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Chronic illnesses are one of the world's most serious health problems, and the number of individuals affected is continually rising. Many of the most common chronic conditions, such as hypertension, diabetes, arthritis, and asthma, have a strong treatment component that includes medication adherence, physical exercise, and disease-specific behaviours. According to the World Health Organization (WHO), non-adherence is caused by five variables: socioeconomic factors, health-care system factors, therapy-related factors, condition-related factors, and patient-related factors. The results of treatment differed by 26% across patients with high and low adherence. Patients' morbidity, death, and preventable health-care expenses rise as a result of nonadherence. Lack of adherence was predicted to be responsible for almost 125,000 fatalities and 10% of hospitalizations in the United States in 2017. Low drug adherence is a major issue all around the world. In Hradec Kralove, the adherence rate to long-term drug therapy is reported to be between 40% and 50%. (Czech Republic). In the United States, more than 80% of persons aged 65 and up did not follow their prescription drug regimens, and more than half of patients using antihypertensive drugs ceased treatment within a year. Patients in India are only half as likely to take their medication as they should be, owing to a lack of effective education and patient counselling. Patients' timely medicine-taking behaviour has a greater impact on people's health than the need for new treatment options.

The delivery of low-carbon buildings (LCBs) in high-rise, high-density cities is still hindered by various common and interdependent constraints. However, a study that developed innovative strategies to address the common constraints to delivering LCBs focusing on traditional high-rise, high-density cities could not be identified in the previous literature. Therefore, this study aimed to identify potential strategies for accelerating the delivery of LCBs in high-rise, high-density cities by addressing relevant common constraints that were identified in recent studies. Accordingly, potentially relevant strategies were identified through eight semi-structured interviews with well-experienced experts in industry and academia. Consequently, 71 strategies were identified under six categories, i.e., policy implementation, building energy/carbon data utilisation, awareness raising/training, technology advancement, incentives, and organisational level commitments. This also required closer collaboration with different stakeholders/stakeholder classes in implementing these strategies, who were, therefore, also identified. An SNA-based analysis was also conducted to explore the connections between constraints and strategies. The strategies related to energy/carbon policy development, standardisation, codes and certifications, mandatory regulations, financial incentives, and technology adoption showed the ability to address a majority of the driving constraints related to policies and technologies. These study findings will assist policymakers and other relevant stakeholders in the arena of the project and asset management in accelerating the delivery of LCBs by adopting an innovative approach to prioritise potential strategies in order to suitably address and synergise the complex interdependencies among the constraints.

For many years, the Government of India has worked hard to offer health services to people all around the country, and it remains dedicated to doing so. It has formed numerous programmes to achieve the goal of “Health for All.” As a result, in 2005, The Hon’ble Prime Minister formed the The National Rural Health Mission will provide the countries’ network with well-being administrations. The National Rural Health Mission, which went into effect in April 2005, is considered the backbone of the rural sector. They have been instilled with the belief that, as a result of their efforts, something special has appeared to assist the country dwellers in re-establishing their well-being. The National Rural Health Mission (NRHM) aims to provide rural populations, especially disadvantaged groups, with comprehensive, low-cost, and high-quality health care. Material & Method: We reviewed all of the articles published on PubMed, Scopus, BMJ, Google scholar, Nature, Web of science that were focusing on, National rural health mission services, to achieving universal health coverage (UHC). Conclusion: This study compiles a list of all social need interventions that have been described in the literature to date. National health systems around the world are reforming to meet health goals, with a focus on cost containment, universal coverage, equity in access and quality, and resource efficiency and effectiveness. The primary purpose of the mission is to establish a fully operational, community-owned, decentralised health-care delivery system with cross-sectoral integration at all levels, enabling for simultaneous action on a wide variety of health determinants such as poverty and social equity.

PurposeGiven the heightened imperatives for boosting supply chain resilience (SCR) in industrialized construction (IC), it is essential to explore the correlational impacts of supply chain vulnerabilities (SCV) and supply chain capabilities (SCC) which are the measures of SCR, specifically in Hong Kong where policymakers actively promote IC. Therefore, this study aims to develop a model to explore the correlational impacts of vulnerabilities and capabilities targeting SCR in IC.Design/methodology/approachAfter drawing on the general literature on SCR, empirical research using an expert opinion survey was conducted following the methodological framework of this study. The gathered data were then subjected to the partial least squares structural equation modeling process. Thereby, four hypotheses were formulated and tested for 20 capability–vulnerability relationships.FindingsSeven of the 20 statistical relationships tested were identified to be significant. Accordingly, production-based SCV were identified as the most critical disruptions. “Resourcefulness” could substantially withstand production-based SCV, receiving the highest path significance. An “enablers-results framework” for achieving SCR of IC was also developed based on these findings to help industry practitioners with SCR implementation.Originality/valueTo the authors' knowledge, this is the first structured evaluation model that measures the correlational impacts of SCC and SCV targeting SCR in the construction domain. Further, this study adds substantially to the existing SCR and construction “body of knowledge” by proposing a model explaining how various SCV and SCC influence SCR in IC. These findings also inform the industry where and how to deploy critical SCC at appropriate levels, targeting critical SCV, to contain or extirpate them.

Inspired by multiple benefits, including competitive advantages from developing resilient supply chains, this study was designed for the development of effective assessment models to evaluate Suppl...

PurposeDemands for Industrialized Construction (IC) have intensified with growing construction industry imperatives to (A) boost performance; (B) reduce reliance on “in-situ and on-site” operations; and (C) strengthen supply chain resilience (SCR) not just for survival but also to fulfill obligations to clients in the coronavirus disease 2019–induced (COVID-19–induced) “new normal”. In addressing these imperatives, this paper targets more effective leveraging of latent efficiencies of off-site-manufacture, based on findings from a Hong Kong (HK)–based study on assessing and improving SCR in IC in a high-density city.Design/methodology/approachStarting with the identification of critical supply chain vulnerabilities (CSCVs), this study developed a multilevel–multicriteria mathematical model to evaluate the vulnerability levels of IC supply chains (SCs) in HK based on an in-depth questionnaire survey followed by experts' inputs and analyzing them using fuzzy synthetic evaluation (FSE).FindingsThe overall vulnerability index indicates that IC in HK is substantially vulnerable to disruptions, while production-based vulnerabilities have the highest impact. Top management attention is needed to address these CSCVs in IC in HK.Originality/valueTo the authors' knowledge, this is the first structured evaluation model that measures the vulnerability level of IC, providing useful insights to industry stakeholders for well-informed decision-making in achieving resilient, sustainable and performance-enhanced SCs.

PurposeThis paper aims to review the state-of-the-art of literature of supply chain resilience (SCR) and to map the SCR domain, so as to provide a launchpad for further knowledge development and dissemination.Design/methodology/approachCiteSpace as a bibliometric analysis software was used to systematically, comprehensively and accurately review the SCR-related literature and to then develop an SCR research map.FindingsThe results revealed the existing SCR publication base, domains, highly contributed publications, research hotspots, key milestones of SCR research development and a dynamic platform to integrate future research and development of SCR.Originality/valueThe scientific contribution to SCR knowledge is an accurate and quantitative SCR research map, including the related SCR publication base, domains, pillars, hotspots, evolution and future trends. The methodology and the findings can be generalised to many other fields. Besides, the proposed SCR research map could be frequently updated by injecting future findings from similar studies to fill any residual or newly emerging research gaps. Moreover, the results could inspire further new knowledge creation in the SCR domain, identify future research demands in this field and ultimately boost the performance of global SCs by triggering smart and sustainable practices.

Buildings are among the largest sources of carbon emissions, so their owners have been compelled to set stringent sustainability goals in response to the global call for carbon neutrality. Consequently, facility managers are pressed to make their buildings smarter through adopting greater value-for-money sustainability solutions. Besides the implementation of traditional energy-saving measures, retrofitting buildings with smart building (SB) features, known as ‘smart retrofitting’ (SR), has become a growing trend. However, there is still no known set of appropriate criteria for making decisions on SR. To fill this void, a study was undertaken, where a four-tier hierarchical framework of SR decision-making criteria has been established after a thorough literature search on the Web of Science database followed by an in-depth qualitative review and a focus group discussion. A total of 32 criteria were identified, which fall into five categories: (1) Financial; (2) Technical; (3) Human; (4) Environmental; and (5) Legal, safety, and security. A key finding is that it is not merely the post-retrofit performance but also the retrofitting process itself that plays an important part in SR decision-making. The identified criteria demonstrate that ‘smartness’ encompasses not only ‘energy efficiency’ but also a vast array of other technical and social factors. The broad scope portrayed by the criteria, which needs to be considered holistically, provides guidance to facility managers in making SR decisions. Future works for refining the SR decision-making framework are also outlined.

The pandemic, coronavirus disease (COVID-19) due to SARS-COV-2 also called severe acute respiratory syndrome coronavirus 2, is directly related to bat SARS. Higher risk of spread can be caused due to prolonged exposure to a carrier person and shorter contacts with symptomatic individuals as briefer contacts with asymptomatic contacts are less inclined to transmission. The transmission can be either presymptomatic or asymptomatic. Wearing a face mask is becoming a requisite, in hospitals as well as community settings in this context as it can reduce the SARS Co-2 transmission rates. Masks has to be worn regularly and correctly to keep away from getting the virus. China recommended everyone to wear face masks and cloth masks to the ones less likely to spread or contract the infection when the current pandemic Covid-19 got outbursted. During this pandemic, when countries are facing shortage of resources, it is necessary to adopt and implement policies to ensure the balance of demand and supply to reduce the infection transmission rates. The irrational usage of surgical and the FFP masks by the general public has resulted into a shortage of their supply for the health care workers who need them the most, across the world. Awareness should be created among the public about the necessity of using face masks, selection of the mask, rational use in accordance with the situation, proper discarding of disposable masks, and other control measures that has to be kept in mind to prevent virus transmission. Face shields (Personal protective equipment-PPE) which are used by the healthcare providers in combination with face masks or respirators for eye protection, helps reduce transmission of the virus through respiratory droplets through the mucous membrane of the eyes offering a partial protection to the facial area.

Attention to Smart Infrastructure (SI) has risen due to its advantages, including better access, increased quality of life, and simplified maintenance management. To develop SI, Public–Private Partnerships (PPPs) are identified as potentially beneficial procurement strategies, which boost capacities to manage risks by pooling diverse resources. However, the applicability of PPP in SI developments in developed countries is scarcely researched. This may be due to underestimating the other potential benefits from PPP, although developed countries may have their own funding to develop SI. Hence, this research aims to evaluate the significant factors influencing the success of PPP in SI projects in developed countries based on public-sector satisfaction (S1), private-sector satisfaction (S2), and end-user satisfaction (S3). A comprehensive literature review was followed by expert interviews and an international survey, focusing on developed countries. The Partial Least Squares Structural Equation Modeling (PLS-SEM) technique was applied to map the connections amongst the influencing factors and S1, S2, and S3. The results reveal that legal and political-related factors significantly impact on S2 and S3, while social barriers significantly impact on S1. The effect of the constructs and factors on S1, S2, and S3 along with their rankings are unveiled in this research paper, providing a sound basis to increase success levels and minimize shortfalls in PPP to boost SI developments in developed countries.

PurposeIndustrialized construction (IC) has accelerated the technological advancements of construction supply chains (SCs) in Hong Kong (HK). However, the usually fragmented IC SCs often lead to friction and turbulence that retard their performance. Streamlining these workflows call for resilient SCs that can proactively overcome various vulnerabilities and avoid disruptions. Having identified supply chain capabilities (SCC) as essential precursors to supply chain resilience (SCR), this paper reports on a vital segment of a study on SCC for IC in HK that focused here on critical SCC (CSCC). Specifically, this paper aims at identifying and probing the CSCC for improving SCR in IC in HK.Design/methodology/approachAfter drawing on the plentiful relevant literature, an empirical study using a questionnaire survey and interviews was conducted following the multi-stage methodological framework of this study. Relevant significance analysis of the collected data enabled the selection of CSCC. Next, factor analysis facilitated grouping them under nine underlying components.FindingsThe results reveal 41 CSCC pertinent to achieve resilient SCs in IC in HK under critical capability components of resourcefulness, flexibility, capacity, adaptability, efficiency, financial strength, visibility, anticipation and dispersion.Originality/valueIt is expected that industry practitioners would benefit from prior knowledge of CSCC and their levels of criticalities, so as to prioritize integrating them suitably into SC processes, to develop value-enhanced-resilient SCs. Further, these findings lay the foundations for developing a powerful evaluation model to assess, then improve, SCR in IC in HK by mapping the identified CSCC with relevant critical vulnerabilities, based on study outcomes.

PurposeIndustrialized construction (IC) has been recognized as a game-changing approach in Hong Kong (HK). However, the increasing risks of disruptions in IC supply chains (SCs) raise SC vulnerability levels, prompting attention to developing supply chain resilience (SCR). Since SCR is only attainable through overcoming critical supply chain vulnerabilities (CSCV) with enhanced SC capabilities, this study first aimed to determine the most CSCV of ICSCs by addressing this current research gap and practical need.Design/methodology/approachDrawing on SCV factors identified from a precursor literature review, an empirical study of IC in HK was conducted using a questionnaire survey and interviews with industry experts. Focussed significance analysis of the data collected through questionnaire survey enabled the selection of 26 CSCV as appropriate to IC. Next, factor analysis was conducted, enabling the grouping of these CSCV under five components. The results were verified and reinforced by interview findings.FindingsThe results revealed 26 CSCV pertinent to resilient ICSCs in HK with five underlying components: economic, technological, procedural, organizational and production-based vulnerabilities. Loss of skilled labour is the most critical vulnerability, whereas organizational SCV is the most critical component identified.Originality/valueFindings of this study would motivate IC project professionals to appreciate and address the CSCV in the context of five components and thereby develop adequate specific capabilities to successfully withstand these CSCV. This should trigger future studies to map CSCV with appropriate capabilities in developing an envisaged powerful assessment model for evaluating the SCR in IC in HK.

PurposeRising human aspirations leading to rapid urbanisation, amidst climate changes and other environmental pressures have aggravated the needs for better-focused sustainable urban development in general as well as for smart and sustainable cities in particular. Indeed, smart infrastructure (SI) development is a prerequisite for smart cities (SCs). However, inadequate funding and expertise for such SI development pose profound challenges that may be partially addressed by mobilising private finance and efficiencies through collaborative public–private partnership (PPP) models. This paper provides a holistic review and analysis of the relevant literature, as a basis for proposing such PPP models for developing SI.Design/methodology/approachA systematic literature review helped to fulfil the aim of this paper in the first phase of the underlying longer-term study. Authoritative search engines like Scopus and Web of Science indexed articles were reviewed and analysed, 85% of these being journal articles.FindingsSCs that necessarily include SI are important in overcoming current urban challenges in developing and developed countries. Given shortfalls in traditional procurement and funding models, special PPP models are required for SI development. After identifying the relevant needs, drivers, barriers and challenges in different countries, a general indicative framework is developed to illustrate how the various interacting force fields can be harnessed to develop the envisaged PPP models that can complement non-PPP procurement models.Originality/valuePPP for SI development is a relatively new, hence, under-researched topic. This desktop review and analysis provide a useful launching pad for the development of SI through overcoming the potential challenges in traditional procurement and financial models.

Construction supply chains are subject to much more disruptive forces than before, and the heightened risk exposure of supply chains calls for greater resilience. Focussing on Industrialized Constr...

The anterolateral thigh (ALT) flap was described as the fasciocutaneous flap. It can be harvested as a pedicled and/or free flap. Majority of the free flaps are harvested as a fasciocutaneous flap. Their use in head and neck reconstruction and limb trauma is well established. Apart from these advantages, this flap has various applications which are less utilized. ALT flap can be used as a myocutaneous flap along with vastus lateralis muscle. When muscle and fasciocutaneous flaps are required, both can be harvested as a chimeric flap which can cover two different regions of the wound. Moreover, harvest of the pedicled flap procedure is less time-consuming than that of a free flap. Since it has a long vascular pedicle, when used as pedicled flap, it can reach up to the gluteal region. To evaluate these less applied advantages of pedicled ALT flap, our study was undertaken. This study aimed to evaluate the efficiency of ALT flap in terms of the surface area of coverage, arc of rotation and the advantages of including vastus lateralis muscle as part of the flap.A retrospective record analysis of all pedicled ALT flap reconstruction of trochanteric, upper thigh, gluteal and flank regions from 2016 to 2018 was undertaken; 7 patients with 8 defects were included.All the flaps healed successfully. There was no major necrosis of the flap and minor complications like wound gapping were found in three patients.The ALT-vastus lateralis flap dimensions can be very large and can be easily harvested in a very short time. Vastus lateralis muscle harvested can be used to fill the defect or can be used as chimera to cover the defect. The use of muscle over long standing infective pressure sores can sterilize the wound bed and help in preventing recurrence. The vascularity of this flap is robust and highly reliable. Even after a maximum arc of rotation (up to 170°) all the flaps survived without any major complications.

Resurfacing wound beds with split skin graft is the most common procedure in plastic surgery. Association of more pain in the donor site than in the recipient site has been used as a predictor of successful graft take by Stark in 1962 who termed it Moriartys sign.The aim of the study was: 1) to predict the successful take of skin graft by eliciting Moriartys sign; 2) to decide the day of first graft inspection based on Moriartys sign.The authors hereby present a prospective study in 100 patients who underwent wound resurfacing with split thickness skin graft at the Department of Plastic Surgery in a tertiary care center between January 2014 and June 2015. The area with more pain, absence of pain or equivocal response at the graft donor site was recorded on the visual analog scale for 10 days.In this study, 80 patients had positive Moriartys sign, 12 patients had equivocal responses and 8 patients showed a negative sign. Patients with positive Moriartys sign underwent their first graft inspection on 10th postoperative day and showed 100% graft take. Twelve patients with equivocal response underwent first graft inspection on 5th day and had 70-80% graft take. In 8 patients, with negative Moriartys sign first graft inspection done on 3rd day, the graft take waslt; 50%.The study demonstrates that Moriartys sign is a reliable clinical predictor of split thickness skin graft take and may be useful as a guide to determine the day of first graft inspection. It is an effective method even for junior members of the surgical and nursing team to monitor parameters in relation to this sign. It can be practiced in a smaller group of hospitals, too. Hence, the authors recommend to integrate this clinical assessment in routine practice.

Inflammation is a complex biological response involving immune cells to an infection creating injury to the normal tissues. The anti-inflammatory efficacy of embelin, a benzoquinone from the plant Embelia ribes, was screened for antioxidant and anti-inflammatory activity in carrageenan and Freund’s adjuvant-induced inflammation models. Embelin exhibited significant dose-dependent antioxidant potential. In carrageenan-induced inflammation, embelin (20 mg/kg) showed an inhibition of oedema by 71.01 ± 0.12% and 81.91 ± 0.67% in Freund’s adjuvant-treated chronic inflammation model and resulted in a noticeable increase in adrenal size and restoration of the weight of spleen. Embelin also demonstrated cytoprotective effects on HEK-293 cells under induced oxidative stress. In silico analysis, embelin demonstrated binding energy of − 7.7 kcal/Mol and − 7.0 kcal/Mol with COX1 and COX2 with two hydrogen bonds. These results further prove that embelin could be a promising anti-inflammatory agent and supports the traditional use of Embelia ribes for rheumatism.

Given the heightened imperatives for supply chain resilience (SCR) in industrialized construction (IC) in Hong Kong, this study modeled the dynamic impact of supply chain vulnerabilities (S...

Background: The usage of over-the-counter (OTC) medications has steadily increased in recent years. Improper use of OTC medications might result in health and other drug-related issues. Easy access to OTC medications has become a more critical concern in developing countries. Objective of the study was to assess the OTC drugs dispensed in community pharmacies.Methods: A prospective cross-sectional study was conducted in selected community pharmacies. To evaluate the OTC drugs dispensed; 700 participants were polled using questionnaires through a validated data collection form, and a patient interview respectively. Descriptive statistics and multivariate logistic regression were performed using statistical package for the social sciences (SPSS) (version 20). The Chi-square test was used to test for significant differences between groups (p