commercial payers and Pharmacy Benefit Managers (PBM) were obtained in a review of literature, websites, press releases, and public domain sources. Using this information, anticipated payer evidence requirements for DTx were considered based on current trends and developments identified. Results: The first example of US payers managing DTx came when the PBM Express Scripts announced the introduction of a digital health formulary (2019). The formulary includes 15 solutions from digital health developers including remote monitoring services and digital therapeutics for eight common chronic conditions. The digital health options are for caregiver care, COVID-19 care, diabetes care, cardiovascular care, pulmonary care, behavioral health care, women’s health care, and musculoskeletal care. A case study for Livongo, the preferred diabetes care DTx solution, demonstrates improved outcomes related to hyperglycemic events and cost savings. Another case study for asthma and COPD DTx solution, Propeller, showed improved adherence and lower utilization of rescue medication, which reduces hospitalization. The review of case studies for approved and covered DTx helps to understand study design and outcome measures needed. Conclusions: The COVID-19 pandemic has transformed the digital health space by accelerating acceptance and usage of DTx and this trend is likely to continue into the future. As a result, US payers that have not already done so will need to develop policies to manage coverage and payment for DTx. With increased payer management, manufacturers should track outcomes of assessments for DTx to be informed of clinical trial and real-world evidence needs to support approval and coverage.

16.
Value in Health ; 25(7):S406-S407, 2022.
Article in English | EMBASE | ID: covidwho-1914750

ABSTRACT

Objectives: Catheter ablation for atrial fibrillation (AF) was a novel treatment in 1998. Today, ablations are commonplace and compete with rate/rhythm drugs as first-line therapies. While some ablations are performed as outpatient procedures, many require an overnight hospital stay. Ablations are expensive because they require substantial human and material resources as well as hospital facilities that are subject to inflationary pressures. The aim of this research is to compare hospital charges for catheter ablations performed in the State of Maryland during three consecutive calendar years prior to Covid. Methods: Retrospective analysis of inpatient and outpatient data from 2017, 2018, and 2019 was performed to determine the stability of hospital charges or the amount of change year to year. Charges account for all resources consumed, medical and surgical, in association with any ablation procedure for any form of AF – paroxysmal, persistent, long-term persistent, or permanent. Results: Median charges for ablations performed during a hospital visit without an overnight stay (outpatient) remained steady from year to year – $31,511 (2017), $31,520 (2018), $32,392 (2019). Median charges for an ablation performed during a hospital visit with at least one overnight stay (inpatient) were $47,793 (2017), $48,673 (2018), and $56,670 (2019), reflecting cost stability between 2017 and 2018 but a 15% increase, 2019 versus 2018. Patients undergoing a second ablation within one year were considered to have a repeat ablation. Repeat ablation rates increased from 7.3% to 9.2% for inpatient procedures and from 8.4% to 9.8% for outpatient procedures between 2017 and 2018. Repeat ablation charges covered by private payers were higher than those covered by Medicare. Conclusions: Inpatient charges for catheter ablations are rising in Maryland and so is the re-ablation rate. Cost-containment measures, improvements in ablation procedures and skills, as well as advances in electrophysiology technologies are needed to improve cost-efficiencies.

17.
Journal of Mental Health Policy and Economics ; 25(SUPPL 1), 2022.
Article in English | EMBASE | ID: covidwho-1912832

ABSTRACT

The proceedings contain 69 papers. The topics discussed include: valuing mental illness by using the well-being valuation method;psychotropic polypharmacy use among high need children - the role of the individual, family, and neighborhood characteristics;secure attachment and sensitive parenting: potential for longer-term cost savings;workplace disclosure of serious mental illness: theory and evidence;new set of reference unit costs (RUCs) for health economic evaluations in Europe: methods and tools for development;psychiatric emergencies in Los Angeles county during, and after, initial COVID-19 societal restrictions: an interrupted time-series analysis;changes in outpatient care for alcohol use disorders among the commercially insured in the U.S. during the COVID-19 pandemic;and mental health care integration in community health centers and hospital emergency department utilization.

18.
Vehicles ; 4(2):433, 2022.
Article in English | ProQuest Central | ID: covidwho-1911733

ABSTRACT

Transport automation is increasingly being studied from different perspectives;however, the perceptions of road haulage companies have received less attention. This study explores the views of representatives of small- and medium-sized road haulage companies on transport automation in Finland. We conducted an online survey to gather perceptions of automation, which received 254 responses from representatives of a range of different transport industries. The respondents’ views towards automation were generally negative. The overall view was that automation may not be possible for heavy vehicles in Finland due to the adverse weather and driving conditions. The perception was that road haulage automation is unlikely to occur before 2050 in Finland. The results provide valuable insight for vehicle manufacturers, technology developers, policy makers, and haulage companies. As the road haulage industry is dominated by small- and medium-sized companies, hauliers should be supported in actively implementing new technologies.

19.
Economic and Business Review ; 24(2):84-100, 2022.
Article in English | ProQuest Central | ID: covidwho-1903978

ABSTRACT

The Western Balkan region (WB) small and medium enterprises (SMEs) lag behind the EU-28 counterparts in their export activities. The positive influence of the Enterprise Europe Network (EEN) on local business support organisations and the local businesses is identified as a contributing factor to that improvement. To investigate the EEN's role in the export of the WB SMEs in the period 2014-2017, the authors used available statistical data on export from the WB countries. The survey was conducted in three phases, with the samples of 1,463, 222, and 12 companies. Analysed results of the EEN activities in the WB show that EEN had a positive influence on the firms' performance and their international activities;67% of supported firms increased their turnover, 62% increased their market share, and the EEN services had a positive impact on the jobs in 52% of the examined firms. The survey results about the expected and actual impact of the EEN services proved a positive impact of the Network on the five indicators: market improvement, cost savings, job creation or maintenance, quality improvement, and innovation. The paper contains important practical implications for the policymakers and the SME managers alike, and the implications mentioned above are generalisable.

20.
Diabetes Research and Clinical Practice ; 186, 2022.
Article in English | EMBASE | ID: covidwho-1894945

ABSTRACT

Background: People living with diabetes are at increased risk of being admitted to hospital and to stay in hospital longer. With a rising prevalence of diabetes globally and excessive expenditure on this condition, opportunities to reduce length of hospital stay must be prioritised. Aim: This review aims to explore the efficacy of hospital-based interventions (i.e., a clinical interaction in a hospital setting for health-related outcomes) in reducing length of hospital stay for the inpatient with diabetes and describing the findings based on a systematic review of relevant studies. Method: A systematic search of CINAHL, Medline Ovid, Web of Science and SCOPUS databases for research papers relating to adult inpatients with diabetes was conducted for the period 2010–2020. Methodological assessments were undertaken with a narrative synthesis to assess study quality and implement Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria with the population, intervention, comparison, outcome model utilised in the search strategy. Results: Seventeen intervention studies spanning a range of inpatient areas relevant to adults with diabetes examined clinical procedures and treatments (n=8), education of patients and junior doctors (n=2), multidisciplinary teams, diabetes inpatient specialist nurses (n=5) and the use of technology (n=2). The studies demonstrated significant improvements in clinical outcomes including reduction in length of hospital stay. Encouraging results were seen with the introduction of a podiatric foot coordinator position that showed the most significant reduction in length of hospital stay at 10.4 days, closely followed by a diabetic foot ulcer treatment programme that established a reduced length of hospital stay of 9.3 days and a nurse led insulin protocol showed reduced length of hospital stay by 4.1 days. These studies also demonstrated improved clinical outcomes across other parameters including estimated cost savings of £234K, lowered amputation rate, and decreased hypoglycaemia and hyperglycaemia. Similarly, remaining studies determined additional outcomes of increased time in target, high levels of patient satisfaction and postoperative complications significantly decreased. Discussion: This review demonstrates the potential for hospital-based interventions to impact positively on length of stay for adults with diabetes and demonstrates significantly reduced length of hospital stay following a podiatric high-risk foot coordinator position and diabetic foot ulcer treatment programme. Investment in and commissioning of programmes that show significant impact in reducing length of stay and hospital costs should be worthwhile. As the health service rebuilds and recovers from the devastation of COVID-19 the adaptability of the healthcare system is vital for future planning. As length of stay is a key performance indicator, made even more relevant during the pandemic, these results should be a catalyst for nurses and managers with cooperation from organisational management to facilitate translation of such evidence into practice.

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