Human-Capital based Governance Structure, Success Factors and Barriers to Effective Governance: Co-operatives in Malaysia

Directory of Open Access Journals (Sweden)

Rohana Othman

2016-01-01

Full Text Available Co-operatives comprise the crucial third engine of growth for the Malaysian economy after the public and private sectors. This study investigates the human capital based governance structure, success factors and barriers to effective governance of co-operatives in Malaysia. Questionnaires were distributed to the top 100 co-operatives listed in the Malaysian Co-operative Societies Commission website. Analysis of the responses to the questionnaires showed that human capital based co-operatives governance comprise members’ participation, independence of the board, depth of expertise and competencies of directors and other characteristics of the board. This study also identified branding as the most important success factor ahead of competitiveness and proximity. Malaysia’s economy is projected to continue relying significantly on the performance of co-operatives. Thus, it is incumbent for greater attention to be given towards an effective governance that results in successful co-operatives.

Inclusive Education in Government Primary Schools: Teacher Perceptions

Directory of Open Access Journals (Sweden)

Itfaq Khaliq Khan

2017-06-01

Full Text Available The perceptions of primary school teachers towards inclusive education was investigated in mainstream government schools of Islamabad capital territory where inclusive education was being supported by Sight savers and other international organizations. The study was carried out involving 54 teachers in six randomly selected primary schools. The sampled group comprised both, teachers trained in inclusive education and teachers working in same schools, but not trained in inclusive education. Purposive sampling method was used to select the teachers. Structured questionnaire (Likert Scale and structured interview method was used for data collection. The results of the study revealed that inclusive education is considered to be a desirable practice. The teachers believed that all learners regardless of their disabilities should be in regular classrooms and they showed more favorable attitude towards children with mild disabilities, but were not very optimistic about children with severe disabilities. The study also recognized teachers’ capacity as an essential component of inclusive education and recommends that inclusive education should be a part of pre and in-service teacher education.

Comparison of Cardiovascular Risk Screening Methods and Mortality Data among Hungarian Primary Care Population: Preliminary Results of the First Government-Financed Managed Care Program.

Science.gov (United States)

Móczár, Csaba; Rurik, Imre

2015-09-01

Besides participation in the primary prevention, screening as secondary prevention is an important requirement for primary care services. The effect of this work is influenced by the characteristics of individual primary care practices and doctors' screening habits, as well as by the regulation of screening processes and available financial resources. Between 1999 and 2009, a managed care program was introduced and carried out in Hungary, financed by the government. This financial support and motivation gave the opportunity to increase the number of screenings. 4,462 patients of 40 primary care practices were screened on the basis of SCORE risk assessment. The results of the screening were compared on the basis of two groups of patients, namely: those who had been pre-screened (pre-screening method) for known risk factors in their medical history (smoking, BMI, age, family cardiovascular history), and those randomly screened. The authors also compared the mortality data of participating primary care practices with the regional and national data. The average score was significantly higher in the pre-screened group of patients, regardless of whether the risk factors were considered one by one or in combination. Mortality was significantly lower in the participating primary practices than had been expected on the basis of the national mortality data. This government-financed program was a big step forward to establish a proper screening method within Hungarian primary care. Performing cardiovascular screening of a selected target group is presumably more appropriate than screening within a randomly selected population. Both methods resulted in a visible improvement in regional mortality data, though it is very likely that with pre-screening a more cost-effective selection for screening may be obtained.

Implementing clinical governance in English primary care groups/trusts: reconciling quality improvement and quality assurance.

Science.gov (United States)

Campbell, S M; Sheaff, R; Sibbald, B; Marshall, M N; Pickard, S; Gask, L; Halliwell, S; Rogers, A; Roland, M O

2002-03-01

To investigate the concept of clinical governance being advocated by primary care groups/trusts (PCG/Ts), approaches being used to implement clinical governance, and potential barriers to its successful implementation in primary care. Qualitative case studies using semi-structured interviews and documentation review. Twelve purposively sampled PCG/Ts in England. Fifty senior staff including chief executives, clinical governance leads, mental health leads, and lay board members. Participants' perceptions of the role of clinical governance in PCG/Ts. PCG/Ts recognise that the successful implementation of clinical governance in general practice will require cultural as well as organisational changes, and the support of practices. They are focusing their energies on supporting practices and getting them involved in quality improvement activities. These activities include, but move beyond, conventional approaches to quality assessment (audit, incentives) to incorporate approaches which emphasise corporate and shared learning. PCG/Ts are also engaged in setting up systems for monitoring quality and for dealing with poor performance. Barriers include structural barriers (weak contractual levers to influence general practices), resource barriers (perceived lack of staff or money), and cultural barriers (suspicion by practice staff or problems overcoming the perceived blame culture associated with quality assessment). PCG/Ts are focusing on setting up systems for implementing clinical governance which seek to emphasise developmental and supportive approaches which will engage health professionals. Progress is intentionally incremental but formidable challenges lie ahead, not least reconciling the dual role of supporting practices while monitoring (and dealing with poor) performance.

Success Factors for an E-Government Strategy: Austrian Experiences, Indonesian Challenges

Directory of Open Access Journals (Sweden)

Christoph Behrens

2012-02-01

Full Text Available Focus of this paper are success factors for the implementation of an E-Government strategy. While concepts for a sophisticated strategy process in Public Sector are delivered on a regular basis, the gap between ambitious planning and its implementation seems to get wider. Authors seek to define what makes a “good strategy” in order to enhance management capacity. Meanwhile some scholars from Political Science see limitation of Governments on announcements which are not followed up by sufficient action rather as systematic problems, challenging concept and rules of liberal western democracy, or owed to growing complexity of Governance under the conditions of globalization. In context of the introduction of New Public Management and its perception of citizens as customers and on the basis of new available technical options in Information Society, a key Governance reform project in European and other Countries over the last fifteen years has been the introduction of E-Government. European market leader in this field is Austria. The author reviews concept and implementation experiences of the Austrian E-Government strategy, analyzes key success factors and opens a discussion, under which conditions a successful implementation of E-Government can take place in Indonesia.

Primary Education in Delhi, Hyderabad and Kolkata: Governance by Resignation, Privatisation by Default

NARCIS (Netherlands)

J.E. Mooij (Jos); J. Jalal (Jennifer)

2009-01-01

textabstract1. Introduction As described in the earlier chapters, one of the entry points in our study of urban governance was the supply and demand of services. Education is one important service that we studied in three of the four cities (Delhi, Hyderabad and Kolkata). Our focus was on primary

Do project management and network governance contribute to inter-organisational collaboration in primary care? A mixed methods study.

Science.gov (United States)

Schepman, Sanneke; Valentijn, Pim; Bruijnzeels, Marc; Maaijen, Marlies; de Bakker, Dinny; Batenburg, Ronald; de Bont, Antoinette

2018-06-07

The need for organisational development in primary care has increased as it is accepted as a means of curbing rising costs and responding to demographic transitions. It is only within such inter-organisational networks that small-scale practices can offer treatment to complex patients and continuity of care. The aim of this paper is to explore, through the experience of professionals and patients, whether, and how, project management and network governance can improve the outcomes of projects which promote inter-organisational collaboration in primary care. This paper describes a study of projects aimed at improving inter-organisational collaboration in Dutch primary care. The projects' success in project management and network governance was monitored by interviewing project leaders and board members on the one hand, and improvement in the collaboration by surveying professionals and patients on the other. Both qualitative and quantitative methods were applied to assess the projects. These were analysed, finally, using multi-level models in order to account for the variation in the projects, professionals and patients. Successful network governance was associated positively with the professionals' satisfaction with the collaboration; but not with improvements in the quality of care as experienced by patients. Neither patients nor professionals perceived successful project management as associated with the outcomes of the collaboration projects. This study shows that network governance in particular makes a difference to the outcomes of inter-organisational collaboration in primary care. However, project management is not a predictor for successful inter-organisational collaboration in primary care.

Traditional leadership factor in modern local government system in ...

African Journals Online (AJOL)

Traditional leadership factor in modern local government system in Ghana: policy Implementation, role conflict and marginalization. ... at promoting education, health and environmental management, are highly commendable in Ghana.

Are classroom internet use and academic performance higher after government broadband subsidies to primary schools?

OpenAIRE

Hyland, Marie; Layte, Richard; Lyons, Sean; McCoy, Selina; Silles, Mary

2013-01-01

This paper combines data from a government programme providing broadband access to primary schools in Ireland with survey microdata on schools', teachers' and pupils use of the internet to examine the links between public subsidies, classroom use of the internet and educational performance. Provision of broadband service under a government scheme was associated with more than a doubling of teachers' use of the internet in class after about a two year lag. Better computing facilities in school...

Factors of Local E-Government Development in Poland: The Case of the Poznań Agglomeration

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Perdał Robert

2016-06-01

Full Text Available This paper seeks to analyse factors of e-government development at the local government level in Poland. The analysis proceeded in three stages. In the first, a survey of the literature on the subject was made and a model of factors of e-government development was constructed. In the second, the factors distinguished were operationalised: indicators representing them were constructed. The third stage involved an empirical verification of the model using partial correlation and multiple regression methods; significant factors of e-government development were distinguished at the local government level. The analysis was conducted for a group of 18 communes making up the Poznań agglomeration. It was demonstrated that significant factors of local e-government development in Poland included the level of socio-economic development, inhabitants’ access to ICT, their attitudes and skills, the size of administrative units, attitudes of local authorities and leaders, a vision and a strategy of e-government development, human resources in offices, and the financial situation of a commune.

Success and failure factors for e-government projects: A case from Egypt

Directory of Open Access Journals (Sweden)

Hatem Elkadi

2013-07-01

Full Text Available E-government implementations in developing countries still face difficulties, leading to a large failure ratio. This is too high a cost for developing countries. Analysis of the reasons behind success and failure of e-government projects is still an interesting domain of investigation. Several approaches were advanced and success and failure factors have been stipulated, but factors pertinent to Public Administration have yet to be investigated and analyzed. This work builds on the results of earlier research, analyzing the factors behind the change in performance of the different sites of a specific project, reasons of their original success, and the relapse of one site. It reviews in detail the factors advanced by previous works and integrates for the first time the results obtained by 3 different research methodologies. It clarifies the causality between different factors presumed to individually affect the e-government implementations, thus enabling the disambiguation between the main and secondary less effective causes of failure. The success and failure factors significance and relative importance are identified, revealing the recommended track of action for the set-back remedy.

Significant Factors Determining E-government Adoption in Selangor, Malaysia

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Siti Hajar Mohd Idris

2016-06-01

Full Text Available Studies have shown that low adoption rate among citizens has been hindering the optimization of e-Government services especially in developing countries. Hence, one of the critical measures that has to be undertaken is to identify and overcome possible barriers to further facilitate a higher rate of adoption. A multistage stratified sampling was used in this study to collect data from 1000 respondents, both user and non-user residing in the state of Selangor, Malaysia. This state was chosen as to provide a better understanding of low adoption when issues of basic facilities have been successfully overcome. An exploratory factor analysis was performed to identify latent constructs and seven key factors were identified. A multiple regression model was subsequently used to analyze significant factors in determining the willingness to use e-Government services. The determinants are language barrier, educational level, secure, format, easy to use, enjoyable, reliable, visual appeal and infrastructure. The result shows significant variables that act as barriers to adoption are reliable, enjoyable, easy to use, secure, and language used. The constraints pointed out in the open ended questions mainly focus on the issue of accessibility, ease of use and awareness. Overcoming these obstacles is therefore crucial in order to enhance the usage of e-Government services which consequently will improve the quality of public administration in Malaysia.

Factors governing the deep ventilation of the Red Sea

KAUST Repository

Papadopoulos, Vassilis P.; Zhan, Peng; Sofianos, Sarantis S.; Raitsos, Dionysios E.; Qurban, Mohammed; Abualnaja, Yasser; Bower, Amy; Kontoyiannis, Harilaos; Pavlidou, Alexandra; Asharaf T.T., Mohamed; Zarokanellos, Nikolaos; Hoteit, Ibrahim

2015-01-01

A variety of data based on hydrographic measurements, satellite observations, reanalysis databases, and meteorological observations are used to explore the interannual variability and factors governing the deep water formation in the northern Red

Content validity of critical success factors for e-Government implementation in Indonesia

Science.gov (United States)

Napitupulu, D.; Syafrullah, M.; Rahim, R.; Amar, A.; Sucahyo, YG

2018-05-01

The purpose of this research is to validate the Critical Success Factors (CSFs) of e-Government implementation in Indonesia. The e-Government initiative conducted only to obey the regulation but ignoring the quality. Defining CSFs will help government agencies to avoid failure of e-Government projects. A survey with the questionnaire was used to validate the item of CSF based on expert judgment through two round of Delphi. The result showed from 67 subjects in instrument tested; there are 11 invalid items deleted and remain only 56 items that had good content validity and internal reliability. Therefore, all 56 CSFs should be adopted by government agencies in Indonesia to support e-Government implementation.

Exploring the success, failure and factors influencing M-government implementation in developing countries

CSIR Research Space (South Africa)

Ogunleye, OS

2014-05-01

Full Text Available and to provide better services to citizens, businesses, and government agencies through using mobile technology. This research reviews the success, failures and factors influencing m-Government development and implementation in developing countries...

Teacher Governance Factors and Social Cohesion: Insights from Pakistan

Science.gov (United States)

Halai, Anjum; Durrani, Naureen

2016-01-01

This paper explores teacher governance factors, particularly recruitment and deployment of teachers, in relation to inequalities and social cohesion. Pakistan introduced major reforms in education in the post 9/11 context of escalating conflict. These include a merit and needs-based policy on teacher recruitment to eliminate corruption in…

Sources of Cost Expansion: Primary Education in Norway 1946-90.

Science.gov (United States)

Falch, Torberg; Rattso, Jorn

1996-01-01

Shows that primary education spending growth in Norway resulted from cost factors determined at the national level, together with lack of adjustment to rising costs in local governments. Policies to control school spending must address the central government's bargaining strength to hold back on teacher wages and employment and local governments'…

A governance model for integrated primary/secondary care for the health-reforming first world - results of a systematic review.

Science.gov (United States)

Nicholson, Caroline; Jackson, Claire; Marley, John

2013-12-20

Internationally, key health care reform elements rely on improved integration of care between the primary and secondary sectors. The objective of this systematic review is to synthesise the existing published literature on elements of current integrated primary/secondary health care. These elements and how they have supported integrated healthcare governance are presented. A systematic review of peer-reviewed literature from PubMed, MEDLINE, CINAHL, the Cochrane Library, Informit Health Collection, the Primary Health Care Research and Information Service, the Canadian Health Services Research Foundation, European Foundation for Primary Care, European Forum for Primary Care, and Europa Sinapse was undertaken for the years 2006-2012. Relevant websites were also searched for grey literature. Papers were assessed by two assessors according to agreed inclusion criteria which were published in English, between 2006-2012, studies describing an integrated primary/secondary care model, and had reported outcomes in care quality, efficiency and/or satisfaction. Twenty-one studies met the inclusion criteria. All studies evaluated the process of integrated governance and service delivery structures, rather than the effectiveness of services. They included case reports and qualitative data analyses addressing policy change, business issues and issues of clinical integration. A thematic synthesis approach organising data according to themes identified ten elements needed for integrated primary/secondary health care governance across a regional setting including: joint planning; integrated information communication technology; change management; shared clinical priorities; incentives; population focus; measurement - using data as a quality improvement tool; continuing professional development supporting joint working; patient/community engagement; and, innovation. All examples of successful primary/secondary care integration reported in the literature have focused on a combination

Trachoma Prevalence and Risk Factors in Eight Local Government ...

African Journals Online (AJOL)

is worst in Anka LGA (7%); whereas knowledge of how to prevent trachoma is generally poor in all the LGAs. Trachoma prevalence and risk factors in eight local government areas of Zamfara state. The burden of active trachoma (TF) in children is low in the surveyed LGAs with the exception of Bungudu and Maradun that ...

Assessing the Adoption of e-Government Services by Teachers in Greece

Directory of Open Access Journals (Sweden)

Vasiliki Vrana

2012-05-01

Full Text Available Technological developments and governments’ understanding of what citizens need usually determine the design of public online services. For successful implementation of e-Government services, governments have to place the user in the center of future developments, understand what citizens need and measure what increases citizens’ willingness to adopt e-government services. The paper uses the Technology Acceptance Model (TAM, the extended TAM, the Diffusion of Innovations (DOI theory and the important determinants of user acceptance perceived risk and trust, in order to describe teachers’ behavioral intensions to adopt e-Government services. A model containing trust and risk, along with cognitive, social and intrinsic factors is used to study the intentions of e-Government use by Greek primary and secondary education teachers. Two hundred and thirty teachers responded to an online survey. Findings reveal that cognitive and intrinsic factors have significant effects on intentions to use e-Government websites.

A hypothesis: factor VII governs clot formation, tissue repair and apoptosis.

Science.gov (United States)

Coleman, Lewis S

2007-01-01

A hypothesis: thrombin is a "Universal Enzyme of Energy Transduction" that employs ATP energy in flowing blood to activate biochemical reactions and cell effects in both hemostasis and tissue repair. All cells possess PAR-1 (thrombin) receptors and are affected by thrombin elevations, and thrombin effects on individual cell types are determined by their unique complement of PAR-1 receptors. Disruption of the vascular endothelium (VE) activates a tissue repair mechanism (TRM) consisting of the VE, tissue factor (TF), and circulating Factors VII, IX and X that governs localized thrombin elevations to activate clot formation and cellular effects that repair tissue damage. The culmination of the repair process occurs with the restoration of the VE followed by declines in thrombin production that causes Apoptosis ("programmed cell death") in wound-healing fibroblasts, which functions as a mechanism to draw wound edges together. The location and magnitude of TRM activity governs the location and magnitude of Factor VIII activity and clot formation, but the large size of Factor VIII prevents it from penetrating the clot formed by its activity, so that its effects are self-limiting. Factors VII, IX and X function primarily as tissue repair enzymes, while Factor VIII and Factor XIII are the only serine protease enzymes in the "Coagulation Cascade" that are exclusively associated with hemostasis.

Impacts of government and market on firm's efforts to reduce pollution

OpenAIRE

Kim, Bowon; Sim, Jeong Eun

2015-01-01

We examine how the government and the market affect firm’s pollution abatement efforts, i.e. firm’s efforts to reduce its pollution emission. The way for the government to control firm’s pollution is to impose penalty, whereas the consumers (the market) make their purchasing decision by taking into account the pollution, i.e. the demand is affected by the stock of pollution. In effect, we consider two forces, government penalty and consumer’s sensitivity to pollution, as primary factors to co...

A governance model for integrated primary/secondary care for the health-reforming first world – results of a systematic review

Science.gov (United States)

2013-01-01

Background Internationally, key health care reform elements rely on improved integration of care between the primary and secondary sectors. The objective of this systematic review is to synthesise the existing published literature on elements of current integrated primary/secondary health care. These elements and how they have supported integrated healthcare governance are presented. Methods A systematic review of peer-reviewed literature from PubMed, MEDLINE, CINAHL, the Cochrane Library, Informit Health Collection, the Primary Health Care Research and Information Service, the Canadian Health Services Research Foundation, European Foundation for Primary Care, European Forum for Primary Care, and Europa Sinapse was undertaken for the years 2006–2012. Relevant websites were also searched for grey literature. Papers were assessed by two assessors according to agreed inclusion criteria which were published in English, between 2006–2012, studies describing an integrated primary/secondary care model, and had reported outcomes in care quality, efficiency and/or satisfaction. Results Twenty-one studies met the inclusion criteria. All studies evaluated the process of integrated governance and service delivery structures, rather than the effectiveness of services. They included case reports and qualitative data analyses addressing policy change, business issues and issues of clinical integration. A thematic synthesis approach organising data according to themes identified ten elements needed for integrated primary/secondary health care governance across a regional setting including: joint planning; integrated information communication technology; change management; shared clinical priorities; incentives; population focus; measurement – using data as a quality improvement tool; continuing professional development supporting joint working; patient/community engagement; and, innovation. Conclusions All examples of successful primary/secondary care integration reported in

Strengthening primary health care through primary care and public health collaboration: the influence of intrapersonal and interpersonal factors.

Science.gov (United States)

Valaitis, Ruta K; O'Mara, Linda; Wong, Sabrina T; MacDonald, Marjorie; Murray, Nancy; Martin-Misener, Ruth; Meagher-Stewart, Donna

2018-04-12

AimThe aim of this paper is to examine Canadian key informants' perceptions of intrapersonal (within an individual) and interpersonal (among individuals) factors that influence successful primary care and public health collaboration. Primary health care systems can be strengthened by building stronger collaborations between primary care and public health. Although there is literature that explores interpersonal factors that can influence successful inter-organizational collaborations, a few of them have specifically explored primary care and public health collaboration. Furthermore, no papers were found that considered factors at the intrapersonal level. This paper aims to explore these gaps in a Canadian context. This interpretative descriptive study involved key informants (service providers, managers, directors, and policy makers) who participated in one h telephone interviews to explore their perceptions of influences on successful primary care and public health collaboration. Transcripts were analyzed using NVivo 9.FindingsA total of 74 participants [from the provinces of British Columbia (n=20); Ontario (n=19); Nova Scotia (n=21), and representatives from other provinces or national organizations (n=14)] participated. Five interpersonal factors were found that influenced public health and primary care collaborations including: (1) trusting and inclusive relationships; (2) shared values, beliefs and attitudes; (3) role clarity; (4) effective communication; and (5) decision processes. There were two influencing factors found at the intrapersonal level: (1) personal qualities, skills and knowledge; and (2) personal values, beliefs, and attitudes. A few differences were found across the three core provinces involved. There were several complex interactions identified among all inter and intra personal influencing factors: One key factor - effective communication - interacted with all of them. Results support and extend our understanding of what influences

A primary reduced TCA flux governs substrate oxidation in T2D skeletal muscle

DEFF Research Database (Denmark)

Gaster, Michael

2012-01-01

Our current knowledge on substrate oxidation in skeletal muscle in relation to insulin resistance and type 2 diabetes (T2D) originate mainly from in vivo studies. The oxidative capacity of skeletal muscle is highly influenced by physical activity, ageing, hormonal status, and fiber type composition...... further regulatory mechanism to our understanding of substrate oxidation in human skeletal muscle during normo- an pathophysiological conditions, focusing especially on the governing influence of a primary reduced TCA flux for the diabetic phenotype in skeletal muscle....

Factors affecting guidance and counseling programme in primary ...

African Journals Online (AJOL)

The objective of this study was to establish the factors that affect guidance and counseling in primary schools. Guidance and counseling seems not to be adequately helping pupils with physical and psychological problems in Nairobi province of Kenya. Many primary schools are faced with indiscipline and poor performance ...

Critical success factors for governing farmer-managed public goods in rural areas in the Netherlands

NARCIS (Netherlands)

Blom-Zandstra, Greet; Korevaar, Hein; Stuiver, Marian; Groot, Annemarie

2016-01-01

Multifunctional land use has become a widely supported pathway for Europe's countryside. Brussels and the national governments stimulate farmers to integrate primary production with non-agricultural practices from which they can also benefit. In favour of this development different stakeholders

Environmental Factors Associated with Primary Care Access Among Urban Older Adults

OpenAIRE

Ryvicker, Miriam; Gallo, William T.; Fahs, Marianne C.

2012-01-01

Disparities in primary care access and quality impede optimal chronic illness prevention and management for older adults. Although research has shown associations between neighborhood attributes and health, little is known about how these factors – in particular, the primary care infrastructure – inform older adults’ primary care use. Using geographic data on primary care physician supply and surveys from 1,260 senior center attendees in New York City, we examined factors that facilitate and ...

Association of Psychologic and Nonpsychologic Factors With Primary Dysmenorrhea

Science.gov (United States)

Faramarzi, Mahbobeh; Salmalian, Hajar

2014-01-01

Background: Primary dysmenorrhea seems to be one the most common gynecologic condition in women of childbearing age. Objectives: The aim of this research was to evaluate psychologic and nonpsychologic risk factors of primary dysmenorrhea. Materials and Methods: A cross-sectional study was conducted on medical sciences students of Babol University of Medical Sciences. In this study, 180 females with dysmenorrhea and 180 females without dysmenorrhea were enrolled. Psychological risk factors were evaluated in four domains including affect, social support, personality, and alexithymia. Four questionnaires were used to assessed aforementioned domains, namely, Social Support Questionnaire (SSQ), depression, anxiety, stress (DAS-21), 20-item Toronto Alexithymia Scale (TAS-20), and NEO-Five Factor Inventory of Personality (NEO-FFI). In addition, nonpsychologic factors were evaluated in three domains including demographic characteristics, habits, and gynecologic factors. Data were analyzed using the χ2 test and multiple logistic regression analysis. Results: The strongest predictor of primary dysmenorrhea was low social support (OR = 4.25; 95% CI, 2.43-7.41). Risk of dysmenorrhea was approximately 3.3 times higher in women with alexithymia (OR = 3.26; 95% CI, 1.88-5.62), 3.1 times higher in women with menstrual bleeding duration ≥ 7 days (OR = 3.06; 95% CI, 1.73-5.41), 2.5 times higher in women with a neurotic character (OR = 2.53; 95% CI, 1.42-4.50), 2.4 times higher in women with a family history of dysmenorrhea (OR = 2.43; 95% CI, 1.42-4.50), and twice higher in women with high caffeine intake (OR = 1.97; 95% CI, 1.09-3.59). Conclusions: Low social support, alexithymia, neuroticism trait, long menstrual bleeding, family history of dysmenorrhea, and high-caffeine diet are important risk factors for women with primary dysmenorrhea. This study recommended considering psychologic factors as an adjuvant to medical risks in evaluation and treatment of primary dysmenorrhea

Factors influencing the prevalence of primary dysmenorrhoea ...

African Journals Online (AJOL)

... of primary dysmenorrhoea amongst Abia State university medical students, South ... its impact on school and social activities and the students' management strategies. ... is high, and not consistently associated with demographic risk factors.

Internationalization versus Localization: "The Case of Primary Education in Taiwan"

Science.gov (United States)

Wang, Li-Ping; Ho, Hsuan-Fu

2012-01-01

Internationalization is receiving increasing attention at academic institutions all over the world. Taiwan is no exception, where the government is promoting internationalization not only in higher education, but also at the primary education level. In this research we identified the key factors of the internationalization of primary education in…

Twin Specific Risk Factors in Primary School Achievements

NARCIS (Netherlands)

de Zeeuw, L.E.J.; van Beijsterveldt, C.E.M.; de Geus, E.J.C.; Boomsma, D.I.

2012-01-01

The main aim of this study was to examine twin specific risk factors that influence educational achievement in primary school. We included prenatal factors that are not unique to twins, except for zygosity, but show a higher prevalence in twins than in singletons. In addition, educational

Lean government: Critical success factors for XBRL-based business-to-government reporting

OpenAIRE

Bharosa, N.; De Winne, C.P.I.; Van Wijk, R.; Janssen, M.F.W.H.A.

2012-01-01

Lean government is all about doing better with less through the use of ICT and the realisation of process improvements. The recently introduced eXtensible Business Reporting Language (XBRL) has shown some initial success in realising lean government. Once data is stored in XBRL format, businesses can transmit it electronically to government for reporting purposes. For businesses, XBRL will increase both corporate accountability and transparency by reducing the time needed to collect, structur...

Factors affecting knowledge governance implementation among Malaysian SMEs

Directory of Open Access Journals (Sweden)

Khong Sin Tan

2018-05-01

Full Text Available Knowledge governance is a relatively new discipline in Malaysia with very little research work performed so far. As Malaysian government is actively involved in the implementation of Economic Transformation Program (ETP, Government Transformation Program (GTP and Urban Trans-formation Program (UTP, Small and Medium Enterprises (SMEs need to react to the government move by transforming their conventional knowledge management practices to knowledge govern-ance. As of today, there has been very limited study conducted in Malaysia on the extent of the company acceptance of such governance. This research was therefore conducted to measure the SME users' acceptance and identify the pros and cons of knowledge governance. With these findings, recommendations were given to policy makers and industries to increase the company's knowledge governance acceptance. Questionnaire was used for data collection. Systematic random sampling methods was used to select respondents. The questionnaire was developed and adapted based on knowledge management and IT governance frameworks. In this model, the dependent variable was company's intention to adopt knowledge governance. Independent variables included knowledge application needs, knowledge architecture, knowledge infrastructure, knowledge investment and knowledge principles.

[Modifiable risk factors for primary headache. A systematic review].

Science.gov (United States)

Albers, L; Ziebarth, S; von Kries, R

2014-08-01

Strategies to prevent primary headaches could be very beneficial, especially given that primary headaches can lead to the development of chronic headache. In order to establish headache prevention strategies, the modifiable risk factors for primary headaches need to be identified. A systematic literature search on the risk factors for primary headaches was conducted independently by two persons using the databases MEDLINE and Embase. Further inclusion criteria were observational studies in adult general populations or case-control studies, where the effect sizes were reported as odds ratios or where the odds ratios could be calculated from the given data. In all, 24 studies were included in the analysis. There was a large amount of heterogeneity among the studies concerning headache acquisition, headache classification, and risk factors for headache development. Independent of headache trigger and definition of headache, the association between headache and the risk factor "stress" was very high: The meta-analysis shows an overall effect of 2.26 (odds ratio; 95 %-CI = [1.79; 2.85]). Studies evaluating neck and shoulder pain also report a strong association with headache; however, these results could not be summarized in a meta-analysis. Equally, the overall effects of smoking and coffee consumption on headaches could not be verified because the effect sizes were rather small and predominantly noticeable only at higher doses. A strong association between headache and the risk factors stress and neck and shoulder pain was confirmed. The effect sizes of smoking and coffee consumption on headaches were rather small.

Empirical and dynamic primary energy factors

International Nuclear Information System (INIS)

Wilby, Mark Richard; Rodríguez González, Ana Belén; Vinagre Díaz, Juan José

2014-01-01

Current legislation, standards, and scientific research in the field of energy efficiency often make use of PEFs (primary energy factors). The measures employed are usually fixed and based on theoretical calculations. However given the intrinsically variable nature of energy systems, these PEFs should rely on empirical data and evolve in time. Otherwise the obtained efficiencies may not be representative of the actual energy system. In addition, incorrect PEFs may cause a negative effect on the energy efficiency measures. For instance, imposing a high value on the PEF of electricity may discourage the use of renewable energy sources, which have an actual value close to 1. In order to provide a solution to this issue, we propose an application of the Energy Networks (ENs), described in a previous work, to calculate dynamic PEFs based on empirical data. An EN represents an entire energy system both numerically and graphically, from its primary energy sources to their final energy forms, and consuming sectors. Using ENs we can calculate the PEF of any energy form and depict it in a simple and meaningful graph that shows the details of the contribution of each primary energy and the efficiency of the associated process. The analysis of these PEFs leads to significant conclusions regarding the energy models adopted among countries, their evolution in time, the selection of viable ways to improve efficiency, and the detection of best practices that could contribute to the overall energy efficiency targets. - Highlights: • Primary Energy Factors (PEFs) are foundation of much energy legislation and research. • Traditionally, they have been treated as geotemporally invariant. • This work provides a systematic and transparent methodology for adding variability. • It also shows the variability between regions due to market, policy, and technology. • Finally it demonstrates the utility of extended PEFs as a tool in their own right

Optimalisasi Penerapan Prinsip Good Governance Bidang Akademik dalam Upaya Mewujudkan Good University Governance

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Hery Harjono Muljo

2014-05-01

Full Text Available This study wants to know and understand whether good governance principles have been well applied as well as the factors influencing optimization of the implementation of good governance principles on the academic field in an effort to realize good university governance in Bina Nusantara University. The study aims to evaluate the implementation of good governance principles on the academic field, know the factors that affect the implementation of good governance principles on the academic field, and improve and develop the academic areas in accordance with good governance principles in order to maximize the role of Bina Nusantara University as Good University Governance. The approach model used to understand the implementation of good governance principles was a model to educational institution using the 8 principles, namely academic freedom, shared governance, clear rights and responsibilities, selection at merit, financial stability, accountability, regular testing of standards, and the importance of close cooperation. Research used qualitative method with descriptive analysis, by analyzing the factors influencing optimization of the implementation of good governance principles, particularly on academic areas. The results achieved there were 18 factors that affect the optimization of the implementation of good governance principles. Then the factors affected the optimization ofthe implementation of good governance principles the most are operational centralization and academic decentralization which were the novelty of this study.

Factors shaping intersectoral action in primary health care services.

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Anaf, Julia; Baum, Fran; Freeman, Toby; Labonte, Ron; Javanparast, Sara; Jolley, Gwyn; Lawless, Angela; Bentley, Michael

2014-12-01

To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory. Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners. The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed. Factors facilitating intersectoral action included sufficient human and financial resources, diverse backgrounds and skills and the personal rewards that sustain commitment. Key constraining factors were financial and time limitations, and a political and policy context which has become less supportive of intersectoral action; including changes to primary health care. While intersectoral action is an effective way for primary health care services to address social determinants of health, commitment to social justice and to adopting a social view of health are constrained by a broader health service now largely reinforcing a biomedical model. Effective organisational practices and policies are needed to address social determinants of health in primary health care and to provide a supportive context for workers engaging in intersectoral action. © 2014 Public Health Association of Australia.

Impacts of government and market on firm’s efforts to reduce pollution

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Bowon Kim

2015-12-01

Full Text Available We examine how the government and the market affect firm’s pollution abatement efforts, i.e. firm’s efforts to reduce its pollution emission. The way for the government to control firm’s pollution is to impose penalty, whereas the consumers (the market make their purchasing decision by taking into account the pollution, i.e. the demand is affected by the stock of pollution. In effect, we consider two forces, government penalty and consumer’s sensitivity to pollution, as primary factors to control firm’s pollution and analyze their interaction in relation to the firm’s pollution reduction efforts. The analysis suggests as follows. The government penalty and the consumer’s awareness are substitutes either (1 when the market size is relatively large or (2 when the market is relatively small, but the government penalty is relatively heavy. On the contrary, the two factors are complements when the market size is relatively small and the government penalty is relatively light. We discuss managerial and economic implications of the analysis results.

Environmental factors associated with primary care access among urban older adults.

Science.gov (United States)

Ryvicker, Miriam; Gallo, William T; Fahs, Marianne C

2012-09-01

Disparities in primary care access and quality impede optimal chronic illness prevention and management for older adults. Although research has shown associations between neighborhood attributes and health, little is known about how these factors - in particular, the primary care infrastructure - inform older adults' primary care use. Using geographic data on primary care physician supply and surveys from 1260 senior center attendees in New York City, we examined factors that facilitate and hinder primary care use for individuals living in service areas with different supply levels. Supply quartiles varied in primary care use (visit within the past 12 months), racial and socio-economic composition, and perceived neighborhood safety and social cohesion. Primary care use did not differ significantly after controlling for compositional factors. Individuals who used a community clinic or hospital outpatient department for most of their care were less likely to have had a primary care visit than those who used a private doctor's office. Stratified multivariate models showed that within the lowest-supply quartile, public transit users had a higher odds of primary care use than non-transit users. Moreover, a higher score on the perceived neighborhood social cohesion scale was associated with a higher odds of primary care use. Within the second-lowest quartile, nonwhites had a lower odds of primary care use compared to whites. Different patterns of disadvantage in primary care access exist that may be associated with - but not fully explained by - local primary care supply. In lower-supply areas, racial disparities and inadequate primary care infrastructure hinder access to care. However, accessibility and elder-friendliness of public transit, as well as efforts to improve social cohesion and support, may facilitate primary care access for individuals living in low-supply areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

Governance Regime Factors Conducive to Innovation Uptake in Urban Water Management: Experiences from Europe

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Josselin Rouillard

2016-10-01

Full Text Available Innovative ways to manage the urban water cycle are required to deal with an ageing drinking and waste water infrastructure and new societal imperatives. This paper examines the influence of water governance in enabling transformations and technological innovation uptake in urban water management. A governance assessment framework is developed and applied in three case-studies, examining different scales and types of innovations used to tackle challenges in European urban water management. The methodology combines documentary analysis and interviews to reconstruct historical storylines of the shift in the water governance of urban water management for each site. The research provides detailed empirical observations on the factors conducive to innovation uptake at the local level. Critical governance factors such as commitment to compromise, the necessity to build political support, and the role of “entrepreneurs” and coalitions are highlighted. The paper also explores the role of discursive strategies and partnership design, as well as that of regulative, economic and communicative instruments, in creating barriers and opportunities to initiate and secure change. A number of recommendations targeted at innovators and water managers are presented in the conclusion.

Factors Affecting M-Government Deployment and Adoption

OpenAIRE

Saif Obaid Alkaabi; Nabil Ayad

2016-01-01

Governments constantly seek to offer faster, more secure, efficient and effective services for their citizens. Recent changes and developments to communication services and technologies, mainly due the Internet, have led to immense improvements in the way governments of advanced countries carry out their interior operations Therefore, advances in e-government services have been broadly adopted and used in various developed countries, as well as being adapted to developing countries. The imple...

Factors associated with a primary surgical approach for sinonasal squamous cell carcinoma.

Science.gov (United States)

Cracchiolo, Jennifer R; Patel, Krupa; Migliacci, Jocelyn C; Morris, Luc T; Ganly, Ian; Roman, Benjamin R; McBride, Sean M; Tabar, Viviane S; Cohen, Marc A

2018-03-01

Primary surgery is the preferred treatment of T1-T4a sinonasal squamous cell carcinoma (SNSCC). Patients with SNSCC in the National Cancer Data Base (NCDB) were analyzed. Factors that contributed to selecting primary surgical treatment were examined. Overall survival (OS) in surgical patients was analyzed. Four-thousand seven hundred and seventy patients with SNSCC were included. In T1-T4a tumors, lymph node metastases, maxillary sinus location, and treatment at high-volume centers were associated with selecting primary surgery. When primary surgery was utilized, tumor factors and positive margin guided worse OS. Adjuvant therapy improved OS in positive margin resection and advanced T stage cases. Tumor and non-tumor factors are associated with selecting surgery for the treatment of SNSCC. When surgery is selected, tumor factors drive OS. Negative margin resection should be the goal of a primary surgical approach. When a positive margin resection ensues, adjuvant therapy may improve OS. © 2017 Wiley Periodicals, Inc.

Indigenous Social Capital in Traditional Agro-Food Marketing Systems: The Role of Trust in Governance Structure Selection in the Philippine Highlands

OpenAIRE

Milagrosa, Aimee; Slangen, Louis H.G.

2006-01-01

The decision-making of indigenous Ibaloi and Kankanaey growers in seven highland communities of Benguet, Cordillera region Philippines was captured in three models. The models explain factors affecting their selection of primary transacting partners. The farmers three main primary marketing links are commissioners, wholesalers and contractors. Commissioner-led governance structures are market-based and the relationship is motivated by profit. Wholesaler-led governance structures are partly-ma...

Factors Influencing Individual Performance In An Indonesian Government Office

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Azizatul Munawaroh

2013-11-01

Full Text Available 1024x768 Reformation in Indonesian government offices leads to many substantial changes, and demands improved job performances while arguably loading employees with more work. This research aims to understand factors that potentially influence job performance in Indonesian government offices that carries on such reformation. Using adapted scales from previous studies, this research investigates the role of workload, responsibility for others (level of responsibility to care for other people and need for achievement on employee’s performance.  A survey to all full-time workers in an Indonesian government office is conducted. Contrary to expectation, workload does not influence employee’s performance. Instead, regression analysis demonstrates that, employee’s need for achievement and responsibility for others are significant factors affecting individual performance. These results are important because they highlight the significance of need for achievement for the success of reformation in this office, and by extension for reformation in Indonesia. The results are also interesting because this is the first study that points out to the role of responsibility for others in influencing individual performance in Indonesia which is characterized by collectivistic culture. This paper discusses the contributions of these results for theory and practice.   Keywords: Indonesian public, need for achievement, responsibility for others, workload. Normal 0 false false false IN X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso

Chapter 6: Working together in the federal government

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

In his review of the management of the environment and sustainable development within the federal government, the Commissioner stressed the importance of defining clearly of 'who does what' and identified a variety of mechanisms government departments have at their disposal to work together. These mechanisms range from the creation of new organizations to cost sharing agreements to voluntary networks for information exchange. Six case studies are described in detail designed to examine the key factors that could affect the success of such mechanisms. These factors include managing the effects of participant turnover, ensuring the continuity of departmental incentives, and paying attention to results of monitoring and evaluation to learn from past experience. It is suggested that since other than persuasion and negotiation, interdepartmental cooperation is limited by departments' inability to compel other departments to act, the primary central agencies, such as the Privy Council Office and the Treasury Board Secretariat must play a crucial leadership role in achieving a 'Government of Canada' perspective.

Health worker posting and transfer at primary level in Tamil Nadu: Governance of a complex health system function

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Surekha Garimella

2016-01-01

Full Text Available Background: Posting and transfer (PT of health personnel - placing the right health workers in the right place at the right time - is a core function of any large-scale health service. In the context of government health services, this may be seen as a simple process of bureaucratic governance and implementation of the rule of law. However the literature from India and comparable low and middle-income country health systems suggests that in reality PT is a contested domain, driven by varied expressions of private and public interest throughout the chain of implementation. Objective: To investigate policymaking for PT in the government health sector and implementation of policies as experienced by different health system actors and stakeholders at primary health care level. Methodology: We undertook an empirical case study of a PT reform policy at primary health care level in Tamil Nadu State, to understand how different groups of health systems actors experience PT. In-depth qualitative methods were undertaken to study processes of implementation of PT policies enacted through ′counselling′ of health workers (individualized consultations to determine postings and transfers. Results: PT emerges as a complex phenomenon, shaped partially by the laws of the state and partially as a parallel system of norms and incentives requiring consideration and coordination of the interests of different groups. Micro-practices of governance represent homegrown coping mechanisms of health administrators that reconcile public and private interests and sustain basic health system functions. Beyond a functional perspective of PT, it also reflects justice and fairness as it plays out in the health system. It signifies how well a system treats its employees, and by inference, is an index of the overall health of the system. Conclusions: For a complex governance function such as PT, the roles of private actors and private interests are not easily separable from the

Lean government : Critical success factors for XBRL-based business-to-government reporting

NARCIS (Netherlands)

Bharosa, N.; De Winne, C.P.I.; Van Wijk, R.; Janssen, M.F.W.H.A.

2012-01-01

Lean government is all about doing better with less through the use of ICT and the realisation of process improvements. The recently introduced eXtensible Business Reporting Language (XBRL) has shown some initial success in realising lean government. Once data is stored in XBRL format, businesses

Primary Tumor Thickness is a Prognostic Factor in Stage IV Melanoma: A Retrospective Study of Primary Tumor Characteristics.

Science.gov (United States)

Luen, Stephen; Wong, Siew Wei; Mar, Victoria; Kelly, John W; McLean, Catriona; McArthur, Grant A; Haydon, Andrew

2018-01-01

Stage IV melanoma exhibits a diverse range of tumor biology from indolent to aggressive disease. Many important prognostic factors have already been identified. Despite this, the behavior of metastatic melanoma remains difficult to predict. We sought to determine if any primary tumor characteristics affect survival following the diagnosis of stage IV melanoma. All patients diagnosed with stage IV melanoma between January 2003 and December 2012 were identified from the Victorian Melanoma Service database. Retrospective chart review was performed to collect data on primary tumor characteristics (thickness, ulceration, mitotic rate, melanoma subtype, or occult primary). Known and suspected prognostic factors were additionally collected (time to diagnosis of stage IV disease, age, sex, stage, receipt of chemotherapy, and era of recurrence). The effect of primary tumor characteristics on overall survival from the date of diagnosis of stage IV disease was assessed. A total of 227 patients with a median follow-up of 5 years from diagnosis of stage IV disease were identified. Median overall survival of the cohort was 250 days.Of the primary tumor characteristics assessed, only tumor thickness affected survival from diagnosis of stage IV disease, hazard ratio=1.09 (1.02 to 1.16), P=0.008. This remained significant in multivariate analysis, P=0.007. Other primary tumor characteristics did not significantly influence survival. Primary tumor thickness is a significant prognostic factor in stage IV melanoma. Our data suggest that the biology of the primary melanoma may persist to influence the behavior of metastatic disease.

Factors associated with professional satisfaction in primary care: Results from EUprimecare project.

Science.gov (United States)

Sanchez-Piedra, Carlos Alberto; Jaruseviciene, Lina; Prado-Galbarro, Francisco Javier; Liseckiene, Ida; Sánchez-Alonso, Fernando; García-Pérez, Sonia; Sarria Santamera, Antonio

2017-12-01

Given the importance of primary care to healthcare systems and population health, it seems crucial to identify factors that contribute to the quality of primary care. Professional satisfaction has been linked with quality of primary care. Physician dissatisfaction is considered a risk factor for burnout and leaving medicine. This study explored factors associated with professional satisfaction in seven European countries. A survey was conducted among primary care physicians. Estonia, Finland, Germany and Hungary used a web-based survey, Italy and Lithuania a telephone survey, and Spain face to face interviews. Sociodemographic information (age, sex), professional experience and qualifications (years since graduation, years of experience in general practice), organizational variables related to primary care systems and satisfaction were included in the final version of the questionnaire. A logistic regression analysis was performed to assess the factors associated with satisfaction among physicians. A total of 1331 primary care physicians working in primary care services responded to the survey. More than half of the participants were satisfied with their work in primary care services (68.6%). We found significant associations between satisfaction and years of experience (OR = 1.01), integrated network of primary care centres (OR = 2.8), patients having direct access to specialists (OR = 1.3) and professionals having access to data on patient satisfaction (OR = 1.3). Public practice, rather than private practice, was associated with lower primary care professional satisfaction (OR = 0.8). Elements related to the structure of primary care are associated with professional satisfaction. At the individual level, years of experience seems to be associated with higher professional satisfaction.

Some behavioural risk factors for intestinal helminthiasis in nursery and primary school children in Enugu, south eastern Nigeria.

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Ilechukwu, G C; Ilechukwu, C G A; Ozumba, A N; Ojinnaka, N C; Ibe, B C; Onwasigwe, C N

2010-09-01

The objective of this study was to determine some common behavioural risk factors for intestinal helminthiasis in nursery and primary school children in Enugu. A cross-sectional survey on 460 children attending nursery and primary schools in Enugu was carried out in 2003 with a view to determine some behavioural risk factors for intestinal helminthiasis. This study was carried out in the research laboratory of the Federal Ministry of Health, National Arbovirus and Vector Research Centre, Enugu. Intestinal helminthiasis was diagnosed using the kato-katz method in analysing fresh stool samples collected from nursery and primary school children in Enugu. These fresh stool samples were collected into appropriately labeled clean containers. Questionnaires were administered by the researchers to obtain data from the children and their parents or guardians as regards some behavioural risk factors for intestinal helminthiasis. The results from this study showed that the prevalence of intestinal helminthiasis was significantly affected by various behavioural risk factors. The rate of helminthic infection varied significantly with hand washing habits after defeacation (chi2 = 75.77; df= 2; p = 0.001) and with different habits of washing fruits before eating (chi2 = 52.79; df=2; p = 0.001) among the pupils. Also, the rate ofhelminthic infection varied significantly with the source of drinking water (chi2 = 55.12; df = 3; p = 0.01), water boiling habits (chi2 = 40.89; df = 2; p = 0.001), use of footwear after school hours (chi2 = 30.72; df = 2; p = 0.001). Sites utilized for defeacation by the pupils (chi2 = 80.25; df=3; p = 0.001) also significantly influenced the rate ofhelminthic infection. Various behavioural factors which significantly affect the rate of helminthic infection abound in children living in Enugu. The government should give attention to the control of these behavioural risk factors. A lot of health education will be needed to curb the poor personal hygienic

Factors affecting job satisfaction among primary and secondary school teachers in the autonomous province of Vojvodina

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Majstorović Nebojša Z.

2017-01-01

Full Text Available The study presented in this paper analyses the impact of the individual factors of mental and physical health and life satisfaction, as well as the importance of some organizational factors such as the climate in schools, the composition of classes in the case of class teachers, and certain demographic characteristics on primary and secondary school teachers' job satisfaction. The data were collected from a convenience sample of 176 teachers of primary and secondary schools in Serbia's autonomous province of Vojvodina, of different ages, genders, and years of service. The principal results indicate that job satisfaction is higher among teachers who perceive the climate in their school as positive, among teachers with higher life satisfaction, and among teachers who are in good health and, most importantly, lacking depressive reactions. When it comes to perceptions of the climate, the best predictor of job satisfaction is the degree of respondents' satisfaction with collaboration with colleagues and with decision making processes. The results also indicate that secondary school teachers report a higher level of overall job satisfaction, specifically, a higher level of satisfaction with school governance, co-workers and communication than primary school teachers. As regards demographic characteristics, the results suggest that there are no significant gender differences in job satisfaction levels and that job satisfaction declines with the number of years of service, with respondents who had between 21 and 30 years of service reporting the lowest levels of job satisfaction, which tended to rise towards the end of the teaching career.

Low prevalence of cardiovascular risk factors among primary school ...

African Journals Online (AJOL)

Background: Identification of obesity and other risk factors for cardiovascular disease in childhood is strongly recommended for prevention of the diseases in adulthood. Objectives: To determine the prevalence of the conventional cardiovascular risk factors among primary school children aged 6-15 years in Urban Dar es ...

The Effect of Free Primary Education Policy on Late School Entry in Urban Primary Schools in Kenya

Science.gov (United States)

Ngware, Moses W.; Oketch, Moses; Ezeh, Alex C.; Mutisya, Maurice

2013-01-01

Late school entry is driven by several factors, one of the key ones being the cost barrier to schooling. Policies such as free primary education (FPE) that advocate for universal coverage are therefore partly aimed at removing the cost barrier. The Kenyan Government, like many in sub-Saharan Africa (SSA), introduced FPE in 2003 with the aim of…

Factors affecting bank governance in Malaysia

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Wan Masliza Wan Mohammad

2012-03-01

Full Text Available Since the financial crisis in year 1997, banks in Malaysia had undergone various issues and transformations, including stricter regulation on merger and acquisitions and greater enforcement of corporate governance. Besides that, the institutions had also gone through the transformation in terms of the risk assessment practice due to the stricter rulings under Basel II regulations. Taking into account of these changes, this study empirically examines the effects of corporate governance, risk and capital on the performance of banks in Malaysia. Based on 132 firm-year samples for the period of 2004-2009, study indicates a significant and negative relationship between bank risks and performance. It further reveals that the risk weighted capital (RRWC improves bank performance. However none of the corporate governance variables have any associations with banks performance. The detail explanations of the findings along with the suggestions for future research are provided in the full text of the reports

Industry Issue Paper: Cross-Cultural Factors and Corporate Governance Transparency in Global Airline Strategic Alliances

OpenAIRE

Giapponi, Catherine C.; Scheraga, Carl A.

2007-01-01

This paper argues that a critical dimension in understanding the factors that inhibit the effectiveness and benefits of airline alliances is corporate transparency. Specifically, the issue of transparency in corporate governance is considered. Corporate governance is the set of institutional arrangements affecting corporate decision making, and deals with the relationship among various participants in determining the direction and performance of corporations. However, airline strategic allian...

Questionnaire Based Assessment of Risk Factors for Primary Biliary Cirrhosis

Science.gov (United States)

Lammert, Craig; Nguyen, Douglas L.; Juran, Brian D.; Schlicht, Erik; Larson, Joseph J.; Atkinson, Elizabeth J.; Lazaridis, Konstantinos N.

2013-01-01

Background Primary Biliary Cirrhosis is a cholestatic liver disease characterized by immune-mediated destruction of bile ducts. Its pathogenesis is largely unknown, although complex interactions between environment and genetic predisposition are proposed. Aims Identify disease risk factors using a detailed patient questionnaire and compare study findings to 3 published reports. Methods Questionnaire data were prospectively collected from 522 cases and 616 controls of the Mayo Clinic Primary Biliary Cirrhosis Genetic Epidemiology Registry. Case and control responses were compared using logistic regression, adjusting for recruitment age, sex, and education level. Results Cases reported ever regularly smoking cigarettes more frequently than controls (P < 0.001). History of urinary tract infection (UTI) was similar between groups; however, cases reported multiple UTIs more commonly than controls (P < 0.001). Frequency of other autoimmune disease was higher in cases than controls (P < 0.001). As well, prevalence of primary biliary cirrhosis among first-degree relatives was higher in case families than control families (P < 0.001). Conclusions Our study confirms prior reported risk factors associated with disease risk. Given the potential importance of gene and environment interactions, further examination of environmental risk factors considering genetic background may provide new insight into primary biliary cirrhosis pathogenesis. PMID:23490343

Corporate governance, cultural factors and voluntary disclosure: Evidence from selected companies in Bangladesh

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M. Akhtaruddin

2012-01-01

Full Text Available This research aims to test empirically the relationship between corporate governance, cultural factors and voluntary disclosure by the listed companies in Bangladesh. The corporate governance factors examined are proportion of independent non-executive directors (INDs, board leadership structure, management ownership, board size and audit committee size. The extent of voluntary disclosure level is measured using 68 items of information. Data are taken from annual reports of the listed companies in Bangladesh. The result shows a positive association between board size, board leadership structure, audit committee size and voluntary disclosure. However, no evidence is found to support the contention that independent directors are associated with increased disclosure, consistent with previous studies. Higher education of the CEO and CFO is positively related to the level of voluntary disclosure. The result also indicates that the extent of voluntary disclosures is negatively associated with a higher management ownership.

Exploring Context and the Factors Shaping Team-Based Primary Healthcare Policies in Three Canadian Provinces: A Comparative Analysis.

Science.gov (United States)

Misfeldt, Renée; Suter, Esther; Mallinson, Sara; Boakye, Omenaa; Wong, Sabrina; Nasmith, Louise

2017-08-01

This paper discusses findings from a high-level scan of the contextual factors and actors that influenced policies on team-based primary healthcare in three Canadian provinces: British Columbia, Alberta and Saskatchewan. The team searched diverse sources (e.g., news reports, press releases, discussion papers) for contextual information relevant to primary healthcare teams. We also conducted qualitative interviews with key health system informants from the three provinces. Data from documents and interviews were analyzed qualitatively using thematic analysis. We then wrote narrative summaries highlighting pivotal policy and local system events and the influence of actors and context. Our overall findings highlight the value of reviewing the context, relationships and power dynamics, which come together and create "policy windows" at different points in time. We observed physician-centric policy processes with some recent moves to rebalance power and be inclusive of other actors and perspectives. The context review also highlighted the significant influence of changes in political leadership and prioritization in driving policies on team-based care. While this existed in different degrees in the three provinces, the push and pull of political and professional power dynamics shaped Canadian provincial policies governing team-based care. If we are to move team-based primary healthcare forward in Canada, the provinces need to review the external factors and the complex set of relationships and trade-offs that underscore the policy process. Copyright © 2017 Longwoods Publishing.

A retrospective study of the role of intracavitary brachytherapy and prognotic factors determining local tumour control after primary radical radiotherapy in 903 non-disseminated nasopharyngeal carcinoma patients

International Nuclear Information System (INIS)

Teo, P.M.L.; Kwan, W.H.; Yu, P.; Lee, W.Y.; Leung, S.F.; Choi, P.

1996-01-01

The aims of this retrospective study were to determine the role of intracavitary brachytherapy given shortly after external beam radiotherapy in the primary radical treatment of non-metastatic nasopharyngeal (NPC) cancer patients, and the prognostic factors governing local tumour control. From 1984 to 1989, 903 patients with non-disseminated NPC who had no previous treatment were managed at the Prince of Wales Hospital, Hong Kong, where investigation and treatment methods had been standardized according to a departmental protocol. In the 903 non-disseminated NPCs, the patient's age and tumour involvement of the skull base and cranial nerves were significant independent prognostic factors governing local tumour control. In the 358 patients with Ho T 3 disease, tumour involvement of the orbits and the laryngopharynx significantly worsened local tumour control. The presence of local persistence at 4 weeks after external radiotherapy, for which therapeutic brachytherapy was given, was marginally significant as a prognostic factor in addition to the presence of cranial nerve palsy. (author)

An international corporate governance index

NARCIS (Netherlands)

Martynova, M.; Renneboog, L.D.R.; Wright, M.; Siegel, D.; Keasey, K.; Filatotchev, I.

2013-01-01

This chapter presents a comparative analysis of corporate governance regulatory systems and their development since 1990 in the United States and in 30 European countries. It introduces a proposed methodology that would help create detailed corporate governance indices which describe the primary

An overview of future EU health systems. An insight into governance, primary care, data collection and citizens' participation.

Science.gov (United States)

Quaglio, Gianluca; Figueras, Josep; Mantoan, Domenico; Dawood, Amr; Karapiperis, Theodoros; Costongs, Caroline; Bernal-Delgado, Enrique

2018-03-26

Health systems in the European Union (EU) are being questioned over their effectiveness and sustainability. In pursuing both goals, they have to conciliate coexisting, not always aligned, realities. This paper originated from a workshop entitled 'Health systems for the future' held at the European Parliament. Experts and decision makers were asked to discuss measures that may increase the effectiveness and sustainability of health systems, namely: (i) increasing citizens' participation; (ii) the importance of primary care in providing integrated services; (iii) improving the governance and (iv) fostering better data collection and information channels to support the decision making process. In the parliamentary debate, was discussed the concept that, in the near future, health systems' effectiveness and sustainability will very much depend on effective access to integrated services where primary care is pivotal, a clearer shift from care-oriented systems to health promotion and prevention, a profound commitment to good governance, particularly to stakeholders participation, and a systematic reuse of data meant to build health data-driven learning systems. Many health issues, such as future health systems in the EU, are potentially transformative and hence an intense political issue. It is policy-making leadership that will mostly determine how well EU health systems are prepared to face future challenges.

People and Teams Matter in Organizational Change: Professionals’ and Managers’ Experiences of Changing Governance and Incentives in Primary Care

Science.gov (United States)

Allan, Helen T; Brearley, Sally; Byng, Richard; Christian, Sara; Clayton, Julie; Mackintosh, Maureen; Price, Linnie; Smith, Pam; Ross, Fiona

2014-01-01

ObjectivesTo explore the experiences of governance and incentives during organizational change for managers and clinical staff. Study SettingThree primary care settings in England in 2006–2008. Study DesignData collection involved three group interviews with 32 service users, individual interviews with 32 managers, and 56 frontline professionals in three sites. The Realistic Evaluation framework was used in analysis to examine the effects of new policies and their implementation. Principal FindingsIntegrating new interprofessional teams to work effectively is a slow process, especially if structures in place do not acknowledge the painful feelings involved in change and do not support staff during periods of uncertainty. ConclusionsEliciting multiple perspectives, often dependent on individual occupational positioning or place in new team configurations, illuminates the need to incorporate the emotional as well as technocratic and system factors when implementing change. Some suggestions are made for facilitating change in health care systems. These are discussed in the context of similar health care reform initiatives in the United States. PMID:23829292

Factor Configurations with Governance as Conditions for Low HIV/AIDS Prevalence in HIV/AIDS Recipient Countries: Fuzzy-set Analysis.

Science.gov (United States)

Lee, Hwa-Young; Yang, Bong-Min; Kang, Minah

2015-11-01

This paper aims to investigate whether good governance of a recipient country is a necessary condition and what combinations of factors including governance factor are sufficient for low prevalence of HIV/AIDS in HIV/AIDS aid recipient countries during the period of 2002-2010. For this, Fuzzy-set Qualitative Comparative Analysis (QCA) was used. Nine potential attributes for a causal configuration for low HIV/AIDS prevalence were identified through a review of previous studies. For each factor, full membership, full non-membership, and crossover point were specified using both author's knowledge and statistical information of the variables. Calibration and conversion to a fuzzy-set score were conducted using Fs/QCA 2.0 and probabilistic tests for necessary and sufficiency were performed by STATA 11. The result suggested that governance is the necessary condition for low prevalence of HIV/AIDS in a recipient country. From sufficiency test, two pathways were resulted. The low level of governance can lead to low level of HIV/AIDS prevalence when it is combined with other favorable factors, especially, low economic inequality, high economic development and high health expenditure. However, strengthening governance is a more practical measure to keep low prevalence of HIV/AIDS because it is hard to achieve both economic development and economic quality. This study highlights that a comprehensive policy measure is the key for achieving low prevalence of HIV/AIDS in recipient country.

Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study.

Science.gov (United States)

Hernan, Andrea L; Giles, Sally J; Fuller, Jeffrey; Johnson, Julie K; Walker, Christine; Dunbar, James A

2015-09-01

Patients can have an important role in reducing harm in primary-care settings. Learning from patient experience and feedback could improve patient safety. Evidence that captures patients' views of the various contributory factors to creating safe primary care is largely absent. The aim of this study was to address this evidence gap. Four focus groups and eight semistructured interviews were conducted with 34 patients and carers from south-east Australia. Participants were asked to describe their experiences of primary care. Audio recordings were transcribed verbatim and specific factors that contribute to safety incidents were identified in the analysis using the Yorkshire Contributory Factors Framework (YCFF). Other factors emerging from the data were also ascertained and added to the analytical framework. Thirteen factors that contribute to safety incidents in primary care were ascertained. Five unique factors for the primary-care setting were discovered in conjunction with eight factors present in the YCFF from hospital settings. The five unique primary care contributing factors to safety incidents represented a range of levels within the primary-care system from local working conditions to the upstream organisational level and the external policy context. The 13 factors included communication, access, patient factors, external policy context, dignity and respect, primary-secondary interface, continuity of care, task performance, task characteristics, time in the consultation, safety culture, team factors and the physical environment. Patient and carer feedback of this type could help primary-care professionals better understand and identify potential safety concerns and make appropriate service improvements. The comprehensive range of factors identified provides the groundwork for developing tools that systematically capture the multiple contributory factors to patient safety. Published by the BMJ Publishing Group Limited. For permission to use (where not

Factors Affecting Project Governance Of Arusha Archdiocesan Food Security And Livelihood Project In Monduli District Tanzania.

Directory of Open Access Journals (Sweden)

Kisame Deogratious

2015-06-01

Full Text Available Abstract This research project dealt with the factors affecting governance of Food security and livelihood projects a case study of the Food security and livelihood project that was implemented by AAIDRO in Monduli district and included 60 respondents all together. The specific objectives of this study intended to access the Leadership styles that are being used in project governance. The findings of the study indicated that 91.7 of the respondents were in favor of their leaders project governance styles it was portrayed that participative leadership style was being used by the leaders for project governance. Based on a sample of 60 project members this study had confirmed that a project leaders leadership roles like mentor facilitator innovator and coordinator are important in influencing project governance effectiveness which includes team mission goal achievement and empowerment open and honest communication

Introducing Children to Democratic Government

Science.gov (United States)

Alleman, Janet; Brophy, Jere

2006-01-01

Researchers have been studying children's knowledge, thinking, and attitudes about government for several decades. However, the studies focusing on elementary students, and especially primary students, have little or nothing to say about children's ideas about democracy or democratic government. That is because children at these ages have not yet…

District Governance and Student Learning in Indonesia

OpenAIRE

Pradhan, Menno; de Ree, Joppe

2014-01-01

We document the likely importance of district governance and teacher management policies in relation to student learning in Indonesian primary schools. As the responsibility to deliver primary education has been decentralized to district governments, we expect district specific variations in teacher management policies. Consequently, we also expect variations in learning trajectories across districts. We document substantial heterogeneity in learning gains across districts. Furthermore, we sh...

Contextual Factors Affecting E-Government Strategy Implementation and Its Impact on Public Sector Performance in Kenya

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Dr. James Gathungu

2013-06-01

Full Text Available This paper assesses the contextual factors affecting the implementation of e-government strategy and its impact on the performance of the public sector in Kenya using the Wing Lam, (2005 E-government Integration Model. Electronic government (E-government is viewed in this study as the utilization of Information Communication Technologies (ICTs to transform the efficiency, effectiveness, transparency and accountability of exchanges within government, between government and citizens and businesses locally and abroad; and to empower citizens through access and use of information. Although e-government is a rapidly growing concept in both developing and developed countries very few e-government initiatives progress to maturity. Different countries are faced with different contextual circumstances and environments in the realization of e-government initiatives. This study attempts to address the gap between theory and rhetoric about the potential of e-government and the reality of its application on the ground in Kenya. The study attempts to analyze the philosophy, theories and paradigms of e-government. The development of the commercial concept as a new paradigm in public administration replacing the traditional bureaucratic systems of government is highlighted in the study. A detailed conceptual discussion anchors the study on the Wing Lam, (2005 E-government Integration Model (EGI basing it on the Kenyan perspective. The study also reviews relevant e-government studies from an international, regional and local perspective anchoring the study on the configuration school of management thought. These discussions are used to develop new insights in view of the emerging issues and their relevance to the public sector in Kenya.

Contextual Factors Affecting E-Government Strategy Implementation and Its Impact on Public Sector Performance in Kenya

Directory of Open Access Journals (Sweden)

Dr. James Gathungu

2013-06-01

Full Text Available This paper assesses the contextual factors affecting the implementation of e-government strategy and its impact on the performance of the public sector in Kenya using the Wing Lam, (2005 E-government Integration Model. Electronic government (E-government is viewed in this study as the utilization of Information Communication Technologies (ICTs to transform the efficiency, effectiveness, transparency and accountability of exchanges within government, between government and citizens and businesses locally and abroad; and to empower citizens through access and use of information. Although e-government is a rapidly growing concept in both developing and developed countries very few e-government initiatives progress to maturity. Different countries are faced with different contextual circumstances and environments in the realization of e-government initiatives. This study attempts to address the gap between theory and rhetoric about the potential of e-government and the reality of its application on the ground in Kenya. The study attempts to analyze the philosophy, theories and paradigms of e-government. The development of the commercial concept as a new paradigm in public administration replacing the traditional bureaucratic systems of government is highlighted in the study. A detailed conceptual discussion anchors the study on the Wing Lam, (2005 E-government Integration Model (EGI basing it on the Kenyan perspective. The study also reviews relevant e-government studies from an international, regional and local perspective anchoring the study on the configuration school of management thought. These discussions are used to develop new insights in view of the emerging issues and their relevance to the public sector in Kenya.  

Governance matters: an ecological association between governance and child mortality.

Science.gov (United States)

Lin, Ro-Ting; Chien, Lung-Chang; Chen, Ya-Mei; Chan, Chang-Chuan

2014-09-01

Governance of a country may have widespread effects on the health of its population, yet little is known about the effect of governance on child mortality in a country that is undergoing urbanization, economic development, and disease control. We obtained indicators of six dimensions of governance (perceptions of voice and accountability, political stability and absence of violence, government effectiveness, regulatory quality, rule of law, and control of corruption) and national under-5 mortality rates for 149 countries between 1996 and 2010. We applied a semi-parametric generalized additive mixed model to examine associations after controlling for the effects of development factors (urbanization level and economy), disease control factors (hygienic conditions and vaccination rates), health expenditures, air quality, and time. Governance, development, and disease control showed clear inverse relations with the under-5 mortality rate (pcountry's need for better governance is as important as improvements in development and disease control. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Investigating antecedent factors to job performance: Contemporary evidence from government supply management professionals

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Chengedzai Mafini

2015-06-01

Full Text Available Purpose: The purpose of the study was to investigate the influence of transformational leadership, organisational citizenship behaviour and quality of work life on job performance amongst supply management professionals employed by the South African government. Rationale: The depressed job performance of supply management professionals in the South African government presents an impetus to generate new empirical information on the subject in order to find solutions. Methodology: A quantitative survey approach was followed using a sample of 264 supply management professionals employed in the South African government and were based in Gauteng Province. A Confirmatory Factor Analysis (CFA was conducted to assess psychometric properties of the measurement instrument. Hypotheses were tested using Structural Equation Modelling (SEM. Findings: Transformational leadership had positive and significant relationships with organisational citizenship behaviour and quality of work life. Quality of work life exerted a greater influence of job performance than organisational citizenship behaviour. Value of research: The study provides current evidence of the influence of transformational leadership on organisational citizenship behaviour and quality of work life, as well as the influence of organisational citizenship behaviour and quality of work life on job performance amongst supply management professionals. Conclusion: Transformational leadership has a positive influence on organisational citizenship behaviour and quality of work life amongst supply management professionals in the government. Both organisational citizenship behaviour and quality of work life exerta positive influence on the job performance of supply management professionals in the government. Future studies should be extended to other professional cohorts in both the private and the government sectors.

Bringing Democratic Governance into Practice: Policy Enactments Responding to Neoliberal Governance in Spanish Public Schools

Science.gov (United States)

Prieto-Flores, Òscar; Feu, Jordi; Serra, Carles; Lázaro, Laura

2018-01-01

This article explores different ways in which public primary schools sustain democratic governance structures created beyond those mandated by law in Spain. These new institutional designs, while not opposed to policy text requirements of having a governing body with representatives of parents, teachers and public administration, are being carried…

Regulatory factors governing adenosine-to-inosine (A-to-I) RNA editing.

Science.gov (United States)

Hong, HuiQi; Lin, Jaymie Siqi; Chen, Leilei

2015-03-31

Adenosine-to-inosine (A-to-I) RNA editing, the most prevalent mode of transcript modification in higher eukaryotes, is catalysed by the adenosine deaminases acting on RNA (ADARs). A-to-I editing imposes an additional layer of gene regulation as it dictates various aspects of RNA metabolism, including RNA folding, processing, localization and degradation. Furthermore, editing events in exonic regions contribute to proteome diversity as translational machinery decodes inosine as guanosine. Although it has been demonstrated that dysregulated A-to-I editing contributes to various diseases, the precise regulatory mechanisms governing this critical cellular process have yet to be fully elucidated. However, integration of previous studies revealed that regulation of A-to-I editing is multifaceted, weaving an intricate network of auto- and transregulations, including the involvement of virus-originated factors like adenovirus-associated RNA. Taken together, it is apparent that tipping of any regulatory components will have profound effects on A-to-I editing, which in turn contributes to both normal and aberrant physiological conditions. A complete understanding of this intricate regulatory network may ultimately be translated into new therapeutic strategies against diseases driven by perturbed RNA editing events. Herein, we review the current state of knowledge on the regulatory mechanisms governing A-to-I editing and propose the role of other co-factors that may be involved in this complex regulatory process.

FACTORS INFLUENCING THE SUCCESS OF PERFORMANCE MEASUREMENT: EVIDENCE FROM LOCAL GOVERNMENT

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Herlina Primarisanti

2015-01-01

Full Text Available There were only a few government institutions in Indonesia capable of preparing good accountability reports. Based on the survey conducted in the Special District of Yogyakarta, the study aimed to empirically examine the influencing factors in the development of the measure-ment system of performance, performance accountability and the use of performance informa-tion. Additionally, it also tried to interpret and to explain empirical evidence in the perspective of the institutional theory. The institutional theory was used to find out the extent to which the development of the measurement system of the performance, the performance accountability and the use of the performance information was influenced because of the presence of coercive, mimetic and normative isomorphism phenomena. The study used mixed methods that combined quantitative and qualitative study approaches simultaneously and a sequential explanatory strategy. It used Partial Least Square (PLS analysis to test the hypotheses. It gave evidence that training, incentives and authority in decision making had significant impacts on the development of the measurement of the performance, the performance accountability and the use of the performance information. It contributed to the understanding of the influencing factors of the development of the measurement system of the performance, the performance accountability and the use of the performance information in order to improve the measurement system of the performance of government institutions.

Historical Assessment Of The Government's Provision Of Primary ...

African Journals Online (AJOL)

Infrastructure in Lagos State public primary and secondary schools should be up graded and modern ones be provided.Infrastructure in Lagos State public primary and secondary schools should be up graded and modern ones be provided. African Journal of Cross-Cultural Psychology and Sport Facilitation Vol. 10 2008: ...

Human factors and ergonomics for primary care.

Science.gov (United States)

Bowie, Paul; Jeffcott, Shelly

2016-03-01

In the second paper of this series, we provide a brief overview of the scientific discipline of human factors and ergonomics (HFE). Traditionally the HFE focus in healthcare has been in acute hospital settings which are perceived to exhibit characteristics more similar to other high-risk industries already applying related principles and methods. This paper argues that primary care is an area which could benefit extensively from an HFE approach, specifically in improving the performance and well-being of people and organisations. To this end, we define the purpose of HFE, outline its three specialist sub-domains (physical, cognitive and organisational HFE) and provide examples of guiding HFE principles and practices. Additionally, we describe HFE issues of significance to primary care education, improvement and research and outline early plans for building capacity and capability in this setting.

Effects of Corporate Social Responsibility and Governance on Its Credit Ratings

Science.gov (United States)

Kim, Dong-young

2014-01-01

This study reviews the impact of corporate social responsibility (CSR) and corporate governance on its credit rating. The result of regression analysis to credit ratings with relevant primary independent variables shows that both factors have significant effects on it. As we have predicted, the signs of both regression coefficients have a positive sign (+) proving that corporates with excellent CSR and governance index (CGI) scores have higher credit ratings and vice versa. The results show nonfinancial information also may have effects on corporate credit rating. The investment on personal data protection could be an example of CSR/CGI activities which have positive effects on corporate credit ratings. PMID:25401134

Effects of corporate social responsibility and governance on its credit ratings.

Science.gov (United States)

Kim, Dong-young; Kim, JeongYeon

2014-01-01

This study reviews the impact of corporate social responsibility (CSR) and corporate governance on its credit rating. The result of regression analysis to credit ratings with relevant primary independent variables shows that both factors have significant effects on it. As we have predicted, the signs of both regression coefficients have a positive sign (+) proving that corporates with excellent CSR and governance index (CGI) scores have higher credit ratings and vice versa. The results show nonfinancial information also may have effects on corporate credit rating. The investment on personal data protection could be an example of CSR/CGI activities which have positive effects on corporate credit ratings.

Correlation Factors Describing Primary and Spatial Sensations of Sound Fields

Science.gov (United States)

ANDO, Y.

2002-11-01

The theory of subjective preference of the sound field in a concert hall is established based on the model of human auditory-brain system. The model consists of the autocorrelation function (ACF) mechanism and the interaural crosscorrelation function (IACF) mechanism for signals arriving at two ear entrances, and the specialization of human cerebral hemispheres. This theory can be developed to describe primary sensations such as pitch or missing fundamental, loudness, timbre and, in addition, duration sensation which is introduced here as a fourth. These four primary sensations may be formulated by the temporal factors extracted from the ACF associated with the left hemisphere and, spatial sensations such as localization in the horizontal plane, apparent source width and subjective diffuseness are described by the spatial factors extracted from the IACF associated with the right hemisphere. Any important subjective responses of sound fields may be described by both temporal and spatial factors.

Factors Influencing Electronic Government Adoption Perspectives Of Less Frequent Internet Users Of Pakistan

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Farooq Alam Khan

2015-01-01

Full Text Available Abstract Much literature on electronic government services research could be found on adoptability issues from government and service providers point of view. Many studies have looked into adoptability factors from user perspectives and majority captured adoptability perspectives of frequent Internet users the ones who use Internet applications for more than 10 hours a week. On the contrary the perspectives of majority of Pakistani users which use Internet applications for less than 10 hours per week are never inquired. This paper tries to fill this gap by looking into electronic government adoptability perspectives and expectations of such Internet users of Pakistan which are much greater in numbers than others. An amended UTAUT model with all its moderators is used in this study and the results demonstrate that performance level ease of effort and social influence strongly effect behavioral intention of users in using electronic government services in Pakistan. The individuals behavioral intention along with presence of appropriate facilitating conditions triggers use behavior of users. The results show that only gender moderates majority of UTAUT relationships and accordingly a modified UTAUT model is presented. The paper provides certain insights for people making policies and academicians for performing further research while it stresses for service proliferation with special attention towards female population.

Beyond job security and money: driving factors of motivation for government doctors in India.

Science.gov (United States)

Purohit, Bhaskar; Bandyopadhyay, Tathagata

2014-02-21

Despite many efforts from government to address the shortage of medical officers (MOs) in rural areas, rural health centres continue to suffer from severe shortage of MOs. Lack of motivation to join and continue service in rural areas is a major reason for such shortage. In the present study, we aimed to assess and rank the driving factors of motivation important for in-service MOs in their current job. The study participants included ninety two in-service government MOs from three states in India. The study participants were required to rank 14 factors of motivation important for them in their current job. The factors for the study were selected using Herzberg's two-factor theory of motivation and the data were collected using an instrument that has an established reliability and validity. Test of Kendall's coefficient of concordance (W) was carried out to assess the agreement in ranks assigned by participants to various motivation factors. Next, we studied the distributions of ranks of different motivating factors using standard descriptive statistics and box plots, which gave us interesting insights into the strength of agreement of the MOs in assigning ranks to various factors. And finally to assess whether MOs are more intrinsically motivated or extrinsically motivated, we used Kolmogorov-Smirnov test. The (W) test indicated statistically significant (P factors than to extrinsic factors. The study results indicate that job security was the most important factor related to motivation, closely followed by interesting work and respect and recognition. Among the top five preferred factors, three were intrinsic factors indicating a great importance given by MOs to factors beyond money and job security. To address the issue of motivation, the health departments need to pay close attention to devising management strategies that address not only extrinsic but also intrinsic factors of motivation. The study results may be useful to understand the complicated issue of

Corporate Governance and Equity Returns

OpenAIRE

Uchida, Shigeru

2012-01-01

This paper analyses the relationship between corporate governance and equity returns from the small investors view point. A primary survey has been conducted to gather the data required to examine the link. Preliminary result of the study shows that the four elements of governance: board structure, transparency, fairness and responsibility are positively related with equity returns.

Sociotechnical factors influencing unsafe use of hospital information systems: A qualitative study in Malaysian government hospitals.

Science.gov (United States)

Salahuddin, Lizawati; Ismail, Zuraini; Hashim, Ummi Rabaah; Raja Ikram, Raja Rina; Ismail, Nor Haslinda; Naim Mohayat, Mohd Hariz

2018-03-01

The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.

Burnout among primary school teachers in Iraq: prevalence and risk factors.

Science.gov (United States)

Al-Asadi, Jasim; Khalaf, Shukrya; Al-Waaly, Aqeel; Abed, Alaa; Shami, Sabah

2018-06-10

Studies from various parts of the world have shown that teachers are likely to suffer from burnout. So far, there has been no research on burnout among primary school teachers in Basrah, Iraq. We aimed to determine the prevalence and predisposing factors of self-reported burnout among primary school teachers in Basrah. This was a cross-sectional study in 32 governmental primary schools during November 2014-February 2015. A self-administered questionnaire was used to collect sociodemographic and work-related data using the Oldenburg Burnout Inventory. Of 800 questionnaires distributed, 706 (88.3%) were completed; 58.4% were from women. The prevalence of burnout was 24.5% (95% CI: 21.5-27.8). A statistically significant association was found between burnout and age, sex and marital status. Work-related factors that showed significant association with burnout were: work overload, problems related to career advancement, high number of students per class and student misbehaviour. Burnout is an important health problem among primary school teachers in Basrah. A number of risk factors, particularly those related to work, are amenable to modification since they are related to the education policy. Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

Analysis of the financial factors governing the profitability of lunar helium-3

Science.gov (United States)

Kulcinski, G. L.; Thompson, H.; Ott, S.

1989-01-01

Financial factors influencing the profitability of the mining and utilization of lunar helium-3 are examined. The analysis addressed the following questions: (1) which financial factors have the greatest leverage on the profitability of He-3; (2) over what range can these factors be varied to keep the He-3 option profitable; and (3) what ultimate effect could this energy source have on the price of electricity for U.S. consumers. Two complementary methods of analysis were used in the assessment: rate of return on incremental investment required and reduction revenue requirements (total cost to customers) achieved. Some of the factors addressed include energy demand, power generation costs with and without fusion, profitability for D-He(3) fusion, annual capital and operating costs, launch mass and costs, He-3 price, and government funding. Specific conclusions are made with respect to each of the companies considered: utilities, lunar mining company, and integrated energy company.

Metagoverning Collaborative Innovation in Governance Networks

DEFF Research Database (Denmark)

Sørensen, Eva; Torfing, Jacob

2017-01-01

, the current wave of New Public Governance reforms perceives collaboration between relevant and affected actors from the public and private sector as the primary vehicle of public innovation, and tends to see governance networks as potential arenas for collaborative innovation. The new focus on collaborative...... innovation in networks poses a fundamental challenge for public managers, elected politicians, and others aiming to metagovern governance networks. Hence, we claim that a specific metagovernance strategy is needed when the purpose of governance networks is to stimulate efficiency, effectiveness...

Factors Influencing Belize District Primary School Teachers' Attitudes toward Inclusive Education

Science.gov (United States)

McKay, Maxine

2012-01-01

Inclusive education continues to be a reoccurring challenge as various factors affect to what extent teachers or educators are willing to educate children with disabilities in the regular education setting alongside their non-disabled peers. This quantitative study examined factors influencing Belize District Primary School teachers' attitudes…

INSOMNIA AND CORRELATION WITH PSYCHOSOCIAL FACTORS IN PRIMARY HEALTH CARE

OpenAIRE

Made Gede Cahyadi Permana

2013-01-01

Insomnia is regarded as sleep disorder that most often affects people in the world, both in primary and in the presence of comorbid conditions. Based on those facts, insomnia could be a serious problem at the level of primary health care. General Practitioner should be able to diagnose insomnia and able to perform the appropriate treatment for the patient. Psychosocial factors may related to the degree of severity of insomnia, among others are health status, depression, dysfunctional beliefs ...

Prevalence of depression among women attending a primary urban care clinic in Malaysia.

Science.gov (United States)

Sidik, Sherina Mohd; Arroll, Bruce; Goodyear-Smith, Felicity; Ahmad, Rozali

2012-07-01

Depression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic. A cross-sectional study was conducted in a government-funded primary care clinic in Malaysia. Consecutive adult female patients attending the clinic during the data collection period were invited to participate. The participants completed self-administered questionnaires (including the validated Patient Health Questionnaire [PHQ-9], which was translated into the Malay language). A total of 895 female patients participated in the study (response rate 87.5%). The prevalence of depression (PHQ-9 scores ≥ 10) was 12.1%. Based on multiple logistic regression analysis, certain stressful life events were found to be associated with depression (p depression among participants in this study was clinically significant and corresponded with the findings of other international studies. Factors associated with depression need to be highlighted and addressed accordingly. Clinicians in Malaysia should be aware of this prevalence when making diagnoses in primary care.

Enhanced understanding of energy ratepayers: Factors influencing perceptions of government energy efficiency subsidies and utility alternative energy use

International Nuclear Information System (INIS)

Craig, Christopher A.; Allen, Myria W.

2014-01-01

This study explores factors related to energy consumers' perceptions of government subsidies for utility provided energy efficiency (EE) programs and for utility providers' use of more clean/alternative energy sources. Demographic factors, attitudes, planned purchases, and perceptions of utility provider motives in relation to governmental and utility provider EE initiatives (i.e. providing discounts and coupons for CFL bulbs), plus the influence of gain- and loss-framed messages are investigated. Over 2000 respondents completed a 16 item phone survey. Hierarchical regression explained 38% of the variance in reactions regarding government subsidies of the cost of utility provided EE programs and 43% of the variance in perceptions involving whether utility companies should use of more clean or alternative forms of energy. Gender and party differences emerged. Loss-framed messages were more important when the issue was government subsidies. Both gain- and loss-framed messages were important when clean/alternative energy was the issue. - Highlights: • Over 2000 ratepayers were surveyed on their attitudes, planned behaviors and perceptions towards energy efficiency programs. • Almost 40% of how ratepayers feel about government subsidies and utility use of clean/alternative energy was explained. • Loss-framed messages were more effective when the dependent variable was ratepayer perception of government subsidies

Does Good Governance Mediate Relationship Between E-Government and Public Trust in Lebanon?

OpenAIRE

Alaaraj, Hassan; Hassan, Sallahudin

2016-01-01

The main objective of this research is to study the mediating effect of good governance on the relationship between e-government practices and public trust in Lebanon. Based on extensive literature review and conceptual background including the theories of institutional-based trust and the diffusion of innovation, the theoretical research framework was developed. Primary data was collected using survey involving 400 Lebanese employees from different small and medium enterprises in Beirut. The...

Twin specific risk factors in primary school achievements.

Science.gov (United States)

de Zeeuw, Eveline L; van Beijsterveldt, Catherina E M; de Geus, Eco J C; Boomsma, Dorret I

2012-02-01

The main aim of this study was to examine twin specific risk factors that influence educational achievement in primary school. We included prenatal factors that are not unique to twins, except for zygosity, but show a higher prevalence in twins than in singletons. In addition, educational achievement was compared between twins and their nontwin siblings in a within-family design. Data were obtained from parents and teachers of approximately 10,000 twins and their nontwin siblings registered with the Netherlands Twin Register. Teachers rated the proficiency of the children on arithmetic, language, reading, and physical education, and reported a national educational achievement test score (CITO). Structural equation modeling showed that gestational age, birth weight, and sex were significant predictors of educational achievement, even after correction for socioeconomic status. Mode of delivery and zygosity did not have an effect, while parental age only influenced arithmetic. Mode of conception, incubator time, and birth complications negatively affected achievement in physical education. The comparison of educational achievement of twins and singletons showed significantly lower ratings on arithmetic, reading, and language in twins, compared to their older siblings, but not compared to their younger siblings. Low gestational age and low birth weight were the most important risk factors for lower educational achievement of twins in primary school. It seems that the differences observed between twins and their nontwin siblings in educational achievement can largely be explained by birth order within the family.

Crepuscular flight activity of an invasive insect governed by interacting abiotic factors.

Directory of Open Access Journals (Sweden)

Yigen Chen

Full Text Available Seasonal and diurnal flight patterns of the invasive walnut twig beetle, Pityophthorus juglandis, were assessed between 2011 and 2014 in northern California, USA in the context of the effects of ambient temperature, light intensity, wind speed, and barometric pressure. Pityophthorus juglandis generally initiated flight in late January and continued until late November. This seasonal flight could be divided approximately into three phases (emergence: January-March; primary flight: May-July; and secondary flight: September-October. The seasonal flight response to the male-produced aggregation pheromone was consistently female-biased (mean of 58.9% females. Diurnal flight followed a bimodal pattern with a minor peak in mid-morning and a major peak at dusk (76.4% caught between 1800 and 2200 h. The primarily crepuscular flight activity had a Gaussian relationship with ambient temperature and barometric pressure but a negative exponential relationship with increasing light intensity and wind speed. A model selection procedure indicated that the four abiotic factors collectively and interactively governed P. juglandis diurnal flight. For both sexes, flight peaked under the following second-order interactions among the factors when: 1 temperature between was 25 and 30 °C and light intensity was less than 2000 lux; 2 temperature was between 25 and 35 °C and barometric pressure was between 752 and 762 mba (and declined otherwise; 3 barometric pressure was between 755 and 761 mba and light intensity was less than 2000 lux (and declined otherwise; and 4 temperature was ca. 30 °C and wind speed was ca. 2 km/h. Thus, crepuscular flight activity of this insect can be best explained by the coincidence of moderately high temperature, low light intensity, moderate wind speed, and low to moderate barometric pressure. The new knowledge provides physical and temporal guidelines for the application of semiochemical-based control techniques as part of an IPM

Primary health care workers' views of motivating factors at individual, community and organizational levels: a qualitative study from Nasarawa and Ondo states, Nigeria.

Science.gov (United States)

Bhatnagar, Aarushi; Gupta, Shivam; Alonge, Olakunle; George, Asha S

2017-04-01

Current efforts to motivate primary health workers in Nigeria focus on better financial incentives, and the role of other motivating factors has received less attention. The aim of this study is to explore individual and organizational determinants, their interactions and effects on motivation. Exploratory qualitative research, involving semi-structured interviews with 29 primary health workers (doctors, nurses, midwives and community health workers), was conducted in Nasarawa and Ondo states in Nigeria. Nine key informant interviews were conducted with government officials. Interviews were digitally recorded, transcribed and coded. Thematic analysis was conducted to identify common themes, as well as unique narratives. Results from this study suggest that health workers are motivated by individual (vocation, religion, humanity and self-efficacy) and organizational (monetary incentives, good working environment) factors and community recognition. Supervision and leadership provided by the officer in charge as compared with that by external agencies appeared to have a positive effect on motivation. Policy makers and donor agencies should take into account a broader range of factors while designing strategies to motivate the health workforce. The study also underscores how officer in charges with enhanced skills are likely to motivate health workers by creating a more supportive environment. Copyright © 2016 John Wiley & Sons, Ltd.

Primary Hyperaldosteronism As A Risk Factor For Recurrent Nephrolithiasis

Directory of Open Access Journals (Sweden)

Ekamol Tantisattamo

2012-06-01

Hyperaldosteronism can cause hypercalciuria, phosphaturia, and hypocitraturia, all of which are risk factors for nephrolithiasis. Additionally, hyperaldosteronism and deoxycorticosterone mediated hypertension have been associated with hypocalcemia and secondary hyperparathyroidism. Our case augments earlier literature suggesting increased risk for nephrolithiasis in patients with hyperaldosteronism and suggests that hyperaldosteronism should be considered as a risk factor for patient with nephrolithiasis. It remains unclear if both primary and secondary hyperaldosteronism increase the relative risk for nephrolithiasis and the role of aldosterone receptor antagonist therapy for recurrent nephrolithiasis associated with hyperaldosteronism.

[Risk factors and burnout levels in Primary Care nurses: A systematic review].

Science.gov (United States)

Gómez-Urquiza, Jose L; Monsalve-Reyes, Carolina S; San Luis-Costas, Concepción; Fernández-Castillo, Rafael; Aguayo-Estremera, Raimundo; Cañadas-de la Fuente, Guillermo A

2017-02-01

To determine the risk factors and levels of burnout in Primary Care nurses. A systematic review was performed. CINAHL, CUIDEN, LILACS, PubMed, ProQuest, ScienceDirect and Scopus databases were consulted. Search equations were 'burnout AND community health nursing' and 'burnout AND primary care nursing'. The search was performed in October 2015. The final sample was n=12 studies. Quantitative primary studies that used Maslach Burnout Inventory for burnout assessment in Primary Care nurses were included without restriction by publication date. The main variables were the mean and standard deviation of the three burnout dimensions, high, medium and low prevalence rates of each dimension, and socio-demographic, occupational and psychological variables that potentially influence burnout level. Studies show high prevalence rates, generally between 23% and 31%, of emotional exhaustion. The prevalence rates of high depersonalisation and low personal accomplishment show heterogeneity, varying between 8%-32% and 4%-92% of the sample, respectively. Studies show that older nurses with more seniority, anxiety and depression, among other variables, have higher burnout levels, while nurses with higher salary, high job satisfaction, organisational support, and good self-concept have less burnout. High emotional exhaustion is the main affected dimension of burnout in Primary Care nursing. There is heterogeneity in depersonalisation and personal accomplishment. Burnout must be prevented in these professionals, by increasing protective factors and monitoring its appearance in those with risk factors. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Evaluation of aldehyde dehydrogenase 1 and transcription factors in both primary breast cancer and axillary lymph node metastases as a prognostic factor.

Science.gov (United States)

Ito, Maiko; Shien, Tadahiko; Omori, Masako; Mizoo, Taeko; Iwamoto, Takayuki; Nogami, Tomohiro; Motoki, Takayuki; Taira, Naruto; Doihara, Hiroyoshi; Miyoshi, Shinichiro

2016-05-01

Aldehyde dehydrogenase 1 (ALDH1) is a marker of breast cancer stem cells, and the expression of ALDH1 may be a prognostic factor of poor clinical outcome. The epithelial-mesenchymal transition may produce cells with stem-cell-like properties promoted by transcription factors. We investigated the expression of ALDH1 and transcription factors in both primary and metastatic lesions, and prognostic value of them in breast cancer patients with axillary lymph node metastasis (ALNM). Forty-seven breast cancer patients with ALNM who underwent surgery at Okayama University Hospital from 2002 to 2008 were enrolled. We retrospectively evaluated the levels of ALDH1 and transcription factors, such as Snail, Slug and Twist, in both primary and metastatic lesions by immunohistochemistry. In primary lesions, the positive rate of ALDH1, Snail, Slug and Twist was 19, 49, 40 and 26%, respectively. In lymph nodes, that of ALDH1, Snail, Slug and Twist was 21, 32, 13 and 23%, respectively. The expression of ALDH1 or transcription factors alone was not significantly associated with a poor prognosis. However, co-expression of ALDH1 and Slug in primary lesions was associated with a shorter DFS (P = 0.009). The evaluation of the co-expression of ALDH1 and transcription factors in primary lesions may be useful in prognosis of node-positive breast cancers.

Governance Factors Affecting Community Participation In Public Development Projects In Meru District In Arusha In Tanzania

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Jackson Estomih Muro

2015-06-01

Full Text Available ABSTRACT The purpose of this study was to have a fresh look at the local governance status through exploring governance factors affecting community participation in public development projects. The study also has investigated the actors and factors shaping participation as well as causes for non-participation. For the purpose of the study six wards within two divisions of Poli and Mbuguni and Meru district headquarters were selected. In the wards a total of 80 respondents from among the community members were interviewed through a structured questionnaire. Others were Village chairman Village Executive Officers Ward Executive Officers and Councilors were also interviewed and involved in the FGD. Data were analyzed using SPSS. Simple descriptive statistics and cross tabulation and figures were used in the analysis. The analysis showed that the communities were participated in the public development projects and people were participating through financial material and labor contribution to the public development projects. The analysis also showed that the government supported the ongoing public development projects including through provision of fund and expertise. The study showed the benefit of community participation in the development projects or programs like ownership of the projects and enjoying the benefits accrued from the projects. The study also indicated that there is significant change in terms of governance as influencers of community participation in public development projects. Despite the fortunes study showed some challenges found in wards and villages being the incidence of corruptions and misuse of public resources which were mentioned to slow community participation in public development projects. It was therefore concluded that adhering to the good governance principles contribute positively towards community participation in public development projects.

Cross-country differences in government sector activities

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Primož Pevcin

2005-06-01

Full Text Available The purpose of the analysis presented in the article is to identify various economic, social, political, demographic and cultural factors that could shape the differences in the size of government sector across countries and, with the use of econometric analysis empirically verify the effect of those factors. The analysis focuses only on ”budgetary” government, meaning that the size of government is measured with a certain government spending ratio. The results of the analysis revealed that economic factors are more important in explaining the variation in the size of government consumption spending, whereas political, social and cultural factors are more important in explaining the variation in the size of transfer spending. In addition, the results indicate that the relative size of government spending is inversely related to the extent of the regulation of the economy.

Dietary Factors Associated To Obesity In Ahwaz Primary School Pupils

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Dorosty A.R; Tabatabaei M

2005-05-01

Full Text Available Background: Increase in obesity prevalence in recent years are associated to genetics as well environmental and behavioral factors. Change in dietary patterns including fatty and high density energy foods consumption have been reported to be very important. This study aimed to determine dietary factors (daily energy and macronutrient intakes, energy percentage of macronutrient, energy and macronutrient intakes per kilogram body weight, frequency of cola, natural fruit juice drinking, dairy products except cheese, tomato chips, puff, chocolate and fast food consumption and eating speed associated to obesity in Ahwaz primary school pupils. Materials and Methods: Using two stage cluster sampling from 35 Ahwaz primary schools, all 10-11y students who had a BMI 95th percentile of Hosseini et al. (1999 reference, were identified as obese (n=150 and 150 same age and gender pupils (having BMI0.05. macronutrient intakes per kilogram body weight were significantly lower in obese group (p0.05. Obese students used to eat faster (p<0.05. Conclusion: In conclusion, high intakes of energy, protein, carbohydrate, tomato chips and puff and high eating speed were associated to obesity in Ahwaz primary school pupils.

Governance structures impact on eHealth

DEFF Research Database (Denmark)

Kierkegaard, Patrick

2015-01-01

Background National eHealth implementation efforts need to move beyond the scope of making technology the primary focus and instead consider the broader spectrum of influences that can either hinder or facilitate eHealth adoption such as governance structures and policies. In this study, Denmark...... serves as an ideal candidate for further examination due to the country׳s rich history of intertwining events that have played an important role in the dynamic relationship between governance and eHealth success and failures. Methods A case study approach was used to gather a combination of primary...... and secondary data sources. All data collection was carried out through desk-research. Data collection relied on performing an extensive search of literature for relevant studies using combinations of keywords that reflected eHealth and governance-related topics. Inclusion and exclusion criteria׳s were applied...

Predictors of relational continuity in primary care: patient, provider and practice factors.

Science.gov (United States)

Kristjansson, Elizabeth; Hogg, William; Dahrouge, Simone; Tuna, Meltem; Mayo-Bruinsma, Liesha; Gebremichael, Goshu

2013-05-31

Continuity is a fundamental tenet of primary care, and highly valued by patients; it may also improve patient outcomes and lower cost of health care. It is thus important to investigate factors that predict higher continuity. However, to date, little is known about the factors that contribute to continuity. The purpose of this study was to analyse practice, provider and patient predictors of continuity of care in a large sample of primary care practices in Ontario, Canada. Another goal was to assess whether there was a difference in the continuity of care provided by different models of primary care. This study is part of the larger a cross-sectional study of 137 primary care practices, their providers and patients. Several performance measures were evaluated; this paper focuses on relational continuity. Four items from the Primary Care Assessment Tool were used to assess relational continuity from the patient's perspective. Multilevel modeling revealed several patient factors that predicted continuity. Older patients and those with chronic disease reported higher continuity, while those who lived in rural areas, had higher education, poorer mental health status, no regular provider, and who were employed reported lower continuity. Providers with more years since graduation had higher patient-reported continuity. Several practice factors predicted lower continuity: number of MDs, nurses, opening on weekends, and having 24 hours a week or less on-call. Analyses that compared continuity across models showed that, in general, Health Service Organizations had better continuity than other models, even when adjusting for patient demographics. Some patients with greater health needs experience greater continuity of care. However, the lower continuity reported by those with mental health issues and those who live in rural areas is concerning. Furthermore, our finding that smaller practices have higher continuity suggests that physicians and policy makers need to consider

SME perception of government assistance within South Africa

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Melanie Gopaul

2015-10-01

Full Text Available Small and medium enterprises (SMEs play a vital role in the economies of countries throughout the world. They contribute to the creation of jobs, economic upliftment as well as the gross domestic product (GDP. It is of great concern however to note that the majority of SMEs fail within their first few years of operation which could be due to many factors such as management skills, finance, access to markets and appropriate technology. With the National Development Plan’s objective to create 11 million jobs by 2030, it is crucial that the government provides assistance needed by SMEs to achieve this goal. Although government assistance may be evident, SMEs and their perceptions regarding this assistance is unclear. The purpose of this paper was therefore to investigate the perception of SME owners of the various government assistance and initiatives that are offered to them. The authors feel that the findings will be universally applicable to SMEs in most countries. The study followed a quantitative research approach, whereby a self-administered online questionnaire was used to collect primary data. The results indicate that SMEs feel that local government and municipalities are not doing enough to support and assist them

Governance for Urban Health Equity: Mobilizing Demand for Primary ...

International Development Research Centre (IDRC) Digital Library (Canada)

Home · What we do ... New research will identify opportunities to improve health care for the urban poor and involve communities ... Addressing this governance crisis will be paramount to improving service delivery for slum residents and to ...

Factors Influencing Adaptive Marine Governance in a Developing Country Context: a Case Study of Southern Kenya

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Louisa S. Evans

2011-06-01

Full Text Available Adaptive governance can be conceptualized as distinct phases of: 1 understanding environmental change; 2 using this understanding to inform decision making; and 3 acting on decisions in a manner that sustains resilience of desirable system states. Using this analytical framework, we explore governance in practice in two case studies in Kenya, that reflect the "messiness" of contemporary coastal governance in many developing country contexts. Findings suggest that adaptive marine governance is unlikely to be a smooth process of learning, knowledge sharing, and responding. There are institutional, sociocultural, and political factors, past and present, that influence each phase of both local and state decision making. New local institutions related to fisher associations and Beach Management Units influence learning and knowledge sharing in ways contrary to those expected of institutions that enable collaborative fisheries management. Similarly, state decision making is relatively uninformed by the diverse knowledge systems available in the coastal zone, despite the rhetoric of participation. Historical relations and modes of working continue to play a significant role in mediating the potential for adaptive governance in the future. The case studies are illustrative and point to a number of institutional and political issues that would need to be addressed in processes of governance reform towards more adaptive management in developing country contexts.

Factor structure of functional state of primary school age children

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Davidenko O.V.

2011-02-01

Full Text Available The examination of primary school children to determine the ranking of significant factors that determine the structure of their functional state depending on the level of physical health. It is shown that the main factor in the structure of the functional state of younger schoolchildren in low-and lower-middle level of physical fitness is selected morpho-functional status, which characterizes the functions of the body at rest. For children with average or above average level of physical fitness is a leading factor in physical fitness of schoolchildren.

Dose rate determining factors of PWR primary water

International Nuclear Information System (INIS)

Terachi, Takumi; Kuge, Toshiharu; Nakano, Nobuo

2014-01-01

The relationship between dose rate trends and water chemistry has been studied to clarify the determining factors on the dose rates. Therefore dose rate trends and water chemistry of 11 PWR plants of KEPCO (Kansai Electric Power Co., Inc.) were summarized. It is indicated that the chemical composition of the oxide film, behaviour of corrosion products and Co-58/Co-60 ratio in the primary system have effected dose rate trends based on plant operation experiences for over 40 years. According to plant operation experiences, the amount of Co-58 has been decreasing with the increasing duration of SG (Steam Generator) usage. It is indicated that the stable oxide film formation on the inner surface of SG tubing, is a major beneficial factor for radiation sources reduction. On the other hand, the reduction of the amount of Co-60 for the long term has been not clearly observed especially in particular high dose plants. The primary water parameters imply that considering release and purification balance on Co-59 is important to prevent accumulation of source term in primary water. In addition, the effect of zinc injection, which relates to the chemical composition of oxide film, was also assessed. As the results, the amount of radioactive Co has been clearly decreased. The decreasing trend seems to correlate to the half-life of Co-60, because it is considered that the injected zinc prevents the uptake of radioactive Co into the oxide film on the inner surface of the components and piping. In this paper, the influence of water chemistry and the replacement experiences of materials on the dose rates were discussed. (author)

Governance, Government, and the Search for New Provider Models

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Richard B. Saltman

2016-01-01

Full Text Available A central problem in designing effective models of provider governance in health systems has been to ensure an appropriate balance between the concerns of public sector and/or government decision-makers, on the one hand, and of non-governmental health services actors in civil society and private life, on the other. In tax-funded European health systems up to the 1980s, the state and other public sector decision-makers played a dominant role over health service provision, typically operating hospitals through national or regional governments on a command-and-control basis. In a number of countries, however, this state role has started to change, with governments first stepping out of direct service provision and now de facto pushed to focus more on steering provider organizations rather than on direct public management. In this new approach to provider governance, the state has pulled back into a regulatory role that introduces market-like incentives and management structures, which then apply to both public and private sector providers alike. This article examines some of the main operational complexities in implementing this new governance reality/strategy, specifically from a service provision (as opposed to mostly a financing or even regulatory perspective. After briefly reviewing some of the key theoretical dilemmas, the paper presents two case studies where this new approach was put into practice: primary care in Sweden and hospitals in Spain. The article concludes that good governance today needs to reflect practical operational realities if it is to have the desired effect on health sector reform outcome.

Governance, Government, and the Search for New Provider Models.

Science.gov (United States)

Saltman, Richard B; Duran, Antonio

2015-11-03

A central problem in designing effective models of provider governance in health systems has been to ensure an appropriate balance between the concerns of public sector and/or government decision-makers, on the one hand, and of non-governmental health services actors in civil society and private life, on the other. In tax-funded European health systems up to the 1980s, the state and other public sector decision-makers played a dominant role over health service provision, typically operating hospitals through national or regional governments on a command-and-control basis. In a number of countries, however, this state role has started to change, with governments first stepping out of direct service provision and now de facto pushed to focus more on steering provider organizations rather than on direct public management. In this new approach to provider governance, the state has pulled back into a regulatory role that introduces market-like incentives and management structures, which then apply to both public and private sector providers alike. This article examines some of the main operational complexities in implementing this new governance reality/strategy, specifically from a service provision (as opposed to mostly a financing or even regulatory) perspective. After briefly reviewing some of the key theoretical dilemmas, the paper presents two case studies where this new approach was put into practice: primary care in Sweden and hospitals in Spain. The article concludes that good governance today needs to reflect practical operational realities if it is to have the desired effect on health sector reform outcome. © 2016 by Kerman University of Medical Sciences.

Risk management and corporate governance performance ...

African Journals Online (AJOL)

The study examines the relative effect of risk management and corporate governance on bank performance in Nigeria. The study utilizes both primary and secondary data. The primary data were collected using structured questionnaire that were administered in Four-hundred and eighty (480) employees of Wema Bank Plc ...

Factors Affecting the Adoption of Cloud Computing in the Government Sector: A Case Study of Saudi Arabia

OpenAIRE

Majed alsanea; Jennifer Barth

2015-01-01

Cloud computing technology can play an important role in the public sector organisations since it decreases the cost of using information technology (IT) services and also has several other benefits. This paper aims to examine a range of factors affecting the cloud computing adoption by governments. In a case study of Saudi government organasations, a survey was conducted and four Saudi organisations participated in the study. The survey was theoretically designed based on the literature. An ...

Managerialism and higher education governance: Implications for ...

African Journals Online (AJOL)

This article identifies some of the implications of corporate forms of higher education governance for the management of South African universities. It explores corporate higher educational governance with reference to institutional autonomy incorporating academic freedom. It is the contention of this article that the primary ...

Organizational factors and depression management in community-based primary care settings

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Kilbourne Amy M

2009-12-01

Full Text Available Abstract Background Evidence-based quality improvement models for depression have not been fully implemented in routine primary care settings. To date, few studies have examined the organizational factors associated with depression management in real-world primary care practice. To successfully implement quality improvement models for depression, there must be a better understanding of the relevant organizational structure and processes of the primary care setting. The objective of this study is to describe these organizational features of routine primary care practice, and the organization of depression care, using survey questions derived from an evidence-based framework. Methods We used this framework to implement a survey of 27 practices comprised of 49 unique offices within a large primary care practice network in western Pennsylvania. Survey questions addressed practice structure (e.g., human resources, leadership, information technology (IT infrastructure, and external incentives and process features (e.g., staff performance, degree of integrated depression care, and IT performance. Results The results of our survey demonstrated substantial variation across the practice network of organizational factors pertinent to implementation of evidence-based depression management. Notably, quality improvement capability and IT infrastructure were widespread, but specific application to depression care differed between practices, as did coordination and communication tasks surrounding depression treatment. Conclusions The primary care practices in the network that we surveyed are at differing stages in their organization and implementation of evidence-based depression management. Practical surveys such as this may serve to better direct implementation of these quality improvement strategies for depression by improving understanding of the organizational barriers and facilitators that exist within both practices and practice networks. In addition

RETROSPECTIVE STUDY OF PRIMARY CAESAREAN SECTION AT A TERTIARY CARE CENTRE

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S. Prasanna Lakshmi

2016-12-01

Full Text Available BACKGROUND The caesarean section epidemic is a reason for immediate concern and deserves serious National and International attention. Rates of caesarean section are of concern to both developed and developing countries. The indications for caesarean section have been undergoing a gradual change over the last few decades. Besides the obstetric causes, several other medical, social, ethical, economical and medicolegal factors play a role in the rising trend of caesarean section. The aim of the study was undertaken to determine the rate, indications, intraoperative and postoperative complications of primary caesarean section in primi and multipara and maternal and foetal morbidities in these patients. MATERIALS AND METHODS This is a retrospective study carried out on primary caesarean section in the Department of O and G at Mahatma Gandhi Memorial Government Hospital attached to K.A.P.Viswanatham Government Medical College, Trichy, during 1 year period from January 2015-December 2015. Inclusion Criteria- Patients (booked/unbooked attending the labour room undergoing primary caesarean section in the department. Their intraoperative and postoperative complications were noted and also maternal and foetal morbidities and complications. Exclusion Criteria- Gestational age <28 wks., previous LSCS, previous uterine surgery or hysterotomy, multiple gestation. RESULTS There has been a steady increase in total deliveries (increase by 5.2% in the last 2 yrs. at Mahathma Gandhi Memorial Government Hospital attached to K.A.P. Viswanatham Government Medical College, Trichy, and total caesarean section rate (increased by 19.3% and primary caesarean section rate (increased by 12.3% in the past 2 years with concomitant reduction in neonatal mortality rate by 28%. However, this doesn’t justify the increase in primary caesarean section rate. CONCLUSION Potentially modifiable factors such as patient preferences, practice variations among hospitals, systems and

Course, risk factors, and prognostic factors in elderly primary care patients with mild depression: a two-year observational study.

Science.gov (United States)

Magnil, Maria; Janmarker, Lena; Gunnarsson, Ronny; Björkelund, Cecilia

2013-03-01

The aim of this study was to observe course, risk factors, and prognostic factors in a primary care cohort aged > 60 with mild to moderate depression during two-year follow-up. Observational study. Primary care. During an 11-month period all (n = 302) consecutive patients aged 60 and above attending a primary care centre in Gothenburg, Sweden were screened by a nurse for depressive symptoms with the Primary Care Evaluation of Mental Disorders, Patient Questionnaire (PRIME-MD PQ) and the Montgomery-Åsberg Depression Rating Scale, self-rated version (MADRS-S) and by a GP with a patient-centred consultation model. In the second step, the GPs diagnosed depression in screen-positives by use of the PRIME-MD Clinical Evaluation Guide (PRIME-MD CEG). All patients with mild to moderate depression were followed up for two years to assess course with several MADRS-S score assessments. Main outcome measures. Risk factors, prognostic factors, and symptoms at baseline and after two years were tested with logistic regression, using the DSM-IV and MADRS-S (cut-off > 13) respectively. Course patterns were observed and described. A total of 54 patients were diagnosed with depression. Follow-up revealed declining median MADRS-S scores and three course patterns: remitting, stable, and fluctuating. History of depression, significant life events, lacking leisure activities, and use of sedatives were risk factors for depression, all previously known. An important finding was that lacking leisure activities also increased the risk of depressive symptoms after two years (odds ratio 12, confidence interval 1.1-136). It is desirable to identify elderly individuals with less severe depression. Three course patterns were observed; this finding requires further study of the clinical characteristics related to the different patterns. Awareness of risk factors may facilitate identification of those at highest risk of poor prognosis.

Pesticides in stream sediment and aquatic biota: distribution, trends, and governing factors

Science.gov (United States)

Nowell, Lisa H.; Capel, Peter D.

1999-01-01

More than 20 years after the ban of DDT and other organochlorine pesticides, pesticides continue to be detected in air, rain, soil, surface water, bed sediment, and aquatic and terrestrial biota throughout the world. Recent research suggests that low levels of some of these pesticides may have the potential to affect the development, reproduction, and behavior of fish and wildlife, and possibly humans. Pesticides in Stream Sediment and Aquatic Biota: Distribution, Trends, and Governing Factors assesses the occurrence and behavior of pesticides in bed sediment and aquatic biota-the two major compartments of the hydrologic system where organochlorine pesticides are most likely to accumulate. This book collects, for the first time, results from several hundred monitoring studies and field experiments, ranging in scope from individual sites to the entire nation. Comprehensive tables provide concise summaries of study locations, pesticides analyzed, and study outcomes. Comprehensive and extensively illustrated, Pesticides in Stream Sediment and Aquatic Biota: Distribution, Trends, and Governing Factors evaluates the sources, environmental fate, geographic distribution, and long-term trends of pesticides in bed sediment and aquatic biota. The book focuses on organochlorine pesticides, but also assesses the potential for currently used pesticides to be found in bed sediment and aquatic biota. Topics covered in depth include the effect of land use on pesticide occurrence, mechanisms of pesticide uptake and accumulation by aquatic biota, and the environmental significance of observed levels of pesticides in stream sediment and aquatic biota.

Corporate Governance and Shareholder Litigation

OpenAIRE

Kalchev, Georgi

2009-01-01

The probability for shareholder litigation is studied and how corporate governance characteristics and other factors explain it. Shareholder litigation results from failure of corporate governance. Thus a better quality of corporate governance is hypothesized to decrease the litigation probability. Corporate governance index is constructed based on principal components. It is found to be a significant predictor of shareholder litigation.

Exclusion Factors in Latin American Higher Education: A Preliminary Analyze From University Governing Board Perspective

Science.gov (United States)

Castro, Diego; Rodríguez-Gómez, David; Gairín, Joaquín

2017-01-01

Access to higher education has increased substantially in Latin America, but inequalities in access to and completion of higher education still remain. In this regard, identifying vulnerable groups and exclusion factors is a priority in Latin America's university systems. The aim of this article is to understand in depth governing board…

Retention factors of management staff in the maintenance phase of their careers in local government

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Mervin Munsamy

2009-10-01

Full Text Available Organisations require an employer value proposition (EVP to attract and retain people in management. This study was undertaken to understand the key retention factors that influence experienced management employees, in the maintenance phase of their careers, to remain employed at a local government organisation. Retention factors inform the organisation’s EVP. A qualitative, empirical-analytical research paradigm with a modernist approach was adopted. Data were obtained through purposive sampling (n = 10 by way of semi-structured interviews. A theoretical framework was used against which data could be deducted and compared. Sixteen key factors were identified, of which Job Aligned with Personal Meaning or Passion emerged as the strongest retention factor among the study’s participants.

CORPORATE GOVERNANCE PRACTICES IN INDIA – A STUDY

OpenAIRE

Navneet Kaur*

2018-01-01

The primary driver mentioned behind the corporate governance practice is the interest of the stakeholders. Indian corporate governance has taken major steps toward becoming a system capable of inspiring confidence among institutions and increase foreign investors. The overall purpose of study is provide an overview of various components of corporate governance and the conclusion of study is idea about how much important corporate governance is for all types of corporations and how these corpo...

Cardiovascular risk factor assessment after pre-eclampsia in primary care

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Numans Mattijs E

2009-12-01

Full Text Available Abstract Background Pre-eclampsia is associated with an increased risk of development of cardiovascular disease later in life. It is not known how general practitioners in the Netherlands care for these women after delivery with respect to cardiovascular risk factor management. Methods Review of medical records of 1196 women in four primary health care centres, who were registered from January 2000 until July 2007 with an International Classification of Primary Care (ICPC code indicating pregnancy. Records were searched for indicators of pre-eclampsia. Of those who experienced pre-eclampsia and of a random sample of 150 women who did not, the following information on cardiovascular risk factor management after pregnancy was extracted from the records: frequency and timing of blood pressure, cholesterol and glucose measurements - and vascular diagnoses. Additionally the sensitivity and specificity of ICPC coding for pre-eclampsia were determined. Results 35 women experienced pre-eclampsia. Blood pressure was more often checked after pregnancy in these women than in controls (57.1% vs. 12.0%, p Conclusion Despite the evidence of increased risk of future cardiovascular disease in women with a history of pre-eclampsia, follow-up of these women is insufficient and undeveloped in primary care in the Netherlands.

Impact of socioeconomic factors on nutritional status in primary school children.

Science.gov (United States)

Babar, Nabeela Fazal; Muzaffar, Rizwana; Khan, Muhammad Athar; Imdad, Seema

2010-01-01

Child malnutrition is a major public health and development concern in most of the poor communities leading to high morbidity and mortality. Various studies have highlighted the factors involved. The present study focuses on socioeconomic inequality resulting in malnutrition. Objectives of the Study were to find the Impact of socio-economic factors on nutritional status in primary school children. It was a cross sectional survey conducted at Lahore from February to August 2005 among primary schools from public and private sectors to assess the nutritional status of primary school going children age 5-11 years belonging to different socio economic classes of the society. Systematic random sampling technique was applied to collect the sample. Body Mass Index in relation to NHANES reference population was used for assessing nutritional status. The nutritional status of children from lower socio economic class was poor as compared to their counter parts in upper socio economic class. Children with BMI children of illiterate mothers as compare to 20% in those of literate mothers. Poverty, low literacy rate, large families, food insecurity, food safety, women's education appears to be the important underlying factors responsible for poor health status of children from low socioeconomic class. It requires economic, political and social changes as well as changes for personal advancement mainly through educational opportunities to improve the nutritional status of the children.

Corporate Governance as a Crucial Factor in Achieving Sustainable Corporate Performance

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Julija Bistrova

2014-06-01

Full Text Available In the developed stock markets the corporate governance aspect is crucial in the stock portfolio selection process for investor seeking to achieve shareholder value sustainability. In the emerging markets the importance of the corporate governance role just starts to be realized by the investors and by the corporate managers. The present research, looking at the stock performance leaders and laggards, analyzes whether the corporate governance system matters to achieve long-term shareholder value within the Central and Eastern European stock markets universe. Corporate governance quality was assessed and compared among the out- and underperformers. The financial results plausibility and the ownership structure were considered as well. Additionally, the authors analyzed whether the quality of corporate governance influences the economic performance of the company. The obtained results provide the proof that the corporate governance does matter as the market outperformers have above average corporate governance quality and provide trustworthy financial results more often than the underperforming companies. Besides, well-governed companies are also able to deliver more attractive financial results.

Change Management as a Critical Success Factor in e-Government Implementation

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Janja Nograšek

2011-01-01

Full Text Available Change management in e-government implementation is a very complex issue. E-government services are frequently distributed over different IT systems and organizations. There are also events from outside the public administration that cause changes such as government policies and legislation, public-private partnership, etc., and finally a huge resistance to change exists in public administration proverbial. Another problem is that the e-government is predominantly seen only as a technology mission and not as an organizational transformation issue. Those are probably the main reasons that the existing literature about change management in e-government is still missing at large. There are articles dealing with some aspects of changes affected by the new technology implementation, however, there is no comprehensive framework that would identify changes that have to be managed in e-government implementation. Therefore, the main aim of the paper is to identify a comprehensive set of changes that have to be considered in e-government implementation and the role of leadership in such processes. Finally, the paper proposes a conceptual model of change management in e-government implementation.

Preliminary Investigation Of Emirati Women Entrepreneurship In The UAE Motivating Factors Challenges And Government Initiatives

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Mohammad Rehan Shahnawaz

2015-08-01

Full Text Available Abstract Purpose The purpose of this research is to conduct an in depth preliminary investigation of the Emirati Women Entrepreneurship in the UAE in terms of the factors motivating the Emirati women to engage in the entrepreneurial activities challenges and issues faced by them in that process and initiatives taken by the government of UAE in overcoming those challenges and in encouraging promoting and safeguarding their interests. Methodology This research is an exploratory one due to the fact that the topic of the research strongly requires an in depth analysis or investigation of the underlying motivating factors challenges and issues and the government initiatives taken on behalf of Emirati women entrepreneurs. The research has used qualitative content analysis technique in which the existing literature secondary data on women and Emirati women entrepreneurship was gathered and discussed to serve the purpose of the research such as from other published researches internet searches and books. DiscussionsFindings The research explored an array of factors motivating the Emirati women towards entrepreneurship and the challenges and issues they come across in that process. The motivating factors were divided into positive and negative factors with main emphasis on the positive factors. Among the positive motivating factors were the Emiratization change in the organizational culture and beliefs relaxation of social and cultural structures inde-pendence and self-improvement and development. The negative motivating factors were the necessity unacceptable working conditions inflexible work hours wage gap between males and females and job frustrations. The major challenges and issues they usually come across are traditions cultural religious and social restrictions lack of managerial experience and basic business knowledge low self-confidence and determination male prejudice stereotyping and preconception minimal networking gender based promotional

Government Debt Reduction in the USA and Greece: A Comparative VECM Analysis

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Gisele MAH

2016-11-01

Full Text Available The purpose of this paper is to estimate comparative debt reduction models for the USA and Greece using Vector Error Correction Model analysis and Granger causality test. The study provides an empirical framework that could assist in policy formulation for countries with high debt rates as well as those experiencing debt crises. The US model revealed a negative and significant relationship between general government debt and inflation as well as negative significance with primary balance. In Greece, the relationship between general government debts with primary balance is found to be positive and significant while negative and significant with net transfer from abroad. Granger causality is from general government debts to inflation in the USA and from primary balance to general government debts in Greece.

Government for the People; On the Determinants of the Size of U.S. Government

OpenAIRE

Tamim Bayoumi; Fernando M. Gonçalves

2007-01-01

Trends in the size of U.S. government are examined. In the postwar period, general government primary spending rose by ¼ percent of GDP a year through 1975, stabilizing thereafter. With higher social transfers offset by a lower burden of defense spending, expansion reflected a baby-boom driven rise in education spending. The parallel improvement in tax efficiency helped equate the benefits of higher spending with the costs from higher taxation, in accordance with a marginalist view of the siz...

[Job satisfaction and improvement factors in primary care professionals].

Science.gov (United States)

Pérez-Ciordia, I; Guillén-Grima, F; Brugos, A; Aguinaga, I

2013-09-06

The quality of services in a health system is related to the level of satisfaction of its professionals. The aim of this article is to determine job satisfaction in primary care professionals and rank those factors capable of improving it. Descriptive study carried out in Navarre in 2010. A validated questionnaire was sent by post to the population of the study: primary care doctors, pediatricians and nurses. Variables on socio-demographic data were collected and job satisfaction was self-evaluated on a scale of 1 to 10. Respondents were asked to rank 10 factors that could improve the previously mentioned satisfaction. Averages were compared and bivariate analysis was carried out using the chi-square test, studying the association between variables through the Odds Ratio (OR). The adjusted analysis was realized through unconditional logistic regression. We collected 432 questionnaires (77.5%). Average satisfaction was 6.7 (scale of 1 to 10), higher in nursing. Women showed a higher average than men (6.90:6.34). The workers at urban health centers (OR: 1.71; CI: 1.10-2.65) showed a higher risk of dissatisfaction with respect to professionals at rural centers. The training activities of the professional is the most highly valued item, followed by economic questions and questions of care pressure, with no differences found by profession. Job satisfaction is a dimension of quality management in primary care and its study enables identification of problems or opportunities for improvement with an impact on the quality of the services offered.

Effects of cutbacks on motivating factors among nurses in primary health care.

Science.gov (United States)

Halldorsdottir, Sigridur; Einarsdottir, Emilia J; Edvardsson, Ingi Runar

2018-03-01

When financial cuts are made, staff redundancies and reorganisation in the healthcare system often follow. Little is known how such cutbacks affect work motivation of nurses in primary health care. Examine the effects of cutbacks on motivating factors among nurses in primary health care. A phenomenological approach involving a purposeful sample of ten nurses in primary health care. Average age 44. The participants identified the job itself, autonomy, independence, good communication with co-workers, and the potential for professional training, learning and development as the main internal motivational factors related to their work. However, increased stress and uncertainty, growing fatigue and understaffing were starting to have a negative impact on these internal motivational factors. Moreover, reduced opportunities for professional training and development had negative effects on the participants. Many saw these opportunities as a vital part of recognition for their job performance. Regarding external motivation, the factors identified were job security, salaries and rewards, and interaction with management. The participants expressed their interest in more consultation with managers and most preferred an increased flow of information from managers to staff members during cutbacks. Salaries, professional training opportunities and appreciation were rewards named by participants for a job well done. All agreed that salaries are stronger motivational factors than before cutbacks. In the case of cutbacks, nursing managers should increase consultations with staff and make sure that nurses maintain their independence, autonomy, opportunities for professional training as well as appreciation for job well done. © 2017 Nordic College of Caring Science.

Political, cultural and economic foundations of primary care in Europe.

Science.gov (United States)

Kringos, Dionne S; Boerma, Wienke G W; van der Zee, Jouke; Groenewegen, Peter P

2013-12-01

This article explores various contributing factors to explain differences in the strength of the primary care (PC) structure and services delivery across Europe. Data on the strength of primary care in 31 European countries in 2009/10 were used. The results showed that the national political agenda, economy, prevailing values, and type of healthcare system are all important factors that influence the development of strong PC. Wealthier countries are associated with a weaker PC structure and lower PC accessibility, while Eastern European countries seemed to have used their growth in national income to strengthen the accessibility and continuity of PC. Countries governed by left-wing governments are associated with a stronger PC structure, accessibility and coordination of PC. Countries with a social-security based system are associated with a lower accessibility and continuity of PC; the opposite is true for transitional systems. Cultural values seemed to affect all aspects of PC. It can be concluded that strengthening PC means mobilising multiple leverage points, policy options, and political will in line with prevailing values in a country. Copyright © 2013 Elsevier Ltd. All rights reserved.

What systemic factors contribute to collaboration between primary care and public health sectors? An interpretive descriptive study.

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Wong, Sabrina T; MacDonald, Marjorie; Martin-Misener, Ruth; Meagher-Stewart, Donna; O'Mara, Linda; Valaitis, Ruta K

2017-12-01

Purposefully building stronger collaborations between primary care (PC) and public health (PH) is one approach to strengthening primary health care. The purpose of this paper is to report: 1) what systemic factors influence collaborations between PC and PH; and 2) how systemic factors interact and could influence collaboration. This interpretive descriptive study used purposive and snowball sampling to recruit and conduct interviews with PC and PH key informants in British Columbia (n = 20), Ontario (n = 19), and Nova Scotia (n = 21), Canada. Other participants (n = 14) were knowledgeable about collaborations and were located in various Canadian provinces or working at a national level. Data were organized into codes and thematic analysis was completed using NVivo. The frequency of "sources" (individual transcripts), "references" (quotes), and matrix queries were used to identify potential relationships between factors. We conducted a total of 70 in-depth interviews with 74 participants working in either PC (n = 33) or PH (n = 32), both PC and PH (n = 7), or neither sector (n = 2). Participant roles included direct service providers (n = 17), senior program managers (n = 14), executive officers (n = 11), and middle managers (n = 10). Seven systemic factors for collaboration were identified: 1) health service structures that promote collaboration; 2) funding models and financial incentives supporting collaboration; 3) governmental and regulatory policies and mandates for collaboration; 4) power relations; 5) harmonized information and communication infrastructure; 6) targeted professional education; and 7) formal systems leaders as collaborative champions. Most themes were discussed with equal frequency between PC and PH. An assessment of the system level context (i.e., provincial and regional organization and funding of PC and PH, history of government in successful implementation of health care reform, etc) along

Socioeconomic status and geographical factors associated with active listing in primary care: a cross-sectional population study accounting for multimorbidity, age, sex and primary care.

Science.gov (United States)

Ranstad, Karin; Midlöv, Patrik; Halling, Anders

2017-06-09

Socioeconomic status and geographical factors are associated with health and use of healthcare. Well-performing primary care contributes to better health and more adequate healthcare. In a primary care system based on patient's choice of practice, this choice (listing) is a key to understand the system. To explore the relationship between population and practices in a primary care system based on listing. Cross-sectional population-based study. Logistic regressions of the associations between active listing in primary care, income, education, distances to healthcare and geographical location, adjusting for multimorbidity, age, sex and type of primary care practice. Population over 15 years (n=123 168) in a Swedish county, Blekinge (151 731 inhabitants), in year 2007, actively or passively listed in primary care. The proportion of actively listed was 68%. Actively listed in primary care on 31 December 2007. Highest ORs for active listing in the model including all factors according to income had quartile two and three with OR 0.70 (95% CI 0.69 to 0.70), and those according to education less than 9 years of education had OR 0.70 (95% CI 0.68 to 0.70). Best odds for geographical factors in the same model had municipality C with OR 0.85 (95% CI 0.85 to 0.86) for active listing. Akaike's Information Criterion (AIC) was 124 801 for a model including municipality, multimorbidity, age, sex and type of practice and including all factors gave AIC 123 934. Higher income, shorter education, shorter distance to primary care or longer distance to hospital is associated with active listing in primary care.Multimorbidity, age, geographical location and type of primary care practice are more important to active listing in primary care than socioeconomic status and distance to healthcare. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Primary graft dysfunction of the liver: definitions, diagnostic criteria and risk factors.

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Neves, Douglas Bastos; Rusi, Marcela Balbo; Diaz, Luiz Gustavo Guedes; Salvalaggio, Paolo

2016-01-01

Primary graft dysfunction is a multifactorial syndrome with great impact on liver transplantation outcomes. This review article was based on studies published between January 1980 and June 2015 and retrieved from PubMed database using the following search terms: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" and "liver transplantation". Graft dysfunction describes different grades of graft ischemia-reperfusion injury and can manifest as early allograft dysfunction or primary graft non-function, its most severe form. Donor-, surgery- and recipient-related factors have been associated with this syndrome. Primary graft dysfunction definition, diagnostic criteria and risk factors differ between studies. RESUMO A disfunção primária do enxerto hepático é uma síndrome multifatorial com grande impacto no resultado do transplante de fígado. Foi realizada uma ampla revisão da literatura, consultando a base de dados PubMed, em busca de estudos publicados entre janeiro de 1980 e junho de 2015. Os termos descritivos utilizados foram: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" e "liver transplantation". A disfunção traduz graus diferentes da lesão de isquemia e reperfusão do órgão, e pode se manifestar como disfunção precoce ou, na forma mais grave, pelo não funcionamento primário do enxerto. Fatores relacionados ao doador, ao transplante e ao receptor contribuem para essa síndrome. Existem definições diferentes na literatura quanto ao diagnóstico e aos fatores de risco associados à disfunção primária.

Failed anterior cruciate ligament reconstruction: analysis of factors leading to instability after primary surgery.

Science.gov (United States)

Ma, Yong; Ao, Ying-Fang; Yu, Jia-Kuo; Dai, Ling-Hui; Shao, Zhen-Xing

2013-01-01

Revision anterior cruciate ligament (ACL) surgery can be expected to become more common as the number of primary reconstruction keeps increasing. This study aims to investigate the factors causing instability after primary ACL reconstruction, which may provide an essential scientific base to prevent surgical failure. One hundred and ten revision ACL surgeries were performed at our institute between November 2001 and July 2012. There were 74 men and 36 women, and the mean age at the time of revision was 27.6 years (range 16 - 56 years). The factors leading to instability after primary ACL reconstruction were retrospectively reviewed. Fifty-one knees failed because of bone tunnel malposition, with too anterior femoral tunnels (20 knees), posterior wall blowout (1 knee), vertical femoral tunnels (7 knees), too posterior tibial tunnels (12 knees), and too anterior tibial tunnels (10 knees). There was another knee performed with open surgery, where the femoral tunnel was drilled through the medial condyle and the tibial tunnel was too anterior. Five knees were found with malposition of the fixation. One knee with allograft was suspected of rejection and a second surgery had been made to take out the graft. Three knees met recurrent instability after postoperative infection. The other factors included traumatic (48 knees) and unidentified (12 knees). Technical errors were the main factors leading to instability after primary ACL reconstructions, while attention should also be paid to the risk factors of re-injury and failure of graft incorporation.

X-linked primary ciliary dyskinesia due to mutations in the cytoplasmic axonemal dynein assembly factor PIH1D3.

NARCIS (Netherlands)

Olcese, C.; Patel, M.P.; Shoemark, A.; Kiviluoto, S.; Legendre, M.; Williams, H.J.; Vaughan, C.K.; Hayward, J.; Goldenberg, A.; Emes, R.D.; Munye, M.M.; Dyer, L.; Cahill, T.; Bevillard, J.; Gehrig, C.; Guipponi, M.; Chantot, S.; Duquesnoy, P.; Thomas, L.; Jeanson, L.; Copin, B.; Tamalet, A.; Thauvin-Robinet, C.; Papon, J.F.; Garin, A.; Pin, I.; Vera, G.; Aurora, P.; Fassad, M.R.; Jenkins, L.; Boustred, C.; Cullup, T.; Dixon, M.; Onoufriadis, A.; Bush, A.; Chung, E.M.; Antonarakis, S.E.; Loebinger, M.R.; Wilson, R.; Armengot, M.; Escudier, E.; Hogg, C.; Amselem, S.; Sun, Z.; Bartoloni, L.; Blouin, J.L.; Mitchison, H.M.; Schmidts, M.; et al.,

2017-01-01

By moving essential body fluids and molecules, motile cilia and flagella govern respiratory mucociliary clearance, laterality determination and the transport of gametes and cerebrospinal fluid. Primary ciliary dyskinesia (PCD) is an autosomal recessive disorder frequently caused by non-assembly of

Assessing the effect of demographic factors on conflict situations in Ghana government hospitals

OpenAIRE

Dwomoh, Gabriel; Kwarteng, Kofi; Frempong, Evelyn; Frempong, Regina Anima

2014-01-01

   The   study   seeks   to   examine   the   influence   of   demographic   factors   on   conflict   in  Ghana  government  hospitals.    It  adopted  the  quantitative  approach  which  involves  the  use  of  questionnaires  and  interviews  coupled  with  statistical  analysis  to  assess  the   effect   of   demographic   factors   (age,   educational   level,   gender   and   number   of  years  on  the  job  of  employees)  and  conflict  occurrences  at  the  workplace.    The  use  ...

Factor analysis of the Children's Behaviour Questionnaire in a Nigerian paediatric primary care population

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O O Omigbodun

2004-04-01

Full Text Available Objective. This paper examines the factor structure of the Yoruba translation of the Children’s Behaviour Questionnaire for Completion by Parents (CBQ administered in a Nigerian paediatric primary care population. Design. A cross-sectional questionnaire survey. Subjects. Four hundred and seventy-eight children aged 7 - 14 years who attended a primary care clinic in Ibadan, Nigeria, over a 3-month period. Methods. Parents’ ratings of the children were obtained using the Yoruba translation of the CBQ. The factor structure of this instrument was examined using principal component analysis with varimax rotation. Only factors with eigenvalues of greater than 1 were examined further. Results. The first seven dimensions were readily conceptu- alised. These factors are conduct problem, hyperactivity, emotional problem, irritability, problems with elimination, a somatic complaint and a school problem dimension. Conclusion. These factors are similar to what has been observed in other studies involving populations of children with psychopathology, with the exception of the somatic com- plaint and school problem dimension. The emergence of these two factors, which are quite different from what has been observed in other studies, may demonstrate differences that reflect the influence of language, culture and the peculiarities of a primary care setting. On the other hand the similarity of most of the factors to those found in previous studies con- firms the broad similarities in the behaviour of children across different cultures.

Factors associated with primary care residents' satisfaction with their training.

Science.gov (United States)

Randall, C S; Bergus, G R; Schlechte, J A; McGuinness, G; Mueller, C W

1997-01-01

Satisfaction is known to impact work performance, learning, recruitment, and retention. This study identifies the factors associated with primary care residents' satisfaction with their training. We used a cross-sectional survey based on the Price-Mueller model of job satisfaction. The model included 14 job characteristics, four personal characteristics, and four demographic factors. Data were collected in February and March 1996 from residents in three primary care training programs (family practice, pediatrics, and internal medicine) at a large academic medical center. The same standardized, self-administered questionnaires were used in all three departments. Seventy-five percent (n = 119) of the residents returned questionnaires. Five job characteristics were positively associated with resident satisfaction: continuity of care, autonomy, collegiality, work that encourages professional growth, and work group loyalty. Role conflict, a sixth job characteristic, was negatively associated with satisfaction. The personal characteristic of having an optimistic outlook on life was also positively associated with satisfaction. The model explained 66% of the variation in self-reported satisfaction. The satisfaction of the residents was significantly associated with six job characteristics and one personal factor. Interventions based on these job characteristics may increase resident satisfaction and may lead to better patient outcomes, better work performance, greater patient satisfaction, and more success in recruiting top students into a residency.

Factors associated with job satisfaction by Chinese primary care providers.

Science.gov (United States)

Shi, Leiyu; Song, Kuimeng; Rane, Sarika; Sun, Xiaojie; Li, Hui; Meng, Qingyue

2014-01-01

This study provides a snapshot of the current state of primary care workforce (PCW) serving China's grassroots communities and examines the factors associated with their job satisfaction. Data for the study were from the 2011 China Primary Care Workforce Survey, a nationally representative survey that provides the most current assessment of community-based PCW. Outcome measures included 12 items on job satisfaction. Covariates included intrinsic and extrinsic factors associated with job satisfaction. In addition, PCW type (i.e., physicians, nurses, public health, and village doctors) and practice setting (i.e., rural versus urban) were included to identify potential differences due to the type of PCW and practice settings. The overall satisfaction level is rather low with only 47.6% of the Chinese PCW reporting either satisfied or very satisfied with their job. PCW are least satisfied with their income level (only 8.6% are either satisfied or very satisfied), benefits (12.8%), and professional development (19.5%). They (particularly village doctors) are also dissatisfied with their workload (37.2%). Lower income and higher workload are the two major contributing factors toward job dissatisfaction. To improve the general satisfaction level, policymakers must provide better pay and benefits and more opportunities for career development, particularly for village doctors.

Risk factors for revision of primary total hip arthroplasty: a systematic review

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Prokopetz Julian JZ

2012-12-01

Full Text Available Abstract Background Numerous papers have been published examining risk factors for revision of primary total hip arthroplasty (THA, but there have been no comprehensive systematic literature reviews that summarize the most recent findings across a broad range of potential predictors. Methods We performed a PubMed search for papers published between January, 2000 and November, 2010 that provided data on risk factors for revision of primary THA. We collected data on revision for any reason, as well as on revision for aseptic loosening, infection, or dislocation. For each risk factor that was examined in at least three papers, we summarize the number and direction of statistically significant associations reported. Results Eighty-six papers were included in our review. Factors found to be associated with revision included younger age, greater comorbidity, a diagnosis of avascular necrosis (AVN as compared to osteoarthritis (OA, low surgeon volume, and larger femoral head size. Male sex was associated with revision due to aseptic loosening and infection. Longer operating time was associated with revision due to infection. Smaller femoral head size was associated with revision due to dislocation. Conclusions This systematic review of literature published between 2000 and 2010 identified a range of demographic, clinical, surgical, implant, and provider variables associated with the risk of revision following primary THA. These findings can inform discussions between surgeons and patients relating to the risks and benefits of undergoing total hip arthroplasty.

Teachers' Demographic Factors on Attitude towards Guidance and Counselling Services in Public Primary Schools of Kimilili Subcounty, Kenya

Science.gov (United States)

Nasilumbi, Wesonga Joanne; Jenniffer, Munyau K.; Prisca, Tarus

2016-01-01

The government of Kenya through the Ministry of education banned corporal punishment in schools. This necessitated strengthening of guidance and counseling (G&C) services in schools. This study aimed to: determine the teachers' attitude towards guidance and counseling services in public primary schools in Kimilili Sub-County and determine the…

Organizational Enablers for Project Governance

DEFF Research Database (Denmark)

Müller, Ralf; Shao, Jingting; Pemsel, Sofia

and their relationships to organizational success. Based on these results, the authors discovered that organizational enablers (including key factors such as leadership, governance, and influence of project managers) have a critical impact on how organizations operate, adapt to market fluctuations and forces, and make......While corporate culture plays a significant role in the success of any corporation, governance and “governmentality” not only determine how business should be conducted, but also define the policies and procedures organizations follow to achieve business functions and goals. In their book......, Organizational Enablers for Project Governance, Ralf Müller, Jingting Shao, and Sofia Pemsel examine the interaction of governance and governmentality in various types of companies and demonstrate how these factors drive business success and influence project work, efficiency, and profitability. The data...

Platelet-Released Growth Factors Induce Differentiation of Primary Keratinocytes

Science.gov (United States)

Tohidnezhad, Mersedeh; Lammel, Justus; Lippross, Sebastian; Behrendt, Peter; Klüter, Tim; Pufe, Thomas; Jahr, Holger; Cremer, Jochen; Rademacher, Franziska; Gläser, Regine; Harder, Jürgen

2017-01-01

Autologous thrombocyte concentrate lysates, for example, platelet-released growth factors, (PRGFs) or their clinically related formulations (e.g., Vivostat PRF®) came recently into the physicians' focus as they revealed promising effects in regenerative and reparative medicine such as the support of healing of chronic wounds. To elucidate the underlying mechanisms, we analyzed the influence of PRGF and Vivostat PRF on human keratinocyte differentiation in vitro and on epidermal differentiation status of skin wounds in vivo. Therefore, we investigated the expression of early (keratin 1 and keratin 10) and late (transglutaminase-1 and involucrin) differentiation markers. PRGF treatment of primary human keratinocytes decreased keratin 1 and keratin 10 gene expression but induced involucrin and transglutaminase-1 gene expression in an epidermal growth factor receptor- (EGFR-) dependent manner. In concordance with these results, microscopic analyses revealed that PRGF-treated human keratinocytes displayed morphological features typical of keratinocytes undergoing terminal differentiation. In vivo treatment of artificial human wounds with Vivostat PRF revealed a significant induction of involucrin and transglutaminase-1 gene expression. Together, our results indicate that PRGF and Vivostat PRF induce terminal differentiation of primary human keratinocytes. This potential mechanism may contribute to the observed beneficial effects in the treatment of hard-to-heal wounds with autologous thrombocyte concentrate lysates in vivo. PMID:28808357

Platelet-Released Growth Factors Induce Differentiation of Primary Keratinocytes

Directory of Open Access Journals (Sweden)

Andreas Bayer

2017-01-01

Full Text Available Autologous thrombocyte concentrate lysates, for example, platelet-released growth factors, (PRGFs or their clinically related formulations (e.g., Vivostat PRF® came recently into the physicians’ focus as they revealed promising effects in regenerative and reparative medicine such as the support of healing of chronic wounds. To elucidate the underlying mechanisms, we analyzed the influence of PRGF and Vivostat PRF on human keratinocyte differentiation in vitro and on epidermal differentiation status of skin wounds in vivo. Therefore, we investigated the expression of early (keratin 1 and keratin 10 and late (transglutaminase-1 and involucrin differentiation markers. PRGF treatment of primary human keratinocytes decreased keratin 1 and keratin 10 gene expression but induced involucrin and transglutaminase-1 gene expression in an epidermal growth factor receptor- (EGFR- dependent manner. In concordance with these results, microscopic analyses revealed that PRGF-treated human keratinocytes displayed morphological features typical of keratinocytes undergoing terminal differentiation. In vivo treatment of artificial human wounds with Vivostat PRF revealed a significant induction of involucrin and transglutaminase-1 gene expression. Together, our results indicate that PRGF and Vivostat PRF induce terminal differentiation of primary human keratinocytes. This potential mechanism may contribute to the observed beneficial effects in the treatment of hard-to-heal wounds with autologous thrombocyte concentrate lysates in vivo.

Examining Auditing as an Essential Element of Financial Management and Good Governance in Local Government

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Sindisile Maclean

2014-06-01

Full Text Available The purpose of the article is to address issues of auditing in the context of financial management as a contribution to good governance. Generally, not all local governments have effective and operational audit units and committees. As a result, auditing is not used as an essential element of good governance and this leads to bad audit outcomes like disclaimers and adverse opinions. The bad audit outcomes in local government have motivated the researcher to conduct the study on auditing. There are internal factors within the municipalities as well as external factors that are of interest and directed the researcher to have desire and commitment to make a contribution in this particular field of research. The key issues, amongst others, are principles of financial management, financial strategy, auditing functions such as forensic auditing, fraud auditing, forensic accounting and detection of fraud, including accounting systems and auditor’s role. This article will also attempt to reinforce existing theories and add value to local government financial discourse and good governance.

Belongingness in Early Secondary School: Key Factors that Primary and Secondary Schools Need to Consider.

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Sharmila Vaz

Full Text Available It is unknown if, and how, students redefine their sense of school belongingness after negotiating the transition to secondary school. The current study used longitudinal data from 266 students with, and without, disabilities who negotiated the transition from 52 primary schools to 152 secondary schools. The study presents the 13 most significant personal student and contextual factors associated with belongingness in the first year of secondary school. Student perception of school belongingness was found to be stable across the transition. No variability in school belongingness due to gender, disability or household-socio-economic status (SES was noted. Primary school belongingness accounted for 22% of the variability in secondary school belongingness. Several personal student factors (competence, coping skills and school factors (low-level classroom task-goal orientation, which influenced belongingness in primary school, continued to influence belongingness in secondary school. In secondary school, effort-goal orientation of the student and perception of their school's tolerance to disability were each associated with perception of school belongingness. Family factors did not influence belongingness in secondary school. Findings of the current study highlight the need for primary schools to foster belongingness among their students at an early age, and transfer students' belongingness profiles as part of the hand-over documentation. Most of the factors that influenced school belongingness before and after the transition to secondary are amenable to change.

Governance factors in the identification of global conservation priorities for mammals.

Science.gov (United States)

Eklund, Johanna; Arponen, Anni; Visconti, Piero; Cabeza, Mar

2011-09-27

Global conservation priorities have often been identified based on the combination of species richness and threat information. With the development of the field of systematic conservation planning, more attention has been given to conservation costs. This leads to prioritizing developing countries, where costs are generally low and biodiversity is high. But many of these countries have poor governance, which may result in ineffective conservation or in larger costs than initially expected. We explore how the consideration of governance affects the selection of global conservation priorities for the world's mammals in a complementarity-based conservation prioritization. We use data on Control of Corruption (Worldwide Governance Indicators project) as an indicator of governance effectiveness, and gross domestic product per capita as an indicator of cost. We show that, while core areas with high levels of endemism are always selected as important regardless of governance and cost values, there are clear regional differences in selected sites when biodiversity, cost or governance are taken into account separately. Overall, the analysis supports the concentration of conservation efforts in most of the regions generally considered of high priority, but stresses the need for different conservation approaches in different continents owing to spatial patterns of governance and economic development.

AWARENESS AS A FACTOR OF INFLUENCE ON THE LEVEL OF PUBLIC SATISFACTION WITH LOCAL SELF-GOVERNMENT ACTIVITIES

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Kiseleva N. V.

2014-12-01

Full Text Available In the modern period of the development of statehood in Russia the significant increase of attention is attributed to the issue of effectiveness of state power and government not only on the federal and regional levels, but on the local level as well. In 2009 there was developed and implemented the system of indicators of the effectiveness’ estimates of the activity of local self-government. The system of effectiveness’ estimates included sociological indices of satisfaction of population. Implementation of sociological indices in the system of effectiveness’ estimates of the activity of local self-government brought positive responses from academic community, politicians, managers, and the public. In the article the analysis of influence of cognitive factor (being kept informed on the level of social contentment of the activity of local self-government’ bodies is done. We do this, based on the results of sociological studies of the major Russian research organizations and data from the aggregate reports, which deal with the monitoring of effectiveness of local self-government of some subjects in the Central federal district of Russia.

Corporate Governance and Pension Fund Performance

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Oskar Kowalewski

2012-03-01

Full Text Available This study provides new evidence on the impact of governance on the performance of privately defined contribution pension plans. Using a hand collected data set on governance factors, the study shows that the external and internal governance mechanisms in pension plans are weak. One explanation for this weakness is the potential conflict between the pension beneficiaries and the fund’s owner, which depends on who bears the investment risk in the pension plan. Hence, different governance factors are found to be important for pension fund return on invested assets and also for its economic performance. Consequently, the overall policy conclusion is that more focus should be put on the governance of the pension funds, taking into account the different interests of the beneficiaries and owners as it may determine their performance.

[Prevalence of myopia and influencing factors among primary and middle school students in 6 provinces of China].

Science.gov (United States)

Zhou, Jia; Ma, Yinghua; Ma, Jun; Zou, Zhiyong; Meng, Xiangkun; Tao, Fangbiao; Luo, Chunyan; Jing, Jin; Pan, Dehong; Luo, Jiayou; Zhang, Xin; Wang, Hong; Zhao, Haiping

2016-01-01

To understand the prevalence of myopia in primary and middle school students in 6 provinces and the possible influencing factors. Primary and middle school students were selected through multistage cluster sampling in 60 primary and middle schools in 6 provinces in China. The questionnaire survey and eyesight test were conducted among all the students selected according to the national student's physique and health survey protocol. Pearson chi-square test and binary multivariate logistic regression analysis were done to identify the influencing factors for myopia in students. The prevalence of myopia among primary and middle school students surveyed was 55.7%, the gender specific difference was statistically significant (59.7% for girls, 51.9% for boys) (Psleep time, average outdoor activity time during last week, school sport activities in the afternoon, the size of television set at home, time spent on watching TV and playing computer were the influencing factors for myopia. The prevalence of myopia is till high in primary and middle school students. Myopia is associated with both genetic factors and individual eye health related behaviors.

Impact of socioeconomic factors on nutritional status in primary school children

International Nuclear Information System (INIS)

Babar, N.F.; Khan, M.A.

2010-01-01

Child malnutrition is a major public health and development concern in most of the poor communities leading to high morbidity and mortality. Various studies have highlighted the factors involved. The present study focuses on socioeconomic inequality resulting in malnutrition. Objectives of the Study were to find the Impact of socio-economic factors on nutritional status in primary school children. Methods: It was a cross sectional survey conducted at Lahore from February to August 2005 among primary schools from public and private sectors to assess the nutritional status of primary school going children age 5-11 years belonging to different socio economic classes of the society. Systematic random sampling technique was applied to collect the sample. Body Mass Index in relation to NHANES reference population was used for assessing nutritional status. Results: The nutritional status of children from lower socio economic class was poor as compared to their counter parts in upper socio economic class. Children with BMI <5 percentile were 41% in lower class while in upper class it was 19.28%. Prevalence of malnutrition was 42.3% among children of illiterate mothers as compare to 20% in those of literate mothers. Conclusion: Poverty, low literacy rate, large families, food insecurity, food safety, women's education appears to be the important underlying factors responsible for poor health status of children from low socioeconomic class. It requires economic, political and social changes as well as changes for personal advancement mainly through educational opportunities to improve the nutritional status of the children. (author)

Integrated primary health care in Australia

Directory of Open Access Journals (Sweden)

Gawaine Powell Davies

2009-10-01

Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

Integrated primary health care in Australia.

Science.gov (United States)

Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna

2009-10-14

To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

An explorative study of factors contributing to the job satisfaction of primary care midwives

NARCIS (Netherlands)

Warmelink, J.C.; Hoijtink, K.; Noppers, M.; Wiegers, T.A.; de Cock, T.P.; Klomp, T.; Hutton, E.K.

2015-01-01

Objective: the main objectives of our study was to gain an understanding of how primary care midwives in the Netherlands feel about their work and to identify factors associated with primary care midwives' job satisfaction and areas for improvement. Design: a qualitative analysis was used, based on

An explorative study of factors contributing to the job satisfaction of primary care midwives.

NARCIS (Netherlands)

Warmelink, J.C.; Hoijtink, K.; Noppers, M.; Wiegers, T.A.; Cock, T.P. de; Klomp, T.; Hutton, E.K.

2015-01-01

Objective: the main objectives of our study was to gain an understanding of how primary care midwives in the Netherlands feel about their work and to identify factors associated with primary care midwives׳ job satisfaction and areas for improvement. Design: a qualitative analysis was used, based on

Business Climate and Good Governance

Directory of Open Access Journals (Sweden)

Besmira Manaj

2015-03-01

Full Text Available This paper consists of three factors, namely: Good Governance, Business Climate and Corruption. How they affect the development product of Albania, not only as a concept, and a principle but mostly as a sensitive aspect in the integration process. There are some interpretations of this concept, but I intend to analyze the key factors and actors, their cooperation and concrete production in society. Improving governance is necessary to have an integrated long term strategy based upon a continuous cooperation between institutions and citizens. But in developing countries like Albania there are some important questions such as: How can we measure the improvement of Good Governance through policies? Has Good Governance indicated an effective way for the sustainable development? (Meisel, 2008, 6. These question give us the orientation to reflect about the process of development, social economic political behavior and how this multidimensional is transformed in product of good governance. The business cycle is strongly connected with many aspects of political-, social-, juridical aspects and good governance. Despite attempts to draft law regulations, the level of corruption and informality in Albania continues to be a major obstacle. The credibility level in the implementation of law is an indicator that affects democratization and institutional integration. At present, different reports of international institutions, define Albania as the country with the highest level of Corruption in the Balkans, which is a key factor influencing business. The ways with

Predictive factors for postoperative visual function of primary chronic rhegmatogenous retinal detachment after scleral buckling.

Science.gov (United States)

Fang, Wei; Li, Jiu-Ke; Jin, Xiao-Hong; Dai, Yuan-Min; Li, Yu-Min

2016-01-01

To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment (RRD) after sclera buckling (SB). Totally 48 patients (51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study, which underwent SB alone from June 2008 to December 2014. Age, sex, symptoms duration, detached extension, retinal hole position, size, type, fovea on/off, proliferative vitreoretinopathy (PVR), posterior vitreous detachment (PVD), baseline best corrected visual acuity (BCVA), operative duration, follow up duration, final BCVA were measured. Pearson correlation analysis, Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity. Student's t-test, Wilcoxon two-sample test, Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement. Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR. Primary surgical success rate was 92.16% (47/51). Correlation analyses revealed shorter symptoms duration (r=0.3850, P=0.0053), less detached area (r=0.5489, Ppredictive factors were better baseline BCVA [partial R-square (PR(2))=0.5316, Ppredictive factors for better vision improvement were better baseline vision [odds ratio (OR) =50.369, P=0.0041] and longer follow up duration (OR=1.144, P=0.0067). Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA, shorter symptoms duration, shorter operative duration and longer follow up duration, while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.

An explorative study of factors contributing to the job satisfaction of primary care midwives.

Science.gov (United States)

Warmelink, J Catja; Hoijtink, Kirsten; Noppers, Marloes; Wiegers, Therese A; de Cock, T Paul; Klomp, Trudy; Hutton, Eileen K

2015-04-01

the main objectives of our study was to gain an understanding of how primary care midwives in the Netherlands feel about their work and to identify factors associated with primary care midwives׳ job satisfaction and areas for improvement. a qualitative analysis was used, based on the constructivist/interpretative paradigm. Three open-ended questions in written or online questionnaire, analysed to identify factors that are linked with job satisfaction, were as follows: 'What are you very satisfied with, in your work as a midwife?', 'What would you most like to change about your work as a midwife?' and 'What could be improved in your work?'. 20 of the 519 primary care practices in the Netherlands in May 2010 were included. at these participating practices 99 of 108 midwives returned a written or online questionnaire. in general, most of the participating primary care midwives were satisfied with their job. The factors positively associated with their job satisfaction were their direct contact with clients, the supportive co-operation and teamwork with immediate colleagues, the organisation of and innovation within their practice group and the independence, autonomy, freedom, variety and opportunities that they experienced in their work. Regarding improvements, the midwives desired a reduction in non-client-related activities, such as paperwork and meetings. They wanted a lower level of work pressure, and a reduced case-load in order to have more time to devote to individual clients׳ needs. Participants identified that co-operation with other partners in the health care system could also be improved. our knowledge, our study is the first explorative study on factors associated with job satisfaction of primary care midwives. While there are several studies on job satisfaction in health care; little is known about the working conditions of midwives in primary care settings. Although the participating primary care midwives in the Netherlands were satisfied with their

Why Mobile Government isn’t successful (yet)

DEFF Research Database (Denmark)

Ohme, Jakob; Seifert, Claudia; Renatus, Rebecca

Mobile Government as a subset of E-Government is part of the Open Government approach of leading countries, like Germany. Since adoption rates among the citizens are still low this study tries to answer the question, what factors concerning the relationship of the government and its citizens migh...

Governance in Health - The Need for Exchange and Evidence Comment on "Governance, Government, and the Search for New Provider Models".

Science.gov (United States)

Chanturidze, Tata; Obermann, Konrad

2016-05-17

Governance in health is cited as one of the key factors in balancing the concerns of the government and public sector with the interests of civil society/private players, but often remains poorly described and operationalized. Richard Saltman and Antonio Duran look at two aspects in the search for new provider models in a context of health markets signalling liberalisation: (i) the role of the government to balance public and private interests and responsibilities in delivering care through modernised governance arrangements, and (ii) the finding that operational complexities may hinder well-designed provider governance models, unless governance reflects country-specific realities. This commentary builds on the discussion by Saltman and Duran, and argues that the concept of governance needs to be clearly defined and operationalized in order to be helpful for policy debate as well as for the development of an applicable framework for performance improvement. It provides a working definition of governance and includes a reflection on the prevailing cultural norms in an organization or society upon which any governance needs to be build. It proposes to explore whether the "evidence-based governance" concept can be introduced to generate knowledge about innovative and effective governance models, and concludes that studies similar to the one by Saltman and Duran can inform this debate. © 2016 by Kerman University of Medical Sciences.

RE-ENGINEERING GOVERNANCE; E-GOVERNMENT AS A TOOL FOR DECENTRALIZATION; GHANA AS A CASE STUDY

DEFF Research Database (Denmark)

Gyaase, Patrick Ohemeng Kwadwo

This research was undertaken to study the diffusion of E-government as a tool for decentralization, using Ghana as a case study. E-governance has been credited with the potency of facilitating good governance in countries with appreciable level of E-government maturity. Much attention is being...... espoused by E-government. This research therefore assesses the diffusion of E-government as a tool for decentralization in Ghana. The research was carried out using mixed-methods and was approached from four theoretical perspectives namely Innovation Diffusion theory the TOE framework for technological....... Qualitative data was used to assess the factors affecting the diffusion of e-government as a tool for decentralization and the results pointed to vendor and donor led diffusion as affecting E-government implementation. There is also the absence of convergence between the E-government, the decentralization...

Identification of transcriptional factors and key genes in primary osteoporosis by DNA microarray.

Science.gov (United States)

Xie, Wengui; Ji, Lixin; Zhao, Teng; Gao, Pengfei

2015-05-09

A number of genes have been identified to be related with primary osteoporosis while less is known about the comprehensive interactions between regulating genes and proteins. We aimed to identify the differentially expressed genes (DEGs) and regulatory effects of transcription factors (TFs) involved in primary osteoporosis. The gene expression profile GSE35958 was obtained from Gene Expression Omnibus database, including 5 primary osteoporosis and 4 normal bone tissues. The differentially expressed genes between primary osteoporosis and normal bone tissues were identified by the same package in R language. The TFs of these DEGs were predicted with the Essaghir A method. DAVID (The Database for Annotation, Visualization and Integrated Discovery) was applied to perform the GO (Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway enrichment analysis of DEGs. After analyzing regulatory effects, a regulatory network was built between TFs and the related DEGs. A total of 579 DEGs was screened, including 310 up-regulated genes and 269 down-regulated genes in primary osteoporosis samples. In GO terms, more up-regulated genes were enriched in transcription regulator activity, and secondly in transcription factor activity. A total 10 significant pathways were enriched in KEGG analysis, including colorectal cancer, Wnt signaling pathway, Focal adhesion, and MAPK signaling pathway. Moreover, total 7 TFs were enriched, of which CTNNB1, SP1, and TP53 regulated most up-regulated DEGs. The discovery of the enriched TFs might contribute to the understanding of the mechanism of primary osteoporosis. Further research on genes and TFs related to the WNT signaling pathway and MAPK pathway is urgent for clinical diagnosis and directing treatment of primary osteoporosis.

A Primary Human Critical Success Factors Model for the ERP System Implementation

Directory of Open Access Journals (Sweden)

Jenko Aleksander

2016-08-01

Full Text Available Background and Purpose: Many researchers have investigated various Critical success factors (CSFs and the different causes of ERP implementation project failures. Despite a detailed literature preview, we were unable to find an appropriate research with a comprehensive overview of the true causes behind CSFs, observed from a human factors perspective. The objective of this research was therefore to develop and evaluate the Primary human factors (PHFs model and to confirm the significant impact of PHFs on traditional CSFs and on the project success.

A Cursory Look at Primary School Libraries and Utilization in Ado ...

African Journals Online (AJOL)

The study is a survey of primary school libraries and usage in Ado- EkitiLocal Government Area of Ekiti State, Nigeria. Ten primary schools wereselected for the study. They represented three categories of primary schoolsin the State as follows: Government owned Public Schools State UniversalBasic Education Board ...

SOCIO-ECONOMIC FACTORS AFFECTING GROUNDNUT PRODUCTION IN SABONGARI LOCAL GOVERNMENT OF KADUNA STATE, NIGERIA

Directory of Open Access Journals (Sweden)

Ibrahim Usman

2013-07-01

Full Text Available Groundnut an important oil seed crop provides significant sources of cash through the sales of seed, cakes, oil and haulms. Groundnut plays an important role in the diets of rural populations. Groundnut pod yields from farmer’s field are low, averaging about 800 kg per ha, less than one-third the potential yield of 3000 kg per ha. This large gap is of concern and in view of this, the study was carried out to assess the socio economic characteristics of groundnut farmers, determine the level of profitability of groundnut production, the resource use efficiency as well as to find out problems encountered in groundnut production in Sabon-gari local government area. Seventy-nine farmers involved in groundnut production were randomly selected from the various farms located within the local government area. Data were collected using primary and secondary sources. To examine the profitability of groundnut production, the gross margin and cost benefit analysis were carried out. The result of the study shows that experienced farmers are less involved in groundnut production and most groundnut farmers are engaged in other form of businesses. The cost, availability, and lack of technical knowledge of inputs requirements are responsible for poor use of the inputs. Labour, fertilizer, seed and herbicides are all over utilized except insecticide which is underutilized. Among the problems encountered in groundnut production in the study are lacks of capital and extension services. These two problems accounted for over 78% of the problem of groundnut in the study area. It is therefore recommended that government and research institutes should strengthen extension services to deliver improved technologies to the farmers. Farmers are also advised to source for loans through cooperatives, banks and other available sources at low charges and the procedure for loan should be made simple to enable farmers’ access loans so that groundnut production can be improved.

Rate and Risk Factors for Periprosthetic Joint Infection Among 36,494 Primary Total Hip Arthroplasties.

Science.gov (United States)

Triantafyllopoulos, Georgios K; Soranoglou, Vasileios G; Memtsoudis, Stavros G; Sculco, Thomas P; Poultsides, Lazaros A

2018-04-01

As periprosthetic joint infections (PJIs) can have tremendous health and socioeconomic implications, recognizing patients at risk before surgery is of great importance. Therefore, we sought to determine the rate of and risk factors for deep PJI in patients undergoing primary total hip arthroplasty (THA). Clinical characteristics of patients treated with primary THA between January 1999 and December 2013 were retrospectively reviewed. These included patient demographics, comorbidities (including the Charlson/Deyo comorbidity index), length of stay, primary diagnosis, total/allogeneic transfusion rate, and in-hospital complications, which were grouped into local and systemic (minor and major). We determined the overall deep PJI rate, as well as the rates for early-onset (occurring within 2 years after index surgery) and late-onset PJI (occurring more than 2 years after surgery). A Cox proportional hazards regression model was constructed to identify risk factors for developing deep PJI. Significance level was set at 0.05. A deep PJI developed in 154 of 36,494 primary THAs (0.4%) during the study period. Early onset PJI was found in 122 patients (0.3%), whereas late PJI occurred in 32 patients (0.1%). Obesity, coronary artery disease, and pulmonary hypertension were identified as independent risk factors for deep PJI after primary THA. The rate of deep PJIs of the hip is relatively low, with the majority occurring within 2 years after THA. If the optimization of modifiable risk factors before THA can reduce the rate of this complication remains unknown, but should be attempted as part of good practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Business Climate and Good Governance

OpenAIRE

Besmira Manaj

2015-01-01

This paper consists of three factors, namely: Good Governance, Business Climate and Corruption. How they affect the development product of Albania, not only as a concept, and a principle but mostly as a sensitive aspect in the integration process. There are some interpretations of this concept, but I intend to analyze the key factors and actors, their cooperation and concrete production in society. Improving governance is necessary to have an integrated long term strategy based upon a continu...

Predictive factors of user acceptance on the primary educational mathematics aids product

Science.gov (United States)

Hidayah, I.; Margunani; Dwijanto

2018-03-01

Mathematics learning in primary schools requires instructional media. According to Piaget's theory, students are still in the concrete operational stage. For this reason, the development of the primary level mathematics aids is needed to support the development of successful mathematics learning. The stages of this research are the stages of commercialization with preparatory, marketing, and measurement analysis procedures. Promotion as part of marketing is done by doing a demonstration to the teacher. Measurements were performed to explore the predictive factors of user feasibility in adopting the product. Measurements were conducted using the concept of Technology Acceptance Model (TAM). Measurement variables include external variables, perceived usefulness, perceived ease of use, attitude, intention to use, and actual use. The result of this research shows that the contribution of predictive factors of mathematics teachers on the teaching aids product as follows: the external variable and perceived ease of use at 74%, perceived usefulness at 72%, intention to use (behavioral) at 58%, attitude at 52%, and the consequence factor (actual use) at 42%.

Primary care in the United States: practice-based innovations and factors that influence adoption.

Science.gov (United States)

Goldberg, Debora Goetz

2012-01-01

This study aims to explore the use of specific innovations in primary care practices. The research seeks to examine whether a relationship exists between environmental factors and organizational characteristics and the level of innovation in primary care practices in Virginia. The study utilized multiple secondary data sets and an organizational survey of primary care practices to define the external environment and the level of innovation. Institutional theory was used to explain the connection between innovations in primary care practices and institutional forces within the environment. Resource dependency theory was used to explain motivators for change based on a dependence on scarce financial, human, and information resources. Results show a positive association between organizational size, organizational relationships, and stakeholder expectations on the level of innovation. A negative association was found between competition and the level of innovation. No relationship was found between degree of Medicare and managed care penetration and innovation, nor between knowledge of, and difficulty complying with, payer organization requirements and innovation. Primary care physician practices exist in a market-driven environment characterized by high pressure from regulatory sources, decreasing reimbursement levels, increasing rate of change in technologies, and increasing patient and community expectations. This study contributes new information on the relationship between organizational characteristics, the external environment and specific innovations in primary care practices. Information on the contributing factors to innovation in primary care is important for improving delivery of health care services and the ability of these practices to survive.

Selection of unusual actinomycetal primary sigma70 factors by plant-colonizing Frankia strains.

Science.gov (United States)

Lavire, Céline; Blaha, Didier; Cournoyer, Benoit

2004-02-01

Functional adaptations of sigma70 transcriptional factors led to the emergence of several paralogous lineages, each one being specialized for gene transcription under particular growth conditions. Screening of a Frankia strain EaI-12 gene library by sigma70 DNA probing allowed the detection and characterization of a novel actinomycetal primary (housekeeping) sigma70 factor. Phylogenetic analysis positioned this factor in the RpoD cluster of proteobacterial and low-G+C-content gram-positive factors, a cluster previously free of any actinobacterial sequences. sigma70 DNA probing of Frankia total DNA blots and PCR screening detected one or two rpoD-like DNA regions per species. rpoD matched the conserved region in all of the species tested. The other region was found to contain sigA, an alternative primary factor. sigA appeared to be strictly distributed among Frankia species infecting plants by the root hair infection process. Both genes were transcribed by Frankia strain ACN14a grown in liquid cultures. The molecular phylogeny of the sigma70 family determined with Frankia sequences showed that the alternative actinomycetal factors and the essential ones belonged to the same radiation. At least seven distinct paralogous lineages were observed among this radiation, and gene transfers were detected in the HrdB actinomycetal lineage.

Romanian government bond market

Directory of Open Access Journals (Sweden)

Cornelia POP

2012-12-01

Full Text Available The present paper aims to present the level of development reached by Romanian government bond market segment, as part of the country financial market. The analysis will be descriptive (the data series available for Romania are short, based on the secondary data offered by the official bodies involved in the process of issuing and trading the Romanian government bonds (Romanian Ministry of Public Finance, Romanian National Bank and Bucharest Stock Exchange, and also on secondary data provided by the Federation of European Stock Exchanges.To enhance the market credibility as a benchmark, a various combination of measures is necessary; among these measures are mentioned: the extension of the yield curve; the issuance calendars in order to improve transparency; increasing the disclosure of information on public debt issuance and statistics; holding regular meetings with dealers, institutional investors and rating agencies; introducing a system of primary dealers; establishing a repurchase (repo market in the government bond market. These measures will be discussed based on the evolution presented inside the paper.The paper conclude with the fact that, until now, the Romanian government bond market did not provide a benchmark for the domestic financial market and that further efforts are needed in order to increase the government bond market transparency and liquidity.

A new corporate governance

Directory of Open Access Journals (Sweden)

Ion Bucur

2015-12-01

Full Text Available The issue of corporate governance has become increasingly important as globalisation has begun to accelerate and the economic and financial turmoil have intensified. Post-crisis context has imposed the need to expand the prospects for analysis over governance and companies, as well as the need to identify new ways of administration and resource management. From this perspective, the author aims to highlight the conditions, factors and events that have generated profound changes within the business environment, while the analysis is focusing on contemporary changes in the systems of corporate governance and economic mutations, especially in terms of the companies. The establishment of new governance rules is demanding a theoretical approach based on new methodological requirements which are needed to reform theoretical foundations and to promote creative and effective shapes and governance systems.

Twin Evils: Government Copyright and Copyright-like Controls Over Government Information

National Research Council Canada - National Science Library

Gellman, Robert

1995-01-01

.... Nevertheless, several factors work together to allow agencies to deny public access to or effective use of uncopyrighted government information, restrict use of that information, or charge royalties...

N2O emission hotspots at different spatial scales and governing factors for small scale hotspots

International Nuclear Information System (INIS)

Heuvel, R.N. van den; Hefting, M.M.; Tan, N.C.G.; Jetten, M.S.M.; Verhoeven, J.T.A.

2009-01-01

Chronically nitrate-loaded riparian buffer zones show high N 2 O emissions. Often, a large part of the N 2 O is emitted from small surface areas, resulting in high spatial variability in these buffer zones. These small surface areas with high N 2 O emissions (hotspots) need to be investigated to generate knowledge on the factors governing N 2 O emissions. In this study the N 2 O emission variability was investigated at different spatial scales. Therefore N 2 O emissions from three 32 m 2 grids were determined in summer and winter. Spatial variation and total emission were determined on three different scales (0.3 m 2 , 0.018 m 2 and 0.0013 m 2 ) at plots with different levels of N 2 O emissions. Spatial variation was high at all scales determined and highest at the smallest scale. To test possible factors inducing small scale hotspots, soil samples were collected for slurry incubation to determine responses to increased electron donor/acceptor availability. Acetate addition did increase N 2 O production, but nitrate addition failed to increase total denitrification or net N 2 O production. N 2 O production was similar in all soil slurries, independent of their origin from high or low emission soils, indicating that environmental conditions (including physical factors like gas diffusion) rather than microbial community composition governed N 2 O emission rates

Factors associated with primary care prescription of opioids for joint pain.

Science.gov (United States)

Green, D J; Bedson, J; Blagojevic-Burwell, M; Jordan, K P; van der Windt, D

2013-02-01

Opioids are commonly prescribed in primary care and can offer pain relief but may also have adverse effects. Little is known about the characteristics of people likely to receive an opioid prescription in primary care. The aim is to identify what factors are associated with primary care prescribing of high-strength analgesics in a community sample of older people with joint pain. A prospective two-stage postal survey completed at baseline and 3-year follow-up in a population aged 50 and over registered with eight general practitioner (GP) practices in North Staffordshire (North Staffordshire Osteoarthritis Project cohorts) linked with data from medical records. Participants were selected who reported joint pain in one or more joints at baseline. Outcome measures were the number of prescriptions for high-strength pain medication (opioids) in the following 3 years. Socio-demographic and health status factors associated with prescription were assessed using a zero-inflated Poisson model. 873 (19%) people were prescribed opioids (out of 4652 providing complete data) ranging from 1 to 76 prescriptions over 3 years. Baseline factors significantly associated with increased rates of prescription were younger age group [65-74 group: incidence rate ratio (IRR) = 1.26 (1.18-1.35)], male gender [IRR = 1.17 (1.12-1.23)], severe joint pain [IRR = 1.19 (1.12-1.26)] poor physical function [IRR = 0.99 (0.99-0.99)] and lower frequency of alcohol consumption [once/twice a year: IRR = 1.13 (1.06-1.21), never: IRR = 1.14 (1.06-1.22)]. Restricting the analysis to those without prior prescriptions for strong opioids showed similar results. Poor physical function and participation restrictions were strongly associated with prescriptions of stronger opioids in addition to several socio-demographic and lifestyle factors. Given the uncertainties over the effectiveness and risks of opioid use, future research could investigate decision making of GPs, exploring reasons for prescribing them. �

The status of vaccine availability and associated factors in Tshwane government clinics.

Science.gov (United States)

Ngcobo, Ntombenhle Judith; Kamupira, Mercy G

2017-05-24

Vaccines have greatly contributed to the control of vaccine-preventable diseases and to human development. Efforts by many countries to introduce new vaccines are a significant move towards achieving the sustainable development goal for health. However, effective vaccine supply chains that ensure an uninterrupted supply of vaccines are pivotal to attaining universal access to life-saving vaccines and sustainable development. The introduction of new vaccines puts a strain on supply chains; South Africa (SA) is no exception, as there are indications of vaccine stock-outs in clinics. To establish the status of vaccine availability and associated factors in government health facilities of Tshwane Health District in Gauteng Province, SA. A cross-sectional study was conducted in a sample of randomly selected government clinics in the Tshwane health district of Gauteng Province. Data were collected using a structured measurement instrument in participating clinics. Data were analysed using Excel-based software (Microsoft, USA). A total of 31 clinics participated. In the preceding 12 months, clinics had experienced vaccine stock-outs, especially of the three newer vaccines: pneumococcal conjugate vaccine, rotavirus and Pentaxim. These were also out of stock for a long duration; for over 2 weeks in a majority of clinics. The causes of vaccine stock-outs were: poor management of stock, district depot out of stock, unreliable deliveries, lack of pharmacy assistants and limited fridge capacity. Further burdening the situation is the ineffective emergency-ordering system. Significant shortages of vaccines, which are essential drugs, occur in Tshwane government clinics. Vaccine supply chain issues and vaccine shortages should be treated as a priority at all levels of the healthcare system; therefore, a similar study should be conducted at national level. It is recommended that the vaccine supply chain should be restructured and overhauled with the use of advances in technology

Factors Influencing Academic Performance Of Standard Eight Girls In National Examinations In Public Primary Schools A Case Of Matungu Division.

Directory of Open Access Journals (Sweden)

Oparanya Wamukoya Windrick

2015-06-01

Full Text Available ABSTARCT This study is designed to establish the factors influencing academic of standard eight girls in public primary schools in National exams in Matungu division. The researcher aimed at finding out why there is increased low performance of girls in public schools despite the fact that they are assessed through periodic performance tests do continuous assessment tests CATS midterm carry out tuition and the provision of free primary education which is aimed at improving academic performance. This study adapted a descriptive survey design as a major method of research where data was collected by the researcher members of a population under study. The target population comprised of Head teachers teachers pupils parents and parent schools representatives. Purposive sampling and simple random technique were used. Data was collected by use of questionnaires and interview guides. Data was analyzed by use of descriptive statistics constituting frequencies and percentages.The study established that girls were exposed to harsh school environmental conditions they walked long distances to school schools lacked facilities like toilets libraries and were exposed to male pest teachers. There were also teacher factors like training teacher shortage and motivation that affected girls performance.The study came up with recommendations for improvement of girls academic performance. More public schools should be build to reduce on distance and also overpopulation. The ministry of Education should monitor and evaluate the academic performance of girls in rural areas. The government should put up strict rules on pest teachers. The ministry should hire more teachers.

Primary Candida guilliermondii Infection of the Knee in a Patient without Predisposing Factors

Directory of Open Access Journals (Sweden)

Gun Woo Lee

2012-01-01

Full Text Available Isolated primary candidal infection of joint is extremely rare, with only a few reported cases. It occurs as a result of accidental implantations of fungus during traumatic procedures, such as surgery, and is usually reported in patients with predisposing factors such as immunosuppression, malignancy, and drug abuse. If left untreated, irreversible deformity and pain with severe osteoarticular destruction occur. Thus, early diagnosis and treatment are important. This paper presents a case of 72-year-old man with primary C. guilliermondii infection of knee joint without predisposing factors and previous traumatic procedures, who was misdiagnosed with advanced degenerative osteoarthritis. Our case is the second case of primary C. guilliermondii arthritis of knee to be reported in the English-language literature and the first to be successfully treated with total knee arthroplasty following IV amphotericin B and oral fluconazole. Primary candidal infection of joint is generally asymptomatic or involves only mild pain and swelling in the affected knee. Thus, although the majority of knee joint infections are of a pyogenic or tuberculous origin, if a patient complains of mild pain and swelling in the knee and has mild signs of infection, the possibility of fungal infection should be considered.

E-GOVERNMENT: A DRIVING FACTOR FOR STIMULATING INNOVATION PERFORMANCE IN ROMANIA?

Directory of Open Access Journals (Sweden)

Coculescu Cristina

2011-07-01

Full Text Available The development of public services is one of the priorities on the agendas of all policies, both national and European. One of the most recent concerns of the European Commission, as shown in the 2010 Innobarometer, is to find ways and develop strategies to support the innovation in the public administration sector, in the context of the continuously changing economic background. In this paper, we'll investigate the relationship between e-Government, and the overall innovation performance at national level, for some European Union countries. e-Government is already a known concept, widespread in the world, promoting the implementation of information and communication technologies in the public administration, in order to provide better public services to citizens and businesses. A main component of the e-Government concept is the 'counter reform', aimed to streamlining administrative act quickly in order to respond to the demands of citizens, businesses and government structures. Innovation in e-Government will be measured with two Eurostat indicators e-Government on-line availability and e-Government usage by individuals while for the overall innovation performance we'll use a composite indicator the Summary Innovation Index (SII - from the Innovation Union Scoreboard (IUS. In Romania, even if the values of these indicators are not at the level of other EU countries, we can say that the situation has improved and electronic public services are being used increasingly often. The study also includes a comparison between two modest innovators: Romania and Bulgaria. Regarding the overall innovation performance, according to the 2010 Innovation Union Scoreboard ranking, Romania is the leader of the modest innovators countries, overcoming Latvia, Bulgaria and Lithuania. However, in the field of e-Government our country has major shortcomings. Romania has registered a significant progress in the years after the EU integration, followed by a setback in

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes.

Science.gov (United States)

McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

2018-01-01

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

Prevalence of Primary Dysmenorrhea and Factors Associated with Its Intensity Among Undergraduate Students: A Cross-Sectional Study.

Science.gov (United States)

Habibi, Nahal; Huang, Mary Soo Lee; Gan, Wan Ying; Zulida, Rejali; Safavi, Sayyed Morteza

2015-12-01

Primary dysmenorrhea is a womanhood problem around the world and negatively affects quality of life. This study was designed to investigate the prevalence of primary dysmenorrhea and to determine the factors associated with its intensity. A cross-sectional study was carried out among 311 undergraduate female students aged 18 to 27 years in Isfahan University of Medical Sciences, Iran. Socio-demographic characteristics and menstrual factors were obtained through interviews with the help of a pretested questionnaire. The prevalence of primary dysmenorrhea was 89.1%. Residing at home, younger age, lower number of years of formal education for the mother, positive family history of dysmenorrhea, higher severity of bleeding, and shorter menstrual period intervals were significantly associated with the higher intensity of primary dysmenorrhea. Primary dysmenorrhea is a common health concern among young women. Being aware of the factors that are associated with its intensity makes it possible for health professionals to organize better focused programs to reduce the adverse effects of dysmenorrhea. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Factors Influencing the Selection of the Systems Integration Organizational Model Type for Planning and Implementing Government High-Technology Programs

Science.gov (United States)

Thomas, Leann; Utley, Dawn

2006-01-01

While there has been extensive research in defining project organizational structures for traditional projects, little research exists to support high technology government project s organizational structure definition. High-Technology Government projects differ from traditional projects in that they are non-profit, span across Government-Industry organizations, typically require significant integration effort, and are strongly susceptible to a volatile external environment. Systems Integration implementation has been identified as a major contributor to both project success and failure. The literature research bridges program management organizational planning, systems integration, organizational theory, and independent project reports, in order to assess Systems Integration (SI) organizational structure selection for improving the high-technology government project s probability of success. This paper will describe the methodology used to 1) Identify and assess SI organizational structures and their success rate, and 2) Identify key factors to be used in the selection of these SI organizational structures during the acquisition strategy process.

Research on evaluation of third-party governance operation services for environmental pollution

Science.gov (United States)

Xu, Bingsheng; Ling, Lin; Jin, Huang

2017-11-01

This paper focuses on the evaluation of third-party governance operation services for environmental pollution, and determines the evaluation indicator system composed of 5 primary indicators as the basic competence of enterprise, operation of equipment, technique economics, environmental benefit and management level, and 26 secondary indicators via policies and regulations, standards, literature research and expert consultation in combination with the composition elements, service value judgment factors and full-life cycle of the work, providing theoretical support for the effect evaluation of third-governance over the environmental pollution in China. Then, the hierarchical analytic matrix is formed by analyzing the environmental pollution governance evaluation indicator system via analytic hierarchy process and scoring the importance of various indicators by experts by applying the Delphi method. The feature vector of the matrix is then calculated to obtain the weight of each indicator and verify the effectiveness of the Delphi method and obtain the comprehensive weight by judging the consistency of the matrix, so as to finally determine the overall ordering level of the importance of secondary indicators.

The Acceptance of Mobile Government from a Citizen‘s Perspective

DEFF Research Database (Denmark)

Ohme, Jakob

Mobile Government (in short: M-Government) is just at the beginning of its rise as a future trend of E-Government. Considering the technical advancements such as mobile Internet, smart phones and tablet-PCs, M-Government tremendously develops a new potential for organizational communication proce......-Government is significantly influenced by both, factors citizens see as a benefit but also by factors of perceived risks...... processes. There are many examples of failures of early E-Government-projects due to a lack of consideration of users’ requirements. Against this background, the paper tries to contribute to organizational communication processes by addressing the driving factors influencing the acceptance of Mobile...... Government among the citizens. Extending the approaches of the Technology Acceptance Model (TRA) (Davis, Bagozzi & Warshaw, 1989) and the Theory of Planned Behavior (TPB) (Ajzen, 1991) to Mobile Government, a new M-Government-Acceptance-Model was developed. It shows that the intention to use M...

The prevalence and risk factors of stunting among primary school children in North Sumatera, Indonesia

Science.gov (United States)

Lestari, S.; Fujiati, I. I.; Keumalasari, D.; Daulay, M.

2018-03-01

Stunting in primary school-aged children is a kind of health and nutrition problem in Indonesia which has an impact on the human quality resources degradation. This research aimed to determine the stunting prevalence and the risk factors associated with stunting in primary school children in North Sumatra Province. This research is an analysis of cross-sectional approach. The total sampleis 400 children aged 8-13 years old were in the study from the Medan city and Langkat regency in July - October 2017. Data collected by using questionnaire and anthropometric assessment. Stunting (<-2 SD of height-for-age Z-score) were defined by using the World Health Organization reference 2007. Chi-square analysis and logistic regression were used toassess the association between risk factors and stunting. The prevalence of stunting in primary school children was 38.87%. The factors associated with stunting school children were theeducation of mother (OR=1.53), income (OR=2.27), work of mother (OR=1.39), energy intake (OR=2.66) and protein intake (OR=2.02). The dominant factor that influences stunting in school children was energy intake. The conclusion of this study is stunting prevalence in school children in NorthSumatra higher.

Effective Information Technology Governance Mechanisms: An Australian Study

Directory of Open Access Journals (Sweden)

Syaiful Ali

2006-01-01

Full Text Available Growing importance of information technology (IT, as a strategic factor for organizations in achieving their objectives, have raised the concern of organizations in establishing and implementing effective IT governance. This study seeks to empirically examine the individual IT governance mechanisms that influence the overall effectiveness of IT governance. The data were obtained by using web based survey from 176 members of ISACA (Information Systems and Audit Control Association Australia. This study examines the influences of six proposed IT governance mechanisms on the overall effectiveness of IT governance. Using Factor Analysis and Multiple Regression techniques, the current study finds significant positive relationships between the overall level of effective IT governance and the following four IT governance mechanisms: the existence of ethics/ culture of compliance in IT, corporate communication systems, an IT strategy committee, and the involvement of senior management in IT.

CORPORATE GOVERNANCE IN INDIA: STUDY OF the TOP 100 FIRMS

OpenAIRE

Rajesh K PILLANIA

2012-01-01

The concept of corporate governance is centuries old but it has gained a lot of momentum in last two decades in India. This paper studies the corporate governance practices in the top 100 companies in India. We find that in all industries irrespective of sector all companies practice some sort of corporate governance at least as said in their annual reports due to mandatory requirements. The primary driver mentioned behind the corporate governance practices is the interest of the stakeholders...

Ovarian metastases resection from extragenital primary sites: outcome and prognostic factor analysis of 147 patients

International Nuclear Information System (INIS)

Li, Wenhua; Wang, Huaying; Wang, Jian; LV, Fangfang; Zhu, Xiaodong; Wang, Zhonghua

2012-01-01

To explore the outcomes and prognostic factors of ovarian metastasectomy intervention on overall survival from extragenital primary cancer. Patients with ovarian metastases from extragenital primary cancer confirmed by laparotomy surgery and ovarian metastases resection were retrospectively collected in a single institution during an 8-year period. A total of 147 cases were identified and primary tumor sites were colorectal region (49.0%), gastric (40.8%), breast (8.2%), biliary duct (1.4%) and liver (0.7%). The pathological and clinical features were evaluated. Patients’ outcome with different primary tumor sites and predictive factors for overall survival were also investigated by univariate and multivariate analysis. Metachronous ovarian metastasis occurred in 92 (62.6%) and synchronous in 55 (37.4%) patients. Combined metastases occurred in 40 (27.2%). Bilateral metastasis was found in 97 (66%) patients. The median ovarian metastasis tumor size was 9 cm. There were 39 (26.5%) patients with massive ascites ≥ 1000 mL on intraoperative evaluation. With a median follow-up of 48 months, the median OS after ovarian metastasectomy for all patients was 8.2 months (95% CI 7.2-9.3 months). In univariate analyses, there is significant (8.0 months vs. 41.0 months, P = 0.000) difference in OS between patients with gastrointestinal cancer origin from breast origin, and between patients with gastric origin from colorectal origin (7.4 months vs. 8.8 months, P = 0.036). In univariate analyses, synchronous metastases, locally invasion, massive intraoperative ascites (≥ 1000 mL), and combined metastasis, were identified as significant poor prognostic factors. In multivariate analyses combined metastasis (RR, 1.72; 95% CI, 1.09-2.69, P = 0.018), locally invasion (RR, 1.62; 95% CI, 1.03-2.54, P = 0.038) and massive intraoperative ascites (RR, 1.58; 95% CI, 1.02-2.49, P = 0.04) were independent factors for predicting unfavorable overall survival. Ovarian metastases are more

Shopping Association Of Government Education Development In East Java

OpenAIRE

Muhamamd Guzali Tafalas; Deddy T. Tikson; Baharuddin; Hj. Hasniati

2017-01-01

The purpose of this study is to explain and analyze in detail The positive association Government spending in education PP with a Gross Enrolment Ratio GER and net enrollment ratio NER in East Java Province. Government spending on education is less associated significantly to the gross enrollment ratio at primary education. gross enrollment GER especially at the level of elementary education. As for the middle and high school level of education government spending on education was significant...

A Conceptual Model Of E-Government Adoption in Indonesia

OpenAIRE

Darmawan Napitupulu

2017-01-01

This study aims to determine various factors are related with the process of e-Government adoption. Many researchers have traced the success factors of e-Government but are still partial. This research contributes not only in terms of technological factors but also the attitudes and behaviors of its users (personality traits) which is also influential in the process of technology adoption. In this research, will be developed an adoption model of technology in the context of e-Government. This...

Platelet-released growth factors inhibit proliferation of primary keratinocytes in vitro.

Science.gov (United States)

Bayer, Andreas; Tohidnezhad, Mersedeh; Berndt, Rouven; Lippross, Sebastian; Behrendt, Peter; Klüter, Tim; Pufe, Thomas; Jahr, Holger; Cremer, Jochen; Rademacher, Franziska; Simanski, Maren; Gläser, Regine; Harder, Jürgen

2018-01-01

Autologous thrombocyte concentrate lysates as platelet-released growth factors (PRGF) or Vivostat Platelet Rich Fibrin (PRF ® ) represent important tools in modern wound therapy, especially in the treatment of chronic, hard-to-heal or infected wounds. Nevertheless, underlying cellular and molecular mechanisms of the beneficial clinical effects of a local wound therapy with autologous thrombocyte concentrate lysates are poorly understood. Recently, we have demonstrated that PRGF induces antimicrobial peptides in primary keratinocytes and accelerates keratinocytes' differentiation. In the present study we analyzed the influence of PRGF on primary human keratinocytes' proliferation. Using the molecular proliferation marker Ki-67 we observed a concentration- and time dependent inhibition of Ki-67 gene expression in PRGF treated primary keratinocytes. These effects were independent from the EGFR- and the IL-6-R pathway. Inhibition of primary keratinocytes' proliferation by PRGF treatment was confirmed in colorimetric cell proliferation assays. Together, these data indicate that the clinically observed positive effects of autologous thrombocytes concentrates in the treatment of chronic, hard-to-heal wounds are not based on an increased keratinocytes proliferation. Copyright © 2017 Elsevier GmbH. All rights reserved.

Risk factors leading to mucoperiosteal flap necrosis after primary palatoplasty in patents with cleft palate.

Science.gov (United States)

Rossell-Perry, Percy; Figallo-Hudtwalcker, Olga; Vargas-Chanduvi, Roberto; Calderon-Ayvar, Yvette; Romero-Narvaez, Carolina

2017-10-01

Few studies have been published reporting risk factors for flap necrosis after primary palatoplasty in patients with cleft palate. This complication is rare, and the event is a disaster for both the patient and the surgeon. This study was performed to explore the associations between different risk factors and the development of flap necrosis after primary palatoplasty in patients with cleft palate. This is a case-control study. A 20 years retrospective analysis (1994-2015) of patients with nonsyndromic cleft palate was identified from medical records and screening day registries). Demographical and risk factor data were collected using a patient´s report, including information about age at surgery, gender, cleft palate type, and degree of severity. Odds ratios and 95% confident intervals were derived from logistic regression analysis. All cases with diagnoses of flap necrosis after primary palatoplasty were included in the study (48 patients) and 156 controls were considered. In multivariate analysis, female sex, age (older than 15 years), cleft type (bilateral and incomplete), and severe cleft palate index were associated with significantly increased risk for flap necrosis. The findings suggest that female sex, older age, cleft type (bilateral and incomplete), and severe cleft palatal index may be associated with the development of flap necrosis after primary palatoplasty in patients with cleft palate.

Study of factors governing US utility nuclear power decisions

International Nuclear Information System (INIS)

1980-05-01

Under DOE contract No. DE-AC02-79ET34009, The S.M. Stoller Corporation has conducted a study of US utility attitudes toward nuclear power. In the course of this study SMSC carried out a utility survey the objectives of which were: (1) to identify and rank in importance the governing considerations in actions taken in the past three years to cancel or defer nuclear projects, and (2) to gain insight into the circumstances and attitudes likely to govern new base-load commitments over the next several years. During the survey, contacts were made at the senior management level with utilities representing approximately half of the country's total electric capacity and two-thirds of its present nuclear commitment. Analysis of the responses led to the conclusion that most, if not all, of the decisions reached by the respondent utilities in the past several years to cancel or defer nuclear projects were triggered by one or a combination of the following four considerations: financial constraints; reduction in expected system load growth; schedule delay in licensing and construction and/or unpredictability; and adverse state government policies or attitudes regarding nuclear power

Explaining the democratic anchorage of governance networks

DEFF Research Database (Denmark)

Skelcher, Chris; Klijn, Erik-Hans; Kübler, Daniel

2011-01-01

Advances in understanding the democratic anchorage of governance networks require carefully designed and contextually grounded empirical analysis that take into account contextual factors. The article uses a conjectural framework to study the impact of the national democratic milieu...... on the relationship between network governance and representative institutions in four European countries: the United Kingdom, Switzerland, the Netherlands, and Denmark. The article shows that the distinction between majoritarian and consensus democracy as well as the varying strength of voluntary associations...... are important contextual factors that help explain cross-national differences in the relationship between governance networks and representative institutions. We conclude that a context of weak associationalism in majoritarian democracies facilitates the instrumentalization of networks by government actors...

Primary Neuroendocrine Carcinoma of the Breast: Histopathological Criteria, Prognostic Factors, and Review of the Literature

Science.gov (United States)

Marinova, Lena; Vicheva, Snezhinka

2016-01-01

We present here a case of a 42-year-old woman diagnosed with primary neuroendocrine carcinoma of the breast (NECB). We discuss the importance of histological criteria for primary neuroendocrine mammary carcinoma, established by WHO in 2003 and 2012. After an overview of different cases of primary neuroendocrine carcinoma of the breast published in the literature, we present information about differential diagnosis, prognostic factors, and surgical and adjuvant treatment. Prognosis of NECB is not different from that of other invasive breast carcinomas and the most important prognostic factor is tumor grade (G). There is no standard treatment and patients should be treated similarly to patients with invasive ductal carcinoma, NOS (not otherwise specified), whose choice of therapy depends on tumor's size, degree of differentiation, clinical stage, and hormonal status. PMID:27840759

Infected primary knee arthroplasty: Risk factors for surgical treatment failure

Directory of Open Access Journals (Sweden)

Joao Gabriel Duarte Paes Pradella

2013-09-01

Full Text Available OBJECTIVE: To present epidemiological data and risk factors associated with surgical out-comes favorable or unfavorable for the treatment of infection in infected total knee arthroplasty. METHODS: We reviewed medical records of 48 patients who underwent treatment of primary total knee arthroplasty for infection between January 1994 and December 2008, in the Orthopedics and Traumatology Department of the Santa Casa de Misericórdia de São Paulo. The variables associated with favorable outcome of surgical treatment (debridement and retention or exchange arthroplasty in two days or unfavorable (arthrodesis or death infection. RESULTS: A total of 39 cases of infection after primary total knee arthroplasty, 22 progressed to 17 for a favorable outcome and unfavorable outcome. Early infections (OR: 14.0, 95% CI 1.5-133.2, p = 0.016 and diabetes (OR: 11.3, 95% CI 1.4-89.3, p = 0.032 were associated with arthrodesis joint and death respectively. CONCLUSION: Patients with early infection had a higher risk of developing surgical procedure with unfavorable outcome (arthrodesis and diabetics had higher odds of death after infection of primary knee arthroplasties.

The contingent effect of governance on organizational performance school boards in Dutch primary education

NARCIS (Netherlands)

Torenvlied, René; van den Bekerom, P.; Akkerman, A.

2013-01-01

The present paper tests the effects of governance structure on organizational performance. While most studies in public management are concerned with the impact of different types of managerial behavior on organizational performance, the context of the governance structure is mostly neglected. The

'Good Governance' dan 'Governability'

Directory of Open Access Journals (Sweden)

- Pratikno

2005-03-01

Full Text Available The article endeavors to trace the outset of governance concept, its dominant meanings and discourse, and its implication towards governability. The central role of government in the governing processes has predominantly been adopted. The concept of governance was emerged precisely in the context of the failure of government as key player in regulation, economic redistribution and political participation. Governance is therefore aimed to emphasize pattern of governing which are based both on democratic mechanism and sound development management. However, practices of such good governance concept –which are mainly adopted and promoted by donor states and agencies– tend to degrade state and/or government authority and legitimacy. Traditional function of the state as sole facilitator of equal societal, political and legal membership among citizens has been diminished. The logic of fair competition has been substituted almost completely by the logic of free competition in nearly all sectors of public life. The concept and practices of good governance have resulted in decayed state authority and failed state which in turn created a condition for "ungovernability". By promoting democratic and humane governance, the article accordingly encourages discourse to reinstall and bring the idea of accountable state back in.

Good Governance and Successful Development: Cross Countries Investigation

Directory of Open Access Journals (Sweden)

Tabthip Kraipornsak

2014-05-01

Full Text Available Good Governance is one of the essential factors of success in business as well as in a country’s development. This study aimed at examining the role of good governance and the success of the development. The comparable per head GDP measured in PPP (purchasing power parity was used as the proxy of the successful economic development of countries in the study. Four out of total six factors (indicators being the good governance and the other two being social environmental factors were employed in the investigation following concept of the role of external business environmental factors so called “PESTLE or Political, Economic, Social, Technological, Legislative or Legal, and Eco-environmental analysis”. These four indicators of good governance are political stability, control of corruption, rule of law, and voice and accountability which are available from the World Bank’s governance project data base. In addition, the other two indicators, country’s openness and size of population, are the major social variables included in the study which can also affect the success. The total six indicators are taken to examine with the GDP per head to see whether these factors can help countries achieve higher levels of income per head. The study indicates connection between the levels of success with these four indicators of the good governance and the two external social variables. For Thailand, the political instability was found to be a problem of the progress of development among those six indicators.

Dotting the I and Crossing (out) the T in IT Governance: New Challenges for Information Governance

NARCIS (Netherlands)

Borgman, H.; Heier, H.; Bahli, B.; Boekamp, T.; Bui, T.X.; Sprague, R.H.

2016-01-01

The purpose of this paper is to explore the factors influencing information governance, and particularly the role of new challenges such as cloud-based services, boundary-crossing use of data and new system development practices. Governing information within - as well as outside - the organization,

Factors Related to Perceived Needs of Primary Caregivers of Patients with Schizophrenia

Directory of Open Access Journals (Sweden)

Ling-Ling Yeh

2008-08-01

Conclusion: Four clusters of caregivers' perceived needs were identified and found to be related to psychopathologic and demographic factors. These data are of value in designing appropriate community psychiatric programs to improve the quality of care and enhance the capacity of primary caregivers to care for patients.

Long-term primary patency prognostic factors after endovascular therapy for acute lower limb ischemia

International Nuclear Information System (INIS)

Zhang Di; Gu Jianping; Lou Wensheng; He Xu; Chen Liang; Chen Guoping; Su Haobo; Song Jinhua; Wang Tao

2012-01-01

Objective: To assess prognostic factors regarding long-term primary patency for patients who underwent intra-arterial thrombolysis and/or adjuvant endovascular techniques due to acute lower limb ischemia. Methods: Consecutive patients with ALI of the lower extremities treated via interventional methods between January 2005 and June 2010 were identified and reviewed (exclude patient suffered from aortic dissection involved artery of lower extremity or trauma). Analyze the potential variables with univariable analysis and only factors associated with long-term primary patency with a P value less than 0.1 in univariable analysis were introduced into the Cox regression mode. Total long-term primary patency and grouped primary patency were assessed using Kaplan-Meier estimation. Results: The analyzed dataset included 107 limbs treated in 101 patients presenting with ALI (class Ⅰ 15, class Ⅱ A 36, class Ⅱ B to Ⅲ 56, according to Rutherford classification). Eight nine limbs were enrolled in follow-up.The mean followup was 34 months (range: 1 to 53 months). Primary patency at 12, 24 and 36 months was 87%, 68% and 55%, respectively. Multivariable analyses identified patients presenting with diabetes mellitus (P=0.00), PAOD (P<0.02) and thrombolysis time (P<0.02) were associated with primary patency. Compare the patency rate of patients with different thrombolysis time, the results showed that the patency rate of the patients thrombolysis time less than 4 d was higher than those more than 4 c. Conclusions: Interventional therapy remains an effective treatment option for patients presenting with lower extremity ALI. Diabetes mellitus and PAOD negatively affect the rates of limb primary patency. Thrombolysis should be limited to <4 days. (authors)

Enterprise investment, local government intervention and coal overcapacity: The case of China

International Nuclear Information System (INIS)

Zhang, Yanfang; Zhang, Ming; Liu, Yue; Nie, Rui

2017-01-01

Long-term management of China's coal overcapacity depends on the targeted policy guidance on industry production capacity expansion in the overcapacity formation process. In this study, coal enterprise and local government are treated as game participants, and a three-stage dynamic game model has been developed to depict the boosting effect of the game behavior of coal enterprise's and local government's capacity investments in different markets of supply and demand. The results are shown in the following: (1) local government has been the 'behind-the-scenes' operator of over-investment and redundant construction, and its excessive interventions in coal industry investment have been the primary cause of overcapacity formation; (2) when the market is in short supply, coal enterprise's optimal behavior is to continuously increase the rate of investment growth until it reaches the threshold to obtain the maximum excess profits, ultimately leading to overinvestment in the industry; and (3) the key factors affecting the game abilities of coal enterprise and local government are the market's self-regulation and the central government's supervision intensity. Although the Chinese government, a highly vertically oriented bureaucratic structure, is implementing a mandatory de-capacity policy to alleviate the intensity of excessive coal capacity, it is not a long-term regularization on the supply-side reform. - Highlights: • The formation of China's coal overcapacity is studied from capacity investors. • A three-stage game is developed to depict the boosting effect of coal overcapacity. • Local government has been the 'behind-the-scenes' operators of coal overcapacity. • Coal enterprise's optimal strategy is reaching an investment-max with undersupply. • Chinese government should rely more on market mechanisms instead of intervention.

Governance in Health – The Need for Exchange and Evidence; Comment on “Governance, Government, and the Search for New Provider Models”

Directory of Open Access Journals (Sweden)

Tata Chanturidze

2016-08-01

Full Text Available Governance in health is cited as one of the key factors in balancing the concerns of the government and public sector with the interests of civil society/private players, but often remains poorly described and operationalized. Richard Saltman and Antonio Duran look at two aspects in the search for new provider models in a context of health markets signalling liberalisation: (i the role of the government to balance public and private interests and responsibilities in delivering care through modernised governance arrangements, and (ii the finding that operational complexities may hinder well–designed provider governance models, unless governance reflects country-specific realities. This commentary builds on the discussion by Saltman and Duran, and argues that the concept of governance needs to be clearly defined and operationalized in order to be helpful for policy debate as well as for the development of an applicable framework for performance improvement. It provides a working definition of governance and includes a reflection on the prevailing cultural norms in an organization or society upon which any governance needs to be build. It proposes to explore whether the “evidence-based governance” concept can be introduced to generate knowledge about innovative and effective governance models, and concludes that studies similar to the one by Saltman and Duran can inform this debate.

Risk Factors for Blood Transfusion With Primary Posterior Lumbar Fusion.

Science.gov (United States)

Basques, Bryce A; Anandasivam, Nidharshan S; Webb, Matthew L; Samuel, Andre M; Lukasiewicz, Adam M; Bohl, Daniel D; Grauer, Jonathan N

2015-11-01

Retrospective cohort study. To identify factors associated with blood transfusion for primary posterior lumbar fusion surgery, and to identify associations between blood transfusion and other postoperative complications. Blood transfusion is a relatively common occurrence for patients undergoing primary posterior lumbar fusion. There is limited information available describing which patients are at increased risk for blood transfusion, and the relationship between blood transfusion and short-term postoperative outcomes is poorly characterized. The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify patients undergoing primary posterior lumbar fusion from 2011 to 2013. Multivariate analysis was used to find associations between patient characteristics and blood transfusion, along with associations between blood transfusion and postoperative outcomes. Out of 4223 patients, 704 (16.7%) had a blood transfusion. Age 60 to 69 (relative risk [RR] 1.6), age greater than equal to 70 (RR 1.7), American Society of Anesthesiologists class greater than equal to 3 (RR 1.1), female sex (RR 1.1), pulmonary disease (RR 1.2), preoperative hematocrit less than 36.0 (RR 2.0), operative time greater than equal to 310 minutes (RR 2.9), 2 levels (RR 1.6), and 3 or more levels (RR 2.1) were independently associated with blood transfusion. Interbody fusion (RR 0.9) was associated with decreased rates of blood transfusion. Receiving a blood transfusion was significantly associated with any complication (RR 1.7), sepsis (RR 2.6), return to the operating room (RR 1.7), deep surgical site infection (RR 2.6), and pulmonary embolism (RR 5.1). Blood transfusion was also associated with an increase in postoperative length of stay of 1.4 days (P risk factors for these occurrences were characterized. Strategies to minimize blood loss might be considered in these patients to avoid the associated complications. 3.

People, Governance and Forests—The Stumbling Blocks in Forest Governance Reform in Latin America

Directory of Open Access Journals (Sweden)

Arnoldo Contreras-Hermosilla

2011-01-01

Full Text Available This article examines common barriers to achieving adequate levels of forest resource governance in countries of Latin America. It looks at the deficiencies of the policy and regulatory frameworks affecting forests, the common failure to impose the rule of law, the main factors that constrain the effectiveness of government actions in the forest sector and at the political barriers to introducing reforms for change in governance structures. The elimination of these barriers acquires new importance in the implementation of successful REDD+ programs in the countries of the region.

E-Government and Citizen Adoption of Innovations: Factors Underlying Citizen Use of the Internet for State Tax Filing

Science.gov (United States)

Boone, Michael A.

2012-01-01

Electronic government has been embraced by many organizations seeking to dramatically improve service delivery, but results to date have often fallen short of expectations. This dissertation is focused on state revenue agencies and their electronic tax filing mechanisms for state individual income taxes. It asks: What factors best explain whether…

Re-Engineering Primary School Teachers for Sustainable ...

African Journals Online (AJOL)

engineer primary school teachers for sustainable development in Onitsha North Local Government Area. Three research questions and a hypothesis were formulated to guide the study. Descriptive survey research design was used. 300 primary ...

the search for local government autonomy in nigeria

African Journals Online (AJOL)

RAYAN_

autonomous. Keywords: Search, local government, autonomy, pathways and realization .... time. 6 There were, for instance, the Native Authority Ordinance, the Native Revenue .... Construction and maintenance of primary schools; and e.

The Usage of E-Governance Applications by Higher Education Students

Science.gov (United States)

Öktem, M. Kemal; Demirhan, Kamil; Demirhan, Haydar

2014-01-01

This study aims to analyze the factors affecting the Internet usage of university students using e-governance applications. It is important to examine these factors to understand why the online citizen participation is not increasing as expected, while Information and Communication Technologies (ICT) usage is improving in governance. Governance is…

Polycentrism in Global Health Governance Scholarship

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Tosun, Jale

2018-01-01

Drawing on an in-depth analysis of eight global health networks, a recent essay in this journal argued that global health networks face four challenges to their effectiveness: problem definition, positioning, coalition-building, and governance. While sharing the argument of the essay concerned, in this commentary, we argue that these analytical concepts can be used to explicate a concept that has implicitly been used in global health governance scholarship for quite a few years. While already prominent in the discussion of climate change governance, for instance, global health governance scholarship could make progress by looking at global health governance as being polycentric. Concisely, polycentric forms of governance mix scales, mechanisms, and actors. Drawing on the essay, we propose a polycentric approach to the study of global health governance that incorporates coalitionbuilding tactics, internal governance and global political priority as explanatory factors. PMID:29325406

Clinical outcome after pulmonary metastasectomy from primary hepatocellular carcinoma: Analysis of prognostic factors

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Kwon, Jong-Bum; Park, Khun; Kim, Young-Du; Seo, Jong-Hee; Moon, Seok-Whan; Cho, Deog-Gon; Kim, Yong-Whan; Kim, Dong-Goo; Yoon, Seung-Kew; Lim, Hyeon-Woo

2008-01-01

AIM: To review the surgical outcomes in terms of the surgical indications and relevant prognostic factors. METHODS: Sixteen patients underwent therapeutic lung surgery between March 1999 and May 2006. The observation period was terminated on May 31, 2007. The surgical outcomes and the clinicopathological factors were compared. RESULTS: There was no mortality or major morbidity encountered in this study. The mean follow-up period after metastasectomy was 26.7 ± 28.2 (range: 1-99 mo), and the median survival time was 20 mo. The 1- and 5-year survival rates were 56% and 26%, respectively. At the end of the follow-up, 1 patient died from hepatic failure without recurrence, 6 died from hepatic failure with a recurrent hepatocellular carcinoma (HCC), and 4 died from recurrent HCC with cachexia. Among several clinical factors, Kaplan-Meier analysis revealed that liver transplantation as a treatment for the primary lesion, grade of cell differentiation, and negative evidence HBV infection were independent predictive factors. On Cox’s proportional hazard model, there were no significant factors affecting survival after pulmonary metastasectomy in patients with HCC. CONCLUSION: A metastasectomy should be performed before other treatments in selected patients. Although not significant, patients with liver transplantation of a primary HCC survived longer. Liver transplantation might be the most beneficial modality that can offer patients better survival. A multi-institutional and collaborative study would be needed for identifying clinical prognostic factors predicting survival in patients with HCC and lung metastasis. PMID:18837090

Factors of quality of financial report of local government in Indonesia

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Muda, Iskandar; Haris Harahap, Abdul; Erlina; Ginting, Syafruddin; Maksum, Azhar; Abubakar, Erwin

2018-03-01

The purpose of this research is to find out whether the Accounting Information System and Internal Control in Local Revenue Office to the affect the Quality of Financial Report of Local Government. The sampling was conducted by using simple random sampling method in which the sample was determined without considering strata. The data research was conducted by distributing the questionnaires. The results showed that the degree of Accounting Information System and Internal Control simultaneously affect the Quality of Financial Report of Local Government. However, partially, Partially, accounting information system influence to the quality of financial report of local government and the internal control does not affect the quality of financial report.

The status of vaccine availability and associated factors in Tshwane government clinics

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Ntombenhle Judith Ngcobo

2017-06-01

Full Text Available Background. Vaccines have greatly contributed to the control of vaccine-preventable diseases and to human development. Efforts by many countries to introduce new vaccines are a significant move towards achieving the sustainable development goal for health. However, effective vaccine supply chains that ensure an uninterrupted supply of vaccines are pivotal to attaining universal access to life-saving vaccines and sustainable development. The introduction of new vaccines puts a strain on supply chains; South Africa (SA is no exception, as there are indications of vaccine stock-outs in clinics. Objective. To establish the status of vaccine availability and associated factors in government health facilities of Tshwane Health District in Gauteng Province, SA. Methods. A cross-sectional study was conducted in a sample of randomly selected government clinics in the Tshwane health district of Gauteng Province. Data were collected using a structured measurement instrument in participating clinics. Data were analysed using Excel-based software (Microsoft, USA. Results. A total of 31 clinics participated. In the preceding 12 months, clinics had experienced vaccine stock-outs, especially of the three newer vaccines: pneumococcal conjugate vaccine, rotavirus and Pentaxim. These were also out of stock for a long duration; for over 2 weeks in a majority of clinics. The causes of vaccine stock-outs were: poor management of stock, district depot out of stock, unreliable deliveries, lack of pharmacy assistants and limited fridge capacity. Further burdening the situation is the ineffective emergency-ordering system. Conclusion. Significant shortages of vaccines, which are essential drugs, occur in Tshwane government clinics. Vaccine supply chain issues and vaccine shortages should be treated as a priority at all levels of the healthcare system; therefore, a similar study should be conducted at national level. It is recommended that the vaccine supply chain should

Prevalence and Risk Factors of Voice Problems Among Primary School Teachers in India.

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Devadas, Usha; Bellur, Rajashekhar; Maruthy, Santosh

2017-01-01

Teachers are more prone to develop voice problems (VPs) when compared with other professional voice users. The aim of present study was to investigate the prevalence and risk factors of VPs among primary school teachers in India. Epidemiological cross-sectional survey. Self-reporting questionnaire data were collected from 1082 teachers. Out of 1082 teachers who participated in the present study, 188 teachers reported VPs that account for a prevalence rate of 17.4%. Tired voice after long hours of talking was the most frequently reported symptom, followed by sore/dry throat, strain in voice, neck muscle tension, and difficulty in projecting voice. The adjusted odds ratio values showed number of years of teaching, high background noise levels in the classroom, experiencing psychological stress while teaching classes, improper breath management (holding breath while speaking), poor focus of the tone (clenching jaw/teeth while speaking), upper respiratory tract infection, thyroid problems, and acid reflux as significant risk factors for the development of VPs in the current cohort of teachers. Current results suggest that teachers develop VPs due to multiple risk factors. These factors may be either biological, psychomotor, or environment-related factors. A holistic approach (which could include educating teachers about voice care during their training, and if they develop VP during their career, then managing the VP by taking into consideration different risk factors) addressing all these factors needs to be adopted to prevent VPs in primary school teachers. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Evaluation of pN factors in patients with primary lung cancer by using perfusion, inhalation and ventilation studies

International Nuclear Information System (INIS)

Tamai, Toyosato; Tanabe, Masatada; Satoh, Katashi

1987-01-01

The interpretation of scintigraphic patterns and the role of pathophysiological mechanisms in patients with primary lung cancer were investigated. To determine the relative roles of perfusion, inhalation and ventilation scintigraphy, the relationship between the count ratio of the affected side to the healthy side and the post-surgical histological lymph nodes factors were observed in this study. These scintigraphic count ratio's in patients with primary lung cancer did not reflect the pN factors except in the perfusion study in patients with hilar primary lung cancer. (author)

Risk factors for perioperative hyperglycemia in primary hip and knee replacements

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Jämsen, Esa; Nevalainen, Pasi I; Eskelinen, Antti; Kalliovalkama, Jarkko; Moilanen, Teemu

2015-01-01

Background and purpose Background and purpose — Perioperative hyperglycemia has been associated with adverse outcomes in several fields of surgery. In this observational study, we identified factors associated with an increased risk of hyperglycemia following hip and knee replacement. Patients and methods Patients and methods — We prospectively monitored changes in glucose following primary hip and knee replacements in 191 patients with osteoarthritis. Possible associations of patient characteristics and operation-related factors with hyperglycemia (defined as glucose > 7.8 mmol/L in 2 consecutive measurements) and severe hyperglycemia (glucose > 10 mmol/L) were analyzed using binary logistic regression with adjustment for age, sex, operated joint, and anesthesiological risk score. Results Results — 76 patients (40%) developed hyperglycemia, and 48 of them (25% of the whole cohort) had severe hyperglycemia. Glycemic responses were similar following hip replacement and knee replacement. Previously diagnosed diabetes was associated with an increased risk of hyperglycemia and severe hyperglycemia, compared to patients with normal glucose metabolism, whereas newly diagnosed diabetes and milder glucose metabolism disorders had no effect. In patients without previously diagnosed diabetes, increased values of preoperative glycosylated hemoglobin (HbA1c) and fasting glucose on the day of operation were associated with hyperglycemia. Higher anesthesiological risk score—but none of the operation-related factors analyzed—was associated with an increased risk of hyperglycemia. Interpretation Interpretation — Perioperative hyperglycemia is common in primary hip and knee replacements. Previously diagnosed diabetes is the strongest risk factor for hyperglycemia. In patients with no history of diabetes, preoperative HbA1c and fasting glucose on the day of operation can be used to stratify the risk of hyperglycemia. PMID:25409255

Primary health care reform, dilemmatic space and risk of burnout among health workers.

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Freeman, Toby; Baum, Fran; Labonté, Ronald; Javanparast, Sara; Lawless, Angela

2018-05-01

Health system changes may increase primary health care workers' dilemmatic space, created when reforms contravene professional values. Dilemmatic space may be a risk factor for burnout. This study partnered with six Australian primary health care services (in South Australia: four state government-managed services including one Aboriginal health team and one non-government organisation and in Northern Territory: one Aboriginal community-controlled service) during a period of change and examined workers' dilemmatic space and incidence of burnout. Dilemmatic space and burnout were assessed in a survey of 130 staff across the six services (58% response rate). Additionally, 63 interviews were conducted with practitioners, managers, regional executives and health department staff. Dilemmatic space occurred across all services and was associated with higher rates of self-reported burnout. Three conditions associated with dilemmatic space were (1) conditions inherent in comprehensive primary health care, (2) stemming from service provision for Aboriginal and Torres Strait Islander peoples and (3) changes wrought by reorientation to selective primary health care in South Australia. Responses to dilemmatic space included ignoring directives or doing work 'under the radar', undertaking alternative work congruent with primary health care values outside of hours, or leaving the organisation. The findings show that comprehensive primary health care was contested and political. Future health reform processes would benefit from considering alignment of changes with staff values to reduce negative effects of the reform and safeguard worker wellbeing.

[Chronic kidney disease in Primary Health Care: prevalence and associated risk factors].

Science.gov (United States)

Salvador González, Betlem; Rodríguez Pascual, Mercedes; Ruipérez Guijarro, Laura; Ferré González, Antonia; Cunillera Puertolas, Oriol; Rodríguez Latre, Luisa M

2015-04-01

To determine the prevalence of chronic kidney disease and associated risk factors in subjects over 60 years of age, as well as its staging by determining the glomerular filtration rate (GFR). Cross-sectional observational study. Primary Health Care. Patients≥60 years of age who were seen in 40 Primary Health Care centres with serum creatinine measured in a central laboratory between January 1 and December 31, 2010. kidney transplant, home care. Social-demographic and anthropometric data, cardiovascular risk factors, and diseases established according to electronic clinical records. Serum creatinine was measured using standardised Jaffe kinetic method, and GFR estimated with MDRD-4-IDMS and CKD-EPI. A total of 97,665 subjects (57.3% women, median age 70.0 years [Q1: 65.0, Q3: 77.0]). GFR-MDRD prevalence<60=15.1% (16.6% in women, 13.2% in men; P<.001) and increased with age. Multivariate analysis showed a positive association between GFR-MDRD<60 and age (OR=1.74; 95% CI 1.70 to 1.77), hypertension (OR=2.18; 95% CI 2.08 to 2.30), heart failure (OR=2.03; 95% CI 1.83 to 2.25), atrial fibrillation (OR=1.57; 95% CI 1.41 to 1.76), ischaemic heart disease (OR=1.40; 95% CI 1.30 to 1.50), peripheral arterial disease (OR=1.31; 95% CI 1.09 to 1.57), dyslipidaemia (OR=1.28; 95% CI 1.23 to 1.33), diabetes (OR=1.26; 95% CI 1.17 to 1.34), and stroke (OR=1.17; 95% CI 1.09 to 1.25). The GFR-CKD-EPI model showed an increase in OR with age and male sex, that became significant as a chronic kidney disease risk factor. Chronic kidney disease has considerable prevalence in subjects≥60 years seen in Primary Health Care, more in women, and increasing with age. Hypertension, more than diabetes, was the main associated cardiovascular risk factor. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Factors Contributing To The Sustainability Of 5S Programmes In Government Hospitals In Regional Director Of Health Services Area Kurunegala

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Dr. K.W.C.U.K Kendangamuwa

2015-03-01

Full Text Available Abstract Introduction 5S is the stepping stone for many quality improvement concepts and its roots date back to 16th century. When successfully implemented 5S gives many benefits to the organization as well as its stakeholders. Though 5S itself has a tool to sustain most of the organizations find it difficult to sustain the 5S practice over the time. Therefore the objective of this study was to find out the factors contributing to sustainability of 5S programmes in Government Hospitals in RDHS area Kurunegala. Methodology This study was a descriptive cross sectional study with two components. First component was to identify the 5S sustaining hospitals from not sustaining hospitals by validated evaluation sheet. Second component was to determine the factors contributing to sustainability of 5S programmes in selected study setting. Self-administrated questionnaire was used for this purpose. Total study population was 543 employees of all the categories of hospital staff. Calculated sample size was 422 and 375 were responded to the questionnaire giving response rate of 88.9. Results The study revealed that the implemented 5S programmes were sustaining in eight hospitals out of ten i.e. sustaining rate was 80. When it considered the degree of sustainability 50 of the selected hospitals reported more than 70 sustainability. This was considered as favourable trend in government health sector in healthcare quality point of view. Ten factors were studied as contributing factors for the 5S sustainability. Socio- demographic factors were also considered. Those ten factors were top management commitment leadership of the organization commitment of middle amp frontline managers commitment amp satisfaction of employees training amp changing attitude of employees motivation of employees organizational culture group cohesiveness community participation and customer satisfaction. Study revealed that organizational leadership customer satisfaction community

Development of Corporate Governance Performance Indicators for Czech Manufacturing Companies

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Pavláková Docekalová Marie

2015-03-01

Full Text Available Effective corporate governance is a key element in achieving long-term success for any company. The codes of conduct that corporate governance adopts directly determine the sustainability of business activities. With this in mind, this paper aims to demonstrate the results of research that identifies a set of key indicators of corporate governance performance. The presented research is quantitative. In order to identify key performance indicators, factor analysis was employed. It was found that corporate governance performance is influenced by two factors. For the first factor, the relationship between corporate governance and stakeholders is measured by key indicators: percentage of women within CG, contributions to political parties, politicians and related institutions and number of complaints received from stakeholders. The second factor, strategy & compliance, is generated from the following: percentage of strategic objectives met and total number of sanctions for breaching the law. This research aims to assist both academic and corporate practitioners who want to improve corporate governance performance and, through the use of key performance indicators, support the transparency and sustainability of their business.

Healthcare is primary

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Raman Kumar

2015-01-01

Full Text Available India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2 nd National Conference on Family Medicine and Primary Care 2015 (FMPC brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care, the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

Flood risk governance arrangements in Europe

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Matczak, P.; Lewandowski, J.; Choryński, A.; Szwed, M.; Kundzewicz, Z. W.

2015-06-01

The STAR-FLOOD (Strengthening and Redesigning European Flood Risk Practices Towards Appropriate and Resilient Flood Risk Governance Arrangements) project, funded by the European Commission, investigates strategies for dealing with flood risk in six European countries: Belgium, the UK, France, the Netherlands, Poland and Sweden and in 18 vulnerable urban regions in these countries. The project aims to describe, analyse, explain, and evaluate the main similarities and differences between the selected EU Member States in terms of development and performance of flood risk governance arrangements. It also discusses the scientific and societal importance of these similarities and differences. Attention is paid to identification and characterization of shifts in flood risk governance arrangements and in flood risk management strategies and to determination of triggering factors and restraining factors. An assessment of a change of resilience and appropriateness (legitimacy, effectiveness, efficiency) of flood risk governance arrangements in Poland is presented and comparison with other European countries is offered.

Flood risk governance arrangements in Europe

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P. Matczak

2015-06-01

Full Text Available The STAR-FLOOD (Strengthening and Redesigning European Flood Risk Practices Towards Appropriate and Resilient Flood Risk Governance Arrangements project, funded by the European Commission, investigates strategies for dealing with flood risk in six European countries: Belgium, the UK, France, the Netherlands, Poland and Sweden and in 18 vulnerable urban regions in these countries. The project aims to describe, analyse, explain, and evaluate the main similarities and differences between the selected EU Member States in terms of development and performance of flood risk governance arrangements. It also discusses the scientific and societal importance of these similarities and differences. Attention is paid to identification and characterization of shifts in flood risk governance arrangements and in flood risk management strategies and to determination of triggering factors and restraining factors. An assessment of a change of resilience and appropriateness (legitimacy, effectiveness, efficiency of flood risk governance arrangements in Poland is presented and comparison with other European countries is offered.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

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Janya McCalman

2018-03-01

Full Text Available Continuous quality improvement (CQI processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

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McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

2018-01-01

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271

Factors governing sustainable groundwater pumping near a river.

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Zhang, Yingqi; Hubbard, Susan; Finsterle, Stefan

2011-01-01

The objective of this paper was to provide new insights into processes affecting riverbank filtration (RBF). We consider a system with an inflatable dam installed for enhancing water production from downstream collector wells. Using a numerical model, we investigate the impact of groundwater pumping and dam operation on the hydrodynamics in the aquifer and water production. We focus our study on two processes that potentially limit water production of an RBF system: the development of an unsaturated zone and riverbed clogging. We quantify river clogging by calibrating a time-dependent riverbed permeability function based on knowledge of pumping rate, river stage, and temperature. The dynamics of the estimated riverbed permeability reflects clogging and scouring mechanisms. Our results indicate that (1) riverbed permeability is the dominant factor affecting infiltration needed for sustainable RBF production; (2) dam operation can influence pumping efficiency and prevent the development of an unsaturated zone beneath the riverbed only under conditions of sufficient riverbed permeability; (3) slow river velocity, caused by dam raising during summer months, may lead to sedimentation and deposition of fine-grained material within the riverbed, which may clog the riverbed, limiting recharge to the collector wells and contributing to the development of an unsaturated zone beneath the riverbed; and (4) higher river flow velocities, caused by dam lowering during winter storms, scour the riverbed and thus increase its permeability. These insights can be used as the basis for developing sustainable water management of a RBF system. Journal compilation © 2010 National Ground Water Association. No claim to original US government works.

Correlation of primary tumor FDG uptake with clinicopathologic prognostic factors in invasive ductal carcinoma of the breast

International Nuclear Information System (INIS)

Jo, I; Kim, Sung Hoon; Kim, Hae Won; Kang, Sung Hee; Zeon, Seok Kil; Kim, Su Jin

2015-01-01

The purpose of this study was to investigate the correlation of primary tumor FDG uptake to clinicopathological prognostic factors in invasive ductal carcinoma of the breast. We retrospectively reviewed 136 of 215 female patients with pathologically proven invasive ductal breast cancer from January 2008 to December 2011 who underwent F-18 FDG PET/CT for initial staging and follow-up after curative treatment with analysis of estrogen receptor (ER), progesterone receptor (PR) and human epithelial growth factor receptor 2 (HER2). The maximum standardized uptake value (SUV max ) of the primary breast tumor was measured and compared with hormonal receptor and HER2 overexpression status. The high SUV max of primary breast tumors is significantly correlated with the clinicopathological factors: tumor size, histologic grade, TNM stage, negativity of ER, negativity of PR, HER2 overexpression and triple negativity. The recurrent group with non-triple negative cancer had a higher SUV max compared with the non-recurrent group, though no significant difference in FDG uptake was noted between the recurrence and non-recurrent groups in subjects with triple-negative cancer. Lymph node involvement was the independent risk factor for cancer recurrence in the multivariate analysis. In conclusion, high FDG uptake in primary breast tumors is significantly correlated with clinicopathological factors, such as tumor size, histologic grade, TNM stage, negativity of the hormonal receptor, HER2 overexpression and triple negativity. Therefore, FDG PET/CT is a helpful prognostic tool to direct the further management of patients with breast cancer

Control of territorial communities in local government

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О. А. Смоляр

2015-11-01

Full Text Available According to Art. 5 of the Constitution of Ukraine all power in Ukraine belong to people, which is primary, unified, inalienable and carried people through free will through elections, referendum and other forms of direct democracy, including those intended to control the activity of bodies and officials of the government and local government. Paper objective. At the local level the main supervisory entity in local government is local community. Consolidation of the Constitution of Ukraine the primary subject of local self-government territorial community not only meets current international practice, but also the historical traditions of Ukrainian people. Control territorial community in all phases of local government is one of the most important functions of managing the development of appropriate settlements, and therefore needs an effective mechanism of legal regulation, clearly define mutual rights and responsibilities of controlling and controlled entities. Recent research and publications analysis. Problems Assessment of local communities and the activities of local government officials in their works viewed Y.G. Barabash, P.M. Liubchenko, O.D. Skopych, Y.P. Strilets. However, given the variety of aspects of this area of research remain many questions that need resolving, on which depends largely on the further process of local governance. The paper main body. The existing regulation territorial communities can exercise control in local government actually only through local governments. The control of the executive bodies of village, town council municipalities can only be made through the appropriate council. The existing regulation of territorial communities can exercise control in local government actually only through local governments. The control of the executive bodies of village, town council municipalities can only be made through the appropriate council. The author emphasizes that only by implementing self-control powers local

[Prevalence of burnout syndrome and its associated factors in Primary Care staff].

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Navarro-González, D; Ayechu-Díaz, A; Huarte-Labiano, I

2015-01-01

Burnout syndrome is an emerging disease among health professionals. The aim of this study is to determine the prevalence of occupational burnout among Primary Care staff, as well as to determine the differences in prevalence between family doctors, paediatricians, nurses, administrative-officers, and social-workers, and to evaluate the different related factors. A cross-sectional, descriptive study was conducted on 178 professionals from 5 different occupational groups in 54 Primary Care centres in Navarre from September to December 2010. An anonymous, self-administered questionnaire that included: the Maslach Burnout Inventory and a questionnaire on socio-demographic and work-related factors. Burnout was detected in 39.3% of staff. Those with higher levels are administrative-officers and family doctors, with an OR compared to nurses of 4.58 and 5.37, respectively in the dimension of emotional exhaustion, 4.98 and 2.87 in depersonalization, and 8.37 for administrative-officers in personal accomplishment. An association was found between burnout and the following factors: to be a male (for the dimensions of emotional exhaustion and depersonalization, 25.5 and 31.9%, respectively), to be employed in an urban area (for emotional exhaustion and depersonalization, 20 and 27.8%, respectively), use of psychiatric medication (for emotional exhaustion, 30%), size of patient-quota (for depersonalization, with an average of 1,565 patients), and welfare pressure (for emotional exhaustion and depersonalization, averages of 170.35 and 153.54 patients/week, respectively). About one-third of Primary Care professionals have a high level of burnout, which is mainly associated with the working area, the size of the quota, and professional group, with higher prevalence in administrative-officers and family doctors. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Occupational and environmental risk factors of adult primary brain cancers: a systematic review.

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Gomes, J; Al Zayadi, A; Guzman, A

2011-04-01

The incidence of brain neoplasm has been progressively increasing in recent years in the industrialized countries. One of the reasons for this increased incidence could be better access to health care and improved diagnosis in the industrialized countries. It also appears that Caucasians have a higher incidence than blacks or Hispanics or Asians. A number of risk factors have been identified and described including the genetic, ethnic and age-based factors. Certain occupational and environmental factors are also believed to influence the risk of primary adult brain tumors. Potential occupational and environmental factors include exposure to diagnostic and therapeutic radiations, electromagnetic radiation from cellular phones and other wireless devices, infectious agents, air pollution and residence near landfills and high-voltage power lines and jobs as firefighters, farmers, physician, chemists and jobs in industries such as petrochemical, power generation, synthetic rubber manufacturing, agricultural chemicals manufacturing. The purpose of this systematic review is to examine occupational and environmental risk factors of brain neoplasm. A range of occupational and environmental exposures are evaluated for significance of their relationship with adult primary brain tumors. On the basis of this review we suggest a concurrent evaluation of multiple risk factors both within and beyond occupational and environmental domains. The concurrent approach needs to consider better exposure assessment techniques, lifetime occupational exposures, genotypic and phenotypic characteristics and lifestyle and dietary habits. This approach needs to be interdisciplinary with contributions from neurologists, oncologists, epidemiologists and molecular biologists. Conclusive evidence that has eluded multitude of studies with single focus and single exposure needs to multifaceted and multidisciplinary.

Third sector primary care for vulnerable populations.

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Crampton, P; Dowell, A; Woodward, A

2001-12-01

This paper aims to describe and explain the development of third sector primary care organisations in New Zealand. The third sector is the non-government, non-profit sector. International literature suggests that this sector fulfils an important role in democratic societies with market-based economies, providing services otherwise neglected by the government and private for-profit sectors. Third sector organisations provided a range of social services throughout New Zealand's colonial history. However, it was not until the 1980s that third sector organisations providing comprehensive primary medical and related services started having a significant presence in New Zealand. In 1994 a range of union health centres, tribally based Mäori health providers, and community-based primary care providers established a formal network -- Health Care Aotearoa. While not representing all third sector primary care providers in New Zealand, Health Care Aotearoa was the best-developed example of a grouping of third sector primary care organisations. Member organisations served populations that were largely non-European and lived in deprived areas, and tended to adopt population approaches to funding and provision of services. The development of Health Care Aotearoa has been consistent with international experience of third sector involvement -- there were perceived "failures" in government policies for funding primary care and private sector responses to these policies, resulting in lack of universal funding and provision of primary care and continuing patient co-payments. The principal policy implication concerns the role of the third sector in providing primary care services for vulnerable populations as a partial alternative to universal funding and provision of primary care. Such an alternative may be convenient for proponents of reduced state involvement in funding and provision of health care, but may not be desirable from the point of view of equity and social cohesion

Factors associated with support for smoke-free policies among government workers in Six Chinese cities: a cross-sectional study.

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Kegler, Michelle C; Hua, Xinwei; Solomon, Madeleine; Wu, Yiqun; Zheng, Pin Pin; Eriksen, Michael

2014-11-04

A certain level of public support for smoke-free environments is a prerequisite for adoption and enforcement of policies and can be used as an indicator of readiness for legislative action. This study assessed support for comprehensive smoke-free policies in a range of settings such as hotels and colleges among government workers in China and identified factors associated with support for smoke-free policies. Understanding the extent to which government workers, a large segment of the working population in China, report a smoke-free workplace and support for smoke-free policies may be important indicators of readiness for strengthened policies given their role in formulating, implementing and enforcing regulations. Data were from an evaluation of the Tobacco Free Cities initiative of Emory University's Global Health Institute-China Tobacco Control Partnership. Self-administered surveys were completed by 6,646 workers in 160 government agencies in six Chinese cities. Multivariate logistic regression was used to identify factors associated with support for smoke-free worksites, bars, hotels, and colleges. Over half (54.6%) of participants were male. A large percentage of the male workers smoked (45.9%,) whereas very few women did (1.9%). Fewer than 50% of government workers reported smoke-free policies at work, with 19.0% reporting that smoking is allowed anywhere. Support for smoke-free policies was generally very high, with the lowest levels of support for smoke-free bars (79.0%) and hotels (82.3%), higher levels of support for restaurants (90.0%) and worksites (93.0%), and above 95% support for hospitals, schools, colleges, public transportation and religious settings. Knowledge of the harmfulness of secondhand smoke was positively associated with support for smoke-free policies. Stricter worksite smoking policies were associated with support for smoke-free workplaces and bars, but not hotels and colleges. Women and nonsmokers were more supportive of smoke

Intestinal helminth infections among primary school pupils in ...

African Journals Online (AJOL)

A study was carried out to determine the prevalence of intestinal helminth infections among primary school pupils in Ekwulumili Community, Nnewi South Local Government Area, Anambra State, Nigeria, between April and July 2012. Five primary schools were involved in the study namely, Bethel Nursery and Primary ...

The importance of motivation factors in career development of primary and secondary school professionals

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Petra Stepišnik

2017-03-01

Full Text Available This research examines the career motivation factors among Slovene teachers. They go hand in hand with two other processes: the psycho-social development of individuals and their family life. We present the results of the empirical research that was carried out on a sample of 360 professionals from primary and secondary schools. We established a scale for determining the importance of motivation factors by asking the professionals to grade their level of agreement with the statements considering the following motivational factors: the legislation and the organization of files in the context of school, the organisational climate and culture at schools, the school management, schools as learning organisations, the need of individuals for career development. We were interested if there exist any differences in the opinions of professionals in primary and secondary schools regarding the importance of individual motivation factors. We were also interested if there exists an interdependence between the final results and the individual variables. The findings are important for professionals and school management in schools that encourage career development. It would be sensible to take these findings into consideration when planning, as well as monitoring career development of school professionals.

Occupational low back pain in primary and high school teachers: prevalence and associated factors.

Science.gov (United States)

Mohseni Bandpei, Mohammad A; Ehsani, Fatemeh; Behtash, Hamid; Ghanipour, Marziyeh

2014-01-01

The purposes of this study were to investigate the prevalence of and risk factors for low back pain (LBP) in teachers and to evaluate the association of individual and occupational characteristics with the prevalence of LBP. In this cross-sectional study, 586 asymptomatic teachers were randomly selected from 22 primary and high schools in Semnan city of Iran. Data on the personal, occupational characteristics, pain intensity, and functional disability as well as the prevalence and risk factors of LBP were collected using different questionnaires. Point, last month, last 6 months, annual, and lifetime prevalence rates of LBP were 21.8%, 26.3%, 29.6%, 31.1%, and 36.5%, respectively. The highest prevalence was obtained for the high school teachers. The prevalence of LBP was significantly associated with age, body mass index, job satisfaction, and length of employment (P teachers appears to be high. High school teachers were more likely to experience LBP than primary school teachers. Factors such as age, body mass index, length of employment, job satisfaction, and work-related activities were significant factors associated with LBP in this teacher population. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

The social problems and strategies of the government GIS in China

Science.gov (United States)

Chen, Nan; Fu, Zhongliang

2007-06-01

GIS has wider and wider applications. The application in the field of administrative management and assistant decision-making have formed a specific research area--the government GIS. As an information industry with great sociality, GIS and its development are influenced by many technical factors and social factors. As for the government GIS in China, the social factors often play a more important role in it. A description of the current development status of the government GIS, both in China and abroad, was made in this paper. After the description, researchers pointed out the deficiency of Chinese government GIS. On the basis of this, the rational suggestion of government GIS in China were put forward at last.

Head Lice Infestation (Pediculosis and Associated Factors among Primary School Girls in Sirik County, Southern Iran

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Alireza Sanei-Dehkordi

2017-12-01

Full Text Available Background Head lice infestation (pediculosis is a serious health problem that can cause a high level of anxiety and psychological frustration, especially in developing countries.Socio-demographic factors are important determinants of the occurrence of head lice infestation. This study aimed to determine the head lice infestations and the factors affecting the rate of infestationin primary school girls.   Materials and Methods In this cross-sectional study, a total of 358 school girls from two urban and three rural primary school girls in Sirik County, Southern Iran, were randomly selected. For the diagnosis of head lice infestation, students were examined carefully by visual inspection of the scalp and hair for the presence of lice. Self-administered questionnaire was used to collect data on socio-demographic and associated factors of head lice infestation. SPSS version 21.0 was used to analyze the data. Results The prevalence of head lice infestation among primary school girls was 56.15%. There were significant associations between head lice infestation and age (p

Functional bowel disorders in primary care: factors associated with health-related quality of life and doctor consultation.

Science.gov (United States)

Lee, Victoria; Guthrie, Else; Robinson, Andrew; Kennedy, Anne; Tomenson, Barbara; Rogers, Anne; Thompson, David

2008-02-01

The role of psychological factors in irritable bowel syndrome (IBS) remains unclear, particularly in a primary care setting, where relatively little research on this common and costly condition has been carried out. The aim of this study was to investigate the relative contribution of physical and psychological factors to health-related quality of life and health-care utilization in patients with functional bowel disease (IBS-like symptoms) in primary care. We also wished to establish the relevance of formal diagnostic criteria to IBS in the primary care setting. This study used a cross-sectional design. Four hundred twenty patients with functional bowel disorders in primary care completed a series of measures, including bowel symptom status and severity, severity of psychological distress, personality, and quality of life. The number of visits to a general practitioner (GP) in the previous 12 months was recorded. The following variables were independently and highly significantly associated with health-related quality of life in patients with functional bowel disorders in primary care: total psychological symptom score, diarrhea severity, abdominal pain for >12 weeks, and abdominal distension. A similar pattern emerged between patients who met meet Rome II criteria for IBS and patients who did not meet Rome II criteria for IBS. Relatively few variables (either physical or psychological) had a major impact on the number of GP consultations, with the exception of frequency of bowel movements. This study confirms that psychological factors are significantly associated with health-related quality of life in patients with IBS in primary care. Physical symptom severity is also important. Relatively few symptom measures, either physical or psychological, have a major impact on doctor consultation rates in primary care.

Internal Control Good Cooperative Governance And Performance

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Andry Arifian Rachman

2017-11-01

Full Text Available This study aims to examine the influence of internal control and good cooperative governance partially and simultaneously to the performance of cooperatives in West Java Province. The research method used in this research is descriptive and verification. The sample in this research is 22 boards as manager of cooperative in West Java Province. The data used in the research is the primary data through questionnaire collection. Validity and reliability testing is performed before hypothesis testing. This research uses multiple regression analysis technique. Based on hypothesis testing obtained 1 internal control has no significant effect on performance 2 good cooperative governance has a significant effect on performance and 3 internal control and good cooperative governance have a significant effect on performance.

Psychiatric disorders in children attending a Nigerian primary care unit: functional impairment and risk factors

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Tunde-Ayinmode Mosunmola

2012-07-01

Full Text Available Abstract Background There is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians. Methods A cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7 and 30% of low scorers (score  In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity. Results It was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p  Conclusions Child psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of

Theoretical interpretation of e-government implementation challenges in South Africa: A case study of a selected provincial government

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Michael Twum-Darko

2015-04-01

Full Text Available This paper discusses factors influencing e-Government initiatives by African Governments to improve services to their citizens, businesses and their constituent. It further discusses, as a socially constructed phenomenon, the degree of readiness of governments to implement e-Government initiatives to improve services. The discussion uses Actor Network Theory (ANT and in particular the concepts of moments of translation and irreversibility as a lens through which to understand and interpret the social phenomenon. Although a number of e-Government researchers have argued that strong leadership and clear vision is required to implement e-Government initiatives, the view is that Governments have continuously failed to achieve the intended results. E-Government potentials and benefits which are well documented in Information Systems and e-Government research literature have not been realised by governments due to limited capabilities in the administration of the public service. The study applied a deductive approach where semi-structured interviews were used for data collection in a selected Provincial Government in South Africa. The outcome is a general framework to determine the readiness of South Africa government and generally, African governments for e-Government initiatives to achieve the intended results.

The team climate inventory as a measure of primary care teams' processes: validation of the French version.

Science.gov (United States)

Beaulieu, Marie-Dominique; Dragieva, Nataliya; Del Grande, Claudio; Dawson, Jeremy; Haggerty, Jeannie L; Barnsley, Jan; Hogg, William E; Tousignant, Pierre; West, Michael A

2014-02-01

Evaluate the psychometric properties of the French version of the short 19-item Team Climate Inventory (TCI) and explore the contributions of individual and organizational characteristics to perceived team effectiveness. The TCI was completed by 471 of the 618 (76.2%) healthcare professionals and administrative staff working in a random sample of 37 primary care practices in the province of Quebec. Exploratory factor analysis confirmed the original four-factor model. Cronbach's alphas were excellent (from 0.88 to 0.93). Latent class analysis revealed three-class response structure. Respondents in practices with professional governance had a higher probability of belonging to the "High TCI" class than did practices with community governance (36.7% vs. 19.1%). Administrative staff tended to fall into the "Suboptimal TCI" class more frequently than did physicians (36.5% vs. 19.0%). Results confirm the validity of our French version of the short TCI. The association between professional governance and better team climate merits further exploration. Copyright © 2014 Longwoods Publishing.

Correlation between dmft, Diet and Social Factors in Primary School Children of Tehran-Iran in 2009-2010

OpenAIRE

Mozhgan Faezi; Sareh Farhadi; Hossein NikKerdar

2012-01-01

Introduction: One of the factors that can affect dental caries is the type of diet. So, this study was designed to evaluate the correlation between diet, social factors and dmft in primary school children of Tehran in 2009 and 2010.Materials & Methods: Eight handred and twenty primary school children of 6-12 years old (boys and girls) in Tehran were randomly selected in this descriptive study and after filling out the forms, underwent dental examinations. The data were analyzed by chi-square ...

Primary health care in Canada: systems in motion.

Science.gov (United States)

Hutchison, Brian; Levesque, Jean-Frederic; Strumpf, Erin; Coyle, Natalie

2011-06-01

During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early 2000s, a new policy environment emerged. This policy analysis examines primary health care reform efforts in Canada during the last decade, drawing on descriptive information from published and gray literature and from a series of semistructured interviews with informed observers of primary health care in Canada. Primary health care in Canada has entered a period of potentially transformative change. Key initiatives include support for interprofessional primary health care teams, group practices and networks, patient enrollment with a primary care provider, financial incentives and blended-payment schemes, development of primary health care governance mechanisms, expansion of the primary health care provider pool, implementation of electronic medical records, and quality improvement training and support. Canada's experience suggests that primary health care transformation can be achieved voluntarily in a pluralistic system of private health care delivery, given strong government and professional leadership working in concert. © 2011 Milbank Memorial Fund. Published by Wiley Periodicals Inc.

Growth hormone-releasing factor induces c-fos expression in cultured primary pituitary cells

DEFF Research Database (Denmark)

Billestrup, Nils; Mitchell, R L; Vale, W

1987-01-01

GH-releasing factor (GRF) and somatostatin regulates the secretion and biosynthesis of GH as well as the proliferation of GH-producing cells. In order to further characterize the mitogenic effect of GRF, we studied the expression of the proto-oncogene c-fos in primary pituitary cells. Maximal...... induction of c-fos mRNA was observed 20-60 min after stimulation with 5 nM GRF, returning to basal levels after 2 h. Somatostatin-14 (5 nM) partially inhibited the GRF induced c-fos expression. Forskolin and phorbol 12, 13 dibutyrate induced c-fos gene in cultured primary pituitary cells with similar...

Factors associated with integrating self-management support into primary care.

Science.gov (United States)

Crespo, Richard; Shrewsberry, Molly

2007-06-01

The purpose of this article is to expand the understanding of self-management support by describing factors that contribute to implementing a comprehensive self-management program in primary care. Four rural health centers in medically underserved areas participated in a study to document the implementation of a self-management program. This program consisted of a social marketing plan and decision-making tools to guide patients in making self-management behavior changes. The stages of change constructs of the transtheoretical model were used to design the social marketing plan. Key informant interviews were conducted at 6-month and 9-month intervals to document the implementation process. A standardized set of questions was used in the interviews. The data from the interviews were analyzed using content analysis techniques. One of the principle findings is that self-management support requires putting a system in place, not just adding a new component to primary care. The health centers that fully implemented the self-management program made an organizational commitment to keep self-management on the agenda in management meetings, clinical staff set the example by adopting self-management behaviors, and patient self-management support was implemented in multiple patient care venues. Primary care centers with limited financial resources are able to integrate self-management support into their system of chronic illness care.

[Governance of PHC development in Rosario, Argentina].

Science.gov (United States)

Báscolo, Ernesto; Yavich, Natalia

2010-01-01

Describing the development of PHC policy as promoted by Rosario Municipality (Argentina). A case-study was carried out during 2007 and 2008. Data was collected from secondary and primary sources (interviews, organisational census and observations). PHC development stages were identified by recognising the social norms which produced institutional change and transformation in municipal health services structure and health care and management models. The prevailing modes of governance in each stage were reconognised and characterised (clan, hierarchy and/or incentives). Four stages were identified between 1990 and 2008: 1990-1995/hierarchical mode: primary health care level organisation autonomied from hospitals. 1995-2000/ clan mode: developing of participatory managerial boards and community participation. 2000-2004/ clan mode: maturation of the "PHC movement" in competition with hospitals. 2004-2008/ clan-hierarchical mode: "movement's" crisis and constructions of norms tending towards enhancing an integrated network. Strengthening and empowering first-level health-care produced innovation favouring: the consolidation of a "PHC movement" having strong social commitment and improved services performance. The clan governance mode (regulating collective action via voluntary adhesion to shared values) was crucial for developing PHC between 1995 and 2004. Later on, the movement's fragmentation and the challenges of integrating the health system required developing hierarchical regulation mechanisms to complement the governance clan mode regulation.

Diversity in Primary Teacher Education : Gender differences in Student Factors and Curriculum perception

NARCIS (Netherlands)

Gerda Geerdink; H. Dekkers; T. Bergen

2011-01-01

In the Netherlands only a small number of male students opt for primary school teaching and a relatively large percentage of them leave without graduating. A small-scale research project was set up to explore the question: Can gender-specific student factors be identified in relation to the initial

Diversity in primary teacher education gender differences in student factors and curriculum perception

NARCIS (Netherlands)

Geerdink, G.M.T.; Bergen, T.C.M.; Dekkers, H.P.J.M.

2011-01-01

In the Netherlands only a small number of male students opt for primary school teaching and a relatively large percentage of them leave without graduating. A small-scale research project was set up to explore the question: Can genderspecific student factors be identified in relation to the initial

Diversity in primary teacher education gender differences in student factors and curriculum perception

NARCIS (Netherlands)

Geerdink, G.; Bergen, T.C.M.; Dekkers, Hetty

2010-01-01

In the Netherlands only a small number of male students opt for primary school teaching and a relatively large percentage of them leave without graduating. A small-scale research project was set up to explore the question: Can gender-specific student factors be identified in relation to the initial

Employing the Five-Factor Mentoring Instrument: Analysing Mentoring Practices for Teaching Primary Science

Science.gov (United States)

Hudson, Peter; Usak, Muhammet; Savran-Gencer, Ayse

2009-01-01

Primary science education is a concern around the world and quality mentoring within schools can develop pre-service teachers' practices. A five-factor model for mentoring has been identified, namely, personal attributes, system requirements, pedagogical knowledge, modelling, and feedback. Final-year pre-service teachers (mentees, n = 211) from…

Effect of the International Agreement on Government Procurement and the Government Procurement Chapter of the North American Free Trade Agreement on public contracting opportunities

OpenAIRE

Heldreth, Steven E.

1994-01-01

Approved for public release, distribution unlimited This paper explores the specific legal content of the 1979 and 1993 Agreements on Government Procurement as well as the North American Free Trade Agreement's Chapter Ten (Government Procurement). One chapter addresses the use of free trade agreements, associated problems, and how the agreements have been applied to the public sector. The content of each of the primary documents is an...

Do Policy Networks lead to Network Governing?

DEFF Research Database (Denmark)

Damgaard, Bodil

This paper challenges the notion that creation of local policy networks necessarily leads to network governing. Through actor-centred case studies in the area of municipally implemented employment policy in Denmark it was found that the local governing mode is determined mainly by the municipality......’s approach to local co-governing as well as by the capacity and interest of key private actors. It is argued that national legislation requesting the creation of local policy networks was not enough to assure network governing and the case studies show that local policy networks may subsist also under...... hierarchical governing modes. Reasons why hierarchical governing modes prevail over network governing in some settings are identified pointing to both actor borne and structural factors. Output indicators of the four cases do not show that a particular governing mode is more efficient in its employment policy...

Factors Associated with Primary School Teachers' Attitudes Towards the Inclusion of Students with Disabilities.

Science.gov (United States)

Vaz, Sharmila; Wilson, Nathan; Falkmer, Marita; Sim, Angela; Scott, Melissa; Cordier, Reinie; Falkmer, Torbjörn

2015-01-01

Teachers' attitudes toward inclusion are often based on the practical implementation of inclusive education rather than a specific ideology and understanding of inclusiveness. This study aimed to identify the factors associated with primary school teachers' attitudes towards inclusion of students with all disabilities in regular schools. Seventy four primary school teachers participated in a cross-sectional survey conducted in Western Australia. Teachers' attitudes and efficacy toward integration of students with disabilities were measured using the Opinions Relative to Integration of Students with Disabilities scale and Bandura's Teacher Efficacy scale respectively. Four teacher attributes-age, gender, teaching self-efficacy and training collectively explained 42% of the variability in teachers' attitude toward including students with disabilities. The current study further contributes to the accumulation of knowledge that can unpack the complex pattern of factors that should be considered to promote positive attitudes towards inclusive schools.

Civic Political Culture, Participatory Governance and Political ...

African Journals Online (AJOL)

Prof

This study x-rayed the significance of civic political culture on participatory governance and its .... The literature on participatory governance theory assumes that deliberation is key to effective .... factors and capture all considerations involved in making certain that citizen interests .... vital element in any organization.

Government and industry roles in heavy oil resource development

International Nuclear Information System (INIS)

Sharp, D.A.

1994-01-01

Developing a heavy oil deposit in Canada requires proper reservoir selection and ongoing resrvoir management. The number of unexploited heavy oil reservoirs whch can be economically produced through primary methods is rapidly declining. In addition, primary recoveries of 5-10% of the heavy oil in place are unacceptable and recovery rates of over 50% are needed. Enhanced thermal recovery projects are therefore needed, but these entail significant technical and commodity pricing risks. It is suggested that provincial governments recognize those risks and offer incentives by not encumbering such projects with up-front royalties. If industry is to assume the risks, governments must develop a fiscal regime that allows for a satisfactory return on capital and acceptable sharing of profits. At the federal level, it is suggested to broaden the interpretation of research and development activity to include enhanced recovery projects, making the tax breaks available to scientific research also available to heavy oil development. Government policies favoring heavy oil in Saskatchewan and Alberta are cited as good examples of ways to encourage the heavy oil industry

Parental and Related Factors Affecting Students' Academic Achievement in Oyo State, Nigeria

OpenAIRE

Oladele K. Ogunsola; Kazeem A. Osuolale; Akintayo O. Ojo

2015-01-01

Many factors influence the educational outcome of students. Some of these have been studied by researchers with many emphasizing the role of students, schools, governments, peer groups and so on. More often than not, some of these factors influencing the academic achievement of the students have been traced back to parents and family; being the primary platform on which learning not only begins but is nurtured, encouraged and developed which later transforms to the perfor...

[Detection of intimate partner violence in primary care and related factors].

Science.gov (United States)

Rodríguez-Blanes, Gloria M; Vives-Cases, Carmen; Miralles-Bueno, Juan José; San Sebastián, Miguel; Goicolea, Isabel

Intimate partner violence (IPV) against women is a significant public health and human rights problem. Primary care professionals play a key role in detecting and addressing this issue. The aim of this study is to determine the frequency of IPV and its associated factors in primary care by means of a screening questionnaire and to describe the main actions taken in identified cases. Cross-sectional study in 15 health centres in four autonomous regions of Spain with a total of 265 health professionals. The information was collected through the self-administered PREMIS questionnaire (Physician Readiness to Manage Intimate Partner Violence Survey), which includes variables concerning screening questions, sociodemographic factors, level of training/knowledge about IPV, perceptions and actions. A descriptive and analytical study was conducted. 67.2% of participants said they ask about IPV during consultations. The most frequent actions were: referring patients to other departments, individual counselling and information delivery. ≥21hours of training, an advanced training level, knowledge of policies and programmes and the implementation of an appropriate protocol and reference resources were all factors that increased the likelihood of investigating IPV. The asking of questions increases in line with professionals' perceived level of training in IPV and the provision of a case management protocol. Two thirds of health professional respondents said they inquire about IPV. Given the influence of training in IPV and awareness of the resources to address the issue, it is essential to continue investing in the IPV training of healthcare personnel. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Factors Predictive of Sentinel Lymph Node Involvement in Primary Breast Cancer.

Science.gov (United States)

Malter, Wolfram; Hellmich, Martin; Badian, Mayhar; Kirn, Verena; Mallmann, Peter; Krämer, Stefan

2018-06-01

Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) for axillary staging in patients with early-stage breast cancer. The need for therapeutic ALND is the subject of ongoing debate especially after the publication of the ACOSOG Z0011 trial. In a retrospective trial with univariate and multivariate analyses, factors predictive of sentinel lymph node involvement should be analyzed in order to define tumor characteristics of breast cancer patients, where SLNB should not be spared to receive important indicators for adjuvant treatment decisions (e.g. thoracic wall irradiation after mastectomy with or without reconstruction). Between 2006 and 2010, 1,360 patients with primary breast cancer underwent SLNB with/without ALND with evaluation of tumor localization, multicentricity and multifocality, histological subtype, tumor size, grading, lymphovascular invasion (LVI), and estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 status. These characteristics were retrospectively analyzed in univariate and multivariate logistic regression models to define significant predictive factors for sentinel lymph node involvement. The multivariate analysis demonstrated that tumor size and LVI (pbreast cancer. Because of the increased risk for metastatic involvement of axillary sentinel nodes in cases with larger breast cancer or diagnosis of LVI, patients with these breast cancer characteristics should not be spared from SLNB in a clinically node-negative situation in order to avoid false-negative results with a high potential for wrong indication of primary breast reconstruction or wrong non-indication of necessary post-mastectomy radiation therapy. The prognostic impact of avoidance of axillary staging with SLNB is analyzed in the ongoing prospective INSEMA trial. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care.

NARCIS (Netherlands)

Prins, M.A.; Verhaak, P.F.; Smolders, M.; Laurant, M.G.H.; Meer, K. de; Spreeuwenberg, P.; Marwijk, H.W.J. van; Penninx, B.W.J.H.; Bensing, J.M.

2010-01-01

OBJECTIVE: To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. DESIGN: Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). PARTICIPANTS: Seven hundred and

Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care

NARCIS (Netherlands)

Prins, M.A.; Verhaak, P.; Smolders, M.; Laurant, M.G.H.; van der Meer, K; Spreeuwenberg, P.; van Marwijk, H.W.J.; Penninx, B.W.J.H.; Bensing, J.M.

2010-01-01

Objective: To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Design: Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Participants: Seven hundred and

The Economy Governing During Globalization Era

Directory of Open Access Journals (Sweden)

Ion Bucur

2006-09-01

Full Text Available World and national economie governing is an essential premise of the political stability and democratic evolution. In this study are approached theoretical and practical aspects of the economie governing. Theoretical acquisitions in this field highlit multiple perspectives of approaching and difficulties to characterize this complex and multisized fenomenon. A possible theory of governing the economy needs to use some concepts and mechanisms particular to more scientific fields (political science, economy, cibernetics, the theory of systems and others. The dinamic character and the instability of the present system of governing imposed the analysis of the factors and conditions which have generated the crises of the national and world economic governing. In this context, there are indentified the forms of manifesting the instability (lack of legitimacy, transpa¬rence and democratic responsability, and also the direction of necessary action to implement an efficient and responsable economic governing.

The Economy Governing During Globalization Era

Directory of Open Access Journals (Sweden)

Ion Bucur

2006-07-01

Full Text Available World and national economie governing is an essential premise of the political stability and democratic evolution. In this study are approached theoretical and practical aspects of the economie governing. Theoretical acquisitions in this field highlit multiple perspectives of approaching and difficulties to characterize this complex and multisized fenomenon. A possible theory of governing the economy needs to use some concepts and mechanisms particular to more scientific fields (political science, economy, cibernetics, the theory of systems and others. The dinamic character and the instability of the present system of governing imposed the analysis of the factors and conditions which have generated the crises of the national and world economic governing. In this context, there are indentified the forms of manifesting the instability (lack of legitimacy, transpa¬rence and democratic responsability, and also the direction of necessary action to implement an efficient and responsable economic governing.

Influence of Psychosocial Factors on Aging among the Aged in Ihitte-Uboma Local Government Area of Imo State, Nigeria

Science.gov (United States)

Ojukwu, M. O.

2016-01-01

The major aim of this study was to examine influence of psychosocial factors on aging among the aged in Ihitte Uboma Local Government Area of Imo State, Nigeria. Ex-post facto or casual comparative research design was adopted for the study. Two hundred and twenty-five (225) old people were selected through random sampling for the study.…

[Relevant factors of early puberty timing in urban primary schools in Chongqing].

Science.gov (United States)

Luo, Yan; Liu, Qin; Wen, Yi; Liu, Shudan; Lei, Xun; Wang, Hong

2016-05-01

To investigate the status of puberty timing and relevant factors of early puberty timing in children from grade one to four in urban primary schools of Chongqing. According to the purposive sample method, four urban primary schools in Chongqing were selected and of which 1471 children from grade one to four who have obtained informed consent were recruited. Questionnaire survey on social-demographic characteristics and family environment (e.g., age, parents' relationship, diet and lifestyle, etc), and Pubertal Development Scale (PDS) survey and physical examination (measurements of height, weight, pubertal development status, etc) were conducted. P25, P50, P75 ages of each important pubertal event were calculated by probit regression. Univariate and multivariate analysis were used to analyze relevant factors. The detection rate of early puberty timing was 17.7%, and the median ages of the onset of breast and testicular development were 10.77 and 11.48 years old, respectively. Multivariate logistic regression showed that early puberty timing occurred more likely in girls than in boys (OR = 0.561, 95% CI 0.406-0.774), and bad relationship between parents (OR = 1.320, 95% CI 1.007-1.729) and hair-products-use (OR = 1.685, 95%, CI 1.028-2.762) were risk factors of early puberty timing. Early onset of puberty in urban Chongqing is still exist. Gender, parents' relationship, and hair-products-use have an essential impact on early puberty timing.

Voluntary resettlement in China : policy and outcomes of government-organised poverty reduction projects

NARCIS (Netherlands)

Lin, Z.

2003-01-01

The primary concern of this research is the justice of using government resources for poverty reduction, in other words investigating whether or not such investment has served its claimed purpose. My central argument is that government organized resettlement projects have