Effectiveness of Digital Health Services: Challenges and Constraints for Society

This article discusses the effectiveness of digital health services by looking at the challenges and obstacles for society. One form of public services implemented by the government for the community is meeting the need for quality public services and having an orientation to the effectiveness of services to the community that are needed. In the health sector itself, advances in information technology have greatly supported health services. This online system is of high quality to be implemented because the public and members of the medical system can receive and provide detailed and fast information with the help of computerized technology. Information technology has reached various fields of life including the health sector to help the efficiency and effectiveness of health services. Information technology that is properly implemented can support the management process to be effective and efficient. The corona pandemic is changing people's habits in visiting and consulting doctors at hospitals. However, digital-based health services have not been effectively accepted by the public from various service units. They still need improvements in terms of connectivity, content and clarity of regulations.

Nitrogen Use-Efficiency in Rice-Wheat Cropping System in Different Types of Salt-Affected Soils Receiving Gypsum

Considerable nitrogen (N) losses lead to lower N use-efficiency (NUE) in salt- affected soils due to leaching and volatilization. A lysimeter experiment was conducted to determine NUE in two salt-affected soils of different texture (clay loam and sandy clay loam), using various rates of N fertilizer. The experiment used a three replicate completely randomized design. The treatments included five N rates, three higher (15, 30 and 45%) and two lower (15 and 30%) than recommended rate of 125 kg ha-1. Additionally, gypsum was added at 50 and 100% of soil gypsum requirement (SGR) in both salt-affected soils. Maximum paddy and straw yields were recorded for sandy clay loam saline-sodic soil collected from Village 132, Faisalabad (132S), using 45% higher N + gypsum at 100% SGR. Whereas clay loam saline-sodic soil, from Village 84, Faisalabad (84S) at 30% higher N rate with gypsum at 50% SGR gave the highest paddy and straw yields. In general, the clay loam soil produced more paddy yield than the sandy clay loam soil at similar N fertilization. In the sandy clay loam soil, gypsum at 100% SGR along with a 30% higher N rate increased the grain and straw yields of wheat significantly (p < 0.05) compared to application of gypsum at only 50% SGR. Nitrogen use efficiency was the highest with 45% higher N (N145) with gypsum applied @ 100% SGR compared to 50% SGR in severe salt-affected (sandy clay loam) soil during rice crop. From marginal clay loam saline-sodic soil, NUE remained higher with N130 along with gypsum @ 100% SGR which was statistically on par with gypsum @ 50% SGR. It was concluded that NUE remained highest with N130 and N145 with gypsum applied @ 100% SGR during rice crop from clay loam and sandy clay loam soils, respectively. Moreover, NUE was higher at recommended N fertilization when gypsum was applied at 100% SGR which was also attributed to improved soil chemical properties, i.e. pHs, ECe and SAR. A field experiment was conducted at Village 132/ GB and 84/ GB to determine NUE in the two salt-affected soils of contrasting texture (clay loam and sandy clay loam), using higher rates of N than that in their counterpart normal soils. The experiment was laid-out in a randomized complete block design with three replications. The promising treatments were selected from lysimeter experiments for field experimentation. The treatments employed for normal soils were: No fertilizer (C), recommended N fertilizer (N100), 15% higher N than recommended N fertilizer (N115), 30% higher N than recommended N fertilizer (N130). The treatments selected for salt-affected soils were: No fertilizer and no gypsum (C), recommended N + gypsum @ 50% SGR (N100+G50), 30% higher N than recommended N fertilizer + gypsum @ 50% SGR (N130+G50), recommended N + gypsum @ 100% SGR (N100+G100), 30% higher N than recommended N fertilizer + gypsum @ 100% SGR (N130+G100). The highest NO3- leaching was recorded with N130 along with gypsum @ 100% SGR from clay loam (84S) and sandy clay loam (132S) salt-affected soils. During wheat crop, more NO3- concentration in leachate was recorded compared to those during rice crop. The crop yield was lowered from salt-affected soils during amelioration by using higher rates of fertilizer (N130) and gypsum application compared to their counterpart normal soils. The 30% higher N than recommended with gypsum @ 50% and 100% SGR improved (salt- affected soil) properties and crop yields from clay loam (marginal SA) and sandy clay loam (highly SA) soils, respectively. During early stages of reclamation, higher doses of N and gypsum are required to achieve maximum economical yield and NUE. During 2nd year, NUE was the highest with recommended rate of N and gypsum @ 50% and 100% SGR for clay loam and sandy clay loam soils, respectively. The greatest decrease in yield gap from sandy clay loam and clay loam saline-sodic soils was observed with 30% higher rate of applied N along with gypsum @ 100% SGR and 50% SGR, respectively.