Determinantes dos honorários de auditoria para Portugal e Espanha

A liberalização dos serviços de auditoria em Portugal , com a eliminação em 2005, da tabela que fixava honorários mínimos baseados em padrões de dimensão da empresa auditada desperta o interesse em percecionar quais são os fatores que originam a determinação dos honorários de auditoria. Em Espanha, o conjunto de escândalos fina nceiros de que tem sido alvo tem colocado os honorários de auditoria no foco principal. A análise inclui uma amostra de 40 empresas cotadas em Portugal e 113 empresas cotadas em Espanha p ara o ano de 2013 utilizando a regressão dos mínimos quadrados (OSL). Os resultados indicam que em Espanha, os honorários são fixados principalmente em função da dimensão, complexidade e risco de auditoria, sendo que quanto maior a dimensão, a complexidade e o risco da empresa auditada, maiores os honorários de auditoria. E m Portugal, a dimensão da empresa auditada foi considerado o único fator que contribui para a determinação dos honorários em Portugal. Os resultados obtidos permitem - nos assim concluir que a determinação dos honorários de auditoria em Portugal é muito dife rente da dos honorários das empresas cotadas em Espanh

Water Source and Water Demand Needs Assessments for Bonwire

This work assessed the water supply source and water demand of Bonwire, a town in the Ashanti Region of Ghana. The work was done to solve an identified water threat in Bonwire. The assessment was done via the identification and discharge quantification of water sources; the physicochemical and biological assessments of the source(s); estimation of water needs and a comparison of the supply and demand in Bonwire, and to recommend this assessment to the local government and Donor Agencies. The methodology for the work was site reconnaissance and desk studies, water discharge measurement via area-velocity method, field sampling and laboratory testing. The ions were analysed by ICP-AES and IC. The current water demand was estimated as 274 m3d-1.The  two sources of water identified for Bonwire were four (4) rivers and groundwater from two (2) boreholes. The discharge measurements and borehole yields indicated that the total discharge for Bonwire is 14,239 m3d-1 of which rivers contribute about 99%.  Inspite of the large river discharges, the physicochemical properties finger the river waters as unpotable, because the rivers are contaminated with contaminants (nitrates, sulphates, coliform) and hardness. The groundwater source which is the only potable source has a daily discharge of 86 m3d-1, which is in a deficit of 188 m3d-1 for the current water demand. It was concluded that there was a water threat in Bonwire. It was therefore recommended that contamination of the rivers should be controlled; a hydrogeological assessment for additional borehole drilling should be conducted, and  the possibility of treating the rivers for supplying water to Bonwire and the Municipality should be considered. Keywords: Water Supply, Water Demand, Water Threat, Contaminants, Coliform, Water Hardness, Hydrogeological Assessment

Determinants of agriculture credit fungibility among smallholder farmers: The case of rural Ghana

This study examined the determinants of rural household agriculture credit fungibility (CF). The study found agricultural CF among farmers, with approximately 79% of farmers involved in agricultural CF. Household financial burden was found to be the main cause of CF among the studied farmers. Most fungible credit was used for clothing and food consumption. A probit model was employed to analyze survey data collected from four regions in Ghana. We employed an instrumental variable approach (IV-Probit) to test for robustness due to endogeneity issues. The econometric model results show that the variables of off-farm income and farm size inversely influenced agricultural CF, while those of education, household size, male farmer gender, and chronic disease variables had a positive effect on agricultural CF. Our findings have policy implications for alleviating agricultural CF. &nbsp

Application of the Consolidated Framework for Implementation Research to examine nurses’ perception of the task shifting strategy for hypertension control trial in Ghana

Background: The burden of hypertension in many low-and middle-income countries is alarming and requires effective evidence-based preventative strategies that is carefully appraised and accepted by key stakeholders to ensure successful implementation and sustainability. We assessed nurses’ perceptions of a recently completed Task Shifting Strategy for Hypertension control (TASSH) trial in Ghana, and facilitators and challenges to TASSH implementation. Methods: Focus group sessions and in-depth interviews were conducted with 27 community health nurses from participating health centers and district hospitals involved in the TASSH trial implemented in the Ashanti Region, Ghana, West Africa from 2012 to 2017. TASSH evaluated the comparative effectiveness of the WHO-PEN program versus provision of health insurance for blood pressure reduction in hypertensive adults. Qualitative data were analyzed using open and axial coding techniques with emerging themes mapped onto the Consolidated Framework for Implementation Research (CFIR). Results: Three themes emerged following deductive analysis using CFIR, including: (1) Patient health goal setting- relative priority and positive feedback from nurses, which motivated patients to make healthy behavior changes as a result of their health being a priority; (2) Leadership engagement (i.e., medical directors) which influenced the extent to which nurses were able to successfully implement TASSH in their various facilities, with most directors being very supportive; and (3) Availability of resources making it possible to implement the TASSH protocol, with limited space and personnel time to carry out TASSH duties, limited blood pressure (BP) monitoring equipment, and transportation, listed as barriers to effective implementation. Conclusion: Assessing stakeholders’ perception of the TASSH implementation process guided by CFIR is crucial as it provides a platform for the nurses to thoroughly evaluate the task shifting program, while considering the local context in which the program is implemented. The feedback from the nurses informed barriers and facilitators to implementation of TASSH within the current healthcare system, and suggested system level changes needed prior to scale-up of TASSH to other regions in Ghana with potential for long-term sustainment of the task shifting intervention

Training nurses in task-shifting strategies for the management and control of hypertension in Ghana: a mixed-methods study

Background: Nurses in Ghana play a vital role in the delivery of primary health care at both the household and community level. However, there is lack of information on task shifting the management and control of hypertension to community health nurses in low- and middle-income countries including Ghana. The purpose of this study was to assess nurses\u27 knowledge and practice of hypertension management and control pre- and post-training utilizing task-shifting strategies for hypertension control in Ghana (TASSH). Methods: A pre- and post- test survey was administered to 64 community health nurses (CHNs) and enrolled nurses (ENs) employed in community health centers and district hospitals before and after the TASSH training, followed by semi-structured qualitative interviews that assessed nurses\u27 satisfaction with the training, resultant changes in practice and barriers and facilitators to optimal hypertension management. Results: A total of 64 CHNs and ENs participated in the TASSH training. The findings of the pre- and post-training assessments showed a marked improvement in nurses\u27 knowledge and practice related to hypertension detection and treatment. At pre-assessment 26.9% of the nurses scored 80% or more on the hypertension knowledge test, whereas this improved significantly to 95.7% post-training. Improvement of interpersonal skills and patient education were also mentioned by the nurses as positive outcomes of participation in the intervention. Conclusions: Findings suggest that if all nurses receive even brief training in the management and control of hypertension, major public health benefits are likely to be achieved in low-income countries like Ghana. However, more research is needed to ascertain implementation fidelity and sustainability of interventions such as TASSH that highlight the potential role of nurses in mitigating barriers to optimal hypertension control in Ghana. Trial registration: Trial registration for parent TASSH study: NCT01802372 . Registered February 27, 2013

Protocol for a two-arm feasibility RCT to support postnatal maternal weight management and positive lifestyle behaviour in women from an ethnically diverse inner city population: the SWAN feasibility trial

IntroductionA high BMI during and after pregnancy is linked to poor pregnancy outcomes and contributes to long-term maternal obesity, hypertension, and diabetes. Evidence of feasible, effective postnatal interventions is lacking. This randomised controlled trial will assess the feasibility of conducting a future definitive trial to determine effectiveness and cost-effectiveness of lifestyle information and access to Slimming World® (Alfreton, UK) groups for 12 weeks commencing from 8 to 16 weeks postnatally, in relation to supporting longer-term postnatal weight management in women in an ethnically diverse inner city population. Methods/analysis:Women will be recruited from one maternity unit in London. To be eligible, women will be overweight (BMI 25–29.9 kg/m2) or obese (BMI ≥ 30 kg/m2) as identified at their first antenatal contact, or have a normal BMI (18.5–24.9 kg/m2) at booking but gain excessive gestational weight as assessed at 36 weeks gestation. Women will be aged 18 and over, can speak and read English, expecting a single baby, and will not have accessed weight management groups in this pregnancy. Women will be randomly allocated to standard care plus lifestyle information and access to Slimming World® (Alfreton, UK) groups or standard care only. A sample of 130 women is required. Feasibility trial objectives reflect those considered most important inform a decision about undertaking a definitive future trial. These include estimation of impact of lifestyle information and postnatal access to Slimming World® (Alfreton, UK) on maternal weight change between antenatal booking weight and weight at 12 months postbirth, recruitment rate and time to recruitment, retention rate, influence of lifestyle information and Slimming World® (Alfreton, UK) groups on weight management, diet, physical activity, breastfeeding, smoking cessation, alcohol intake, physical and mental health, infant health, and health-related quality of life 6 and 12 months postnatally. An embedded process evaluation will assess acceptability of study processes and procedures to women. Ethics/dissemination:London–Camberwell St Giles Research Ethics Committee, reference: 16/LO/1422. Outcomes will be disseminated in peer-reviewed journals and presentations at national and international conferences. Trial registration:Trial registration number: ISRCTN 39186148. Protocol version number: v7, 13 August 17. Trial sponsor: King’s College London.</p

An assessment of indoor radon level in a suburb of Ghana

Abstract Radiation and radioactive isotopes form part of our natural environment. Elevated levels of these radioactive isotopes in the environment can pose a threat to our health. A greater proportion of the natural radiation is from the radioactive gas radon. Although it cannot be detected by human senses, radon and its progenies are of health concern as it can cause lung cancer when inhaled over a period of time. This study sought to provide baseline indoor radon data, the life time risk of lung cancer and its interpretation within a suburb of Ghana. Solid State Nuclear Track Detector (LR-115 type II) was deployed in 82 homes within a suburb for a period of three months (September 2017- January 2018). Indoor radon concentration (IRC) for the suburb was within the range of 4.1�176.3 Bq m?3. With mean 57 ± 39 Bq m?3. The mean radon exposure to the dwellers was recorded as 0.12 ± 0.08 WLMy?1 resulting in 0.7 ± 0.5 mSvy?1 effective dose to the lung with an excess lifetime cancer risk of 0.39 ± 0.26%. There was a positive correlation between indoor radon concentration and the building type and the association was significant with a P value of 0.047.</jats:p