Assessment at Antiretroviral Clinics during TB Treatment Reduces Loss to Follow-Up among HIV-Infected Patients

A South African township clinic where loss to follow-up during TB treatment may prevent HIV-infected TB patients from receiving life-saving ART.To determine factors associated with loss to follow-up during TB treatment.Regression analyses of a cohort of ART-eligible TB patients who commenced TB treatment and were followed for 24 weeks.Of 111 ART-eligible TB patients, 15 (14%) died in the ensuing 24 weeks. Of the remaining 96 TB patients, 11 (11%) were lost to follow-up. All TB patients lost to follow-up did not initiate ART. Of 85 TB patients in follow-up, 62 (73%) initiated ART 56 days after TB diagnosis (median, IQR 33-77 days) and 31 days after initial assessment at an ART clinic (median, IQR: 18-55 days). The median duration from TB diagnosis to initial assessment at an ART clinic was 19 days (IQR: 7-48 days). At 24 weeks, 6 of 85 (7%) TB patients who presented to an ART clinic for assessment were lost to follow-up, compared to 5 of 11 (45%) TB patients who did not present to an ART clinic for assessment. Logistic regression analysis (adjusted odds ratio = 0.1, 95% confidence interval [95% CI]: 0.03-0.66) and our Cox proportional hazards model (hazard ratio = 0.2, 95% CI: 0.04-0.68) confirmed that assessment at an ART clinic during TB treatment reduced loss to follow-up.Assessment at antiretroviral clinics for HIV care by trained health-care providers reduces loss to follow-up among HIV-infected patients with TB

Psychological contract inducements and expectations conveyed to potential employees on organisations’ websites

Abstract: The employer–employee relationship is becoming increasingly strained, evidenced by the increase in cases referred to the Commission for Conciliation, Mediation and Arbitration. These disputes are presumed to be a consequence of breach of the psychological contract of undelivered expectations or obligations. There seems to be a need to improve the management of employer–employee relationships. Research purpose: The purpose of this investigation was to identify inducements and obligations made known by organisations on their websites. Motivation for the study: Clarity of inducements and expectations may provide a foundation to proactively improve the employer–employee relationship..

A review of web-based support systems for students in higher education

Abstract Background Recent evidence suggests that there is an increasing need for accessible and anonymous services to support higher education (HE) students suffering from psychological and/or academic difficulties. Such difficulties can lead to several negative outcomes, including poor academic performance, sub-optimal mental health, reduced study satisfaction, and dropout from study. Currently, universities in the UK lack financial resources and the on-campus mental health services traditionally offered to students are increasingly economically unsustainable. Compounded by the perceived stigma of using such services, mental health providers have been driven to address the escalating needs of students through online services. Methods In this paper, we review online support systems identified through a literature search and a manual search of references in the identified papers. Further systems were identified through web searches, and systems still in development were identified by consultation with researchers in the field. We accessed systems online to extract relevant information, regarding the main difficulties addressed by the systems, the psychological techniques used and any relevant research evidence to support their effectiveness. Conclusion A large number of web-based support systems have been developed to support mental health and wellbeing, although few specifically target HE students. Further research is necessary to establish the effectiveness of such interventions in providing a cost-effective alternative to face-to-face therapy, particularly in certain settings such as HE institutions

Effects of a mechanical engineering design course on students’ motivational features

Diverse learning opportunities and deep engagement are needed to support development of engineering competencies and expertise. Deep engagement evolves from productive and high-quality motivation that derives from both internal and external sources. Motivation to learn is lacking in many fields, like engineering, because it is too often assumed or ignored, rather than explicitly built into course instruction. While the lack of motivation in engineering education is clear in data-like attrition, there is little relevant research that informs the necessary changes for the field. The purpose of this study is to present a systematic approach that explicitly considers motivational elements in engineering courses. First a comprehensive set of motivational characteristics and the interrelationships for productive motivation of mechanical engineering students are identified. Students’ motivational characteristics and profiles of change over time are assessed using a multipoint predictive correlational design. This information is then used to strategically redesign motivational elements of a senior-level mechanical engineering design course. The SUCCESS framework has been used to redesign motivational features of the existing course. This paper reports results of the study, including implications for redesign of other engineering courses. Analysis of the data demonstrates the complexity of motivation in the engineering classroom, which includes addressing implicit and explicit, intrinsic and extrinsic, individual and team interaction and instruction. These elements extend not only to direct communication and interactions of instructor with students but into the full scope of the learning environment, peer-to-peer interactions, grading, (a)synchronous activities, face to face, and virtual communications. Key features of engineering students’ productive (learning and engagement-related) motivational profiles consisted of clusters of perceptual and experiential variables that were strongly correlated with motivational and learning outcomes. Tracking these factors demonstrated that they changed over time. These changes corresponded to perceptions of instructor and peer interactions, which were amenable to instructional intervention and responsive to social modeling. This study also revealed links among engineering students’ perceptions of their field of study, their own development of self-efficacy, and success expectations in both the design course and for their careers. This work revealed important distinctions between engineering students’ self-efficacy for, and engagement in, the course generally and for group tasks more specifically. These newly revealed relationships offer the opportunity to improve engineering instruction and the design of dynamic learning environments that support adaptive skill development.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Effects of perceived cost, service quality, and customer satisfaction on health insurance service continuance

This paper aims to contribute to the universal discourse on financial services continuance behavior by examining the impact of service cost on customers\u27 service-quality perception and service continuance intention. It presents the results of an empirical study that has explored the impacts of service cost, service quality, and customer satisfaction on health insurance customers\u27 behavioral intention toward continuing or discontinuing with their service providers. Very few studies had examined the impact of service cost on service-quality perception. Our study attempts to fill that gap. A sample of 820 customers was surveyed, and 624 usable responses were analyzed with ANOVA, standard multiple regression, and logistic regression. Our findings indicate that, although highly satisfied health insurance customers will most likely retain their current service providers, customer dissatisfaction does not necessarily lead to discontinuance. Our results also provide some operational implications for health insurance managers, with strategies for reducing attrition and improving customer retention

Room at the top? A study of women chief executives in local government in England and Wales

SIGLEAvailable from British Library Document Supply Centre-DSC:m01/23880 / BLDSC - British Library Document Supply CentreGBUnited Kingdo