Purpose To review the scientific literature seeking lessons for the COVID-19 era that could be learned from previous health services interruptions that affected the delivery of cancer screening services. Methods A systematic search was conducted up to April 17, 2020, with no restrictions on language or dates and resulted in 385 articles. Two researchers independently assessed the list and discussed any disagreements. Once a consensus was achieved for each paper, those selected were included in the review. Results Eleven articles were included. Three studies were based in Japan, two in the United States, one in South Korea, one in Denmark, and the remaining four offered a global perspective on interruptions in health services due to natural or human-caused disasters. No articles covered an interruption due to a pandemic. The main themes identified in the reviewed studies were coordination, communication, resource availability and patient follow-up. Conclusion Lessons learned applied to the context of COVID-19 are that coordination involving partners across the health sector is essential to optimize resources and resume services, making them more resilient while preparing for future interruptions. Communication with the general population about how COVID-19 has affected cancer screening, measures taken to mitigate it and safely re-establish screening services is recommended. Use of mobile health systems to reach patients who are not accessing services and the application of resource-stratified guidelines are important considerations. More research is needed to explore best strategies for suspending, resuming and sustaining cancer screening programs, and preparedness for future disruptions, adapted to diverse health care systems.
An increase of gas utilization in Peninsular Malaysia causes an expansion of upstream gas producing facilities. As the number of the facilities increases, it becomes important to predict the reliability of the integrated system to ensure sufficient delivery of gas to meet the consumer needs while maintaining economical investments. Due to the complexity of the system, a joint study between PETRONAS, Esso Production Malaysia Inc. and PETRONAS Carigali Sdn. Bhd. was conducted to analyze the gas supply system reliability and determine the overall system capability to make-up for production losses due to failures of equipment within the system. The study was conducted in two phases. Phase 1 of the study involved the assessment of the existing facilities and also the facilities that are in advanced stage of development to determine the system availability. Phase 2 utilized the same concept as Phase 1, but models were created for long term development options to better define future design and sparing philosophies. This paper describes how the upstream gas system model was setup using a statistical simulation software specifically designed to model process systems. The general layout of the offshore gas platforms and the onshore receiving facilities and the basis used in setting up the model are discussed briefly. Examples of results obtained for the existing system and the applications of model to help assess future competing development options will also be discussed. Introduction Esso Production Malaysia Inc. (EPMI) involvement in Peninsular Malaysia's gas industry began in mid-80s with production through the Joint Delivery System (JDS), an offshore pipeline operated by PETRONAS Carigali Sdn. Bhd (PCSB). This pipeline transports associated and non-associated gas from EPMI and PCSB Production Sharing Contract areas to the Onshore Gas Terminal (OGT) in Kerteh. The completion of PETRONAS' gas transmission network, additional gas processing plants and EPMI's Jerneb field in 1992 marked the beginning of the gas era in Peninsular Malaysia. Another EPMI gas field, Lawit, is being developed. Drilling and facility commissioning are currently underway with first production scheduled for the second quarter 1997. As gas demand to fuel the power and industrial sectors is forecasted to continue increasing, additional gas platforms will be installed. Due to the complexity of the system, there is potential for failures to occur which can affect the ability of the upstream suppliers (EPMI and PCSB) to deliver designed quantities of gas. Therefore, it is important to analyze both existing and future gas production and delivery system reliability to determine the upstream system capability. System Modeling Software Description. A third party software was used to setup the model. The software utilized Monte Carlo simulation techniques and is specifically designed to model process systems. The system uses the computer's ability to generate a string of random numbers. A simple expression for the probability of failure of an equipment is used and this probability is equated to a random number between 0 and 1 generated by the computer. The failure frequency of an item will normally vary according to the length of time it has been operating. There will normally be a period when failures occur during the initial start-up of new equipment that are not thoroughly tested. The items will then settle down to a period of high reliability until it reaches the time when ‘wear-out’ failure starts to occur. P. 267
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