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1
Tayo-Ladega, Oluwadamisi, Taye Mohammed Abdullahi, and K. M. Anwarul Islam. "FACTORS MILITATING AGAINST PUBLIC HEALTH FINANCING IN NIGERIA: AN EMPIRICAL REVIEW." American International Journal of Multidisciplinary Scientific Research 7, no. 2 (April 12, 2021): 1–10. http://dx.doi.org/10.46281/aijmsr.v7i2.1073.
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An effective and quality health care service is one of the fundamental visions of every government to its citizenry because it is only the healthy people that can be governed and will value developmental projects. Citizens having access to quality health services translate to significant development in modern society. Therefore, the provision of adequate funds for the sector is essential. However, the Nigeria health care sector is currently confronted with colossal issues that should be surmounted to enhance effective and quality health care delivery to the citizens. This study is rooted in the evidence of appropriate works of literature in the financing of public health care services in Nigeria. From the extant works of the literature surveyed, it was revealed that public health care services in Nigeria are financed by revenue that is accrued from public tax, funding from donors, health insurance, and direct payments made by individuals. Furthermore, public health service is mostly financed by direct payments made by individuals with the government. The most perturbing issues combating public health care financing are direct payments made by individuals, poor government funding, health care policy defects in implementation, and corruption scandals. On this note, the study recommended an effective and robust government funding of public health, implementation of sound health care policies, efficient monitoring of public funds utilization, and discouraging foreign medical trips.
JEL Classification Codes: A19, B10, B25, C10, C53.
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Lawan, Aminu Mohammed. "An Overview of the Impact of Restructuring on Public Service in Nigeria." Asia Proceedings of Social Sciences 4, no. 3 (April 26, 2019): 33–36. http://dx.doi.org/10.31580/apss.v4i3.828.
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The Restructuring is the process of changing the lawful, possession, functioning, or other structures of an organisation to make it more lucrative or well planned for its current needs. The paper discusses the various mechanisms of public service reorganisation, which are economic steadiness, management productivity, confidence building and public transparency. It led to the downsizing and casualisation of a civil servant. This study aims to examine the impact of restructuring on public service in Nigeria. The methodology involves a systematic literature review which entails the document analysis of secondary data of the related subject matter. The discoveries reveal that restructuring sometimes invades on the right of a civil servant by stripping out their social security. The article concludes that the régime must halt unfair work practice such as cost-cutting and casualisation of employees, and advance right working environments to ensure civil servant double their effort.
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Duke II, Joe, and Kechi A. Kankpang. "EFFECT OF FRAUD RISK REDUCTION STRATEGY ON THE LEVEL OF EMPLOYEE FRAUD IN NIGERIAN PUBLIC SERVICE ORGANIZATIONS." Problems of Management in the 21st Century 4, no. 1 (July 15, 2012): 30–44. http://dx.doi.org/10.33225/pmc/12.04.30.
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Given the rampant headline revelations of widespread fraud perpetrated in Nigerian public service organizations in recent times, this study addresses a topical subject that commands urgent attention, understanding and intervention. Using a survey design and case approach, a cross-sectional study was carried out on a sample of 54 systematically selected public service organizations spread across the South-South geopolitical region of Nigeria. The study showed that the fraud risk reduction strategy deployed in Nigerian public service organizations is not effective in reducing the overall level of employee fraud. The study showed that auditor’s monitoring strength is low. It also found that the prevailing reward and compensation system does not facilitate reduction of incentive for employee fraud. These results point to a need to review, strengthen and make more dynamic and responsive the current fraud risk reduction strategy used. Key words: employee fraud, organizations, Nigeria.
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Mohammed Lawan, Aminu, and Razlini Mohd Ramli. "The impact of globalization on Workers: an Analysis of Nigerian Public Service." International Journal of Engineering & Technology 7, no. 3.30 (August 24, 2018): 480. http://dx.doi.org/10.14419/ijet.v7i3.30.18362.
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Globalization is the increasing interaction of peoples, states or countries through the growth of the global trade, international flow of capital, ideas and culture. The paper discusses how privatization of public corporations and invention of information and communication technology (ICT) lead to the retrenchment and casualization of public servant. The aim of this study is to examines the impact of globalization on the public servant in Nigeria. The methodology involves the use of secondary data, through a systematic literature review which entails the document analysis of related matters. The findings reveal that globalization infringes on the right of a public servant by making them vulnerable without job security. The paper concludes that government must stop unfair labor practice such as retrenchment and casualization of workers, and improve good working conditions to make public servant more productive.
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Ogujiuba, Kanayo, and Omoju Sola . "Medium Term Expenditure and Fiscal Management in Nigeria: A Review of the (2005-2008) Framework." Journal of Economics and Behavioral Studies 5, no. 5 (May 30, 2013): 291–306. http://dx.doi.org/10.22610/jebs.v5i5.405.
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The Medium Term Expenditure Framework (MTEF) provides the link between policy priorities and the budget. Given that in developing countries in general, and in Nigeria in particular, there is a disconnection between planning, policy and the budget, the MTEF has increasingly been regarded as central to public expenditure reforms. The objectives of this paper are to review the MTEF and budget performance in Nigeria for the period 2005-2008, and identify the challenges undermining the effective operation of the budgetary processes. The paper gathered that the MTEF is the bridge between the national development plan, its underlying policies and the annual budget. Analysis of available data on budget performance during the review period shows that public finance in Nigeria have not been operated within the specifications of the MTEF and the budget, and the priorities expressed in the budget are not always in sync with national objective plans. Some of the identified challenges to effective public expenditure management in Nigeria include lack of citizen’s participation in the process, the bureaucratic and inefficient nature of the civil service, large scale corruption, lack of proper coordination between the national development plan and budget, lack of adequate reforms in other key budget areas, such as execution, monitoring and reporting, lack of political commitment, and lack of adequate coordination between the national and sub-national governments.
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Nwogbe, Olayemi A., and Yacob Haliso. "Continuing Professional Development Assessment of Healthcare Professionals in Public Secondary Hospitals in Lagos State, Nigeria." Information Impact: Journal of Information and Knowledge Management 11, no. 1 (April 30, 2020): 26–39. http://dx.doi.org/10.4314/iijikm.v11i1.3.
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This study investigates the engagement of healthcare professionals in continuing professional development in public secondary hospitals in Lagos State, Nigeria. A survey research design and a multistage sampling technique were adopted for the study. The sample consisted of 356 healthcare professionals (112 physicians, 32 pharmacists and 212 nurses). The data were collected using a self-developed structured questionnaire. The questions were built based on the literature review with modified questions adapted from widely used the questionnaires on hospital survey on patient safety, ambulatory and community pharmacy, nursing safety practices and CPD professional and skill competency and World Health Organization Regional Guidelines for Continuing Medical Education. Healthcare professionals in adult general outpatient departments were only included in the study. Findings revealed that physicians engagement in informal CPD (conferences, seminars, in-service training) is (M = 3.09), and formal CPD (conduct of research, publications or peer journal review) (M = 2.11). Pharmacists engagement in informal CPD is (M = 3.10) and formal CPD (M =1.89), Nurses’ engagement in informal CPD is (M =2.30) and CPD (M = 1.78). These evidence indicates that the respondents tend to lean more on less time-demanding and work-based capacity building approach, than they engaged mostly in informal CPD activities than they engaged in a methodical educational and professional advanced method of capacity building. The study recommends improved Government funding for training, policy improvement on organizational support and working conditions for study leave opportunities, and aligning the metrics of evaluating and scoring CPD engagement with the need assessment gaps in healthcare system in renewing practicing license of healthcare professionals.
Keywords: Capacity building, Healthcare professionals Public healthcare service, Health workers training
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Hughes, Roger. "Competencies for effective public health nutrition practice: a developing consensus." Public Health Nutrition 7, no. 5 (August 2004): 683–91. http://dx.doi.org/10.1079/phn2003574.
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AbstractObjectives:To assess the level of consensus amongst an international panel of public health nutrition leaders regarding the essential competencies required for effective public health nutrition practice.Design:A modified Delphi study involving three rounds of questionnaires.Subjects:A panel of 20 public health nutrition experts from seven countries in the European Union, the USA and Australia.Results:Expert panellists completed three rounds of the study relating to competencies. A literature review conducted as a prelude to the expert panel survey identified common competency units from the fields of public health, health promotion, nutrition and dietetics, and health education. These were categorised into seven competency areas including analytical, socio-cultural and political, public health service, communication, management and leadership, nutrition science and professional competency categories. There was strong initial agreement (≥90% of panellists at Round 1) that developing internationally recognised competencies for public health nutrition specialists was a priority. Twenty-six of an initial listing of 52 competency units were rated as essential competencies by ≥80% of the panellists after Round 1. Iteration rounds resulted in the addition of five extra competency units suggested by panellists after Round 1 and an increase by 13 in the number of competencies rated as essential to consensus levels. From a total of 57 competency units rated after the final survey round, 41 competency units were rated as essential competencies by ≥80% of the panellists (consensus), with 21 of these unanimously rated as essential competencies.Conclusions:There is strong international agreement amongst public health nutrition leaders in Europe, the USA and Australia about a range of competencies required for effective public health nutrition practice. Essential competency units identified can be used to develop and review competency standards for public health nutrition.
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B. Olokoba, Lateefat, Kabir A. Durowade, Feyi G. Adepoju, and Abdulfatai B. Olokoba. "Assessment of patients waiting and service times in the ophthalmology clinic of a public tertiary hospital in Nigeria." Ghana Medical Journal 54, no. 4 (December 4, 2020): 231–37. http://dx.doi.org/10.4314/gmj.v54i4.5.
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Introduction: Long waiting time in the out-patient clinic is a major cause of dissatisfaction in Eye care services. This study aimed to assess patients’ waiting and service times in the out-patient Ophthalmology clinic of UITH.
Methods: This was a descriptive cross-sectional study conducted in March and April 2019. A multi-staged sampling technique was used. A timing chart was used to record the time in and out of each service station. An experience based exit survey form was used to assess patients’ experience at the clinic. The frequency and mean of variables were generated. Student t-test and Pearson’s correlation were used to establish the association and relationship between the total clinic, service, waiting, and clinic arrival times. Ethical approval was granted by the Ethical Review Board of the UITH.
Result: Two hundred and twenty-six patients were sampled. The mean total waiting time was 180.3± 84.3 minutes, while the mean total service time was 63.3±52.0 minutes. Patient’s average total clinic time was 243.7±93.6 minutes. Patients’ total clinic time was determined by the patients’ clinic status and clinic arrival time. Majority of the patients (46.5%) described the time spent in the clinic as long but more than half (53.0%) expressed satisfaction at the total time spent at the clinic.
Conclusion: Patients’ clinic and waiting times were long, however, patients expressed satisfaction with the clinic times.
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Winter, Michael, and Fanan Ujoh. "A Review of Institutional Frameworks & Financing Arrangements for Waste Management in Nigerian Cities." Urban Studies and Public Administration 3, no. 2 (May 18, 2020): p21. http://dx.doi.org/10.22158/uspa.v3n2p21.
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Nigeria is rapidly urbanizing and is forecasted to become the 3rd most urbanized nation by 2100. Expectedly, the rapid urbanization presents challenges in many areas including the management of municipal services such as solid waste. This yawning failure is reflected in the poor quality of waste services across Nigerian cities. The study reviewed municipal waste management governance and institutional frameworks, and financing arrangements in two major cities in the North-western and south-eastern parts of Nigeria—Kano and Enugu cities. Key Informant Interviews (KIIs) using a number of structured questions checklist were conducted for the Heads of Government institutions responsible for waste management, Public Appropriation/Budget and Finance Units, as well as other key stakeholders including waste generators (residents and business owners), waste pickers and informal waste recyclers, and waste service providers. Additional, existing policy frameworks and infrastructure financing were reviewed. The findings reveal institutional and policy inadequacies, financing limitations, technical incapacity, infrastructural inadequacies, and socio-economic and attitudinal barriers, that collectively impede effective and efficient waste management service delivery in both cities. The assumption is that the findings of this study reflects the status in many Nigerian cities.
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C.J, Igbokwe-Ibeto,. "The Effect of Job Analysis on Service Delivery in Federal Airports Authority of Nigeria (FAAN) 2005-2014." International Journal of Human Resource Studies 9, no. 2 (May 5, 2019): 195. http://dx.doi.org/10.5296/ijhrs.v9i2.14745.
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The issue of public service delivery has been a high priority subject for organizational researchers and practitioners alike in Nigeria. However, linking human resource management practices such as job analysis that has received considerable attention in developed western countries as a useful human resource planning tool towards improving service delivery in the country is relatively new and requires scholarly attention particularly in the context of Nigerian public sector organizations. Within the framework of New Public Management (NPM) theory, the study examined the effect of job analysis on service delivery in the Federal Airports Authority of Nigeria (FAAN) 2005-2014. The study was guided by two research questions and hypotheses. The study adopted the survey research design. The study relied on primary and secondary data, and multiple stage sampling technique was used to select the sample population. Pearson Product Moment Correlation Coefficient and Simple Regression Analyses statistical techniques were used with the aid of Statistical Package for the Social Sciences (SPSS) to test the research hypotheses. Findings of the study show that job analysis has a significant effect on employee commitment in Federal Airports Authority of Nigeria at the 5percent levels. There is also a significant relationship between job analysis and quality of service delivery at the conventional 5percent levels. Given the pivotal role that job analysis plays in the 21st century, FAAN should adopt the conduct of job analysis as a basic human resource management tool for proper personnel utilization and improve quality of service delivery. FAAN should through job analysis, identify and develop proper employee commitment scheme, such as training and retraining, and performance review standards that could enhance service delivery. It should also make expertise available to conduct job analysis. This would assist to ensure that all critical aspects such as skills, knowledge and competencies are taken into consideration thereby eliminate the concept of garbage in garbage out.
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Igbokwe-Ibeto, Chinyeaka Justine. "Re-inventing Nigeria's Public Sector: A Review of National Agency for Food, Drug Administration and Control (NAFDAC)." Africa’s Public Service Delivery and Performance Review 3, no. 2 (June 1, 2015): 183. http://dx.doi.org/10.4102/apsdpr.v3i2.85.
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Public Over the years, the efficiency and effectiveness of Nigeria’s public sector has been a subject of debate. However, in recent time, the organizational performance and service delivery of National Agency for Food, Drug Administration and Control (NAFDAC) have been a success story. Within the framework of New Public Management (NPM) theory, the study investigates the secrete behind the degree of success achieved by NAFDAC with the aim of recommending such to other public sector organizations in Nigeria which has over the year’s demonstrated lack of zeal for service delivery. The study relied heavily on primary and secondary data. Yamani’s formula for sample size determination was used to select a sample of 133 employees from NAFDAC Lagos office out of a total of 200. Weighted mean and chi-square statistical tools was used to determine the independence or otherwise of the variables under investigation. It is the position of the study that NPM has enhanced NAFDAC’s performance and service delivery. It concludes that since the traditional public administration theories has failed to deliver the much needed public goods and services, it is therefore imperative to reinvent Nigeria’s public sector in line with (NPM) international best practices so as to reposition the Nigerian public sector for the challenges of a modern and rapidly changing world. However, while change is desirable, we feel there is need to exercise caution on account of the peculiar nature and character of the Nigerian state and society. Reinventing the country’s public sector should progress slowly and wisely.
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Patricia, Egenti Uju. "STRATEGIC APPROACHES FOR REENGINEERING GUIDANCE AND COUNSELLING SERVICES IN PUBLIC SECONDARY SCHOOLS IN ANAMBRA STATE, NIGERIA." International Journal of Education, Psychology and Counseling 5, no. 37 (December 8, 2020): 270–82. http://dx.doi.org/10.35631/ijepc.5370022.
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This study was carried out to identify strategic approaches for reengineering guidance and counselling services in public secondary schools in Anambra State, Nigeria. A descriptive survey research design was adopted in carrying out the study. The sample for the study was 255 respondents made up of guidance counsellors and secondary school managers in the area of the study. The instrument for data collection was a structured close-ended questionnaire titled: “Strategic Approaches for Reengineering Guidance and Counselling Services Questionnaire (SARGCSQ)”. The instrument was validated by three experts while the reliability was ascertained using the Cronbach Alpha reliability method which yielded a coefficient of 0.88. Two hundred and fifty-five (255) copies of the questionnaire were administered to the respondents out of which 243 copies were completely filled and retrieved. Data collected were analysed using mean and standard deviation to answer the research questions and t-test statistics were used to test the null hypotheses at a 0.05 level of significance. The researcher in the study identified 10 capacity building approaches, 8 fund-related approaches and 10 programme review approaches for reengineering guidance and counselling services in public secondary schools in Anambra State. Findings indicated that there are no significant (p<0.05) differences in the mean ratings of the responses of guidance counsellors and school management on fund-related approaches and programme review approaches for reengineering guidance and counselling services in public secondary schools in Anambra State, Nigeria. Although, there was a significant (p<0.05) difference in the mean ratings of the responses of guidance counsellors and school management on capacity building approaches for reengineering guidance and counselling services in public secondary schools in Anambra State, Nigeria. Based on the findings, the study among others recommended that there should be constant capacity building of guidance counsellors through in-service training and retraining, relevant conferences, and workshops for improved efficiency in service delivery.
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Jonathan, Gideon Mekonnen, Aminat Abdul-Salaam, Omogunloye Oluwasanmi, and Lazar Rusu. "Business-IT Alignment Barriers in a Public Organisation." International Journal of Innovation in the Digital Economy 9, no. 1 (January 2018): 1–13. http://dx.doi.org/10.4018/ijide.2018010101.
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Business-IT alignment (BITA) continues to attract the interest of researchers and practitioners. Literature review reveals that the focus of past studies was investigated BITA mostly at (1) strategic level, in (2) private and commercial organisations, and in (3) developed countries. Thus, making a generalisation from these findings is difficult. The current study is aimed at shading light on the barriers of BITA based on a case study in a public organisation like The Federal Inland Revenue Service of Nigeria. The data was collected through semi-structured email interviews from business and IT managers as well as IT officers and also from internal organisational documents too. The data collected has been analysed using thematic analysis and has revealed six BITA barriers at tactical and operational levels like previous IT failures, lack of feedback mechanism, organisational structure, lack of standard infrastructure, insufficient time to acquire knowledge, and poor communication between the mangers.
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Talabi, Aroge Stephen. "Job Satisfaction and Work Performance of Public Secondary School Teachers In Akoko North West Local Government Area Of Ondo State." Journal of Arts and Humanities 5, no. 8 (August 31, 2016): 39. http://dx.doi.org/10.18533/journal.v5i8.959.
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<p><em>The study examined the relationship between job satisfaction and work performance of secondary school teachers in Akoko North West Local Government Area of Ondo-State, Nigeria. The study population consisted of all secondary school teachers, while two hundred of them were randomly selected for the study. Regular payment of salary, opportunities for promotion, rapport with school authority, in-service training, job security, career prospect and retirement benefits were the variables considered. The questionnaire titled “Workers Opinion Survey Inventory (WOSI)” and the Productivity Rating Scale (PRS) which was in line with Annual Performance Evaluation Report (APPER) was used to obtain information for the study. The data was analyzed using Pearson Product Correlation Moment. One of the recommendations made include the onward review of policies, remuneration and work conditions of teachers in the public secondary schools in Nigeria for optimum productivity.</em></p>
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Carroll, Pádraig, Adrian Dervan, Anthony Maher, Ciarán McCarthy, Ian Woods, Rachel Kavanagh, Cliff Beirne, et al. "Patient and Public Involvement (PPI) in preclinical research: A scoping review protocol." HRB Open Research 4 (August 31, 2021): 61. http://dx.doi.org/10.12688/hrbopenres.13303.2.
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Introduction: Patient and public involvement (PPI) aims to improve the quality, relevance, and appropriateness of research and ensure that it meets the needs and expectations of those affected by particular conditions to the greatest possible degree. The evidence base for the positive impact of PPI on clinical research continues to grow, but the role of PPI in preclinical research (an umbrella term encompassing ‘basic’, ‘fundamental’, ‘translational’ or ‘lab-based’ research) remains limited. As funding bodies and policymakers continue to increase emphasis on the relevance of PPI to preclinical research, it is timely to map the PPI literature to support preclinical researchers involving the public, patients, or other service users in their research. Therefore, the aim of this scoping review is to explore the literature on patient and public involvement in preclinical research from any discipline. Methods: This scoping review will search the literature in Medline (PubMed), Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, and OpenGrey.net to explore the application of PPI in preclinical research. This review will follow the Joanna Briggs Institute (JBI) guidelines for scoping reviews. It will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Two reviewers will independently review articles for inclusion in the final review. Data extraction will be guided by the research questions. The PPI advisory panel will then collaboratively identify themes in the extracted data. Discussion: This scoping review will provide a map of current evidence surrounding preclinical PPI, and identify the body of literature on this topic, which has not been comprehensively reviewed to date. Findings will inform ongoing work of the research team, support the work of other preclinical researchers aiming to include PPI in their own research, and identify knowledge and practice gaps. Areas for future research will be identified.
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Carroll, Pádraig, Adrian Dervan, Anthony Maher, Ciarán McCarthy, Ian Woods, Rachel Kavanagh, Cliff Beirne, et al. "Patient and Public Involvement (PPI) in preclinical research: A scoping review protocol." HRB Open Research 4 (May 28, 2021): 61. http://dx.doi.org/10.12688/hrbopenres.13303.1.
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Introduction: Patient and public involvement (PPI) aims to improve the quality, relevance, and appropriateness of research and ensure that it meets the needs and expectations of those affected by particular conditions to the greatest possible degree. The evidence base for the positive impact of PPI on clinical research continues to grow, but the role of PPI in preclinical research (an umbrella term encompassing ‘basic’, ‘fundamental’, ‘translational’ or ‘lab-based’ research) remains limited. As funding bodies and policymakers continue to increase emphasis on the relevance of PPI to preclinical research, it is timely to map the PPI literature to support preclinical researchers involving the public, patients, or other service users in their research. Therefore, the aim of this scoping review is to explore the literature on patient and public involvement in preclinical research from any discipline. Methods: This scoping review will search the literature in Medline (PubMed), Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, and OpenGrey.net to explore the application of PPI in preclinical research. This review will follow the Joanna Briggs Institute (JBI) guidelines for scoping reviews. It will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Two reviewers will independently review articles for inclusion in the final review. Data extraction will be guided by the research questions. The PPI advisory panel will then collaboratively identify themes in the extracted data. Discussion: This scoping review will provide a map of current evidence surrounding preclinical PPI, and identify the body of literature on this topic, which has not been comprehensively reviewed to date. Findings will inform ongoing work of the research team, support the work of other preclinical researchers aiming to include PPI in their own research, and identify knowledge and practice gaps. Areas for future research will be identified.
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Llewellyn, Nick, Alan Lawton, Charles Edwards, and Geoff Jones. "Entrepreneurship and the Public Sector." International Journal of Entrepreneurship and Innovation 1, no. 3 (October 2000): 163–71. http://dx.doi.org/10.5367/000000000101298667.
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This paper reports key findings from a series of structured public sector practitioner panel seminars, convened at the Open University Business School (OUBS) as part of a three-year study assessing the meaning and significance of entrepreneurship for the practice of public management. The seminars were structured around issues emerging from a detailed literature review. Reflecting the structure of the seminars, findings are presented around four themes: (a) the meaning of entrepreneurship as applied to public services; (b) the impact of entrepreneurial behaviour on traditional public service values; (c) contingencies that relate to entrepreneurial public management; and (d) outcomes of entrepreneurship. In the initial section of the paper traditional theories of the entrepreneur are contrasted with the way in which entrepreneurship has recently been linked to social, rather than individual goals. Methodology is then discussed, exploring the way in which field notes were generated and analysed. Key outcomes are then presented. The research reveals a balance between entrepreneurial behaviour and bureaucratic accountability, and a concern that public services, rather than individual goals are achieved. Entrepreneurial behaviour is found to exist across the public services, but it is recognized that there may be a core of activities that do not lend themselves to entrepreneurial behaviour. In the discussion section a number of implications emerging from the research are presented.
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Birnbaum, David, Elizabeth Borycki, Bryant Thomas Karras, Elizabeth Denham, and Paulette Lacroix. "Addressing Public Health informatics patient privacy concerns." Clinical Governance: An International Journal 20, no. 2 (April 7, 2015): 91–100. http://dx.doi.org/10.1108/cgij-05-2015-0013.
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Purpose – The purpose of this paper is to review stakeholder perspectives and provide a framework for improving governance in health data stewardship. Patients may wish to view their own lab results or clinical records, but others (notably academics, journalists and lawyers) tend to want scores of patient records in their search for patterns or trends. Public Health informatics capabilities are growing in scope and speed as clinical information systems, health information exchange networks and other potential database linkages enable more access to healthcare data. This change facilitates novel service improvements, but also raises new personal privacy protection issues. Design/methodology/approach – This paper summarizes a panel session discussion from the 2015 Information Technology and Communication in Health biennial international conference. The perspectives of health service research, journalism, Public Health informatics and privacy protection were represented. Findings – In North America, an expectation of personal privacy exists as a quasi-constitutional right. Individuals should be allowed to control the amount of information shared about them, and in particular the public expects that details of their personal healthcare data are protected. This is supported by laws, regulations and administrative structures; however, there are fundamental differences between the approaches taken in Canada and in the USA. In both countries, population and Public Health has wide powers to collect data and share it appropriately in order to accomplish a social good. A recent report issued by the British Columbia Information and Privacy Commissioner, and a recent story issued by the Bloomberg News service, highlight ways in which laws and regulations have not kept pace with advances in technology. Changes are needed to enable population and Public Health agencies to protect confidential personal information while still being able to comply with legitimate requests for data by researchers, policy makers and the public at large. Originality/value – Similarities and differences in approach, gaps, current issues and recommendations of several countries were revealed in a conference session. Those concepts and the likelihood of ensuing legislative changes directly impact healthcare organizations’ patients and leadership.
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Tobin, Michael R., James R. Hartline, Scott B. Sullivan, Christopher S. Kang, and Diane Devita. "Utility of Nonspecific Laboratory Testing for Psychiatric Patients Undergoing Medical Screening in a Military Emergency Department." Military Medicine 185, no. 11-12 (November 1, 2020): e1941-e1945. http://dx.doi.org/10.1093/milmed/usaa163.
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ABSTRACT Introduction Psychiatric complaints account for a sizable and increasing portion of emergency department (ED) visits. Compared with other medical patients, these patients often require substantial resources because of limited specialized resources and prolonged boarding times, which can be detrimental to the safety and satisfaction of other patients. This can prompt early and indiscriminate laboratory testing to expedite early requests for admission consideration. Numerous emergency medicine literature and clinical policies already recommend against indiscriminate screening labs for these patients, yet many psychiatric services require these tests. This study further evidences the limited clinical utility and high associated costs of mandatory protocol screening labs for psychiatric patients evaluated in military EDs. Materials and Methods A retrospective chart review of 441 active duty military patients and their families presenting to Madigan Army Medical Center’s ED who received psychiatric diagnoses underwent analysis. A 3-physician review panel evaluated each identified patient case to confirm eligibility and determine whether or not laboratory studies led to a change in patient disposition that was not identified by history, review of systems, physical exam, and known past medical history. The review was approved by the hospital’s institutional review board. Contemporary laboratory tests ordered in the evaluation of these patients included complete blood count with differential, complete metabolic panel, thyroid-stimulating hormone, serum ethanol, serum acetaminophen, serum salicylates, urine drug screening, urinalysis, urine human chorionic gonadotropin, and electrocardiograms. Results Broad screening labs may have altered dispositions for 0.9% (4) of patients. In total, 93% (202) of admitted patients were dispositioned to a psychiatric service. Of the 15 patients admitted to a medical service, 10 involved overdoses or intoxication. One patient had anemia in addition to opioid use disorder as diagnoses and was dispositioned to a medicine service. One pediatric patient was admitted for observation only. The remaining patients had diagnoses based on physical exam and history requiring medical service admission. In total, 7 patients had unknown dispositions, of which 4 carried solely psychiatric diagnoses. Conclusions The cumulative reimbursement costs of broad testing in the studied population were estimated at $36,325.17 and rarely altered patient disposition. Further testing does not increase the incidence of disposition altering diagnoses and is associated with increased costs. When individual state laws and the clinical assessment by the responsible emergency physician are considered, future standardized ED lab screening evaluations of psychiatric patients in military EDs may be concentrated to breathalyzer alcohol level, urine drug screen, serum salicylates, serum acetaminophen, and urine human chorionic gonadotropin.
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Yemisi Esther, Olanrewaju, Sanni Mubaraq, Lateef Saheed Ademola, and Aliu Ismaila Daudu. "The Relationship between Organization Structures and Performance in the Nigerian Public Sector." Jurnal Aplikasi Manajemen, Ekonomi dan Bisnis 4, no. 2 (April 16, 2020): 49–62. http://dx.doi.org/10.51263/jameb.v4i2.98.
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The main purpose of instituting good organizational structure as a parameter for public sector governance control practices is to resolve issues affecting the prudent management of resources to ensure effective public service delivery. However, quality of public service delivery only increased by an aggregate average of 2.4 percent from 2008 to 2017 as a result of poor organization structure. This implies that existence organization structure seems not useful due to the level of decay in public service delivery. Consequently, the present study assesses the relationship between organizational structure tools such communication with stakeholder, accountability and internal control on performance of Nigerian public sector. The study employed the two popular survey research instruments (questionnaire and interview) to collect data concurrently, analyzes separately and merged the results during interpretations. The target population for quantitative analysis is made up of Six (6) from each of the 175 MDAs in Nigeria as at December, 2018 while the study proposed Ten (10) participants for interviews. The quantitative data were analysed using descriptive and inferential statistic. The Partial Least Square Structural Equation Modelling (PLS-SEM) was used to test the hypotheses. The findings of the study from quantitative and qualitative analysis reveal that communication with stakeholder; accountability and internal control are positively and significantly associated with public sector performance. The study concludes that the three constructs proxied for organization structure have positive influence on the public sector performance. Therefore, the study recommends that all the heads of MDAs should lay more emphasis on transparency and accountability in order to be accessible independently by the public, the internal control system of MDAs should be regularly review and updated to achieve the stated public service objective and all MDAs staff should be training regarding the line of communication in public services in order to enhance public sector performance.
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Olakunde, Babayemi O., Daniel A. Adeyinka, John O. Olawepo, Jennifer R. Pharr, Chamberline E. Ozigbu, Sabastine Wakdok, Tolu Oladele, and Echezona E. Ezeanolue. "Towards the elimination of mother-to-child transmission of HIV in Nigeria: a health system perspective of the achievements and challenges." International Health 11, no. 4 (April 27, 2019): 240–49. http://dx.doi.org/10.1093/inthealth/ihz018.
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Abstract Despite its scaled-up response for prevention of mother-to-child transmission of HIV (PMTCT), Nigeria still contributes the greatest number of infants infected with HIV worldwide. Drawing on our knowledge, and review of policy documents and research papers, we explored the achievements and challenges in the elimination of mother-to-child transmission of HIV in Nigeria using the WHO’s health systems framework. We found that Nigeria has increased the number of PMTCT sites, decentralized and integrated PMTCT care for expanded service delivery, adopted task-shifting to address the shortage of skilled healthcare providers, explored alternative sources of domestic funding to bridge the funding gap and harmonized the health management information system to improve data quality. Some of the challenges we identified included: difficulty in identifying HIV-infected pregnant women because of low uptake of antenatal care; interrupted supplies of medical commodities; knowledge gaps among healthcare workers; and lack of a national unique identifying system to enhance data quality. While there have been some achievements in the PMTCT program, gaps still exist in the different blocks of the health system. Elimination of mother-to-child transmission of HIV in Nigeria will require the implementation of feasible, culturally acceptable and sustainable interventions to address the health system-related challenges.
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Tamayose, Teri S., Farzin Madjidi, June Schmieder-Ramirez, and Gail T. Rice. "Important Factors When Choosing a Career in Public Health." Californian Journal of Health Promotion 2, no. 1 (March 1, 2004): 65–73. http://dx.doi.org/10.32398/cjhp.v2i1.584.
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The purpose of this descriptive study was to identify the factors perceived to be important and not important when students are choosing a career. Factors derived from the literature review and suggestions made through the processes of content validity and reliability testing were included when developing the four-point Likert scale survey instrument. The instrument was reviewed by a panel of experts for content validity. In the survey, respondents were asked to indicate the level of importance of statements identified as being influential in making career decisions. Methods: The survey instrument was distributed to 258 Loma Linda University School of Public Health students following a short introduction of the study at the New Student Orientation which took place in Loma Linda, California. A total of 103 surveys were returned. Results: Descriptive statistics were used to report results. Frequencies and means were calculated for each variable and variables were ranked to determine level of importance. Correlation Analysis examined the relationship between variables in the study and Exploratory Factor Analysis determined the factors that emerged from the data. Discussion: The service-related statements showed the highest level of importance for choosing a career in public health. Demographic variables were found to have some impact on responses. Findings from this study should aid in the development of a strategic marketing plan for Loma Linda University School of Public Health.
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Ogbo, Ann, Happiness Ozioma Obi-Anike, E. K. Agbaeze, and Wilfred Isioma Ukpere. "Strategic restructuring for effective police system in Nigeria." Journal of Governance and Regulation 3, no. 4 (2014): 163–73. http://dx.doi.org/10.22495/jgr_v3_i4_c1_p9.
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The success of a security outfit depends on the strategies and structure of the organisation. The study aims to unravel the possible ways of positioning the Nigerian Police force for effective service delivery through strategic restructuring. Nigerian police was instituted by the colonial authors on the threshold of oppression to achieve subjection and control. Upon this pattern of operation, the Nigerian police force lost the confidence of the public. To position this agency for desired performance, several changes should be made in the strategies and structure of the force, de-emphasizing on the issues that are no longer recent problems and emphasizing on the current bane of the nation, such as corruption and insecurity. This paper adopted the mono-method qualitative approach which made use of secondary sources of data collection. Findings, revealed that the department of the Force that was responsible for information and intelligent gathering, the CID has lied dormant for long a time due to lack of adequate structure as a background that will add value to the department. Furthermore, the force was bedevilled with poor information gathering due to lack of trust and confidence in the police force, the level of motivation was found to be low, as there were no insurance policies for the Force. It is thus obvious to note that the Nigerian police force has suitable strategies that are capable of a sustainable performance, but it is challenged by lack of corresponding structure to work out the strategies. The study proposed that one DIG in addition to the twelve DIGs should be integrated to man a department with the duty of developing and maintaining good relationship with the public, and providing EFCC, ICPC and other crime related agencies with the needed force in discharging their duties. Finally, there is a need for an upward review of the reward and compensation package of the Nigerian Police Force as a way of stepping up on motivation, particularly in the area of training and re-training of the Police officers. A mind set of seeing a well-trained police officer as an investment to the country’s security sector which translates to security of life and properties must be developed and nurtured.
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Fajana, Sola, and Adedoyinsola Shonuga. "Job-Related Factors And Productivity Of Labour In The Nigerian Public Sector: The Case Of Lamata." Archives of Business Research 8, no. 9 (October 2, 2020): 77–85. http://dx.doi.org/10.14738/abr.89.8959.
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Productivity has a sustained demonstrable influence on business and political processes and outcomes in all climes. This study explores how the public sector in Nigeria can create ‘decent jobs’ which are more productive and rewarding in all senses. The adopted methodology was positivism which involves figurative or quantitative investigation and communication of observed phenomena. Based on this approach, a questionnaire was designed to gather information from fifty (50) staff in the Lagos Metropolitan Area Transport Authority (LAMATA). Data was analyzed with the use of descriptive statistics, and the Pareto chart and Kano’ Product/Service attribute classification mechanism. The findings were indicative of dominant factors such as opportunities for learning and development (µ=4.4), gifts at special periods (µ=4.7), and pay and rewards (µ=4.5). It was recommended that organizational and institutional policy drivers should continually consider these factors as expressed in the direct and group expectations of the employees in the policy-making and review processes.
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Ofori-Asenso, Richard, Akosua Adom Agyeman, and Amos Laar. "Metabolic Syndrome in Apparently “Healthy” Ghanaian Adults: A Systematic Review and Meta-Analysis." International Journal of Chronic Diseases 2017 (2017): 1–9. http://dx.doi.org/10.1155/2017/2562374.
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Background. Metabolic syndrome (MetS) is a major public health problem in Sub-Saharan Africa. We systematically reviewed the literature towards estimating the prevalence of MetS among apparently “healthy” Ghanaian adults. Methods. We searched PubMed, Web of Science, Scopus, Africa Journals Online, African Index Medicus, and Google scholar as well as the websites of the Ministry of Health and Ghana Health service through September 2016. Only studies conducted among apparently “healthy” (no established disease, e.g., diabetes and hypertension) adults aged ≥ 18 years were considered. Only studies that utilised the National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP), World Health Organization (WHO), or International Diabetes Federation (IDF) classifications for MetS were included. Results. Data from nine studies involving 1,559 individuals were pooled. The prevalence of MetS based on NCEP-ATP, WHO, and IDF classifications was 12.4% (95% confidence interval [CI] = 8.3–17.4%), 6.0% (95% CI = 1.4–13.1%), and 21.2% (95% CI = 12.4–30.9), respectively. Prevalence of MetS was higher among women than men. Conclusion. Among a population of adult Ghanaians deemed “healthy,” there is a high prevalence of MetS. Preventive measures are required to address the risk components of MetS such as obesity and hypertension which are rapidly rising in Ghana.
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Jankauskiene, Danguole, and Gintare Petronyte. "A MODEL FOR HTA PRIORITY SETTING: EXPERIENCE IN LITHUANIA." International Journal of Technology Assessment in Health Care 29, no. 4 (October 2013): 450–55. http://dx.doi.org/10.1017/s0266462313000470.
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Objectives: To promote the further development of HTA, this study aims to design a model for HTA priority setting, which would address national needs for a country with little experience in the field of HTA, and assess its feasibility for the health system.Methods: Literature search and review, as well as qualitative research have been used in the design and testing of the model for HTA priority setting. To test the model and the methodology, a three-round Delphi study was conducted in 2011 in the form of an electronic questionnaire, which was distributed to the panel of eleven national experts. The panel was composed of experts representing various fields of the health care sector: policy-makers, health care service professionals and academics, with diverse professional roles.Results: The designed model consists of four stages: (i) selection of experts for the panel, (ii) indication and selection of health policy topics, (iii) identification of health technologies, and (iv) priority setting. Three rounds of the Delphi study were performed to test the model and reach expert consensus on a list of health technologies for assessment, including pharmaceuticals, vaccines, medical devices, diagnostic methods, public health interventions, organizational systems, etc.Conclusions: Based on the Delphi technique as a method for consensus building, the model for HTA priority setting was developed for Lithuania; however, it could also be used for other countries with little experience in the field of HTA.
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Bukar, Modu Alh Bukar, Mohammed Kaka, and Mai Dunoma Zannah. "Press freedom and media ownership are factors that influence media performance: comparative analysis of these factors in USA and Nigeria." Technium Social Sciences Journal 1 (December 1, 2019): 13–20. http://dx.doi.org/10.47577/tssj.v1i1.31.
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The paper is to examine the influence of press freedom and media ownership in the performance of the media institutions in the United States of America and Federal Republic of Nigeria. However, in order to set for such discourse there is indispensable need to review some of the normative theories of the media, which will enable us to locate the appropriate principles guiding the operation of the media in each countries under study. The subdivided into: Abstract, Introduction, Normative Theories of the press, press freedom in United States, press freedom in Nigeria (democracy and press freedom, freedom of information act and conclusion). The analysis concludes that, The United States even has provision in their law and constitution forbidding state interference in the area of information content and dissemination. In Nigeria however, the state control society including the mass media. In this regard, whether media are owned by public or private individuals, they are only meant to service the government in power and were forbidden to criticize the government or its functionaries. The paper recommends that, For Nigerian press to be free the country should militate the all laws or factors that against the press freedom and Members of the Nigerian press must adhere to the ethics of the profession, in order to compete with others freers press of the other countries.
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Shin, Hosung, Han-A. Cho, and Bo-Ra Kim. "Dental Expenditure by Household Income in Korea over the Period 2008–2017: A Review of the National Dental Insurance Reform." International Journal of Environmental Research and Public Health 18, no. 8 (April 7, 2021): 3859. http://dx.doi.org/10.3390/ijerph18083859.
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Since 2009, the National Health Insurance in Korea (NHI) has been implementing a series of policies to expand the scope of dental benefits. This study reviewed the changes in co-payments and dental use patterns before (2008 to 2012) and after (2013 to 2017) the NHI’s dental health insurance reform. The study used Korea Health Panel data of 7681 households (16,493 household members) from a 10-year period (2008–2017). Dental expenditures and equivalent income using square root of household size were analyzed. Dental services were categorized into 13 types and a concentration index and 95% confidence interval using the delta method was calculated to identify income-related inequalities by a dental service. Dental expenditures and the number of dental services used increased significantly, while the proportion of out-of-pocket spending by the elderly decreased. The expenditure ratio for implant services to total dental expenditures increased substantially in all age groups, but the ratio of expenditures for dentures and fixed bridges decreased relatively. The concentration index of implant services was basically in favor of the rich, but there was no longer a significant bias favoring the better-off after the reforms. The dental health insurance reform in Korea appears to contribute not only to lowering the ratio of out-of-pocket to total dental expenses per episode in the elderly but also to improving the inequality of dental expenses.
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Ibadin, Michael O., and George O. Akpede. "A revised scoring scheme for the classification of socio-economic status in Nigeria." Nigerian Journal of Paediatrics 48, no. 1 (February 4, 2021): 26–33. http://dx.doi.org/10.4314/njp.v48i1.5.
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Background: Researchers in medicine and related fields in Nigeria have usually made recourse to the instrument developed by Olusanya et al and Oyedeji in the past three-and-a half decades for determination of socioeconomic status (SES). Beside the question of their age, however, these instruments were purposive and might no longer be suitable because of the changes in the parameters on which they were based.Objective: To develop a robust but generic scheme that takes into consideration the changes in the nation’s socioeconomic space in the succeeding three and a half decades.Methods: A detailed and comprehensive review of the extant schemes was undertaken with a view to identifying their inherent weaknesses. The latter were then factored into the design of a new scheme taking into consideration the emergent restructuring of career positions in the civil/public service as well as the place of private and informal sectors of the economy. The new scheme was validated at the University of Beninand Irrua Specialist Teaching Hospitals.Results: The new scheme had a remarkably high Inter-rater reliability (r = 0.947, p<0.001), raterre- rater reliability (r = 0.984, p <0.001) and % agreement (with modified Oyedeji’s tool as standard) of 67% (K coefficient = 0.47, r = 0.71, p<0.001)Conclusion/Recommendation: The new scheme could be a viable tool for the assessment of SES of families and individuals, which not only takes into consideration current realities of the nation’s economy, but also is readily adaptable to meet foreseeable changes.
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Staley, Kristina, Joanne Ashcroft, Lisa Doughty, and George Szmukler. "Making it clear and relevant: patients and carers add value to studies through research document reviews." Mental Health and Social Inclusion 20, no. 1 (March 14, 2016): 36–43. http://dx.doi.org/10.1108/mhsi-09-2015-0037.
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Purpose – The National Institute of Health Research MHRN established the Feasibility and Support to Timely recruitment for Research (FAST-R) service in 2011, to provide rapid patient and carer feedback on research documents, prior to ethical review. The aims were to improve the feasibility of studies, to speed up regulatory processes and enhance study set up and completion. The purpose of this paper is to explore whether and how the FAST-R service benefits the review process. Design/methodology/approach – An independent evaluator analysed the comments made by FAST-R members on 85 studies over the past 3.5 years. The evaluation team reflected on the nature of these comments and the implications for future practice. Findings – The FAST-R members’ comments fell into seven categories relating to: the quality of the information, the informed consent process, care and protection of participants, practical arrangements for participants, data protection and confidentiality, recruitment and research design. Based on the evaluation team’s experience of research document review, some of these comments were similar to those made by ethics committees. In other cases, the FAST-R Panel provided a different kind of input by identifying concerns specific to service users and carers. Practical implications – Patient/carer involvement in reviewing research documents brings added benefits to existing processes because their views are informed by their knowledge and experience. They are able to question assumptions and highlight concerns that people lacking their perspective might otherwise miss. These findings suggest that patient/carer involvement should form an integral part of ethical review, and that the FAST-R model might be usefully applied to other areas of health and social care research. Originality/value – This original work adds value to the practice of patient and public involvement in research.
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Nelson, D. Alan, Matthew C. Pflipsen, and Lianne M. Kurina. "Military Occupational Disability Risk Surveillance: A Retrospective Cohort Study of Modifiable Risk Factors." Military Medicine 185, no. 11-12 (November 1, 2020): e1977-e1985. http://dx.doi.org/10.1093/milmed/usaa175.
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Abstract Introduction Occupational disability among military service members is an important target for preventive screening. The specific aim of this study was to quantify disability risk levels among soldiers with selected risk factors (body mass index extremes, poor or absent physical fitness scores, and tobacco and opioid use) and combinations thereof, suggesting priorities for preventive actions. Materials and Methods This was a retrospective cohort study of 607,006 active-duty soldiers who served in the U.S. Army during 2011–2014. Official medical and administrative data were combined to produce a person-month-based panel dataset with identifiers removed. The subjects were observed longitudinally for incident disability (termed medical nonreadiness) during 1,305,618 person-years at risk. We employed Weibull parametric survival regression models to determine the adjusted medical nonreadiness hazard for selected variables. We then computed individual adjusted risk scores and the population proportions affected by risk factors and combinations thereof in postregression analyses. The project was approved by the Stanford University’s Institutional Review Board and underwent secondary review by the Human Research Protections Office of the Defense Health Agency. Results During the observed time, 81,571 (13.4%) of subjects were found medically not ready. High or low body mass index, low or missing physical fitness test scores, tobacco use, and the highest levels of opioid use were each associated with increased adjusted hazards of medical nonreadiness. The hazards increased substantially when multiple risk factors were present, albeit while affecting reduced population proportions. Conclusions We identified marked disability hazard increases, especially in association with opioid use and high body mass index. These factors, in addition to tobacco use and low physical fitness, are potential early prevention targets for clinicians who screen military service members.
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Omisanjo, Olufunmilade A., Olawale O. Ogunremi, Olufemi O. Akinola, Olaolu O. Adebayo, Olufemi Ojewuyi, Mofeyisayo O. Omorinde, Abimbola A. Abolarinwa, Stephen O. Ikuerowo, and Fatai A. Balogun. "Waiting Times for Prostate Cancer Diagnosis in a Nigerian Population." Journal of Cancer Epidemiology 2021 (August 16, 2021): 1–6. http://dx.doi.org/10.1155/2021/5534683.
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Background. Prostate biopsy remains an important surgical procedure in the diagnostic pathway for prostate cancer, but access to prostate biopsy service is poorly studied in the Nigerian population. While there has been a well-documented delay in patient presentation with prostate cancer in Nigeria, little is however known about how long patients wait to have a histological diagnosis of prostate cancer and start treatment after presenting at Nigerian hospitals. Method. This was a descriptive retrospective study to document the specific duration of the various timelines in getting a diagnosis of prostate cancer at the Lagos State University Teaching Hospital, Ikeja, Nigeria. Results. There were 270 patients. The mean age was 69.50 ± 8.03 years (range 45-90). The mean PSA at presentation was 563.2 ± 1879.2 ng / ml (range 2.05-15400), and the median PSA was 49.3 ng/ml. The median waiting times were (i) 10 days from referral to presentation; (ii) 30 days from presentation to biopsy; (iii) 24 days from biopsy to review of histology; (iv) 1 day from histology review to discussion/planning of treatment. The median overall waiting time from referral to treatment was 103 days. The mean time from presentation to biopsy was significantly shorter for patients with PSA of ≥50 ng/ml compared to those with PSA < 50 ng / ml . p = 0.048 . Overall, the median time from biopsy to histology was significantly shorter for patients whose specimens were processed in private laboratories (17 days) compared to those whose specimens were processed at the teaching hospital laboratory (30 days), p ≤ 0.001 . Conclusion. There is a significant delay within the health care system in getting a prostate cancer diagnosis in the Nigerian population studied. The major points of the identified delay were the waiting time from patient presentation to having a biopsy done and the histology report waiting time.
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Walsh, Deirdre M. J., Lisa Hynes, Mary Clare O'Hara, Jenny Mc Sharry, Séan F. Dinneen, and Molly Byrne. "Embedding a user-centred approach in the development of complex behaviour change intervention to improve outcomes for young adults living with type 1 diabetes: The D1 Now Study." HRB Open Research 1 (February 28, 2018): 8. http://dx.doi.org/10.12688/hrbopenres.12803.1.
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Background: Type 1 diabetes (T1D) is an auto-immune condition which requires intensive self-management. Diabetes self-management is challenging, especially during young adulthood. Effective interventions to improve outcomes for young adults with T1D are needed. This paper describes the development of the D1 Now intervention, employing a user-centred approach to engage with stakeholders in parallel with the application of theory. Methods: Intervention development consisted of 4 phases: 1) the formation of a public and patient involvement (PPI) Young Adult Panel (YAP); 2) a systematic review to synthesise evidence regarding the effectiveness of interventions aimed at improving outcomes for young adults with T1D; 3) understand young adults’ diabetes self-management behaviour through engagement with key stakeholders; and 4) an expert consensus meeting to discuss self-management strategies identified in Phase 1 and 3 that would form the core components of the D1 Now intervention. Results: The YAP resulted in meaningful involvement between young adults, researchers and service providers. The systematic review highlighted a lack of quality intervention studies. Qualitative findings highlighted how young adult self-management is driven by complex interactions between external resources, which influence capability, and motivation. The expert panel in Phase 4 highlighted focus areas to improve outcomes for young adults and implementation strategies. Subsequent to these 4 phases, 3 intervention components have been identified: 1) a key worker to liaise with the young adult; 2) an online portal to facilitate relationship building between staff and young adults; and 3) an agenda setting tool to facilitate joint decision-making. Conclusions: This study described the systematic development of an intervention underpinned by theoretical frameworks and PPI, and has identified components for the D1 Now intervention. The resulting intervention content will now be subject to an intervention optimisation process.
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Walsh, Deirdre M. J., Lisa Hynes, Mary Clare O'Hara, Jenny Mc Sharry, Séan F. Dinneen, and Molly Byrne. "Embedding a user-centred approach in the development of complex behaviour change intervention to improve outcomes for young adults living with type 1 diabetes: The D1 Now Study." HRB Open Research 1 (August 2, 2018): 8. http://dx.doi.org/10.12688/hrbopenres.12803.2.
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Background: Type 1 diabetes (T1D) is an auto-immune condition which requires intensive self-management. Diabetes self-management is challenging, especially during young adulthood. Effective interventions to improve outcomes for young adults (18-30 year olds) with T1D are needed. This paper describes the development of the D1 Now intervention, employing a user-centred approach to engage with stakeholders in parallel with the application of theory. Methods: Intervention development consisted of 4 phases: 1) the formation of a public and patient involvement (PPI) Young Adult Panel (YAP); 2) a systematic review to synthesise evidence regarding the effectiveness of interventions aimed at improving outcomes for young adults with T1D; 3) understand young adults’ diabetes self-management behaviour through engagement with key stakeholders; and 4) an expert consensus meeting to discuss self-management strategies identified in Phase 1 and 3 that would form the core components of the D1 Now intervention. Results: The YAP resulted in meaningful involvement between young adults, researchers and service providers. The systematic review highlighted a lack of quality intervention studies. Qualitative findings highlighted how young adult self-management is driven by complex interactions between external resources, which influence capability, and motivation. The expert panel in Phase 4 highlighted focus areas to improve outcomes for young adults and implementation strategies. Subsequent to these 4 phases, 3 intervention components have been identified: 1) a key worker to liaise with the young adult; 2) an online portal to facilitate relationship building between staff and young adults; and 3) an agenda setting tool to facilitate joint decision-making. Conclusions: This study described the systematic development of an intervention underpinned by theoretical frameworks and PPI, and has identified components for the D1 Now intervention. The resulting intervention content will now be subject to an intervention optimisation process.
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Sepah, Yasir, Lubna Samad, Arshad Altaf, Nithya Rajagopalan, and Aamir Javed Khan. "Aspiration in injections: should we continue or abandon the practice?" F1000Research 3 (July 10, 2014): 157. http://dx.doi.org/10.12688/f1000research.1113.1.
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Aspiration during any kind of injection is meant to ensure that the needle tip is at the desired location during this blind procedure. While aspiration appears to be a simple procedure, it has generated a lot of controversy concerning the perceived benefits and indications. Advocates and opponents of aspiration both make logically sound claims. However, due to scarcity of available data, there is no evidence that this procedure is truly beneficial or unwarranted. Keeping in view the huge number of injections given worldwide, it is important that we draw attention to key questions regarding aspiration that, up till now, remain unanswered. In this review, we have attempted to gather and present literature on aspiration both from published and non-published sources in order to provide not only an exhaustive review of the subject, but also a starting point for further studies on more specific areas requiring clarification. A literature review was conducted using the US National Institute of Health’s PubMed service (including Medline), Google Scholar and Scopus. Guidelines provided by the World Health Organization, Safe Injection Global Network, International Council of Nursing, Center for Disease Control, US Federal Drug Agency, UK National Health Services, British Medical Association, Europe Nursing and Midwifery Council, Public Health Agency Canada, Pakistan Medical Association and International Organization of Standardization recommendations 7886 parts 1-4 for sterile hypodermics were reviewed for relevant information. In addition, curricula of several medical/-nursing schools from India, Nigeria and Pakistan, the US pharmacopeia Data from the WHO Program for International Drug Monitoring network in regard to adverse events as a result of not aspirating prior to injection delivery were reviewed. Curricula of selected major medical/nursing schools in India, Nigeria and Pakistan, national therapeutic formularies, product inserts of most commonly used drugs and other possible sources of information regarding aspiration and injections were consulted as well.
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Sepah, Yasir, Lubna Samad, Arshad Altaf, Muhammad Sohail Halim, Nithya Rajagopalan, and Aamir Javed Khan. "Aspiration in injections: should we continue or abandon the practice?" F1000Research 3 (February 1, 2017): 157. http://dx.doi.org/10.12688/f1000research.1113.2.
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Aspiration during any kind of injection is meant to ensure that the needle tip is at the desired location during this blind procedure. While aspiration appears to be a simple procedure, it has generated a lot of controversy concerning the perceived benefits and indications. Advocates and opponents of aspiration both make logically sound claims. However, due to scarcity of available data, there is no evidence that this procedure is truly beneficial or unwarranted. Keeping in view the huge number of injections given worldwide, it is important that we draw attention to key questions regarding aspiration that, up till now, remain unanswered. In this review, we have attempted to gather and present literature on aspiration both from published and non-published sources in order to provide not only an exhaustive review of the subject, but also a starting point for further studies on more specific areas requiring clarification. A literature review was conducted using the US National Institute of Health’s PubMed service (including Medline), Google Scholar and Scopus. Guidelines provided by the World Health Organization, Safe Injection Global Network, International Council of Nursing, Center for Disease Control, US Federal Drug Agency, UK National Health Services, British Medical Association, Europe Nursing and Midwifery Council, Public Health Agency Canada, Pakistan Medical Association and International Organization of Standardization recommendations 7886 parts 1-4 for sterile hypodermics were reviewed for relevant information. In addition, curricula of several medical/-nursing schools from India, Nigeria and Pakistan, the US pharmacopeia Data from the WHO Program for International Drug Monitoring network in regard to adverse events as a result of not aspirating prior to injection delivery were reviewed. Curricula of selected major medical/nursing schools in India, Nigeria and Pakistan, national therapeutic formularies, product inserts of most commonly used drugs and other possible sources of information regarding aspiration and injections were consulted as well.
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Sepah, Yasir, Lubna Samad, Arshad Altaf, Muhammad Sohail Halim, Nithya Rajagopalan, and Aamir Javed Khan. "Aspiration in injections: should we continue or abandon the practice?" F1000Research 3 (March 1, 2017): 157. http://dx.doi.org/10.12688/f1000research.1113.3.
Full textAbstract:
Aspiration during any kind of injection is meant to ensure that the needle tip is at the desired location during this blind procedure. While aspiration appears to be a simple procedure, it has generated a lot of controversy concerning the perceived benefits and indications. Advocates and opponents of aspiration both make logically sound claims. However, due to scarcity of available data, there is no evidence that this procedure is truly beneficial or unwarranted. Keeping in view the huge number of injections given worldwide, it is important that we draw attention to key questions regarding aspiration that, up till now, remain unanswered. In this review, we have attempted to gather and present literature on aspiration both from published and non-published sources in order to provide not only an exhaustive review of the subject, but also a starting point for further studies on more specific areas requiring clarification. A literature review was conducted using the US National Institute of Health’s PubMed service (including Medline), Google Scholar and Scopus. Guidelines provided by the World Health Organization, Safe Injection Global Network, International Council of Nursing, Center for Disease Control, US Federal Drug Agency, UK National Health Services, British Medical Association, Europe Nursing and Midwifery Council, Public Health Agency Canada, Pakistan Medical Association and International Organization of Standardization recommendations 7886 parts 1-4 for sterile hypodermics were reviewed for relevant information. In addition, curricula of several medical/nursing schools from India, Nigeria and Pakistan, the US pharmacopeia Data from the WHO Program for International Drug Monitoring network in regard to adverse events as a result of not aspirating prior to injection delivery were reviewed. Curricula of selected major medical/nursing schools in India, Nigeria and Pakistan, national therapeutic formularies, product inserts of most commonly used drugs and other possible sources of information regarding aspiration and injections were consulted as well.
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Ogar, Tom Eneji, and Ushie Abel Idagu. "PUBLIC PROCUREMENT IN AFRICA AND THE INTEGRITY QUESTION: TOWARDS AN ETHICAL NARRATIVE." Social Sciences, Humanities and Education Journal (SHE Journal) 1, no. 3 (September 30, 2020): 1. http://dx.doi.org/10.25273/she.v1i3.7549.
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This work is an analysis of public procurement and the role integrity and ethics plays in enhancing effectiveness and efficiency of the procurement system. The paper situates that though public procurement is a worldwide exercise where government spends public funds for the procurement of goods works and services, for the good of the people, inefficiencies has trailed the procurement system in most developing countries of Africa. Some of these countries have taken some steps to reform the sector, but there are still noticeable challenges and obstacles to a full maximization of the goals of a good procurement system. One of the major challenges, identified has been that of a dearth of integrity and ethical consciousness on the part of procurement professionals and stakeholders alike. It is essential that public procurement professional and stake holders adhere to a well-defined and established code of ethics. Ethics are the principles which defines behaviours as right, good and appropriate. Employees in public service are expected to uphold certain core values and any attempt to pursue personal interest using conduct that are not consistent with the proper discharge of the employee’s duties is a breach of the public trust. In the public sector where procurement is funded by public expenditure, it is imperative that procurement operates with integrity, transparency and professionalism. In most African countries, Nigeria, Uganda, Tanzania to mention a few, the ethos of an efficient system devoid of unethical behaviours by professionals has been far from achieved. The procurement systems have therefore been plagued by integrity and ethical issues leading to unwholesome and undesirable situations. A review of related literatures to these topics was carried out with a view to carry out a contextual analysis in addressing the specific issues under study. This work is therefore significant as it tried to apply ethics to a fundamental aspect of governance which is the procurement of goods, services and works for the ultimate benefits of the populace.
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Lyons, Jane, Ashley Akbari, Utkarsh Agrawal, Gill Harper, Amaya Azcoaga-Lorenzo, Rowena Bailey, James Rafferty, et al. "Protocol for the development of the Wales Multimorbidity e-Cohort (WMC): data sources and methods to construct a population-based research platform to investigate multimorbidity." BMJ Open 11, no. 1 (January 2021): e047101. http://dx.doi.org/10.1136/bmjopen-2020-047101.
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IntroductionMultimorbidity is widely recognised as the presence of two or more concurrent long-term conditions, yet remains a poorly understood global issue despite increasing in prevalence.We have created the Wales Multimorbidity e-Cohort (WMC) to provide an accessible research ready data asset to further the understanding of multimorbidity. Our objectives are to create a platform to support research which would help to understand prevalence, trajectories and determinants in multimorbidity, characterise clusters that lead to highest burden on individuals and healthcare services, and evaluate and provide new multimorbidity phenotypes and algorithms to the National Health Service and research communities to support prevention, healthcare planning and the management of individuals with multimorbidity.Methods and analysisThe WMC has been created and derived from multisourced demographic, administrative and electronic health record data relating to the Welsh population in the Secure Anonymised Information Linkage (SAIL) Databank. The WMC consists of 2.9 million people alive and living in Wales on the 1 January 2000 with follow-up until 31 December 2019, Welsh residency break or death. Published comorbidity indices and phenotype code lists will be used to measure and conceptualise multimorbidity.Study outcomes will include: (1) a description of multimorbidity using published data phenotype algorithms/ontologies, (2) investigation of the associations between baseline demographic factors and multimorbidity, (3) identification of temporal trajectories of clusters of conditions and multimorbidity and (4) investigation of multimorbidity clusters with poor outcomes such as mortality and high healthcare service utilisation.Ethics and disseminationThe SAIL Databank independent Information Governance Review Panel has approved this study (SAIL Project: 0911). Study findings will be presented to policy groups, public meetings, national and international conferences, and published in peer-reviewed journals.
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Wagner, Aylin, Franziska Zúñiga, Peter Rüesch, René Schaffert, and Julia Dratva. "Selecting home care quality indicators based on the Resident Assessment Instrument-Home Care (RAI-HC) for Switzerland: A public health and healthcare providers' perspective." PLOS ONE 15, no. 12 (December 30, 2020): e0244577. http://dx.doi.org/10.1371/journal.pone.0244577.
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Background Despite an increasing importance of home care, quality assurance in this healthcare sector in Switzerland is hardly established. In 2010, Swiss home care quality indicators (QIs) based on the Resident Assessment Instrument-Home Care (RAI-HC) were developed. However, these QIs have not been revised since, although internationally new RAI-HC QIs have emerged. The objective of this study was to assess the appropriateness of RAI-HC QIs to measure quality of home care in Switzerland from a public health and healthcare providers’ perspective. Methods First, the appropriateness of RAI-HC QIs, identified in a recent systematic review, was assessed by a multidisciplinary expert panel based on the RAND/UCLA Appropriateness Method taking into account indicators’ public health relevance, potential of influence, and comprehensibility. Second, the QIs selected by the experts were afterwards rated regarding their relevance, potential of influence, and practicability from a healthcare providers’ perspective in focus groups with home care nurses based on the Nominal-Group-Technique. Data were analyzed using median scores and the Disagreement Index. Results 18 of 43 RAI-HC QIs were rated appropriate by the experts from a public health perspective. The 18 QIs cover clinical, psychosocial, functional and service use aspects. Seven of the 18 QIs were subsequently rated appropriate by home care nurses from a healthcare providers’ perspective. The focus of these QIs is narrow, because three of seven QIs are pain-related. From both perspectives, the majority of RAI-HC QIs were rated inappropriate because of insufficient potential of influence, with healthcare providers rating them more critically. Conclusions The study shows that the appropriateness of RAI-HC QIs differs according to the stakeholder perspective and the intended use of QIs. The findings of this study can guide policy-makers and home care organizations on selecting QIs and to critically reflect on their appropriate use.
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Crowther, A., A. Taylor, R. Toney, S. Meddings, T. Whale, H. Jennings, K. Pollock, et al. "The impact of Recovery Colleges on mental health staff, services and society." Epidemiology and Psychiatric Sciences 28, no. 5 (October 23, 2018): 481–88. http://dx.doi.org/10.1017/s204579601800063x.
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AbstractAimsRecovery Colleges are opening internationally. The evaluation focus has been on outcomes for Recovery College students who use mental health services. However, benefits may also arise for: staff who attend or co-deliver courses; the mental health and social care service hosting the Recovery College; and wider society. A theory-based change model characterising how Recovery Colleges impact at these higher levels is needed for formal evaluation of their impact, and to inform future Recovery College development. The aim of this study was to develop a stratified theory identifying candidate mechanisms of action and outcomes (impact) for Recovery Colleges at staff, services and societal levels.MethodsInductive thematic analysis of 44 publications identified in a systematised review was supplemented by collaborative analysis involving a lived experience advisory panel to develop a preliminary theoretical framework. This was refined through semi-structured interviews with 33 Recovery College stakeholders (service user students, peer/non-peer trainers, managers, community partners, clinicians) in three sites in England.ResultsCandidate mechanisms of action and outcomes were identified at staff, services and societal levels. At the staff level, experiencing new relationships may change attitudes and associated professional practice. Identified outcomes for staff included: experiencing and valuing co-production; changed perceptions of service users; and increased passion and job motivation. At the services level, Recovery Colleges often develop somewhat separately from their host system, reducing the reach of the college into the host organisation but allowing development of an alternative culture giving experiential learning opportunities to staff around co-production and the role of a peer workforce. At the societal level, partnering with community-based agencies gave other members of the public opportunities for learning alongside people with mental health problems and enabled community agencies to work with people they might not have otherwise. Recovery Colleges also gave opportunities to beneficially impact on community attitudes.ConclusionsThis study is the first to characterise the mechanisms of action and impact of Recovery Colleges on mental health staff, mental health and social care services, and wider society. The findings suggest that a certain distance is needed in the relationship between the Recovery College and its host organisation if a genuine cultural alternative is to be created. Different strategies are needed depending on what level of impact is intended, and this study can inform decision-making about mechanisms to prioritise. Future research into Recovery Colleges should include contextual evaluation of these higher level impacts, and investigate effectiveness and harms.
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Akram, Naeem. "Is public debt hindering economic growth of the Philippines?" International Journal of Social Economics 42, no. 3 (March 2, 2015): 202–21. http://dx.doi.org/10.1108/ijse-02-2013-0047.
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Purpose – Over the years most of the developing countries have failed to collect enough revenues to finance their budgets. As a result, they have to face the problem of twin deficits and to rely on external and domestic debt to finance their developmental activities. The positive effects of public debt relate to the fact that in resource-starved economies debt financing (if done properly) leads to higher growth and adds to their capacity to service and repay external and internal debt. The negative effects work through two main channels – i.e., “Debt Overhang” and “Crowding Out” effects. The purpose of this paper is to examine the consequences of public debt for economic growth and investment for the Philippines. Design/methodology/approach – The present study examines the consequences of public debt for economic growth and investment for the Philippines during the period 1975-2010, by using autoregressive distributed lag technique. Findings – The results reveal that in the Philippines, public external debt has negative and significant relationship with economic growth and investment confirming the existence of “Debt Overhang effect”. But due to insignificant relationships of debt servicing with investment and economic growth, the existence of the crowding out hypothesis could not be confirmed. The domestic debt has a negative relationship with investment and positive relationship with economic growth. Research limitations/implications – First and foremost implication of the study is that heavy reliance on external debt must be discouraged. Therefore, in order to accelerate economic growth, developing countries must adopt those policies that are likely to result in reducing their debt burden, and it must not be allowed to reach unsustainable level. In the case of domestic debt, the present study finds that investment is negatively affected by domestic debt due to the crowding out effect; yet real GDP has a positive relationship with domestic debt. Thus, if policy makers want to use domestic debt as a tool to stimulate real GDP then it must keep an eye on the consequences of domestic debt on the investment. Practical implications – First and foremost implication of the study is that heavy reliance on external debt must be discouraged. Therefore, in order to accelerate economic growth, the Philippines must adopt those policies that are likely to result in reducing their debt burden, and external debt it must not be allowed to reach unsustainable level. In the case of domestic debt, the present study finds that investment is negatively affected by domestic debt due to the crowding out effect; yet real GDP has a positive relationship with domestic debt. Thus, if policy makers want to use domestic debt as a tool to stimulate real GDP then it must keep an eye on the consequences of domestic debt for on the investment. Social implications – It also follows from the estimation results that population growth rate is harmful for the economic growth. So in order to stimulate the growth performance, it must adopt effective population control policies. Similarly, since openness and investment are growth enhancing so there is need for the trade and investment supportive policies. Originality/value – From the review of literature on the issue, it can be broadly summarized that most of the studies are on the relationship of external debt and economic growth, neglecting domestic debt entirely or mentioning it in the passing. Second, most of these studies have been conducted by using panel data. However, as the different countries vary in socio-economic conditions so it is better to conduct the country specific study. The present study is an attempt to fill these gaps in the existing literature.
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Doi, Lawrence, Kathleen Morrison, Ruth Astbury, Jane Eunson, Margaret A. Horne, Ruth Jepson, Louise Marryat, Rachel Ormston, and Rachael Wood. "Study protocol: a mixed-methods realist evaluation of the Universal Health Visiting Pathway in Scotland." BMJ Open 10, no. 12 (December 2020): e042305. http://dx.doi.org/10.1136/bmjopen-2020-042305.
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IntroductionThe growing political emphasis on the early years reflects the importance of these formative years of life. Health visitors in the UK are uniquely positioned to improve health outcomes for children and families and to reduce health inequalities. Recently, there has been a policy change in Scotland in an attempt to enhance the delivery of the universal health visiting service. This study aims to examine the extent to which the enhanced Universal Health Visiting Pathway is implemented and delivered across Scotland and to assess any associated impacts.Methods and analysisA mixed-methods study incorporating four methodological components and uses realist evaluation as the overall conceptual framework. It comprises three phases (1) initial programme theory development; (2) programme theory validation and (3) programme theory refinement. The programme theory validation will use interview and focus group data of parents and health visitors, and conduct a case note review at five study sites. It also involves a national survey of parents and health visitors and routine data analysis of existing secondary data. The analyses of the ensuing qualitative and quantitative data will be carried out using a convergent mixed-methods approach to ensure continuous triangulation of multiple data. The findings of the evaluation will provide contextually relevant understanding of how the Universal Health Visiting Pathway works and evidence the impact of increased investments in health visiting in Scotland.Ethics and disseminationThis protocol has been approved by the School of Health in Social Science Research Ethics Committee, University of Edinburgh. Additional approvals have been granted/will be sought from the Public Benefit and Privacy Panel for health and social care in Scotland for the case note review,survey and routine data analysis elements of the evaluation. The findings will be prepared as reports to the funders and presented at conferences. It will be submitted for publication in peer-reviewed journals.
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Austin, Zubin, Anna van der Gaag, Ann Gallagher, Robert Jago, Sarah Banks, Grace Lucas, and Magda Zasada. "Understanding Complaints to Regulators About Paramedics in the UK and Social Workers in England: Findings from a Multi-Method Study." Journal of Medical Regulation 104, no. 3 (October 1, 2018): 19–28. http://dx.doi.org/10.30770/2572-1852-104.3.19.
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ABSTRACT Within the regulatory community, there has been increasing interest in the issue of proportionality in regulation — that is, using the right amount and right types of regulatory interventions to achieve the primary mandate of the regulatory community in order to serve and to protect. The Health and Care Professions Council (HCPC) in the United Kingdom, one of the largest health-care regulatory bodies in the world, recently commissioned a study examining the disproportionately large number of complaints against paramedics in the UK and social workers in England. The objective of the study was to examine the nature of, and to better understand the reasons behind, this disproportionality, and to identify options and opportunities from a regulatory perspective that could be taken to address this issue. The study involved a systematic multi-methods research approach involving four key interrelated research elements:A systematic literature reviewA Delphi consultation with international expertsInterviews (n=26) and four focus groups (n=23) with UK experts, including service users and caregiversA review of a random sample (n=284) of fitness-to-practice cases over two years across the three stages of the process (initial complaint, Investigating Committee Panel, and final hearing) Findings from this study highlight the evolving nature of both professions and the influence of a binary model of complaints adjudication that may not be sufficiently nuanced to balance public protection with practitioners' learning needs. A non-binary option for understanding complaints against practitioners is suggested in this paper, offering a process that involves and engages both employers and practitioners in a more meaningful manner.
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Inscoe, Christina R., Yueh Lee, Alex J. Billingsley, Connor Puett, Daniel Nissman, Jianping Lu, and Otto Zhou. "Point-of-Care Tomosynthesis Imaging of the Wrist." Military Medicine 186, Supplement_1 (January 1, 2021): 745–50. http://dx.doi.org/10.1093/milmed/usaa337.
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ABSTRACT Introduction Musculoskeletal injury to extremities is a common issue for both stateside and deployed military personnel, as well as the general public. Superposition of anatomy can make diagnosis difficult using standard clinical techniques. There is a need for increased diagnostic accuracy at the point-of-care for military personnel in both training and operational environments, as well as assessment during follow-up treatment to optimize care and expedite return to service. Orthopedic tomosynthesis is rapidly emerging as an alternative to digital radiography (DR), exhibiting an increase in sensitivity for some clinical tasks, including diagnosis and follow-up of fracture and arthritis. Commercially available digital tomosynthesis systems are large complex devices. A compact device for extremity tomosynthesis (TomoE) was previously demonstrated using carbon nanotube X-ray source array technology. The purpose of this study was to prepare and evaluate the prototype device for an Institutional Review Board-approved patient wrist imaging study and provide initial patient imaging results. Materials and Methods A benchtop device was constructed using a carbon nanotube X-ray source array and a flat panel digital detector. Twenty-one X-ray projection images of cadaveric specimens and human subjects were acquired at incident angles from −20 to +20 degrees in various clinical orientations, with entrance dose calibrated to commercial digital tomosynthesis wrist scans. The projection images were processed with an iterative reconstruction algorithm in 1 mm slices. Reconstruction slice images were evaluated by a radiologist for feature conspicuity and diagnostic accuracy. Results The TomoE image quality was found to provide more diagnostic information than DR, with reconstruction slices exhibiting delineation of joint space, visual conspicuity of trabecular bone, bone erosions, fractures, and clear depiction of normal anatomical features. The scan time was 15 seconds and the skin entrance dose was verified to be 0.2 mGy. Conclusions The TomoE device image quality has been evaluated using cadaveric specimens. Dose was calibrated for a patient imaging study. Initial patient images depict a high level of anatomical detail and an increase in diagnostic value compared to DR.
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Ayeni, Philips O., Blessed O. Agbaje, and Maria Tippler. "A Systematic Review of Library Services Provision in Response to COVID-19 Pandemic." Evidence Based Library and Information Practice 16, no. 3 (September 15, 2021): 67–104. http://dx.doi.org/10.18438/eblip29902.
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Objective – Libraries have had to temporarily shut their doors because of the COVID-19 pandemic, resulting in the provision of online and remote services. This review analyzed services offered by libraries, the technological tools used, and the challenges facing libraries during the pandemic. Methods – This study employed a systematic literature review, following the PRISMA checklist (Moher at al., 2009). The Building Blocks search strategy was employed to search for keywords of concepts in Library and Information Science Abstract (LISA), Library and Information Science Technology Abstract (LISTA), Library Science Database, Web of Science (WoS) core collections, and Google Scholar. A set of inclusion and exclusion criteria was pre-determined by the authors prior to database searching. Quality assessment of included studies was performed using the Mixed Methods Appraisal Tool (Hong et al., 2018). A tabular approach was used to provide a summary of each article allowing the synthesis of results, which led to the identification of eight broad categories of services provided by libraries in included studies. Results – The first set of searches from the 5 databases produced 3,499 results. After we removed duplicates and applied the inclusion and exclusion criteria based on titles and abstracts, 37 potentially relevant articles were identified. Further screening of the full-text led to the final inclusion of 23 articles used for the qualitative synthesis. The majority of the studies were conducted in the United States of America (n= 6, 26.1%), followed by India (n=4, 17%), and China (n=2, 8.7%). The remaining studies were carried out in United Kingdom, Ireland, Canada, Mexico, Romania, Czech Republic, Indonesia, Pakistan, Nigeria, Lesotho, and Zimbabwe. The most common method used in selected studies was the case study (n= 11, 48%), followed by survey (n=7, 30.4%), content analysis (n=4, 17.4%), and mixed methods (n=1, 4.3%). The majority of the studies were carried out in academic libraries (74%), while the rest were based on medical, public, and special libraries. Findings show that the majority of academic libraries in the included studies are providing and expanding access to electronic resources (n=16, 69.6%) and increasing open access resources and services (n=11, 47.8%). More so, most academic libraries are assisting in virtual education and teaching endeavors of faculty and students (n=13, 56.5%). In addition, some medical and public libraries are bolstering public health safety through health literacy (n=12, 52.2%), supporting research efforts, and engaging in virtual reference services, among others. In order to carry out these services, libraries are harnessing several educational, social networking, communication, and makerspaces technologies. Most of the libraries in the included studies reported budgetary challenges, and the need for new ICT infrastructure and Internet service as they move their services online. Conclusion – This review found that libraries are adapting in a number of ways to continue their roles in meeting patrons’ needs in spite of the growing challenges posed by COVID-19 restrictions and lockdown. For libraries to thrive in these trying times, there must be a well-structured approach to ensuring continuity of services. Libraries should prioritize the acquisition of electronic resources as well as increase their efforts to digitize resources that are only available in printed copies. As library services have predominantly shifted online, there should be concerted effort and support from government and funding agencies to equip libraries with the technological facilities needed to provide cutting-edge services. The quality assessment of the included studies shows that there is need for rigor and transparency in the methodological description of studies investigating library services provision in a pandemic. This review provides an overview of the ways libraries have responded to the challenges posed by a global pandemic, and hence will be of use and interest to all librarians especially those in health and academic sectors.
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Dewi Teresia, Estiani Sinta, and Hermi Hermi. "PENGARUH STRUKTUR KEPEMILIKAN, UKURAN PERUSAHAAN DAN KEPUTUSAN KEUANGAN TERHADAP NILAI PERUSAHAAN DENGAN PERTUMBUHAN PERUSAHAAN SEBAGAI VARIABEL MODERATING." Jurnal Magister Akuntansi Trisakti 3, no. 1 (February 29, 2016): 73. http://dx.doi.org/10.25105/jmat.v3i1.4969.
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<p>Abukosim, Mukhtaruddin, Ika Sasti Ferina and Claudya Nurcahaya. 2014. Ownership Structure and Firm Value : Empirical Study on Indonesia Manufacturing Listed Company. <em>Journal of Economic</em>. Vol. 5, No. 4.</p><p>Afzal, Arie. 2012. Pengaruh Keputusan Investasi, Keputusan Pendanaan, dan Kebijakan Dividen terhadap Nilai Perusahaan.<em>Skripsi Universitas Diponegoro</em>. Semarang. (tidak dipublikasikan)</p><p>Aries, Heru Prasetyo. 2011. Evaluasi Perusahaan. Jakarta Pusat. PPM.</p><p>Asmawati dan Lailatul Amanah. 2013. Pengaruh Struktur Kepemilikan, Keputusan Keuangan Terhadap Nilai Perusahaan : Profitabilitas sebagai Variabel Moderating. <em>Jurnal Ilmu dan Riset.</em>Vol. 2, No. 4.</p><p>Ashamu, S., Abiola, J., and Badmus, S. 2012. Dividend Policy as Strategic Tool of Financing in Public Firm : Evidence From Nigeria. <em>Europan Scientific Journal</em>. Vol. 8 No. 9. PP : 1-24.</p><p>Belkaoui, A.R. 2007. <em>Accounting Theory</em>. 5th Edition. Buku 2. Edisi Terjemahan. Jakarta: Salemba Empat.</p><p>Bernandhi, Riza. 2013. Pengaruh Kepemilikan Manajerial, Kepemilikan Institusional, Kebijakan Deviden, Leverage dan Ukuran Perusahaan Terhadap Nilai Perusahaan. <em>Skripsi Fakultas Ekonomi dan Bisnis Universitas Diponegoro</em>. (tidak dipublikasikan)</p><p>Brealey, R.A, Myers, S.C, Marcus, A.J.2008. <em>Dasar-Dasar Manajemen Keuangan Perusahaan Jilid I.</em>Jakarta : Erlangga.</p><p>Brigham & Weston. 1998. <em>Dasar-dasar Manajemen Keuangan</em>. Terjemahan : Ali Akbar Yulianto. Jakarta : Salemba Empat.</p><p>Brigham, Eugene F. and Houston, Joel F. 2006. Dasar-Dasar Manajemen Keuangan, diterjemahkan oleh Ali Akbar Yulianto.Edisi sepuluh. Jakarta : PT. Salemba Empat.</p><p>Brigham, Eugene F. and Houston, Joel F. 2007.<em>Essentials of Financial Management</em>. Singapore : Cengage Learning.</p><p>Dewi, Putu Yunita Saputri, Gede Adi Yuniarta dan Ananta Wikrama Tungga Atmadja.2014. Pengaruh Struktur Modal, Pertumbuhan Perusahaan dan Profitabilitas terhadap Nilai Perusahaan pada Perusahaan. <em>Jurnal Akuntansi</em>. Vol. 2 No. 1.</p><p>Downes, John and Jordan Elliot Goodman,1999, Kamus Istilah Akuntansi, Jakarta, Penerbit Elex Media Komputindo.</p><p>Efni, Yulia. 2011. Pengaruh Keputusan Investasi, Keputusan Pendanaan, Kebijakan Dividen terhadap Nilai Perusahaan Studi pada Sektor Properti dan Real Estate di Bursa Efek Indonesia. <em>Jurnal Aplikasi Manajemen</em> : No. 66B/DIKTI/KEP/2011.</p><p>Faizal, Achmad.2011.Pengaruh Kebijakan Dividen, Struktur Kepemilikan dan Biaya Agensi terhadap Harga Saham.</p><p>Gultom, Robinhot dkk. 2013. Analisis Faktor-Faktor yang Mempengaruhi Nilai Perusahaan pada Perusahaan Farmasi di Bursa Efek Indonesia. <em>Jurnal Ekonomi</em>. Vol. 3 No. 1.</p><p>Ghozali, Imam. 2012. <em>Aplikasi Analisis Multivariate dengan Program SPSS</em>. Semarang : Badan Penerbit Universitas Diponegoro.</p><p>Gill, Amarjit. and Obradovich, John D. 2012. The Impact of Corporate Governance and Financial Leverage on the Value of American Firms. International Research <em>Journal of Finance and Economics</em>. PP : 91.</p><p>Harjito, Agus dan Martono. 2006. <em>Manajemen Keuangan</em>. Yogyakarta : Ekonisia.</p><p>Harqiansyah, Rizqi Faisal. 2015. Pengaruh Ukuran Perusahaan, Leverage dan Proftabilitas terhadap Nilai Perusahaan. <em>Jurnal Akuntansi</em>. (tidak dipublikasikan)</p><p>Hasnawati, Sri. 2015. Implikasi Struktur Modal dan Kepemilikan Saham Terhadap Nilai Perusahaan Publik di Bursa Efek Indonesia. <em>Jurnal Akuntansi dan Auditing Indonesia</em>.Vol. 9, No. 2.</p><p>Husnan,S.dan Pudjiastusti.2006.<em>Dasar-Dasar Manajemen Keuangan</em>. Edisi Keempat. Yogyakarta : AMP YKPN.</p><p>Honarbakhsh, S., Birjandi, H., and Birjandi M. 2013.The Effects of Dividend Policy on Market Value on Companies Listed In Tehran Stock Exchange. <em>International Review of Managementand Business Research</em>. Vol. 1, No. 1. PP : 65-75.</p><p>Irawan, Arif, Rina Arifati dan Abrar Oemar. 2016. Pengaruh Aset Berwujud, Ukuran Perusahaan, Pertumbuhan Perusahaan, Lama Perusahaan dan Probabilitas terhadap Kebijakan Hutang pada Perusahaan Manufaktur yang Terdaftar di Bursa Efek Indonesia Periode Tahun 2010-2014. <em>Jurnal Akuntansi</em>. Vol. 2 No. 2.</p><p>Irvaniawati. 2014. Analisis Pengaruh Kebijakan Hutang, Kebijakan Investasi, dan Kebijakan Deviden Terhadap Nilai Perusahaan. <em>Jurnal Ilmu dan Riset Manajemen.</em>Vol. 3, No. 6.</p><p>Jensen, M.C. and Meckling, W.H. 1976. Theory of the Firm : Mangerial Behavior, Agency Cost, and Ownership Structur. <em>Journal of Financial Economics</em>. Vol. 76, PP. 305-360.</p><p>Jogiyanto. 2013. <em>Teori Portofolio dan Analisis Investasi</em>. Edisi Ketujuh. Yogyakarta : BPFEE.</p><p>Kumar, S., Anjum B. and Nayyar S. 2012. Financing Decisions : Study of Pharmaceutical Companies of India. <em>International Journal of Marketing</em>, <em>Financial Services and Management Research</em>. Vol. 1 No. 1. PP. 14-28.</p><p>Kusumajaya, Dewa Kadek Oka. 2011. Pengaruh Struktur Modal dan Pertumbuhan Perusahaan terhadap Profitabilitas dan Nilai Perusahaan pada Perusahaan Manufaktur di Bursa Efek Indonesia. <em>Tesis Universitas Udayana</em>.</p><p>Kouki, Mondher and Hatem ben Said. 2011. Does Management Ownership Explain The Effect of Leverage on Firm Value? An Analysis of French Listed Firms. <em>Journal of Bussiness Studies Quarterly</em>. Vol. 3, No. 1.</p><p>Mandagi, S.E.A. 2010. Pengaruh Keputusan Keuangan terhadap Nilai Perusahaan Manufaktur yang terdaftar di Bursa Efek Indonesia periode 2008-2010.<em>Jurnal Bisnis.</em> Hal : 28-32.</p><p>Marhamah.2013. Pengaruh Manajemen Laba, Ukuran Perusahaan terhadap Corporate Sosial Responsibility dan Nilai Perusahaan pada Perusahaan Manufaktur yang tercatat di Bursa Efek Indonesia tahun 2007-2010. <em>Jurnal STIE Semarang</em>. Vol. 5, No. 3.</p><p>Moeljadi. 2006.<em>Manajemen Keuangan Pendekatan Kuantitatif dan Kualitatif. </em>Edisi Pertama. Malang : Banyumedia Publishing.</p><p>Moradi, Nassim S., Aldin, Mahmood M., Heyrani, F., and Iranmhad, M. 2012. The Effect of Corporate Governance, Corporate Financing Decision and Ownership Structure on Firm Performance: A Panel Data Approach from Tehran Stock Exchange. <em>International Journal of Economics and Finance</em>. Vol. 4, No. 9. PP : 86-93.</p><p>Nabela, Yoandhika.2012. Pengaruh Kepemilikan Institusional, Kebijakan Dividen, dan Profitabilitas terhadap Kebijakan Hutang pada Perusahaan Properti dan Real Estate di Bursa Efek Indonesia.<em>Jurnal Manajemen</em>. Vol. 01, No. 01.</p><p>Nuraina, Elva. 2012. Pengaruh Kepemilikan Institusional dan Ukuran Perusahaan terhadap Kebijakan Hutang dan Nilai Perusahaan. <em>Jurnal Ekonomi</em>. Vol.19 No. 2.</p><p>Pratama, I Gusti Bagus Angga dan I Gusti Bagus Wiksuana. 2016. Pengaruh Ukuran Perusahaan dan <em>Leverage</em> terhadap Nilai Perusahaan dengan Profitabilitas sebagai Variabel Mediasi. <em>Jurnal Manajemen</em>. Vol. 5 No. 2.</p><p>Priyo, Estetika Maulida. 2013. Analisis Pengaruh Return on Asset, Debt to Equty Ratio, Firm Size, Growth dan Free Cash Flow terhadap Dividen Payout Ratio studi empiris pada Perusahaan Manufaktur yang terdaftar di Bursa Efek Indonesia periode 2008-2011. <em>Disertasi Univesitas Diponegoro Semarang. </em></p><p>Ratih, I Dewa Ayu dan I Gusti Ayu Eka Damayanthi. 2016. Kepemilikan Manajerial dan Profitabilitas pada Nilai Perusahaan dengan Pengungkapan Tanggungjawab Sosial sebagai Variabel Moderasi.<em>Jurnal Akuntansi</em>.Universitas Udayana.</p><p>Rizqia, Dwita A., Aisjah S., and Sumiati.2013. 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Dutra, Evelyn De Britto, and Vanessa Cabral Gomes. "Painel de Monitoramento e de Avaliação da Gestão do SUS: um mapeamento das principais fontes de informações públicas de saúde no Brasil com base no modelo sistêmico." Revista Foco 12, no. 3 (October 8, 2019): 04. http://dx.doi.org/10.28950/1981-223x_revistafocoadm/2019.v12i3.710.
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A gestão de serviços de saúde apresenta um contexto desafiador em meio aos diferentes níveis de assistência e estruturas complexas e precisa dispor de uma prática administrativa que otimize os recursos na obtenção de melhores resultados. Essa complexidade pode ser melhor entendida com a abordagem da teoria de sistemas e aplicando técnicas de melhoria para obter os resultados esperados, que de maneira geral representam o atendimento às necessidades de saúde da população. Atualmente no Brasil, existe uma grande quantidade de informações produzidas pelo sistema de saúde que subsidia a criação de indicadores e possibilita o acompanhamento do sistema. Nesse contexto, o objetivo geral desse trabalho é mapear as principais fontes de dados públicos de saúde no Brasil, com base em indicadores Painel de Monitoramento e de Avaliação da Gestão do SUS. Para complementar o painel, buscou-se informações sobre parâmetros para avaliação desses indicadores, o que pode servir de base na compreensão dos dados coletados. Trata-se de uma pesquisa descritiva, realizada por duas etapas: mapeamento das principais fontes de dados online dos indicadores e pesquisa bibliográfica e documental sobre a existência de parâmetros para esses indicadores. O instrumento utilizado na pesquisa, o qual identificou os indicadores do sistema de saúde, é o Painel de Monitoramento e de Avaliação da Gestão do SUS. Dos 17 indicadores selecionados, nove (9) foram encontrados em bases de dados diferentes das apresentadas pelo Painel. Isso mostra a necessidade da revisão periódica da fonte dos dados disponíveis. Em relação aos parâmetros, buscou-se métricas para cada um dos 17 indicadores, sendo identificados 10 indicadores com algum parâmetro oficial para análise. Como já colocado, a inclusão desses parâmetros pode ajudar na avaliação dos indicadores ao ser uma base para comparação dos resultados. Health service management presents a challenging context amidst different levels of care and complex structures, and needs to have an administrative practice that optimizes resources for better results. This complexity can be better understood by the systemic theory and applying improvement techniques to obtain the expected results, which, in general, represents the health needs of the population. Currently in Brazil, there is a great amount of information produced by the health system that subsidizes the creation of indicators and enables monitoring of the system. In this context, the aim of this study is to map the main sources of public health data in Brazil, based on indicators of the Monitoring and Evaluation Panel of SUS’ Management. To complement the panel, information about parameters was sought to evaluate these indicators, which may serve as a basis for understanding the data collected. This is a descriptive research carried out by two steps: mapping of the main online data sources of the indicators and bibliographic and documentary research on the existence of parameters for these indicators.The resource used in the research, which identified the indicators of the health system, is the SUS’ Monitoring and Evaluation Panel. The main results show that of the 17 selected indicators, nine (9) were found in databases other than those presented by the Panel, showing the need of a frequent review of the available data sources. Regarding the parameters, the metrics was searched for each of the 17 indicators, and identified 10 indicators with official parameter for analysis. As mentioned, these official parameters can contribute to increase the evaluation of the indicators, as being a metric-based results comparison.
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Lyons, Jane, Ashley Akbari, Fatemeh Torabi, Gareth I. Davies, Laura North, Rowena Griffiths, Rowena Bailey, et al. "Understanding and responding to COVID-19 in Wales: protocol for a privacy-protecting data platform for enhanced epidemiology and evaluation of interventions." BMJ Open 10, no. 10 (October 2020): e043010. http://dx.doi.org/10.1136/bmjopen-2020-043010.
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IntroductionThe emergence of the novel respiratory SARS-CoV-2 and subsequent COVID-19 pandemic have required rapid assimilation of population-level data to understand and control the spread of infection in the general and vulnerable populations. Rapid analyses are needed to inform policy development and target interventions to at-risk groups to prevent serious health outcomes. We aim to provide an accessible research platform to determine demographic, socioeconomic and clinical risk factors for infection, morbidity and mortality of COVID-19, to measure the impact of COVID-19 on healthcare utilisation and long-term health, and to enable the evaluation of natural experiments of policy interventions.Methods and analysisTwo privacy-protecting population-level cohorts have been created and derived from multisourced demographic and healthcare data. The C20 cohort consists of 3.2 million people in Wales on the 1 January 2020 with follow-up until 31 May 2020. The complete cohort dataset will be updated monthly with some individual datasets available daily. The C16 cohort consists of 3 million people in Wales on the 1 January 2016 with follow-up to 31 December 2019. C16 is designed as a counterfactual cohort to provide contextual comparative population data on disease, health service utilisation and mortality. Study outcomes will: (a) characterise the epidemiology of COVID-19, (b) assess socioeconomic and demographic influences on infection and outcomes, (c) measure the impact of COVID-19 on short -term and longer-term population outcomes and (d) undertake studies on the transmission and spatial spread of infection.Ethics and disseminationThe Secure Anonymised Information Linkage-independent Information Governance Review Panel has approved this study. The study findings will be presented to policy groups, public meetings, national and international conferences, and published in peer-reviewed journals.
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Grusenmeyer, Patrick A., and Yu-Ning Wong. "Interpreting the Economic Literature in Oncology." Journal of Clinical Oncology 25, no. 2 (January 10, 2007): 196–202. http://dx.doi.org/10.1200/jco.2006.09.0738.
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New treatment options provide hope for patients with localized and advanced cancer. However, these advances are associated with cost, both in terms of treatment-related expenditures and effects on quality of life. It is important that patients, physicians, insurers, and policymakers understand the relationship between costs and outcomes of new cancer treatments. Various methods of cost analysis can provide a structured manner to assess cost. Cost-effectiveness analysis (CEA) compares the cost of the intervention with the effect, resulting in a cost per effect (eg, cost per year of life gained) that can be compared across interventions. In this article, we review three recent CEAs in the oncology literature, including chemoprevention in breast cancer, adjuvant endocrine therapy in early-stage breast cancer, and salvage chemotherapy in advanced ovarian cancer. The important elements of CEA, including the recommendations of the US Public Health Service Panel on Cost Effectiveness in Health and Medicine as they relate to cancer treatments, are discussed. Many well-done CEAs in cancer treatment have been performed during the last decade. As with clinical trials, the rigor and methods of the analysis are critical to the reliability of the results. Therapies with high cost and small incremental improvement in survival and/or quality of life may find it difficult to meet the societal thresholds for what is considered cost effective. CEA is a method to assess the cost and effect of cancer treatments, providing important insights into the best use (ie, obtaining the most value for) of health care expenditures. As the literature indicates, one must be cognizant of the fact that there can be extraordinary costs associated with some newer cancer therapies that provide small incremental clinical benefit. Better understanding of the cancer economic literature can help lead to an informed dialogue on the health policy implications of resource allocation in cancer care.