Search results for: evidence analysis
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 30088

Search results for: evidence analysis

29368 E-Governance: A Key for Improved Public Service Delivery

Authors: Ayesha Akbar

Abstract:

Public service delivery has witnessed a significant improvement with the integration of information communication technology (ICT). It not only improves management structure with advanced technology for surveillance of service delivery but also provides evidence for informed decisions and policy. Pakistan’s public sector organizations have not been able to produce some good results to ensure service delivery. Notwithstanding, some of the public sector organizations in Pakistan has diffused modern technology and proved their credence by providing better service delivery standards. These good indicators provide sound basis to integrate technology in public sector organizations and shift of policy towards evidence based policy making. Rescue-1122 is a public sector organization which provides emergency services and proved to be a successful model for the provision of service delivery to save human lives and to ensure human development in Pakistan. The information about the organization has been received by employing qualitative research methodology. The information is broadly based on primary and secondary sources which includes Rescue-1122 website, official reports of organizations; UNDP (United Nation Development Program), WHO (World Health Organization) and by conducting 10 in-depth interviews with the high administrative staff of organizations who work in the Lahore offices. The information received has been incorporated with the study for the better understanding of the organization and their management procedures. Rescue-1122 represents a successful model in delivering the services in an efficient way to deal with the disaster management. The management of Rescue has strategized the policies and procedures in such a way to develop a comprehensive model with the integration of technology. This model provides efficient service delivery as well as maintains the standards of the organization. The service delivery model of rescue-1122 works on two fronts; front-office interface and the back-office interface. Back-office defines the procedures of operations and assures the compliance of the staff whereas, front-office equipped with the latest technology and good infrastructure handles the emergency calls. Both ends are integrated with satellite based vehicle tracking, wireless system, fleet monitoring system and IP camera which monitors every move of the staff to provide better services and to pinpoint the distortions in the services. The standard time of reaching to the emergency spot is 7 minutes, and during entertaining the case; driver‘s behavior, traffic volume and the technical assistance being provided to the emergency case is being monitored by front-office. Then the whole information get uploaded to the main dashboard of Lahore headquarter from the provincial offices. The latest technology is being materialized by Rescue-1122 for delivering the efficient services, investigating the flaws; if found, and to develop data to make informed decision making. The other public sector organizations of Pakistan can also develop such models to integrate technology for improving service delivery and to develop evidence for informed decisions and policy making.

Keywords: data, e-governance, evidence, policy

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29367 The Impact of Governance on Happiness: Evidence from Quantile Regressions

Authors: Chiung-Ju Huang

Abstract:

This study utilizes the quantile regression analysis to examine the impact of governance (including democratic quality and technical quality) on happiness in 101 countries worldwide, classified as “developed countries” and “developing countries”. The empirical results show that the impact of democratic quality and technical quality on happiness is significantly positive for “developed countries”, while is insignificant for “developing countries”. The results suggest that the authorities in developed countries can enhance the level of individual happiness by means of improving the democracy quality and technical quality. However, for developing countries, promoting the quality of governance in order to enhance the level of happiness may not be effective. Policy makers in developed countries may pay more attention on increasing real GDP per capita instead of promoting the quality of governance to enhance individual happiness.

Keywords: governance, happiness, multiple regression, quantile regression

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29366 Reaching the Goals of Routine HIV Screening Programs: Quantifying and Implementing an Effective HIV Screening System in Northern Nigeria Facilities Based on Optimal Volume Analysis

Authors: Folajinmi Oluwasina, Towolawi Adetayo, Kate Ssamula, Penninah Iutung, Daniel Reijer

Abstract:

Objective: Routine HIV screening has been promoted as an essential component of efforts to reduce incidence, morbidity, and mortality. The objectives of this study were to identify the optimal annual volume needed to realize the public health goals of HIV screening in the AIDS Healthcare Foundation supported hospitals and establish an implementation process to realize that optimal annual volume. Methods: Starting in 2011 a program was established to routinize HIV screening within communities and government hospitals. In 2016 Five-years of HIV screening data were reviewed to identify the optimal annual proportions of age-eligible patients screened to realize the public health goals of reducing new diagnoses and ending late-stage diagnosis (tracked as concurrent HIV/AIDS diagnosis). Analysis demonstrated that rates of new diagnoses level off when 42% of age-eligible patients were screened, providing a baseline for routine screening efforts; and concurrent HIV/AIDS diagnoses reached statistical zero at screening rates of 70%. Annual facility based targets were re-structured to meet these new target volumes. Restructuring efforts focused on right-sizing HIV screening programs to align and transition programs to integrated HIV screening within standard medical care and treatment. Results: Over one million patients were screened for HIV during the five years; 16, 033 new HIV diagnoses and access to care and treatment made successfully for 82 % (13,206), and concurrent diagnosis rates went from 32.26% to 25.27%. While screening rates increased by 104.7% over the 5-years, volume analysis demonstrated that rates need to further increase by 62.52% to reach desired 20% baseline and more than double to reach optimal annual screening volume. In 2011 facility targets for HIV screening were increased to reflect volume analysis, and in that third year, 12 of the 19 facilities reached or exceeded new baseline targets. Conclusions and Recommendation: Quantifying targets against routine HIV screening goals identified optimal annual screening volume and allowed facilities to scale their program size and allocate resources accordingly. The program transitioned from utilizing non-evidence based annual volume increases to establishing annual targets based on optimal volume analysis. This has allowed efforts to be evaluated on the ability to realize quantified goals related to the public health value of HIV screening. Optimal volume analysis helps to determine the size of an HIV screening program. It is a public health tool, not a tool to determine if an individual patient should receive screening.

Keywords: HIV screening, optimal volume, HIV diagnosis, routine

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29365 Organizational Resilience in the Perspective of Supply Chain Risk Management: A Scholarly Network Analysis

Authors: William Ho, Agus Wicaksana

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Anecdotal evidence in the last decade shows that the occurrence of disruptive events and uncertainties in the supply chain is increasing. The coupling of these events with the nature of an increasingly complex and interdependent business environment leads to devastating impacts that quickly propagate within and across organizations. For example, the recent COVID-19 pandemic increased the global supply chain disruption frequency by at least 20% in 2020 and is projected to have an accumulative cost of $13.8 trillion by 2024. This crisis raises attention to organizational resilience to weather business uncertainty. However, the concept has been criticized for being vague and lacking a consistent definition, thus reducing the significance of the concept for practice and research. This study is intended to solve that issue by providing a comprehensive review of the conceptualization, measurement, and antecedents of operational resilience that have been discussed in the supply chain risk management literature (SCRM). We performed a Scholarly Network Analysis, combining citation-based and text-based approaches, on 252 articles published from 2000 to 2021 in top-tier journals based on three parameters: AJG ranking and ABS ranking, UT Dallas and FT50 list, and editorial board review. We utilized a hybrid scholarly network analysis by combining citation-based and text-based approaches to understand the conceptualization, measurement, and antecedents of operational resilience in the SCRM literature. Specifically, we employed a Bibliographic Coupling Analysis in the research cluster formation stage and a Co-words Analysis in the research cluster interpretation and analysis stage. Our analysis reveals three major research clusters of resilience research in the SCRM literature, namely (1) supply chain network design and optimization, (2) organizational capabilities, and (3) digital technologies. We portray the research process in the last two decades in terms of the exemplar studies, problems studied, commonly used approaches and theories, and solutions provided in each cluster. We then provide a conceptual framework on the conceptualization and antecedents of resilience based on studies in these clusters and highlight potential areas that need to be studied further. Finally, we leverage the concept of abnormal operating performance to propose a new measurement strategy for resilience. This measurement overcomes the limitation of most current measurements that are event-dependent and focus on the resistance or recovery stage - without capturing the growth stage. In conclusion, this study provides a robust literature review through a scholarly network analysis that increases the completeness and accuracy of research cluster identification and analysis to understand conceptualization, antecedents, and measurement of resilience. It also enables us to perform a comprehensive review of resilience research in SCRM literature by including research articles published during the pandemic and connects this development with a plethora of articles published in the last two decades. From the managerial perspective, this study provides practitioners with clarity on the conceptualization and critical success factors of firm resilience from the SCRM perspective.

Keywords: supply chain risk management, organizational resilience, scholarly network analysis, systematic literature review

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29364 Identifying Dominant Anaerobic Microorganisms for Degradation of Benzene

Authors: Jian Peng, Wenhui Xiong, Zheng Lu

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An optimal recipe of amendment (nutrients and electron acceptors) was developed and dominant indigenous benzene-degrading microorganisms were characterized in this study. Lessons were learnt from the development of the optimal amendment recipe: (1) salinity and substantial initial concentration of benzene were detrimental for benzene biodegradation; (2) large dose of amendments can shorten the lag time for benzene biodegradation occurrence; (3) toluene was an essential co-substance for promoting benzene degradation activity. The stable isotope probing study identified incorporation 13C from 13C-benzene into microorganisms, which can be considered as a direct evidence of the occurrence of benzene biodegradation. The dominant mechanism for benzene removal was identified by quantitative polymerase chain reaction analysis to be nitrate reduction. Microbial analyses (denaturing gradient gel electrophoresis and 16S ribosomal RNA) demonstrated that members of genus Dokdonella spp., Pusillimonas spp., and Advenella spp. were predominant within the microbial community and involved in the anaerobic benzene bioremediation.

Keywords: benzene, enhanced anaerobic bioremediation, stable isotope probing, biosep biotrap

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29363 A Psychosocial Approach to Community Development, Lessons from the Transition Town Movement in Italy

Authors: Anna Zoli

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In recent years, we have been witnessing a surge of locally-sustained communities committed to promoting new ethical economies while fostering the full participation of socially excluded groups and individuals into the labor market. This article explores the practices of a particular community development model, Transition Towns, as implemented in Monteveglio, Italy. Data were gathered throughout two years long ethnography, using multiple qualitative techniques, namely participant observation, document analysis, and semi-structured interviews. Data were analyzed triangulating from multiple sources of evidence and using hybrid thematic analysis. Major findings show that Transition Town movement works on two main axes, vertical and horizontal. Vertical transition involves interactions with an overreaching political, economic, and social structure which is not transitioning, and therefore poses structural resistances to the transformative social change fostered by the TT. Conversely, horizontal transition involves intragroup dynamics within the communal relational and geographical spaces and therefore poses process resistances between 'self and others' to the interpersonal communication between TT members. The study concludes that a psychosocial approach to community development is essential in order to conflate macro-social dynamics and psychological processes that may obstacle grassroots social movements to thrive. Skills from psychosocial disciplines are a unique set that could facilitate communication and relational processes for community development, and ultimately enabling social change.

Keywords: community development, grassroots social movements, psychosocial approaches, Transition Towns

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29362 From E-Government to Cloud-Government Challenges of Jordanian Citizens' Acceptance for Public Services

Authors: Abeer Alkhwaldi, Mumtaz Kamala

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On the inception of the third millennium, there is much evidence that cloud technologies have become the strategic trend for many governments not only developed countries (e.g., UK, Japan, and USA), but also developing countries (e.g. Malaysia and the Middle East region), who have launched cloud computing movements for enhanced standardization of IT resources, cost reduction, and more efficient public services. Therefore, cloud-based e-government services considered as one of the high priorities for government agencies in Jordan. Although of their phenomenal evolution, government cloud-services still suffering from the adoption challenges of e-government initiatives (e.g. technological, human-aspects, social, and financial) which need to be considered carefully by governments contemplating its implementation. This paper presents a pilot study to investigate the citizens' perception of the extent in which these challenges affect the acceptance and use of cloud computing in Jordanian public sector. Based on the data analysis collected using online survey some important challenges were identified. The results can help to guide successful acceptance of cloud-based e-government services in Jordan.

Keywords: challenges, cloud computing, e-government, acceptance, Jordan

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29361 Innovation and Employment in Sub-Saharan Africa: Evidence from Uganda Microdata

Authors: Milton Ayoki, Edward Bbaale

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This paper analyses the relationship between innovation and employment at firm level with the objective of understanding the contribution of the different innovation strategies in fostering employment growth in Uganda. We use National Innovation Survey (micro-data of 705 Ugandan firms) for the period 2011-2014 and follow closely Harrison et al. (2014) structured approach, and relate employment growth to process innovations and to the growth of sales separately due to innovative and unchanged products. We find positive effects of product innovation on employment at firm level, while process innovation has no discernable impact on employment. Although there is evidence to suggest displacement of labour in some cases where firms only introduce new process, this effect is compensated by growth in employment from new products, which for most firms are introduced simultaneously with new process. Results suggest that source of innovation as well as size of innovating firms or end users of innovation matter for job growth. Innovation that develops from within the firm itself (user) and involving larger firms has greater impact on employment than that developed from outside or coming from within smaller firms. In addition, innovative firms are one and half times more likely to survive in the innovation driven economy environment than those that do not innovate. These results have important implications for policymakers and stakeholders in innovation ecosystem. Supporting policies need to be correctly tailored since the impacts depend on the innovation strategy (type) and characteristics and sector of the innovative firms (small, large, industry, etc.). Policies to spur investment, particularly in innovative sectors and firms with high growth potential would have long lasting effects on job creation. JEL Classification: D24, J0, J20, L20, O30.

Keywords: employment, process innovation, product innovation, Sub-Saharan Africa

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29360 Comparing Double-Stranded RNA Uptake Mechanisms in Dipteran and Lepidopteran Cell Lines

Authors: Nazanin Amanat, Alison Tayler, Steve Whyard

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While chemical insecticides effectively control many insect pests, they also harm many non-target species. Double-stranded RNA (dsRNA) pesticides, in contrast, can be designed to target unique gene sequences and thus act in a species-specific manner. DsRNA insecticides do not, however, work equally well for all insects, and for some species that are considered refractory to dsRNA, a primary factor affecting efficacy is the relative ease by which dsRNA can enter a target cell’s cytoplasm. In this study, we are examining how different structured dsRNAs (linear, hairpin, and paperclip) can enter mosquito and lepidopteran cells, as they represent dsRNA-sensitive and refractory species, respectively. To determine how the dsRNAs enter the cells, we are using chemical inhibitors and RNA interference (RNAi)-mediated knockdown of key proteins associated with different endocytosis processes. Understanding how different dsRNAs enter cells will ultimately help in the design of molecules that overcome refractoriness to RNAi or develop resistance to dsRNA-based insecticides. To date, we have conducted chemical inhibitor experiments on both cell lines and have evidence that linear dsRNAs enter the cells using clathrin-mediated endocytosis, while the paperclip dsRNAs (pcRNAs) can enter both species’ cells in a clathrin-independent manner to induce RNAi. An alternative uptake mechanism for the pcRNAs has been tentatively identified, and the outcomes of our RNAi-mediated knockdown experiments, which should provide corroborative evidence of our initial findings, will be discussed.

Keywords: dsRNA, RNAi, uptake, insecticides, dipteran, lepidopteran

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29359 Problems Confronting the Teaching of Sex Education in Some Selected Secondary Schools in the Akoko Region of Ondo State, Nigeria

Authors: Jimoh Abiodun Alaba

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Context: In many traditional African societies, sex education is often considered a taboo topic. However, the importance of sex education is becoming increasingly evident. This study aims to investigate the challenges faced in teaching sex education in selected secondary schools in the Akoko region of Ondo state, Nigeria. Research Aim: The aim of this study is to identify and examine the problems confronting the teaching of sex education in selected secondary schools in the Akoko region of Ondo state, Nigeria. Methodology: The study utilized a multi-stage sampling method. The first stage involved a purposive selection of ten (10) secondary schools in the Akoko region of Ondo State, while the second stage was a random selection of twenty (20) students, each in the selected secondary schools of the study area. This makes a total of two (200) hundred students that were considered for the survey. Descriptive analysis using percentages was employed to analyze the collected data. Factor analysis was also used to identify the most significant problems. Findings: The study revealed that sex education has been neglected in the sampled secondary schools due to traditional African beliefs that do not support the teaching and learning of this subject. Furthermore, there was evidence to suggest that parents also displayed reluctance towards the teaching of sex education, fearing that it might expose students to inappropriate behavior. Consequently, students were deprived of this essential aspect of education necessary for self-awareness and development. Theoretical Importance: This study contributes to the understanding of the challenges faced in teaching sex education in traditional African societies, specifically in the selected secondary schools in the Akoko region of Ondo state, Nigeria. Data Collection: Data were collected through the administration of 200 questionnaires in ten selected secondary schools. Additionally, information was gathered from federal, state, and local government authorities. Analysis Procedures: The collected data were analyzed using descriptive analysis, employing percentage calculations for better interpretation. Furthermore, factor analysis was conducted to isolate the most significant problems identified. Conclusion: The study concludes that sex education in the sampled secondary schools in the Akoko region of Ondo state, Nigeria, has suffered neglect due to traditional African beliefs and parental concerns. Consequently, students are denied an important aspect of education necessary for their self-awareness and development. Recommendations are made to change the negative perception of sex education, enrich the curriculum, and employ qualified personnel for its teaching. Additionally, it is suggested that sex education should be integrated with moral instruction.

Keywords: African traditional belief, sex, sex education, sexual misdemeanor, morality

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29358 The Relationship between Depression, HIV Stigma and Adherence to Antiretroviral Therapy among Adult Patients Living with HIV at a Tertiary Hospital in Durban, South Africa: The Mediating Roles of Self-Efficacy and Social Support

Authors: Muziwandile Luthuli

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Although numerous factors predicting adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) have been broadly studied on both regional and global level, up-to-date adherence of patients to ART remains an overarching, dynamic and multifaceted problem that needs to be investigated over time and across various contexts. There is a rarity of empirical data in the literature on interactive mechanisms by which psychosocial factors influence adherence to ART among PLWHA within the South African context. Therefore, this study was designed to investigate the relationship between depression, HIV stigma, and adherence to ART among adult patients living with HIV at a tertiary hospital in Durban, South Africa, and the mediating roles of self-efficacy and social support. The health locus of control theory and the social support theory were the underlying theoretical frameworks for this study. Using a cross-sectional research design, a total of 201 male and female adult patients aged between 18-75 years receiving ART at a tertiary hospital in Durban, KwaZulu-Natal were sampled, using time location sampling (TLS). A self-administered questionnaire was employed to collect the data in this study. Data were analysed through SPSS version 27. Several statistical analyses were conducted in this study, namely univariate statistical analysis, correlational analysis, Pearson’s chi-square analysis, cross-tabulation analysis, binary logistic regression analysis, and mediational analysis. Univariate analysis indicated that the sample mean age was 39.28 years (SD=12.115), while most participants were females 71.0% (n=142), never married 74.2% (n=147), and most were also secondary school educated 48.3% (n=97), as well as unemployed 65.7% (n=132). The prevalence rate of participants who had high adherence to ART was 53.7% (n=108), and 46.3% (n=93) of participants had low adherence to ART. Chi-square analysis revealed that employment status was the only statistically significant socio-demographic influence of adherence to ART in this study (χ2 (3) = 8.745; p < .033). Chi-square analysis showed that there was a statistically significant difference found between depression and adherence to ART (χ2 (4) = 16.140; p < .003), while between HIV stigma and adherence to ART, no statistically significant difference was found (χ2 (1) = .323; p >.570). Binary logistic regression indicated that depression was statistically associated with adherence to ART (OR= .853; 95% CI, .789–.922, P < 001), while the association between self-efficacy and adherence to ART was statistically significant (OR= 1.04; 95% CI, 1.001– 1.078, P < .045) after controlling for the effect of depression. However, the findings showed that the effect of depression on adherence to ART was not significantly mediated by self-efficacy (Sobel test for indirect effect, Z= 1.01, P > 0.31). Binary logistic regression showed that the effect of HIV stigma on adherence to ART was not statistically significant (OR= .980; 95% CI, .937– 1.025, P > .374), but the effect of social support on adherence to ART was statistically significant, only after the effect of HIV stigma was controlled for (OR= 1.017; 95% CI, 1.000– 1.035, P < .046). This study promotes behavioral and social change effected through evidence-based interventions by emphasizing the need for additional research that investigates the interactive mechanisms by which psychosocial factors influence adherence to ART. Depression is a significant predictor of adherence to ART. Thus, to alleviate the psychosocial impact of depression on adherence to ART, effective interventions must be devised, along with special consideration of self-efficacy and social support. Therefore, this study is helpful in informing and effecting change in health policy and healthcare services through its findings

Keywords: ART adherence, depression, HIV/AIDS, PLWHA

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29357 Exploiting the Potential of Fabric Phase Sorptive Extraction for Forensic Food Safety: Analysis of Food Samples in Cases of Drug Facilitated Crimes

Authors: Bharti Jain, Rajeev Jain, Abuzar Kabir, Torki Zughaibi, Shweta Sharma

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Drug-facilitated crimes (DFCs) entail the use of a single drug or a mixture of drugs to render a victim unable. Traditionally, biological samples have been gathered from victims and conducted analysis to establish evidence of drug administration. Nevertheless, the rapid metabolism of various drugs and delays in analysis can impede the identification of such substances. For this, the present article describes a rapid, sustainable, highly efficient and miniaturized protocol for the identification and quantification of three sedative-hypnotic drugs, namely diazepam, chlordiazepoxide and ketamine in alcoholic beverages and complex food samples (cream of biscuit, flavored milk, juice, cake, tea, sweets and chocolate). The methodology involves utilizing fabric phase sorptive extraction (FPSE) to extract diazepam (DZ), chlordiazepoxide (CDP), and ketamine (KET). Subsequently, the extracted samples are subjected to analysis using gas chromatography-mass spectrometry (GC-MS). Several parameters, including the type of membrane, pH, agitation time and speed, ionic strength, sample volume, elution volume and time, and type of elution solvent, were screened and thoroughly optimized. Sol-gel Carbowax 20M (CW-20M) has demonstrated the most effective extraction efficiency for the target analytes among all evaluated membranes. Under optimal conditions, the method displayed linearity within the range of 0.3–10 µg mL–¹ (or µg g–¹), exhibiting a coefficient of determination (R2) ranging from 0.996–0.999. The limits of detection (LODs) and limits of quantification (LOQs) for liquid samples range between 0.020-0.069 µg mL-¹ and 0.066-0.22 µg mL-¹, respectively. Correspondingly, the LODs for solid samples ranged from 0.056-0.090 µg g-¹, while the LOQs ranged from 0.18-0.29 µg g-¹. Notably, the method showcased better precision, with repeatability and reproducibility both below 5% and 10%, respectively. Furthermore, the FPSE-GC-MS method proved effective in determining diazepam (DZ) in forensic food samples connected to drug-facilitated crimes (DFCs). Additionally, the proposed method underwent evaluation for its whiteness using the RGB12 algorithm.

Keywords: drug facilitated crime, fabric phase sorptive extraction, food forensics, white analytical chemistry

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29356 The Role of Knowledge Management in Innovation: Spanish Evidence

Authors: María Jesús Luengo-Valderrey, Mónica Moso-Díez

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In the knowledge-based economy, innovation is considered essential in order to achieve survival and growth in organizations. On the other hand, knowledge management is currently understood as one of the keys to innovation process. Both factors are generally admitted as generators of competitive advantage in organizations. Specifically, activities on R&D&I and those that generate internal knowledge have a positive influence in innovation results. This paper examines this effect and if it is similar or not is what we aimed to quantify in this paper. We focus on the impact that proportion of knowledge workers, the R&D&I investment, the amounts destined for ICTs and training for innovation have on the variation of tangible and intangibles returns for the sector of high and medium technology in Spain. To do this, we have performed an empirical analysis on the results of questionnaires about innovation in enterprises in Spain, collected by the National Statistics Institute. First, using clusters methodology, the behavior of these enterprises regarding knowledge management is identified. Then, using SEM methodology, we performed, for each cluster, the study about cause-effect relationships among constructs defined through variables, setting its type and quantification. The cluster analysis results in four groups in which cluster number 1 and 3 presents the best performance in innovation with differentiating nuances among them, while clusters 2 and 4 obtained divergent results to a similar innovative effort. However, the results of SEM analysis for each cluster show that, in all cases, knowledge workers are those that affect innovation performance most, regardless of the level of investment, and that there is a strong correlation between knowledge workers and investment in knowledge generation. The main findings reached is that Spanish high and medium technology companies improve their innovation performance investing in internal knowledge generation measures, specially, in terms of R&D activities, and underinvest in external ones. This, and the strong correlation between knowledge workers and the set of activities that promote the knowledge generation, should be taken into account by managers of companies, when making decisions about their investments for innovation, since they are key for improving their opportunities in the global market.

Keywords: high and medium technology sector, innovation, knowledge management, Spanish companies

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29355 Newspaper Headlines as Tool for Political Propaganda in Nigeria: Trend Analysis of Implications on Four Presidential Elections

Authors: Muhammed Jamiu Mustapha, Jamiu Folarin, Stephen Obiri Agyei, Rasheed Ademola Adebiyi, Mutiu Iyanda Lasisi

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The role of the media in political discourse cannot be overemphasized as they form an important part of societal development. The media institution is considered the fourth estate of the realm because it serves as a check and balance to the arms of government (Executive, Legislature and Judiciary) especially in a democratic setup, and makes public office holders accountable to the people. They scrutinize the political candidates and conduct a holistic analysis of the achievement of the government in order to make the people’s representative accountable to the electorates. The media in Nigeria play a seminal role in shaping how people vote during elections. Newspaper headlines are catchy phrases that easily capture the attention of the audience and call them (audience) to action. Research conducted on newspaper headlines looks at the linguistic aspect and how the tenses used has a resultant effect on peoples’ attitude and behaviour. Communication scholars have also conducted studies that interrogate whether newspaper headlines influence peoples' voting patterns and decisions. Propaganda and negative stories about political opponents are stapling features in electioneering campaigns. Nigerian newspaper readers have the characteristic of scanning newspaper headlines. And the question is whether politicians effectively have played into this tendency to brand opponents negatively, based on half-truths and inadequate information. This study illustrates major trends in the Nigerian political landscape looking at the past four presidential elections and frames the progress of the research in the extant body of political propaganda research in Africa. The study will use the quantitative content analysis of newspaper headlines from 2007 to 2019 to be able to ascertain whether newspaper headlines had any effect on the election results of the presidential elections during these years. This will be supplemented by Key Informant Interviews of political scientists or experts to draw further inferences from the quantitative data. Drawing on newspaper headlines of selected newspapers in Nigeria that have a political propaganda angle for the presidential elections, the analysis will correspond to and complements extant descriptions of how the field of political propaganda has been developed in Nigeria, providing evidence of four presidential elections that have shaped Nigerian politics. Understanding the development of the behavioural change of the electorates provide useful context for trend analysis in political propaganda communication. The findings will contribute to how newspaper headlines are used partly or wholly to decide the outcome of presidential elections in Nigeria.

Keywords: newspaper headlines, political propaganda, presidential elections, trend analysis

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29354 Patient Care Needs Assessment: An Evidence-Based Process to Inform Quality Care and Decision Making

Authors: Wynne De Jong, Robert Miller, Ross Riggs

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Beyond the number of nurses providing care for patients, having nurses with the right skills, experience and education is essential to ensure the best possible outcomes for patients. Research studies continue to link nurse staffing and skill mix with nurse-sensitive patient outcomes; numerous studies clearly show that superior patient outcomes are associated with higher levels of regulated staff. Due to the limited number of tools and processes available to assist nurse leaders with staffing models of care, nurse leaders are constantly faced with the ongoing challenge to ensure their staffing models of care best suit their patient population. In 2009, several hospitals in Ontario, Canada participated in a research study to develop and evaluate an RN/RPN utilization toolkit. The purpose of this study was to develop and evaluate a toolkit for Registered Nurses/Registered Practical Nurses Staff mix decision-making based on the College of Nurses of Ontario, Canada practice standards for the utilization of RNs and RPNs. This paper will highlight how an organization has further developed the Patient Care Needs Assessment (PCNA) questionnaire, a major component of the toolkit. Moreover, it will demonstrate how it has utilized the information from PCNA to clearly identify patient and family care needs, thus providing evidence-based results to assist leaders with matching the best staffing skill mix to their patients.

Keywords: nurse staffing models of care, skill mix, nursing health human resources, patient safety

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29353 Relationship Quality, Value Creation Practices and Brand Loyalty in Virtual Communities: Evidence from Facebook Communities

Authors: Zoya Khan, Amina Muzaffar

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Social media based brand communities are communities that are developed around a brand. In the highly globalized world of today, Facebook is undoubtedly being regarded and has been widely recognized as a trendy and well-accepted medium of marketing. By means of a Facebook fan page, organizations can effectually create, enhance, and sustain customer-brand relationship. In this article, we explore whether brand communities based on social media (a special type of online brand communities) have positive effects on the main community elements and value creation practices in the communities as well as on brand trust and brand loyalty. A survey was conducted and 201 valid responses were used for analysis. The results of structural equation modeling show that brand communities established on social media have positive effects on value creation practices. Brand use, impression management practices and brand identification has an impact on brand trust and this brand trust then further leads to brand loyalty.

Keywords: relationship quality, impression management practices, brand identification, brand trust, brand loyalty

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29352 A Patient-Centered Approach to Clinical Trial Development: Real-World Evidence from a Canadian Medical Cannabis Clinic

Authors: Lucile Rapin, Cynthia El Hage, Rihab Gamaoun, Maria-Fernanda Arboleda, Erin Prosk

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Introduction: Sante Cannabis (SC), a Canadian group of clinics dedicated to medical cannabis, based in Montreal and in the province of Quebec, has served more than 8000 patients seeking cannabis-based treatment over the past five years. As randomized clinical trials with natural medical cannabis are scarce, real-world evidence offers the opportunity to fill research gaps between scientific evidence and clinical practice. Data on the use of medical cannabis products from SC patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to report information on the profiles of both patients and prescribed medical cannabis products at SC clinics, and to assess the safety of medical cannabis among Canadian patients. Methods: This is an observational retrospective study of 1342 adult patients who were authorized with medical cannabis products between October 2017 and September 2019. Information regarding demographic characteristics, therapeutic indications for medical cannabis use, patterns in dosing and dosage form of medical cannabis and adverse effects over one-year follow-up (initial and 4 follow-up (FUP) visits) were collected. Results: 59% of SC patients were female, with a mean age of 56.7 (SD= 15.6, range= (19-97)). Cannabis products were authorized mainly for patients with a diagnosis of chronic pain (68.8% of patients), cancer (6.7%), neurological disorders (5.6%), and mood disorders (5.4 %). At initial visit, a large majority (70%) of patients were authorized exclusively medical cannabis products, 27% were authorized a combination of pharmaceutical cannabinoids and medical cannabis and 3% were prescribed only pharmaceutical cannabinoids. This pattern was recurrent over the one-year follow-up. Overall, oil was the preferred formulation (average over visits 72.5%) followed by a combination of oil and dry (average 19%), other routes of administration accounted for less than 4%. Patients were predominantly prescribed products with a balanced THC:CBD ratio (59%-75% across visits). 28% of patients reported at least one adverse effect (AE) at the 3-month follow-up visit and 12% at the six-month FUP visit. 84.8% of total AEs were mild and transient. No serious AE was reported. Overall, the most common side effects reported were dizziness (11.95% of total AEs), drowsiness (11.4%), dry mouth (5.5%), nausea (4.8%), headaches (4.6%), cough (4.4%), anxiety (4.1%) and euphoria (3.5%). Other adverse effects accounted for less than 3% of total AE. Conclusion: Our results confirm that the primary area of clinical use for medical cannabis is in pain management. Patients in this cohort are largely utilizing plant-based cannabis oil products with a balanced ratio of THC:CBD. Reported adverse effects were mild and included dizziness and drowsiness. This real-world data confirms the tolerable safety profile of medical cannabis and suggests medical indications not yet validated in controlled clinical trials. Such data offers an important opportunity for the investigation of the long-term effects of cannabinoid exposure in real-life conditions. Real-world evidence can be used to direct clinical trial research efforts on specific indications and dosing patterns for product development.

Keywords: medical cannabis, safety, real-world data, Canada

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29351 Systematic Review and Meta-analysis Investigating the Efficacy of Walking-based Aerobic Exercise Interventions to Treat Postpartum Depression

Authors: V. Pentland, S. Spilsbury, A. Biswas, M. F. Mottola, S. Paplinskie, M. S. Mitchell

Abstract:

Postpartum depression (PPD) is a form of major depressive disorder that afflicts 10–22% of mothers worldwide. Rising demands for traditional PPD treatment options (e.g., psychiatry), especially in the context of the COVID-19 pandemic, are increasingly difficult to meet. More accessible treatment options (e.g., walking) are needed. The objective of this review is to determine the impact of walking on PPD severity. A structured search of seven electronic databases for randomised controlled trials published between 2000 and July 29, 2021, was completed. Studies were included if walking was the sole or primary aerobic exercise modality. A random-effects meta-analysis was conducted for studies reporting PPD symptoms measured using a clinically validated tool. A simple count of positive/null effect studies was undertaken as part of a narrative summary. Five studies involving 242 participants were included (mean age=~28.9 years; 100% with mild-to-moderate depression). Interventions were 12 (n=4) and 24 (n=1) weeks long. Each assessed PPD severity using the Edinburgh Postnatal Depression Scale (EPDS) and was included in the meta-analysis. The pooled effect estimate suggests that relative to controls, walking yielded clinically significant decreases in mean EPDS scores from baseline to intervention end (pooled MD=-4.01; 95% CI:-7.18 to -0.84, I2=86%). The narrative summary provides preliminary evidence that walking-only, supervised, and group-based interventions, including 90-120+ minutes/week of moderate-intensity walking, may produce greater EPDS reductions. While limited by a relatively small number of included studies, pooled effect estimates suggest walking may help mothers manage PPD. This is the first time walking as a treatment for PPD, an exercise modality that uniquely addresses many barriers faced by mothers has been summarized in a systematic way. Trial registration: PROSPERO (CRD42020197521) on August 16th, 2020

Keywords: postpartum, exercise, depression, walking

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29350 Dynamic Exergy Analysis for the Built Environment: Fixed or Variable Reference State

Authors: Valentina Bonetti

Abstract:

Exergy analysis successfully helps optimizing processes in various sectors. In the built environment, a second-law approach can enhance potential interactions between constructions and their surrounding environment and minimise fossil fuel requirements. Despite the research done in this field in the last decades, practical applications are hard to encounter, and few integrated exergy simulators are available for building designers. Undoubtedly, an obstacle for the diffusion of exergy methods is the strong dependency of results on the definition of its 'reference state', a highly controversial issue. Since exergy is the combination of energy and entropy by means of a reference state (also called "reference environment", or "dead state"), the reference choice is crucial. Compared to other classical applications, buildings present two challenging elements: They operate very near to the reference state, which means that small variations have relevant impacts, and their behaviour is dynamical in nature. Not surprisingly then, the reference state definition for the built environment is still debated, especially in the case of dynamic assessments. Among the several characteristics that need to be defined, a crucial decision for a dynamic analysis is between a fixed reference environment (constant in time) and a variable state, which fluctuations follow the local climate. Even if the latter selection is prevailing in research, and recommended by recent and widely-diffused guidelines, the fixed reference has been analytically demonstrated as the only choice which defines exergy as a proper function of the state in a fluctuating environment. This study investigates the impact of that crucial choice: Fixed or variable reference. The basic element of the building energy chain, the envelope, is chosen as the object of investigation as common to any building analysis. Exergy fluctuations in the building envelope of a case study (a typical house located in a Mediterranean climate) are confronted for each time-step of a significant summer day, when the building behaviour is highly dynamical. Exergy efficiencies and fluxes are not familiar numbers, and thus, the more easy-to-imagine concept of exergy storage is used to summarize the results. Trends obtained with a fixed and a variable reference (outside air) are compared, and their meaning is discussed under the light of the underpinning dynamical energy analysis. As a conclusion, a fixed reference state is considered the best choice for dynamic exergy analysis. Even if the fixed reference is generally only contemplated as a simpler selection, and the variable state is often stated as more accurate without explicit justifications, the analytical considerations supporting the adoption of a fixed reference are confirmed by the usefulness and clarity of interpretation of its results. Further discussion is needed to address the conflict between the evidence supporting a fixed reference state and the wide adoption of a fluctuating one. A more robust theoretical framework, including selection criteria of the reference state for dynamical simulations, could push the development of integrated dynamic tools and thus spread exergy analysis for the built environment across the common practice.

Keywords: exergy, reference state, dynamic, building

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29349 Test of Capital Account Monetary Model of Floating Exchange Rate Determination: Further Evidence from Selected African Countries

Authors: Oloyede John Adebayo

Abstract:

This paper tested a variant of the monetary model of exchange rate determination, called Frankel’s Capital Account Monetary Model (CAAM) based on Real Interest Rate Differential, on the floating exchange rate experiences of three developing countries of Africa; viz: Ghana, Nigeria and the Gambia. The study adopted the Auto regressive Instrumental Package (AIV) and Almon Polynomial Lag Procedure of regression analysis based on the assumption that the coefficients follow a third-order Polynomial with zero-end constraint. The results found some support for the CAAM hypothesis that exchange rate responds proportionately to changes in money supply, inversely to income and positively to interest rates and expected inflation differentials. On this basis, the study points the attention of monetary authorities and researchers to the relevance and usefulness of CAAM as appropriate tool and useful benchmark for analyzing the exchange rate behaviour of most developing countries.

Keywords: exchange rate, monetary model, interest differentials, capital account

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29348 Neuroimaging Markers for Screening Former NFL Players at Risk for Developing Alzheimer's Disease / Dementia Later in Life

Authors: Vijaykumar M. Baragi, Ramtilak Gattu, Gabriela Trifan, John L. Woodard, K. Meyers, Tim S. Halstead, Eric Hipple, Ewart Mark Haacke, Randall R. Benson

Abstract:

NFL players, by virtue of their exposure to repetitive head injury, are at least twice as likely to develop Alzheimer's disease (AD) and dementia as the general population. Early recognition and intervention prior to onset of clinical symptoms could potentially avert/delay the long-term consequences of these diseases. Since AD is thought to have a long preclinical incubation period, the aim of the current research was to determine whether former NFL players, referred to a depression center, showed evidence of incipient dementia in their structural imaging prior to diagnosis of dementia. Thus, to identify neuroimaging markers of AD, against which former NFL players would be compared, we conducted a comprehensive volumetric analysis using a cohort of early stage AD patients (ADNI) to produce a set of brain regions demonstrating sensitivity to early AD pathology (i.e., the “AD fingerprint”). A cohort of 46 former NFL players’ brain MRIs were then interrogated using the AD fingerprint. Brain scans were done using a T1-weighted MPRAGE sequence. The Free Surfer image analysis suite (version 6.0) was used to obtain the volumetric and cortical thickness data. A total of 55 brain regions demonstrated significant atrophy or ex vacuo dilatation bilaterally in AD patients vs. healthy controls. Of the 46 former NFL players, 19 (41%) demonstrated a greater than expected number of atrophied/dilated AD regions when compared with age-matched controls, presumably reflecting AD pathology.

Keywords: alzheimers, neuroimaging biomarkers, traumatic brain injury, free surfer, ADNI

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29347 The Efficacy of Psychological Interventions for Psychosis: A Systematic Review and Network Meta-Analysis

Authors: Radu Soflau, Lia-Ecaterina Oltean

Abstract:

Background: Increasing evidence supports the efficacy of psychological interventions for psychosis. However, it is unclear which one of these interventions is most likely to address negative psychotic symptoms and related outcomes. We aimed to determine the relative efficacy of psychological and psychosocial interventions for negative symptoms, overall psychotic symptoms, and related outcomes. Methods: To attain this goal, we conducted a systematic review and network meta-analysis. We searched for potentially eligible trials in PubMed, EMBASE, PsycInfo, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases up until February 08, 2022. We included randomized controlled trials that investigated the efficacy of psychological for adults with psychosis. We excluded interventions for prodromal or “at risk” individuals, as well as patients with serious co-morbid medical or psychiatric conditions (others than depressive and/or anxiety disorders). Two researchers conducted study selection and performed data extraction independently. Analyses were run using STATA network and mvmeta packages, applying a random effect model under a frequentist framework in order to compute standardized mean differences or risk ratio. Findings: We identified 47844 records and screened 29466 records for eligibility. The majority of eligible interventions were delivered in addition to pharmacological treatment. Treatment as usual (TAU) was the most frequent common comparator. Theoretically driven psychological interventions generally outperformed TAU at post-test and follow-up, displaying small and small-to-medium effect sizes. A similar pattern of results emerged in sensitivity analyses focused on studies that employed an inclusion criterion for relevant negative symptom severity. Conclusion: While the efficacy of some psychological interventions is promising, there is a need for more high-quality studies, as well as more trials directly comparing psychological treatments for negative psychotic symptoms.

Keywords: psychosis, network meta-analysis, psychological interventions, efficacy, negative symptoms

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29346 Risk Factors for Postoperative Recurrence in Indian Patients with Crohn’s Disease

Authors: Choppala Pratheek, Vineet Ahuja

Abstract:

Background: Crohn's disease (CD) recurrence following surgery is a common challenge, and current detection methods rely on risk factors identified in Western populations. This study aimed to investigate the risk factors and rates of postoperative CD recurrence in a tuberculosis-endemic region like India. Retrospective data was collected from a structured database from a specialty IBD clinic by reviewing case files from January 2005 to December 2021. Inclusion criteria involved CD patients diagnosed based on the ECCO-ESGAR consensus guidelines, who had undergone at least one intestinal resection and had a minimum follow-up period of one year at the IBD clinic. Results: A total of 90 patients were followed up for a median period of 45 months (IQR, 20.75 - 72.00). Out of the 90 patients, 61 received ATT prior to surgery, with a mean delay in diagnosis of 2.5 years, although statistically non-significant (P=0.078). Clinical recurrence occurred in 50% of patients, with the cumulative rate increasing from 13.3% at one year to 40% at three years. Among 63 patients who underwent endoscopy, 65.7% showed evidence of endoscopic recurrence, with the cumulative rate increasing from 31.7% at one year to 55.5% at four years. Smoking was identified as a significant risk factor for early endoscopic recurrence (P=0.001) by Cox regression analysis, but no other risk factors were identified. Initiating post-operative medications prior to clinical recurrence delayed its onset (P=0.004). Subgroup analysis indicated that endoscopic monitoring aided in the early identification of recurrence (P=0.001). The findings contribute to enhancing post-operative CD management strategies in such regions where the disease burden is escalating.

Keywords: crohns, post operative, tuberculosis-endemic, risk factors

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29345 Intramuscular Heat Shock Protein 72 and Heme Oxygenase-1 mRNA are Reduced in Patients with Type 2 Diabetes Evidence That Insulin Resistance is Associated with a Disturbed Antioxidant Defense Mechanism

Authors: Ghibeche Abderrahmane

Abstract:

To examine whether genes associated with cellular defense against oxidative stress are associated with insulin sensitivity, patients with type 2 diabetes (n=7) and age-matched (n=5) and young (n=9) control subjects underwent a euglycemic-hyperinsulinemic clamp for 120 min. Muscle samples were obtained before and after the clamp and analyzed for heat shock protein (HSP)72 and heme oxygenase (HO)-1 mRNA, intramuscular triglyceride content, and the maximal activities of β-hyroxyacyl-CoA dehydrogenase (β-HAD) and citrate synthase (CS). Basal expression of both HSP72 and HO-1 mRNA were lower (P < 0.05) by 33 and 55%, respectively, when comparing diabetic patients with age-matched and young control subjects, with no differences between the latter groups. Both basal HSP72 (r = 0.75, P < 0.001) and HO-1 (r = 0.50,P < 0.05) mRNA expression correlated with the glucose infusion rate during the clamp. Significant correlations were also observed between HSP72 mRNA and both β-HAD (r = 0.61, P < 0.01) and CS (r = 0.65, P < 0.01). HSP72 mRNA was induced (P < 0.05) by the clamp in all groups. Although HO-1 mRNA was unaffected by the clamp in both the young and age-matched control subjects, it was increased (P < 0.05) ∼70-fold in the diabetic patients after the clamp. These data demonstrate that genes involved in providing cellular protection against oxidative stress are defective in patients with type 2 diabetes and correlate with insulin-stimulated glucose disposal and markers of muscle oxidative capacity. The data provide new evidence that the pathogenesis of type 2 diabetes involves perturbations to the antioxidant defense mechanism within skeletal muscle.

Keywords: euglycemic-hyperinsulinemic, HSP72, mRNA, diabete

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29344 Epigenomic Analysis of Lgr5+ Stem Cells in Gastrointestinal Tract

Authors: Hyo-Min Kim, Seokjin Ham, Mi-Joung Yoo, Minseon Kim, Tae-Young Roh

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The gastrointestinal (GI) tract of most animals, including murine, is highly compartmentalized epithelia which also provide distinct different functions of its own tissue. Nevertheless, these epithelia share certain characteristics that enhance immune responses to infections and maintain the barrier function of the intestine. GI tract epithelia also undergo regeneration not only in homeostatic conditions but also in a response to the damage. A full turnover of the murine gastrointestinal epithelium occurs every 4-5 day, a process that is regulated and maintained by a minor population of Lgr5+ adult stem cell that commonly conserved in the bottom of crypts through GI tract. Maintenance of the stem cell is somehow regulated by epigenetic factors according to recent studies. Chromatin vacancy, remodelers, histone variants and histone modifiers could affect adult stem cell fate. In this study, Lgr5-EGFP reporter mouse was used to take advantage of exploring the epigenetic dynamics among Lgr5 positive mutual stem cell in GI tract. Cells were isolated by fluorescence-activated cell sorting (FACS), gene expression levels, chromatin accessibility changes and histone modifications were analyzed. Some notable chromatin structural related epigenetic variants were detected. To identify the overall cell-cell interaction inside the stem cell niche, an extensive genome-wide analysis should be also followed. According to the results, nevertheless, we expected a broader understanding of cellular niche maintaining stem cells and epigenetic barriers through conserved stem cell in GI tract. We expect that our study could provide more evidence of adult stem cell plasticity and more chances to understand each stem cell that takes parts in certain organs.

Keywords: adult stem cell, epigenetics, LGR5 stem cell, gastrointestinal tract

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29343 Achieving Supply Chain Competitiveness through Successful Buyer-Supplier Relationships

Authors: Kamran Rashid, Tashfeen M. Azhar, Asad-ur-Rahman Wahla

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Current research aims to understand the role of successful buyer-supplier relationship in achieving supply chain competitiveness in a developing country perspective. Five hypotheses are developed to test structural model. Survey data is collected from the manufacturing sector of Pakistan. Analysis is conducted using Partial Least Squares (PLS) Structural Equation Modeling (SEM) through Smart PLS version 2.0 M3. Results demonstrate positive impact of effective supplier selection, buyer-supplier engagement, and information sharing capability on success of buyer supplier relationship. This successful buyer supplier relationship drives the supply chain firm financial and market performance. Additional analyses with large sample sizes are required in other developing countries to cross validate the results. Current study provides empirical evidence of the role of successful buyer supplier relationship in achieving supply chain competitiveness.

Keywords: supply chain management, successful buyer-supplier relationship, supply chain competitiveness, developing country

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29342 Neonatal Mortality, Infant Mortality, and Under-five Mortality Rates in the Provinces of Zimbabwe: A Geostatistical and Spatial Analysis of Public Health Policy Provisions

Authors: Jevonte Abioye, Dylan Savary

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The aim of this research is to present a disaggregated geostatistical analysis of the subnational provincial trends of child mortality variation in Zimbabwe from a child health policy perspective. Soon after gaining independence in 1980, the government embarked on efforts towards promoting equitable health care, namely through the provision of primary health care. Government intervention programmes brought hope and promise, but achieving equity in primary health care coverage was hindered by previous existing disparities in maternal health care disproportionately concentrated in urban settings to the detriment of rural communities. The article highlights policies and programs adopted by the government during the millennium development goals period between 1990-2015 as a response to the inequities that characterised the country’s maternal health care. A longitudinal comparative method for a spatial variation on child mortality rates across provinces is developed based on geostatistical analysis. Cross-sectional and time-series data was extracted from the World Health Organisation (WHO) global health observatory data repository, demographic health survey reports, and previous academic and technical publications. Results suggest that although health care policy was uniform across provinces, not all provinces received the same antenatal and perinatal services. Accordingly, provincial rates of child mortality growth between 1994 and 2015 varied significantly. Evidence on the trends of child mortality rates and maternal health policies in Zimbabwe can be valuable for public child health policy planning and public service delivery design both in Zimbabwe and across developing countries pursuing the sustainable development agenda.

Keywords: antenatal care, perinatal care, infant mortality rate, neonatal mortality rate, under-five mortality rate, millennium development goals, sustainable development agenda

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29341 Linking Market Performance to Exploration and Exploitation in The Pharmaceutical Industry

Authors: Johann Valentowitsch, Wolfgang Burr

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In organizational research, strategies of exploration and exploitation are often considered to be contradictory. Building on the tradeoff argument, many authors have assumed that a company's market performance should be positively dependent on its strategic balance between exploration and exploitation over time. In this study, we apply this reasoning to the pharmaceutical industry. Using exploratory regression analysis we show that the long-term market performance of a pharmaceutical company is linked to both its ability to carry out exploratory projects and its ability to develop exploitative competencies. In particular, our findings demonstrate that, on average, the company's annual sales performance is higher the better the strategic alignment between exploration and exploitation is balanced. The contribution of our research is twofold. On the one hand, we provide empirical evidence for the initial tradeoff hypothesis and thus support the theoretical position of those who understand exploration and exploitation as strategic substitutes. On the other hand, our findings show that a balanced relationship between exploration and exploitation is also important in research-intensive industries, which naturally tend to place more emphasis on exploration.

Keywords: exploitation, exploration, market performance, pharmaceutical industry, strategy

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29340 Design of Evaluation for Ehealth Intervention: A Participatory Study in Italy, Israel, Spain and Sweden

Authors: Monika Jurkeviciute, Amia Enam, Johanna Torres Bonilla, Henrik Eriksson

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Introduction: Many evaluations of eHealth interventions conclude that the evidence for improved clinical outcomes is limited, especially when the intervention is short, such as one year. Often, evaluation design does not address the feasibility of achieving clinical outcomes. Evaluations are designed to reflect upon clinical goals of intervention without utilizing the opportunity to illuminate effects on organizations and cost. A comprehensive design of evaluation can better support decision-making regarding the effectiveness and potential transferability of eHealth. Hence, the purpose of this paper is to present a feasible and comprehensive design of evaluation for eHealth intervention, including the design process in different contexts. Methodology: The situation of limited feasibility of clinical outcomes was foreseen in the European Union funded project called “DECI” (“Digital Environment for Cognitive Inclusion”) that is run under the “Horizon 2020” program with an aim to define and test a digital environment platform within corresponding care models that help elderly people live independently. A complex intervention of eHealth implementation into elaborate care models in four different countries was planned for one year. To design the evaluation, a participative approach was undertaken using Pettigrew’s lens of change and transformations, including context, process, and content. Through a series of workshops, observations, interviews, and document analysis, as well as a review of scientific literature, a comprehensive design of evaluation was created. Findings: The findings indicate that in order to get evidence on clinical outcomes, eHealth interventions should last longer than one year. The content of the comprehensive evaluation design includes a collection of qualitative and quantitative methods for data gathering which illuminates non-medical aspects. Furthermore, it contains communication arrangements to discuss the results and continuously improve the evaluation design, as well as procedures for monitoring and improving the data collection during the intervention. The process of the comprehensive evaluation design consists of four stages: (1) analysis of a current state in different contexts, including measurement systems, expectations and profiles of stakeholders, organizational ambitions to change due to eHealth integration, and the organizational capacity to collect data for evaluation; (2) workshop with project partners to discuss the as-is situation in relation to the project goals; (3) development of general and customized sets of relevant performance measures, questionnaires and interview questions; (4) setting up procedures and monitoring systems for the interventions. Lastly, strategies are presented on how challenges can be handled during the design process of evaluation in four different countries. The evaluation design needs to consider contextual factors such as project limitations, and differences between pilot sites in terms of eHealth solutions, patient groups, care models, national and organizational cultures and settings. This implies a need for the flexible approach to evaluation design to enable judgment over the effectiveness and potential for adoption and transferability of eHealth. In summary, this paper provides learning opportunities for future evaluation designs of eHealth interventions in different national and organizational settings.

Keywords: ehealth, elderly, evaluation, intervention, multi-cultural

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29339 The Determinants of Corporate Hedging Strategy

Authors: Ademola Ajibade

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Previous studies have explored several rationales for hedging strategies, but the evidence provided by these studies remains ambiguous. Using a hand-collected dataset of 2460 observations of non-financial firms in eight African countries covering 2013-2022, this paper investigates the determinants and extent of corporate hedge use. In particular, this paper focuses on the link between country-specific conditions and the corporate hedging behaviour of firms. To our knowledge, this represents the first African studies investigating the association between country-specific factors and corporate hedging policy. The evidence based on both univariate and multivariate reveal that country-level corruption and government quality are important indicators of the decisions and extent of hedge use among African firms. However, the connection between country-specific factors as a rationale for corporate hedge use is stronger for firms located in highly corrupt countries. This suggest that firms located in corrupt countries are more motivated to hedge due to the large exposure they face. In addition, we test the risk management theories and observe that CEOs educational qualification and experience shape corporate hedge behaviour. We implement a lagged variables in a panel data setting to address endogeneity concern and implement an interaction term between governance indices and firm-specific variables to test for robustness. Generally, our findings reveal that institutional factors shape risk management decisions and have a predictive power in explaining corporate hedging strategy.

Keywords: corporate hedging, governance quality, corruption, derivatives

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