The Impacts of National Rebirth Programme on the Moral Character of Nigerian Civil Service Employees (1999 a 2011): Akwa Ibom State Perspective

This study examines the National Rebirth Programme with a view to determine the extent to which it has affected the attitude and behaviour patterns of Nigerians with special emphasis on Akwa Ibom State civil servants The study s objectives were to investigate the impact of the National Rebirth Programme on the moral character of civil service employees in Akwa Ibom State to find out whether the programme has engendered efficiency in service delivery in the state civil service and to recommend ways of making the programme more responsive effective and relevant The study adopted the qualitative and quantitative research methods and utilized data from both the primary and secondary sources which were analyzed within the context of structural functional theory The findings of the study revealed that prior to the commencement of Obasanjo s administration in 1999 Nigerian civil public service was plagued by moral decadence inefficiency and poor attitude to work Moreover the study revealed that the civil service that was supposed to be the engine room of the system was not spared as vices such as corruption indiscipline and other related parochial considerations became prevalent in place of meritocracy diligence and accountability Our analysis revealed that the National Rebirth Programme have had a positive impact on the moral character ethical behaviour and general attitude of Akwa Ibom State civil servants as it has engendered a reduction in the level of corruption discipline and increased work commitment in the civil service The study noted however that a greater proportion of civil servants are still influenced by certain negative forces within the larger society Consequently the study recommended among others that government should make civic education compulsory to all civil servants in order to help in inculcating the right values and ideals in the citizenry while earnest effort should be made to address the poor conditions of service thu

The Impacts of National Rebirth Programme on the Moral Character of Nigerian Civil Service Employees (1999 a 2011): Akwa Ibom State Perspective

This study examines the National Rebirth Programme with a view to determine the extent to which it has affected the attitude and behaviour patterns of Nigerians with special emphasis on Akwa Ibom State civil servants The study s objectives were to investigate the impact of the National Rebirth Programme on the moral character of civil service employees in Akwa Ibom State to find out whether the programme has engendered efficiency in service delivery in the state civil service and to recommend ways of making the programme more responsive effective and relevant The study adopted the qualitative and quantitative research methods and utilized data from both the primary and secondary sources which were analyzed within the context of structural functional theory The findings of the study revealed that prior to the commencement of Obasanjo s administration in 1999 Nigerian civil public service was plagued by moral decadence inefficiency and poor attitude to work Moreover the study revealed that the civil service that was supposed to be the engine room of the system was not spared as vices such as corruption indiscipline and other related parochial considerations became prevalent in place of meritocracy diligence and accountability Our analysis revealed that the National Rebirth Programme have had a positive impact on the moral character ethical behaviour and general attitude of Akwa Ibom State civil servants as it has engendered a reduction in the level of corruption discipline and increased work commitment in the civil service The study noted however that a greater proportion of civil servants are still influenced by certain negative forces within the larger society Consequently the study recommended among others that government should make civic education compulsory to all civil servants in order to help in inculcating the right values and ideals in the citizenry while earnest effort should be made to address the poor conditions of service thu

Curriculum Management and Graduate Programmes’ Viability: The Mediation of Institutional Effectiveness Using PLS-SEM Approach

This study used a partial least squares structural equation modelling (PLS-SEM) to estimate curriculum management's direct and indirect effects on university graduate programmes' viability. The study also examined the role of institutional effectiveness in mediating the nexus between the predictor and response variables. This is a correlational study with a factorial research design. The study's participants comprised 149 higher education administrators (23 Faculty Deans and 126 HODs) from two public universities in Nigeria. A structured questionnaire designed by the researchers was used for data collection. The questionnaire was duly validated with an acceptable scale and item content validity indices. The dimensionality of the instrument was determined using exploratory factor analysis (EFA). Convergent validity was based on Average Variance Extracted (AVE), whereas discriminant validity was based on Fornell-Lacker criteria and the Hetero-Trait Mono-Trait (HTMT) ratio. Acceptable composite reliability estimates of internal consistency were reached for the three sub-scales. Following ethical practices, the questionnaire was physically administered to respondents and retrieved afterwards. Smart PLS (version 3.2.9) and SPSS (version 26.0) programs were used for all the statistical analyses. This study uncovered significant direct and indirect effects of curriculum management on the viability of graduate programmes. Institutional effectiveness significantly impacted graduate programmes’ viability while mediating the nexus between curriculum management and graduate programmes’ viability. Curriculum management and institutional effectiveness jointly explained a significant proportion of graduate programmes’ viability variance. The result of this study proved that graduate programmes’ viability depends, to a great extent, on how much curriculum is managed and how effective institutions are with their services. The result of this study can enable institutions seeking to run viable graduate programmes to re-evaluate their curriculum management practices and the effectiveness of their services

Effectiveness and tolerability of standardized milk based, standardized non-milk based and hospital-based formulations in the management of moderate acute malnutrition in under-five children: A randomized clinical trial

Introduction : Moderate acute malnutrition (MAM) is a leading cause of under-five morbidity and mortality globally. Supplementary feeding is a strategy recommended by WHO for managing the condition.Objective: To evaluate the effectiveness and tolerability of standardized milk-based formulation (SMBF), standardized non-milk based formulation (SNMBF) and hospital-based formulation (HBF) in under-fives with MAM.Method: This was an open label randomized clinical trial in which eligible children aged 6 – 59 months with MAM were assigned to receive the SMBF, SNMBF or HBF at 50% of their daily caloric requirement with their regular family diet for four months. Their baseline characteristics and anthropometric indices were noted. They were followed up on two weekly basis during which further assessments were performed. The analysis for effectiveness and tolerability of the formulations were based on “per protocol”.Results: A total of 687 children were screened and 188 enrolled. Seventy children received SMBF, 63 received SNMBF while 55 received HBF. There were 54/70 (77.1%), 57/64 (89.1%) and 46/55 (83.6%) evaluable participants in the SMBF, SNMBF and HBF group respectively. Recovery from MAM was 43/54 (79.6%), 40/57 (70.2%) and 32/46 (69.6%) in the SMBF, SNMBF and HBF group respectively. Normal nutritional status was attained by 13 (24.0%), 10 (17.6%) and 5 (10.9%) children in the SMBF, SNMBF and HBF group respectively. Diarrhea and skin rashes were the main features of poor tolerability.Conclusions: The formulations were effective in managing MAM in childhood but the SMBF was the most effective. Diarrhea and skin rashes were the main features of poor tolerability

Analysis of Factors Relevant to Revenue Enhancement in Hernia Interventions (SwissDRG G09)

Background: Since diagnosis-related groups (SwissDRG) were established in Switzerland in 2012, small and medium-size hospitals have encountered increasing financial troubles. Even though hernia repair operations are frequent, most hospitals fail to cover their costs with these procedures. Previous studies have focused mainly on analyzing costs and the contributing factors but less on variables that can be positively influenced. Therefore, this study aims to identify the relevant and influenceable factors for revenue growth in hernia repair surgery. Methods: Data from all patients who underwent the SwissDRG G09 surgery for a hernia in 2019 were analyzed. The contribution margin (CM4), as well as any over- or under-coverage, was correlated to case-specific costs. Results: A total of 168 patients received hernia repair surgery with the SwissDRG code G09. The average revenue/loss generated by one procedure was CHF −623.84. Procedures covered by the General Health Insurance (OKP) generated a loss of CHF −830.70 on average, whereas procedures covered by private insurance companies (VVG) generated revenue of CHF +1100 on average. Significant factors impacting the profitability of hernia repair operations were teaching during surgery (p < 0.005), the surgical operating time (p < 0.001), the total anesthesia time (p < 0.001), the number of surgeons present (p = 0.022), the insurance state of patients (p < 0.001), and the type of surgery (p < 0.01 for Lichtenstein’s procedure). Conclusions: This study reveals that hernia repair surgery performed under cost coverage by OKP is generally unprofitable. Our results further imply that the most important and influenceable factors for revenue enhancement are the quality and process optimization of the surgical department. To compensate for this deficit, hospitals should aim to increase the percentage of patients with private health insurance coverage in their procedures. Since outpatient surgery does not provide a valid alternative due to the low reimbursement by insurance companies, the cost efficiency of inpatient hernia repair needs to be increased by process optimization of the surgical department; for instance, by providing specialized hernia teams performing with shorter operation times and high quality

An Assessment of Ovarian Cancer Histotypes Across the African Diaspora

ObjectiveOvarian cancer in Black women is common in many West African countries but is relatively rare in North America. Black women have worse survival outcomes when compared to White women. Ovarian cancer histotype, diagnosis, and age at presentation are known prognostic factors for outcome. We sought to conduct a preliminary comparative assessment of these factors across the African diaspora. MethodsPatients diagnosed with ovarian cancer (all histologies) between June 2016-December 2019 in Departments of Pathology at 25 participating sites in Nigeria were identified. Comparative population-based data, inclusive of Caribbean-born Blacks (CBB) and US-born Blacks (USB), were additionally captured from the International Agency for Research on Cancer and Florida Cancer Data Systems. Histology, country of birth, and age at diagnosis data were collected and evaluated across the three subgroups: USB, CBB and Nigerians. Statistical analyses were done using chi-square and student's t-test with significance set at pResultsNigerians had the highest proportion of germ cell tumor (GCT, 11.5%) and sex-cord stromal (SCST, 16.2%) ovarian cancers relative to CBB and USB (p=0.001). CBB (79.4%) and USB (77.3%) women were diagnosed with a larger proportion of serous ovarian cancer than Nigerians (60.4%) (p<0.0001). Nigerians were diagnosed with epithelial ovarian cancers at the youngest age (51.7 +/- 12.8 years) relative to USB (58.9 +/- 15.0) and CBB (59.0 +/- 13.0,p<0.001). Black women [CBB (25.2 +/- 15.0), Nigerians (29.5 +/- 15.1), and USB (33.9 +/- 17.9)] were diagnosed with GCT younger than White women (35.4 +/- 20.5, p=0.011). Black women [Nigerians (47.5 +/- 15.9), USB (50.9 +/- 18.3) and CBB (50.9 +/- 18.3)] were also diagnosed with SCST younger than White women (55.6 +/- 16.5, p<0.01). ConclusionThere is significant variation in age of diagnosis and distribution of ovarian cancer histotype/diagnosis across the African diaspora. The etiology of these findings requires further investigation

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways