Background: Most primary Health Care Centers (PHCCs) in Iraq have a referral system records; however, this mechanism does not function well because of the lack of other requirements for an efficient referral system.

Objective: To assess the practice & opinion of doctors in PHCs toward the referral system, and to determine the doctors in PHC's commitment to referral system instructions and guidelines.

Subjects and methods: A cross-sectional study with analytic elements was conducted in nine health directorates in Iraq, from the 1st October 2018 – 30th June 2019.One PHC was selected randomly form each sector in every governorate, A questionnaire was used to collect the required information.

In this paper, a compact genetic algorithm (CGA) is enhanced by integrating its selection strategy with a steepest descent algorithm (SDA) as a local search method to give I-CGA-SDA. This system is an attempt to avoid the large CPU time and computational complexity of the standard genetic algorithm. Here, CGA dramatically reduces the number of bits required to store the population and has a faster convergence. Consequently, this integrated system is used to optimize the maximum likelihood function lnL(φ1, θ1) of the mixed model. Simulation results based on MSE were compared with those obtained from the SDA and showed that the hybrid genetic algorithm (HGA) and I-CGA-SDA can give a good estimator of (φ1, θ1) for the ARMA(1,1) model. Anot

Electrochemical Grinding (ECG) process is a mechanically assisted electrochemical process for material processing. The process is able to successfully machine electrically conducting harder materials at faster rate with improved surface finish and dimensional control. This research studies the effect of applied current, electrolyte concentration, spindle speed and the gap between workpiece and tool on hardness and material removal rate during electrochemical grinding for stainless steel 316. The characteristic features of the electrochemical grinding process are explored through Taguchi-design-based experimental studies. The better hardness can be obtained at 10 A of the current, 150 g/l of the electrolyte concentration, 0.3 mm of gap an

The aim of the present study was to develop theophylline (TP) inhalable sustained delivery system by preparing solid lipid microparticles using glyceryl behenate (GB) and poloxamer 188 (PX) as a lipid carrier and a surfactant respectively. The method involves loading TP nanoparticles into the lipid using high shear homogenization – ultrasonication technique followed by lyophilization. The compositional variations and interactions were evaluated using response surface methodology, a Box – Behnken design of experiment (DOE). The DOE constructed using TP (X₁), GB (X₂) and PX (X₃) levels as independent factors. Responses measured were the entrapment efficiency (% EE) (Y₁), mass median

Incorporating waste byproducts into concrete is an innovative and promising way to minimize the environmental impact of waste material while maintaining and/or improving concrete’s mechanical characteristics and strength. The proper application of sawdust as a pozzolan in the building industry remains a significant challenge. Consequently, this study conducted an experimental evaluation of sawdust as a fill material. In particular, sawdust as a fine aggregate in concrete offers a realistic structural and economical possibility for the construction of lightweight structural systems. Failure under four-point loads was investigated for six concrete-filled steel tube (CFST) specimens. The results indicated that recycled lightweight co

In this paper, nanofluid of TiO₂/water of concentrations of 0.002% and 0.004% volume was used. This nanofluid was flowing through heat exchanger of shell and concentric double tubes with counter current flow to the hot oil. The thermal conductivity of nanofluid is enhanced with increasing concentrations of the TiO₂, this increment was by 19% and 16.5% for 0.004% and 0.002% volume respectively relative to the base fluid (water). Also the heat transfer coefficient of the nanofluid is increased as Reynold's number and nanofluid concentrations increased too. The heat transfer coefficient is increased by 66% and 49% for 0.004% and 0.002% volume respectively relative to the base fluid. This study showed that the friction

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In this paper presents two dimensional turbulent flow of different nanofluids and ribs configuration in a circular tube have been numerically investigation using FLUENT 6.3.26. Two samples of CuO and, ZnO nanoparticles with 2% v/v concentration and 40 nm as nanoparticle diameter combined with trapezoidalribs with aspect ratio of p/d=5.72 in a constant tube surface heat flux were conducted for simulation. The results showed that heat flow as Nusselt number for all cases raises with Reynolds number and volume fraction of nanofluid, likewise the results also reveal that ZnO with volume fractions of 2% in trapezoidal ribs offered highest Nusselt number at Reynolds number of Re= 30000.

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