Search results for: public sector hospital

Authors: Itulelo Matiyabu Imaja, Manoj Maharaj, Patrick Ndayizigamiye

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Lack of transparency in public funds management is observed in many African countries. The DR Congo is among the most corrupted countries in Africa, and this is due mainly to lack of transparency and accountability in public funds management. Corruption has a negative effect on the welfare of the country’s citizens and the national economic growth. Public funds collection and allocation are the major areas whereby malpractices such as bribe, extortion, embezzlement, nepotism and other practices related to corruption are prevalent. Hence, there is a need to implement strong mechanisms to enforce transparency in public funds management. Many researchers have suggested some control mechanisms in curbing corruption in public funds management focusing mainly on law enforcement and administrative reforms with little or no insight on the role that ICT can play in preventing and curbing the corrupt behaviour. In the Democratic Republic of Congo (DRC), there are slight indications that the government of the DR Congo is integrating ICT to fight corruption in public funds collection and allocation. However, such government initiatives are at an infancy stage, with no tangible evidence on how ICT could be used effectively to address the issue of corruption in the context of the country. Hence, this research assesses the role that ICT can play for transparency in public funds management and suggest a framework for its adoption in the Democratic Republic of Congo. This research uses the revised Capability model (Capability, Empowerment, Sustainability model) as the guiding theoretical framework. The study uses the exploratory design methodology coupled with a qualitative approach to data collection and purposive sampling as sampling strategy.

Keywords: corruption, DR congo, ICT, management, public funds, transparency

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Authors: Mohd Taufiq bin Azmy, Yahaya Hassan, Shubashini Gnanasan, Loganathan Fahrni

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Inappropriate prescribing in older patients has been associated with resource utilization and adverse drug events (ADE) such as hospitalization, morbidity and mortality. Globally, there is a lack of published data on ADE induced by inappropriate prescribing. Our study is specific to an older population and is aimed at identifying risk factors for ADE and to develop a model that will link ADE to inappropriate prescribing. The design of the study was prospective whereby computerized medical records of 302 hospitalized elderly aged 65 years and above in 3 public hospitals in Malaysia (Hospital Serdang, Hospital Selayang and Hospital Sungai Buloh) were studied over a 7 month period from September 2013 until March 2014. Potentially inappropriate medications and potential prescribing omissions were determined using the published and validated START-STOPP criteria. Patients who had at least one inappropriate medication were included in Phase II of the study where ADE were identified by local expert consensus panel based on the published and validated Naranjo ADR probability scale. The panel also assessed whether ADE were causal or contributory to current hospitalization. The association between inappropriate prescribing and ADE (hospitalization, mortality and adverse drug reactions) was determined by identifying whether or not the former was causal or contributory to the latter. Rate of ADE avoidability was also determined. Our findings revealed that the prevalence of potential inappropriate prescribing was 58.6%. A total of ADEs were detected in 31 of 105 patients (29.5%) when STOPP criteria were used to identify potentially inappropriate medication; All of the 31 ADE (100%) were considered causal or contributory to admission. Of the 31 ADEs, 28 (90.3%) were considered avoidable or potentially avoidable. After adjusting for age, sex, comorbidity, dementia, baseline activities of daily living function, and number of medications, the likelihood of a serious avoidable ADE increased significantly when a potentially inappropriate medication was prescribed (odds ratio, 11.18; 95% confidence interval [CI], 5.014 - 24.93; p < .001). The medications identified by STOPP criteria, are significantly associated with avoidable ADE in older people that cause or contribute to urgent hospitalization but contributed less towards morbidity and mortality. Findings of the study underscore the importance of preventing inappropriate prescribing.

Keywords: adverse drug events, appropriate prescribing, health services research

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Authors: Maria Kralova, Michal Palecek

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We have detected factors leading to recidivism (the Czech Republic data). The employment during imprisonment turned out to be the most significant predictor with a positive effect on reduction of a rate of recidivism. Accordingly, we mainly focus on this predictor and its economic consequences. Smart public policy can cut government costs dramatically as more than a half of prisoners in the Czech Republic are recidivists. The operating cost cut of the Czech prison service could be CZK 127,680,000 (USD 5,889,623) in 2013 if a public policy had been set smarter.

Keywords: cost-cut, effective, optimal, public policy, reducing recidivism

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Authors: Winiswa Mavutha

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The adoption of sustainable textiles and smart apparel technology is crucial for the South African healthcare sector. It’s all about finding innovative solutions to track patient health and improve overall healthcare delivery. This research focuses on how sustainable textile fibers can be integrated with smart apparel technologies by utilizing embedded sensors and some serious data analytics—to enable real-time monitoring of patients. Smart apparel technology conducts constant monitoring of patients’ heart rate, temperature, and blood pressure, including delivering medication electronically, which enhances patient care and reduces hospital readmissions. Currently, the South African healthcare system has its own set of challenges, such as limited resources and a heavy disease burden. Apparel and textile manufacturers in South Africa can address these challenges while promoting environmental sustainability through waste reduction and decreased reliance on harmful chemicals that are typically utilized in traditional textile manufacturing. The study will emphasize the importance of sustainable practices in the textile supply chain. Additionally, this study will examine the importance of collaborative initiatives among stakeholders—such as government entities healthcare providers, including textile and apparel manufacturers, which promotes an environment that fosters innovation in sustainable smart textiles and apparel technology. If South Africa taps into its local resources and skills, it could be a pioneer in the global South for creating eco-friendly healthcare solutions. This aligns perfectly with global sustainability trends and sustainable development goals. The study will use a mixed-method approach by conducting surveys, focus group interviews, and case studies with healthcare professionals, patients, as well as textile and apparel manufacturers. The utilization of sustainable smart textiles doesn’t only enhance patient care through better monitoring, but it also supports a circular economy with biodegradable fibers and minimal textile waste. There’s a growing acknowledgment in the global healthcare sector about the benefits of smart textiles for personalized medicine, and South Africa has the chance to use this advancement to enhance its healthcare services while also addressing some persistent environmental challenges.

Keywords: smart apparel technologies, sustainable textiles, south African healthcare innovation, technology acceptance model

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Authors: Hazem Abuorf

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From the perspective of viewing urban design as the architecture of public spaces, the latter has many advantages; for example, in achieving attractive and vibrant public spaces, ensuring safety and amenity, supporting a strong sense of place and local character. Besides all advantages, such spaces nevertheless trigger numerous dilemmas, how to design urban spaces preserving the quality of life in the long term while equally achieving cohesion between new urban developments and the already existing urban structure without causing a split in history through the cause of functional and aesthetic degradation. Analysis of this article seeks to propose a methodology deemed essential for assessing and stimulating design criteria of the public spaces when rehabilitating urban sites. The method’s utility is shown by analyzing rehabilitation projects in Gaza Strip, whose design of the public spaces has mainly focused on the physical aspect ignoring the place’s local identity, users’ needs, and history. The proposed methodology serves as a guide for municipal authorities and technical teams to deal with interventions that would rework the role of urban design towards making sense of place.

Keywords: urban design, public realm, rehabilitation projects, quality of life

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Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

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Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

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Authors: Sergio Zabala-Vargas, Miguel Jiménez-Barrera, Luz VArgas-Sánchez

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In recent years, information related to project management in organizations has been increasing exponentially. Performance data, management statistics, indicator results have forced the collection, analysis, traceability, and dissemination of project managers to be essential. In this sense, there are current trends to facilitate efficient decision-making in emerging technology projects, such as: Machine Learning, Data Analytics, Data Mining, and Big Data. The latter is the most interesting in this project. This research is part of the thematic line Construction methods and project management. Many authors present the relevance that the use of emerging technologies, such as Big Data, has taken in recent years in project management in the construction sector. The main focus is the optimization of time, scope, budget, and in general mitigating risks. This research was developed in the northeastern region of Colombia-South America. The first phase was aimed at diagnosing the use of emerging technologies (Big-Data) in the construction sector. In Colombia, the construction sector represents more than 50% of the productive system, and more than 2 million people participate in this economic segment. The quantitative approach was used. A survey was applied to a sample of 91 companies in the construction sector. Preliminary results indicate that the use of Big Data and other emerging technologies is very low and also that there is interest in modernizing project management. There is evidence of a correlation between the interest in using new data management technologies and the incorporation of Building Information Modeling BIM. The next phase of the research will allow the generation of guidelines and strategies for the incorporation of technological tools in the construction sector in Colombia.

Keywords: big data, building information modeling, tecnology, project manamegent

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Authors: Thomas Chinwe Urama, Patrick Oseloka Ezepue, Peters Chimezie Nnanwa

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This paper investigates the universal financial dynamics in two dominant stock markets in Sub-Saharan Africa, through an in-depth analysis of the cross-correlation matrix of price returns in Nigerian Stock Market (NSM) and Johannesburg Stock Exchange (JSE), for the period 2009 to 2013. The strength of correlations between stocks is known to be higher in JSE than that of the NSM. Particularly important for modelling Nigerian derivatives in the future, the interactions of other stocks with the oil sector are weak, whereas the banking sector has strong positive interactions with the other sectors in the stock exchange. For the JSE, it is the oil sector and beverages that have greater sectorial correlations, instead of the banks which have the weaker correlation with other sectors in the stock exchange.

Keywords: random matrix theory, cross-correlations, emerging markets, option pricing, eigenvalues eigenvectors, inverse participation ratios and implied volatility

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Authors: Caroline Bradbury-Jones, Maria Clark, Eleanor Molloy, Nicki Ward

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Background: Significant developments in the protection of Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) rights culminated in their inclusion in the Equality Act 2010. This provides legal protection against discrimination including the Public Sector Equality Duty requiring public bodies to consider all individuals when carrying out their day-to-day work. In the UK, whilst the Higher Education sector has made some commitment to eliminating discrimination and addressing LGBTQ inclusivity, there are two particular problems specifically affecting students on professional programmes: -All students will come into contact with LGBTQ patients/clients/students and need to be equipped to respond appropriately to their diverse needs but evidence suggests that this is not always the case. -Many LGBTQ students have specific concerns on professional placements; often ‘going back in the closet’ or feeling uncertain how to respond to questions about their personal lives and being reticent to challenge discrimination against LGBTQ patients/clients/students for fear of reprisal. Study aim: To investigate how best to prepare all students to deal with the issue of gender and sexual diversity and to support LGBTQ students in negotiating (non) disclosure in practice placements. Methods: This multi-method study was conducted in 2017 in the UK. It comprised a student survey, focus group interview with students and a national benchmarking exercise. Findings: Preliminary findings are that there is considerable variation across professional programmes regarding the preparation of students to respond to LGBTQ issues. Similarly, there is considerable difference between the level of preparedness experienced by students irrespective of whether they identify as LGBTQ. Discussion: Nationally there are a number of ‘best practice’ examples that we share in this presentation. These contain important details and guidance about how to better prepare university students for professional practice, and to contribute to eliminating discrimination and addressing LGBTQ inclusivity. Conclusions: The presentation will appeal to delegates who are interested in the equality agenda regarding LGBTQ people. The study findings will be discussed and debated to explore their impact on higher education and learning and to identify ways to integrate best practice into professional curricula across the UK and beyond.

Keywords: diversity, equality, practice, sexuality, students, university

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Authors: Sharjeel Saleem

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The glass ceiling has been a burning issue for many researchers. In this research, we examine gender of the BOD, training and development, workforce diversity, positive attitude towards women, and employee acts as antecedents of glass ceiling. Furthermore, we also look for effects of glass ceiling on likelihood of female selection and promotion and on female effectiveness. Multiple linear regression conducted on data drawn from different public and private sector organizations support our hypotheses. The research, however, is limited to Faisalabad city and only females from minority group are targeted here.

Keywords: glass ceiling, stereotype attitudes, female effectiveness

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Authors: María García-García, Esther Simancas-González, Said Balhadj, Carmen Silva-Robles, Driss Ferhane

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Cooperation between the territories on both sides of the Strait of Gibraltar is an urgent reality. the south of Spain and northern Morocco share a common historical past and belong to a very similar geographical and ecological area. Economic, social and cultural relations make cooperation between the two countries’ (Spain and Morocco) a priority for the EU and both countries governments. Likewise, deepened changes happened in production systems and consumption patterns had seriously damaged and weakened the craftwork sector. The promotion of local crafts, and its economic value, and the cooperation with the north of Morocco has been an important issue for the Andalusian government in recent years. The main aim of this work is to understand the strengths and weaknesses of the Tangier - Tetuan region craftworks sector in order to develop accurate communication and promotion plans. From the knowledge of the real identity, the sector could be repositioned. Promotion and communication could be a spur to traditional sectors, such as crafts. Competitiveness requires "the culture of communication, the cooperation between different companies to build powerful territory brands and maintain the establishment confidence and effectiveness relationships among agencies and organizations". The lack of previous literature addressing how Tangier craftwork promote and communicate its value to their stakeholders, has conducted the study to an exploratory approach with a double dimension: internal, Tangier craftwork sector image, and external, Andalusia image of the sector in Tangier. Different interviews were conducted with Andalusian partners involved in the artisanal sector (9 master craftsmen and 3 institutions) and focus groups with 9 Tangiers craftsmen were developed. The result of these interviews and expert groups are reflected in a SWOT analysis which reveals a handcraft industry with a worrying wide-spread and undifferentiated identity and reluctance to innovation and new technologies.

Keywords: communication management, image, Moroccan crafts, Spain-Morocco cooperation

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Authors: Majed Ahmed Alfayad

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Technology is now present in almost all areas and practices globally, and this has led governments around the world to adopt technology in the public sector. Therefore, electronic government has been introduced as a means of the automation of government services. New technologies and trends appear every single day, and governments need to meet the citizen’s requirements and expectations in order to succeed in the E-Government program. This research investigates the potential of mobile government as an enhancement force for the E-Government project in the Kingdom of Saudi Arabia, where the usage of mobile technology is coming to be favoured by citizens. Qualitative methodology has been adopted in this study for the data collection and analysis, and in particular the grounded theory approach.

Keywords: e-government, e-participation, m-government, mobile technology

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Authors: Marah El-Beeli, Abdullah Balkhair, Zakaryia Al Muharmi, Samir Al Adawi, Mansoor Al-Jabri, Abdullah Al Rawahi, Hazaa Al Yahyae, Eman Al Balushi, Yahya M. Al-Farsi

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The health care service and the anticancer chemotherapeutics has changed the natural history of cancer into manageable chronic disease and improve the cancer patient’s lifestyle and increase the survival time. Despite that, still, infection is the major dilemma opposing the cancer patient either because of the clinical presentation of the cancer type and impaired immune system or as a consequence of anticancer therapy. This study has been conducted to1) track changes in the epidemiology of hospital-acquired bloodstream infections among patients with malignancies in the last five years. 2) To explore the causative pathogens and 3) the outcome of HA-BSIs in patients with a different types of malignancies. An ampi-directional study (retrospective and prospective follow up) of patients with malignancies admitted at Sultan Qaboos University hospital (570-bed tertiary hospital) during the study period (from January 2015 to December 2019). The cumulative frequency and prevalence rates of HA-BSIs by patients and isolates were calculated. In addition, the cumulative frequency of participants with single versus mixed infections and types of causative micro-organisms of HA-BSIs were obtained. A total of 1246 event of HA-BSIs has occurred during the study period. Nearly the third (30.25%) of the HA-BSI events was identified among 288 patients with malignancies. About 20% of cases were mixed infections (more than one isolate). Staphylococcus spp were the predominant isolated pathogen (24.7%), followed by Klebsiella spp (15.8%), Escherichia spp (13%), and Pseudomonas spp (9.3%). About half (51%) of cases died in the same year, and (64%) of the deaths occur within two weeks after the infection. According to the observations, no changes in the trends of epidemiology, causative pathogens, morbidity, and mortality rates in the last five years.

Keywords: epidemiology, haematological malignancies, hospital acquired bloodstream infections, solid malignancies

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Authors: Hee Sun (Sunny) Choi, Gerhard Bruyns, Wang Zhang, Sky Cheng, Saijal Sharma

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This research addresses the need for a comprehensive framework that can guide the design and assessment of multi-level public spaces and public realms and their impact on the built environment. The study aims to understand and measure the neural mechanisms involved in this process. By doing so, it can lay the foundation for vertical and volumetric urbanism and ensure consistency and excellence in the field while also supporting scientific research methods for urban design with cognitive neuroscientists. To investigate these aspects, the paper focuses on the neighborhood scale in Hong Kong, specifically examining multi-level public spaces and quasi-public spaces within both commercial and residential complexes. The researchers use predictive Artificial Intelligence (AI) as a methodology to assess and comprehend the applicability of the urban design framework for vertical and volumetric urbanism. The findings aim to identify the factors that contribute to successful public spaces within a vertical living environment, thus introducing a new typology of public spaces.

Keywords: vertical urbanism, scientific research methods, spatial cognition, urban design guideline

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Authors: Dave Kenneth Tayao Cayado, Carlo P. Magno

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The most common source of bias detected are those of gender and socioeconomic status. The present study investigated the Differential Item Functioning (DIF) or item bias between public and private school students in a vocabulary test. Studies on DIF were expanded by using the type of school as a source of bias. There were 200 participants in this study. 100 came from a public secondary school and 100 came from a private secondary school. The vocabulary skills of students were measured using a standardized vocabulary test for grade 7 students. Using DIF, specifically the Rasch-Welch approach, it was found that out of 24 items, 12 were biased for a specific group. The vocabulary skills on the use of slang, idiomatic expression, personification, collocations, and partitive relations were biased for private schools while the use of slang and homonymous words were biased for public school students. The analysis debunked the trend that private school students are outperforming public school students in terms of academic achievement. It was revealed that there are some competencies that private school students are having difficulty and vice versa.

Keywords: differential item functioning, item bias, public school students, private school students, vocabulary

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Authors: Mrigakshi Das

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The private sector investments and quantum of money required in this sector critically hinges on the financial risk and returns the sector offers to providers of capital. Therefore, it becomes important to understand financial performance of hospitals. Financial Analysis is useful for decision makers in a variety of settings. Consider the small proprietary hospitals, say, Physicians Clinic. The managers of such clinic need the information that financial statements provide. Attention to Financial Statements of healthcare Organizations can provide answers to questions like: How are they doing? What is their rate of profit? What is their solvency and liquidity position? What are their sources and application of funds? What is their Operational Efficiency? The researcher has studied Financial Statements of 5 Private Healthcare Organizations in Guwahati City.

Keywords: not-for-profit organizations, financial analysis, ratio analysis, profitability analysis, liquidity analysis, operational efficiency, capital structure analysis

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Authors: Emeshaw Damtew Zebene, Edom Seife, Hagos Tesfay, Gurja Belay

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Background: cancer incidence and mortality has grown rapidly throughout the world. Aging of the population, urbanization, physical inactivity, economic growth followed by smoking and drinking contributed a lot for the increased incidence of cancer all over the globe. Objective: the aim of this study was to assess a one-year trend of cancer patients who underwent curative/radical radiotherapy at radiotherapy center, Tikur Anbessa specialized hospital, Ethiopia. Methodology: We performed a prospective descriptive study of cancer patients treated with LINAC at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia, from April 2021- March 2022. A standardized questionnaire was used to collect sociodemographic and clinical characteristics of the patients. Descriptive statistics and chi-square results were generated using SPSS version 24. The level of significance was obtained at 0.05. Results: Sixty-four (64) curative/radical patients-44 females and 20 males were analyzed. Majority, 27(42.2%), of the patients age range from 45 to 64, and 45(70%) of them were urban residents where a group of higher gynecologic cancer was observed.78% of the patients were with locally advanced cancer, and 54(84.4%) of them had no awareness about cancer. Generally, head & neck cancer were found the most prevalent cancer 20(31.3%), and the leading cause of cancer among women was cervical cancer 17(38.6%), where about half 7(15.9%) of them were HIV positive. Conclusion: Our finding revealed that most of curative/radical patients presented at a locally advanced stage of the disease. Hence, maintaining the already available teletherapy machines and installing additional radiotherapy centers may help in treating the patients at the early stage of the disease. Since almost all of our study participants did not have information about cancer, awareness raising mechanisms should be done. Additionally, understanding differences in cancer incidence between urban and rural is important. Key words: Cancer, Curative/radical, Radiotherapy, Tikur Anbessa Specialized Hospital

Keywords: cancer, curative/radical, radiotherapy, tkur anbessa specialized hospital

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Authors: Delly C. Lestari, Linosefa, Ardiana Kusumaningrum, Andi Yasmon, Anis Karuniawati

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The objective of this study is to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mecA genes from screening isolates among intensive care unit (ICU) patients. All MRSA screening isolates from ICU’s patients of Cipto Mangunkusumo Hospital during 2011 and 2014 were included in this study. Identification and susceptibility test was performed using Vitek2 system (Biomereux®). PCR was conducted to characterize the SCCmec of S. aureus harboring the mecA gene on each isolate. Patient’s history of illness was traced through medical record. 24 isolates from 327 screening isolates were MRSA positive (7.3%). From PCR, we found 17 (70.8%) isolates carrying SCCmec type I, 3 (12.5%) isolates carrying SCCmec type III, and 2 (8.3%) isolates carrying SCCmec type IV. In conclusion, SCCmec type I is the most prevalent MRSA colonization among ICU patients in Cipto Mangunkusumo Hospital.

Keywords: MRSA, mecA genes, ICU, colonization

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Authors: S. Halioui, I. Arikan, M. Schmidt

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Tourism sector in Tunisia faces several problems that range from economic challenges to environmental degradation and social instability. These problems have been intensified because of the increased competition in the tourism market, the political instability, financial crises, and recently terrorism problems have aggravated the situation. As a consequence, a new framework that promotes sustainable tourism in the country and increases its competitiveness is urgently needed. Planning for sustainable tourism sector requires the integration of complex interactions between economic, social and environmental aspects. Sustainable tourism principles can be implemented with the help of Strategic Environmental Assessment (SEA) process, which ensures the full integration of economic, social and environmental considerations while planning for the tourism sector in Tunisia. Results of the paper have broad implications for policy makers and tourism professionals.

Keywords: sustainable tourism, strategic environmental assessment, tourism planning, policy

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Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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Authors: Sharon Jackson White

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Purpose: Nurse practitioners (NPs) practicing within hospital medicine play a significant role in caring for patients who might benefit from palliative care (PC) services. Using the Theory of Planned Behavior, the purpose of this study was to examine the relationships among facilitators to referral, barriers to referral, self-efficacy with end-of-life discussions, history of referral, and referring to PC among NPs in hospital medicine. Hypotheses: 1) Perceived facilitators to referral will be associated with a higher history of referral and a higher number of referrals to PC. 2) Perceived barriers to referral will be associated with a lower history of referral and a lower number of referrals to PC. 3) Increased self-efficacy with end-of-life discussions will be associated with a higher history of referral and a higher number of referrals to PC. 4) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the history of referral to PC. 5) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the number of referrals to PC. Significance: Previous studies of referring patients to PC within the hospital setting care have focused on physician practices. Identifying factors that influence NPs referring hospitalized patients to PC is essential to ensure that patients have access to these important services. This study incorporates the SNRS mission of advancing nursing research through the dissemination of research findings and the promotion of nursing science. Methods: A cross-sectional, predictive correlational study was conducted. History of referral to PC, facilitators to referring to PC, barriers to referring to PC, self-efficacy in end-of-life discussions, and referral to PC were measured using the PC referral case study survey, facilitators and barriers to PC referral survey, and self-assessment with end-of-life discussions survey. Data were analyzed descriptively and with Pearson’s Correlation, Spearman’s Rho, point-biserial correlation, multiple regression, logistic regression, Chi-Square test, and the Mann-Whitney U test. Results: Only one facilitator (PC team being helpful with establishing goals of care) was significantly associated with referral to PC. Three variables were statistically significant in relation to the history of referring to PC: “Inclined to refer: PC can help decrease the length of stay in hospital”, “Most inclined to refer: Patients with serious illnesses and/or poor prognoses”, and “Giving bad news to a patient or family member”. No predictor variables contributed a significant variance in the number of referrals to PC for all three case studies. There were no statistically significant results showing a relationship between the history of referral and referral to PC. All five hypotheses were partially supported. Discussion: Findings from this study emphasize the need for further research on NPs who work in hospital settings and what factors influence their behaviors of referring to PC. Since there is an increase in NPs practicing within hospital settings, future studies should use a larger sample size and incorporate hospital medicine NPs and other types of NPs that work in hospitals.

Keywords: palliative care, nurse practitioners, hospital medicine, referral

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Authors: Galih Imaduddin

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Knowledge has been viewed as one of the most important resources in organizations, including those that operate in the healthcare sector. On that basis, Knowledge Management (KM) is crucial for healthcare organizations to improve their productivity and ensure effective utilization of their resources. Despite the growing interests to understand how KM might work for healthcare organizations, there is only a modest amount of empirical inquiries which have specifically focused on the tools and initiatives to share knowledge. Hence, the main purpose of this paper is to investigate the way healthcare organizations, particularly public sector ones, utilize knowledge sharing tools and initiatives for the benefit of patient-care. Employing a qualitative method, 13 (thirteen) Community Health Centers (CHCs) from a high-performing district health setting in Indonesia were observed. Data collection and analysis involved a repetition of document retrievals and interviews (n=41) with multidisciplinary health professionals who work in these CHCs. A single case study was cultivated reflecting on the means that were used to share knowledge, along with the factors that inhibited the exchange of knowledge among those health professionals. The study discovers that all of the thirteen CHCs exhibited and applied knowledge sharing means which included knowledge documents, virtual communication channels (i.e. emails and chatting applications), and social learning forums such as staff meetings, morning briefings, and communities of practices. However, the intensity of utilization was different among these CHCs, in which organizational culture, leadership, professional boundaries, and employees’ technological aptitude were presumed to be the factors that inhibit knowledge sharing processes. Making a distance with the KM literature of other sectors, this study denounces the primacy of technology-based tools, suggesting that socially-based initiatives could be more reliable for sharing knowledge. This suggestion is largely due to the nature of healthcare work which is still predominantly based on the tacit form of knowledge.

Keywords: knowledge management, knowledge sharing, knowledge sharing tools and initiatives, knowledge sharing inhibitors, primary health care organizations

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Authors: Yuhiro Mizunuma, Keita Tsuji

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In Japan, local governments have long managed public libraries; however, organizations including private enterprises took over their management with the introduction of an outsourcing system in 2003. Now, whether local governments should apply this system to public libraries is under discussion, and many argue that it is inappropriate for public libraries. In this study, to provide basic data for such discussions, the differences between public libraries managed by outsourcing (henceforth, 'outsourcing libraries') and those managed directly by local governments (henceforth 'direct management libraries') were examined, focusing on bestsellers. We chose the 435 books on the top-20 bestseller lists published from 1996 to 2015 inclusive, as our sample bestseller books; and 413 outsourcing libraries' and 2,619 direct management libraries' holdings of them were investigated using the Calil API (a free Web service that can perform cross-library searches on libraries in Japan). Results show that outsourcing libraries tend to hold fewer bestsellers than direct management libraries. It was also found that direct management libraries tend to hold many duplicates of bestsellers, and that, in many cases, many of those were not being borrowed in direct management libraries.

Keywords: bestseller books, book collection, Japanese public libraries, outsourcing

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Authors: Bruno Valverde Chahaira, Matheus Jeronimo Low Lopes, Marta Beatriz Tanaka Ferdinandi

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This paper proposes to dissect the meanings and / or directions of the State, in order, to present the State models to elaborate a conceptual framework about its function in the legal scope. To do so, it points out the possible contracts established between the State and the Society, since the general principles immanent in them can guide the models of society in force. From this orientation arise the contracts, whose purpose is by the effect to modify the status (the being and / or the opinion) of each of the subjects in presence - State and Society. In this logic, this paper announces the fiduciary contracts and “veredicção”(portuguese word) contracts, from the perspective of semiotics discourse (or greimasian). Therefore, studies focus on the issue of manifest language in unilateral and bilateral or reciprocal relations between the State and Society. Thus, under the biases of the model of the communicative situation and discourse, the guidelines of these contractual relations will be analyzed in order to see if there is a pragmatic sanction: positive when the contract is signed between the subjects (reward), or negative when the contract between they are broken (punishment). In this way, a third path emerges which, in this specific case, passes through the subject-third sector. In other words, the proposal, which is systemic in nature, is to analyze whether, since the contract of the welfare state is not carried out in the constitutional program on fundamental rights: education, health, housing, an others. Therefore, in the structure of the exchange demanded by the society according to its contractual obligations (others), the third way (Third Sector) advances in the empty space left by the State. In this line, it presents the modalities of action of the third sector in the social scope. Finally, the normative communication organization of these three subjects is sought in the pragmatic model of discourse, namely: State, Society and Third Sector, in an attempt to understand the constant dynamics in the Law and in the language of the relations established between them.

Keywords: access to justice, state, social rights, third sector

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Authors: Dora Martins, Susana Silva, Cândida Silva

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Human Resources Management (HRM) has been recognized by academics and practitioners as an important element in organizations. Therefore, this paper explores the best practices of HRM and seeks to understand the level of participation in the development of these practices by human resources managers in the hospitality industry and compare it with other industries. Thus, the study compared the HRM practices of companies in the hospitality sector with HRM practices of companies in other sectors, and identifies the main differences between their HRM practices. The results show that the most frequent HRM practices in all companies, independently of its sector of activity, are hiring and training. When comparing hospitality sector with other sectors of activity, some differences were noticed, namely in the adoption of the practices of communication and information sharing, and of recruitment and selection. According to these results, the paper discusses the major theoretical and practical implications. Suggestions for future research are also presented.

Keywords: exploratory study, human resources management practices, human resources manager, hospitality companies, Portuguese companies

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Authors: David Quevedo, Diana Coronel

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The present article carries out an evaluation of the drinking water system in the Bellavista sector of the city of Azogues, with the purpose of determining the appropriate equipment to record the actual consumption flows of the inhabitants in said sector. Taking into account that the study area is located in a rural and economically disadvantaged area, there is an urgent need to establish a control system for the consumption of drinking water in order to conserve and manage the vital resource in the best possible way, considering that the water source supplying this sector is approximately 9km away. The research began with the collection of cartographic, demographic, and statistical data of the sector, determining the coverage area, population projection, and a provision that guarantees the supply of drinking water to meet the water needs of the sector's inhabitants. By using hydraulic modeling through the United States Environmental Protection Agency Application for Modeling Drinking Water Distribution Systems EPANET 2.0 software, theoretical hydraulic data were obtained, which were used to design and justify the most suitable measuring equipment for the Bellavista drinking water system. Taking into account a minimum service life of the drinking water system of 30 years, future flow rates were calculated for the design of the macro-measuring device. After analyzing the network, it was evident that the Bellavista sector has an average consumption of 102.87 liters per person per day, but considering that Ecuadorian regulations recommend a provision of 180 liters per person per day for the geographical conditions of the sector, this value was used for the analysis. With all the collected and calculated information, the conclusion was reached that the Bellavista drinking water system needs to have a 125mm electromagnetic macro-measuring device for the first three quinquenniums of its service life and a 150mm diameter device for the following three quinquenniums. The importance of having equipment that provides real and reliable data will allow for the control of water consumption by the population of the sector, measured through micro-measuring devices installed at the entrance of each household, which should match the readings of the macro-measuring device placed after the water storage tank outlet, in order to control losses that may occur due to leaks in the drinking water system or illegal connections.

Keywords: macrometer, hydraulics, endowment, water

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Authors: Simisola I. Akintoye, Sunday K. Iyaniwura

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Recent global corporate failures have called for increase in the need to regulate corporate governance across the world. In Nigeria, the impact of corporate governance regulation in the banking sector has reached epidemic levels contributing to the country’s economic depression. This study critically evaluates Nigeria’s corporate governance regime and explores how weak regulation has impacted on the banking sector. By adopting a socio legal methodology, the study analyses both theoretical and empirical works from a socio-scientific point of view to examine the role of Nigeria’s legal, cultural and social arrangements in corporate governance regulation. The study reveals that Nigeria’s institutional arrangement has contributed to its weak system of corporate governance regulation with adverse effects on the banking sector. The research mainly impacts on current global corporate governance literature in sub-Saharan Africa by contributing to knowledge of the peculiarities of corporate governance regulation in different institutional jurisdictions. The particular focus on emerging economies such as Nigeria expands on the need for countries to develop a bespoke system of corporate governance regulation that takes into consideration the peculiarities of individual countries devoid of external influence.

Keywords: banks, corporate governance, emerging economies, Nigeria

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Authors: Dingiswayo Likhona, Arko-Cobbah Emmanuel, Carolina Pohl, Nthabiseng Z. Mokoena, Jolly Musoke

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A distinct strain of Klebsiella pneumoniae (K. pneumoniae), referred to as hypervirulent (hvKp), is associated with invasive infections such as an invasive pyogenic liver abscess in young and healthy individuals. In South Africa, limited information is known about the prevalence and virulence of this hvKp strain. Thus, this study aimed to determine the prevalence of hvKp and virulence-associated factors in K. pneumoniae isolates from one of the largest Tertiary hospitals in a South African province. A total of 74 K. pneumoniae isolates were received from Pelonomi National Health Laboratory Services (NHLS), Bloemfontein. Virulence-associated genes (rmpA, capsule serotype K1/K2, iroB, and irp2) were screened, and the virulence of hvKp vs. classical Klebsiella pneumoniae (cKp) was investigated using Caenorhabditis elegans nematode model. The iutA (aerobactin transporter) gene was used as a primary biomarker of hvKp. An average of 12% (9/74) of cases were defined as hvKp. Moreover, hvKp was found to be significantly more virulent in vivo Caenorhabditis elegans relative to cKp. The virulence-associated genes (rmpA, iroB, hmv phenotype, and capsule K1/K2) were significantly (p< 0.05) associated with hvKp. Findings from this study confirm the presence of hvKp in one large Tertiary hospital in South Africa. However, the low prevalence and mild to moderate clinical presentation suggest a marginal threat to public health. Further studies in different settings are required to establish the true potential impact of hvKp in developing countries.

Keywords: hypervirulent klebsiella pneumoniae, virulence, caenorhabditis elegans, aerobactin (iutA)

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Authors: Praveen Priyadarshi

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What is the nature of the 'political subjects' in the new urban spaces of the Indian cities? How do they become a 'public'? The paper explores these questions by studying the National Capital Region's gated communities in India. Even as the 'gated-ness' of these neighborhoods constantly underlines the definitive spatial boundary of the 'public' that it is constituted within the walls of a particular gated community, the making of this 'public' occurs as much in the digital spaces—in the digital space of online messaging apps and platforms—populated by unique digital identities. It is through constant exchanges of the digital identities that the 'public' is created. However, the institutional framework and the formal rules governing the making of the public are still analogue because they presume and privilege traditional modes of participation for people to constitute a 'public'. The institutions are designed as rules and norms governing people's behavior when they participate in traditional, physical mode, whereas rules and norms designed in the algorithms regulate people's social and political behavior in the digital domain. In exploring this disjuncture between the analogue institutions and the digital public, the paper analytically evaluates the nature of everyday politics in gates neighborhoods in India.

Keywords: gated communities, everyday politics, new urban spaces, digital publics

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Authors: Mansilla, Juan Camilo

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According to many studies, public space in the cities of Global South is constantly morcellated and captured by a multiplicity of actors in a permanent struggle for power. This imposed public space restricts the access to services and political actions to many inhabitants. The author has conducted several focus group sessions using video in a reflective mode with low-income communities in Medellín, Colombia in order to study how people in this city are shift from a physical public space to a hybrid public space shaped by internet. Beyond the fragmented city and the violent urban context manifested by participants, these activities have highlighted how the access to the city is currently going through a dialectic movement between the physical and the digital space. The purpose of this article is to make explicit the link between this hybrid public space and the boundaries of exclusion in the city. Urban marginality is closely related with the idea of access and space. Low-income communities in Medellín assume the digital realm like a “not controlled space” of resistance, where alternative ways of expression like hip hop movement, graffiti, dance, video and virtual communities produce effective changes in the physical realm.

Keywords: access to the city, hybrid public space, low-income communities, Medellín, urban marginality

Procedia PDF Downloads 494