Exploring IT benefits evaluation effectiveness at ex-ante project justification stage

The business benefits of IT projects are becoming the main determining factor in selecting projects at the ex-ante justification stage. The core stakeholders, i.e. the business management and IT professionals are charged with the task of evaluating the benefits of IT investment. Despite high adoption rates of formal IT investment appraisal methods, there is still on-going evidence that show organisations not being able to appropriately evaluate IT benefits. This study investigates the process of IT project evaluation at the ex-ante justification stage to understand factors that contribute to ineffective practical application of evaluation and based on the findings, to explore how these factors can be redeemed to improve the benefit evaluation process. A case study research was conducted to explore how benefits can be evaluated appropriately within its context in a tertiary educational institution. The case study research approach enabled the researcher to gain a complete and in-depth understanding of the process and activities involved to identify and measure benefits at the justification stage. Business middle managers that are involved and responsible for IT project justification were approached from various business units as case study participants. Interview questions addressed various aspects of the benefits evaluation process in reference to participants’ experience and past IT project justifications. Content analysis was used to identify frequencies and intensities with which themes and concepts appear in interviewee responses. In addition, a cause and effect relationship tool was used to summarize the research findings for better data analysis and interpretation. The findings indicate factors that contributed to ineffective benefit evaluation in the organization. Close collaboration and partnership between business management and IT professionals is shown to be a crucial component of the justification process. The suggested role of IT management exceeds beyond the task of technical advisor and involves the task of being a coach, informer, educator, assessor, transparency and communication agent. The results also show how best the measurement process can be performed at this stage. This study confirms that business management’s clear understanding of IT benefit concepts is necessary in the evaluation process. Based on the findings, an IT benefit evaluation method is developed as a modification of the current justification process in the organisation. The results presented in this study lay plausible insights for additional approaches to IT benefit evaluation research. It compels researchers to consider new methodologies in the quest for improving benefit evaluation.Dissertation (MIT)--University of Pretoria, 2011.Informaticsunrestricte

PREVALENCE OF ANEMIA AMONG ELEMENTARY AND HIGH SCHOOL STUDENTS LIVING IN GORGORA

INTRODUCTIONAnemia may be defined as a state in which the level of hemoglobin in the blood is below that which is expected, taking into account both age and sex (1). Patients with anemia have significant reduction of red cell mass and a corresponding decrease in the oxygen carrying capacity of the blood. Normally blood volume is maintained at a nearly constant level, therefore anemia entails a decrease in the concentration of red cells or hemoglobin in peripheral blood. The presence of symptoms related to anemia depend partly on this severity but also on how rapidly the anemia has appeared. The purposes of this investigation were to determine the point prevalence rate of anemia among elementary and high school students and to identify important determinants of its occurrence among students residing in Gorgora (south Gonder). This study is not aimed at identifying anemia of specific causes, but will use technol-ogies appropriate to the field situation and search among risk factors known to be prevalent in the region

The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. Methods We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. Findings In 2017, cirrhosis caused more than 1.32 million (95% UI 1.27-1.45) deaths (440000 [416 000-518 000; 33.3%] in females and 883 000 [838 000-967 000; 66.7%] in males) globally, compared with less than 899 000 (829 000-948 000) deaths in 1990. Deaths due to cirrhosis constituted 2.4% (2.3-2.6) of total deaths globally in 2017 compared with 1.9% (1.8-2.0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21.0 (19.2-22.3) per 100 000 population in 1990 to 16.5 (15.8-18-1) per 100 000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32.2 [25.8-38.6] deaths per 100 000 population in 2017), and the high-income super-region had the lowest (10.1 [9.8-10-5] deaths per 100 000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3.7 [3.3-4.0] per 100 000 in 2017) and highest in Egypt in all years since 1990 (103.3 [64.4-133.4] per 100 000 in 2017). There were 10.6 million (10.3-10.9) prevalent cases of decompensated cirrhosis and 112 million (107-119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33.2% for compensated cirrhosis and 54.8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases snore than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI. Interpretation Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Cost-effective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.Peer reviewe

Virological and immunological failure of HAART and associated risk factors among adults and adolescents in the Tigray region of Northern Ethiopia

<div><p>Background</p><p>Human immunodeficiency virus/Acquired immunodeficiency syndrome associated morbidity and mortality has reduced significantly since the introduction of highly active antiretroviral therapy. As a result of increasing access to highly active antiretroviral therapy, the survival and quality of life of the patients has significantly improved globally. Despite this promising result, regular monitoring of people on antiretroviral therapy is recommended to ensure whether there is an effective treatment response or not. This study was designed to assess virological and immunological failure of highly active antiretroviral therapy users among adults and adolescents in the Tigray region of Northern Ethiopia, where scanty data are available.</p><p>Methods</p><p>A retrospective follow up study was conducted from September 1 to December 30, 2016 to assess the magnitude and factors associated with virological and immunological failure among 260 adults and adolescents highly active antiretroviral therapy users who started first line ART between January 1, 2008 to March 1, 2016. A standardized questionnaire was used to collect socio-demographic and clinical data. SPSS Version21 statistical software was used for analysis. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated to virological and immunological failure. Statistical association was declared significant if p-value was ≤ 0.05.</p><p>Result</p><p>A total of 30 (11.5%) and 17 (6.5%) participants experienced virological and immunological failure respectively in a median time of 36 months of highly active antiretroviral therapy. Virological failure was associated with non-adherence to medications, aged < 40 years old, having CD4⁺ T-cells count < 250 cells/μL and male gender. Similarly, immunological failure was associated with non-adherence, tuberculosis co-infection and Human immunodeficiency virus RNA ≥1000 copies/mL.</p><p>Conclusions</p><p>The current result shows that immunological and virological failure is a problem in a setting where highly active antiretroviral therapy has been largely scale up. The problem is more in patients with poor adherence. This will in turn affect the global targets of 90% viral suppression by 2020. This may indicate the need for more investment and commitment to improving patient adherence in the study area.</p></div

Baseline and follow up characteristics on first line ART from January 1, 2008 to March 1, 2016 at Mekelle hospital and Ayder Comprehensive Specialized Hospital (n = 260).

<p>Baseline and follow up characteristics on first line ART from January 1, 2008 to March 1, 2016 at Mekelle hospital and Ayder Comprehensive Specialized Hospital (n = 260).</p

Socio demographic characteristics of HIV infected individuals on ART from January 1, 2008 to March 1,2016 at Mekelle hospital and Ayder Comprehensive Specialized Hospital (n = 260).

<p>Socio demographic characteristics of HIV infected individuals on ART from January 1, 2008 to March 1,2016 at Mekelle hospital and Ayder Comprehensive Specialized Hospital (n = 260).</p

Virological failure and associated risk factors among HIV infected individuals on ART from January 2008 to March 2016 at Mekelle hospital and Ayder Comprehensive Specialized Hospital (n = 30).

<p>Virological failure and associated risk factors among HIV infected individuals on ART from January 2008 to March 2016 at Mekelle hospital and Ayder Comprehensive Specialized Hospital (n = 30).</p

Immunological failure and associated risk factors among HIV infected individuals on ART from January 2008 to March 2016 at Mekelle hospital and Ayder Comprehensive Specialized Hospital(n = 17).

<p>Immunological failure and associated risk factors among HIV infected individuals on ART from January 2008 to March 2016 at Mekelle hospital and Ayder Comprehensive Specialized Hospital(n = 17).</p

Work flow of the study.

<p>Work flow of the study.</p

Trends of median CD4⁺ count at different periods of time of study participants on first line ART at Mekelle hospital and Ayder Comprehensive Specialized Hospital.

<p>Trends of median CD4⁺ count at different periods of time of study participants on first line ART at Mekelle hospital and Ayder Comprehensive Specialized Hospital.</p