ResearchPad - Management https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Panel Dataset of Ethical Commitment Disclosures in Malaysia]]> https://www.researchpad.co/product?articleinfo=N7a48c7c0-efb8-4adb-9d33-3e94a0c9e849 <![CDATA[Datasets for corporate governance index of Jordanian non-financial sector firms]]> https://www.researchpad.co/product?articleinfo=N0cbed61a-d15d-49f9-9c44-24b6087678fa

This article covers comprehensive data on firm-level corporate governance practices as imposed by the Jordan Securities Commission (JSC). The study includes panel data for 95 non-financial Jordanian listed firms (industrial and service sector) in Amman Stock Exchange (ASE). The time frame used for this study is from 2012 to 2017. Data presented were extracted from the annual reports of each firm. The annual reports had been downloaded from the official website of the ASE. The data can be used easily by the researcher to develop and calculate a corporate governance index that involves thirty-two internal governance attributes and is comprised of three equally weighted sub-indices. The first sub-index which is “Disclosure and Transparency” consists of 15 unique attributes. While the second sub-index, “Board Effectiveness and Composition” consists of 9 unique attributes. The last sub-index which is “Shareholders Rights” consists of 8 unique attributes. Thus, the un-weighted corporate governance index has an important feature that is easily replicated and modified, enabling the researcher to rate firms based on an aggregate index score or by using the sub-indices score also.

]]>
<![CDATA[Estimation of soil salt content by combining UAV-borne multispectral sensor and machine learning algorithms]]> https://www.researchpad.co/product?articleinfo=N794eaa1f-1abe-45a2-a5c3-7892b7f2c9aa

Soil salinization is a global problem closely related to the sustainable development of social economy. Compared with frequently-used satellite-borne sensors, unmanned aerial vehicles (UAVs) equipped with multispectral sensors provide an opportunity to monitor soil salinization with on-demand high spatial and temporal resolution. This study aims to quantitatively estimate soil salt content (SSC) using UAV-borne multispectral imagery, and explore the deep mining of multispectral data. For this purpose, a total of 60 soil samples (0–20 cm) were collected from Shahaoqu Irrigation Area in Inner Mongolia, China. Meanwhile, from the UAV sensor we obtained the multispectral data, based on which 22 spectral covariates (6 spectral bands and 16 spectral indices) were constructed. The sensitive spectral covariates were selected by means of gray relational analysis (GRA), successive projections algorithm (SPA) and variable importance in projection (VIP), and from these selected covariates estimation models were built using back propagation neural network (BPNN) regression, support vector regression (SVR) and random forest (RF) regression, respectively. The performance of the models was assessed by coefficient of determination (R2), root mean squared error (RMSE) and ratio of performance to deviation (RPD). The results showed that the estimation accuracy of the models had been improved markedly using three variable selection methods, and VIP outperformed GRA and GRA outperformed SPA. However, the model accuracy with the three machine learning algorithms turned out to be significantly different: RF > SVR > BPNN. All the 12 SSC estimation models could be used to quantitatively estimate SSC (RPD > 1.4) while the VIP-RF model achieved the highest accuracy (Rc2 = 0.835, RP2 = 0.812, RPD = 2.299). The result of this study proved that UAV-borne multispectral sensor is a feasible instrument for SSC estimation, and provided a reference for further similar research.

]]>
<![CDATA[Superior Mesenteric Artery Dissection After Lumbar Puncture]]> https://www.researchpad.co/product?articleinfo=N186d9125-0c1e-470d-bfc5-9fec941039f6

We hereby present a case of iatrogenic dissection of the superior mesenteric artery dissection in a 63-year-old female undergoing a lumbar puncture (LP). She presented with severe diffused abdominal pain accompanied by lower back pain, nausea and vomiting a few hours after undergoing an LP due to ongoing headaches. Abdominal CT showed evidence of hemoperitoneum. She was then transferred to another facility and while in route received one unit of packed red blood cellsdue to drop in hemoglobin levels from 15 to 11 gm/dl. Physicians should consider the possibility of arterial variations and the level at which spinal tap is performed during interventions. Acute abdominal pain is a significant, common complaint that should be appropriately investigated.

]]>
<![CDATA[Monitoring body condition score of reintroduced banteng (Bos javanicus D’Alton, 1923) into Salakphra Wildlife Sanctuary, Thailand]]> https://www.researchpad.co/product?articleinfo=Nc8cb63f8-58d8-41ad-b3f5-af60a70e8f31

Background

Banteng (Bos javanicus d’Alton 1823) are an endangered species, highly sensitive to habitat structure and quality. In many areas, banteng were extinct and needed to be reintroduced to restore their population. Thus, understanding the responses of body condition of reintroduced banteng to their habitat was important for ensuring the sustainability of a reintroduction program. The aim of the present study was to evaluate the body condition of banteng after reintroduction into the Salakphra Wildlife Sanctuary in Thailand based on photographs from camera-traps carried out between July 2016 and November 2018.

Methods

Seven banteng were bred at the Khao Nampu Nature and Wildlife Education Center and systematically reintroduced into the Salakphra Wildlife Sanctuary in December 2015 (four) and July 2016 (three). The seven reintroduced adults and two newborns (from the 2015 group) were captured via camera traps in 2018. The body condition scoring (BCS) obtained from these photographs was used to identify the individual performance of all seven adults after their reintroduction.

Results

The BCS scores in reintroduced adult banteng, both males and females, (between 5 and 7 years old) increased significantly over time after reintroduction into a natural habitat (p < 0.05), although the BCS scores in females were not significantly different between the second and third years (p > 0.05).

Conclusions

The results from the present study suggest that camera traps are a practical tool to assess the BCS of reintroduced banteng, and can be used to monitor their condition post-release. These techniques may be appropriate for translocation programs elsewhere.

]]>
<![CDATA[Site selection for subtropical thicket restoration: mapping cold-air pooling in the South African sub-escarpment lowlands]]> https://www.researchpad.co/product?articleinfo=Nbeca63fb-07a4-49df-acae-d8def863bbe9

Restoration of subtropical thicket in South Africa using the plant Portulacaria afra (an ecosystem engineer) has been hampered, in part, by selecting sites that are frost prone—this species is intolerant of frost. Identifying parts of the landscape that are exposed to frost is often challenging. Our aim is to calibrate an existing cold-air pooling (CAP) model to predict where frost is likely to occur in the valleys along the sub-escarpment lowlands (of South Africa) where thicket is dominant. We calibrated this model using two valleys that have been monitored during frost events. To test the calibrated CAP model, model predictions of frost-occurrence for six additional valleys were assessed using a qualitative visual comparison of existing treelines in six valleys—we observe a strong visual match between the predicted frost and frost-free zones with the subtropical thicket (frost-intolerant) and Nama-Karoo shrubland (frost-tolerant) treelines. In addition, we tested the model output using previously established transplant experiments; ∼300 plots planted with P. afra (known as the Thicket-Wide Plots) were established across the landscape—without consideration of frost—to assess the potential factors influencing the survival and growth of P. afra. Here we use a filtered subset of these plots (n = 70), and find that net primary production of P. afra was significantly lower in plots that the model predicted to be within the frost zone. We suggest using this calibrated CAP model as part of the site selection process when restoring subtropical thicket in sites that lie within valleys—avoiding frost zones will greatly increase the likelihood of restoration success.

]]>
<![CDATA[Data on the potential of nutrition-information apps from a consumer behaviour perspective]]> https://www.researchpad.co/product?articleinfo=N611f0b55-9dc9-4b11-898f-3afe59db61cd

This paper presents data on the influence of the use of a nutrition-information app (Edo) on healthy eating. The methodology adopted included a baseline (t0) and a follow-up online questionnaire (t1). The first survey was sent to 7000 consumers who had already downloaded the app. This survey collected data on users’ perceived healthiness of their own diet, food purchasing habits, sociodemographic information, concern for appearance, perception of the Health Belief Model constructs, and objective and perceived healthy food knowledge. The follow-up survey (t1) was sent to the respondents who had used the app for 12 weeks. It collected data on app satisfaction, recommended additional app features, consumers’ perception on the Health Belief Model constructs, and consumers’ objective and perceived healthy food knowledge. Data elaboration included two factor analyses elaboration, one for t0 data and one for t1 data. The aim was the identification of constructs as latent factors of the data. The value of each construct was calculated and compared between t0 and t1. The data presented in this article can help the replication of studies about similar apps and enhance the cooperation among app developers, consumer behaviour scientists, nutritionists and marketing experts for apps development. For conclusion and interpretation of data, the original article can be consulted (DOI:10.1016/j.foodres.2019.108766).

]]>
<![CDATA[On the potential for saturated buffers in northwest Ohio to remediate nutrients from agricultural runoff]]> https://www.researchpad.co/product?articleinfo=Na0af8a4b-035f-4965-a36e-0d93e5055174

Nutrient loading from nonpoint source runoff in the Midwest has emerged as one of the largest threats to water quality as the frequency of harmful algal blooms, hypoxic zones, and issues associated with human-resource interactions have risen abruptly over the past several decades. In this study, a saturated buffer ~500 m in length located in the western basin of the Lake Erie watershed was evaluated for its potential to reduce edge of field runoff and nutrient loading. Saturated buffers reduce runoff by routing subsurface tile drainage water into the riparian zone, providing an opportunity for drainage volume as well as nutrient reduction of runoff waters. Over a 12-month study period, controlled drainage was used to redirect nearly 25% of the total tile flow into the riparian zone from a subwatershed in corn/soybean rotation with near complete reductions of dissolved nitrogen and phosphorus from tile inflows averaging 4.7 and 0.08 mg/L, respectively, as well as total reduction of suspended sediments (average 10.4 mg/L). This study provides additional evidence that riparian areas are an important part of nutrient reduction strategies as they can act as both controlled drainage points by raising water tables in fields as well as nutrient sinks which couple to help mitigate nutrient runoff in the region.

]]>
<![CDATA[A comparative study of aceclofenac versus etoricoxib in the management of acute low back pain in a tertiary care hospital]]> https://www.researchpad.co/product?articleinfo=N156d8f7f-7014-480f-880b-77cd310ce1c9

Abstract

Background: The aim of management of acute low back pain is to alleviate the pain quickly and improve functional ability. Non-steroidal anti-inflammatory drugs are the first line of treatment. The challenge lies in deciding which NSAIDs will provide greater symptomatic relief, while also being cost-effective.

Objective: To compare the effectiveness of aceclofenac and etoricoxib in the management of acute low back pain.

Methods: This prospective, open label, observational study was conducted at a tertiary care hospital. Patients over 18 years of age and presenting with low back pain of less than 6 weeks duration were enrolled in the study. Fifty patients with non-specific low back pain were randomized into two groups: Group A received aceclofenac (2 mg/kg) twice a day and Group B received etoricoxib (1 mg/kg) twice a day for 1 week. The Numerical Rating Scale (NRS) and Oswestry Low Back Disability Index (ODI) determined the clinically meaningful outcomes.

Results: The decrease in pain intensity in Group A was 52.27%, while in Group B it was 62.53%. However, the decrease in pain scores between the groups was not statistically significant (p = .3795). Improvement in functional ability in Group A and Group B was 57.01% and 61.48%, respectively. However, this improvement between the groups was not statistically significant (p > .999) at the end of 1 week. The average cost-effectiveness ratio indicated that etoricoxib was the dominant treatment over aceclofenac. Therefore, etoricoxib was found to be the cost-effective option for short-term pain relief in acute low back pain for 1 week.

Conclusion: Both aceclofenac and etoricoxib were clinically effective in reducing the pain intensity and in improving functional ability. However, etoricoxib was found to be the cost-effective intervention.

]]>
<![CDATA[Chalcone synthase (CHS) family members analysis from eggplant (Solanum melongena L.) in the flavonoid biosynthetic pathway and expression patterns in response to heat stress]]> https://www.researchpad.co/product?articleinfo=N0c4703df-5c43-4557-a077-ba839b092c8d

Enzymes of the chalcone synthase (CHS) family participate in the synthesis of multiple secondary metabolites in plants, fungi and bacteria. CHS showed a significant correlation with the accumulation patterns of anthocyanin. The peel color, which is primarily determined by the content of anthocyanin, is an economically important trait for eggplants that is affected by heat stress. A total of 7 CHS (SmCHS1-7) putative genes were identified in a genome-wide analysis of eggplants (S. melongena L.). The SmCHS genes were distributed on 7 scaffolds and were classified into 3 clusters. Phylogenetic relationship analysis showed that 73 CHS genes from 7 Solanaceae species were classified into 10 groups. SmCHS5, SmCHS6 and SmCHS7 were continuously down-regulated under 38°C and 45°C treatment, while SmCHS4 was up-regulated under 38°C but showed little change at 45°C in peel. Expression profiles of key anthocyanin biosynthesis gene families showed that the PAL, 4CL and AN11 genes were primarily expressed in all five tissues. The CHI, F3H, F3’5’H, DFR, 3GT and bHLH1 genes were expressed in flower and peel. Under heat stress, the expression level of 52 key genes were reduced. In contrast, the expression patterns of eight key genes similar to SmCHS4 were up-regulated at a treatment of 38°C for 3 hour. Comparative analysis of putative CHS protein evolutionary relationships, cis-regulatory elements, and regulatory networks indicated that SmCHS gene family has a conserved gene structure and functional diversification. SmCHS showed two or more expression patterns, these results of this study may facilitate further research to understand the regulatory mechanism governing peel color in eggplants.

]]>
<![CDATA[First description of a herpesvirus infection in genus Lepus]]> https://www.researchpad.co/product?articleinfo=N2b9a02c7-7220-4716-8700-9456c07e4236

During the necropsies of Iberian hares obtained in 2018/2019, along with signs of the nodular form of myxomatosis, other unexpected external lesions were also observed. Histopathology revealed nuclear inclusion bodies in stromal cells suggesting the additional presence of a nuclear replicating virus. Transmission electron microscopy further demonstrated the presence of herpesvirus particles in the tissues of affected hares. We confirmed the presence of herpesvirus in 13 MYXV-positive hares by PCR and sequencing analysis. Herpesvirus-DNA was also detected in seven healthy hares, suggesting its asymptomatic circulation. Phylogenetic analysis based on concatenated partial sequences of DNA polymerase gene and glycoprotein B gene enabled greater resolution than analysing the sequences individually. The hare’ virus was classified close to herpesviruses from rodents within the Rhadinovirus genus of the gammaherpesvirus subfamily. We propose to name this new virus Leporid gammaherpesvirus 5 (LeHV-5), according to the International Committee on Taxonomy of Viruses standards. The impact of herpesvirus infection on the reproduction and mortality of the Iberian hare is yet unknown but may aggravate the decline of wild populations caused by the recently emerged natural recombinant myxoma virus.

]]>
<![CDATA[Barriers to linking high-risk jail detainees to HIV pre-exposure prophylaxis]]> https://www.researchpad.co/product?articleinfo=N6cdd8894-eb56-44cf-b406-5a297c3ac14c

Individuals involved in the criminal justice (CJ) system continue to be at disproportionate risk for HIV infection, and often have a greater prevalence of substance use and sexual related risk behaviors relative to their non-CJ involved peers. Pre-exposure prophylaxis (PrEP), a once daily antiretroviral medicine, is an evidence-based approach for reducing the risk of contracting HIV but limited data exist regarding the use of PrEP among CJ populations, especially in the U.S. South. This study was conducted at the Pulaski County Regional Detention Facility (PCRDF) in Little Rock, Arkansas (AR), the largest county jail in the state. We explored knowledge about PrEP and HIV, perceptions about PrEP feasibility in both the jail and community settings and barriers to PrEP program implementation, through in-depth qualitative interviews with 21 jail detainees. We purposively sampled individuals based on specific self-reported risk behavior, including sexual risk (both heterosexual and same-sex) and drug related risk (e.g. IDU), among all eligible individuals. We identified five primary themes from the interviews: 1) accessing healthcare during community reentry was a low priority; 2) perception of risk and interaction with people with HIV was low; 3) there are many barriers to disclosing HIV risk behaviors in jail settings; 4) knowledge of PrEP is low but willingness to use is high; and 5) multiple barriers exist to PrEP uptake post-release. Our findings are contextually unique and therefore have important implications for future implementation of PrEP access either within jail settings or linkage to PrEP post release.

]]>
<![CDATA[Oxycodone versus morphine for cancer pain titration: A systematic review and pharmacoeconomic evaluation]]> https://www.researchpad.co/product?articleinfo=N5c0f7a4c-4090-42ec-ba95-57e120b0c99c

Objective

To evaluate the efficacy, safety and cost-effectiveness of Oxycodone Hydrochloride Controlled-release Tablets (CR oxycodone) and Morphine Sulfate Sustained-release Tablets (SR morphine) for moderate to severe cancer pain titration.

Methods

Randomized controlled trials meeting the inclusion criteria were searched through Medline, Cochrane Library, Pubmed, EMbase, CNKI,VIP and WanFang database from the data of their establishment to June 2019. The efficacy and safety data were extracted from the included literature. The pain control rate was calculated to eatimate efficacy. Meta-analysis was conducted by Revman5.1.4. A decision tree model was built to simulate cancer pain titration process. The initial dose of CR oxycodone and SR morphine group were 20mg and 30mg respectively. Oral immediate-release morphine was administered to treat break-out pain. The incremental cost-effectiveness ratio was performed with TreeAge Pro 2019.

Results

19 studies (1680 patients)were included in this study. Meta-analysis showed that the pain control rate of CR oxycodone and SR morphine were 86% and 82.98% respectively. The costs of CR oxycodone and SR morphine were $23.27 and $13.31. The incremental cost-effectiveness ratio per unit was approximate $329.76. At the willingness-to-pay threshold of $8836, CR oxycodone was cost-effective, while the corresponding probability of being cost-effective at the willingness-to-pay threshold of $300 was 31.6%. One-way sensitivity analysis confirmed robustness of results.

Conclusions

CR oxycodone could be a cost-effective option compared with SR morphine for moderate to severe cancer pain titration in China, according to the threshold defined by the WHO.

]]>
<![CDATA[Dataset for understanding why people share their travel experiences on social media: Structural equation model analysis]]> https://www.researchpad.co/product?articleinfo=N2f383dac-4af3-4187-9f1b-0cfb3f96cdca

The data presented in this article relates to the individual intrinsic and extrinsic motivations to share travel experience in social media. The 381 records were gathered in Portugal using an online survey. A statistical analysis of the data was carried out using partial least squares (PLS). This dataset shows a relationship between identification, internalization, and compliance to perceived enjoyment, and also, between perceived enjoyment, altruistic motivations, personal fulfillment, and self-actualization as well as security and privacy reasons to actual travel experience sharing. For further findings and interpretation, please refer to the research article entitled “Why do people share their travel experiences on social media?” [1]. We suggest the use of this data to compare with data collected by other researchers to develop cross-country analyses based on the model proposed by Oliveira, Araujo, and Tam [1].

]]>
<![CDATA[Clinical applicability of the Feline Grimace Scale: real-time versus image scoring and the influence of sedation and surgery]]> https://www.researchpad.co/product?articleinfo=N2856c4d5-d500-4a4f-95c9-9bc743f8a422

Background

The Feline Grimace Scale (FGS) is a facial expression-based scoring system for acute pain assessment in cats with reported validity using image assessment. The aims of this study were to investigate the clinical applicability of the FGS in real-time when compared with image assessment, and to evaluate the influence of sedation and surgery on FGS scores in cats.

Methods

Sixty-five female cats (age: 1.37 ± 0.9 years and body weight: 2.85 ± 0.76 kg) were included in a prospective, randomized, clinical trial. Cats were sedated with intramuscular acepromazine and buprenorphine. Following induction with propofol, anesthesia was maintained with isoflurane and cats underwent ovariohysterectomy (OVH). Pain was evaluated at baseline, 15 min after sedation, and at 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 h after extubation using the FGS in real-time (FGS-RT). Cats were video-recorded simultaneously at baseline, 15 min after sedation, and at 2, 6, 12, and 24 h after extubation for subsequent image assessment (FGS-IMG), which was performed six months later by the same observer. The agreement between FGS-RT and FGS-IMG scores was calculated using the Bland & Altman method for repeated measures. The effects of sedation (baseline versus 15 min) and OVH (baseline versus 24 h) were assessed using linear mixed models. Responsiveness to the administration of rescue analgesia (FGS scores before versus one hour after) was assessed using paired t-tests.

Results

Minimal bias (−0.057) and narrow limits of agreement (−0.351 to 0.237) were observed between the FGS-IMG and FGS-RT. Scores at baseline (FGS-RT: 0.16 ± 0.13 and FGS-IMG: 0.14 ± 0.13) were not different after sedation (FGS-RT: 0.2 ± 0.15, p = 0.39 and FGS-IMG: 0.16 ± 0.15, p = 0.99) nor at 24 h after extubation (FGS-RT: 0.16 ± 0.12, p = 0.99 and FGS-IMG: 0.12 ± 0.12, p = 0.96). Thirteen cats required rescue analgesia; their FGS scores were lower one hour after analgesic administration (FGS-RT: 0.21 ± 0.18 and FGS-IMG: 0.18 ± 0.17) than before (FGS-RT: 0.47 ± 0.24, p = 0.0005 and FGS-IMG: 0.45 ± 0.19, p = 0.015).

Conclusions

Real-time assessment slightly overestimates image scoring; however, with minimal clinical impact. Sedation with acepromazine-buprenorphine and ovariohysterectomy using a balanced anesthetic protocol did not influence the FGS scores. Responsiveness to analgesic administration was observed with both the FGS-RT and FGS-IMG.

]]>
<![CDATA[Distinguishing moral hazard from access for high-cost healthcare under insurance]]> https://www.researchpad.co/product?articleinfo=N9aa1c21e-eb0c-47d9-9336-743c9eef5b98

Context

Health policy has long been preoccupied with the problem that health insurance stimulates spending (“moral hazard”). However, much health spending is costly healthcare that uninsured individuals could not otherwise access. Field studies comparing those with more or less insurance cannot disaggregate moral hazard versus access. Moreover, studies of patients consuming routine low-dollar healthcare are not informative for the high-dollar healthcare that drives most of aggregate healthcare spending in the United States.

Methods

We test indemnities as an alternative theory-driven counterfactual. Such conditional cash transfers would maintain an opportunity cost for patients, unlike standard insurance, but also guarantee access to the care. Since indemnities do not exist in U.S. healthcare, we fielded two blinded vignette-based survey experiments with 3,000 respondents, randomized to eight clinical vignettes and three insurance types. Our replication uses a population that is weighted to national demographics on three dimensions.

Findings

Most or all of the spending due to insurance would occur even under an indemnity. The waste attributable to moral hazard is undetectable.

Conclusions

For high-cost care, policymakers should be more concerned about the foregone efficient spending for those lacking full insurance, rather than the wasteful spending that occurs with full insurance.

]]>
<![CDATA[Clustered micronodules as predominant manifestation on CT: A sign of active but indolently evolving pulmonary tuberculosis]]> https://www.researchpad.co/product?articleinfo=N48b20e2f-c3ed-4c3c-a251-c583ed3c8c8a

Objective

To investigate the prevalence, patient characteristics, and natural history of clustered micronodules (CMs) in active pulmonary tuberculosis.

Materials and methods

From January 2013 through July 2018, 833 consecutive patients with bacteriologically or polymerase chain reaction–proven active pulmonary tuberculosis were retrospectively evaluated. CMs were defined as a localized aggregation of multiple dense discrete micronodules, which primarily distributed around small airways distal to the level of the segmental bronchus: small airways surrounded by CMs maintained luminal patency and the CMs might coalesce into a larger nodule. The patients were dichotomized according to whether the predominant computed tomography (CT) abnormalities were CMs. We analyzed radiologic and pathologic findings in patients whose predominant diagnostic CT abnormalities were CMs, along with those of incidental pre-diagnostic CT scans, if available. Chi-square, McNemar, Student t-test and Wilcoxon-signed rank test were performed.

Results

CMs were the predominant CT abnormality in 2.6% of the patients (22/833, 95% CI, 1.8–4.0%) with less sputum smear-positivity (4.8% vs 31.0%; p = .010) and a similar proportion of immunocompromised status (40.9% vs 46.0%; p = .637) than those without having CMs as the predominant CT abnormality. The time interval for minimal radiologic progression was 6.4 months. The extent of CMs increased with disease progression, frequently accompanied by consolidation and small airway wall thickening. Pathologically, smaller CMs were non-caseating granulomas confined to the peribronchiolar interstitium, whereas larger CMs were caseating granulomas involving lung parenchyma. Two of the five patients with a pre-diagnostic CT scan obtained more than 50 months pre-diagnosis showed an incipient stage of CMs, in which they were small peribronchiolar nodules.

Conclusion

Active pulmonary tuberculosis manifested predominantly as CMs in 2.6% of patients, with scarce of acid-fast bacilli smear-positivity and no association with impaired host immunity. CMs indolently progressed, accompanied by consolidation and small airway wall thickening, and originated from small nodules.

]]>
<![CDATA[Partition dependence in financial aid distribution to income categories]]> https://www.researchpad.co/product?articleinfo=N0611b39b-d559-4542-a5d9-a69c54a62df4

When allocating resources, people often diversify across categories even when those categories are arbitrary, such that allocations differ when identical sets of options are partitioned differently (“partition dependence”). The first goal of the present work (Experiment 1) was to replicate an experiment by Fox and colleagues in which graduate students exhibited partition dependence when asked how university financial aid should be allocated across arbitrarily partitioned income brackets. Our sample consisted of community members at a liberal arts college where financial aid practices have been recent topics of debate. Because stronger intrinsic preferences can reduce partition dependence, these participants might display little partition dependence with financial aid allocations. Alternatively, a demonstration of strong partition dependence in this population would emphasize the robustness of the effect. The second goal was to extend a “high transparency” modification to the present task context (Experiment 2) in which participants were shown both possible income partitions and randomly assigned themselves to one, to determine whether partition dependence in this paradigm would be reduced by revealing the study design (and the arbitrariness of income categories). Participants demonstrated clear partition dependence in both experiments. Results demonstrate the robustness of partition dependence in this context.

]]>
<![CDATA[Can mutual health organisations influence the quality and the affordability of healthcare provision? The case of the Democratic Republic of Congo]]> https://www.researchpad.co/product?articleinfo=Nf97c5072-5c0f-45dc-b83f-09c75045dd0d

Background

In their mission to achieve better access to quality healthcare services, mutual health organisations (MHOs) are not limited to providing health insurance. As democratically controlled member organisations, MHOs aim to make people’s voices heard. At national level, they seek involvement in the design of social protection policies; at local level, they seek to improve responsiveness of healthcare services to members’ needs and expectations.

Methods

In this qualitative study, we investigated whether MHOs in the Democratic Republic of Congo (DRC) succeed in defending members’ rights by improving healthcare quality while minimising expenses. The data originate from an earlier in-depth investigation conducted in the DRC in 2016 of the performance of 13 MHOs. We re-analysed this existing dataset and more specifically investigated actions that the MHOs undertook to improve quality and affordability of healthcare provision for their members, using a framework for analysis based on Hirschman’s exit-voice theory. This framework distinguishes four mechanisms for MHO members to use in influencing providers: (1) ‘exit’ or ‘voting with the feet’; (2) ‘co-producing a long voice route’ or imposing rules through strategic purchasing; (3) ‘guarding over the long voice route of accountability’ or pressuring authorities to regulate and enforce regulations; and (4) ‘strengthening the short voice route’ by transforming the power imbalance at the provider–patient interface.

Results

All studied MHOs used these four mechanisms to improve healthcare provision. Most healthcare providers, however, did not recognise their authority to do so. In the DRC, controlling quality and affordability of healthcare is firmly seen as a role for the health authorities, but the authorities only marginally take up this role. Under current circumstances, the power of MHOs in the DRC to enhance quality and affordability of healthcare is weak.

Conclusion

On their own, mutual health organisations in the DRC do not have sufficient power to influence the practices of healthcare providers. Greater responsiveness of the health services to MHO members requires cooperation of all actors involved in healthcare delivery to create an enabling environment where voices defending people’s rights are heard.

]]>
<![CDATA[“It is always better for a man to know his HIV status” – A qualitative study exploring the context, barriers and facilitators of HIV testing among men in Nairobi, Kenya]]> https://www.researchpad.co/product?articleinfo=N633bb09e-858a-4016-b37a-13e5d588b21f

HIV testing services are an important component of HIV program and provide an entry point for clinical care for persons newly diagnosed with HIV. Although uptake of HIV testing has increased in Kenya, men are still less likely than women to get tested and access services. There is, however, limited understanding of the context, barriers and facilitators of HIV testing among men in the country. Data are from in-depth interviews with 30 men living with HIV and 8 HIV testing counsellors that were conducted to gain insights on motivations and drivers for HIV testing among men in the city of Nairobi. Men were identified retroactively by examining clinical CD4 registers on early and late diagnosis (e.g. CD4 of ≥500 cells/mm, early diagnosis and <500 cells/mm, late diagnosis). Analysis involved identifying broad themes and generating descriptive codes and categories. Timing for early testing is linked with strong social support systems and agency to test, while cost of testing, choice of facility to test and weak social support systems (especially poor inter-partner relations) resulted in late testing. Minimal discussions occurred prior to testing and whenever there was dialogue it happened with partners or other close relatives. Interrelated barriers at individual, health-care system, and interpersonal levels hindered access to testing services. Specifically, barriers to testing included perceived providers attitudes, facility location and set up, wait time/inconvenient clinic times, low perception of risk, limited HIV knowled ge, stigma, discrimination and fear of having a test. High risk perception, severe illness, awareness of partner’s status, confidentiality, quality of services and supplies, flexible/extended opening hours, and pre–and post–test counselling were facilitators. Experiences between early and late testers overlapped though there were minor differences. In order to achieve the desired impact nationally and to attain the 90-90-90 targets, multiple interventions addressing both barriers and facilitators to testing are needed to increase uptake of testing and to link the positive to care.

]]>