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Introduction: The Ministry of Public Health in Lebanon is in the process of converting the surveillance reporting from a cumbersome paper-based system to a web-based electronic platform (DHIS-2) to have real-time information for early detection of alerts and outbreaks and for initiating a prompt response., Objectives: This paper aimed to document the Lebanese experience in implementing DHIS-2 for the disease surveillance system. It also targets to assess the improvement of reporting rates and timeliness of the reported data and to disclose the encountered challenges and opportunities., Methodology: This is a retrospective description of processes involved in the implementation of the DHIS-2 tool in Lebanon. Initially, it was piloted for the school-based surveillance in 2014; then its use was extended in May 2017 to cover other specific surveillance systems. This included all surveillance programs collecting aggregate data from hospitals, medical centers, dispensaries, or laboratories at the first stage. As part of the national roll-out process, the online application was developed. The customized aggregated-based datasets, organization units, user accounts, specific and generic dashboards were generated. More than 80 training sessions were conducted throughout the country targeting 1290 end-users including health officers at the national and provincial levels, focal persons who were working in all public and private hospitals, laboratories, and medical centers as well. Completeness and timeliness of reported data were compared before and after the implementation of DHIS-2. The unveiled challenges and the main lessons learned during the roll-out process were discussed., Results: For laboratory-based surveillance, completeness of reporting increased from 70.8% in May to 89.6% in October. Timeliness has improved from 25 to 74%. For medical centers, an improvement of 8.1% for completeness and 9.4% in timeliness was recorded before and after training sessions. For zero reporting, completeness remains the same (88%) and timeliness has improved from 74 to 87%. The main challenges faced during the implementation of DHIS-2 were mainly infrastructural and system-related in addition to poor internet connectivity, limited workforce, and frequent changes to DHIS-2 versions., Conclusion: Implementation of DHIS-2 improved timeliness and completeness for aggregated data reporting. Continued on-site support, monitoring, and system enhancement are needed to improve the performance of DHIS-2., (© 2022. The Author(s).)

To increase the accuracy of reservoir evaluation, a new type of seismoelectric logging instrument was designed. The designed tool comprises the invented sonde-structured array complex. The tool includes several modules, including a signal excitation module, data acquisition module, phased array transmitting module, impedance matching module and a main system control circuit, which are interconnected through high-speed tool bus to form a distributed architecture. UC/OS-II was used for the real-time system control. After constructing the experimental measurement system prototype of the seismoelectric logging detector, its performance was verified in the laboratory. The obtained results showed that the consistency between the multi-channel received waveform amplitude and benchmark spectrum was more than 97%. The binary phased linear array transmitting module of the instrument can realize 0° to 20° deflection and directional radiation. In the end, a field test was conducted to verify the tool's performance in downhole conditions. The results of this test proved the effectiveness of the developed seismoelectric logging tool.

Purpose: To present the antibiotic prescription trend between 2011-2018 at primary healthcare in Turkey in order to evaluate the effects of interventions at national level for providing rational prescription of antibiotics., Methods: Electronic prescription data of the family physicians collected from January 1, 2011 to December 31, 2018 in 81 provinces of Turkey were recorded through the Prescription Information System and screened for the antimicrobial drugs. The interventions to promote rational antibiotic use during 2011-2018 in Turkey includes reminding the legislation to stop access of antibiotics without prescription, monitoring of antibiotic prescription behaviors of primary healthcare physicians, and education of healthcare workers and the public on the appropriate use of antibiotics., Results: A total of 1 054 261 396 prescriptions for outpatients of all age groups were recorded during this period. Of the prescriptions written by family physcians, 34.94% were containing at least one antibiotic in 2011, which declined to 24.55% in 2018. Antibiotics constituted 13.99% of all the items in prescriptions in 2011 and 10.47% in 2018. Percentage of total antibiotic expenditure to the total drug expanditure decreased from 14.14% to 4.12% during 2011-2018. The most commonly prescribed antibiotics were amoxicillin and enzyme inhibitor combination, cefdinir, and cefuroxime during 2011-2018, with an increasing trend for prescription of first-line antibiotic, amoxicillin, in recent years., Conclusions: Governmental interventions at national level have contributed to reducing antibiotic prescription and increasing preference of first-line antibiotics at primary healthcare level in Turkey over a course of 8 years. Turkey's model of governmental interventions may set an example for other countries with high consumption of antibiotics, and contribute to the actions against antimicrobial resistance worldwide., (© 2021 John Wiley & Sons Ltd.)

This work presents the design and development of a new alternative tool to measure the Center of Pressure (CoP) displacements, intended to evaluate the human balance. The device is based on a modified commercial balance board used for video games, resulting in a low-cost, portable device capable of computing the CoP, providing 24 of the most used indexes to test the human balance. The proposed standalone device runs on rechargeable batteries, weighs only 3.5 kg, and has a data storage capacity for over 1000 tests. Visual and auditory instructions assist its user interface. Thus, contrary to the commercial systems designed for laboratory use, this device enables the measurement of quantitative balance parameters in non-laboratory places, allowing the study of the balance of vulnerable populations directly on their typical environments. To evaluate the device, 20 older adults (68.60 ± 1.23 years) were tested, and the resulting values were compared with a similar study using a force platform; 19 indexes showed a similarity with those reported using force platform and 12 of these were statistically equivalent. The proposed device represents an open-source alternative tool for researchers and healthcare personnel to acquire reliable data to evaluate human balance.

The results of scientific research can be trusted when initial data is processed properly. To watch out quality of data is the most important in those research studies that provide their results to Russian health care officials for management decision-making that effect medical care support on national scale. The financial support of science within the framework of public contracts turns out less efficient when deductions are based on unreliably collected, altered or omitted information. When electronic systems are applied in data collection, they are to meet definite requirements. There are several international documents defining requirements to electronic systems collecting and processing information in medical scientific research. In the Russian Federation, such requirements are absent. The solution of this problem is in gradual implementation of common international standards into practice of collecting research data initially through researchers' training and then through Russian regulatory documentation amendment.

Background: Chronic kidney disease (CKD) is a long-term medical condition associated with symptoms which may negatively impact on patients' health-related quality of life (HRQOL). Patient-reported outcome (PRO) measures or questionnaires may be used to capture symptoms/HRQOL experienced by patients with advanced CKD., Method: Two PRO questionnaires were electronically adapted and incorporated in an electronic system developed at University Hospitals Birmingham NHS Foundation Trust (UHB), Birmingham. Usability testing was conducted with patients with advanced CKD. Qualitative methodology was used to elicit participants' views., Results: Participants had a mean age of 64.3 years (range: 36-87 years). All owned electronic devices and had access to the internet. The mean time required to complete the two electronic questionnaires was 15.9 min (range = 8-34 min). Patients who had difficulties with the system were those who had the least experience of using the internet and electronic devices. The average usability and satisfaction score was 4.6 (5-point scale)., Conclusions: Our study suggests that individuals with advanced CKD may find the Renal ePROM system acceptable and easy to use. The use of the Renal ePROM may complement clinician-reported outcomes and assist with the management of patients with advanced CKD., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Setting: Since 2011, tuberculosis (TB) clinics in Ho Chi Minh City (HCMC), Viet Nam, have been entering data from a paper-based TB treatment register into an electronic database known as VITIMES (Viet Nam TB Information Management Electronic System), which is currently used in parallel with the paper system. Objective: To evaluate the sensitivity, completeness and agreement of data in VITIMES with that of paper-based registers among TB patients co-infected with the human immunodeficiency virus (HIV) being treated for TB in HCMC. Design: This was a retrospective data review of all TB-HIV patients receiving anti-tuberculosis treatment in each of the 24 district TB clinics in HCMC in 2013. Data were abstracted from the paper-based TB treatment registers at district level and extracted electronically at the provincial level. Records were matched based on name, age and address. The sensitivity, completeness and agreement of the electronic data were compared with data from the paper system. Results: The findings showed that the electronic system had high sensitivity (99.2%), high completeness (87-99%) and high agreement (κ 0.78-0.97) for all variables. Conclusion: The results of this study suggest that data are being correctly entered into VITIMES and that patient data can be directly entered into VITIMES instead of having a parallel, paper-based system., Competing Interests: Conflict of interests: none declared.

Purpose: In the last few decades, changes to formulary management processes have taken place in institutions with closed formulary systems. However, many P&T committees continued to operate using traditional paper-based systems. Paper-based systems have many limitations, including confidentiality, efficiency, open voting, and paper wastage. This becomes more challenging when dealing with a multisite P&T committee that handles formulary matters across the whole health care system. In this paper, we discuss the implementation of the first paperless, completely electronic, Web-based formulary management system across a large health care system in the Middle East., Summary: We describe the transitioning of a multisite P&T committee in a large tertiary care institution from a paper-based to an all-electronic system. The challenges and limitations of running a multisite P&T committee utilizing a paper system are discussed. The design and development of a Web-based committee floor management application that can be used from notebooks, tablets, and hand-held devices is described. Implementation of a flexible, interactive, easy-to-use, and efficient electronic formulary management system is explained in detail., Conclusion: The development of an electronic P&T committee meeting system that encompasses electronic document sharing, voting, and communication could help multisite health care systems unify their formularies across multiple sites. Our experience might not be generalizable to all institutions because this depends heavily on system features, existing processes and workflow, and implementation across different sites., Competing Interests: Disclosures: The authors report no commercial or financial interests in regard to this article.

The Democratic Republic of Congo has vast natural resources, many of which are regularly exploited by the electronics industry. Unfortunately, in addition to these resources, there are widespread human rights abuses committed by armed groups entrenched in the eastern part of the Democratic Republic of Congo. These armed groups are using profits from these minerals as a source of funding. Their human rights abuses have led to a growing humanitarian interest in the region and prompted the international community to action. This paper explores the conflicts in the Democratic Republic of Congo, provides an understanding of the link between human rights abuses and conflict minerals, and interprets and critiques the legal actions of the international community.