The Public Procurement Act 663 (2003) Of Ghana: Compliance level in Selected Education District Offices

The Procurement of Act 663 (2003) of Ghana was promulgated to sanitize the procurement management process with the ultimate aim of ensuring value for money. Since its introduction in 2003, various evaluation reports have come up with a number of strategies to ensure full compliance in public organizations. The aim of the study was to establish the extent to which district education offices adhere to Act 663; to identify the weakness associated with the practice and to propose recommendations for high level of compliance. The study adopted both qualitative and quantitative research approaches in data collection involving five selected districts in Ashanti region namely Ashanti Akim Central, Asante Akim South, Bosome-Freho, Ejisu-Juaben and Sekyere East. Relative Importance Index (RII) was used to analyze data collected. The study revealed low compliance level of 42.42 percent implying a huge compliance deficit of 57.58 percent. The study further identified contract management, lack of procurement units, lack of proper procurements plans, inadequate use of standard tender documents and high propensity to use sole sourcing method without recourse to Section 40 of Act 663 were identified as weaknesses areas. These weaknesses have negative implications in procurement management practices. It is therefore recommended that procurement units should be established in all the district education offices in Ghana, more importantly, these units should be provided someone with technical expertise in procurement. Similarly, under the auspices the Public Procurement Authority (PPA), refresher courses in procurement management should be organized for district education officers involved in procurement duties. The on-going review of the Act 663 should conspicuously spell out the composition of the Tender Committee at the district education offices. It is anticipated that if these suggestions are enforced, the current level of compliance of the Act 663(2003) would be improved in the district education offices

Analytic continuation of the Hurwitz Zeta Function with physical application

A new formula relating the analytic continuation of the Hurwitz zeta function to the Euler gamma function and a polylogarithmic function is presented. In particular, the values of the first derivative of the real part of the analytic continuation of the Hurwitz zeta function for even negative integers and the imaginary one for odd negative integers are explicitly given. The result can be of interest both on mathematical and physical side, because we are able to apply our new formulas in the context of the Spectral Zeta Function regularization, computing the exact pair production rate per space-time unit of massive Dirac particles interacting with a purely electric background field.Comment: Replaced version, minor changes. 9 pages, to be published in J. Math. Phy

Integrating sustainability practices into the Irish construction supply chain: main contractors' perspective

The low level of sustainable practices in the architectural, engineering and construction (AEC) sector continues to increase. In driving sustainability practice adoption and implementation, construction-contracting firms have introduced sustainability practices to their supply chain network. This study examines the strategies adopted by large construction-contracting firms in Ireland to integrate sustainability practices into their supply chain. The study adopts the mixed-method approach using questionnaires and interviews to collect data. The relative importance index (RII) was used to analyse the data collected through the questionnaire survey. In terms of theoretical underpinning, the study was positioned in the resourced-based view (RBV) theory, which focusses on the link between a firm's internal characteristics and performance. The results revealed that, in building a long-term relationship, trust, knowledge of the construction process, commitment, a common goal and mutual support were the key factors considered. While in developing their supply chain, suppliers' assessment and promoting competition in the supply chain were ranked high amongst the mechanisms utilised. Additional findings revealed that long-term relationships with a supply chain organisation have little impact on the project sustainability performance; instead, close collaboration and trust amongst the project team influenced the project sustainability performance. The study focusses only on the main contractor's organisation. Further study will require exploring the supply chain organisations to provide a deeper understanding. Practical implications The research demonstrates that for construction-contracting firms to contribute positively to sustainability objectives, they will have to collaborate closely with their supply chain.The study provided practical and empirical evidence to guide construction-contracting firms to develop strategies to drive and implement sustainable construction practices

Time-Trends of Drug-Drug Interactions among Elderly Outpatients in the Piedmont Region (Italy): A Population-Based Study

Adverse drug reactions (ADRs) are a major health problem in the primary care setting, particularly among the elderly population. While the high frequency of ADRs in the elderly has several causes, a major and common determinant is polypharmacy, which can in turn increase the risk of drug-drug interactions (DDIs). In this paper, we analyzed the drugs prescriptions dispensed to elderly outpatients, to assess changes in the prevalence of selected DDIs in the period 2013–2019. Overall, about 15% of the patients aged >65 years were poly-treated. Among them, a decreasing trend in prevalence was observed for the majority of DDIs during the study period. This trend was particularly noticeable for DDIs involving fluoroquinolones and vitamin K antagonists, where a sharp reduction of over 40% was observed. On the opposite, a small increase in prevalence was observed for the association of antidiabetics and beta-blocking agents and for that of clopidogrel and PPIs. While the occurrence of most of the considered DDIs among poly-treated elderly decreased over time, the prevalence of some of them is still worrying. The complexity of the national drug formularies, as well as the increased number of prescribing actors that are involved, further urges the update of DDI lists to be used to monitor drug appropriateness and reduce avoidable ADRs

Targeting CD20 in the treatment of interstitial lung diseases related to connective tissue diseases: A systematic review

INTRODUCTION: The effectiveness of CD20 targeting in connective tissue diseases (CTD) with lung involvement is controversial. This paper aims to review the current evidence about rituximab (RTX) use in CTD-related interstitial lung disease (ILD). METHODS: We performed a systematic review of papers published between January 2009 and May 2019. We included clinical trials, case/control studies and cohort studies. We excluded letters, case reports, case series, reviews, and full articles when not in English. The selected studies listed as primary or secondary outcome a variation in pulmonary function tests or in the scores used to radiologically stage lung involvement, in CTD-related ILD patients after RTX. RESULTS: Out of 1206 potentially eligible articles, 24 papers were selected: 3 retrospectively described cohorts of patients with different CTD, 14 dealt with systemic sclerosis (SSc)-related ILD, 5 with idiopathic inflammatory myopathies (IIMs)-related ILD, and 2 with Sjögren's Syndrome-related ILD. A direct comparison of the selected studies was hampered by their heterogeneity for outcomes, follow-up duration, the severity of lung involvement, and clinical features of study populations. However, an overall agreement existed concerning the effectiveness of RTX in the stabilization of lung disease, with some studies reporting an improvement of functional parameters from baseline. IIM-related ILD appeared more responsive than other CTD-related ILD to CD20 targeting. CONCLUSION: RTX is a promising therapeutic tool in CTD-related ILD. This systematic review remarks the unmet need of multicenter prospective studies aiming to evaluate the effectiveness of RTX with adequate sample size and study design

Mental health services utilization after Mariana dam burst

Abstract Background The global burden of mental health conditions is increasing, especially in middle- and low-income countries and frequently the quality of mental health services is lower than the quality of services for other conditions. Disasters may increase this burden through their direct impact or due to secondary stressors, such as the preclusion of access to essential services. The aim of this study is to assess the impact of Mariana dam burst (Brazil) in November 2015, in the utilization of public mental health services by the population that experienced an interruption of water supply after the event. Methods We used data from DATASUS, the database of the Brazilian public health system, analyzing data from 34 months before to 36 months after the event. We defined as affected the population living in the municipalities of Minas Gerais state that had an interruption of water supply after the event and the rest of the state population as the comparison group. We designed an Interrupted time-series analysis to evaluate both immediate and gradual changes in use of mental health services after the accident. Results The affected population included 381,749 inhabitants and the comparison group 20,487,352 inhabitants. The monthly rate of mental health visits in the affected population in the beginning of the series was 296 (CI 182 to 409, p < 0.001) per 100.000 person-month. Comparing the groups after the event, we observed a non-statistically significant higher increase in the rate of visits immediately after the event of 115.96 (CI -30.00 to 261.92, p = 0.118) and a significant increase in the monthly rate of visits (change in slope) of 15.55 (CI 8.19 to 22.92, p < 0.001) in the affected group. Discussion The results suggest that the event translated in a long-term increase in mental health services utilization. We believe that this study presents an innovative methodology on the assessment of mental health services after disasters and that it could be adapted to other contexts. Key messages Indirect impacts of disasters may be associated with long-term changes in the utilization of mental health services. Interrupted time series using routine data are useful tools for the assessment of health services utilization following disasters

Use of administrative health databases to estimate incidence and prevalence of acromegaly in Piedmont Region, Italy

Recent studies from national registries have described changing patterns in epidemiology of acromegaly. Our retrospective study used administrative databases to estimate prevalence and incidence of acromegaly in the Piedmont Region, Italy