Smooth functioning of an organization that works in certain controlled conditions must meet the requirements imposed by the legislator, the market, interested parties, owners and employees. The ...organization, as such, must have technical support that ensures continuity and functionality with the least time possible execution or process monitoring. Service support (Help Desk) must develop principles for problems/incidents that are caused by users, and it is with that kind of support in a position to remain competitive in the market, that leaves its customers the competitive part of the market that are being discussed. In this paper, we present some of the developed processes and methods applicable to a larger number of companies, which are in its nature, dealing with the same or similar jobs and for which we will present a metamodel for processes. PUBLICATION ABSTRACT
This paper introduces two novel concepts of mappings over soft topological spaces: “soft somewhat-r-continuity” and “soft somewhat-r-openness”. We provide characterizations and discuss soft ...composition and soft subspaces. With the use of examples, we offer numerous connections between these two notions and their accompanying concepts. We also offer extension theorems for them. Finally, we investigated a symmetry between our new concepts with their topological analogs.
In this paper, we study local uniform continuity of nonnegative weak solutions to degenerate diffusion-drift equations in the form of ut=Δum+∇⋅B(x,t)u,for m≥1assuming a vector field B∈LtpLxq. ...Regarding local Hölder continuity, we provide a sharp condition on p and q, which is referred to as the subcritical region. In the critical region, the divergence-free condition is essential to providing uniform continuity which depends on the modulus of continuity of the local norm of B.
Introduction
Women of color are at increased risk for poor birth outcomes, often driven by upstream social determinants and socially structured systems. Given the increasing rate of maternal ...mortality in the United States, particularly for women of color, there is a pressing need to find solutions to improving care quality and access for racially marginalized communities. This study aims to describe and thematically analyze the recommendations to improve pregnancy and birth care made by women of color with lived experience of perinatal health care.
Methods
Twenty‐two women of color living in the San Francisco Bay Area and receiving support services from a community‐based nonprofit organization participated in semistructured interviews about their experiences receiving health care during pregnancy and birth. Interviews were audio‐recorded and transcribed, and transcripts were analyzed using thematic analysis to highlight recommendations for improving perinatal care experiences.
Results
Participants shared experiences and provided recommendations for improving care at the individual health care provider level, including spending quality time, relationship building and making meaningful connections, individualized person‐centered care, and partnership in decision making. At the health systems level, recommendations included continuity of care, racial concordance with providers, supportive health care system structures to meet the needs of women of color, and implicit bias trainings and education to reduce judgment, stereotyping, and discrimination.
Discussion
Participants in this study shared practical ways that health care providers and systems can improve pregnancy and birth care experiences for women of color. In addition to the actions needed to address the recommendations, health care providers and systems need to listen more closely to women of color as experts on their experiences in order to create effective change. Community‐centered research, driven by and for women of color, is essential to improve health disparities during pregnancy and birth.
Coronavirus disease has disrupted tuberculosis services globally. Data from 33 centers in 16 countries on 5 continents showed that attendance at tuberculosis centers was lower during the first 4 ...months of the pandemic in 2020 than for the same period in 2019. Resources are needed to ensure tuberculosis care continuity during the pandemic.
The purpose of this paper is to introduce a few variants of generalized quasi-continuity of functions defined on a bitopological space and to study their mutual relationship. Moreover, some ...characterization of sectional quasi-continuous function and its continuity points are investigated.
The present work is dedicated to the improvement of the δ-SPH scheme. This is an enhanced weakly-compressible SPH model widely used in recent years thanks to its benefits to the standard SPH scheme, ...to its low CPU costs and to its ease of implementation. Nonetheless, the δ-SPH still presents some drawbacks as other SPH models. For example, in some critical conditions it does not prevent the tensile instability and the consequent numerical fragmentation. Furthermore, even if the use of a diffusive term in the SPH continuity equation is able to reduce numerical high frequencies on the pressure field, the velocity gradients are generally noisy because of the irregularities of the particle spatial configurations, which, in specific flow conditions, can induce also extra numerical-dissipation. For these reasons a particle shifting technique is used to improve the model and a special treatment has been developed for particles that are close to the free-surface region. The introduction of the particle-shifting procedure is generalized in the context of multi-resolutions for which a novel algorithm is formulated to handle the particle re-positioning in the different resolution levels. The proposed algorithms can be straightforwardly implemented in an SPH model without requiring cumbersome code modifications. The δ+-SPH is validated on seven different benchmarks giving a wide panorama on the improvements of this new SPH model.
•The present work is dedicated to the improvement of the δ-SPH scheme.•A particle shifting technique is introduced in the context of weakly-compressible models.•A special treatment for particles that are close to the free-surface region is developed.•The particle-shifting procedure is generalized for multi-resolutions approaches.•The δ+-SPH is validated on seven different benchmarks.
To quantify the economic impact of upscaling access to continuity of midwifery carer, compared with current standard maternity care, from the perspective of the public health care system.
We created ...a static microsimulation model based on a whole-of-population linked administrative data set containing all public hospital births in one Australian state (Queensland) between July 2017 to June 2018 (n = 37,701). This model was weighted to represent projected State-level births between July 2023 and June 2031. Woman and infant health service costs (inpatient, outpatient and emergency department) during pregnancy and birth were summed. The base model represented current standard maternity care and a counterfactual model represented two hypothetical scenarios where 50 % or 65 % of women giving birth would access continuity of midwifery carer. Costs were reported in 2021/22 AUD.
The estimated cost savings to Queensland public hospital funders per pregnancy were $336 in 2023/24 and $546 with 50 % access. With 65 % access, the cost savings were estimated to be $534 per pregnancy in 2023/24 and $839 in 2030/31. A total State-level annual cost saving of $12 million in 2023/24 and $19 million in 2030/31 was estimated with 50 % access. With 65 % access, total State-level annual cost savings were estimated to be $19 million in 2023/24 and $30 million in 2030/31.
Enabling most childbearing women in Australia to access continuity of midwifery carer would realise significant cost savings for the public health care system by reducing the rate of operative birth.
To assess the relationship between care fragmentation and both quality and costs of care for commercially insured, chronically ill patients.
We used claims data from 2004 to 2008 for 506,376 ...chronically ill, privately insured enrollees of a large commercial insurance company to construct measures of fragmentation. We included patients in the sample if they had chronic conditions in any of the following categories: cardiovascular disease, diabetes, asthma, arthritis, or migraine.
We assigned each patient a fragmentation index based on the patterns of care of their primary care provider (PCP), with care patterns spread across a higher number of providers considered to be more fragmented. We used regression analysis to examine the relationship between fragmentation and both quality and cost outcomes.
Patients of PCPs in the highest quartile of fragmentation had a higher chance of having a departure from clinical best practice (32.8%, vs 25.9% among patients of PCPs in the lowest quartile of fragmentation; P < .001). Similarly, patients of PCPs with high fragmentation had higher rates of preventable hospitalizations (9.1% in highest quartile vs 7.1% in lowest quartile; P < .001). High fragmentation was associated with $4542 higher healthcare spending ($10,396 in the highest quartile vs $5854 in the lowest quartile; P < .001). We found similar or larger effects on quality and costs among patients when we examined the most frequently occurring disease groups individually.
Chronically ill patients whose primary care providers offer highly fragmented care more often experience lapses in care quality and incur greater healthcare costs.
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