Introduction: A functional maternal referral system should encompass a feasible communication system between health facilities. In Uganda, the current paper-based patient referral form is associated with inadequate pa...Introduction: A functional maternal referral system should encompass a feasible communication system between health facilities. In Uganda, the current paper-based patient referral form is associated with inadequate patient-information and low feedback rates. A recent quasi-experimental study demonstrated that a phone-based communication intervention is feasible for iterative communication between health facilities, and there were improved maternal-fetal outcomes and high rates of feedback. However, the acceptability of the intervention was not assessed. Objective: The study assessed the acceptability of a phone-based communication intervention by the health care workers (HCWs) for iterative communication between the referring and receiving health facilities. Methods: This was a qualitative study conducted in South Western Uganda, in April 2021. The study employed a theoretical framework of acceptability of medical interventions. We conducted in-depth interviews with HCWs and used deductive-inductive analysis. Results: We enrolled a total of 23 HCWs, of whom 69.6% (n = 16) were females while 30.4% (n = 7) were males. Majority (65.2%, n = 15), were midwives and the rest were: doctors (30.4%, n = 7) and a nurse (4.3%). The HCWs were positive towards the intervention: they believed that the intervention reduced delays, promoted professional escort, encouraged sharing of supplies, enabled exchange of relatively more patient details, feedback and improved case management. They believed it was culturally acceptable and had enough skills and experience of operating phones. All participants recommended scale out of the intervention, but advised on the need for dedicated human-resource to coordinate phone calls, ensure availability of airtime and charged battery. Conclusion: This study demonstrates that the phone-based communication intervention was highly accepted by the healthcare workers, and that hospitals can successfully give feedback to lower health centres through iterative phone calls. This provides a possible solution to the long-standing challenge of poor feedback rates and a vicious cycle of poor maternal-fetal outcomes in resource limited settings.展开更多
Effective adjustment of fertilization spacing and amounts for different plant distances is beneficial to increase production and reduce the amount of fertilizer used.In order to achieve such a target,an electric-ferti...Effective adjustment of fertilization spacing and amounts for different plant distances is beneficial to increase production and reduce the amount of fertilizer used.In order to achieve such a target,an electric-fertilizing vehicle with staggered fan-shaped openings in a fertilization device is proposed here,and its fertilization spacing and amounts are controlled by a control system and mobile phone-based programs.Further validating multivariable effects on fertilization spacing and amounts,such as openings,rotary speeds,and moving parameters of the vehicle,an integration discrete element model(DEM)is established so that the feasibility of the fertilization device could be evaluated before manufacturing and testing.Finally,it is reflected through field-simulated experiments that fertilizer spacing ranges from 0.27 to 5.45 m.Compared with simulated results,the absolute error varies from-0.08 to 0.05 m,and the maximum relative error is about-5.67%.Therefore,the uniform and stable fertilization for different plant spacing is semi-actively achieved by the designed device and a control system with mobile phone-based programs.The proposed simulation model is feasible,thus presenting a good reference for designing these components.展开更多
文摘Introduction: A functional maternal referral system should encompass a feasible communication system between health facilities. In Uganda, the current paper-based patient referral form is associated with inadequate patient-information and low feedback rates. A recent quasi-experimental study demonstrated that a phone-based communication intervention is feasible for iterative communication between health facilities, and there were improved maternal-fetal outcomes and high rates of feedback. However, the acceptability of the intervention was not assessed. Objective: The study assessed the acceptability of a phone-based communication intervention by the health care workers (HCWs) for iterative communication between the referring and receiving health facilities. Methods: This was a qualitative study conducted in South Western Uganda, in April 2021. The study employed a theoretical framework of acceptability of medical interventions. We conducted in-depth interviews with HCWs and used deductive-inductive analysis. Results: We enrolled a total of 23 HCWs, of whom 69.6% (n = 16) were females while 30.4% (n = 7) were males. Majority (65.2%, n = 15), were midwives and the rest were: doctors (30.4%, n = 7) and a nurse (4.3%). The HCWs were positive towards the intervention: they believed that the intervention reduced delays, promoted professional escort, encouraged sharing of supplies, enabled exchange of relatively more patient details, feedback and improved case management. They believed it was culturally acceptable and had enough skills and experience of operating phones. All participants recommended scale out of the intervention, but advised on the need for dedicated human-resource to coordinate phone calls, ensure availability of airtime and charged battery. Conclusion: This study demonstrates that the phone-based communication intervention was highly accepted by the healthcare workers, and that hospitals can successfully give feedback to lower health centres through iterative phone calls. This provides a possible solution to the long-standing challenge of poor feedback rates and a vicious cycle of poor maternal-fetal outcomes in resource limited settings.
基金supported by the Natural Science Foundation of Hubei Province(Grant No.2021CFB592)the Outstanding Youth Fund of Hubei University of Automotive Technology(Grant No.2023YQ04)+1 种基金This work was also sponsored by the Outstanding Young and Middle-aged Scientific Innovation Team of Colleges and Universities of Hubei Province(Grant No.T201913)the Initiation Fund for Doctoral Research from Hubei University of Automotive Technology(Grant No.BK201608).
文摘Effective adjustment of fertilization spacing and amounts for different plant distances is beneficial to increase production and reduce the amount of fertilizer used.In order to achieve such a target,an electric-fertilizing vehicle with staggered fan-shaped openings in a fertilization device is proposed here,and its fertilization spacing and amounts are controlled by a control system and mobile phone-based programs.Further validating multivariable effects on fertilization spacing and amounts,such as openings,rotary speeds,and moving parameters of the vehicle,an integration discrete element model(DEM)is established so that the feasibility of the fertilization device could be evaluated before manufacturing and testing.Finally,it is reflected through field-simulated experiments that fertilizer spacing ranges from 0.27 to 5.45 m.Compared with simulated results,the absolute error varies from-0.08 to 0.05 m,and the maximum relative error is about-5.67%.Therefore,the uniform and stable fertilization for different plant spacing is semi-actively achieved by the designed device and a control system with mobile phone-based programs.The proposed simulation model is feasible,thus presenting a good reference for designing these components.
