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India Meteorological Department (IMD) operationally issues district-level nowcasts for the occurrence of thunderstorms and associated weather for all districts of India round the clock at three-hour intervals since 2018. These impact-based nowcasts are updated in real-time on the IMD website (https://mausam.imd.gov.in/responsive/districtWiseNowcast.php) and are also communicated to various state and national level stakeholders during thunderstorm events. While a Standard Operating Procedure (SOP) utilizing climatology, observations from various sources, and direct and derived model products is in place for issuing nowcasts, objective verification of these district-level nowcasts has presented a challenge till date. The current study details a method for automatic verification of these district-level operational nowcasts of thunderstorms w.r.t. observations of lightning as a measure of the occurrence of thunderstorms. The data from the ground-based lightning sensor network of the Indian Institute of Tropical Meteorology has been used as the observation dataset. The method is customizable to automatically derive categorical verification scores on a daily, monthly, or seasonal basis or for any arbitrary time period of choice. The verification of the three hourly nowcasts on the monthly scale for the period of April–November of 2022 and 2023 indicates that the all-India Probability of Detection (POD) verification score was in the range of 0.57–0.62, the False Alarm Ratio (FAR) score was about 0.70 to 0.77, the Critical Success Index (CSI) score was in the range of 0.20–0.24 while the Equitable Threat Score (ETS) score was in the range of 0.15–0.20. Verification results for individual districts at a seasonal scale during 2022–2023 indicate that scores were poor during the winter season (<0.2) (except over southeast peninsular India) and improved thereafter during the rest of the year. This may be due to the fact that thunderstorms during the winter season are infrequent, comprise weak cells with short lifetimes over most parts of India (except the southeast peninsula). In non-winter months, the POD score was generally high over the plain regions of the north peninsula, central, and North India, with the best score during the monsoon months (>0.8). However, the FAR score was better (lower values) over peninsular India (0.2 to 0.4). This translated to improved CSI and ETS over peninsular India. FAR score was generally better during the pre-monsoon season compared to other seasons. These district-level nowcast verification results were not confined as per state boundaries but were common across states and parts of multiple states and other years, for each of which a different meteorological centre issues nowcasts. The spatially systematic errors over East India are due to the nature and movement of weather systems over this region. The spatially systematic errors over the western and eastern Himalayan region may be a consequence of the quality of the lightning detection network data used for verification over this region. [ABSTRACT FROM AUTHOR]

Healthcare systems and, more specifically, public sector healthcare systems are complex hierarchical entities. Delivering quality healthcare services is a challenging task facing several key hurdles. Equipment maintenance and availability is one of the key issues since the non-functionality of medical equipment degrades service provision in public sector hospitals. In this case, we discuss the situation of primary and secondary healthcare services in Punjab, Pakistan, focusing on the current condition of equipment functionality and maintenance across thirty-six districts of Punjab. The healthcare sector in Punjab is organized in a tiered manner, with primary health care facilities providing basic medical services to the masses and secondary healthcare facilities providing referral and specialized services to the patients. Providing medical services requires an efficient network of medical professionals, adequate medical equipment, physical infrastructure and sufficient supply of medicines at all levels of the healthcare system. This case identifies and discusses the issue of non-functionality and maintenance of medical equipment in Punjab. Demand for medical equipment is generated on a central and district level, followed by a combination of central- and facility-level procurement. Maintenance of equipment is done by the facility without any standard operating procedures. The purpose of this case is to observe the current maintenance options in practice and to assess the impact of a decentralized maintenance system on the functionality status of biomedical equipment across districts. The objective is also to highlight the need for an efficient maintenance regime in accordance with the nature of the equipment to ensure cost and downtime minimization. [ABSTRACT FROM AUTHOR]

Northwestern University Libraries (NUL), partnering with the Northwestern University – Art Institute of Chicago Center for Scientific Studies in the Arts (NU-ACCESS), identified nineteenth-century green books that were created using arsenic and other heavy metals. Various analytical techniques have revealed that arsenical pigments were used in the USA and Europe on cloth and paper book covers, page edges, and labels producing a range of green hues and tints. Previous research has shown that over time, the pigments transform into degradation products, can migrate to non-pigmented areas, and transfer to adjacent books. As a result of these findings, NUL investigated potential hazards to users and caretakers and concluded that handling these materials presented possible health risks. NUL took steps to reduce risks to patrons and library staff including staff training, removal of suspected volumes containing arsenical materials from the open stacks, updating the reader agreement, establishment of an off-site hazardous materials storage area, creation of standard operating procedures, and development of a housing and labeling system. By sharing these activities, Northwestern hopes to build awareness of potential hazards in cultural institutions, provide safe access to the rare original materials, and provide a model for other organizations who may hold similar materials. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsConclusionRegistrationPersistent post-concussive symptoms (PPCS) are common and disruptive, particularly in military service members (SM), yet there are no approved therapies targeting underlying physiological processes. This study was designed to compare acoustic neuromodulation using Cereset Research™ Standard Operating Procedures (CR-SOP), with Cereset Research Cranial Electrical Stimulation (CR-CES), on PPCS.SM, veterans, or dependents with PPCS (Neurobehavioral Symptom Inventory [NSI] Score ≥23) were randomized to receive 10 sessions of engineered tones linked to brainwaves (CR-SOP) or 5 sessions of CR-CES, which adds intermittent low voltage transcranial alternating current stimulation (tACS) to CR-SOP. Designed to assess non-inferiority between varied doses of CR-SOP and CR-CES, the primary outcome was a change in post-concussive symptoms on the NSI, with secondary outcomes of heart rate variability (HRV) and self-report measures of PTSD, sleep, headaches, and depression.Among study participants (n = 80, 21.3% female, mean age 40.2 [SD 13.2], 4.8 deployments, 3.2 TBIs), mean NSI declined from 45.6 to 29.5 after intervention (p < 0.0001), with gains sustained at 3 months (29.7). No significant between group differences for NSI (CR-SOP: baseline 43.9, post-intervention 26.0, 3-month 27.2, and CR-CES 46.4, 30.7, and 31.1, respectively), and no evidence of inferiority between the groups with respect to NSI. Similar improvements were seen on PCL-5, ISI, HIT-6, and PHQ-9, with no HRV differences between groups.Both acoustic neuromodulation alone (CR-SOP) and a lower dose of CR-SOP, with tACS added (CR-CES), significantly improved PPCS out to 3 months.ClinicalTrials.gov – NCT03649958 [ABSTRACT FROM AUTHOR]

RATIONALE: For staff in adult ICUs, providing family-centered care is an essential skill that affects important outcomes for both patients and families. The COVID-19 pandemic placed unprecedented strain on care of ICU families, and practices for family engagement and support are still adjusting. OBJECTIVES: To review updated evidence for family support in adult ICUs, provide clear recommendations, and spotlight optimal family-centered care practices post-pandemic. PANEL DESIGN: The multiprofessional guideline panel of 28 individuals, including family member partners, applied the processes described in the Society of Critical Care Medicine Standard Operating Procedures Manual to develop and publish evidence-based recommendations in alignment with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Conflict-of-interest policies were strictly followed in all phases of the guidelines, including panel selection, writing, and voting. METHODS: The guidelines consist of four content sections: engagement of families, support of family needs, communication support, and support of ICU clinicians providing family-centered care. We conducted systematic reviews for 15 Population, Intervention, Control, and Outcomes questions, organized among these content sections, to identify the best available evidence. We summarized and assessed the certainty of evidence using the GRADE approach. We used the GRADE evidence-to-decision framework to formulate recommendations as strong or conditional, or as best practice statements where appropriate. The recommendations were approved using an online vote requiring greater than 80% agreement of voting panel members to pass. RESULTS: Our panel issued 17 statements related to optimal family-centered care in adult ICUs, including one strong recommendation, 14 conditional recommendations, and two best practice statements. We reaffirmed the critical importance of liberalized family presence policies as default practice when possible and suggested options for family attendance on rounds and participation in bedside care. We suggested that ICUs provide support for families in the form of educational programs; ICU diaries; and mental health, bereavement, and spiritual support. We suggested the importance of providing structured communication for families and communication training for clinicians but did not recommend for or against any specific clinician-facing tools for family support or decision aids, based on current available evidence. We recommended that adult ICUs implement practices to systematically identify and reduce barriers to equitable critical care delivery for families and suggested that programs designed to support the wellbeing of clinicians responsible for family support be developed. CONCLUSIONS: Our guideline panel achieved consensus regarding recommendations and best practices for family-centered care in adult ICUs. [ABSTRACT FROM AUTHOR]

Introduction: The SAGES Guidelines Committee creates evidence-based clinical practice guidelines (CPGs). Updates which incorporate new evidence into the guidelines are necessary to maintain relevance for clinical use. A description of our standard operating procedure for this process is described here, which contributes to SAGES' commitment to producing high-quality clinical recommendations. Methods: This paper outlines the SAGES Clinical Practice Guideline Update Standard Operating Procedure in order to incorporate regular updates to our guideline development process. Results: SAGES has developed an evidence-based, standardized approach in updating current clinical practice guidelines to ensure that physicians and patients have access to the most appropriate recommendations. Conclusion: Societies that promote guidelines within their organization must make an intentional effort to regularly evaluate the relevance of their recommendations. The SAGES Guidelines Update Standard Operating Procedure aims to provide a framework to reliably and systematically review existing guidelines and update them as needed. [ABSTRACT FROM AUTHOR]

Indonesia tsunami early warning system (Ina TEWS) is used for detecting earthquakes and tsunamis. The system currently is still under development and the government really needs information regarding the technological capabilities of the system in order to provide protection to the community from the threat of tsunamis and earthquakes. To produce the system and its components on an industrial scale, it is important to assess the extent of performance and readiness for technological development. The assessment used the technometric method which groups technological components into technoware, humanware, infoware, and orgaware, integrated with analytic hierarchy process. The results showed that the highest technology component contribution is technoware, and the lowest is infoware. Based on the magnitude of the contribution of technology components and intensity of technology, the priority order is technoware, humanware, orgaware, and infoware. The technology contribution coefficient is 0.522 (Good). The technology level is semi modern. Infoware is the lowest technological component, therefore improvement efforts are needed, namely structuring an integrated document system and improving standard operating procedures for manufacturing operational activities, especially in the testing and data validation. [ABSTRACT FROM AUTHOR]

Urinary proteomics is emerging as a potent tool for detecting sensitive and non-invasive biomarkers. At present, the comparability of urinary proteomics data across diverse liquid chromatography−mass spectrometry (LC-MS) platforms remains an area that requires investigation. In this study, we conduct a comprehensive evaluation of urinary proteome across multiple LC-MS platforms. To systematically analyze and assess the quality of large-scale urinary proteomics data, we develop a comprehensive quality control (QC) system named MSCohort, which extracted 81 metrics for individual experiment and the whole cohort quality evaluation. Additionally, we present a standard operating procedure (SOP) for high-throughput urinary proteome analysis based on MSCohort QC system. Our study involves 20 LC-MS platforms and reveals that, when combined with a comprehensive QC system and a unified SOP, the data generated by data-independent acquisition (DIA) workflow in urine QC samples exhibit high robustness, sensitivity, and reproducibility across multiple LC-MS platforms. Furthermore, we apply this SOP to hybrid benchmarking samples and clinical colorectal cancer (CRC) urinary proteome including 527 experiments. Across three different LC-MS platforms, the analyses report high quantitative reproducibility and consistent disease patterns. This work lays the groundwork for large-scale clinical urinary proteomics studies spanning multiple platforms, paving the way for precision medicine research. Urinary proteomics offers sensitive, non-invasive biomarkers, but cross-platform LC-MS data comparability requires investigation. Here, the authors evaluate 20 LC-MS platforms, developing MSCohort, a QC system with 81 metrics, and a unified SOP, paving the way for precision medicine research. [ABSTRACT FROM AUTHOR]

The significance of forests in absorbing and storing carbon plays a crucial role in international greenhouse gas policies outlined by the United Nations Framework Convention for Climate Change (UNFCC). This study was conducted in a typical tropical moist forest of Ethiopia to assess its carbon stock, a critical issue in climate policy. The study domain was divided into six strata using elevation criteria. Ninety sample plots were used to gather relevant data from all carbon pools (above-ground biomass, below-ground biomass, litter, herbs, lying dead woods, and soils) following the standard operating procedure. ANOVA, post hoc analysis and correlation tests were used to analyze the collected data. The finding revealed that carbon stock in Sele-Nono forest varies not only within its carbon pools but also across environmental factors. Moreover, the study indicated that soil, above-ground biomass, and lying dead woods store the majority of the carbon. The forest stored 284.81±107.81 tons of carbon per hectare, which is equivalent to absorbing 157.12 Megatons of CO2 from the atmosphere. This highlights the critical role of the forest in mitigating climate change on a global scale. The finding from this study encourages policymakers to rigorously focus on forest conservation as a strategy for sustainable climate mitigation. Moreover, conserving forests through strengthening UN initiatives like REDD+ is imperative to prevent potential emissions from land use changes, such as deforestation or degradation. [ABSTRACT FROM AUTHOR]

Background: The optimal timing for administering dual antiplatelet therapy (DAPT) post-coronary artery bypass grafting (CABG) remains a subject of debate. This study aimed to evaluate the safety and efficacy of early DAPT administration within 6 h post-CABG, following the implementation of a new standard operating procedure (SOP). This study was conducted in three phases at the National Heart Institute of Malaysia. Phase 1 involved a clinical audit of 80 isolated CABG patients to evaluate current DAPT practices. Phase 2 was a pilot study involving 320 patients to establish criteria for early DAPT initiation. Phase 3 comprised a prospective cohort analysis comparing outcomes between 939 propensity-matched pairs receiving early/new SOP (< 6 h) and late/old SOP (> 6 h) DAPT. Results: The clinical audit revealed a mean DAPT administration time of 18.3 h post-CABG, highlighting variability in practice. The pilot study demonstrated that early DAPT was associated with a significantly lower chest reopening rate (0.8% vs. 21.6%) under stringent selection criteria. In the follow-up study, early DAPT was linked to reduced rates of postoperative stroke (1.0% vs. 2.5%, p = 0.013), dialysis (5.5% vs. 7.0%, p < 0.001), and chest reoperation (6.5% vs. 9.0%, p = 0.045). Despite a higher transfusion rate in the early DAPT group (76.0% vs. 43.6%, p < 0.001), ICU stays and hospitalization durations were not prolonged. Mortality rates were lower in the early DAPT group (3.2% vs. 4.6%), although the difference was not statistically significant (p = 0.123). Conclusions: Guided by stringent clinical criteria, early DAPT administration within 6 h post-CABG is a feasible and effective strategy for reducing adverse outcomes, such as stroke and dialysis requirements, while maintaining manageable bleeding risks. Future research should explore long-term graft patency, refine transfusion protocols, and assess the broader applicability of this approach. [ABSTRACT FROM AUTHOR]

Introduction: Diagnosing dementia remains challenging in low-income settings due to limited diagnostic options and the absence of definitive biomarkers. The use of brain MRI in the diagnosis of dementia is infrequent in Uganda, and even when it is used, subtle findings like mild regional atrophy are often overlooked, despite being crucial for imaging diagnosis. Objective: The purpose of this study was to explore the perceptions and practices of imaging personnel and physicians regarding the use of brain MRI as a diagnostic approach for dementia in Uganda. Methods: This was an exploratory qualitative study involving radiologists, technologists, senior house officers and psychiatrists. The participants were 25 in total. Data was collected through key informant interviews and focus group discussions and analyzed thematically using an inductive approach. Results: The study revealed three key themes: Brain MRI Practices for Diagnosing Dementia, Facilitators of Appropriate MRI Use, and Barriers to Appropriate Use of Brain MRI. Sub-themes under these themes included cost considerations, poor and good MRI practices, MRI as a standard operating procedure, positive attitudes towards brain MRI, and barriers such as structural, financial, operational, technical, and patient-related issues. Participants acknowledged the high accuracy and superiority of brain MRI for diagnosing dementia and recognized it as the standard of care. However, its use in Uganda is limited due to high costs, restricted access, mechanical failures, patient claustrophobia, myths and misconceptions, and interpretation difficulties by radiologists and inappropriate protocols by technologists. Conclusion: The study identifies barriers to effective brain MRI use for dementia diagnosis in Uganda, including limited training, high costs, and uneven equipment distribution. Despite this, providers are positive about MRI adoption. Enhancing training, awareness, and phased rollouts can improve outcomes. Future research should focus on similar low-resource settings for validation. [ABSTRACT FROM AUTHOR]

This study investigates the readiness of the Social Security Agency for Employment (BPJS Ketenagakerjaan) to implement flexible working arrangements (FWAs) in response to the evolving work landscape post-COVID-19. With the Indonesian government's reclassification of the pandemic, organizations are reconsidering their work models, making it crucial to assess their preparedness for hybrid work systems. The research employs a case study design with a descriptive approach, utilizing the TAIDA method to develop planning scenarios. Data collection includes primary data from in-depth interviews with experts and secondary data from relevant literature and internal documents. Findings reveal that BPJS Ketenagakerjaan demonstrates a very good level of readiness across various dimensions, including technology and management, with an overall readiness index of 82.58. However, the mobility policy dimension indicated potential improvement areas. The study highlights the importance of establishing clear policies and standard operating procedures to support remote work, particularly for employees with specific health needs. The implications of this research are significant for BPJS Ketenagakerjaan as it provides a structured framework for enhancing organizational readiness for FWAs, ensuring employee engagement and satisfaction. This study contributes to the broader discourse on flexible work arrangements, offering practical guidance for public service organizations navigating the complexities of hybrid work implementation. [ABSTRACT FROM AUTHOR]

Deception in research is contentious, as ethical codes stress informed consent, yet complete disclosure may jeopardise validity. Indian Council for Medical Research (ICMR) guidelines classify deception into active, incomplete, and authorised forms. This study explores the ethical justification for incomplete (partial disclosure), permissible instances, and the dilemma faced by ethics committees in balancing scientific rigour and participant protection. The qualitative, non-experimental cross-sectional research, using in-depth interviews, identifies themes through thematic analysis. Findings reveal challenges for ethics committees, as incomplete information hampers understanding, amongst others. The paper proposes an ethics committee framework, urging researchers to minimise or avoid partial deception and recommending institutional awareness campaigns and standard operating procedures for minimal-harm studies using partial disclosure. Therefore, it proposes that partial disclosure should be justified by the 3Vs—value, validity, and veracity to preserve research integrity. [ABSTRACT FROM AUTHOR]

The article "RETRAINING IS NOT A CORRECTIVE ACTION: Digging Deeper When Investigating the Human Cause of Incidents" by Ryan Word discusses the importance of investigating incidents beyond simply attributing them to human error and retraining. The author emphasizes the Human and Organizational Performance (HOP) principles, which focus on understanding human factors and organizational causes of incidents. By using tools like a fishbone diagram and a culpability matrix, safety professionals can identify root causes more effectively and promote a culture of learning and improvement rather than blame. The article highlights the significance of asking questions about job clarity, rule following, supervisor influence, and motivation to uncover real root causes and make workplaces safer for everyone. [Extracted from the article]

This study aimed to characterize pharmaceutical services (PS) in the prison system of Rio Grande do Sul in terms of organization and infrastructure in the context of primary health care. This is a descriptive study, with a cross-sectional design carried out between August and September 2022. Data collection was carried out remotely, using a questionnaire prepared and adapted based on the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM - Brazilian National Survey on Access, Use and Promotion of Rational Use of Medications in Brazil). A total of 51 prison units participated in the survey. There is no specific area for the pharmacy in most prison units, with only one place for storing medications. There are no standard operating procedures for PS activities in 78.4% of prison units. In 9.8% of prison units, the presence of a pharmacist was mentioned. No medication storage conditions are monitored in 31.4% of sites. Medication fractionation was reported by 78.4% of prison units. Medications are dispensed in 3.9% of prison units. The PS overview in the prison context reveals important weaknesses and the need to adapt to current regulations. [ABSTRACT FROM AUTHOR]

Background: The Public Health Agency of Canada oversees the Human Pathogens and Toxins Act and Human Pathogens and Toxins Regulations, and monitors human pathogen and toxin incidents in licensed facilities to minimize exposure impact at the individual and population level. Objective: To provide an overview of confirmed laboratory exposure incidents in Canada in 2023. Methods: Confirmed exposure incident reports in 2023 were analyzed using R 4.2.2, Microsoft Excel and SAS. Results: In 2023, 207 incident reports were received, including 63 confirmed exposure incidents that affected 85 individuals. The academic sector accounted for 50.8% (n=32) of the reported confirmed exposure incidents. Microbiology (n=33; 52.4%) was the predominant activity being performed, with the most common occurrence types being sharps-related (n=22; 27.2%) and procedure-related (n=16; 19.8%). Human interaction (n=36; 57.1%) and standard operating procedures (n=24; 38.1%) were the most frequent root causes cited, with corrective actions often directly addressing these causes. Most of the 85 affected individuals were technicians/technologists (n=55; 64.7%) and had a median of 11 years of laboratory experience. Sixty-seven human pathogens and toxins (HPTs) were implicated in the confirmed exposure incidents, with bacteria (n=36; 53.7%) being the most common biological agent type. The median time between the incident and the reporting date was six days. Conclusion: The number of confirmed exposure incidents increased in 2023 compared to 2022. Microbiology was most often the activity being performed at the time of exposure, and occurrence-types, root causes and HPTs implicated in 2023 mirrored those cited in 2022. [ABSTRACT FROM AUTHOR]

Small and medium enterprises (SMEs), Then struggle with implementing effective quality management practices, especially in traditional industries like batik production. These challenges include ensuring consistent product quality to differentiate from competitors and attract customers. This study focuses on addressing quality control issues in small-scale Batik Tanah Liek production, where significant defects persist. The research aims to assess existing practices, identify defect causes, and propose solutions to enhance product quality and reduce rejection rates. These efforts contribute to improving production efficiency and supporting the sustainability of this traditional craTh. The study employs a systematic approach combining quality management methodologies, including data collection, problem identification, brainstorming, the Failure Mode and Effects Analysis (FMEA) approach, and actionable recommendations. Data was gathered through a questionnaire to capture perspectives on defects and quality control issues in batik production. Key quality challenges identified include faded batik, torn fabric, and incorrect motifs. Analysis revealed that the primary cause of incorrect motifs is the malfunctioning canting tool, which hinders proper wax application. Additionally, defects in dyeing and boiling processes contribute to fabric fading and tearing, exacerbating quality issues. The findings underscore the need for systematic solutions, such as creating clear work instructions, designing Standard Operating Procedures (SOPs) for process consistency, and implementing preventive maintenance schedules for equipment. By addressing these issues, the study provides practical interventions to improve production quality. These measures not only enhance the economic viability of SMEs but also play a crucial role in preserving the cultural heritage of Batik Tanah Liek. The implications of this research highlight the potential for broader adoption of quality management practices in traditional industries to ensure their sustainability in competitive markets. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to answer the question: What dynamic capabilities do diverse humanitarian organizations have? Design/methodology/approach: We examine this question through the lens of dynamic capabilities with sensing, seizing and reconfiguring capacities. The research team interviewed 15 individuals from 12 humanitarian organizations that had (a) different geographic scopes (global versus local) and (b) different missions (emergency response versus long-term development aid). We also gathered data from secondary sources, including standard operating procedures, company websites, and news databases (Factiva, Reuters and Bloomberg). Findings: The findings identify the operational and dynamic capabilities of global and local humanitarian organizations while distinguishing between their mission to provide long-term development aid or emergency relief. (1) The global organizations, with their beneficiary responsiveness, reconfigured their sensing and seizing capacities throughout the COVID-19 pandemic by pivoting quickly to local procurement or regional supply chains. The long-term development organizations pivoted to multi-year supplier agreements with fixed pricing to counter price uncertainty and accessed social capital with government bodies. In contrast, emergency response organizations developed end-to-end supply chain visibility to sense changes in supply and demand. (2) Local humanitarian organizations developed the capacity to sense demand and supply changes to reconfigure based on their experiential learning working with the local community. The long-term-development local organizations used un-owned and scalable relief infrastructure to seize opportunities to rebuild affected areas. In contrast, emergency response organizations developed their capacity to seize opportunities to provide aid stemming from their decentralized decision-making, a lack of structured procedures, and the authority for increased expenditure. Originality/value: We propose a theoretical framework to identify humanitarian organizations' operational and dynamic capabilities, distinguishing between global and local organizations and their emergency response and long-term aid missions. [ABSTRACT FROM AUTHOR]

Robert Onzima DDM Anguyo,1 Semei Christopher Mukama,2 Charles Tasaga,2 Dedrix Stephenson Bindeeba,2 Catherine Senyimba,2 Simons Ezajobo,2 Jane Senyondo Nakawesi,2 Andrew Mugisa,2 Susan Kiwanuka Nakubulwa,2 Eve Namitala II,3 Gilbert Aniku,4 Simon Peter Katongole5 1Department of International Public Health, Liverpool School of Tropical Medicine (LSTM), Kampala, Uganda; 2Mildmay Uganda, Naziba Hill, Lweza, Kampala, Uganda; 3RA International, Medical Department, Mogadishu Somalia, Dubai, United Arab Emirates; 4Department of Paediatrics and Child Health, Arua Regional Referral Hospital, Arua, Uganda; 5School of Public Health, Gudie University Project, Kampala, UgandaCorrespondence: Simon Peter Katongole, Email spkatongole@gmail.comAim: This study examined citizens’ knowledge and compliance with COVID-19 standard operating procedures (SOPs), vaccine acceptance and hesitancy, and factors that could influence these behaviors.Methods: The study that utilised the Lot Quality Assurance Sampling (LQAS) approach was conducted in eight districts of Central Uganda; Kiboga, Kyankwanzi, Mubende, Kasanda, Mityana, Luwero, Nakaseke, and Nakasongola districts. Each district was divided into five supervision areas (SAs). Data were collected from 19 respondents per SA, focusing on women aged 15– 49 years and men aged 15 years and above. A satisfactory performance for study indicators was determined by the LQAS decision rules.Results: There was high awareness of COVID-19, with 98.2% of women and 99.3% of men having heard of the pandemic. However, knowledge of at least four COVID-19 preventive measures was low, reported by only 45.4% of women and 48.6% of men. Adherence to social distancing measures in the previous 24 hours was modest, with 67.2% of men and 66.5% of women complying. There was a pronounced lack of hand hygiene, with only 24.8% of women and 19.0% of men frequently washing their hands or using hand sanitizer. COVID-19 vaccine uptake was relatively high for the first dose, with 83.5% of women and 83.0% of men receiving at least one dose. However, full vaccination coverage was low, at 37.5% for women and 41.5% for men. A hesitancy to get vaccinated was driven by fear of side effects, misinformation, doubts about vaccine effectiveness, long distances and queues, and beliefs that vaccines cause infertility.Conclusion: While awareness of COVID-19 was high, knowledge of preventative measures was lacking. The low vaccination rates highlight barriers to uptake. A tailored, trust-based messaging approach through community leaders was recommended to address these gaps. Inter-district and inter-SA disparities indicated the need for localized interventions.Keywords: COVID-19, vaccine, vaccination, uptake, hesitancy, standard operating procedure

This study aims to develop and implement standard operating procedures (SOPs) for nursing care during DVSS-Si robot-assisted laparoscopic radical prostatectomy (LRP) and to evaluate the clinical outcomes of these procedures. We included 140 patients who underwent robot-assisted LRP: 70 patients who received routine perioperative nursing care (control group) from July 2021 to February 2022, and 70 patients who were provided perioperative care according to the newly established SOPs (intervention group) from March 2022 to December 2022. Comparative analysis of operational metrics revealed that the intervention group had shorter operation position placement times, reduced robot installation times, decreased robot usage durations and fewer adverse events compared to the control group. Additionally, doctor satisfaction levels were significantly higher in the intervention group. In conclusion, the implementation of nursing SOPs for DVSS-Si robot-assisted LRP effectively standardized nursing practices in the operating room, leading to enhanced operational efficiency and improved quality of nursing services.

Background: Railway disasters cause huge loss of life and resources. A triple train collision occurred at 7 PM on 2nd June 2023 at Bahanaga, Balasore, Odisha. It was the third deadliest train accident in India with 288 deaths and more than 900 injured. This study aimed to bring out the experience and capture the emotions of the personnel involved in body management of this major accident. Materials and methods: This qualitative questionnaire-based study was done between 13/07/2023 and 29/01/2024, involving 47 personnel (including faculty, residents, staff, and students) who managed the deceased bodies. Six open-ended questions dealing with the experiences of the body management team were analyzed using thematic analysis framework method. Quirkos software was used to generate themes and subthemes. Another six questions about self-reported satisfaction levels of the personnel were graded on a Likert scale of 1 to 5. Results: Qualitative analysis identified six themes and twelve subthemes. It highlighted critical aspects such as lack of training in managing mass tragedies, inadequate flow of essential supplies, emergency preparedness, and defined standard operating procedures (SOP). Excellent teamwork (91.4% of participants expressed high satisfaction with the teamwork) and on-the-spot decision-making were heralded as strengths. The Likert scale showed that 87.2% of participants rated the overall dead body management at 4 or 5. Furthermore, 93.6% (44/47) of participants gave a score 4 or 5 for Tagging and Embalming. Conclusions: Teamwork and proper embalming were identified as the top-rated contributors towards effective body management. Recommendations suggested were mock drills and refresher courses in body management for all stakeholders and psychological support to handle the emotional toll of managing mass tragedy. The identification and embalming of dead bodies are an essential humanitarian service and it helped bereaved families to say a final farewell to their loved ones. [ABSTRACT FROM AUTHOR]

This study aims to analyze and describe the implementation of the Regional Government Affairs Supervision Program. The research method used is descriptive qualitative method. The results showed that supervision of the implementation of local government affairs in the Annual Supervision Work Program (PKPT) has not been running well until now. This can be explained through the following three indicators: 1. The Role of Government Internal Supervisory Apparatus (APIP) In the context of supervision carried out by the Inspectorate of North Sulawesi Province on the implementation of City Government affairs, the role of APIP has not been fully realized in the form of examination. In other words, the supervisory function has not been carried out in accordance with the applicable standard operating procedures (SOP), so that the supervisory process is not running well. 2. The Implementation of the Supervision Program, the implementation of the Supervision Program has not been running effectively until now, one of which is due to the COVID-19 pandemic. This pandemic has resulted in a refocusing of budgets and face-toface meetings, so that inspection priorities are more focused on the scope of the provincial government and have not reached the government at the district / city level. 3. Program Effectiveness: The implementation of the Annual Supervision Work Program (PKPT) has not been fully effective. Most of the programs in the PKPT have not been implemented and realized properly. There are still various inhibiting factors that result in the non-optimality of the implementation of this program, one of which is the limitations in supervising the implementation of government affairs at the district/city level. [ABSTRACT FROM AUTHOR]

This review sheds light on the crucial role of documentation in the pharmaceutical manufacturing industry, a sector where quality control and regulatory compliance are critical. Documentation, from standard operating procedures to validation protocols, underpins quality assurance systems by shaping and improving manufacturing processes. We examine its significance in maintaining product quality, patient safety, and meeting regulatory requirements, particularly in FDA and EMA audits. Additionally, we explore the digital transformation in documentation practices, introducing of electronic batch records, and the associated challenges and opportunities. The paper underscores the necessity for robust, accurate, and timely documentation, emphasizing it as a pledge to product quality, patient safety, and public health. [ABSTRACT FROM AUTHOR]

This article presents a nuanced perspective on leadership-related popular literature, suggesting that it warrants attention from critical scholars due to its broad influence across various communities and contexts. Focusing specifically on retired Navy SEAL officers Jocko Willink and Leif Babin's books, Extreme Ownership (2017) and its sequel The Dichotomy of Leadership (2018), the study employs complexity leadership theory (CLT) to analyze combat leadership principles articulated in these works. Findings reveal a substantial alignment between Willink and Babin's practice-oriented framework and CLT, particularly evident in how CLT's leadership types incorporate these principles. In the context of the armed forces, enabling leadership heavily relies on the operational system, which sets the parameters for adaptive actions that enabling leadership seeks to promote within these constraints (e.g. standard operating procedures, disciplined training, and Commander's Intent). The study also suggests that Willink and Babin's books serve as a counterbalance to the romanticization of complexity and collective command, a phenomenon highlighted in previous research. Ideally, theory and practice converge, as demonstrated in this article. It shows that the practice-oriented insights of Willink and Babin find support in theoretical knowledge. Conversely, these insights derived from practice potentially contribute to the development of CLT in the context of warfare. [ABSTRACT FROM AUTHOR]

The A549 cell line has become a cornerstone in biomedical research, particularly in cancer studies and serves as a critical tool in cytotoxicity studies and drug screening where it is used to evaluate the impact of pharmaceutical compounds on cellular viability. One of the most widely adopted methods for viability assessment, which is also used in evaluating drug cytotoxicity, is the resazurin-based assay. This assay exploits the ability of living cells to convert resazurin into fluorescent resorufin, providing a reliable indicator of metabolic activity. By measuring this conversion, cell viability can be estimated. Resazurin assay is extensively used for evaluating cytotoxic effects on various cell lines, including A549 cells, thereby bridging the gap between in vitro experimentation and drug development. However, frequent data inconsistencies in pre-clinical drug screening highlight the critical need for standardization to ensure reliability and reproducibility. This manuscript addresses these challenges by describing the optimization of resazurin-based viability assays for A549 cells in both 2D cultures and 3D fibrin gel models. By optimizing this test, the study aims to enhance the reliability of cytotoxicity results and introduces a new standard operating procedure, thus providing consistent results with minimal measurement uncertainty. This standardization is crucial for advancing drug screening and ensuring robust research findings. [ABSTRACT FROM AUTHOR]

Background: The critical shortage of comprehensively trained healthcare staff in Tanzania affects the capacity to deliver essential health services, attain universal health coverage and compromises health outcomes. There is a specific lack of suitably trained pharmaceutical professionals, thus, an increase in the use of unqualified or poorly trained staff. Following the introduction of a one-year pharmacy dispenser course intervention, this study explored the impact that the new cadre of graduates had on pharmacy practice compared to healthcare facilities with non-pharmacy trained dispensers (NPTDs). Methods: A post intervention assessment was conducted in 2021 using questionnaires formulated to measure indicators of Good Pharmacy Practice, comparing 29 public health facilities employing pharmacy-trained dispensers (PTD) with 32 public health facilities with NPTDs in Dodoma, Shinyanga and Morogoro regions of Tanzania. Data were collected by experienced pharmacists or pharmaceutical technicians and subsequently aggregated and statistically analysed. Results: The dispensing times for medicines were found to be the same for PTDs and the NPTDs (2 min). There were no statistically significant differences in the adequacy of labelling elements between PTDs and NPTDs. Patients' level of knowledge of the medicines dispensed to them, from both PTDs and NPTDs, showed no difference. Moreover, no differences were observed in storage practice and documentation performance, records of dispensed medicines, handling of medicines and the dispensing area cleanliness between both groups. Overall, facilities with PTDs averaged a higher availability of tracer medicines (77%) than those with NPTDs (70%), however, availability of health commodities in all health facilities in the three regions was low and there was no statistically significant difference between both groups. Conclusion: The study showed no significant difference in performance of pharmacy practice between PTDs and NPTDs despite the former undertaking a one-year training course intended to improve knowledge and skills. Practice application not only depends on effective training but on the working environment. Clear job descriptions, appropriate tools and references to guide, Standard Operating Procedures, acceptance by management of the training undertaken to actively encourage recruits to apply these new skills could improve PTDs performance. Training and knowledge alone do not seem to lead to better practice and performance. [ABSTRACT FROM AUTHOR]

Introduction: Disengagement and re‐engagement with antiretroviral therapy (ART) are common in South Africa, but routine monitoring is insufficient to inform policy development. To address this gap, Anova implemented the 2020 National Adherence Guidelines' re‐engagement standard operating procedure (re‐engagement SOP) and collected additional data to describe the characteristics of re‐engagement visits to inform HIV programmes. Methods: Between July and December 2022, we conducted a study at nine primary healthcare facilities in Johannesburg. Staff were trained on the re‐engagement SOP and provided with job aides to support implementation. Administration clerks categorized visits based on the time elapsed since the missed appointment: ≤14days and >14 days, with the latter identified as re‐engaging. For these clients, clinicians filled out "re‐engagement clinical assessment forms" that included visit dates, both clinician‐assessed and self‐reported treatment interruptions, and clinical details. Data on missed appointments and previous viral loads were extracted from medical records. The information was entered into REDCap. We present data from three out of the nine facilities, selected for their comprehensive data collection and high coverage of all re‐engaging clients. Results: A total of 2342 clients returned following a missed scheduled appointment. The majority, 1523 (65%), missed their appointments by ≤ 14 days, while 819 (35%) were >14 days late (re‐engaging). Among those re‐engaging, 635 (78%) re‐engagement clinical assessment forms were completed. A missed appointment date was available for 623 with 25% (n = 161) returning 2–4 weeks late, 47% (n = 298) 4–12 weeks and 26% (n = 164) >12 weeks late. Self‐reported ART interruption, available for 89% (567/635), indicated the majority (54%, n = 304) experienced no interruption. Clinical concerns were identified in 65 (10%) cases. A majority (79%, 504/635) had prior viral load results, with 73% (370/504) below 50 copies/ml. Conclusions: Clients frequently return to care shortly after missed appointments. Despite missing scheduled ART refill dates, many report not interrupting treatment, either having treatment on hand or sourcing ART elsewhere. Most re‐engaging clients were adherent prior to disengagement, and clinical concerns are rare. A differentiated service delivery approach, prioritizing flexibility and reduced healthcare burden, is required to support client's needs and preferences at re‐engagement. [ABSTRACT FROM AUTHOR]

Veterinary laboratories face distinct challenges in Pakistan, including inadequate infrastructure, resources, and training opportunities, especially in the Khyber Pakhtunkhwa and Balochistan regions. This study aimed to evaluate the impact of training sessions for veterinary laboratory staff to improve methods and protocols related to sample collection, storage, and transport, while ensuring strict compliance with biosafety and biosecurity guidelines. The study employed a mixed methods approach, incorporating qualitative and quantitative research techniques. Hands-on training, essential laboratory equipment, and a comprehensive training kit, including personal protective equipment (PPE), were provided to 13 laboratories within the Livestock and Dairy Development Departments of Khyber Pakhtunkhwa and Balochistan. A random sample of 152 individuals from a cohort of 314 trained personnel was selected to assess procedural changes post-training, supplemented by Training Needs Assessments (TNAs) and follow-up visits. Data collection involved a combination of open- and closedended questionnaires, individual interviews, and focus group discussions by trained enumerators to maintain a standardized approach. Significant improvements were observed in laboratory practices and procedures, staff competency in sample collection, necropsy techniques, labeling, storage, a chain of custody, packaging, and transport, as well as biosafety and biosecurity practices, such as effective use of PPEs, good laboratory practices, standard operating procedures, handling of sharps, and waste management. However, areas needing refinement, particularly waste management protocols, were identified. The integrated approach combining TNAs, training initiatives, and resource distribution, including laboratory equipment and PPEs, was pivotal in achieving these outcomes. This comprehensive strategy provides a basis for improving biosafety and biosecurity measures within laboratories, thereby contributing to the global effort to mitigate unauthorized access to high-risk pathogens. [ABSTRACT FROM AUTHOR]

Research has focused on episodic crises (e.g., fire extinguished), with regard to causality, management, and recovery. But some crises (e.g., illegal migration) are continuous, with no clear conclusion, and the nature and timing of the recovery phase are indeterminate. To explore the challenges facing leaders in a continuous crisis, we turn to 'extreme fiction' – a radically imaginative narrative of possible accidents, crises and disasters. The television series The Walking Dead is an example of a continuous crisis. This is also a novel crisis, which means that crisis management routines, protocols, and standard operating procedures may not apply, and the value of past experience may be limited. Our analysis offers a novel perspective on the nature of the crisis leadership role, by showing how a continuous crisis generates three paradoxical leadership agendas: managing the crisis (which includes unmanageable elements), managing conflict (while initiating and participating in conflict), and managing values (which may have to be temporarily abandoned). Our findings also demonstrate how contextual properties shape the leadership role in a continuous crisis. [ABSTRACT FROM AUTHOR]

Simple Summary: This study examines the impact of employee-related factors on udder health in dairy cows. Specifically, it investigates how variables such as educational level, the nature and scope of training provided, the methodologies utilized in that training, and the adherence to Standard Operating Procedures (SOPs) within a dairy herd influence Bulk Tank Somatic Cell Count (BTSCC) and new infection risk. We anticipated that employees with formal education and comprehensive training in SOP implementation would be associated with lower BTSCC and new infection risk than their counterparts lacking formal agricultural education. Our findings indicate that the presence of an SOP correlated with an increase in BTSCC by 21,600 cells/mL compared to herds lacking a milking SOP. Furthermore, we observed a reduction of 0.02% in new infection risk when employing educated staff, which decreased to 0.16% when an SOP was incorporated into the training regimen. In contrast, unskilled employees were linked to a 0.02% increase in new infection risk. Notably, the availability of an SOP in the herd that was not incorporated within the training was associated with a 0.15% increase in infection risk. These results underscore the importance of combining foundational knowledge with implementing SOPs in training programs to optimize milking protocols. For decades, bovine mastitis and milk quality have been a focus area for research, agricultural extension, and dairy processors worldwide, yet employee management as a factor in udder health management has received limited attention. This is mainly because the focus has previously been on more classical areas covered by the National Mastitis Council Mastitis Control Program (NMC 10-point plan) in English-speaking countries. Therefore, we wanted more background information on employee management on dairy farms, to identify the human factor of udder health management. The method of investigating employee management and the impact of employee management on udder health was conducting a study of 88 Danish dairy farms with hired employees and parlor or rotary milking systems. An interview-based questionnaire on individual dairy farmers' human resource management was developed based on the current literature and multiple discussions among the authors. The results we found through analyzing associations between the dependent variable BTSCC and employee management, using a regression model, was that providing a generic SOP was associated with a 21,600 cells/mL increase in BTSCC, with estimates in the range (507; 42,674 cells/mL). We also analyzed, applying a Poisson model, that there was a 0.16% reduction in new infection risk if the training was based on a herd-specific SOP and educated employees. In contrast, we identified a 0.15% increase in new infection risk in herds where SOPs were available but not incorporated, both modest but significant results. In conclusion, farms with educated employees and trained by an SOP achieve the lowest new infection risk, but education has no impact on BTSCC. [ABSTRACT FROM AUTHOR]

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Developing theory-informed standard operating procedures (SOPs) for the continuous crystallisation of pharmaceuticals still remains a bottleneck. For the continuous manufacturing of pharmaceuticals, the current methods rely on the laborious trial-and-error approach to identify process conditions such as the dilution rate (flow per unit volume of reactor) and initial supersaturation, where the productivity will be at maximum at steady-state conditions. This approach, while proven and considered to be useful, lacks or ignores the information obtained from batch kinetics. Herein for the first time, we propose a theoretical method to develop batch kinetics-informed theoretical procedures for the continuous manufacturing of a model compound curcumin in isopropanol. The theoretical approach uses batch kinetic constants to theoretically identify the optimum dilution rate and the corresponding mass of the model compound curcumin when crystallised, as well as its productivity at steady-state conditions as a function of initial supersaturation. The theory-informed procedures will serve as a valuable guideline to develop operating procedures for the continuous production of the target compound and thus eliminate the trial-and-error approach used to develop the protocols for the continuous manufacturing of pharmaceuticals. We also showed that our methods allow for the estimation of the dilution rate that corresponds to washout conditions (i.e., where all the crystals in the crystalliser will be washed out due to the high flow rate of the input stream) during the continuous manufacturing of crystals. [ABSTRACT FROM AUTHOR]

The Indian construction industry, the backbone of the country's economy, has been plagued by a lack of transparency, putting homeowners at risk of exploitation. The Real Estate (Regulation and Development) Act 2016 (REA) was enacted to promote transparency and attract investments. Still, its effective implementation is facing several challenges, such as needing more monitoring of the judgements passed by the authorities, exclusion of members of the redevelopment projects, etc. which must be addressed. The study was based on a literature review, questionnaire surveys and interviews of the developers and lawyers, and a case study based on a redevelopment project. Findings reveal critical challenges and suggest practical solutions, such as extending the Act's scope to cover redevelopment projects, establishing a committee of experts, adopting Standard Operating Procedures (SOPs), including members of redevelopment projects in the Judicial Appellate of Real Estate Regulatory Authority (RERA), enhancing the quality of judgments, and considering related laws and regulations in the real estate sector. The real estate sector will become more equitable and just by tackling these challenges, promoting sustainable economic growth and benefiting all stakeholders. Thus, fulfilling India's aspirations for a self-reliant and sustainable future. [ABSTRACT FROM AUTHOR]

This study explored product and process development in the Indian biopharmaceutical industries, crucial in developing, manufacturing, and distributing biopharmaceutical products. Quality by Design (QbD) is a fundamental approach guiding product development, integrating scientific principles, and risk management throughout the lifecycle of biopharmaceutical products. Compliance, desired by regulatory bodies such as the Central Drugs Standard Control Organization (CDSCO), the U.S. Food and Drug Administration (FDA), the European Medicines Evaluation Agency (EMEA), and the International Organization for Standardization (ISO), is essential for market approval and global acceptance. This study examined the Indian biopharmaceutical industry's process and product development standards, focusing on regulatory compliance, international collaborations, operational transparency, inspection practices, and challenges. The results indicated that most companies align with regulatory standards, emphasizing commitment to safety and efficacy in biopharmaceutical product development. International collaborations were highlighted as crucial for innovation and knowledge exchange but presented challenges in harmonizing diverse regulatory frameworks. Clear standard operating procedures (SOP) and routine inspections were important for ensuring product quality and safety, reflecting a commitment to high manufacturing standards. However, the study identified minor challenges, such as the economic feasibility of biopharmaceutical production, and frequently changing regulatory guidelines. Solutions proposed included fostering collaborations with research institutions and enhancing transparency in communication to address industry challenges effectively. The study also highlighted the high costs and regulatory challenges in developing new drugs, promoting collaboration with the biotechnology industry. Furthermore, the research findings align with the "Make in India" initiative, emphasizing transparency, collaboration, and innovation to promote domestic manufacturing capabilities and position India as a global biopharmaceutical manufacturing hub. The Indian biopharmaceutical industry firmly commits to regulatory compliance and manufacturing excellence. [ABSTRACT FROM AUTHOR]

This article analyzes the Danish Mink Scandal of 2020 using Karl Weick's sense-making theory. It zooms in on the 72-hour decision-making process that led to the culling of Denmark's entire 17 million farmed-for-fur mink population in response to the perceived threat of coronavirus disease 2019 (COVID-19) forming a new mutation. Since there was insufficient legal justification for the culling, the prime minister was forced to call a snap general election, leading to a change of government. We exploit detailed data material containing text messages, e-mail correspondence, documentary material, and specific inquiries. The article demonstrates the strength of Weick's social–psychological perspective on sense-making for public management research. It shows how time pressure can cut across heavily institutionalized standard operating procedures. It can increase the centralization of the decision-making power at the apex and decouple the formal legal responsibilities, which remain institutionalized with the line ministries. The study argues that sense-making offers learning points that cannot be obtained from formal legal perspectives, which are used to assign responsibilities. Indeed, ex-post thinking may be too convenient—traditional solutions like punishing leaders or agencies may obscure the discovery of more systemic vulnerabilities when crises unfold. [ABSTRACT FROM AUTHOR]

This study incorporates five different transpiration cooling channels, two circular, two hexagonal, and one novel bio‐inspired blood vessel that are designed in a monolithic turning tool and produced via metal additive manufacturing. They are heat treated under direct aging (DA1 and DA2) and solution heat‐treatment (SHT1 + DA1, SHT1 + DA2, and SHT2 + DA1) conditions to study the effects of heat treatment on the hardness and dimensions of complex internal geometries as they play a significant role in cooling effectiveness. Microstructural characterization for DA revealed the formation of lath‐type martensitic phases with uniform distribution, which improves the microhardness significantly, with SHT2 + DA1 achieving the highest hardness 641.2 HV and DA2 producing 611.7 HV. From the X‐ray microcomputed tomography, various heat treatments have very insignificant deviations in the dimensions of the transpiration channels (0.05% to 1%) from the as‐printed dimensions. Further, variations in design are not associated with the heat‐treatment process and the achieved hardness. This study helps create a standard operating procedure for heat treatment for complex internal channels with minimal dimensional deviations and highest hardness. [ABSTRACT FROM AUTHOR]

Objectives: To assess diagnostic mycology capacity and available fungal diagnostic services of microbiology laboratories in eight tertiary hospitals in Nigeria and one in Ghana. Methods: On-site audits were performed in the microbiology laboratories of nine tertiary hospitals using a structured observation checklist. Results: A total of nine tertiary hospitals' laboratories in Nigeria and Ghana were assessed between June 2022 and December 2023. The majority of audited laboratories lacked basic infrastructure and materials needed for fungal diagnostic testing, with less than half of the labs having a dedicated mycology bench, space or room, 3/9 (33.3%), appropriate bench workflow 1/9 (11.1%), functional biosafety cabinet type two 2/9 (22.2%), dedicated incubators 3/9 (33.3%), standard operating procedures 1/9 (11.1%), mycology atlases 2/9 (22.2%). Trained laboratory personnel for mycology were also lacking with only one of the laboratories 1/9 (11.1%) observed to have a designated trained personnel for the mycology bench. Conclusion: The audit revealed deficits in basic infrastructure, material resources, dedicated human resources, and laboratory capacity to detect serious fungal infections. [ABSTRACT FROM AUTHOR]

Background and Objectives Materials and Methods Results Conclusion Wrong blood in tube (WBIT) continues to be a preventable cause of unintended harm to the patient. The literature describing extent of the problem, its consequences and factors leading to WBIT from the perspective of lower middle‐income countries (LMICs) is limited. The present study describes WBIT and its outcome in a hospital‐based blood centre from an LMIC.WBIT events occurring during the study period were analysed to identify the root cause. In addition, they were analysed according to discipline, department and time of sample draw. Root causes were divided and compared with standard operating procedure (SOP) for sample collection for blood requests. All WBIT events were followed and their outcomes analysed.WBIT events occurred at a rate of 4.8/10,000 blood requests, with a higher rate in urgent requests (5.2/10,000 requests). The average rate of WBIT was higher in surgical disciplines compared to medical and acute care services (6.58 vs. 4.43 vs. 3/10,000 requests). The highest rate of WBIT was observed when requests were received during 8:00 PM–2:00 AM (p = 0.02). Deviations from SOP with contribution from human and organizational elements were identified as the root cause. The consequences ranged from delay in providing blood to acute haemolytic transfusion reactions.We found that WBITs occurred at a rate comparable to that reported from developed countries. Use of software and automation may reduce the rate of WBIT but not eliminate it completely. Strict adherence to SOPs and continuous training of phlebotomy staff would help reduce it to a minimum. Blood centres need to develop specific strategies with respect to their root causes. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions This study sought to better understand discussions of emergency dispatches (i.e., activation of local crisis services to conduct a welfare check) and the circumstances under which Veterans Crisis Line (VCL) callers and responders feel they are able contribute to (collaboration) and agree upon (consent) the decision to initiate an emergency dispatch.Semi‐structured interviews gathered data on veterans' (n = 40) experiences receiving an emergency dispatch and VCL responders' (n = 35) perspectives on initiating dispatches. Data were analyzed using a thematic analysis approach.Veterans calling the VCL were often seeking emotional support and were surprised to receive a suicide risk assessment and emergency dispatch. Responders reported they strive for collaboration and consent prior to sending a dispatch, but the crisis setting challenged this ideal. Overall, veterans and responders described similar features of the ideal, collaborative conversation about dispatches yet noted threats to achieving collaboration: complex standard operating procedures, responder training quality, and responder lack of comfort with de‐escalation.Increasing veteran awareness of VCL services, altering the timing and type of suicide risk assessment, enhancing de‐escalation skill, increasing consistency of VCL responder proficiencies, and revising guidelines for dispatch disclosure were identified as ways to improve collaboration and consent around emergency dispatches. [ABSTRACT FROM AUTHOR]

Objective: To evaluate implementation of a patient decision aid for symptomatic uterine fibroid management to improve shared decision-making at five clinical settings across the United States. Methods: We used a type 3 hybrid effectiveness-implementation stepped-wedge design and the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) planning and evaluation framework. We conducted clinician training, monthly reach tracking with feedback to site clinical leads, patient and clinician surveys, and visit audio-recordings. Implementation strategies included assessment of organizational readiness for shared decision-making, synchronous clinician training, audit and feedback of decision aid reach, and access to multiple decision aid formats. Outcomes and analyses included patient-level reach, clinician-level adoption, and associations of patient-reported decision aid exposure (as treated) and setting-level implementation (intention-to-treat) with patient-reported (collaboRATE measure) and observed (OPTION-5 measure) shared decision-making. We also designed and assessed setting-level plans for sustainability and other factors impacting sustained decision aid use. Results: The decision aid was adopted by 72 of the 74 eligible gynecologists (97%) and reached 2553 patients across five settings. CollaboRATE scores improved among patients who reported receiving the decision aid (as-treated analysis, 69% vs. 59%; OR 1.6, 95% CI 1.16–2.27). CollaboRATE scores remained consistent before and after setting-level decision aid implementation (intention-to-treat analysis, 64% vs. 63%; OR 0.86, 95% CI 0.61–1.22). Participants would prefer to receive a decision aid at multiple time points (91.9% before the visit, 90.7% during the visit, 86.5% after the visit). Shared decision-making experiences did not improve when comparing pre vs. post-implementation collaboRATE scores across included settings (intention-to-treat, 64% vs. 63%; OR 0.86, 95% CI 0.61–1.22). Conclusion: When patients with symptomatic uterine fibroids are given decision aids, they report higher shared decision-making scores. However, the differences we observed between the as-treated and intention-to-treat results suggest that unaddressed implementation challenges continue to limit the extent to which patients receive decision aids and likely hinder their overall impact. Future efforts to implement decision aids should explore enhancing their integration into clinical workflows and standard operating procedures, supported by organizational incentives that prioritize shared decision-making. Trial registration: ClinicalTrials.gov NCT03985449; registered 6 June 2019. [ABSTRACT FROM AUTHOR]

Calf loss continues to be a considerable problem on German dairy farms. Untrained personnel or the lack of best practice routines are potential reasons. Standard operating procedures (SOP) may increase process consistency and can improve animal health and animal welfare. We developed SOP for 8 important tasks in calf care and provided them online to interested dairy farmers and their employees. Five questionnaires were embedded to collect data on demographics, use, perception, and feasibility of SOP. Main objectives of the study were to investigate (1) if there is a gap between the existence of SOP and the wish for SOP, (2) if participants (n = 301) consider ready-made SOP as feasible for their farm and (3) suitable to train new personnel, and (4) if they state their confidence in task execution higher after the courses. We experienced a strong discrepancy between the existence (13.1%) and the wish for SOP (69.4%). Most of the participants rated ready-made SOP as feasible for their farm (66.5%). Eighty-five percent fully agreed or agreed to the statement that SOP are a suitable tool for training new employees. Interestingly, 64.2% of employees mentioned, that they wanted to be involved in the creation of SOP specific to their farm. The SOP-based e-learning courses increased the confidence in performing tasks in calf care, especially concerning tasks that were performed less often such as tube feeding, emergency care, and testing of colostrum quality. The list of standard abbreviations for JDS is available at adsa.org/jds-abbreviations-24. Nonstandard abbreviations are available in the Notes. [ABSTRACT FROM AUTHOR]

Legal protection for the midwife profession is very important to ensure that they can carry out their duties safely and according to standards. Midwives play an important role in providing health services, especially for mothers and children. However, in practice, they often face legal risks related to malpractice, negligence, or violations of professional ethics. The implementation of legal protection is carried out through regulations and standard operating procedures (SOPs) set by the government and professional organizations. This protection includes preventive legal aspects, such as regulating practice permits, as well as repressive aspects, such as legal assistance if problems occur. These efforts aim to maintain the quality of service and protect the rights of midwives and patients. [ABSTRACT FROM AUTHOR]

Background: Social interactions within and between communities influenced the spread of COVID-19. By using social network analysis (SNA), we aimed to understand the effect of social interaction on the spread of disease in a rural district. Method: A retrospective record review study using positive COVID-19 cases and contact-tracing data from an area in Malaysia was performed and analysed using the SNA method through R software and visualised by Gephi software. The justification for utilizing SNA is its capability to pinpoint the individuals with the highest impact and accountability for the transmission of COVID-19 within the area, as determined through SNA. Result: Analysis revealed 76 (4.5%) people tested positive for COVID-19 from 1,683 people, with 51 (67.1%) of the positive ones being male. Outdegrees for 38 positive people were between 1 and 12, while 41 people had 1–13 indegree. Older males have a higher outdegree, while younger females have a higher outdegree than other age groups among same-sex groups. Betweenness was between 0.09 and 34.5 for 15 people. We identified 15 people as super-spreaders from the 42 communities detected. Conclusion: Women play a major role in bridging COVID-19 transmission, while older men may transmit COVID-19 through direct connections. Thus, health education on face mask usage and hand hygiene is important for both groups. Working women should be given priority for the work-from-home policy compared to others. A large gathering should not be allowed to operate, or if needed, with strict adherence to specific standard operating procedures, as it contributes to the spread of COVID-19 in the district. The SNA allows the identification of key personnel within the network. Therefore, SNA can help healthcare authorities recognise evolving clusters and identify potential super-spreaders; hence, precise and timely action can be taken to prevent further spread of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Hemovigilance stands as a fundamental necessity for the safe transfusion practice. It is an essential component of quality management in transfusion. Objectives: The study was conducted with the primary objective of determining the incidence of adverse transfusion reactions occurring in blood/ blood product recipients and the secondary objectives were to assess the imputability and severity of those adverse transfusion reactions. Methods: This was a cross-sectional, observational study conducted in the blood bank department of SHKM GMC Hospital, over a period of 1 year from October 2022 to September 2023. All patients admitted to the clinical wards and ICUs of different clinical departments who were transfused with whole blood/blood components and reported to have transfusion reactions during or after the transfusion of blood components were enrolled in the study. The only exclusion criteria were the participants not willing to participate in the study. Results: The incidence of adverse transfusion reactions in the current study is 0.73%. The majority of Adverse transfusion reactions (ATR) incidence was seen with whole blood 2.41% as compared to other blood components. Allergic reactions accounted for 40.91%, followed by febrile non-hemolytic transfusion reactions (FNHTRs) 33.33%. Most of the adverse transfusion reactions in the study were non-severe (Grade-1) 84.85%. The imputability assessment of the majority of the transfusion reactions was in probable 65.15% and possible category 24.24%. Conclusion: The current study highlights the significance of transfusing blood and blood components judiciously. Blood bank Standard operating procedures (SOPs) regarding transfusion should be strictly followed to prevent errors during transfusion. [ABSTRACT FROM AUTHOR]

PT. XYZ is a foreign investment company engaged in the manufacturing industry of building materials. The products produced by PT. XYZ are concrete wall bricks that adhere to Japanese Industrial Standards (JIS), and have also received SNI product testing certification. In its business processes, PT. XYZ requires supplies of goods and services. The procurement implementation at PT. XYZ applies a "procurement by user" model. Risks may occur in this process, such as a lack of transparency in the supplier selection process, procurement cost constraints, and insufficient professionalism in the receipt of goods or services. ISO 31000 can serve as a guideline for implementing risk management, and the method used in this research is the House of Risk (HOR). HOR Phase 1 will produce an output in the form of Aggregate Risk Potential (ARP), which determines the priority of risk agents that will undergo further action, along with an analysis using a Pareto diagram. Followed by HOR Phase 2, which will produce outputs in the form of the difficulty level of mitigation processes (Dk) and Total Effectiveness of Difficulty Level (ETDk), determining the effectiveness ratio of each mitigation action. In this research, 18 risk events and 17 risk agents were identified, with 2 priority risk agents that will receive mitigation actions. Through HOR Phase 2, five recommendations for mitigation actions were obtained, with the top-ranking recommendation being the establishment of Standard Operating Procedures (SOP) for the procurement process. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic challenged health care organizations to cope with major disruptions, especially in the first waves. Several investigations were undertaken to understand how to support resilience during similar unexpected events. In this study, we attempted to unveil the resilient performance of health care organizations during the first waves of the COVID‐19 pandemic from the viewpoint of resources for action. Thus, the research objectives are twofold: (i) to evaluate organizational resilience in facing COVID‐19 by hospitals in Brazil and (ii) to evaluate the relationship between resources for action and resilient performance. Firstly, an online survey was sent to front‐line health care workers, resulting in 111 responses. Then, a questerview was undertaken through online interviews with some participants of the previous phase. Resources for action were interpreted as five aspects supporting decision‐making in health care organizations: information and communication; team, equipment, and tools; standard operating procedure (SOP); training; and built environment. Each resource was then unfolded based on the four potentials for resilient performance (i.e., anticipate, monitor, respond and learn). Respondents strongly agreed that their institutions are resilient (M = 4.15; standard deviation [SD] = 0.91). The potentials to learn (M = 4.23; SD = 0.96) and respond (M = 4.08; SD = 1.02) stood out, followed by monitoring (M = 3.85; SD = 1.07) and anticipating (M = 3.70; SD = 1.11). Although some differences stand out, findings corroborate with the joint performance of the resources for action to support resilience performance. Information and communication were the most present among the resources for action (M = 4.20). Making resources for action visible is a strategy for designing resilient systems, as it can be considered a bridge linking different resilience levels (micro, meso, and macro). Suggestions for future studies point out the need to promote the development and evaluation of resources for action in health care institutions. [ABSTRACT FROM AUTHOR]