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Healthcare environments are highly complex and full of variation and inefficiency. However, variation and inefficiency can be measured and improved, providing better quality care at a lower cost. This study aims to report the application of Lean Six Sigma (LSS) in a haematology laboratory in a university hospital in Egypt.

The authors used case study research. Applying the define, measure, analyse, improve and control phases of the DMAIC methodology together with lean tools, the problem was identified, the process mapped, the causes analysed and improvements implemented.

Results show that LSS can be successfully implemented in challenging public sector healthcare settings. Management commitment, generating and implementing ideas from frontline staff, using a variety of quality tools and previous LSS training were all key to success. This is evidence that the LSS methodology is adaptable to any process, people or place.

There are no publications on LSS implementation in health care in Egypt. This study demonstrates the successful use of LSS in a university hospital (public sector) in a developing country, sharing insight into the facilitators and barriers in a real context with others in the healthcare field.

This contribution investigates methodological questions concerning Change Laboratory interventions. It contemplates the research questions: To what extent the Change Laboratory can be situated within the panorama of qualitative inquiry? If so, to what extent can the methods and strategies of inquiry help improve a Change Laboratory intervention?

To answer the first question, this paper makes an overview on key terms of qualitative research; subsequently, it presents the characterising features of the Change Laboratory. Then, it takes a historical perspective and compares the Change Laboratory firstly against action research, and secondly with design experiments. To answer the second section, it examines a case study of Change Laboratory with teachers that the first author facilitated. Next, it displays how trustworthiness was ensured through a thick description and member checks.

The paper argues that the Change Laboratory is a strategy of inquiry; it aligns with the characteristics of qualitative research, and it follows the agenda of a participative paradigm. Furthermore, the methods and strategies of inquiry such as thick descriptions and member checks, not only can improve rigour and validity of the intervention but also strengthen the outcomes of the Change Laboratory itself.

The Change Laboratory is well defined as a formative method, but not fully understood as an investigative method. Although scholars discussed methodological issues of Cultural Historical Activity Theory in diverse articles, the relationship between the Change Laboratory and qualitative inquiry has remained unclear.

The purpose of this paper is to introduce an integrated laboratory experiment setup (ILES) to overcome problems encountered in open distance learning (ODL) especially when offering engineering degree programmes.

Engineering laboratory experiments can be classified as experiments which are performed with the intention to inculcate theory, and second, to provide hands-on experience. The ILES integrates both types of experiments with face-to-face laboratory (FFL), online remote laboratory (ORL), and multimedia demonstrations, and it helps to reduce traditional FFL duration by 50 per cent. The first phase of the ILES provides an opportunity to refer multimedia demonstrations of the experiments. Thereafter, students attend the first FFL session, which covers about 25 per cent of the experiments. In the next step, 50 per cent of the experiments are offered using the ORL, via the internet while interacting with real equipment and making actual observations. The final step is used to accomplish the rest of the experiments (25 per cent) in FFL which facilitates the clarification of any problem that may occur in the ORL.

This blended laboratory system will help to achieve ODL objectives while utilising resources productively and cost effectively. Having implemented the idea and based on the information received from the stakeholders, this has proved to be a workable solution to one of the difficulties faced by ODL students.

The level of outcome of the students has to be observed and analysed in comparison with the traditional laboratory setup.

Some experiments (e.g. thermodynamics) which need more safety precautions are difficult to offer via ORL.

The ILES is a blended setup including FFL, ORL and multimedia demonstrations and it is a novel concept which is most applicable to engineering/science programmes offered in ODL mode.

At present, people have a tendency to carry out higher education in a distance mode due to their busy lifestyles. However, open and distance learning (ODL) educational organizations encounter difficulties when delivering laboratory experiments. This paper presents the development of an online laboratory platform as a solution. It can be used to deliver laboratory experiments, using electronic components and instruments such as a signal generator and oscilloscope. Students are able to perform experimental tasks remotely utilizing real equipment and components. The system users can view laboratory environments via a camera which provides a sense of reality.The platform provides facilities to customize and rebuild the laboratory experiments according to the requirements of the organization. It can also be utilized as a useful educational tool to acquire pre-experience before entering the real laboratory. Thestatistical analysis shows no significant difference between the face-to-face laboratory (FFL) and online remote laboratory (ORL) experimental results within a 95% confidence level.The system can enhance the existing open and distance learning system by sharing the resources in a flexible manner.This system reduces the difficulties that distance learning students encounter when participating in FFL sessions. It also reduces the number of FFL sessions and is helpful to working students. One of the main objectives of ODL is to provide a learning environment for those who missed the opportunity for higher education for a variety of reasons. This system will help to achieve this objective.

The purpose of this paper is to operationalise and apply a three-level analysis of double stimulation in a Change Laboratory with teachers.

Within qualitative inquiry, this Change Laboratory intervention was conducted as case study, by way of an intensive analysis of an individual unit. The macro-level deals with the societal problem and the collective solution found to tackle it. An intermediate level looks at the Change Laboratory as a methodology able to boost expansive learning through chains of first and second stimuli. The micro-level analyses the participants’ interactions during the sessions and traces the terms connected to the first and second stimulus.

This analysis suggests that the conflicts of motives experienced by the participants at the micro level refer to the aggravated contradiction identified at the macro level. Conflicts of motives seem to be superior in number during the first block of sessions, when the first stimuli are analysed. The micro analysis indicates the 6th session as the turning point of the intervention, when the participants take the auxiliary stimulus and turn it into and effective and meaningful sign. The intermediate level helps to trace the third transition from the formation of the second stimulus to its implementation, reflection upon and further development and generalisation.

Vygotsky’s method of double stimulation is crucial to develop one’s agency and to explain how individuals deliberately influence events. Yet the literature is fragmented and made of brief accounts, and this paper for the first time inspects double stimulation on different levels within a Change Laboratory intervention with teachers.

In the undergraduate physics laboratory, a student is expected to make precise measurements, hone investigative skills and discover the interplay between experimentation and fundamental principles underlying physical phenomena. But in India, the mainstream conventional UG physics laboratory instruction has all along been cookbook in nature. In such a scenario, incorporating innovative and meaningful laboratory experience in Open and Distance Education programmes becomes a formidable challenge. Recently we evaluated the physics laboratory courses, which are integral to the B.Sc (Physics) programme of IGNOU offered at a distance, for their quality, relevance and effectiveness. Our findings reveal that these courses are being received well particularly by those students who are pursuing the B.Sc (Major) in Physics. The success rates improve as learners evolve in the system and their satisfaction levels are high. However, factor analysis of learners' perceptions brings forth six factors guided approach, student-centered learning and assessment, emphasis on self-learning, use of multimedia and innovative non-conventional teaching strategies, increased student participation and emphasis on problem solving as key determinants for further improving the quality of learning in physics laboratory.

Drug checking is a popular method to reduce risks of drug use. In many countries, including Finland, legislation restricts implementing drug checking. The aim of this study was to explore whether some benefits of drug checking could be achieved by substance residue analysis.

Drug paraphernalia (mostly empty plastic bags) were used in the study. Participants left a sample and information about the former content to a local needle exchange point. After laboratory analysis, participants could return for the results and a short consultation on the substance(s) found. Afterward, participants were asked whether they would still use the batch.

Ninety-eight samples were received. In most cases, the samples had originally been sold as amphetamine (n = 39). Overall, laboratory results matched with supposed content in 52 cases, but in 21 cases, the sold content had been altered, in 17 cases, only other psychoactive substances were found and in 8 cases, no traces of psychoactive substances were found. Participants returned for results in two-thirds of the cases. When the laboratory result did not match participants’ expectations, the majority of participants estimated they would not use the same batch (17/25) or would use it in a different way (2/25).

While reports on drug checking are numerous, studies exploring possibilities to achieve harm-reducing benefits of drug checking by analyzing drug residues are scarce. The results of this pilot study suggest some benefits of drug checking can be achieved by substance residue analysis.

The current study addresses how blockchain can deal with the challenges that the midstream liquefied natural gas (LNG) supply chain poses combined from a management standpoint. Such challenges are: the volume of transactions, communication hurdles and the lack of contemporary management tools. The paper proposes a comprehensive framework to assess the impact of blockchain implementation in the midstream LNG supply chain in order to tackle those barriers.

The basis of the research is the business process modelling (BPM), through which entities, roles, tasks, resources and transactions can be modelled and simulated. The modelling of the midstream LNG supply chain, via BPM, is based on guidelines of the Society of International Gas Tanker and Terminal Operators (SIGGTO) and common industry business models. A quantitative analysis is employed to support the motivation and the potential impact of blockchain implementation. The methodology is used to identify (1) inefficiencies related to large volume of transactions between stakeholders and (2) critical areas of an LNG shipping company, where blockchain can be implemented.

Process repeatability, numerous shared documentation forms, excessive paperwork and communication imbroglios are mapped from the modelling section. Up to 327 processes are repeated during a typical vessel voyage, and up to 122 shared documentation forms are exchanged. Excessive paperwork and communication imbroglios are tracked through, which correspond to 25 severe errors as detected. By implementing the methodology, stakeholders can quantify the possible impact of blockchain on the operational performance of each stakeholder's operations separately and the supply chain as a whole in terms of real-time monitoring, transparency and paperwork reduction, time and cost savings.

The research has certain limitations deriving from its conceptual nature. The business processes' modelling is based on standard procedures described in the guidelines by SIGGTO and may need further adjustment for specific use cases. A structured case study has not been realisable as corporate data for an LNG shipping company regarding processes and other commercial sensitive information are required.

Potential practitioners may exploit the proposed framework as a low cost and seamless tool to evaluate how blockchain could disrupt their operations. Thus, the blockchain implementation's improvements or weaknesses can be pinpointed, and enabling the interested stakeholder of the LNG supply chain with specific feedback, it can guide them towards informed decisions on their operations.

The research has a novel approach as it combines the creation of practical management framework, with a comprehensive visualization of the midstream LNG supply chain. Thus, the reader can identify in which parts of the midstream LNG supply chain can blockchain be implemented, and what impact it could have in terms of supply chain operations.

The Framework Convention on Tobacco Control (FCTC) has been broadly successful but less so in the Global South. This paper aims to effectively design interventions that to mitigate tobacco-related harms in the Global South, further understanding of interventions in this environment will be helpful, in line with FCTC recommendations. The first objective was to locate and review all published literature relating to tobacco control interventions in the Global South. The second objective was to provide information on research trends within Global South tobacco control interventions.

A literature search was conducted across six databases.

Despite the FCTC detailing the significance of the research, studies are still lacking in the Global South. There are significant research gaps such as longitudinal studies, harm reduction and randomized controlled trials.

Limitations arose from differences in study designs of reviewed studies, making it more complex to assess all studies under the same rubric.

Results indicate significant potential for tobacco control interventions in the Global South, potentially moving toward FCTC goals, but also highlight several areas of concern.

There is much evidence on the effectiveness of tobacco control in the Global North, especially in some parts of Europe and the USA. However, the evidence base in the Global South is far more limited. This paper provides an overview of Global South tobacco control interventions and suggests areas of concern, in line with the FCTC 15 years on.