Stated and actual altruistic willingness to pay for insecticide-treated nets in Nigeria: validity of open-ended and binary with follow-up questions.

OBJECTIVES: To determine whether the binary with follow-up (BWFU) or open-ended (OPED) contingent valuation question format would yield better valid estimates of altruistic willingness to pay (WTP) and examine the feasibility of using intra-community altruistic contributions to procure insecticide-treated nets (ITNs) for the poor in Nigeria. METHODS: Structured questionnaires were used to elicit stated altruistic WTP from a random sub-sample of respondents that had either the OPED or BWFU used to elicit WTP in Southeast Nigeria. One month after the survey the respondents were asked to redeem their WTP pledges. Construct validity was determined using econometric analyses, while phi correlation coefficient was used to determine criterion validity. FINDINGS: More than 57% of the respondents were hypothetically willing to pay for altruism in both BWFU and OPED groups. Altruistic WTP was positively related to respondents' WTP for own nets (p<0.01) and nets for other household members (p<0.05) in both groups. A total of 27.0% and 33.1% of the respondents with positive hypothetical WTP in the BWFU and OPED actually contributed. Phi correlation coefficient was 0.23 (95%CI 0.20-0.29) in BWFU and 0.49 (95%CI 0.44-0.54) in OPED. The money realised was used to buy some ITNs, which were presented to poor people selected by community leaders. CONCLUSION: The OPED elicited better valid estimates of altruistic WTP than BWFU. The potential for more capable people to contribute for the poor in ITNs programmes actually exist and malaria control programmes should explore altruistic contributions as a means to increase net coverage

Exemption policies and community preferences for tropical endemic diseases in the Bamako initiative programme in Nigeria.

We determined the actual written policies/guidelines and practices of fee exemptions aimed at the primary health-care level for tropical diseases treatment within the Bamako initiative system and the community's and decision makers' preferences for exemption in Nigeria. Health policy documents from the federal and state ministries of health were reviewed to determine the guidelines for exemptions, services, goods and category of people to receive exemptions. The records of the local government areas, health centres and community health committees were also reviewed to check who had received exemptions and modalities for doing so. In addition, household surveys using questionnaires was conducted. There is no clear-cut national policy regarding exemption. In areas where exemption exists, these are largely unofficial, as no official documents exist to support exemption. A total of 1594 individuals were surveyed. Community members prefer pregnant women, children and patients with TB, malaria, onchocerciasis and leprosy to be exempted from payment of fees: decision makers prefer the poor, children and patients with malaria, TB and leprosy to be exempted from payment for drugs, registration, consultation and preventive services such as immunization and antenatal services. One area of divergence between the preferences of the community and decision makers is the issue of exempting people with malaria and HIV/AIDS

Examining inequities in incidence of catastrophic health expenditures on different healthcare services and health facilities in Nigeria.

OBJECTIVE: There is limited evidence about levels of socio-economic and other differences in catastrophic health spending in Nigeria and in many sub-Saharan African countries. The study estimated the level of catastrophic healthcare expenditures for different healthcare services and facilities and their distribution across socioeconomic status (SES) groups. METHODS: The study took place in four Local Government Areas in southeast Nigeria. Data were collected using interviewer-administered questionnaires administered to 4873 households. Catastrophic health expenditures (CHE) were measured using a threshold of 40% of monthly non-food expenditure. We examined both total monthly health expenditure and disaggregated expenditure by source and type of care. RESULTS: The average total household health expenditure per month was 2354 Naira ($19.6). For outpatient services, average monthly expenditure was 1809 Naira ($15.1), whilst for inpatient services it was 610 Naira ($5.1). Higher health expenditures were incurred by urban residents and the better-off SES groups. Overall, 27% of households incurred CHE, higher for poorer socioeconomic groups and for rural residents. Only 1.0% of households had a member that was enrolled in a health insurance scheme. CONCLUSION: The worse-off households (the poorest SES and rural dwellers) experienced the highest burden of health expenditure. There was almost a complete lack of financial risk protection. Health reform mechanisms are needed to ensure universal coverage with financial risk protection mechanisms

Assessing the Prevalence, Participants, and Predictors of Coproduction: The Case of Atlanta, Georgia

In municipalities across the globe, traditional forms of governance are being supplemented by collaborative arrangements between governments and their constituencies toward jointly produced public services. Since the late 1970s, this phenomenon known as coproduction has been utilized in efforts to survive severe budget cuts, improve performance, increase accountability, and welcome traditionally silenced voices. However, no study to date has undergone a citywide assessment of coproduction to determine its breadth and depth in a city. Additionally, there is practically no empirical study that examines what citizen characteristics and perceptions are associated with participation in coproduction. The present study represents a first attempt to begin to fill these gaps in the literature. Specifically, this dissertation analyses: (1) How prevalent is coproduction? (2) Who engages in coproduction? and (3)What motivates coproducers? I employ a mixed-method case study of Atlanta, Georgia via its Neighborhood Planning Unit system, using focus groups, citizen questionnaires, census and GIS data, and direct observations. Overall, the coproduction classifications developed in this dissertation enable more systematic research on coproduction. The dissertation findings also contribute to our understanding of (1) how much this service delivery strategy is being utilized in an urban municipality, (2) which forms are most utilized, (3) what triggers participation in each form, and (4) who utilizes coproduction the most – even challenging the longstanding perception that African Americans and low-income groups do not participate in such activities. Lastly, study findings suggest a need to reconceptualize the current theory of coproduction as a public service delivery strategy

Safety Practice and Employee Productivity in Selected Mining Firms in Ebonyi State, Nigeria.

There is growing uncertainty about the application of safety practices for the desired employee productivity. This uncertainty arises from a disagreement from two schools of thought as to whether or not safety practices have a direct impact on the productivity of mining firms. This disagreement has resulted to ineffective application of safety practices in securing a healthy working environment necessary for operational excellence. Therefore, this study, sought to establish the correct link between safety practices and employee productivity of selected mining firms in Ebonyi State. The specific objectives of the study are: to determine the extent to which safety culture relates to production output of employees and to ascertain the extent to which safety procedures relate to work input of employees of the selected mining firms in Ebonyi State The study employed a correlational design such that structured questionnaire designed in 5-point likert scale was administered on the sample of two hundred and eighty four (284) drawn from the three senatorial districts of Ebonyi State, out of which, 270 copies were returned, and subsequently used for the analysis. The data collected from respondents were analyzed with Pearson Product Correlation Coefficient via SPSS version .20. The study employed component factor analysis using varimax rotation to ensure the usability and suitability of the research instrument. Also, for sampling adequacy Bartlett Test of Sphericity and Kaiser-Meyer-Olkin were employed. Test retest approach was employed such that Cronbach alpha coefficient was used to determine the reliability of the research instrument. The study revealed that there is a significant and positive relationship between safety culture and production output of employees (r = 0.83) and a significant and positive relationship between safety procedures and work input of employees. From the findings, the study concludes that there is a significant relationship between safety practices and employee productivity. The implication of the result is that effective utilization of safety practices will provide convivial and healthy working environment necessary for improved production output and therefore recommended that management of these firms should take effective measure in ensuring full comply with safety practices of their organizations through hierarchy of control-system-mechanism

NIGELLA SATIVA SUPPLEMENTATION EFFECTS ON GROWTH, ORGAN DEVELOPMENT AND REPRODUCTION IN SPRAGUE-DAWLEY RATS

Nigella sativa (NS) is a small herbaceous plant belonging to the Ranunculaceae family and is cultivated across several regions in Asia, Southern Europe, and the Middle East. Several studies have investigated the effects of alcoholic NS extracts on reproduction, but few have investigated the effects of the dietary supplementation of NS seeds at up to 15% inclusion on pregnancy and pregnancy outcomes. Further, few studies have investigated the effect of acute or chronic aqueous NS extracts administration on hematology, hormone secretion, and the histology of major organs regulating metabolism and reproduction in the male rat. Thus, our studies were intended to bridge those gaps in knowledge. In our first study designed to investigate the effects of the dietary supplementation of NS seeds on pregnancy and pregnancy outcome, thirty-two mature female Sprague-Dawley rats weighing 250-350 g and between seven and ten weeks of age were utilized. Rats were assigned to one of four groups: Control group (0% Nigella sativa seed inclusion; n=8), Low group (5% Nigella sativa seed inclusion; n=8), Medium group (10% Nigella sativa seed inclusion; n=8), and High group (15% Nigella sativa seed inclusion; n=8). Rats were mated and allowed to carry pups in-utero to term. Our results indicated no observable injury in conceived pups in all experimental groups. Lowest incidence of pregnancy was seen in the 10% supplementation group. Mean pup weights in all NS- supplemented groups remained significant higher up to 7 days post-partum when compared to the control group. Dietary supplementation of NS seeds up to 15% had no deleterious effect on pregnancy and pregnancy outcomes. In the second study, we utilized thirty mature male Sprague-Dawley rats weighing 250-350 g, and between seven and ten weeks of age. Each rat was weighed and randomly assigned to receive either Saline, i.p. (Control group, n = 10) or 25mg/Kg BW NS aqueous extract, i.p. (Low dose group, n = 10), or 50mg/Kg BW NS aqueous extract, i.p. (High dose group, n = 15) in a total volume of 200 µl for either 15 days (acute phase; n=15) or for 30 days (chronic phase; n=15). At the end of each phase, 5 rats from each experimental group were euthanized and hormonal analyses and hematological, liver and kidney enzymes and function tests were determined. Further, histological analyses of key organs of metabolism and reproduction were performed. Administration of NS aqueous extract had no effect on liver enzyme levels and weights of the liver, kidney, testes, prostate gland and the epididymis. However, the chronic administration of NS extract increased blood urea nitrogen, reduced testicular and epididymal weights and caused testicular scarring and severe abdominal adhesion. NS aqueous extract administration, either in the acute or chronic phases, had no effect on luteinizing hormone, follicle-stimulating hormone and testosterone hormone levels. However, whereas phase significantly (P=0.03)increased mean LH levels, irrespective of treatment, it decreased mean plasma FSH levels (P=0.001) and this decrease was also not treatment-dependent. Taken together, these results indicate that NS supplementation had no deleterious effect on pregnancy and parturition in the female rat and increased pup weight, possibly as a result of its galactogogue effect. Further, acute NS extract administration had no effect in the male rat but chronic administration although without an effect on liver and kidney histology but induced structural changes in the testes and the epididymides. The NS-induced adhesion observed in the present study could be due to thymoquinone, an active ingredient in NS

Repetitive Finger Movement, Buttoning and Purdue Pegboard Tasks in People with Parkinson’s Disease

Studies have shown repetitive finger movement performance in people with Parkinson’s disease (PD) may be rate dependent. When performing acoustically cued repetitive finger movements at rates near to and above 2 Hz, they exhibit increased movement rate, reduced movement amplitude, and loss of phase accompanied by frequent hesitations. The relationship between this movement deficit and functional fine motor tasks in people with PD is unknown. The purpose of this study was to examine if people with PD who demonstrate repetitive finger movement impairment at rates near to and above 2 Hz perform worse on a buttoning task and a Purdue pegboard task compared to those that do not demonstrate repetitive finger movement impairment at rates near to and above 2 Hz. Forty-eight participants with PD completed an acoustically cued repetitive finger movement task, incrementing from a rate of 1 Hz to 3 Hz in 0.25 Hz. Movement rate and movement amplitude was compared to participants’ performance at 1 Hz and 1.25 Hz, respectively. Participants with PD were divided into groups based upon changes in movement rate and movement amplitude at rates near to and above 2 Hz. Participants also completed a buttoning and Purdue pegboard assembly task. Buttoning and Purdue pegboard performance was compared between groups. For movement rate, there were no significant differences between the fast rate group (moved faster than the tone at rates near to and above 2 Hz) and the normal group (those that were within 2 SD of the tone rate) on the buttoning and Purdue Pegboard tasks. Similarly, there were no significant differences between subgroups for movement amplitude alone on the functional tasks. This study demonstrated that changes in movement rate and movement amplitude during the performance of repetitive finger movement at rates near to and above 2 Hz have differential relationships to performance of functional fine motor tasks in persons with PD. Consideration and evaluation of both movement rate and movement amplitude, separately, may have clinical applications in the treatment of people with PD

Short-term informal leadership learning:a critical realist case study

Uzochukwu Jude UDEDIBIA, B.Phil., MCE, Short-Term Informal Leadership Learning (STILL): A Critical Realist Case Study Research, submitted to Lancaster University Management School for the degree of Doctor of Philosophy (PhD) in Management Learning and Leadership, September 2019. This thesis focuses on the short-term informal learning from the restructuring experience of twenty four senior leaders from three Canadian healthcare organizations who led restructuring in their organizations. This study investigated the leaders’ learning through a critical realist case study research approach. It used Pawson and Tilley’s (1997) Context-Mechanisms-Outcomes (CMO) framework to analyze their learning by describing the context of the learning, inferring mechanisms that can plausibly explain their learning, and describing the learning outcomes that these inferred mechanisms produced. This research’s departure point is the ongoing issue and debate about how formal leadership learning only contributes marginally to leadership emergence and development. In practice, organizations are complaining that they are not seeing acceptable returns in the heavy investments they have made in leadership development programs. On their own side, leadership scholars, having noticed this contribution gap, are calling for more research that may potentially contribute more to leadership learning. Therefore it is valuable to focus research on other sources - as processes or models - that have the potential to contribute more to leadership development. One such area for investigation is understanding how leaders learn informally in the short-term given time pressures occasioned by fast-moving organizational change demands. While previous research identified that learning informally from the experience of activities that they are engaged with is a natural way for leaders to learn, focus on this had remained on the learning that occurs over a long period of time. As insufficient research attention has been given to this area of how short-term informal leadership learning can occur, this research undertook this research to contribute to knowledge in this underserved area of leadership development. This research found that leaders can learn in the short-term and that a model that involves the processes of attention grabbing, rapid reaction, and meaning making can explain how the learning occurs

Contact tracing and isoniazid preventive therapy for prevention of childhood tuberculosis in The Gambia

Background Tuberculosis is a major public health problem worldwide and is characterized by a high incidence in The Gambia. Children acquire infection primarily from adults in their households, and especially young children are at higher risk of progressing to disease and death. In The Gambia, childhood tuberculosis is poorly addressed in the routine national TB program activities; contact tracing and isoniazid preventive therapy (IPT) are not implemented. The burden of childhood TB is therefore poorly characterized and the operational challenges of implementing IPT are not well understood. Methods TB symptoms screening questionnaire and tuberculin skin testing were administered in the community to child contacts of adults recently diagnosed with TB. Those with TB suggestive symptoms and/or positive TST result were further evaluated in a dedicated clinic with physical examination, chest x ray, sputum induction and examination with smear, Xpert MTB/RIF and culture. Adherence to IPT was measured by pill count and IsoScreen test. Results Co-prevalent TB disease was detected in child contacts both within and outside immediate household of the adult index TB case. Altogether, 1.6% of all child contacts screened had co-prevalent TB disease. 42.2% of the co-prevalent TB cases were among asymptomatic but TST positive child contacts. A combination of Xpert and culture was positive in 32.3% of all children diagnosed with TB, an increase of 9.7 – 22.6% over the yields from microscopy, Xpert and culture alone as individual tests. 255/328 (77.7%) children completed each of six months of IPT with good adherence. Conclusions Contact tracing restricted to symptom screening and immediate households would have missed nearly half of all co-prevalent TB disease in child contacts in this setting. A combination of Xpert and mycobacterial culture had incremental benefit for the bacteriological confirmation of TB disease in actively traced child contacts. Uptake of, and adherence to, IPT were high among the eligible child contacts

Information Communication Technology in Schools in African Countries and Factors that Promote Digital Divide

Although globalization tends to paint a fascinating picture of the world where all people are aided by modern-day communication technologies to integrate into the global information village, the digital divide has distorted what intended to follow as a sequence across all regions of the developed and underdeveloped world. Nonetheless, the worldwide recognition and acceptance of the importance of ICT in championing development across different works live and uniting all peoples into one global community has not received any known objections. The worldwide attestation to the relevance of ICT in permeating, championing, and innovating human and material resources cannot find institutional usefulness outside the boundaries of the education system. If schools in African countries are designed like their Western counterparts to tap from the level of information flow orchestrated by ICT, the pursuit of an information rich society where knowledge is placed within the reach of every citizen will be realizable. The position of the Internet in the free flow and dissemination of information depends on the realization of ICT infrastructure. The inevitability of ICT mediation in education and schools has given rise to the need to equip schools with computers and enable free internet access for members of the school community. The provision of ICT will serve a gateway to efficient and effective education systems anchored in research findings that ‘technology-mediated learning is advantageous to students, teachers, and schools.’ Current evidence shows African countries to be on the wrong side of digital diffusion as their schools and pupils are still confronted by the digital divide. Despite a growing integration of communities with mobile network technologies, a digital divide still cuts across schools in African countries, equally damaging the reputation of the continent which has not been able to direct its human and material resources where it matters. The inability of the countries of Africa to meaningfully integrate ICT into school curriculum increases the worries of digital divide, which has created a demarcation between education standards in Africa and developed countries. It identifies factors that promote digital divides in African schools to hang on human and material capacities. These two factors happen to be manmade for lack of due diligence in the race for information freedom. African countries need to modernize its education pedagogy to accommodate ICT. For that to happen, countries have to come up with alternative ideas capable of circumventing the high cost of computers and broadband internet access to bridge the digital divide in schools. The options that can solve ICT problems in schools in African countries hinges on types of digital technology utilized by students as mechanisms for bridging the digital divide. Hence, ICT in the 21st century holds education to ransom with pedagogy anchored on technology as the only solution. Therefore, digital diffusion in all schools merits global concern and the use of every possible methodology as a welcome initiative. Keywords: Information Communication Technology, Digital Divide, Digital Inclusion, Digital Diffusion, Internet Acces