103 research outputs found
Human Resource Audit and Employee Turnover: A Case Study of Uganda Colleges of Commerce
The study examined the role of human resource audit on employee turnover at tertiary institutions in Uganda. Both purposive and simple random sampling procedure was used and a sample of 97participants was selected for the study and data was analyzed using SPSS statistical package. The study found out that Human resource audit is not the only function responsible for the level of turnover in Uganda Colleges of Commerce. The study found out that Employees who perceive to carry skills that are highly demanded are lured away by higher pays. The study recommended that the human resource department of Ministry of Education and sport should review their human resource policy to address the loopholes in staff compensation, recruitment and salary and Supervisors at the institutions should ensure sound supervisory practices, which promote decision-making, recognition of employees’ efforts and unique skills and accomplishments. Keywords: Human Resource Audit, Turn Ove
Credit Financing and Performance of SMEs in Lira Municipality, Uganda
This study sought to examine the role of Credit financing on performance of SMEs in Lira Municipality. A sample of 120 respondents was considered with response rate of 100%. The findings indicated that extending credit to SMEs enables them to access essential resources, increase business diversification and increase productivity levels. The study recommends that Credit institutions should continue providing credit at affordable rates while endeavoring to train their clients on how to keep financial information, which is essential in assessing the borrower’s credit worthiness. SMEs should practice documenting their transactions, including information on personal characteristics, which are essential in assessing the credit worthiness of potential borrowers. Keywords: Credit Financing, Interest rates, Creditor information, Collateral security, Firm Performanc
Analyzing Entrance Exam Item Types with Rasch
大学入試は日本人英語学習者にとって最も大切な節目の一つである。しかし,入試問題の分析はめったに行われていなく,その分析の発表の数は更に少ないと言えるだろう。本研究で,我々はアクション・リサーチの視点に基づき改正されたテスト開発サイクルを提案する。そしてこのサイクルの応用を単一の試験(2003年2月B神奈川大学英語試験)のラッシュ分析を通し説明する。試験全体の信頼性の説明の後,どのような種類の設問が有効でないかを見分ける為特定の項目を分析する。本研究ではラッシュがいかに問題のある項目を算出するか示し,項目能力に影響を及ぼす要素は何であるかを検討し,そして将来の試験作成者への提案を提供する。我々はこの分析を用いる事によって今後の試験の開発の為により良い選択が出来る事を示す
Research Report: A Preliminary Analysis of Medical Futility Decisionmaking: Law and Professional Attitudes
The debate in medical futility decisionmaking centers on the conflict between a patient insisting treatment and a doctor refusing to furnish it. Courts have taken two disparate approaches to the legal status of medical futility. Believing that such legal ambiguity may reflect ambiguity in the medical profession itself, this research report sought to identify any emerging consensus among professionals handling medical futility issues.
The report explains the results of the Life Sustaining Treatment Survey, a nationwide survey of health care professionals at hospitals. Presented with a list of criteria, respondents assigned important ratings to the factors used in recent futility decisions at their institutions.
The resulting data suggests that there is no consensus among professionals in medical futility decisionmaking. The data supports at least three distinct approaches for making futility decisions: emphasis on the patients’ preferences; providing for the patient and family; and adhering to objective medical and social norms.
It is unlikely that the law will realize its full potential to regulate futility judgments until explicitly articulated professional standards emerge. This article advocates continued empirical research to document and test professional judgment principles. Such research may ultimately help identify factors that will form the basis for a consensus in medical futility decisionmaking
Results of endoluminal grafting in an experimental aortic aneurysm model
AbstractWe studied the impact of an endoluminally placed stented aortic graft on the geometry of a surgically created abdominal aortic dilation (AAD) in nonatherosclerotic mongrel dogs. Patulous iliac vein patch infrarenal aortoplasty produced a fusiform AAD, doubling the aorta diameter. Lumbar and mesenteric aortic tributaries were preserved and no mural thrombus formed. AADs created in 23 dogs were endoluminally excluded through transfemoral placement of a thin-wall Dacron graft 4 ± 2 months later. Balloon-expandable stents were used to anchor each end of the graft to the aorta. The graft was crimped radially in its body and longitudinally at its ends to provide longitudinal and radial expandability in these respective zones. Serial color duplex, angiography, and direct caliper measurements were made. Before graft placement, a 19% ± 11% diameter growth was observed. At graft placement, flow arrest immediately occurred in the space between the graft and the AAD intima in all cases. Although microscopic recanalization of the thrombus in this space was seen at sacrifice 6 and 12 months later, no macroscopic duplex flow was imaged. A 10% ± 11% reduction in AAD diameter was measured at 6 months (p < 0.001), with no further reduction at 12 months. Graft dimensions remained stable. No anastomotic leaks developed. AAD growth stopped during the first year after effective endoluminal exclusion in normotensive dogs despite patent side branches (<1.5 mm internal diameter) and no mural thrombus at the time of graft placement. Whether microscopic recanalization of the thrombus that forms outside the graft has an impact after 1 year remains to be seen. (J Vasc Surg 1996;23:819-31.
Development and description of measurement properties of an instrument to assess treatment burden among patients with multiple chronic conditions
Abstract Background: Patients experience an increasing treatment burden related to everything they do to take care of their health: visits to the doctor, medical tests, treatment management and lifestyle changes. This treatment burden could affect treatment adherence, quality of life and outcomes. We aimed to develop and validate an instrument for measuring treatment burden for patients with multiple chronic conditions. Methods: Items were derived from a literature review and qualitative semistructured interviews with patients. The instrument was then validated in a sample of patients with chronic conditions recruited in hospitals and general practitioner clinics in France. Factor analysis was used to examine the questionnaire structure. Construct validity was studied by the relationships between the instrument's global score, the Treatment Satisfaction Questionnaire for Medication (TSQM) scores and the complexity of treatment as assessed by patients and physicians. Agreement between patients and physicians was appraised. Reliability was determined by a test-retest method. Results: A sample of 502 patients completed the Treatment Burden Questionnaire (TBQ), which consisted of 7 items (2 of which had 4 subitems) defined after 22 interviews with patients. The questionnaire showed a unidimensional structure. The Cronbach's α was 0.89. The instrument's global score was negatively correlated with TSQM scores (r s = -0.41 to -0.53) and positively correlated with the complexity of treatment (r s = 0.16 to 0.40). Agreement between patients and physicians (n = 396) was weak (intraclass correlation coefficient 0.38 (95% confidence interval 0.29 to 0.47)). Reliability of the retest (n = 211 patients) was 0.76 (0.67 to 0.83). Conclusions: This study provides the first valid and reliable instrument assessing the treatment burden for patients across any disease or treatment context. This instrument could help in the development of treatment strategies that are both efficient and acceptable for patients
Recommended from our members
Evaluating Leaf and Canopy Reflectance of Stressed Rice Plants to Monitor Arsenic Contamination
Arsenic contamination is a serious problem in rice cultivated soils of many developing countries. Hence, it is critical to monitor and control arsenic uptake in rice plants to avoid adverse effects on human health. This study evaluated the feasibility of using reflectance spectroscopy to monitor arsenic in rice plants. Four arsenic levels were induced in hydroponically grown rice plants with application of 0, 5, 10 and 20 µmol·L⁻¹ sodium arsenate. Reflectance spectra of upper fully expanded leaves were acquired over visible and infrared (NIR) wavelengths. Additionally, canopy reflectance for the four arsenic levels was simulated using SAIL (Scattering by Arbitrarily Inclined Leaves) model for various soil moisture conditions and leaf area indices (LAI). Further, sensitivity of various vegetative indices (VIs) to arsenic levels was assessed. Results suggest that plants accumulate high arsenic amounts causing plant stress and changes in reflectance characteristics. All leaf spectra based VIs related strongly with arsenic with coefficient of determination (r²) greater than 0.6 while at canopy scale, background reflectance and LAI confounded with spectral signals of arsenic affecting the VIs’ performance. Among studied VIs, combined index, transformed chlorophyll absorption reflectance index (TCARI)/optimized soil adjusted vegetation index (OSAVI) exhibited higher sensitivity to arsenic levels and better resistance to soil backgrounds and LAI followed by red edge based VIs (modified chlorophyll absorption reflectance index (MCARI) and TCARI) suggesting that these VIs could prove to be valuable aids for monitoring arsenic in rice fields.Keywords: leaf chlorophyll, red edge, LAI, vegetative indices, rice, soil reflectance, SAIL model, arsenic uptake, plant stress, spectral reflectanc
Rethinking the patient: using Burden of Treatment Theory to understand the changing dynamics of illness
<b>Background</b> In this article we outline Burden of Treatment Theory, a new model of the relationship between sick people, their social networks, and healthcare services. Health services face the challenge of growing populations with long-term and life-limiting conditions, they have responded to this by delegating to sick people and their networks routine work aimed at managing symptoms, and at retarding - and sometimes preventing - disease progression. This is the new proactive work of patient-hood for which patients are increasingly accountable: founded on ideas about self-care, self-empowerment, and self-actualization, and on new technologies and treatment modalities which can be shifted from the clinic into the community. These place new demands on sick people, which they may experience as burdens of treatment.<p></p>
<b>Discussion</b> As the burdens accumulate some patients are overwhelmed, and the consequences are likely to be poor healthcare outcomes for individual patients, increasing strain on caregivers, and rising demand and costs of healthcare services. In the face of these challenges we need to better understand the resources that patients draw upon as they respond to the demands of both burdens of illness and burdens of treatment, and the ways that resources interact with healthcare utilization.<p></p>
<b>Summary</b> Burden of Treatment Theory is oriented to understanding how capacity for action interacts with the work that stems from healthcare. Burden of Treatment Theory is a structural model that focuses on the work that patients and their networks do. It thus helps us understand variations in healthcare utilization and adherence in different healthcare settings and clinical contexts
Protocol for the development and validation of a patient reported measure (PRM) of treatment burden in stroke
Background:
Treatment burden is the workload of healthcare for people with long-term conditions and the impact on wellbeing. A validated measure of treatment burden after stroke is needed. We aim to adapt a patient-reported measure (PRM) of treatment burden in multimorbidity, PETS (Patient Experience with Treatment and Self-Management version 2.0), to create a stroke-specific measure, PETS-stroke. We aim to examine content validity, construct validity, reliability and feasibility in a stroke survivor population.
Methods:
1) Adaptation of 60-item PETS to PETS-stroke using a taxonomy of treatment burden. 2) Content validity testing through cognitive interviews that will explore the importance, relevance and clarity of each item. 3) Evaluation of scale psychometric properties through analysis of data from stroke survivors recruited via postal survey (n=340). Factor structure will be tested with confirmatory factor analysis and Cronbach’s alpha will be used to index internal consistency. Construct validity will be tested against: The Stroke Southampton Self-Management Questionnaire; The Satisfaction with Stroke Care Measure; and The Shortened Stroke Impact Scale. We will explore known-groups validity by exploring the association between treatment burden, socioeconomic deprivation and multimorbidity. Test-retest reliability will be examined via re-administration after 2 weeks. Acceptability and feasibility of use will be explored via missing data rates and telephone interviews with 30 participants.
Conclusions:
We aim to create a validated PRM of treatment burden after stroke. PETS-stroke is designed for use as an outcome measure in clinical trials of stroke treatments and complex interventions to ascertain if treatments are workable for patients in the context of their everyday lives
- …