Practice and Opinion of Doctors in Primary Health Care Centers Toward Referral System: Samples from Nine Governorates in Iraq

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. SPSS version 24 analysis was used for the statistical analysis. Results: sixty-three doctors were working in PHCs had participated in the current study, the mean age (40.03 ±10.24), 58.7%were female, 46% were general practitioner, 30.2% of the participated doctors had 300 and less patient/month; 31.7% of doctors had ≤10 Patients referred/month, emergencies was the main cause for referral (46.03%), and 37(58.37%) of doctors announced that the referred-form not retrained to the PHC, and ever retrained-forms had no feedback 29(46%), 28(44%)of the participated doctors agreed that the current referral-system was effective and seven of them strongly agreed, 59(93.7%) believe in the importance of hospital-feedback, with a significant relationship between their attitude about the effective-current-referral system & Refer cases Percentage, while no significant-relation with their Patients examined/month. Loaded crowded and hospital doctors shortage as possible causes and suggest to referral-system activation especially the hospital -part". Conclusions: there was inadequate knowledge of referral-policies and lack of coordination or/and clear feedback-expectations and PHCs-hospitals collaboration and lack of referral-system integrated within an electronic-health-record.

Modelling Thousands of Fractures Using Analytic Elements

<p>Understanding and modelling hydraulic fractures and fracture networks have a fundamental role in mapping the mechanical behaviour of rocks. A problem arises in the discontinuous behaviour of the fractures and how to accurately and efficiently model this. We present a novel approach for modelling many cracks randomly using analytic elements placed under plane strain conditions in an elastic medium. The analytic elements allow us to model the assembly computationally efficiently and up to machine precision. The crack element is the first step in the development of a model suitable for investigating the effect of fissures on tunnels in rock. The model can be used to validate numerical models and more.The solution for a single hydraulic pressurized crack in an infinite domain in plane strain was initially developed by Griffith (1921). We demonstrate that it is possible, by using series expansions in terms of complex variables, based on the Muskhelisvili-Kolosov functions, to generalize this solution to the case of an assembly of non-intersecting pressurized cracks. The solution consists of infinite series for each element Strack & Toller (2020). The expressions for the displacements and stress tensor components approach the exact solution, as the number of terms in the series approaches infinity.We present the case where two cracks approach each other orthogonally to less than 1/2000th of the cracks length. We show the effect of increasing the number of terms in the expansion and how this influences the precision, demonstrating that the result approaches the exact solution. We also present a case with 10,000 cracks; the coefficients are determined using an iterative solver. By using analytic elements, we can both present the corresponding stress and deformations field for the global scale and for small scales in the close proximity of individual cracks.ReferencesGriffith, A. A. (1921). The phenomena of rupture and flow in solids. Philosophical Transactions of the Royal Society of London. Series A, Containing Papers of a Mathematical or Physical Character, 221(582-593):163–198.Strack, O. D. L. and Toller, E. A. L. (2020). An analytic element model for highly fractured elastic media, manuscript submitted for publication in International Journal for Numerical and Analytical Methods in Geomechanics.</p>

Effectiveness of the use of synthetic analytical structural methods against the ability to begin writing skills in elementary school students

This study aims to determine the effectiveness of the Use of the Effect of Synthetic Analytical Structural Methods on the Beginning Writing Skills of Elementary School Students. This study uses a quantitative method with a type of quasi-experimental research. The results of this study found that there was significant use of the influence of synthetic analytical structural methods on the ability to write skills at the beginning of grade 2 elementary school students. This is because the Synthetic Analytical Structural Method is a story approach accompanied by an image that contains synthetic analytic elements. Synthetic Analytical Structural method implementation learning techniques are writing card skills, syllable cards, word cards, and sentence cards, while some students look for letters, syllables and words, the teacher and some students stick to words arranged into meaningful sentences.

Analytic Elements from Complex Functions

The mathematical functions associated with analytic elements may be formulated using a complex function $\Omega$ of a complex variable ${\zcomplex}$. Complex formulation of analytic elements is introduced in Section 3.1 for exact solutions obtained by embedding point elements that generate divergence, circulation, or velocity within a uniform vector field. Influence functions for analytic elements with circular geometry are obtained using Taylor and Laurent series expansions in Section 3.2, and conformal mapping extends this formulation to analytic elements with the geometry of ellipses (Section 3.3). The Courant's Sewing Theorem is employed in Section 3.4 to develop solutions for interface conditions across straight line segments, and the Joukowsky transformation extends methods to circular arcs and wings (Section 3.5), which satisfy a Kutta condition of non-singular vector field at their trailing edges. Vector fields with spatially distributed divergence and curl are formulated using the complex variable ${\zcomplex}$ with its complex conjugate $\overline{\zcomplex}$ in Section 3.6, and the complex conjugate is further employed in the Kolosov formulas (Section 3.7) to solve force deformation problems for analytic elements with traction or displacement specified boundary conditions.

Analytic Element Method across Fields of Study

This chapter introduces the philosophical perspective for solving problems with the Analytic Element Method, organized within three common types of problems: gradient driven flow and conduction, waves, and deformation by forces. These problems are illustrated by classic, well known solutions to problems with a single isolated element, along with their extension to complicated interactions occurring amongst collections of elements. Analytic elements are presented within fields of study to demonstrate their capacity to represent important processes and properties across a broad range of applications, and to provide a template for transcending solutions across the wide range of conditions occurring along boundaries and interfaces. While the mathematical and computational developments necessary to solve each problem are developed in later chapters, each figure documents where its solutions are presented.

Analytic Elements from Singular Integral Equations

Solutions to interface problems may be developed using analytic elements with mathematical solutions to the Laplace equation developed by singular integral equations. This formulation leads to solutions with discontinuities occurring across line segments, where the potential or stream function is discontinuous across double layer elements in Section 5.2, and the normal or tangential component of the vector field is discontinuous across single layer elements in Section 5.3. Examples illustrate a broad range of solutions to interface conditions possible with these elements. Series expansions are used to represent the far-field at larger distances from elements in Section 5.4, which leads to higher-order elements with nearly exact solutions and also provides a simpler representation for contiguous strings of adjacent elements. Such strings of elements are used with polygon elements in 5.5 to solve conditions along the interfaces of heterogeneities, and to provide a common series expansion to represent the far-field for a group of neighboring elements. Methods are extended to analytic elements with curvilinear geometry using conformal mappings (Section 5.6) and to three-dimensional fields in Section 5.7.

Analytic Elements from Separation of Variables

Separation of variables provides influence functions for analytic elements, which extend the solutions available with complex functions to problems involving the Helmholtz and modified Helmholtz equations. Methods are introduced for one-dimensional problems that provide the background vector field for many problems, and these solutions are extended to finite domains with interconnected rectangle elements in Section 4.3. Circular elements are developed in Section 4.4 using series of Bessel and Fourier functions to model wave propagation around and through collections of elements, and vadose zone solutions are extended to solve the nonlinear interface conditions occurring along circles. Methods are extended to three-dimensional problems for spheres (Section 4.5), and prolate and oblate spheroids in Section 4.6.

Foundation of the Analytic Element Method

The Analytic Element Method provides a foundation to solve boundary value problems commonly encountered in engineering and science, where problems are structured around elements to organize mathematical functions and methods. While this text mostly adheres to a ``just in time mathematics'' philosophy, whereby mathematical approaches are introduced when they are first needed, a comprehensive paradigm is presented in Section 2.1 as four steps necessary to achieve solutions. Likewise, Section 2.2 develops general solution methods, and Section 2.3 presents a consistent notation and concise representation to organize analytic elements across the broad range of disciplinary perspectives introduced in Chapter 1.

Conceptualizing Militias in Africa

Although militias have received increasing scholarly attention, the concept itself remains contested by those who study it. Why? And how does this impact contemporary scholarship on political violence? To answer these questions, we can focus on the field of militia studies in post–Cold War sub-Saharan Africa, an area where militia studies have flourished in the past several decades. Virtually all scholars of militias in post–Cold War Africa describe militias as fluid and changing such that they defy easy definition. As a result, scholars offer complex descriptors that incorporate both descriptive and analytic elements, thereby offering nuanced explanations for the role of militias in violent conflict. Yet the ongoing tension between accurate description and analytic definition has also produced a body of literature that is diffuse and internally inconsistent, in which scholars employ conflicting definitions of militias, different data sources, and often incompatible methods of analysis. As a result, militia studies yield few externally valid comparative insights and have limited analytic power. The cumulative effect is a schizophrenic field in which one scholar’s militia is another’s rebel group, local police force, or common criminal. The resulting incoherence fragments scholarship on political violence and can have real-world policy implications. This is particularly true in high-stakes environments of armed conflict, where being labeled a “militia” can lead to financial support and backing in some circumstances or make one a target to be eliminated in others. To understand how militia studies has been sustained as a fragmented field, this article offers a new typology of definitional approaches. The typology shows that scholars use two main tools: offering a substantive claim as to what militias are or a negative claim based on what militias are not and piggy-backing on other concepts to either claim that militias are derivative of or distinct from them. These approaches illustrate how scholars combine descriptive and analytic approaches to produce definitions that sustain the field as fragmented and internally contradictory. Yet despite the contradictions that characterize the field, scholarship reveals a common commitment to using militias to understand the organization of (legitimate) violence. This article sketches a possible approach to organize the field of militia studies around the institutionalization of violence, such that militias would be understood as a product of the arrangement of violence. Such an approach would both allow studies of militias to place their ambiguity and fluidity at the center of analyses while offering a pathway forward for comparative studies.