The Social, Psychological and Economic Impact of Car Accidents on the Victims' Families

The study aimed at investigating the resulting effects on the families victims of car accidents in Jordan. The study focused on the social, economic  and particularly on the psychological effect as it is the most influential on such families who get depression and anxiety. As car accidents do not stop the study attempted to answer the following question: 1-     The social effects of car accidents on the families victims. 2-     The psychological effects  of car accidents on the families victims. 3-     The economic  effects of car accidents on the families victims. To answer those question, a questionnaire consisted of (17) items delivered into the areas of the study was used.     The population of the study was the Jordanian community. The sample consisted of (250) young male and female whose families were exposed to different car accidents in the year 2012, (135) males and (115) females. The findings showed that the most influential effects on the families were losing the father where the family became in need to be cared about by different areas which caused them anxiety, depression and shocks that lead those families to separation, deviances and shame. This is because of they got a disable member and the high expenses of medical treatment for the injuries resulted from car accidents. As for minimizing the suffering families victims by holding courses and debates to educate people about road regulation. In addition, the government donated such families financial and spiritual help. Keywords: Car accident, Jordan society, Social effects of car accidents, Psychological effects of car accidents, Economic  effects of car accident

The Bi-objective Long-haul Transportation Problem on a Road Network

In this paper we study a long-haul truck scheduling problem where a path has to be determined for a vehicle traveling from a specified origin to a specified destination. We consider refueling decisions along the path, while accounting for heterogeneous fuel prices in a road network. Furthermore, the path has to comply with Hours of Service (HoS) regulations. Therefore, a path is defined by the actual road trajectory traveled by the vehicle, as well as the locations where the vehicle stops due to refueling, compliance with HoS regulations, or a combination of the two. This setting is cast in a bi-objective optimization problem, considering the minimization of fuel cost and the minimization of path duration. An algorithm is proposed to solve the problem on a road network. The algorithm builds a set of non-dominated paths with respect to the two objectives. Given the enormous theoretical size of the road network, the algorithm follows an interactive path construction mechanism. Specifically, the algorithm dynamically interacts with a geographic information system to identify the relevant potential paths and stop locations. Computational tests are made on real-sized instances where the distance covered ranges from 500 to 1500 km. The algorithm is compared with solutions obtained from a policy mimicking the current practice of a logistics company. The results show that the non-dominated solutions produced by the algorithm significantly dominate the ones generated by the current practice, in terms of fuel costs, while achieving similar path durations. The average number of non-dominated paths is 2.7, which allows decision makers to ultimately visually inspect the proposed alternatives

Technical requirements framework of hospital information systems: Design and evaluation

Background: Implementing the health information system (HIS) is more complex and costly than implementing other information systems. The present study was conducted to design and evaluate technical requirements for the HIS. Methods: The present study was conducted in 2016 by determining technical requirements for the HIS using the Delphi technique and then evaluating this system using a checklist based on the approved requirements. Results: The first part of the study designed a 73-item final list of technical requirements for the HIS in four domains, i.e. communication service, system architecture, security service and system response time. The evaluation results obtained in the second part showed that communication service was met in 63.8 of the HIS programs, system architecture in 65.5, security service in 72.4 and system response time in 76.3. Conclusions: A technical evaluation tool was designed and used to select and evaluate the HIS. The evaluation results suggested the study HIS was poorer in terms of communication service and system architecture than in the other two dimensions. © 2020 The Author(s)

Proposing electronic health record usability requirements based on enriched ISO 9241 metric usability model

Abstract Introduction: System usability assessment is among the important aspects in assessing the quality of clinical information technology, especially when the end users of the system are concerned. This study aims at providing a comprehensive list of system usability. Methods: This research is a descriptive cross-sectional one conducted using Delphi technique in three phases in 2013. After experts’ ideas were concluded, the final version of the questionnaire including 163 items in three phases was presented to 40 users of information systems in hospitals. The grading ranged from 0-4. Data analysis was conducted using SPSS software. Those requirements with a mean point of three or higher were finally confirmed. Results: The list of system usability requirements for electronic health record was designed and confirmed in nine areas including suitability for the task (24 items), self-descriptiveness (22 items), controllability (19 questions), conformity with user expectations (25 items), error tolerance (21 items), suitability for individualization (7 items), suitability for learning (19 items), visual clarity (18 items) and auditory presentation (8 items). Conclusion: A relatively comprehensive model including useful requirements for using EHR was presented which can increase functionality, effectiveness and users’ satisfaction. Thus, it is suggested that the present model be adopted by system designers and healthcare system institutions to assess those systems. Keywords: Electronic Health Records, Information System, Information Technolog

Physicians� perspectives on causes of health care errors and preventive strategies: A study in a developing country

Background: To prevent health care errors, the main causes and preventive strategies should be identified. The purpose of this study was to identify the causes and preventive strategies of health care errors from the perspectives of physicians. Methods: We surveyed 250 randomly selected physicians in five teaching hospitals in Tehran, Iran, in 2015. We used a questionnaire with 29 questions regarding causes and 17 ones regarding the preventive strategies. The participants were asked to answer the questions based on Likert�s five-point score (1=very low to 5= very high). The data was analyzed using descriptive (frequency, and mean scores) and inferential statistics in SPSS. Results: Managerial factors (3.6±0.7), personal factors of providers (3.5±0.6), factors related to the patients (3.4±0.71), and the factors pertinent to laboratory and pharmacy (3.2±0.8) were the main causes respectively. The most important preventive strategies were improvement of academic education, better taking past medical history, implementing electronic prescription and increasing healthcare budget. Conclusion: Heavy workloads, long work shifts, failure to do thorough examination and to collect detailed history information, providers� fatigue, patients� reluctance to follow orders or to give their complete information, failure to give detailed instruction to patients about the medications, lack or insufficient monitoring and supervising systems, and lack of enough budget were some of the most important causes of errors. Using IT to access patients� information, improving patients� adherence, reducing workload, developing efficient methods for collecting patients� information, dedicating adequate budget for improvement programs are recommended. © 2018, Iranian Journal of Public Health. All rights reserved

Physicians� perspectives on causes of health care errors and preventive strategies: A study in a developing country

Background: To prevent health care errors, the main causes and preventive strategies should be identified. The purpose of this study was to identify the causes and preventive strategies of health care errors from the perspectives of physicians. Methods: We surveyed 250 randomly selected physicians in five teaching hospitals in Tehran, Iran, in 2015. We used a questionnaire with 29 questions regarding causes and 17 ones regarding the preventive strategies. The participants were asked to answer the questions based on Likert�s five-point score (1=very low to 5= very high). The data was analyzed using descriptive (frequency, and mean scores) and inferential statistics in SPSS. Results: Managerial factors (3.6±0.7), personal factors of providers (3.5±0.6), factors related to the patients (3.4±0.71), and the factors pertinent to laboratory and pharmacy (3.2±0.8) were the main causes respectively. The most important preventive strategies were improvement of academic education, better taking past medical history, implementing electronic prescription and increasing healthcare budget. Conclusion: Heavy workloads, long work shifts, failure to do thorough examination and to collect detailed history information, providers� fatigue, patients� reluctance to follow orders or to give their complete information, failure to give detailed instruction to patients about the medications, lack or insufficient monitoring and supervising systems, and lack of enough budget were some of the most important causes of errors. Using IT to access patients� information, improving patients� adherence, reducing workload, developing efficient methods for collecting patients� information, dedicating adequate budget for improvement programs are recommended. © 2018, Iranian Journal of Public Health. All rights reserved

Physicians� perspectives on causes of health care errors and preventive strategies: A study in a developing country

Background: To prevent health care errors, the main causes and preventive strategies should be identified. The purpose of this study was to identify the causes and preventive strategies of health care errors from the perspectives of physicians. Methods: We surveyed 250 randomly selected physicians in five teaching hospitals in Tehran, Iran, in 2015. We used a questionnaire with 29 questions regarding causes and 17 ones regarding the preventive strategies. The participants were asked to answer the questions based on Likert’s five-point score (1=very low to 5= very high). The data was analyzed using descriptive (frequency, and mean scores) and inferential statistics in SPSS. Results: Managerial factors (3.6±0.7), personal factors of providers (3.5±0.6), factors related to the patients (3.4±0.71), and the factors pertinent to laboratory and pharmacy (3.2±0.8) were the main causes respectively. The most important preventive strategies were improvement of academic education, better taking past medical history, implementing electronic prescription and increasing healthcare budget. Conclusion: Heavy workloads, long work shifts, failure to do thorough examination and to collect detailed history information, providers’ fatigue, patients’ reluctance to follow orders or to give their complete information, failure to give detailed instruction to patients about the medications, lack or insufficient monitoring and supervising systems, and lack of enough budget were some of the most important causes of errors. Using IT to access patients’ information, improving patients’ adherence, reducing workload, developing efficient methods for collecting patients’ information, dedicating adequate budget for improvement programs are recommended. Keywords: Medical error, Healthcare error, Patient safety, Physician

Consensos em saúde bucal aprimorando a atenção básica, Ribeirão Preto, SP

Currently the development and use of protocols in the area of health as a tool has contributed to theOrganization and standardization of clinical practice. Model of the study: this study is to estimate qualitatively. Goal of the study: this research if proposed using the Delphi Technique to achieve a consensusamong the participants of the survey in the consolidation of the axles, concepts and categories that willcontribute to the creation and implementation of the Protocol in dental health Public health network of thecity of Ribeirão Preto. Methodology: Delphi Technique was used in the search for convergence of views.The initial sample of random character from sweepstakes between units of Health district west of Ribeirão Preto, was composed by 13 dentists and the method was described in 3 steps. Started with the Groupdental units selected, which responded to a series of questions and the results of this first phasecompiled and the summary of the results communicated again to members to reply again upon reconsideration of his replies. The end product was discussed in the workshop comprised dental practitionersinterviewed representatives of health teams, Secretary of health and of users of the service so that theinstrument could be built containing the views of all those involved in the process. Results: Showed thatthe technique Delphi favoured decision-making professionals and users about consolidation concepts,own the primary dental health for the development of dental health care, collaborating potentially forrational decisions and improving quality of care. Conclusion: Delphi technique proved effective instrument in seeking consensus on Dental public health.Atualmente, o desenvolvimento e utilização dos Protocolos clínicos e de regulação na área da saúde,como ferramenta para gestão, têm contribuído para a organização e padronização da prática clínica emdiversas áreas assistenciais, bem como conferido clareza quanto aos fluxos a serem percorridos pelospacientes, em busca do cuidado à saúde. Por meio de estudo de abordagem qualitativa e valendo-se daTécnica Delphi na busca da convergência de opiniões, objetivou-se obter um consenso entre os participantes da pesquisa para a adoção dos conceitos que pudessem subsidiar a criação e implantaçãode um Protocolo em Saúde Bucal a ser aplicado na Rede Pública de Saúde no município de RibeirãoPreto. A amostra inicial de caráter aleatório, a partir de sorteio entre as Unidades de Saúde do DistritoOeste de Ribeirão Preto foi composta por 13 dentistas e profissionais da equipe de saúde sendo que ametodologia foi desenvolvida em 3 etapas. A primeira iniciou-se com o grupo de dentistas das unidadessorteadas, que responderam a uma série de questões sendo os resultados dessa primeira fasecompilados e a síntese das tarefas reenviada aos membros para que respondessem novamente,reconsiderando as suas respostas. O produto final foi discutido em Oficina composta pelos dentistasentrevistados, representantes das equipes de saúde, da Secretaria de Saúde e dos usuários do serviçoa fim de que o instrumento pudesse ser construído contemplando o ponto de vista de todos os envolvidos no processo. Resultados: O trabalho identificou concordância final entre os participantes, pelo quese comprovou que a Técnica Delphi favoreceu a tomada de decisões dos profissionais e usuáriosacerca da consolidação de conceitos próprios da atenção básica em saúde bucal para o desenvolvimento dos cuidados nessa área, colaborando potencialmente para as decisões racionais e aprimoramento da qualidade da assistência. Mostrou-se  uma ferramenta com potência para a busca de consensos na área de Saúde Pública

‘NOT A RELIGIOUS STATE’ A study of three Indonesian religious leaders on the relation of state and religion

This article explores the concept of a ‘secular state’ offered by three Indonesian religious leaders: a Catholic priest, Nicolaus Driyarkara (1913–1967), and two Muslim intellectuals who were also state officials, Mukti Ali (1923–2004) and Munawir Sjadzali (1925–2004). All three, who represented the immediate generation after the revolution for Indonesian independence from the Dutch (1945), defended the legitimacy of a secular state for Indonesia based on the state ideology Pancasila (Five Principles of Indonesia). In doing so, they argued that a religious state, for example an Islamic state, is incompatible with a plural nation that has diverse cultures, faiths, and ethnicities. The three also argued that the state should remain neutral about its citizens’ faith and should not be dominated by a single religion, i.e. Islam. Instead, the state is obliged to protect all religions embraced by Indonesians. This argument becomes a vital foundation in the establishment of Indonesia’s trajectory of unique ‘secularisation’. Whilst these three intellectuals opposed the idea of establishing a religious or Islamic state in Indonesia, it was not because they envisioned the decline of the role of religion in politics and the public domain but rather that they regarded religiosity in Indonesia as vital in nation building within a multi-religious society. In particular, the two Muslim leaders used religious legitimacy to sustain the New Order’s political stability, and harnessed state authority to modernise the Indonesian Islamic community

Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry

Background and purpose: Prospectively collected data comparing the safety and effectiveness of individual non-vitamin K antagonists (NOACs) are lacking. Our objective was to directly compare the effectiveness and safety of NOACs in patients with newly diagnosed atrial fibrillation (AF). Methods: In GLORIA-AF, a large, prospective, global registry program, consecutive patients with newly diagnosed AF were followed for 3 years. The comparative analyses for (1) dabigatran vs rivaroxaban or apixaban and (2) rivaroxaban vs apixaban were performed on propensity score (PS)-matched patient sets. Proportional hazards regression was used to estimate hazard ratios (HRs) for outcomes of interest. Results: The GLORIA-AF Phase III registry enrolled 21,300 patients between January 2014 and December 2016. Of these, 3839 were prescribed dabigatran, 4015 rivaroxaban and 4505 apixaban, with median ages of 71.0, 71.0, and 73.0 years, respectively. In the PS-matched set, the adjusted HRs and 95% confidence intervals (CIs) for dabigatran vs rivaroxaban were, for stroke: 1.27 (0.79–2.03), major bleeding 0.59 (0.40–0.88), myocardial infarction 0.68 (0.40–1.16), and all-cause death 0.86 (0.67–1.10). For the comparison of dabigatran vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 1.16 (0.76–1.78), myocardial infarction 0.84 (0.48–1.46), major bleeding 0.98 (0.63–1.52) and all-cause death 1.01 (0.79–1.29). For the comparison of rivaroxaban vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 0.78 (0.52–1.19), myocardial infarction 0.96 (0.63–1.45), major bleeding 1.54 (1.14–2.08), and all-cause death 0.97 (0.80–1.19). Conclusions: Patients treated with dabigatran had a 41% lower risk of major bleeding compared with rivaroxaban, but similar risks of stroke, MI, and death. Relative to apixaban, patients treated with dabigatran had similar risks of stroke, major bleeding, MI, and death. Rivaroxaban relative to apixaban had increased risk for major bleeding, but similar risks for stroke, MI, and death. Registration: URL: https://www.clinicaltrials.gov. Unique identifiers: NCT01468701, NCT01671007. Date of registration: September 2013