The role of intermediaries in facilitating e-government diffusion in Saudi Arabia

Recent studies of e-government activity have highlighted adoption and diffusion issues as important subjects for rating e-government success. However in developing countries inadequate resources and limited citizens’ capabilities regarding new e-government have resulted in low diffusion and adoption of e-government services. This paper examines the role of intermediaries, which can be played by a third party; in bridging the gap between e-government implementation and social reality, and looks at the roles a third party can add within the e-government services mechanism. This paper uses a case study approach in order to reflect e-government progress within the context of the Kingdom of Saudi Arabia (KSA) as one developing country. The result of this paper shows that intermediaries play an important role in the diffusion of e-services in relation to improving the availability, accessibility and enhancing privacy and security

Current state of e-services in Saudi Arabia: the case of intermediaries in facilitating government services in Madinah city

The government of Madinah has launched ‘Khdamatec’ electronic Offices (e-Offices) concept under their national electronic Government (e-Government) modernisation agenda to facilitate service delivery to citizens and seamless interaction to communicate their needs. By offering e-Offices around the government departments, Madinah government hopes to increase accessibility of e-Government services and make steps forward to electronic age, encourage Medina' citizens to participate and use e-Services and bridging digital divide. However, the empirical findings illustrate that the adoption and diffusion of the e-Office concept and e-Government in the wider context at a lethargic pace. This paper highlights some of the challenges faced by the Madinah city in implementing the e-Office concept and e-Government

Examining the influence of intermediaries in facilitating e-government adoption: an empirical investigation

YesThe adoption and diffusion of electronic government is often impeded by many social and individual factors relating to citizens. In this respect, intermediaries have emerged as a new model for delivering e-government services to overcome such obstacles. This study aims to examine the role of intermediaries in facilitating e-government adoption and diffusion using a survey based empirical study of 502 participants in Madinah City in Saudi Arabia. An extended UTAUT model is used as the theoretical basis utlising trust in the Internet and Intermediaries. The results of this study show that there are significant relationships among the factors that influence intention to use e-government, namely, performance expectancy, effort expectancy, and trust of intermediary. In addition, the findings show that there is a significant relationship between facilitating conditions and usage behaviour proving that intermediaries can influence adoption of e-government services

The pattern of branching and intercommunications of the musculocutaneous nerve for surgical issues: anatomical study

Background: The aim of the present work was to provide evidence about the anatomical variations as regard the origin, distribution, and branching pattern of the musculocutaneous nerve (MCN). Materials and methods: Brachial plexus was dissected in 40 upper limbs of 20 male adult cadavers. The pattern of the musculocutaneous nerve was photographed by a digital camera. Results: The location and length of the nerve branches between left and right arms were recorded and statistically analyzed. In (90%) of specimens the MCN originates from the lateral cord of the brachial plexus, in (5%) it arose from the median nerve (MN), while in the remaining (5%) specimen, it was absent. The musculocutaneous nerve pierced the coracobrachialis muscle in 90% of specimens, and in the remaining (10%) did not pierce it. The motor branches to biceps brachii muscle were categorized into: Type 1 (90%): one branch that divides to supply the two heads of biceps; Type 2 (5%): double branches, innervating each head of biceps separately. The motor branches to brachialis muscle were categorized into: Type 1 (82.9%): one branch; Type 2 (14.2%): double branches and Type 3 (2.9%): three branches that innervating brachialis muscle. Communications between the MCN and the MN were observed in 35% of specimens. Conclusions: The knowledge of the common and uncommon musculocutaneous nerve variations is important especially to the surgeons for carrying out surgical procedures in axilla and arm

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Application of i-SDT for safer flare management operation

Utilizing unburn flare streams in a safe way represents one of the key challenges during flare alternatives implementation. Most of the time, process safety is considered on a supplemental basis after accomplishing a detailed plant design and economic analysis. The prime reason is the lack of a systematic design tool that facilitates the incorporation of inherently safer design principles into the early stage of process synthesis and in the absence of an adequate amount of data. It would be therefore advantageous for designers if they were able to assess safety aspects in a continuous manner for retrofitting design purposes as well as appraising innovative alternatives. In this work, a newly developed Inherently Safer Design Tool (i-SDT) has been applied to identify reliable and safer operating conditions while implementing a cogeneration (COGEN) unit as a flare utilization alternative. In the illustrative case study, the COGEN unit has been accompanied by an ethylene process to act as an additional utility provider by using some portion of the unburn hydrocarbon streams. These streams were available from several flaring locations of the plant during different routine/abnormal cases. The objective of this work is to conduct a comprehensive techno-economic and environmental performance analysis by utilizing a multi-objective optimization framework along with the necessary set of process constraints derived from the safety perspective offered by i-SDT. The illustrative case study considered here showed that the proposed i-SDT tool could estimate the limits associated with key safety parameters (flammability, toxicity, explosiveness, and reactivity) by explicitly considering operating conditions. Later, these operating limits are explicitly embedded as safety constraints into the optimization algorithm to assess the techno-economic, environmental and safety performance profiles of the process system under consideration. - 2019 The Institution of Chemical EngineersThis paper was made possible by NPRP grant No 10-0205-170347 from the Qatar National Research Fund (a member of Qatar Foundation). The statements made herein are solely the responsibility of the author[s].Scopu

Characterization of Industrial Flaring under Uncertainty for the Design of Optimum Flare Recovery and Utilization Systems

One of the main challenges in industrial applications is to optimally manage flare gases that are inevitably generated both in routine and non-routine process operations but can yet constitute valuable energy resources for process systems. A main challenge is to explore the best possible strategies for exploiting these valuable hydrocarbon streams and propose process design alternatives and operational solutions that achieve maximum recovery and use of flare gases at minimum total cost and considering the uncertainty variations associated with flaring incidents. This requires an understanding of the characteristics of flare streams that affect their recovery and reutilization potential as well as an examination of their impact on process system performance while recognizing that the inherently uncertain nature of flaring calls upon a probabilistic approach. In our study, we examine the impact of using a comprehensive probabilistic analysis framework for process flare streams’ characterization on the design of an optimal recovery and utilization system. In particular, the work aims to explore the impact of uncertainty for key parameters on the design solutions, such as rate of flare occurrences that were assumed constant in other research works (Kazi et al., 2018). Suitable parametrized Monte Carlo (MC) simulations are employed for more accurate flare profile representations. A comparative study is conducted between the base case optimal design and values at risk solutions for cases where flaring variation increases may significantly affect the design features and economic performance of the process system. The proposed framework could inform decision makers’ assessments of the impact of random variations in flaring profiles on process performance profile. © 2022 Elsevier B.V