Fiscal Conditions, Political Interests, and Service Outsourcing Decisions: The Case of Georgia Counties

The question why a government chooses a specific service delivery tool to provide public service to its citizenry is a central intellectual inquiry in public administration. This paper develops a framework to explain the production and sector choices of public services by political-economic environment, organizational capacity, service market condition, and nature of service. Using operation and financial data of Georgia county governments during 2000-2006, we apply the framework to analyze Georgia counties’ public service outsourcing decisions, focusing on the effects of fiscal condition and political interests. The logistic regression results show that the choice of external production is negatively associated with government’s revenue raising capacity, managerial capacity, and citizens’ political demand for local control yet positively associated with conservative ideology. The choice of private sector is positively correlated with conservative political interest, increase in discretionary financial resources, and the centrality of government’s position in local service provision market

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

Notes for genera: basal clades of Fungi (including Aphelidiomycota, Basidiobolomycota, Blastocladiomycota, Calcarisporiellomycota, Caulochytriomycota, Chytridiomycota, Entomophthoromycota, Glomeromycota, Kickxellomycota, Monoblepharomycota, Mortierellomycota, Mucoromycota, Neocallimastigomycota, Olpidiomycota, Rozellomycota and Zoopagomycota)

Compared to the higher fungi (Dikarya), taxonomic and evolutionary studies on the basal clades of fungi are fewer in number. Thus, the generic boundaries and higher ranks in the basal clades of fungi are poorly known. Recent DNA based taxonomic studies have provided reliable and accurate information. It is therefore necessary to compile all available information since basal clades genera lack updated checklists or outlines. Recently, Tedersoo et al. (MycoKeys 13:1--20, 2016) accepted Aphelidiomycota and Rozellomycota in Fungal clade. Thus, we regard both these phyla as members in Kingdom Fungi. We accept 16 phyla in basal clades viz. Aphelidiomycota, Basidiobolomycota, Blastocladiomycota, Calcarisporiellomycota, Caulochytriomycota, Chytridiomycota, Entomophthoromycota, Glomeromycota, Kickxellomycota, Monoblepharomycota, Mortierellomycota, Mucoromycota, Neocallimastigomycota, Olpidiomycota, Rozellomycota and Zoopagomycota. Thus, 611 genera in 153 families, 43 orders and 18 classes are provided with details of classification, synonyms, life modes, distribution, recent literature and genomic data. Moreover, Catenariaceae Couch is proposed to be conserved, Cladochytriales Mozl.-Standr. is emended and the family Nephridiophagaceae is introduced

Managing information systems in state and local governments: Essays on e-government service adoption and outsourcing

This document, which includes three empirical studies, examines two currently prevailing public administration practices--privitization and e-government development--through a pluralistic lens that incorporates the factors of political interests, motivations, and powers, as well as the structures, processes, and institutions constructed under the macro political system, in addition to the market-based economic considerations. The first essay views e-government service adoption as the result of political power struggle and different application areas resulting from different interest coalitions and influence processes. The essay estimates and compares two nonlinear mixed models with county-level government survey data. Findings about the bias against the e-democracy services reveal the nature of the e-government movement--an executive branch initiated administrative reform. The presence of a jurisdictional digital divide suggests that e-government may reinforce the power structure of the local political arena and social inequality nationwide. The second essay tests the extent to which economic and political rationalities influence government\u27s decision to contract out using data from two state-level national surveys. Economic considerations, such as market competition and economy of scales, are traded off with political concerns, such as local economic development. The arguments associated with markets and economic rationality are in large part politically motivated. The third essay extends the second essay\u27s framework to examine the external and internal institutional contexts of local governments. Using city and county government survey data, it verifies that the public sector institutional environment largely constrains the economic rationality of outsourcing. Despite the efficiency gain and cost reduction claims, outsourcing, while less likely driven by ideological reasons, is a common tool for pursuing political purposes in local governments

Nursing Students’ Evolving Perceptions of Online Learning: A Hierarchy of Curricula

Many nursing programs had relatively light online learning components before the COVID-19 pandemic. The transition to fully online courses without preliminary planning represented a problematic shock to most nursing students and faculty. To understand students’ perceptions of the critical success of online learning factors, an empirical comparison was conducted of nursing (n = 126) and non-nursing students (n = 1766) with similar demographic characteristics, but in different timeframes. A two-sample t-test was conducted for each question to ascertain significant differences in student perceptions between nursing and non-nursing students. While the ranking of critical success factors was similar for nursing and other students, the perceptions of nursing students were generally far more critical of the capability of online learning due, partially due to the perception that the online medium is less well suited to nursing education, and partially to instructional challenges caused by the rapid transition and chaos caused by the pandemic. The pandemic provided an inferior initial exposure to online nursing education in programs that had not previously prepared for online instruction, but had an abnormally increased demand for more online education. Without aggressive efforts to improve online teaching in programs with similar circumstances, students’ perceptions of overall quality may not improve significantly in the long term

Building business-government relations : a skill approach/ Ni

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Building business-government relations : a skill approach/ Ni

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The effect of the COVID pandemic on faculty adoption of online teaching: reduced resistance but strong persistent concerns

This article examines a case study regarding pre- and post-COVID-19 faculty adoption patterns for online teaching. It is based on a usable sample of 184 faculty from a relatively typical, teaching/research institution, in which the bulk of the faculty had some modest level of hybrid or fully online teaching. The Unified Theory of Acceptance and Use of Technology (UTAUT)is used as the framework for the analysis for this descriptive case. The findings indicate that the trajectory of increasing online teaching is likely to continue and grow, despite reasonable and persistent faculty concerns. Based on the case study and literature, twenty recommendations are provided that can encourage faculty adoption and promote high quality online implementation systems