The association between Institutional Absorptive Capacity, Electronic procurement Assimilation and Procurement Process in Public Sector Organizations

Public sector organizations face challenges with their procurement processes. Electronic mode of public procurement enables governments and organizations to achieve efficient and effective tendering information processing, leading to transparency and fairness in the bidding process. However, little is known on the drivers of electronic procurement assimilation in the public sector. The study examines the influence of absorptive capacity on the assimilation of electronic procurement and the subsequent effect on the procurement process in the public sector. In addition, the study explores the mediating role of electronic procurement assimilation on the relationship between institutional absorptive capacity and the procurement process. Structural equation modeling was used to analyze 306 useable data from public sector organizations in Ghana where public procurement laws demand efficient and effective procurement processes. We found support for all the four hypotheses. We offer theoretical and managerial implications

Elections, Political Connections and Cash Holdings: Evidence from Local Assemblies

We examine the relationship between elections, political connections, and cash holdings in Ghanaian local assemblies. Using a panel dataset of 179local assemblies over a period 2012 to 2017, a panel regression and the generalized method of moments estimation techniques was employed for the analysis. We find that local assemblies hold less cash during election years, which suggests that election may be one of the potential factors to mitigate agency conflict in weak governance environment. Further, we demonstrate that local assemblies that have political connections hold less cash; however, political uncertainty makes these entities conducive to agency problems than their non-connected peers because they hold more cash. Additional analysis indicates that one year prior to elections, managerial conservatism kicks-in and leads managers to hold more cash in local assemblies that have political connections, which continues and becomes more pronounced in election years. Our results have implications for regulations on the cash management practices of local assemblies

Electromagnetic navigation transthoracic needle aspiration for the diagnosis of pulmonary nodules: A safety and feasibility pilot study

BACKGROUND: Pulmonary nodules remain a diagnostic challenge for physicians. Minimally invasive biopsy methods include bronchoscopy and CT guided transthoracic needle aspiration (TTNA). A novel electromagnetic guidance transthoracic needle aspiration (ETTNA) procedure which can be combined with navigational bronchoscopy (NB) and endobronchial ultrasound (EBUS) in a single setting has become available. METHODS: A prospective pilot study examining the safety, feasibility and diagnostic yield of ETTNA in a single procedural setting. All patients enrolled underwent EBUS for lung cancer staging followed by NB and ETTNA. Feasibility of performing ETTNA and a safety assessment by recording procedural related complications including pneumothorax or bleeding was performed. Diagnostic yield of ETTNA defined by a definitive pathologic tissue diagnosis was recorded. An additional diagnostic yield analysis was performed using a cohort analysis of combined interventions (EBUS + NB + ETTNA). All non-diagnostic biopsies were either followed with radiographic imaging or a surgical biopsy was performed. RESULTS: Twenty-four subjects were enrolled. ETTNA was feasible in 96% of cases. No bleeding events occurred. There were five pneumothoraces (21%) of which only two (8%) subjects required drainage. The diagnostic yield for ETTNA alone was 83% and increased to 87% (P=0.0016) when ETTNA was combined with NB. When ETTNA and NB were performed with EBUS for complete staging, the diagnostic yield increased further to 92% (P=0.0001). CONCLUSIONS: This is the first human pilot study demonstrating an acceptable safety and feasibility profile with a novel ETTNA system. Further studies are needed to investigate the increased diagnostic yield from this pilot study

Examples of Risk Tools for Pests in Peanut (Arachis hypogaea) Developed for Five Countries Using Microsoft Excel

Suppressing pest populations below economically-damaging levels is an important element of sustainable peanut (Arachis hypogaea L.) production. Peanut farmers and their advisors often approach pest management with similar goals regardless of where they are located. Anticipating pest outbreaks using field history and monitoring pest populations are fundamental to protecting yield and financial investment. Microsoft Excel was used to develop individual risk indices for pests, a composite assessment of risk, and costs of risk mitigation practices for peanut in Argentina, Ghana, India, Malawi, and North Carolina (NC) in the United States (US). Depending on pests and resources available to manage pests, risk tools vary considerably, especially in the context of other crops that are grown in sequence with peanut, cultivars, and chemical inputs. In Argentina, India, and the US where more tools (e.g., mechanization and pesticides) are available, risk indices for a wide array of economically important pests were developed with the assumption that reducing risk to those pests likely will impact peanut yield in a positive manner. In Ghana and Malawi where fewer management tools are available, risks to yield and aflatoxin contamination are presented without risk indices for individual pests. The Microsoft Excel platform can be updated as new and additional information on effectiveness of management practices becomes apparent. Tools can be developed using this platform that are appropriate for their geography, environment, cropping systems, and pest complexes and management inputs that are available. In this article we present examples for the risk tool for each country.Instituto de Patología VegetalFil: Jordan, David L. North Carolina State University. Department of Crop and Soil Sciences; Estados UnidosFil: Buol, Greg S. North Carolina State University. Department of Crop and Soil Sciences; Estados UnidosFil: Brandenburg, Rick L. North Carolina State University. Department of Entomology and Plant Pathology; Estados UnidosFil: Reisig, Dominic. North Carolina State University. Department of Entomology and Plant Pathology; Estados UnidosFil: Nboyine, Jerry. Council for Scientific and Industrial Research. Savanna Agricultural Research Institute; GhanaFil: Abudulai, Mumuni. Council for Scientific and Industrial Research. Savanna Agricultural Research Institute; GhanaFil: Oteng-Frimpong, Richard.Council for Scientific and Industrial Research. Savanna Agricultural Research Institute; GhanaFil: Brandford Mochiah, Moses.Council for Scientific and Industrial Research. Crops Research Institute; GhanaFil: Asibuo, James Y. Council for Scientific and Industrial Research. Crops Research Institute; GhanaFil: Arthur, Stephen. Council for Scientific and Industrial Research. Crops Research Institute; GhanaFil: Paredes, Juan Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Fitopatología y Modelización Agrícola (UFyMA); ArgentinaFil: Paredes, Juan Andrés. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Patología Vegetal; ArgentinaFil: Monguillot, Joaquín Humberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Unidad de Fitopatología y Modelización Agrícola (UFyMA); ArgentinaFil: Monguillot, Joaquín Humberto. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Patología Vegetal; ArgentinaFil: Rhoads, James. University of Georgia. Feed the Future Innovation Lab for Peanut; Estados Unido

Coagulation factors and natural anticoagulants as surrogate markers of preeclampsia and its subtypes: A case-control study in a Ghanaian population

Preeclampsia (PE) is associated with endothelial injury and hemostatic abnormalities. However, the diagnostic role of coagulation parameters and natural anticoagulants in predicting PE has not been explored in Ghana. This study assessed plasma levels of these factors as surrogate markers of PE and its subtypes. This case-control study included 90 women with PE (cases) and 90 normotensive pregnant women (controls). Blood samples were drawn for the estimation of complete blood count and coagulation tests. The prothrombin time (PT), activated partial thromboplastin time (APTT), and the calculation of the international normalized ratio (INR) were determined by an ACL elite coagulometer while the levels of protein C (PC), protein S (PS), antithrombin III (ATIII), and D-dimers were also measured using the solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) method. All statistical analyses were performed using the R Language for Statistical Computing. Results showed significantly (p \u3c .05) shortened APTT (28.25 s) and higher D-dimer levels (1219.00 ng/mL) among PE women, as well as low levels of PC (1.02 g/mL), PS (6.58 g/mL), and ATIII (3.99 ng/mL). No significant difference was found in terms of PT and INR. From the receiver operating characteristic analysis, PC, PS, and ATIII could significantly predict PE and its subtypes at certain cutoffs with high accuracies (area under the curve [AUC] ≥ 0.70). Most women with PE are in a hypercoagulable state with lower natural anticoagulants. PC, PS, and ATIII are good predictive and diagnostic markers of PE and its subtypes (early-onset PE [EO-PE] and late-onset PE [LO-PE]) and should be explored in future studies

Examples of risk tools for pests in Peanut (Arachis hypogaea) developed for five countries using Microsoft Excel

Suppressing pest populations below economically-damaging levels is an important element of sustainable peanut (Arachis hypogaea L.) production. Peanut farmers and their advisors often approach pest management with similar goals regardless of where they are located. Anticipating pest outbreaks using field history and monitoring pest populations are fundamental to protecting yield and financial investment. Microsoft Excel was used to develop individual risk indices for pests, a composite assessment of risk, and costs of risk mitigation practices for peanut in Argentina, Ghana, India, Malawi, and North Carolina (NC) in the United States (US). Depending on pests and resources available to manage pests, risk tools vary considerably, especially in the context of other crops that are grown in sequence with peanut, cultivars, and chemical inputs. In Argentina, India, and the US where more tools (e.g., mechanization and pesticides) are available, risk indices for a wide array of economically important pests were developed with the assumption that reducing risk to those pests likely will impact peanut yield in a positive manner. In Ghana and Malawi where fewer management tools are available, risks to yield and aflatoxin contamination are presented without risk indices for individual pests. The Microsoft Excel platform can be updated as new and additional information on effectiveness of management practices becomes apparent. Tools can be developed using this platform that are appropriate for their geography, environment, cropping systems, and pest complexes and management inputs that are available. In this article we present examples for the risk tool for each country.Fil: Jordan, David L.. University of Georgia; Estados Unidos. North Carolina State University; Estados UnidosFil: Buol, Greg S.. North Carolina State University; Estados UnidosFil: Brandenburg, Rick L.. North Carolina State University; Estados UnidosFil: Reisig, Dominic. North Carolina State University; Estados UnidosFil: Nboyine, Jerry. Council for Scientific and Industrial Research Savanna Agricultural Research Institute; GhanaFil: Abudulai, Mumuni. Council for Scientific and Industrial Research Savanna Agricultural Research Institute; GhanaFil: Oteng Frimpong, Richard. Council for Scientific and Industrial Research Savanna Agricultural Research Institute; GhanaFil: Mochiah, Moses Brandford. Council for Scientific and Industrial Research Crops Research Institute; GhanaFil: Asibuo, James Y.. Council for Scientific and Industrial Research Crops Research Institute; GhanaFil: Arthur, Stephen. Council for Scientific and Industrial Research Crops Research Institute; GhanaFil: Akromah, Richard. Kwame Nkrumah University Of Science And Technology; GhanaFil: Mhango, Wezi. Lilongwe University Of Agriculture And Natural Resources; MalauiFil: Chintu, Justus. Chitedze Agricultural Research Service, Lilongwe; MalauiFil: Morichetti, Sergio. Aceitera General Deheza; ArgentinaFil: Paredes, Juan Andres. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Instituto de Patología Vegetal; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Unidad de Fitopatología y Modelización Agrícola - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Unidad de Fitopatología y Modelización Agrícola; ArgentinaFil: Monguillot, Joaquín Humberto. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Instituto de Patología Vegetal; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Singh Jadon, Kuldeep. Central Arid Zone Research Institute, Jodhpur; IndiaFil: Shew, Barbara B.. North Carolina State University; Estados UnidosFil: Jasrotia, Poonam. Indian Institute Of Wheat And Barley Research, Karnal; IndiaFil: Thirumalaisamy, P. P.. India Council of Agricultural Research, National Bureau of Plant Genetic Resources; IndiaFil: Harish, G.. Directorate Of Groundnut Research, Junagadh; IndiaFil: Holajjer, Prasanna. National Bureau Of Plant Genetic Resources, New Delhi; IndiaFil: Maheshala, Nataraja. Directorate Of Groundnut Research, Junagadh; IndiaFil: MacDonald, Greg. University of Florida; Estados UnidosFil: Hoisington, David. University of Georgia; Estados UnidosFil: Rhoads, James. University of Georgia; Estados Unido

On-site bundled rapid HIV/HCV testing in substance use disorder treatment programs: study protocol for a hybrid design randomized controlled trial

Background More than 1.2 million people in the United States are living with human immunodeficiency virus (HIV), and 3.2 million are living with hepatitis C virus (HCV). An estimated 25 % of persons living with HIV also have HCV. It is therefore of great public health importance to ensure the prompt diagnosis of both HIV and HCV in populations that have the highest prevalence of both infections, including individuals with substance use disorders (SUD). Methods/design In this theory-driven, efficacy-effectiveness-implementation hybrid study, we will develop and test an on-site bundled rapid HIV/HCV testing intervention for SUD treatment programs. Its aim is to increase the receipt of HIV and HCV test results among SUD treatment patients. Using a rigorous process involving patients, providers, and program managers, we will incorporate rapid HCV testing into evidence-based HIV testing and linkage to care interventions. We will then test, in a randomized controlled trial, the extent to which this bundled rapid HIV/HCV testing approach increases receipt of HIV and HCV test results. Lastly, we will conduct formative research to understand the barriers to, and facilitators of, the adoption, implementation, and sustainability of the bundled rapid testing strategy in SUD treatment programs. Discussion Novel approaches that effectively integrate on-site rapid HIV and rapid HCV testing are needed to address both the HIV and HCV epidemics. If feasible and efficacious, bundled rapid HIV/HCV testing may offer a scalable, potentially cost-effective approach to testing high-risk populations, such as patients of SUD treatment programs. It may ultimately lead to improved linkage to care and progress through the HIV and HCV care and treatment cascades. Trial registration ClinicalTrials.gov: NCT02355080. (30 January 2015

Mental health and quality of life burden in Buruli ulcer disease patients in Ghana

Background Buruli ulcer disease (BUD) is a necrotic skin neglected tropical disease (NTD) that has both a mental and physical health impact on affected individuals. Although there is increasing evidence suggesting a strong association between neglected tropical diseases (NTDs) and mental illness, there is a relative lack of information on BUD’s impact on the mental health and quality of life (QoL) of affected individuals in Ghana. This study is to assess the impact of BUD on mental health and quality of life of patients with active and past BUD infection, and their caregivers. Methods We conducted a case control study in 3 BUD endemic districts in Ghana between August and November 2019. Face-to-face structured questionnaire-based interviews were conducted on BUD patients with active and past infection, as well as caregivers of BUD patients using WHO Quality of Life scale, WHO Disability Assessment Schedule, Self-Reporting Questionnaire, Buruli Ulcer Functional Limitation Score and Hospital Anxiety and Depression Scale data tools. Descriptive statistics were used to summarize the characteristics of the study participants. Participant groups were compared using student t test and chi-square (χ2) or Fisher’s exact tests. Mean quality of life scores are reported with their respective 95% confidence intervals. Data was analysed using STATA statistical software. Results Our results show that BUD patients with active and past infection, along with their caregivers, face significant levels of distress and mental health sequelae compared to controls. Depression (P = 0.003) was more common in participants with active (27%) and past BU infection (17%), compared to controls (0%). Anxiety was found in 42% (11/26) and 20% (6/29) of participants with active and past BUD infection compared to 14% (5/36) of controls. Quality of life was also significantly diminished in active BUD infection, compared to controls. In the physical health domain, mean QoL scores were 54 ± 11.1 and 56 ± 11.0 (95% CI: 49.5‒58.5 and 52.2‒59.7) respectively for participants with active infection and controls. Similarly in the psychological domain, scores were lower for active infection than controls [57.1 ± 15.2 (95% CI: 50.9‒63.2) vs 64.7 ± 11.6 (95% CI: 60.8‒68.6)]. Participants with past infection had high QoL scores in both physical [61.3 ± 13.5 (95% CI: 56.1‒66.5)] and psychological health domains [68.4 ± 14.6 (95% CI: 62.7‒74.0)]. Conclusions BUD is associated with significant mental health distress and reduced quality of life in affected persons and their caregivers in Ghana. There is a need for integration of psychosocial interventions in the management of the disease

Caregiver burden in Buruli ulcer disease: Evidence from Ghana

Background Buruli ulcer disease (BUD) results in disabilities and deformities in the absence of early medical intervention. The extensive role of caregiving in BUD is widely acknowledged, however, associated caregiver burden is poorly understood. In this paper we assessed the burden which caregivers experience when supporting patients with BUD in Ghana. Method/ principal findings This qualitative study was conducted in 3 districts in Ghana between August and October 2019. 13 semi-structured interviews were conducted on caregivers of BUD patients in the local language of Twi. Data was translated into English, coded into broad themes, and direct content analysis approach was used to analyse results. The results show the caregivers face financial, psychological and health issues as a consequence of their caregiving role. Conclusion/ significance This study found significant caregiver burden on family members. It also highlighted the psychological burden caregivers experience and the limited knowledge of the disease within endemic communities. Further research is needed to quantify the caregiver burden of BUD at different economic levels in order to better understand the impact of possible caregiver interventions on patient outcomes. Author summary Buruli ulcer disease (BUD) is a stigmatizing skin condition caused by the bacteria, Mycobacterium ulcerans. The disease results in permanent functional limitations in the absence of early medical intervention. The disabling BUD conditions, financial constraints and frequent hospital visits support the role of caregiving for affected individuals. Caregiver burden is poorly understood although the role and need for caregiving is widely recognised in BUD. This study identified a previously unrecognized burden on the caregivers of BUD patients in 3 endemic districts in Ghana. Specifically, we identified significant financial and psychological pressure on affected families in meeting healthcare related costs and physical care while also providing for their own and other family members’ needs. We also highlight the emotional burden experienced by caregivers, their reduced work productivity, the barriers caregivers face in accessing healthcare with BUD patients and the limited support available for caregivers. Our study highlights the serious social consequences of BUD in Ghana. Further quantitative research within different economic regions affected by BUD is warranted to better understand the caregiver burden of BUD

Mixed methods study protocol for combining stakeholder-led rapid evaluation with near real-time continuous registry data to facilitate evaluations of quality of care in intensive care units [version 1; peer review: awaiting peer review]

BACKGROUND: Improved access to healthcare in low- and middle-income countries (LMICs) has not equated to improved health outcomes. Absence or unsustained quality of care is partly to blame. Improving outcomes in intensive care units (ICUs) requires delivery of complex interventions by multiple specialties working in concert, and the simultaneous prevention of avoidable harms associated with the illness and the treatment interventions. Therefore, successful design and implementation of improvement interventions requires understanding of the behavioural, organisational, and external factors that determine care delivery and the likelihood of achieving sustained improvement. We aim to identify care processes that contribute to suboptimal clinical outcomes in ICUs located in LMICs and to establish barriers and enablers for improving the care processes. METHODS: Using rapid evaluation methods, we will use four data collection methods: 1) registry embedded indicators to assess quality of care processes and their associated outcomes; 2) process mapping to provide a preliminary framework to understand gaps between current and desired care practices; 3) structured observations of processes of interest identified from the process mapping and; 4) focus group discussions with stakeholders to identify barriers and enablers influencing the gap between current and desired care practices. We will also collect self-assessments of readiness for quality improvement. Data collection and analysis will be performed in parallel and through an iterative process across eight countries: Kenya, India, Malaysia, Nepal, Pakistan, South Africa, Uganda and Vietnam. CONCLUSIONS: The results of our study will provide essential information on where and how care processes can be improved to facilitate better quality of care to critically ill patients in LMICs; thus, reduce preventable mortality and morbidity in ICUs. Furthermore, understanding the rapid evaluation methods that will be used for this study will allow other researchers and healthcare professionals to carry out similar research in ICUs and other health services