The Impact of Social Networking Sites on the Purchasing Behaviours of Online Travel Community Members

The social networking websites have become quite popular in recent times. Millions of people have grasped the concept and embedded their lives in the interactions on these websites. Academics and businesses have begun to study how information that spreads through these loose associations and the way in which some people become particularly important disseminators of information with their regular postings perhaps would be replacing the traditional marketing communication channels.  The purpose of this study is to investigate how the interactions on these websites impact on the decision making process of participants.  Through content analysis of fifty (50) individual cases reported on TripAdvisor travel review websites at Greece forums of Tripadvisor.com.  The study finds that the online travel community has members that come to the site to search and share travel information and these postings has influenced on community members in their decision making process on planning, purchasing and use of travel products and services. The implications of the findings are discussed and future social networking websites research for the hospitality industry is suggested. Keywords: social networking sites, purchasing behaviour, travelers

RCAP Solutions Breach Management - Case Study

Companies get hacked every day, and our in-scope company for this case study, RCAP Solution, was not an exception. Security incidents have increased both in volume and range in recent years, and cyber-attacks have become more sophisticated than ever before. There are so many reasons that drive this fact; one is that our infrastructure was not protected efficiently, but also attackers have become more knowledgeable in initiating advanced attacks at a scale. Additionally, the entrance of emerging technologies such as blockchain, machine learning, and the internet of things, added additional complexity to the already complex scene. Cybercriminals are using various attack vectors to target their victims. According to Check Point Cyber Security Report, 27% of all organizations globally were impacted by cyber-attacks that involved mobile devices in 2019 (Check Point Cyber Security Report, 2020). Many security incidents happened last year, but phishing attacks were one of the significant attacks initiated in 2019. Phishing is not a new attack; however, it is getting more popular with more efficient techniques using spear phishing, which is a more targeted attack. In general, phishing attacks happen more frequently than other types of attacks (Brute force, DDoS, Malware, etc.) because it is easier to initiate and most cost-effective

Influence of Community Financing Health Insurance Schemes On In-Patient Care In Ghana: The Case Of Nkoranza Scheme

With the introduction of “cash and carry” system in the health sector in Ghana in 1985, it became difficult for many people to afford orthodox health care.  In Nkoranza district, this problem manifested itself in low attendance of in-patient care (admissions) at St. Theresa’s Hospital (the only hospital in the district, a Catholic hospital).  In addition, some of the patients who were hospitalised absconded after treatment because they could not afford to pay their medical bills.  Consequently, in 1989, at Catholic Diocesan Health Committee (DHC) meeting at Sunyani, it was suggested that a community financing health insurance scheme be established in the district in order to reduce the hardship of the people in seeking in-patient treatment.  The scheme was launched and became operational in 1992.  The objectives of this study was to examine the impact of the scheme on in-patient healthcare services at the health facility in the district.  It became evident from the study that insured in-patient attendance at St. Theresa’s Hospital from 1992 to 1998 increased with the scheme, constituting 52% of total admissions within the period. Keywords: cash and carry system, community financing health insurance, patronage, impact, in-patient

Schedule Delay Analysis of Construction Projects in Ghana: Objectives, Importance and Effects

The critical observance of time allocation and sequence of operation of construction activities are essential for construction project managers, as delays in construction projects have negative impact on clients and contractors. This study aims at assessing the objectives, importance and effects of schedule delay in construction project execution in Ghanaian construction industries. The research design adopted for this study was descriptive survey using quantitative method. A purposive sampling technique was used to select 80 respondents. Opinion of employees was solicited using a structured questionnaire for data collection. The data was analysed using statistical package for social sciences (SPSS) version 20. The result showed that, major objectives of scheduling in construction projects are to expose and adjust conflicts between trades or subcontractors, to serve as an effective project control tools and to resolve delay claims. The study also revealed that the primary importance of scheduling in construction are to finish projects on time, and to ensure customer satisfaction. Furthermore, it was established that lack of scheduling of construction projects contribute to delays and causes disruptions of construction projects. The study concludes that to ensure timely delivery of construction project, the project objectives, importance of scheduling and effects of scheduling are key factors to consider in order to avoid delays. Keywords: construction project, disruption, project planning, project delay, schedulin

Causes, survival rates, and short-term outcomes of preterm births in a tertiary hospital in a low resource setting: An observational cohort study

Background: Prematurity is the most important cause of death among children under the age of five years. Globally, most preterm births occur in Sub-Saharan Africa. Subsequent prematurity leads to significant neonatal morbidity, mortality and long-term disabilities. This study aimed to determine the causes, survival rates and outcomes of preterm births up to six weeks of corrected age in Ghana. Materials and methods: An observational prospective cohort study of infants born preterm was conducted in a tertiary hospital in Accra, Ghana from August 2019 to March 2020. Inclusion was performed within 48 h after birth of surviving infants; multiple pregnancies and stillbirths were excluded. Causes of preterm birth were categorized as spontaneous (including preterm pre-labour rupture of membranes) or provider-initiated (medically indicated birth based on maternal or fetal indications). Survival rates and adverse outcomes were assessed at six weeks of corrected age. Recruitment and follow-up were suspended due to the COVID-19 outbreak. Descriptive statistics and differences between determinants were calculated using Chi-squared tests or Kruskal-Wallis test. Results: Of the 758 preterm deliveries, 654 (86.3%) infants were born alive. 179 were enrolled in the cohort and were analyzed. Nine (5%) were extremely preterm [gestational age (GA) < 28 weeks], 40 (22%) very preterm (GA 28–31 weeks), and 130 (73%) moderate to late preterm (GA 32–37 weeks) births. Most deliveries (n = 116, 65%) were provider-initiated, often due to hypertensive disorders in pregnancy (n = 79, 44.1%). Sixty-two infants were followed-up out of which fifty-two survived, presenting a survival rate of 84% (n = 52/62) at six weeks corrected age in this group. Most infants (90%, n = 47/52) experienced complications, predominantly consisted of NICU admission (92%) and interval illnesses (21%) including jaundice and sepsis. Conclusions: The incidence of adverse outcomes associated with preterm birth in a tertiary facility with NICU capacity is high. Larger longitudinal studies are needed for an in-depth understanding of the causes and longer-term outcomes of preterm birth, and to identify effective strategies to improve outcomes in resource constrained settings

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Construction of a Scale Assessing Patients’ Perceptions Regarding Sanitation and Hygiene in a Clinical Setting

Objective This study attempted to develop a scale, hereby called HYGIENICCARE, that assesses patients’ perceptions regarding sanitation and hygiene in a healthcare environment. It also evaluated the relationship between the new measure and a previously validated scale measuring healthcare quality. Methods This study was a psychometric test in which we constructed a new survey and administered the survey to patients in wards and the outpatient departments of 5 hospitals in Accra North. A robust procedure, including a review of selected questions by an expert panel, was followed to determine the original bank of items of the instrument. Principal component analysis with varimax rotation was used to select items for the scale, whereas confirmatory factor analysis was used to assess construct validity. Multiple linear regression was used to examine the association between the new scale and an existing measure of healthcare quality. Results A bank of 10 items was determined through a systematic review of the literature and the engagement of 7 expert reviewers. Through principal component analysis, the items were reduced to 9. Principal component analysis yielded 2 factors: “environment and equipment” and “personnel and process,” which both explained 82% of the total variance and produced Cronbach α coefficients of 0.912 and 0.86, respectively. Confirmatory factor analysis confirmed the 2-factor solution and produced satisfactory discriminant validity and convergent validity indicators. The 2 domains of the new scale were highly correlated with all dimensions of a scale measuring healthcare quality called HEALTHQUAL (r ≥ 0.76, P < 0.001). In multiple linear regression, each of the 2 domains of HYGIENICCARE explained a total variance of 41% or greater in all domains of HEALTHQUAL (P < 0.001). Conclusions We developed a brief scale measuring hospital hygiene and sanitation that correlated well with an existing measure of healthcare quality. This effort shows that the new tool is a valid measure of patient-perceived hospital hygiene and sanitation

NEO-MEDICAL PRACTICE AND DISEASE CONTROL IN GHANA: PERSPECTIVES ON ATIWA DISTRICT (1960–2010)

Using a qualitative research approach, this study focuses on the major medical systems; traditional and western medical practices in the Atiwa District of Ghana from 1960 to 2010 with particular emphasis on western medicine. The people of Atiwa District accessed the two medical systems to combat diseases and also to ensure a healthy life. Before the advent of western medical practice in the Atiwa District, people travelled to Nkawkaw, Koforidua, and Kyebi for medical treatment. Upon the establishment of health centres and hospitals with related impediments, that is, lack of access to health facilities due to long distance, bad roads and low levels of finance from the indigenous population among other things, the local population were not entirely convinced from discontinuing to access the services of traditional medical practitioners in addition to these basic neo-medical facilities. Diseases that were common among the people were malaria, skin diseases and stomach pains among others. However, new and different diseases in other regions also gradually infected the people within the district. They include cerebro-spinal meningitis (CSM), tuberculosis and HIV/AIDS among others within the period under review