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Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

Organizational change is a key mechanism to ensure the sustainability of healthcare systems. However, healthcare organizations are persistently difficult to change, and literature is riddled with examples of failed change endeavors. In this chapter, we attempt to unravel the underlying causes for failed organizational change. We distinguish three types of change with different levels of depth that require different change approaches. Transformations are the deepest forms of change where beliefs and principles need to be modified to successfully influence routines. Renewals are deep forms of change where principles need to be modified to successfully influence routines. Improvements are shallow forms of change where only modifications at the level of routines are needed. Using deoxyribonucleic acid (DNA) as our metaphor, we propose a theory of “organizational DNA” to understand organizations and these three types of organizational changes. We posit that organizations are made up of a double helix consisting of a so-called “social string,” which contains the “soft” interaction or communication among the organization's members, and a so-called “technical string,” which contains “hard” organizational aspects such as structure and technology. Ladders of organizational nucleotides (i.e., Routines, Principles, and Beliefs) connect this double helix in various combinations. Together, the double helix and accompanying nucleotides make up the DNA of an organization. Without knowledge of the architecture of organizational DNA and whether a change addresses beliefs, principles, and/or routines, we believe that organizational change is constrained and based on luck rather than change management expertise. Following this metaphor, we show that organizational change fails when it attempts to change one part of the DNA (e.g., routines) in a way that renders it incompatible with the connecting components (e.g., principles and beliefs). We discuss how the theory can be applied in practice using an exemplar case.

The purpose of this paper is to propose a novel nonlocal fractal calculus scheme dedicated to the analysis of fractal electrical circuit, namely, the generalized nonlocal fractal calculus.

For being generalized, an arbitrary kernel function has been adopted. The condition on order has been derived so that it is not related to the γ-dimension of the fractal set. The fractal Laplace transforms of our operators have been derived.

Unlike the traditional power law kernel-based nonlocal fractal calculus operators, ours are generalized, consistent with the local fractal derivative and use higher degree of freedom. As intended, the proposed nonlocal fractal calculus is applicable to any kind of fractal electrical circuit. Thus, it has been found to be a more efficient tool for the fractal electrical circuit analysis than any previous fractal set dedicated calculus scheme.

A fractal calculus scheme that is more efficient for the fractal electrical circuit analysis than any previous ones has been proposed in this work.

The purpose of this paper is to study the reliability of sintered nano-silver joints on bare copper substrates during high-temperature storage (HTS).

In this study, HTS at 250 °C was carried out to investigate the reliability of nano-silver sintered joints. Combining the evolution of the microstructure and shear strength of the joints, the degradation mechanisms of joints performance were characterized.

The results indicated that the degradation of the shear properties of sintered nano-silver joints on copper substrates was attributed to copper oxidation at the silver/copper interface and interdiffusion of interfacial elements. The joints decreased by approximately 57.4% compared to the original joints after aging for 500 h. In addition, severe coarsening of the silver structure was also an important cause for joints failure during HTS.

This paper provides a comparison of quantitative and mechanistic evaluation of sintered silver joints on bare copper substrates during HTS, which is of great importance in promoting the development of sintered silver technology.

This paper aims to investigate the moisture diffusion behavior in a system-in-package module systematically by moisture-thermalmechanical-coupled finite element modeling with different structure parameters under increasingly harsh environment.

A finite element model for a system-in-package module was built with moisture-thermal-mechanical-coupled effects to study the subsequences of hygrothermal conditions.

It was found in this paper that the moisture diffusion path was mainly dominated by hygrothermal conditions, though structure parameters can affect the moisture distribution. At lower temperatures (30°C~85°C), the direction of moisture diffusion was from the periphery to the center of the module, which was commonly found in simulations and literatures. However, at relatively higher temperatures (125°C~220°C), the diffusion was from printed circuit board (PCB) to EMC due to the concentration gradient from PCB to EMC across the EMC/PCB interface. It was also found that there exists a critical thickness for EMC and PCB during the moisture diffusion. When the thickness of EMC or PCB increased to a certain value, the diffusion of moisture reached a stable state, and the concentration on the die surface in the packaging module hardly changed. A quantified correlation between the moisture diffusion coefficient and the critical thickness was then proposed for structure parameter optimization in the design of system-in-package module.

The different moisture diffusion behaviors at low and high temperatures have seldom been reported before. This work can facilitate the understanding of moisture diffusion within a package and offer some methods about minimizing its effect by design optimization.

This study aims to assess the facilities management (FM) strategies used in multi-tenanted purpose-built office buildings (Mt-POBs) in Ghana and the drivers that influence the decision to use such strategies.

This study was conducted via a survey and key informant interviews. The survey was conducted using a questionnaire targeted at 65 multi-tenanted office building owners in the Greater Accra region. The data from the survey revealed the views of building owners on FM strategy and the extent to which 20 facility management decision drivers influenced their decisions to use a particular strategy and the responses were descriptively analysed. The key informant interviews were conducted among six leaders of the property owners’ association who use in-house FM to further understand their perspectives and decisions on using such strategy. The interviews were conducted over telephone using an interview guide and analysed using thematic analysis.

The results showed that 88% of Mt-POBs in Ghana are managed in-house. The results also showed that the decision to use the in-house strategy was driven by the innovative, strategic and cost-saving advantages associated with the in-house strategy.

This study shows the factors that drive the decision of multi-tenanted office building owners in Ghana to use the in-house strategy. The findings of this study will be useful for prospective owners of office buildings in Ghana.

This study aims to characterize the mechanical properties of sintered nano-silver under various sintering processes by nano-indentation tests.

Through microstructure observations and characterization, the influences of sintering process on the microstructure evolutions of sintered nano-silver were presented. And, the indentation load, indentation displacement curves of sintered silver under various sintering processes were measured by using nano-indentation test. Based on the nano-indentation test, a reverse analysis of the finite element calculation was used to determine the yielding stress and hardening exponent.

The porosity decreases with the increase of the sintering temperature, while the average particle size of sintered nano-silver increases with the increase of sintering temperature and sintering time. In addition, the porosity reduced from 34.88%, 30.52%, to 25.04% if the ramp rate was decreased from 25°C/min, 15°C/min, to 5°C/min, respectively. The particle size appears more frequently within 1 µm and 2 µm under the lower ramp rate. With reverse analysis, the strain hardening exponent gradually heightened with the increase of temperature, while the yielding stress value decreased significantly with the increase of temperature. When the sintering time increased, the strain hardening exponent increased slightly.

The mechanical properties of sintered nano-silver under different sintering processes are clearly understood.

This paper could provide a novel perspective on understanding the sintering process effects on the mechanical properties of sintered nano-silver.

This study aims to analyze the Prandtl fluid flow in the presence of better mass diffusion and heat conduction models. By taking into account a linearly bidirectional stretchable sheet, flow is produced. Heat generation effect, thermal radiation, variable thermal conductivity, variable diffusion coefficient and Cattaneo–Christov double diffusion models are used to evaluate thermal and concentration diffusions.

The governing partial differential equations (PDEs) have been made simpler using a boundary layer method. Strong nonlinear ordinary differential equations (ODEs) relate to appropriate non-dimensional similarity variables. The optimal homotopy analysis technique is used to develop solution.

Graphs analyze the impact of many relevant factors on temperature and concentration. The physical parameters, such as mass and heat transfer rates at the wall and surface drag coefficients, are also displayed and explained.

The reported work discusses the contribution of generalized flux models to note their impact on heat and mass transport.

The purpose of the paper is to analyse the performances of closures and compressibility corrections classically used in turbulence models when applied to highly-compressible turbulent boundary layers (TBLs) over flat plates.

A direct numerical simulation (DNS) database of TBLs, covering a wide range of thermodynamic conditions, is presented and exploited to perform a priori analyses of classical and recent closures for turbulent models. The results are systematically compared to the “exact” terms computed from DNS.

The few compressibility corrections available in the literature are not found to capture DNS data much better than the uncorrected original models, especially at the highest Mach numbers. Turbulent mass and heat fluxes are shown not to follow the classical gradient diffusion model, which was shown instead to provide acceptable results for modelling the vibrational turbulent heat flux.

The main originality of the present paper resides in the DNS database on which the a priori tests are conducted. The database contains some high-enthalpy simulations at large Mach numbers, allowing to test the performances of the turbulence models in the presence of both chemical dissociation and vibrational relaxation processes.