Background: Primary healthcare in Egypt has undergone significant reforms since the 1990s, including the pioneering Family Health Program (FHP). However, limited evaluation exists regarding the FHP's impact on enhancing the delivery of primary healthcare services. The primary objective of this study was to analyze and understand the efficiency and effectiveness of the FHP in altering the delivery of primary healthcare in Egypt. We aimed to outline the fundamental characteristics of the primary healthcare system, compare them between the conventional and the newly reformed FHP centers, and gauge the awareness level of these variances among key decision-makers, focusing specifically on Cairo, Egypt. Methods: This cross-sectional study employed a mixed methods approach to evaluate and compare the quality of care between conventional clinics and FHP clinics in Cairo using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) tool. The study population consisted of healthcare providers and municipal health authorities in Cairo. A purposive sampling method was used to select 19 FHP clinics and 12 conventional clinics, representing 75% of the total government primary care clinics in Cairo. Surveys were conducted among healthcare providers at these clinics, and interviews were conducted with 8 carefully selected municipal health authorities in supervisory roles. Descriptive statistics were used to summarize the survey responses. The chi-square (y2) test was employed to examine variations in scores between FHP and conventional clinics, with significance attributed to differences at the P < 0.05 level. Cronbach's alpha was used to assess the reliability of the scales used within each primary care dimension. Results: FHP clinics scored significantly higher on continuity of care (4.17 ± 0.37 vs. 3.68 ± 0.51, P = 0.05), family-centered approach (4.28 ± 0.59 vs. 2.97 ± 0.44, P = 0.01), and provider competency (4.29 ± 0.39 vs. 3.42 ± 0.99, P = 0.01) compared to conventional clinics. FHP clinics were more likely to offer domestic violence services (2.76 ± 1.49 vs. 1.80 ± 1.74, P = 0.02), tuberculosis treatment (2.73 ± 2.11 vs. 0.12 ± 0.34, P = 0.029), and prenatal care (4.75 ± 0.00 vs. 4.01 ± 1.56, P = 0.014). Conclusion: While FHP clinics demonstrate benefits in continuity, family-focus, and provider competency, quality improvements are still required in both conventional and FHP clinics to achieve comprehensive, continuous, integrated, and patient-centered primary healthcare aligned with community needs. Further evaluations are warranted given the continued expansion of the FHP program.
Sheet piles are necessary with hydraulic structures as seepage cut-off to reduce the seepage. In this research, the computational work methodology was followed by building a numerical model using Geo-Studio program to check the efficiency of using concrete sheet piles as a cut-off or reducer for seepage with time if the sheet piles facing the drawdown technique. Al-Kifil regulator was chosen as a case study, an accurate model was built with a help of observed reading of the measuring devices, which was satisfactory and helped in checking the sheet piles efficiency. Through the study, three scenarios were adopted (with and without) drawdown technique, it was found that at the short time there's no effect of the drawdown technique on
... Show MoreThe effective insulation design of the stress grading (SG) system in form-wound stator coils is essential for preventing partial discharges and excessive heat generation under pulse-width modulation excitation. This paper proposes a method to find the optimal insulation design of the SG system aimed at reducing the dielectric and thermal stresses in the machine coil. The non-uniform transmission line model is used to predict the voltage propagation along the overhang, SG, and slot regions considering the variation in the physical properties of the insulation layers. The machine coil parameters for different insulation materials are calculated by using the finite element method. Two optimization algorithms, fmincon and particle swarm optimiz
... Show MoreMassive multiple-input multiple-output (massive-MIMO) is considered as the key technology to meet the huge demands of data rates in the future wireless communications networks. However, for massive-MIMO systems to realize their maximum potential gain, sufficiently accurate downlink (DL) channel state information (CSI) with low overhead to meet the short coherence time (CT) is required. Therefore, this article aims to overcome the technical challenge of DL CSI estimation in a frequency-division-duplex (FDD) massive-MIMO with short CT considering five different physical correlation models. To this end, the statistical structure of the massive-MIMO channel, which is captured by the physical correlation is exploited to find sufficiently
... Show MoreThis paper investigated the fatigue life behavior of two composite materials subjected to different times of shot peening (2, 4 and 6 min).The first material prepared from unsaturated polyester with E-glass reinforcement by 33% volume fraction. While, the second one was prepared from unsaturated polyester with aluminum powder by2.5% volume fraction. The experimental results showed that the improvement in endurance limit was obtained (for the first material) at 2, 4 and 6 min shot peening times where the percentage of maximum improvement was 25% at shot peening time of 6 min. While, the endurance limit of the second material decreased at shot peening times of 2, 4 and 6 min where the percentage of maximum reduction was 29 % at shot peenin
... Show MoreBearing capacity of soil is an important factor in designing shallow foundations. It is directly related to foundation dimensions and consequently its performance. The calculations for obtaining the bearing capacity of a soil needs many varying parameters, for example soil type, depth of foundation, unit weight of soil, etc. which makes these calculation very variable–parameter dependent. This paper presents the results of comparison between the theoretical equation stated by Terzaghi and the Artificial Neural Networks (ANN) technique to estimate the ultimate bearing capacity of the strip shallow footing on sandy soils. The results show a very good agreement between the theoretical solution and the ANN technique. Results revealed that us
... Show MoreThis paper presents an experimental study for strengthening existing columns against axial compressive loads. The objective of this work is to study the behavior of concrete square columns strengthening with circulation technique. In Iraq, there are significantly more reinforced rectangular and square columns than reinforced circular columns in reinforced concrete buildings. Moreover, early research studies indicated that strengthening of rectangular or square columns using wraps of CFRP (Carbon Fiber Reinforced Polymer) provided rather little enhancement to their load-carrying capacity. In this paper, shape modification technique was performed to modify the shape (cross section) of the columns from square columns into circular colu
... Show MoreA particle swarm optimization algorithm and neural network like self-tuning PID controller for CSTR system is presented. The scheme of the discrete-time PID control structure is based on neural network and tuned the parameters of the PID controller by using a particle swarm optimization PSO technique as a simple and fast training algorithm. The proposed method has advantage that it is not necessary to use a combined structure of identification and decision because it used PSO. Simulation results show the effectiveness of the proposed adaptive PID neural control algorithm in terms of minimum tracking error and smoothness control signal obtained for non-linear dynamical CSTR system.
Abstract
The problem of missing data represents a major obstacle before researchers in the process of data analysis in different fields since , this problem is a recurrent one in all fields of study including social , medical , astronomical and clinical experiments .
The presence of such a problem within the data to be studied may influence negatively on the analysis and it may lead to misleading conclusions , together with the fact that these conclusions that result from a great bias caused by that problem in spite of the efficiency of wavelet methods but they are also affected by the missing of data , in addition to the impact of the problem of miss of accuracy estimation
... Show MoreThe complexity and partially defined nature of jet grouting make it hard to predict the performance of grouted piles. So the trials of cement injection at a location with similar soil properties as the erecting site are necessary to assess the performance of the grouted piles. Nevertheless, instead of executing trial-injected piles at the pilot site, which wastes money, time, and effort, the laboratory cement injection devices are essential alternatives for evaluating soil injection ability. This study assesses the performance of a low-pressure laboratory grouting device by improving loose sandy soil injected using binders formed of Silica Fume (SF) as a chemical admixture (10% of Ordinary Portland Cement OPC mass) to di
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