Search results

Recently, the utilization of cold-formed steel (CFS) roof truss systems and different types of other combination structural support systems, such as concrete or hot-rolled steel support, becomes more frequently used. This paper aims to identify the load transfer characteristics of three different design details for cold-formed truss to supporting system connections and to propose simplified modelling approach for practices.

Simplification modelling of connection design could be proposed for practical purpose based on the load transfer characteristics obtained from detailed study using finite element method. A cold-formed roof truss system with connection is modelled using line elements. However, the supporting system is not modelled in this work. Three types of connection involve, which are five pieces of CFS L-angle brackets, one-piece of CFS L-angle brackets and three types of bolts connection are modelled.

The results of analysis show that the connections located on the loaded side experienced higher reactions than those far from loaded side. From the result, it is also found that the option of “Fixed But” support condition in STAAD.Pro with translational degree of freedom being restrained is the most suitable way to represent the CFS L-angle brackets design for Type 1 connection for use in truss modelled using line elements.

Such increase in usage necessitates an appropriate connection detailing depending on the behaviour of the connection.

As host to over one million Syrian refugees, Lebanon continues to experience challenges addressing the needs of refugee families. This research examined the experiences of Syrian families with the refugee support system in Lebanon. The purpose of this study was to better understand the strengths and gaps in existing mechanisms of support for these Syrian families, including informal support from family, neighbors and community and more formalized support provided through entities such as nongovernmental organizations and United Nations agencies.

Data were collected from 46 families displaced by the war and living in Lebanon (N = 351 individuals within 46 families). Collaborative family interviews were conducted with parents, children and often extended family.

The data identified both strengths and gaps in the refugee support system in Lebanon. Gaps in the refugee support system included inadequate housing, a lack of financial and economic support, challenges with a lack of psychosocial support for pregnant women and support for disabled youth. Despite these challenges, families and community workers reported informal community support as a strong mediator of the challenges in Lebanon. Furthermore, the data find that organizations working with Syrian families are utilizing informal community support through capacity building, to create more effective and sustainable support services.

This study provides an overview of strengths and gaps in supports identified by refugees themselves. The research will inform the development and improvement of better support systems in Lebanon and in other refugee–hosting contexts.

Providing student housing designed to support students living with a disability is a global challenge. This study assesses buildings' physical health condition systems and drivers of physical health condition effects on students living with disability (SWD) in purpose-built university housing in Ghana.

The study used quantitative design and methods based on the theory of supportive design premises. Using the partial least square structural equation model, a survey of 301 students living with a physical disability, mild visual disability and mild hearing disability was collected in 225 student housings.

The study found that insect control and cleaning services are a priority in off-campus building design and management and directly positively affected the sense of control and physical health of SWD. The nature of lightning systems, noise and thermal comfort directly negatively affected SWD disability learning and discomfort.

Reviewing and enforcing student housing design drawings at the preliminary development stage by university management is critical. More broadly, physical health systems that control cleaning, noise and thermal comfort are essential for SWD health in student housing.

Studies on all-inclusive building designs have consistently focused on lecture theaters and libraries with limited attention on the physical health condition systems in student housing that support the quality healthcare of university campuses. Research on physical health condition systems in student housing is significant for all-inclusiveness and student housing management.

The future increase of chronic diseases in the world requires new challenges in the health domain to improve patients' care from the point of view of the organizational processes, clinical pathways and technological solutions of digital health. For this reason, the present paper aims to focus on the study and application of well-known clinical practices and efficient organizational approaches through an innovative model (TALIsMAn) to support new care process redesign and digitalization for chronic patients.

In addition to specific clinical models employed to manage chronic conditions such as the Population Health Management and Chronic Care Model, we introduce a Business Process Management methodology implementation supported by a set of e-health technologies, in order to manage Care Pathways (CPs) digitalization and procedures improvement.

This study shows that telemedicine services with advanced devices and technologies are not enough to provide significant changes in the healthcare sector if other key aspects such as health processes, organizational systems, interactions between actors and responsibilities are not considered and improved. Therefore, new clinical models and organizational approaches are necessary together with a deep technological change, otherwise, theoretical benefits given by telemedicine services, which often employ advanced Information and Communication Technology (ICT) systems and devices, may not be translated into effective enhancements. They are obtained not only through the implementation of single telemedicine services, but integrating them in a wider digital ecosystem, where clinicians are supported in different clinical steps they have to perform.

The present work defines a novel methodological framework based on organizational, clinical and technological innovation, in order to redesign the territorial care for people with chronic diseases. This innovative ecosystem applied in the Italian research project TALIsMAn is based on the concept of a continuum of care and digitalization of CPs supported by Business Process Management System and telemedicine services. The main goal is to organize the different socio-medical activities in a unique and integrated IT system that should be sustainable, scalable and replicable.

The study aims to explore the utilisation of Clinical Decision Support (CDS) tools in Tanzanian healthcare facilities by identifying the tools used, the challenges encountered and the adaptive strategies employed by healthcare practitioners. It utilises an Activity Theory (AT) approach to understand the dynamic interactions between healthcare providers, CDS tools and the broader healthcare system.

The research adopts a qualitative approach in two prominent regions of Tanzania, Dar es Salaam and Dodoma. It involves semi-structured interviews with 26 healthcare professionals and key stakeholders across ten healthcare facilities, supplemented by document reviews. The study employs AT to analyse the interactions between healthcare professionals, CDS tools and the broader healthcare system, identifying best practices and providing recommendations for optimising the use of CDS tools.

The study reveals that Tanzanian healthcare practitioners predominantly rely on non-computerised CDS tools, such as clinical guidelines prepared by the Ministry of Health. Despite the availability of Health Information Systems (HIS), these systems often lack comprehensive decision-support functionalities, leading practitioners to depend on traditional methods and their professional judgement. Significant challenges include limited accessibility to updated clinical guidelines, unreliable infrastructure and inadequate training. Adaptive strategies identified include using non-standardised tools like Medscape, professional judgement and reliance on past experiences and colleagues’ opinions.

The investigation was constrained by access limitations because it was challenging to get some respondents to share information. However, a sufficient number of individuals participated in the interviews, and their knowledge was very beneficial in understanding the procedures and tools for clinical decision support.

This study contributes to AT by extending its application to a low-resource healthcare setting, uncovering new dimensions of the theory related to socio-cultural and technological constraints in healthcare facilities in Tanzania. It provides valuable insights into the practical barriers and facilitators of HIS and CDS tool implementation in developing countries, emphasising the need for context-specific adaptations, robust training programs and user-centred designs. The findings highlight the resilience and imagination of healthcare practitioners in adapting to systemic limitations, offering recommendations to enhance clinical decision-making and improve patient care outcomes in Tanzania.

The study aims to analyse the stability of embankments over the improved ground with stone column (SC) and pervious concrete column (PCC) inclusions using limit equilibrium method. The short-term stability of PCC-supported embankment system is rarely addressed. Therefore, the factor of safety (FOS) of column-supported embankment system is calculated using individual column and equivalent area models.

The stability analysis of column-supported embankment system is conducted using PLAXIS LE 2D. The various geometrical and shear strength parameters influencing the FOS of these embankment systems such as diameter of columns, spacing between columns, embankment height, friction angle of column material, undrained cohesion of weak ground and cohesion of PCC are considered.

The critical failure envelope of PCC-supported embankment system is observed to be of toe failure, whereas the failure envelope of stone column-supported embankment system is generally of deep-seated nature.

It is found that for PCC embankment system, FOS and failure envelope are not influenced by the geometrical/shear strength parameters other than height of embankment. However, for stone column-supported embankment system, FOS and failure envelope are dependent on all the shear strength and geometrical parameters considered in this study.

The purpose of this paper is to improve the understanding of the social contexts of sustainable Lean culture in healthcare by examining self-efficacy (SE) as a fundamental construct related to the value of perceived readiness, prior education of Lean and the importance of leadership’s system-level support.

A descriptive correlational study was conducted to identify the relationships between SE and Lean readiness factors, SE and prior Lean training, SE and clinical vs administrative roles and SE and perceived system-level support in a large health system.

There was a statistically significant difference in self-reported readiness to use Lean tools between individuals who had received Lean training during their academic education and those who had not; however, their level of education did not impact SE. Lastly, and perhaps most important, the learner who embodies SE also has system-level support.

Future directions of this research, in addition to assessing team readiness as other studies suggest, would be to evaluate individual team member readiness by gauging SE and addressing deficits prior to the deployment of process improvement (PI) projects to promote success and sustainability.

This contributes to the ongoing scholarship of Lean management systems, providing clinical and non-clinical leaders with a contextual understanding of their supportive role in the SE of teams.

This study demonstrates the value of understanding SE of individual team members and how it can contribute to overall improved team outcomes, directly impacting the sustainability of Lean change culture and its promotion of improved patient safety, cost efficiencies and access to care.

This paper presents the features and relevance of open distance learning in the context of the socio-economic conditions of people living in the Union Territory of Jammu and Kashmir (J&K) in India. Although the primary purpose of the present study was to ascertain the effectiveness of the learner support services (LSSs) and different facilities offered by the open distance learning (ODL) institutions in that specific region. On the basis of these findings, few suggestions are made for the improvement in the support services, in order to make the ODL system more responsive to the area-specific needs of the learners, especially those residing in inaccessible areas such as J&K.

A survey-based descriptive methodology was applied to conduct this study. The data extracted from primary and secondary sources were analysed to reach certain conclusions. In total, 1,200 distance learners constituted the sample of the research. A semi-structured questionnaire was designed and distributed amongst learners and academics in the region to obtain their feedback and opinion on different aspects of support services and facilities offered to ODL learners.

Results of the study revealed that overall, the LSSs were satisfactory on different parameters, although they slightly varied from institution to institution. However, there was still scope for improvement in certain areas, where institutions further need to make serious efforts to address the identified gaps for improving the LSS and make teaching-learning more learner-centric in view of their specific requirements and local circumstances of J&K.

The present study focusses on presenting an overview of the only major components of LSS offered by ODL institutions and covers six distance education institutions (DEIs) located in different geographical locations within the limited jurisdiction of J&K. There is still scope to make focused (institution-wise) studies in a more specific situation and context to ascertain the problems in a more realistic way.

Although the study has been conducted in a specific territory of J&K, the findings reported in the paper may be equally useful for the other ODL institutions with similar characteristics or located in similar geographical locations, as support services are essential common components of institutions offering distance education programmes or courses.

The study is original research work conducted in the specific context of J&K, and its findings are based on the primary and secondary data collected from learners and other stakeholders of the selected ODL institutions. This work may be significant for the DEIs of J&K to get familiar with the essential components of LSS and develop a mechanism to further improve the academic and administrative support services for distance learners.

The success of an Electronic Health Record (EHR) system is determined by the numerous facilitators and obstacles that influence physicians' intentions toward using these technologies. This study examines physicians' intentions to use EHR by applying the extended technology readiness and acceptance model (TRAM) factors, the result demonstrability, colleagues' opinions, perception of external control, and organizational support.

Convenience sampling was used to collect data from physicians in Egypt (n = 520). To evaluate the model's hypotheses, this study used the partial least squares structural equation modeling (PLS-SEM) method with WarpPLS.7.

The results revealed that positive TR factors (innovativeness and optimism) positively affect perceived usefulness and ease of use, while negative TR factors (discomfort and insecurity) negatively impact perceived usefulness and ease of use. Furthermore, the result demonstrability and colleagues' opinions positively influence perceived usefulness, while the perception of external control and organizational support positively influence perceived ease of use. In addition, significant relationships between perceived ease of use and usefulness and adoption intention were identified.

This is the first study to apply the TRAM to understand physicians' adoption intentions to use EHR systems. Moreover, this study determined the different roles of positive and negative TR affecting physicians' cognition regarding using EHR systems.