Joint venture healthcare system as common practice in developing countries : game changing on assessing health services

To explore the essence of game changing on applying joint venture (JV) approach for healthcare system improvement in developing countries. This is cross-sectional study exploring the factors influencing the successful implementation of JV for the healthcare services in low- and middle-income countries (LMICs). The study included: Qatar Statistical Authority, CIA fact book, Ministry of Health Annual Report, Hamad Medical Corporation Annual Report, Organization for Economic Cooperation and Development information, and Qatar's healthcare system history. The research indicated that the LMIC healthcare system would benefit from affiliation with leading technology partner for healthcare reform. The findings support the view of LMIC healthcare systems' needs to incorporate joint venture approach in implementing JV concept for process improvement and knowledge transfer to contribute in country economic growth, development, and stability. Current study explored evidence supporting decision maker and management control of JV trends in different ways in comparison with developed countries. JV can also help the organization to share the risk and cost of large capital investment. The present study supports observations on expending the use of JVs as approach for improvement in LMIC healthcare system. The current study confirmed the advantages of JV which include helping businesses grow faster, increasing productivity, and generating greater profits, both parties sharing the risks and costs, accessing new markets and distribution networks. [Abstract copyright: Copyright: © 2020 International Journal of Preventive Medicine.

The production of a non-homogeneous classical pion field and the distribution of the neutral and charged pions

The probability distribution $dw/df$ as a function of the ratio $f=n_0/n_{tot}$ of the neutral to total multiplicities is calculated for the classical pion fields quickly varying in space and time.Comment: 6 pages, 1 .eps figure, using epsfig, submitted to Phys.Let

Effects of intervention with the SAFE strategy on trachoma across Ethiopia.

BACKGROUND/AIMS: The impact of the SAFE strategy (surgery, antibiotics, face washing, environmental hygiene), recommended to eliminate blinding trachoma, is not well explored. We determined the operational effectiveness of the whole SAFE intervention package. METHODS: Analytical cross-sectional trachoma surveys were conducted in four program areas across Ethiopia before and after 3 years of intervention with the SAFE strategy. A total of 8358 children 1-9 years, 4684 people above 14 and 3572 households were assessed in the follow-up evaluations using methodologies recommended by the WHO. Effects were measured by comparing follow-up proportions with baseline estimates of four key indicators. RESULTS: Coverage was 36% for trichiasis surgery, 59% for antibiotic and 57% for health-promotion services. Prevalence of trachoma trichiasis (TT) decreased from 4.6% (95% CI: 3.6% to 5.8%) down to 2.9% (CI: 2.1% to 3.9%). Prevalence of trachoma inflammation-follicular (TF) dropped from 36.7% (33.9% to 39.6%) to 18.4% (CI: 15.4% to 21.8%). The proportion of unclean faces and households not using latrines fell from 72.8% (68.9% to 76.4%) and 74.5% (69.9% to 78.7%) down to 47.0% (CI: 43% to 51%) and 51.7% (47.2% to 56.2%), respectively. All the reductions related with antibiotic (TF), face washing (clean face) and environmental (latrine) components were statistically significant except for Surgery (TT). CONCLUSIONS: Considerable decline in the magnitude of trachoma and its risk factors was observed in areas where the SAFE strategy was implemented. The coverage of services should be maintained or improved in order to eliminate blinding trachoma by the year 2020

Association between pretreatment haemoglobin levels and morphometric characteristics of the tumour, response to neoadjuvant treatment and long-term outcomes in patients with locally advanced rectal cancers

Aim The study was carried out to investigate whether pretreatment haemoglobin (Hb) levels act as a biomar- ker in the management of patients with locally advanced rectal cancer. Method\ud We prospectively collected data on all patients within our cancer network with localized low rectal cancer treated with preoperative radiotherapy/chemora- diotherapy at Mount Vernon Centre for Cancer Treat- ment between March 1994 and July 2008. Pretreatment Hb level was assessed as an independent variable for the whole study sample and dichotomised at a value of 12 g/dl. A multivariate analysis of covariance (MANCOVA) was conducted on parameters that had significant association on univariate analysis of covariance (ANCOVA) and cor- relational (Kendall tau/Pearson) analyses. Kaplan – Meier survival analysis and Cox proportional hazard models were used to determine significant prognostic markers. Statistical significance was set at 0.05. Results 463 patients (male/female 2:1; median age = 66 years, interquartile range = 56.5 – 73.0) were included in the analysis. There was significant tumour response of T stage ( P < 0.001) and N stage ( P < 0.001), with 17.6% of patients achieving a pathological complete response. Pretreatment Hb value was inversely related to the craniocaudal vertical tumour length ( P = 0.02) and pretreatment T stage of the tumour ( P = 0.01). Patients with Hb levels of < 12 g/dl and moderately differenti- ated adenocarcinoma were less responsive. Local recur- rence was more common in patients with a pretreatment Hb of < 12 g/dl (hazard ratio = 1.78) over a median follow up of 24 months, but this was not statistically significant ( P = 0.08). Conclusion The pretreatment Hb level might be used as a biomarker of rectal tumour morphology, response to neoadjuvant chemoradiation and risk of local recur- renc

Kv7 and Kv11 channels in myometrial regulation.

Ion channels play a key role in defining myometrial contractility. Modulation of ion channel populations is proposed to underpin gestational changes in uterine contractility associated with the transition from uterine quiescence to active labour. Of the myriad ion channels present in the uterus, this article will focus upon potassium channels encoded by the KCNQ genes and ether-à-go-go-related (ERG) genes. Voltage-gated potassium channels encoded by KCNQ and ERG (termed Kv7 and Kv11, respectively) are accepted as major determinants of neuronal excitability and the duration of the cardiac action potential. However, there is now growing appreciation that these ion channels have a major functional impact in vascular and non-vascular smooth muscle. Moreover, Kv7 channels may be potential therapeutic targets for the treatment of preterm labour

Systematic review of new medics’ clinical task experience by country

OBJECTIVES: There is a need for research which informs on the overall size and significance of clinical skills deficits among new medics, globally. There is also the need for a meta-review of the similarities and differences between countries in the clinical skills deficits of new medics. DESIGN: A systematic review of published literature produced 68 articles from Google/Scholar, of which 9 met the inclusion criteria (quantitative clinical skills data about new medical doctors). PARTICIPANTS: 1329 new medical doctors (e.g., foundation year-1s, interns, PGY1s). SETTING: Ten countries/regions. MAIN OUTCOME MEASURES: 123 data points and representation of a broad range of clinical procedures. RESULTS: The average rate of inexperience with a wide range of clinical procedures was 35.92% (lower CI 30.84%, upper CI 40.99%). The preliminary meta-analysis showed that the overall deficit in experience is significantly different from 0 in all countries. Focusing on a smaller selection of clinical skills such as catheterisation, IV cannulation, nasogastric tubing and venepuncture, the average rate of inexperience was 26.75% (lower CI 18.55%, upper CI 35.54%) and also significant. England presented the lowest average deficit (9.15%), followed by New Zealand (18.33%), then South Africa (19.53%), Egypt, Kuwait, Gulf Cooperation Council countries and Ireland (21.07%), after which was Nigeria (37.99%), then USA (38.5%), and Iran (44.75%). CONCLUSION: A meta-analysis is needed to include data not yet in the public domain from more countries. These results provide some support for the UK General Medical Council’s clear, detailed curriculum, which has been heralded by other countries as good practice

Initial stage of plate lifting from a water surface

This study deals with the flow induced by a rigid flat plate of finite length, initially touching a horizontal water surface, when it starts to move upwards with constant acceleration. In the present model, negative hydrodynamic pressures on the lower (wetted) surface of the plate are allowed, and thus, the water follows the plate due to the resulting suction force. The acceleration of the plate and the plate length are such that gravity, surface tension and viscous effects can be neglected during the early stages of the motion. Under these assumptions, the initial two-dimensional, potential flow caused by the plate lifting is obtained by using the small-time expansion of the velocity potential. This small-time solution is not valid close to the plate edges, as it predicts there singular flow velocities and unbounded displacements of the water-free surface. It is shown that close to the plate edges the flow is nonlinear and self-similar to leading order. This nonlinear flow is computed by the boundary-element method combined with a time-marching scheme. The numerical time-dependent solution approaches the self-similar local solution with time

Spin-strain coupling in NiCl2-4SC(NH2)2

We report results of ultrasonic investigations of the quantum S = 1 spin-chain magnet NiCl2-4SC(NH2)2, also known as DTN, in magnetic fields up to 18 T and temperatures down to 0.3 K. A field H along the [001] direction induces a transition into an antiferromagnetic phase with T(N)max ≈ 1.2 K. Accordingly, at T = 0 there are two quantum critical points at ~2.1 T and at ~12.6 T. The acoustic c33 mode, propagating along the spin chains, shows a pronounced softening close to the phase transition, accompanied by energy dissipation of the sound wave. The H-T phase diagram obtained from our measurements is compared with results from other experimental investigations and the low-temperature acoustic anomalies are traced up to T > T(N). We also report frequency-dependent effects, which open the possibility to investigate the spin fluctuations in the critical regions. Our observations show an important role of the spin-phonon coupling in DTN

Casimir effect of electromagnetic field in Randall-Sundrum spacetime

We study the finite temperature Casimir effect on a pair of parallel perfectly conducting plates in Randall-Sundrum model without using scalar field analogy. Two different ways of interpreting perfectly conducting conditions are discussed. The conventional way that uses perfectly conducting condition induced from 5D leads to three discrete mode corrections. This is very different from the result obtained from imposing 4D perfectly conducting conditions on the 4D massless and massive vector fields obtained by decomposing the 5D electromagnetic field. The latter only contains two discrete mode corrections, but it has a continuum mode correction that depends on the thicknesses of the plates. It is shown that under both boundary conditions, the corrections to the Casimir force make the Casimir force more attractive. The correction under 4D perfectly conducting condition is always smaller than the correction under the 5D induced perfectly conducting condition. These statements are true at any temperature.Comment: 20 pages, 4 figure

Algorithmic statistics revisited

The mission of statistics is to provide adequate statistical hypotheses (models) for observed data. But what is an "adequate" model? To answer this question, one needs to use the notions of algorithmic information theory. It turns out that for every data string $x$ one can naturally define "stochasticity profile", a curve that represents a trade-off between complexity of a model and its adequacy. This curve has four different equivalent definitions in terms of (1)~randomness deficiency, (2)~minimal description length, (3)~position in the lists of simple strings and (4)~Kolmogorov complexity with decompression time bounded by busy beaver function. We present a survey of the corresponding definitions and results relating them to each other