Quality of care in University Hospitals in Saudi Arabia: systematic review

Objectives: To identify the key issues, problems, barriers and challenges particularly in relation to the quality of care in university hospitals in the Kingdom of Saudi Arabia (KSA), and to provide recommendations for improvement. Methods: A systematic search was carried out using five electronic databases, for articles published between January 2004 and January 2015. We included studies conducted in university hospitals in KSA that focused on the quality of healthcare. Three independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies and extracted their relevant characteristics. All studies were assessed using the Institute of Medicine indicators of quality of care. Results: Of the 1430 references identified in the initial search, eight studies were identified that met the inclusion criteria. The included studies clearly highlight a need to improve the quality of healthcare delivery, specifically in areas of patient safety, clinical effectiveness and patient-centredness, at university hospitals in KSA. Problems with quality of care could be due to failures of leadership, a requirement for better management and a need to establish a culture of safety alongside leadership reform in university hospitals. Lack of instructions given to patients and language communication were key factors impeding optimum delivery of patient-centred care. Decisionmakers in KSA university hospitals should consider programmes and assessment tools to reveal problems and issues related to language as a barrier to quality of care. Conclusions: This review exemplifies the need for further improvement in the quality of healthcare in university hospitals in KSA. Many of the problems identified in this review could be addressed by establishing an independent body in KSA, which could monitor healthcare services and push for improvements in efficiency and quality of care

Gogny interaction and nuclear charge distribution in 48Ca Nucleus

تمت دراسة عوامل التشكل الكولومية لمتعددة الاقطاب لنواة 48Ca باستخدام نموذج القشرة النووية. وقد أدخل الجهد النووي fpmb لزوج الجسيمتين للحسابات لتركيب LS. اعتمد جهد المتذبذب التوافقي  Jp`tكدالة موجة للجسيم المنفرد في الفضاء Fp . وقد أضيفت الفضاءات العليا وتأثيرات القلب الخامل كتصحيح من المرتبة الاولى. تم استخدام جهد الجسيمتين الدقيق لكوكني لتفاعل الجسيمات الفعالة في الفضاء مع زوج (جسيم-فجوة) في الفضاءات المستثناة و بطاقة تهيج مقدارها 2ћω .ان اختيار تفاعل كوكني تم على اساس نجاحه في نظرية القشرة.  تم مقارنة النتائج مع القيم العملية.Charge multipole Coulomb scattering form factors in 48Ca nucleus have been reproduced utilizing the theory of nuclear shell. The efficient two-body nuclear potential fpbm is considered to construct the-spin orbit term LS vectors with Harmonic Oscillator HO potential as a wave function of single particle in Fp shell. Discarded spaces ( core + higher configuration) are taken into account through the Core polarization effect by model space with accurate two-body potential of Gogny to  interact the LS operating particles with the discarded space pair ( particle-hole) with energy of excitation equal to 2ћω. Gogny interaction has been selected as it had succeeded in nuclear shell theory. The computed results were compared with the available experimental data

The Effective M3Y Residual Interaction In 41Ca As a Nuclear Diffraction Grating of Electrons

تمت تحقيق عوامل التشكل للاستطارة الالكترونية المغناطيسية المرنة متعددة الاقطاب الكلية والمنفردة  لنظير 41Ca باستخدام أنموذج القشرة النووية الناجح و الواسع التطبيق واعتبار الغلاف 1f7/2 كأنموذج فضاء واعتماد التفاعلF7MBZ    كتفاعل مؤثر لتشكيل دوال موجة انموذج الفضاء. اعتمدت دالة المتذبذب التوافقي كدالة جسيم منفرد , كما تم اعتماد نواة 40Ca كقلب خامل حيث يتم استقطابه واشراكه في حسابات عوامل التشكل المغناطسية المرنة من خلال عملية استقطاب القلب حيث يتم خلع نيوكليون من مدارات القلب الخامل وتهييجه الى مستويات عليا وبفرق طاقة 2ћω وكما تم الاعتماد على التفاعل الواقعي (effective M3Y P2) في حسابات استقطاب القلب والذي يفاعل الزوج( جسيم –فجوة ) ان هذا التفاعل هو نموذج مطور حديثا للتفاعل الاصلي واخيرا تم مقارنة النتائج النظرية مع ما هو متوفر من نتائج عملية.The total and individual multipole moments of  magnetic electron scattering form factors in 41Ca  have been investigated using a widely successful model which is the nuclear shell model configurations keeping in mind of 1f7/2 subshell as an L-S shell and Millinar, Baymann, Zamick as L-S shell (F7MBZ) to give the model space  wave vector. Also, harmonic oscillator wave functions have been used as wave function of a single particle in 1f7/2  shell. Nucleus 40Ca as core closed and Core polarization effects have been used as a corrective with first order correction concept to basic computation of L-S shell and the excitement energy has been implemented with 2ћω. The core polarizability effect has been utilized to incorporate the rejected space (core + higher arrangement) via L-S shell with a realism interaction of effective M3Y P2 interaction to connect the model space particles in motion with the spouse (p-h). The two body M3Y interactions have been utilized as an interaction residue to calculate the core polarizability matrix elements. Finally, the theoretical result of the form factor has been compared with the experimental results

Design of second order sliding mode observer based equivalent Back-EMF for rotor position estimation of PMSM

This study introduces a scheme to estimate rotor position by the use of an Equal electromotive force (EMF) model of a synchronous machine. This use could be substituted by a sliding-mode observer (SMO) according to an equal EMF for superior reference speed tracking. There is an algorithm of the second order sliding-mode-control (SO-SMC) in controlling speed of permanent magnet synchronous motor (PMSM). This is by the use of the proportional plus-integral PI control sliding plane. The current work discusses the PMSM, which follows field-oriented appears. In addition, there are SO-SMC laws and PI sliding plans. This paper shows that the proposed high-speed PMSM sensorless speed control is valid by MATLAB simulations

Data Acquisition and Processing of Hartha Formation in the east Baghdad oil field, Central of Iraq

A three-dimensional survey was carried out to Eastern Baghdad oil field, which consist three parts, the area of (EB South- 2 ) approximately 179,875 km2 and ( EB South-1) is about (602.03) km2, while the space segment (EB South-3) is approximately to (419.095) km2. In this research, was focused on Hartha Formation only. Based on many tests to designation of pre-planning of the survey to get good signal to noise ratio for receivers in addition to the best suit for vibrators distribution and also getting the best signal source where spread of a 60-line impact and the distance between the point of receive and the other are (2 meters), also using (5) vibrators Type (NOMAD 65) with a maximum capacity of (62000 LB) for each shock. Where all processes work such as enhancing signal at the expense of noise, correction CDP gather for Normal Move Out (NMO) and stack them, correction for influence of near-surface time delays (static correction), filtering processes, providing velocity information, increasing resolution and collapsing diffractions and placing dipping events in their correct subsurface locations (migration) This processes are achieved using computers, they include many mathematical processes depend on physical fundamentals. The main processes in seismic data processing include : stacking, deconvolution, and migration. By using the information of EB-1 Well, and making the relationship time-depth curve of EB-1 then following up on getting synthetic to be linked later with seismic data and sections to obtain a real subsurface image

Comparative phytotoxicity of aqueous extracts of centaurea maculosa and melilotus officinalis on germinability and growth of wheat

Weed incursion in cultivated fields is a serious biological problem, which causes considerable yield losses of economically important field crops through allelopathy and competitive interactions. Spotted knapweed (Centaurea maculosa) and yellow melilot (Melilotus officinalis) are among the most prevalent weeds in cultivated fields of Pakistan, particularly in wheat fields. Like many other weeds, they may pose allelopathic and competitive challenges to field crops. The objective of this study was to evaluate allelopathic potentials of the two weeds on germination and seedling growth of wheat under laboratory conditions. Amounts of 15, 20, 25 and 30% concentrated leaf aqueous extracts of C. maculosa and M. officinalis were prepared and tested for their effects on germination percentage, radicle and coleoptile lengths of wheat. Germination, radicle and coleoptile lengths of test crop declined significantly at higher concentration (25-30%) of the extracts of two weeds. However, concentration of M. officinalis up to 20% had either no effect or stimulatory effects on the studied growth characteristics of wheat. Highest germination inhibition and decreased seedling growth were caused by leaf extracts of C. maculosa at 30% extract concentration. Growth inhibition was generally dependent on the extract concentration. The study indicated that both plant exhibited allelopathic activity and growth inhibitory effects on wheat at higher concentration; however, extracts of C. maculosa were more phytoinhibitory than M. officinalis. The weeds could serve as potent allelopathic plants for management of other weeds

Nitrous oxide (N2O) emissions by termites : does the feeding guild matter ?

In the tropics, termites are major players in the mineralization of organic matter leading to the production of greenhouse gases including nitrous oxide (N2O). Termites have a wide trophic diversity and their N-metabolism depends on the feeding guild. This study assessed the extent to which N2O emission levels were determined by termite feeding guild and tested the hypothesis that termite species feeding on a diet rich in N emit higher levels of N2O than those feeding on a diet low in N. An in-vitro incubation approach was used to determine the levels of N2O production in 14 termite species belonging to different feeding guilds, collected from a wide range of biomes. Fungus-growing and soil-feeding termites emit N2O. The N2O production levels varied considerably, ranging from 13.14 to 117.62 ng N2O-N d(-1) (g dry wt.)(-1) for soil-feeding species, with Cubitermes spp. having the highest production levels, and from 39.61 to 65.61 ng N2O-N d(-1) (g dry wt.)(-1) for fungus-growing species. Wood-feeding termites were net N2O consumers rather than N2O producers with a consumption ranging from 16.09 to 45.22 ng N2O-N d(-1) (g dry wt.)(-1). Incubating live termites together with their mound increased the levels of N2O production by between 6 and 13 fold for soil-feeders, with the highest increase in Capritermes capricornis, and between 14 and 34 fold for fungus-growers, with the highest increase in Macrotermes muelleri. Ammoniaoxidizing (amoA-AOB and amoA-AOA) and denitrifying (nirK, nirS, nosZ) gene markers were detected in the guts of all termite species studied. No correlation was found between the abundance of these marker genes and the levels of N2O production from different feeding guilds. Overall, these results support the hypothesis that N2O production rates were higher in termites feeding on substrates with higher N content, such as soil and fungi, compared to those feeding on N-poor wood

Outputs and Growth of Primary Care Databases in the United Kingdom: Bibliometric Analysis.

BACKGROUND: Electronic health database (EHD) data is increasingly used by researchers. The major United Kingdom EHDs are the 'Clinical Practice Research Datalink' (CPRD), 'The Health Improvement Network' (THIN) and 'QResearch'. Over time, outputs from these databases have increased, but have not been evaluated. OBJECTIVE: This study compares research outputs from CPRD, THIN and QResearch assessing growth and publication outputs over a 10-year period (2004-2013). CPRD was also reviewed separately over 20 years as a case study. METHODS:  Publications from CPRD and QResearch were extracted using the Science Citation Index (SCI) of the Thomson Scientific Institute for Scientific Information (Web of Science). THIN data was obtained from University College London and validated in Web of Science. All databases were analysed for growth in publications, the speciality areas and the journals in which their data have been published. RESULTS: These databases collectively produced 1,296 publications over a ten-year period, with CPRD representing 63.6% (n=825 papers), THIN 30.4% (n=394) and QResearch 5.9% (n=77). Pharmacoepidemiology and General Medicine were the most common specialities featured. Over the 9-year period (2004-2013), publications for THIN and QResearch have slowly increased over time, whereas CPRD publications have increased substantially in last 4 years with almost 75% of CPRD publications published in the past 9 years. CONCLUSION: These databases are enhancing scientific research and are growing yearly, however display variability in their growth. They could become more powerful research tools if the National Health Service and general practitioners can provide accurate and comprehensive data for inclusion in these databases

Qualitative and Quantitative Estimation or Chemical Constituents from Leaves and Roots of Iraqi Agave Attenuata by GC-MS and RP-HPLC(Conference Paper) #

This research concentrate on cultivated Iraqi Agave attenuata dried leaves and roots, because of little studies on this plant especially on the root that lead to the eager of study and comparison of phytochemical constituents between leaves and root. Extraction of bioactive constituents was carried out using several solvents with increasing polarity (n-hexane, ethyl acetate and methanol) by soxhlet apparatus. Steroidal saponins in Agave genus is well documented in many species, lightening the minds in this research on extraction method which is specific for steroidal saponins. Phytochemical screening was done by GC/MS for n-hexane fraction, qualitative and quantitative estimation of several bioactive constituents (caffeic acid, p-coumaric acid, and quercetin) for ethyl acetate and methanol fractions while for steroidal saponins (sarsasapogenin, hecogenin and tigogenin) in both leaves and root by using reverse phase-high performance liquid chromatography (RP-HPLC). Among those identified phytochemical constituents, several constituents have not been detected in Agave attenuata leaves and roots before. This study is the first to describe the results in which the highest concentration of caffeic acid was found in leaves ethyl acetate fraction, p-coumaric acid and quercetin in root ethyl acetate fractions. While for steroidal saponins, the hecogenin, tigogenin and sarsasapogenin highest concentrations were found in leaves.      

Allelopathic effect of Ficus benjamina leaf extract, litter, and mulch on germination and growth of sunflower

Allelopathy is an important biological process, which has direct or indirect effects on the germination and growth potentials of plants. Awareness about the allelopathic properties of plants which prevail in agricultural systems can help growers to amend crop cultivation patterns accordingly. In this study, we evaluated the allelopathic effects of Ficus benjamina on germination and early seedling growth of four hybrids of sunflower (Oliver, Parsun-3, SFH-80 and NK- S- 278). Ethanolic and hot-water aqueous extracts from leaves, while litter and mulches of the test allelopathic plant significantly reduced germination, radicle and hypocotyle growth of sunflower. Germination percentage was drastically reduced in all the four sunflower hybrids by ethanolic, hot-water and litter extracts; however, compared to control, mulching assay significantly increased germination in hybrids Oliver (76%), Parsun-3 (42%), SFH-80 (78%) and NK-S-278 (30%) at 2, 4, 8 and 12g extract concentration, respectively. Hypocotyle and radicle length of test hybrids were significantly reduced in each assay type. Among tested assays, ethanolic extracts revealed more drastic effects on the studied parameters than hot-water, litter, and mulching. Sunflower hybrid NK-S-278 was more severely affected, while Parsun-3 exhibited resistance to the allelopathic stress. Inhibitory effects were more prominent with increasing concentration of the extracts. The order of the phytotoxic effects of tested bioassays was ethanolic extract˃ hot-water˃ litter˃ mulching. The study suggested that Ficus leaves may possess potent allelochemicals with growth inhibitory effects on sunflower seedlings. It is suggested that further study might be required to check the allelopathic effect of Ficus benjamina on germination and growth of these sunflower hybrids in field conditions