A thematic approach to succession planning, leadership continuity, and organizational growth: spotlight on chief executive officers in Ghanaian industry

Purpose: This study examines how Succession Planning (SP) for Chief Executive Officers (CEO) of high-performing organizations in emerging markets ensures the steady success of business continuity through competitive advantage and organizational growth. It also takes a keen interest in the role of the board of directors in perpetuating succession planning practices and the key qualities expected of future CEOs which include value-added competencies, specialized knowledge, leadership capabilities, and performance-based success.Design/Methodology/Approach: This study adopts a qualitative and exploratory approach using a thematic approach to analyze the data.Findings: Through a qualitative lens, the study found that most organizations have no succession-planning practices. Again, those that have it had a weak one, and only a few organizations have a mildly strong succession-planning policy. Furthermore, the board of directors plays a crucial role in the succession-planning processes of these organizations.Research Limitation: There were some constraints during the study and writing of this paper which are indicated. The outbreak of the coronavirus (Covid-19) pandemic caused the closing down of targeted companies for research.Practical Implications: Companies should have strategic initiatives to enable the identification of a talent pool for training in all divisions.Social Implications: Training activities such as seminars and workshops should be implemented to improve the understanding of leadership and succession planning.Originality: Studies on succession planning did not consider the role of the board of directors which this study sheds light on. Finally, studies on SP have not emphasized how important it is for chief executive officers to understand the crucial role that strategic decision-making and succession planning play in guaranteeing the long-term growth of organizations in sub-Saharan Africa

Acceptabilite´ du test VIH propose´ aux nourrissons dans les services pe´ diatriques, en Coˆ te d’Ivoire, Significations pour la couverture du diagnostic pe´diatrique

Proble`me: Le de´pistage VIH chez les enfants a rarement e´te´ au centre des pre´occupations des chercheurs. Quand le de´pistage pe´diatrique a retenu l’attention, cela a e´te´ pour e´clairer seulement sur les performances diagnostiques en ignorant meˆme que le test pe´diatrique comme bien d’autres peut s’accepter ou se refuser. Cet article met au coeur de son analyse les raisons qui peuvent expliquer qu’on accepte ou qu’on refuse de faire de´pister son enfant.Objectif: Etudier chez les parents, les me`res, les facteurs explicatifs de l’acceptabilite´ du test VIH des  nourrissons de moins de six mois.Me´thodes: Entretien semi-directif a` passages re´pe´te´s avec les parents de nourrissons de moins de six mois dans les formations sanitaires pour la pese´e/vaccination et les consultations pe´diatriques avec proposition syste´matique d’un test VIH pour leur nourrisson.Re´sultats: Nous retenons que la re´alisation effective du test pe´diatrique du VIH chez le nourrisson repose sur trois e´le´ments. Primo, le personnel de sante´ par son discours (qui de´note de ses connaissances et  perceptions meˆme sur l’infection) oriente´ vers les me`res influence leur acceptation ou non du test. Secundo, la me`re qui par ses connaissances et perceptions meˆme sur le VIH, dont le statut particulier, l’impression de bien-eˆtre chez elle et son enfant influence toute re´alisation du test pe´diatrique VIH. Tertio, l’environnement conjugal de la me`re, particulie`rement caracte´rise´ par les rapports au sein du couple, sur la facilite´ de parler du test VIH et sa re´alisation chez les deux parents ou chez la me`re seulement sont autant de facteurs qui influencent la re´alisation effective du de´pistage du VIH chez l’enfant. Le principe pre´ventif du VIH, et le de´sir de faire tester l’enfant ne suffisent pas a` eux seuls pour aboutir a` sa re´alisation effective, selon certaines me`res confronte´es au refus du conjoint. A l’oppose´, les autres me`res refusant la re´alisation du test  pe´diatrique disent s’y opposer ; bien entendu, meˆme dans le cas ou` le conjoint l’accepterait.Discussion: Les me`res sont les principales mises en cause et craignent les re´primandes et la stigmatisation. Le pe`re, le conjoint peut eˆtre un obstacle, quand il s’oppose au test VIH du nourrisson, ou devenir le facilitateur de sa re´alisation s’il est convaincu. Le positionnement du pe`re demeure donc essentiel dans la question de l’acceptabilite´ du VIH pe´diatrique. Les me`res en ont conscience et pre´sagent des difficulte´s a` faire  de´pister ou non les enfants sans avis pre´alable du conjoint a` la fois pe`re, et chef de famille.Conclusion: La question du de´pistage pe´diatrique du VIH, au terme de notre analyse, met en face trois e´le´ments qui exigent une gestion globale pour assurer une couverture effective. Ces trois e´le´ments n’existeraient pas sans s’influencer, donc ils sont constamment en interaction et empeˆchent ou favorisent la re´alisation ou non du test pe´diatrique. Aussi, dans une intention d’aboutir a` une couverture effective du de´pistage VIH des nourrissons, faut-il tenir compte d’une gestion harmonieuse de ces trois e´le´ments: La premie`re, la me`re seule (avec ses connaissances, ses perceptions), son environnement conjugal (de  proposition du test inte´grant 1- l’e´poux et / ou pe`re de l’enfant avec ses perceptions et connaissances sur l’infection 2- la facilite´ de parler du test et sa re´alisation chez les deux ou un des parents, la me`re) et les connaissances, attitudes et pratiques du personnel de l’e´tablissement sanitaire sur l’infection du VIH.Recommandations: Nos recommandations proposent une rede´finition de l’approche du VIH/sida vers des familles expose´es au VIH et une inte´gration plus accentue´e du pe`re facilitant leur propre acceptation du test VIH et celle de leur enfant.Mots cle´s: Acceptabilite´, Test VIH, Enfants, Nourrissons Problem: HIV testing in children had rarely been a central concern for researchers. When pediatric tracking retained the attention, it was more to inform on the diagnosis tools performances rather than the fact the pediatric test can be accepted or refused. This article highlights the parent’s reasons which explain why pediatric HIV test is accepted or refused.Objective: To study among parents, the explanatory factors of the acceptability of pediatric HIV testing among infant less than six months.Methods: Semi-structured interview with repeated passages in the parents of infants less than six months attending in health care facilities for the pediatric weighing/vaccination and consultations.Results: We highlight that the parent’s acceptance of the pediatric HIV screening is based on three elements.Firstly, the health care workers by his speech (which indicates its own knowledge and perceptions on the infection) directed towards mothers’ influences their acceptance or not of the HIV test. Secondly, the mother who by her knowledge and perceptions on HIV, whose particular status, give an impression of her own wellbeing for her and her child influences any acceptance of the pediatric HIV test. Thirdly, the marital environment of the mother, particularly characterized by the ease of communication within the couple, to speak about the HIV test and its realization for the parents or the mother only are many factors which influence the effective realization of the pediatric HIV testing. The preventive principle of HIV transmission and the desire to realize the test in the  newborn are not enough alone to lead to its effective realization, according to certain mothers confronted with the father’s refusal. On the other hand, the other mothers refusing the realization of the pediatric test told to be opposed to it; of course, even if their partner would accept it.Discussion: The mothers are the principal facing the pediatric HIV question and fear the reprimands and stigma. The father, the partner could be an obstacle, when he is opposed to the infant HIV testing, or also the facilitator with his realization if he is convinced. The father position thus remains essential face to the question of pediatric HIV testing acceptability. The mothers are aware of this and predict the difficulties of achieving their infant to be tested without the preliminary opinion of their partner at the same time father, and head of the family.Conclusion: The issue of pediatric HIV testing, at the end of our analysis, highlights three elements which require a comprehensive management to improve the coverage of pediatric HIV test. These three elements would not exist without being influenced; therefore they are constantly in interaction and prevent or support the realization or not pediatric test. Also, with the aim to improve the pediatric HIV test coverage, it is necessary to take into account the harmonious management of these elements. Firstly, the mother alone (with her knowledge, and perceptions), its marital environment (with the proposal of the HIV test integrating (1) the partner and/or father with his perceptions and knowledge on HIV infection and (2) facility of speaking about the test and its realization at both or one about the parents, the mother) and of the knowledge, attitudes and practices about the infection of health care workers of the sanitary institution.Recommendations: Our recommendations proposed taking into account a redefinition of the HIV/AIDS approach towards the families exposed to HIV and a more accentuated integration of the father facilitating their own HIV test acceptation and that of his child.Keywords: acceptability, HIV testing, children, infantsArticle in French

Determinants of the range of drugs prescribed in general practice: a cross-sectional analysis

Background: Current health policies assume that prescribing is more efficient and rational when general practitioners (GPs) work with a formulary or restricted drugs lists and thus with a limited range of drugs. Therefore we studied determinants of the range of drugs prescribed by general practitioners, distinguishing general GP-characteristics, characteristics of the practice setting, characteristics of the patient population and information sources used by GPs. Methods: Secondary analysis was carried out on data from the Second Dutch Survey in General Practice. Data were available for 138 GPs working in 93 practices. ATC-coded prescription data from electronic medical records, census data and data from GP/ practice questionnaires were analyzed with multilevel techniques. Results: The average GP writes prescriptions for 233 different drugs, i.e. 30% of the available drugs on the market within one year. There is considerable variation between ATC main groups and subgroups and between GPs. GPs with larger patient lists, GPs with higher prescribing volumes and GPs who frequently receive representatives from the pharmaceutical industry have a broader range when controlled for other variables. Conclusion: The range of drugs prescribed is a useful instrument for analysing GPs' prescribing behaviour. It shows both variation between GPs and between therapeutic groups. Statistically significant relationships found were in line with the hypotheses formulated, like the one concerning the influence of the industry. Further research should be done into the relationship between the range and quality of prescribing and the reasons why some GPs prescribe a greater number of different drugs than others.

Severe morbidity and mortality in untreated HIV-infected children in a paediatric care programme in Abidjan, Côte d'Ivoire, 2004-2009

<p>Abstract</p> <p>Background</p> <p>Clinical evolution of HIV-infected children who have not yet initiated antiretroviral treatment (ART) is poorly understood in Africa. We describe severe morbidity and mortality of untreated HIV-infected children.</p> <p>Methods</p> <p>All HIV-infected children enrolled from 2004-2009 in a prospective HIV programme in two health facilities in Abidjan, Côte d'Ivoire, were eligible from their time of inclusion. Risks of severe morbidity (the first clinical event leading to death or hospitalisation) and mortality were documented retrospectively and estimated using cumulative incidence functions. Associations with baseline characteristics were assessed by competing risk regression models between outcomes and antiretroviral initiation.</p> <p>Results</p> <p>405 children were included at a median age of 4.5 years; at baseline, 66.9% were receiving cotrimoxazole prophylaxis, and 27.7% met the 2006 WHO criteria for immunodeficiency by age. The risk of developing a severe morbid event was 14% (95%CI: 10.7 - 17.8) at 18 months; this risk was lower in children previously exposed to any prevention of mother-to-child-transmission (PMTCT) intervention (adjusted subdistribution hazard ratio [sHR]: 0.16, 95% CI: 0.04 - 0.71) versus those without known exposure. Cumulative mortality reached 5.5% (95%CI: 3.5 - 8.1) at 18 months. Mortality was associated with immunodeficiency (sHR: 6.02, 95% CI: 1.28-28.42).</p> <p>Conclusions</p> <p>Having benefited from early access to care minimizes the severe morbidity risk for children who acquire HIV. Despite the receipt of cotrimoxazole prophylaxis, the risk of severe morbidity and mortality remains high in untreated HIV-infected children. Such evidence adds arguments to promote earlier access to ART in HIV-infected children in Africa and improve care interventions in a context where treatment is still not available to all.</p

Emergence of Minor Drug-Resistant HIV-1 Variants after Triple Antiretroviral Prophylaxis for Prevention of Vertical HIV-1 Transmission

Background: WHO-guidelines for prevention of mother-to-child transmission of HIV-1 in resource-limited settings recommend complex maternal antiretroviral prophylaxis comprising antenatal zidovudine (AZT), nevirapine single-dose (NVP-SD) at labor onset and AZT/lamivudine (3TC) during labor and one week postpartum. Data on resistance development selected by this regimen is not available. We therefore analyzed the emergence of minor drug-resistant HIV-1 variants in Tanzanian women following complex prophylaxis. Method: 1395 pregnant women were tested for HIV-1 at Kyela District Hospital, Tanzania. 87/202 HIV-positive women started complex prophylaxis. Blood samples were collected before start of prophylaxis, at birth and 1–2, 4–6 and 12–16 weeks postpartum. Allele-specific real-time PCR assays specific for HIV-1 subtypes A, C and D were developed and applied on samples of mothers and their vertically infected infants to quantify key resistance mutations of AZT (K70R/T215Y/T215F), NVP (K103N/Y181C) and 3TC (M184V) at detection limits of,1%. Results: 50/87 HIV-infected women having started complex prophylaxis were eligible for the study. All women took AZT with a median duration of 53 days (IQR 39–64); all women ingested NVP-SD, 86 % took 3TC. HIV-1 resistance mutations were detected in 20/50 (40%) women, of which 70 % displayed minority species. Variants with AZT-resistance mutations were found in 11/50 (22%), NVP-resistant variants in 9/50 (18%) and 3TC-resistant variants in 4/50 women (8%). Three wome

Assessment of social psychological determinants of satisfaction with childbirth in a cross-national perspective

<p>Abstract</p> <p>Background</p> <p>The fulfilment of expectations, labour pain, personal control and self-efficacy determine the postpartum evaluation of birth. However, researchers have seldom considered the multiple determinants in one analysis. To explore to what extent the results can be generalised between countries, we analyse data of Belgian and Dutch women. Although Belgium and the Netherlands share the same language, geography and political system and have a common history, their health care systems diverge. The Belgian maternity care system corresponds to the ideal type of the medical model, whereas the Dutch system approaches the midwifery model. In this paper we examine multiple determinants, the fulfilment of expectations, labour pain, personal control and self-efficacy, for their association with satisfaction with childbirth in a cross-national perspective.</p> <p>Methods</p> <p>Two questionnaires were filled out by 605 women, one at 30 weeks of pregnancy and one within the first 2 weeks after childbirth either at home or in a hospital. Of these, 560 questionnaires were usable for analysis. Women were invited to participate in the study by independent midwives and obstetricians during antenatal visits in 2004–2005. Satisfaction with childbirth was measured by the Mackey Satisfaction with Childbirth Rating Scale, which takes into account the multidimensional nature of the concept. Labour pain was rated retrospectively using Visual Analogue Scales. Personal control was assessed with the Wijma Delivery Expectancy/Experience Questionnaire and Pearlin and Schooler's mastery scale. A hierarchical linear analysis was performed.</p> <p>Results</p> <p>Satisfaction with childbirth benefited most consistently from the fulfilment of expectations. In addition, the experience of personal control buffered the lowering impact of labour pain. Women with high self-efficacy showed more satisfaction with self-, midwife- and physician-related aspects of the birth experience.</p> <p>Conclusion</p> <p>Our findings focus the attention toward personal control, self-efficacy and expectations about childbirth. This study confirms the multidimensionality of childbirth satisfaction and demonstrates that different factors predict the various dimensions of satisfaction. The model applies to both Belgian and Dutch women. Cross-national comparative research should further assess the dependence of the determinants of childbirth satisfaction on the organisation of maternity care.</p

PLoS One

Introduction The long-term prognosis of HIV-2-infected patients receiving antiretroviral therapy (ART) is still challenging, due to the intrinsic resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI) and the suboptimal response to some protease inhibitors (PI). The objective was to describe the 5-years outcomes among HIV-2 patients harboring drug-resistant viruses. Methods A clinic-based cohort of HIV-2-patients experiencing virologic failure, with at least one drug resistance mutation was followed from January 2012 to August 2017 in Côte d’Ivoire. Follow-up data included death, lost to follow-up (LTFU), immuno-virological responses. The Kaplan-Meier curve was used to estimate survival rates. Results A total of 31 HIV-2 patients with virologic failure and with at least one drug resistance mutation were included. Two-third of them were men, 28(90.3%) were on PI-based ART-regimen at enrolment and the median age was 50 years (IQR = 46–54). The median baseline CD4 count and viral load were 456 cells/mm3 and 3.7 log10 c/mL respectively, and the participants have been followed-up in median 57 months (IQR = 24–60). During this period, 21 (67.7%) patients switched at least one antiretroviral drug, including two (6.5%) and three (9.7%) who switched to a PI-based and an integrase inhibitor-based regimen respectively. A total of 10(32.3%) patients died and 4(12.9%) were LTFU. The 36 and 60-months survival rates were 68.5% and 64.9%, respectively. Among the 17 patients remaining in care, six(35.3%) had an undetectable viral load (2. Conclusions The 36-months survival rate among ART-experienced HIV-2 patients with drug-resistant viruses is below 70%,lower than in HIV-1. There is urgent need to improve access to second-line ART for patients living with HIV-2 in West Afric

Monitor verloskundige zorgverlening: rapportage tweede meting, najaar 2002.

Ruim 34 procent van alle bevallingen in Nederland vindt thuis plaats; dit percentage is in vijftien jaar tijd vrijwel gelijk gebleven. Dit is in tegenstelling met de verwachting eind jaren negentig, dat de thuisbevalling zou verdwijnen. Het NIVEL vergeleek gegevens van twee grootschalige nationale studies naar ziekten en verrichtingen in de huisartspraktijk (NS1 en NS2). Uit hetzelfde onderzoek blijkt, dat ruim 10 % meer mensen gebruik maken van professionele kraamzorg dan 15 jaar geleden, maar dat zij wel minder uren zorg per dag ontvangen. De eerste nationale studie (NS1) is in 1987 gehouden onder 161 huisartsen in 103 huisartsenpraktijken en een steekproef (van13.014 mensen) uit hun ca. 330.000 patiënten. Het vervolgonderzoek uit 2001 (NS2) omvatte 195 huisartsen in 104 praktijken, en een steekproef van 12.699 patiënten uit hun ca. 400.000 patiënten. Voor onderzoek naar de begeleiding bij, de plaats van de bevalling en het gebruik van kraamzorg is gebruik gemaakt van patiënteninterviews. In beide studies gaat het om ongeveer 300 mensen die in het jaar voorafgaand aan het interview, vader of moeder zijn geworden. Slechts 5 procent van de mensen die de enquête hebben ingevuld geven aan dat de huisarts de bevalling begeleid heeft. Dit percentage is een halvering ten opzichte van 15 jaar geleden. Het aandeel klinische bevallingen is in de afgelopen jaren met 4 procent afgenomen. Het percentage poliklinische bevallingen is daarentegen met 5 procent toegenomen. Wat betreft de kraamzorg: de afgelopen vijftien jaar vond er een toename van meer dan 10 procent plaats in het aantal cliënten dat gebruik maakt van professionele kraamzorg in de dagen na de bevalling. Er is echter een afname in het aantal vrouwen dat acht uur zorg per dag ontvangt. Door veranderde leefomstandigheden is er aan langere zorg vaak minder behoefte.Tevens bepalen beleid van zorgverzekeraars, de beschikbare kraamzorg en de inzetbaarheid van personeel deze afname

12 W/mm power density AlGaN/GaN HEMTs on sapphire substrate

Record power performance at 4 GHz has been obtained using field-plated AlGaN/GaN HEMTs on sapphire substrate. High power density (12 W/mm) as well as high efficiency (58%) have been measured. A comparison between devices with and without field plate on the same sample showed a significant reduction in knee-voltage walk-out for the field-plated device, thus enabling high power and efficiency operation