Becoming a research university as a strategic choice in Bahir Dar university፡ A resource dependency perspective

This paper explored how the need for research universities in Ethiopia is justified, practiced, and could be improved using the strategic tactics of the resource dependency perspective. Bahir Dar University (hereafter referred to as BDU) was taken as a case to understand the need for a research university and its practices. Document analysis was used as a source of data. Consequently, an analysis of various institutional and national secondary sources revealed that the existing uncertainties related to critical resources motivated Bahir Dar University to devise a strategic choice of becoming a research university. The uncertainties are justified in terms of economic, political and institutional conditions. Although the university envisioned becoming a research university by 2025, the existing institutional and national conditions seem to be immature to sustain the necessary resources and conditions that a research university requires. As a result, following the higher education differentiation effort, BDU had to revise its vision and extend the possible time its vision could be realized to 2030. It is concluded that the need for BDU to become a research university seems to be challenging and needs much effort to be realized. Hence, institutional re-arrangements following the strategic tactics of the resource dependency perspective need to be devised to realize the strategic choice of becoming a research university

Environmental Associated Emotional Distress and the Dangers of Climate Change for Pastoralist Mental Health

Pastoralists in the Horn of Africa are among the most vulnerable populations to climate change yet little is known about how environmental change shapes their wellbeing and mental health. This paper presents a formative study into the relations between emotion, wellbeing and water security among pastoralist communities in Afar, Ethiopia. It uses focus group and interview data to demonstrate the close relationship between environmental conditions and emotional wellbeing, and shows how current water insecurity leads to extreme worry and fatigue among the studied population, especially in the dry season. In the context of difficulties of translating mental health clinical classifications and diagnostic tools in cross-cultural settings, the paper argues the inductive study of emotion may be a useful approach for studying environmental determined wellbeing outcomes among marginal populations in the light of understanding climate change impacts

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Pathologically confirmed women's breast cancer: A descriptive study of Tunisian and Algerian series

Abstract Background Breast cancer (BC) is the most frequent malignancy among women in Tunisia and Algeria. Clinical and pathological characteristics of this cancer among these populations are not widely reported. The aim of the study was to report clinical and pathological characteristics of women's BC in a Tunisian and Algerian series. Methods Pathologically confirmed 1089 BCs were gathered in the pathology departments of three Northern Tunisian hospitals: Tunis military, Charles Nicolle and Jendouba and in the pathology department of Alger Douera hospital between January 2015 and December 2020. Clinical and pathological findings of the two series: age, tumor size, histological type, grading according to Scarff‐Bloom Richardson grading system, lymph node status at the time of diagnosis in axillary lymphadenectomy specimens and the immunohistochemical expression of estrogen and progesterone receptors (ER/PR), HER2 and Ki‐67, were collected from the pathological reports. Results The median age at diagnosis was 50 and 48 years in Tunisian and Algerian series, respectively (p = 0.016). The diagnosis of BC was made on surgical specimens (lumpectomy or mastectomy) in 373/491 (76%) cases of the Tunisian series and in 225/598 (37.6%) cases of the Algerian one. Median tumor size was 2.8 cm and 2.5 cm in Algerian and Tunisian series, respectively (p = 0.252). Invasive BCs not otherwise specified was observed in 440/481 (91.5%) BCs in Tunisian series and in 519/586 (88.6%) BCs in Algerian series. Axillary lymph node positive tumors were observed in 64.6% and 58.8% of Tunisian and Algerian women, respectively (p = 0.926). BCs were ER positive in 311/385 (80.8%) and 486/571 (85.1%) cases and HER2 positive in 86/283 (30.4%) and 60/385 (15.6%) cases of Tunisian and Algerian series, respectively. Conclusions In Tunisia and Algeria, BC has poor prognostic factors with large tumor sizes and high rates of lymph nodes involvement at diagnosis