Five Years Of Family Medicine Undergraduate Education In Ghana: A Wake-Up Call!

Objectives: Given the introduction in 2008 of undergraduate family medicine in the University of Ghana, the study aimed to identify the perceptions of medical students in Ghana about family medicine with regard to knowledge and relevance as well as specialty preferences.Design: A cross-sectional surveyMethod: Investigators conducted yearly surveys of first clinical year students at the University of Ghana School of Medicine and Dentistry over a 5-year period (2008-2012) using a semi-structured questionnaire. Data was analysed using the first class group as baseline for comparison.Main outcome measures: Trends in respondents’ awareness of different aspects of family medicine, their attitudes towards the specialty and their expressed preference or lack of preference for family medicine as a potential specialty for themselves.Results: Over the five-year period, 748 of 893 eligible first year students participated which comprised 84% of students. Awareness of family medicine as a medical specialty remained high but insignificantly declined over the period of study (88% to 80%, p=0.058). Preference for family medicine as career choice remained low at 4%, but an increase from 2% baseline though insignificant (p=0.397). The primary reason for not listing family medicine as career choice was unfamiliarity with the specialty (80%).Conclusion: Although awareness of family medicine among medical students in Ghana remains relatively high, their knowledge is insufficient to influence their career decisions for family medicine. This is a wake-up call!Funding: None declaredKeywords: education, family medicine, Ghana, primary care, undergraduat

Mathematical Optimization Models and Methods for Open-Pit Mining

Open-pit mining is an operation in which blocks from the ground are dug to extract the ore contained in them, and in this process a deeper and deeper pit is formed until the mining operation ends. Mining is often a highly complex industrial operation, with respect to both technological and planning aspects. The latter may involve decisions about which ore to mine and in which order. Furthermore, mining operations are typically capital intensive and long-term, and subject to uncertainties regarding ore grades, future mining costs, and the market prices of the precious metals contained in the ore. Today, most of the high-grade or low-cost ore deposits have already been depleted, and to obtain sufficient profitability in mining operations it is therefore today often a necessity to achieve operational efficiency with respect to both technological and planning issues. In this thesis, we study the open-pit design problem, the open-pit mining scheduling problem, and the open-pit design problem with geological and price uncertainty. These problems give rise to (mixed) discrete optimization models that in real-life settings are large scale and computationally challenging. The open-pit design problem is to find an optimal ultimate contour of the pit, given estimates of ore grades, that are typically obtained from samples in drill holes, estimates of costs for mining and processing ore, and physical constraints on mining precedence and maximal pit slope. As is well known, this problem can be solved as a maximum flow problem in a special network. In a first paper, we show that two well known parametric procedures for finding a sequence of intermediate contours leading to an ultimate one, can be interpreted as Lagrangian dual approaches to certain side-constrained design models. In a second paper, we give an alternative derivation of the maximum flow problem of the design problem. We also study the combined open-pit design and mining scheduling problem, which is the problem of simultaneously finding an ultimate pit contour and the sequence in which the parts of the orebody shall be removed, subject to mining capacity restrictions. The goal is to maximize the discounted net profit during the life-time of the mine. We show in a third paper that the combined problem can also be formulated as a maximum flow problem, if the mining capacity restrictions are relaxed; in this case the network however needs to be time-expanded. In a fourth paper, we provide some suggestions for Lagrangian dual heuristic and time aggregation approaches for the open-pit scheduling problem. Finally, we study the open-pit design problem under uncertainty, which is taken into account by using the concept of conditional value-atrisk. This concept enables us to incorporate a variety of possible uncertainties, especially regarding grades, costs and prices, in the planning process. In real-life situations, the resulting models would however become very computationally challenging

Smoothing Approximations for Least Squares Minimization with L1-Norm Regularization Functional

The paper considers the problem of least squares minimization with L1-norm regularization functional. It investigates various smoothing approximations for the L1-norm functional. It considers Quadratic, Sigmoid and Cubic Hermite functionals. A Tikhonov regularization is then applied to each of the resulting smooth least squares minimization problem. Results of numerical simulations for each smoothing approximation are presented. The results indicate that our regularization method is as good as any other non-smoothing method used in developed solvers

A maximum flow formulation of a multi-period open-pit mining problem

We consider the problem of finding an optimal mining sequence for an open pit during a number of time periods subject to only spatial and temporal precedence constraints. This problem is of interest because such constraints are generic to any open-pit scheduling problem and, in particular, because it arises as a Lagrangean relaxation of an open-pit scheduling problem. We show that this multi-period open-pit mining problem can be solved as a maximum flow problem in a time-expanded mine graph. Further, the minimum cut in this graph will define an optimal sequence of pits. This result extends a well-known result of J.-C. Picard from 1976 for the open-pit mine design problem, that is, the single-period case, to the case of multiple time periods

Customer Satisfaction in Microfinance Institutions: Insights from Ghana

With increased competition in the microfinance industry in most African markets, customer satisfaction and retention are important issues for most microfinance institutions (MFIs) in the region. We rely on survey data from customers of MFIs in Ghana to examine the potential determinants of customer satisfaction in the microfinance sector. We find customer satisfaction to be significantly related to customers’ experiences and motivations such as the primary reason for associating with MFIs, and the size of credit they seek. We further find customers’ demographic factors such as educational attainment and household income levels to be related to customer satisfaction in the microfinance sector. Our results are largely consistent with the view that MFIs offer a valuable service by expanding access to small credits to poor households and microenterprises who are either denied credit by the formal banking sector or who are exploited by informal moneylenders. Further, our interviews with top managers of MFIs highlight various tactics utilised by MFIs in Ghana to manage their credit risks

Customer satisfaction in microfinance institutions: insights from Ghana

With increased competition in the microfinance industry in most African markets, customer satisfaction and retention are important issues for most microfinance institutions (MFIs) in the region. We rely on survey data from customers of MFIs in Ghana to examine the potential determinants of customer satisfaction in the microfinance sector. We find customer satisfaction to be significantly related to customers’ experiences and motivations such as the primary reason for associating with MFIs, and the size of credit they seek. We further find customers’ demographic factors such as educational attainment and household income levels to be related to customer satisfaction in the microfinance sector. Our results are largely consistent with the view that MFIs offer a valuable service by expanding access to small credits to poor households and microenterprises who are either denied credit by the formal banking sector or who are exploited by informal moneylenders. Further, our interviews with top managers of MFIs highlight various tactics utilised by MFIs in Ghana to manage their credit risks

Innovation input, governance and climate change: evidence from emerging countries

This study sheds light on the extent to which innovation input influences CO2 emissions and how country-level governance factors may moderate this relationship. The sample for the study consists of CO2 emissions per capita from 29 emerging countries and 725 country-year observations. We find a negative relationship between innovation input and CO2 emissions, suggesting that countries that invest in innovation combat climate change by reducing CO2 emissions. By separating the sample into low and high innovative countries, the results show that reduction of CO2 emissions is more pronounced in countries with high innovation input. We further establish that country-level governance factors, including political stability, government effectiveness, regulation quality, rule of law and control of corruption all negatively moderate the effects of innovation input on CO2 emissions. Our findings shed new light on the theoretical and practical implications of innovation and country-level governance on climate change initiatives