Government special education’s principals’ perceptions about total quality management (TQM in education): A qualitative research

The service sector is a rapidly changing sector and this dynamic culture offers a challenge for the service companies to lead or to actually survive in this competitive environment. As the education sector is a part of the overall service industry, this raises the need for a strong framework to reach for high quality service in the education sector. Though, adoption of TQM in the educational institutions is of common practice in the Western world, however, the history of TQM adoption in the Pakistani educational institutions generally and in special education’s institutions is still struggling to get its due status. Therefore, the main purpose of this study was to identify the perceptions of special education’s principals about TQM and its implementation along with other unexplored views about TQM. In doing so, this qualitative study was conducted in special education’s institutes. 15 principals were interviewed. After collecting the data, standard qualitative data analysis procedure was applied to understand the perceptions of the principals about TQM. The results of this study show that in institutes of special education TQM is still a vague concept and there is still room for improvement that influences the level of TQM practices in these institutions

Earning Management and Dividend Policy: Empirical evidence from Pakistani listed companies

The study is an effort to find out the impact of earning management on dividend policy in Pakistan. A set of listed companies from Karachi stock exchange (KSE) 100 indexes have been investigated to analyze the relationship from the year 2005 to 2009 in Pakistan. Dividend policy has been measured by dividend payout whereas earning management has been quantified by discretionary accruals and discretionary accrual is used as a proxy to determine earning management. Modified cross sectional model (1995) has been used to measure discretionary accruals. Regression analysis shows that earning management has impact on dividend policy that rejects our null hypothesis. But coefficient shows that the relationship is so weak that is near to no relationship. Reason behind this no impact is economic decline period, because earning management changes every year. In the decline period our earning management was increase and the companies starts downsizing divided payment. Key words: Dividend Policy, Earning Management, Karachi Stock Exchange

Evidence-Based Practice by Psychologists Treating Secondary Psychological Injuries Within State Insurance Regulatory Authority Governed Frameworks

While psychopathology arising from musculoskeletal injury (i.e., secondary psychological injury) is predictive of poor recovery by injured people claiming compensation, the application of evidence-based practice (EBP) treatment guidelines is associated with improved outcomes. In 2010, the State Insurance Regulatory Authority (SIRA) in New South Wales (NSW), Australia- a body that governs the regulatory functions of Workers Compensation (WC) and motor vehicle Compulsory Third Party (CTP) insurance schemes-implemented EBP treatment guidelines. These guidelines are contained in the document titled: Clinical framework for the delivery of health services (Transport Commission & WorkSafe Victoria, 2012). At the time of conducting this research, the SIRA EBP treatment guidelines had been in effect for over five years; however, their effect on psychologists' practice and injured persons' outcomes was unknown. Therefore, the aims of the thesis were to: 1) to examine the effect of the introduction of the EBP treatment guidelines on claims cost and injured person outcomes within the SIRA insurance schemes and assess the use of EBP by psychologists treating musculoskeletal injuries with secondary psychological injury in this context, 2) to identify barriers to psychologists' use of EBP from the perspective of psychologists and 3) from the perspective of key stakeholders and 4) to elicit and test the feasibility of recommendations made by expert psychologists to improve psychologists' practice. Study 1 investigated whether the implementation of EBP treatment guidelines had reduced claims costs, improved injured person outcomes and resulted in psychologists using EBP. From a time range sample of n = 238 administrative records of people with a musculoskeletal injury and secondary psychological injury, the results revealed that the implementation of EBP had acted as a buffer against broader negative trends in claims cost and return to work timeframes (i.e., compared to the population of injured people n = 26,254 who had suffered a musculoskeletal injury and not consulted a psychologist during the same time period). The second phase of the study included a qualitative case-level analysis of n = 12 WC files and n = 9 CTP showed that within both WC and CTP positive injured person outcomes occurred when psychologists' adherence with EBP guidelines was high. However, the findings also showed that psychologists' application of EBP treatment guidelines was suboptimal. Study 2 explored the barriers in psychologists' adherence with the SIRA EBP guidelines. Psychologists (n = 20) practicing within rural, regional and metropolitan in NSW participated in focus groups. The results revealed three key issues functioned as barriers: 1) a lack of trust in the validity of the recommended EBP guidelines, 2) a lack of knowledge of the psychologist's role in this context and insufficient skills to fully apply the guidelines, protocols and procedures and 3) a poor fit between EBP guidelines, client presentations and circumstances and the SIRA compensation schemes. The findings showed that both individual practitioner variables and contextual barriers influenced adherence to EBP. Study 3 explored the contextual barriers that were identified in Study 2 as affecting practice. These included perceived barriers created by general practitioners (GPs), insurers and injured patients' actions. A sample of n = 27 participants was involved. The results showed that GPs were reticent to access psychological services due to a poor fit between their practice and treatment guidelines. Insurers lacked trust in the validity of 'secondary psychological injury' claims and this was exacerbated by psychologists' non-adherence to insurers' protocols and deficits in insurers' knowledge. Injured peoples' willingness to engage with treatment was impaired by a poor fit between the treatment guidelines and their experience of insurers' and psychologists' practices. Study 4 elicited recommendations to overcome the barriers in psychologists' adherence to EBP guidelines that were identified in Study 2 and examined the feasibility of their implementation. The recommendations proposed by field experts (n = 8) included: 1) mandatory training and continuing professional development in the area of practice, 2) using independent consultants for expert advice, 3) completion of outcome measures prior to the first session, 4) completion of a treatment plan in-session with the injured person and 5) completion of outcome measures in the eighth and final session. These recommendations were considered feasible by most of the participating psychologists (n =150). Taken together, the findings of this project highlight the important role of psychologists in the treatment of musculoskeletal injuries with secondary psychological injury and reinforced the need to integrate the best available research evidence with clinician's expertise and patient expectations and values to deliver beneficial outcomes to people. In addition, the findings illustrate that while psychologists have skills in the treatment of mental disorders they may not be competent in EBP approaches for managing and addressing pain and functional disability arising from secondary psychological injury within the compensation frameworks. The findings also highlight that to increase the application of EBP guidelines, a broad-based commitment from all stakeholders within the SIRA compensation schemes is required. This includes education programs that support all stakeholders to understand that the management of secondary psychological injuries requires a functional restoration perspective within a biopsychosocial paradigm. Lastly, empirical data from the research can be used to encourage stakeholders to change their practices and for policymakers, administrators and professional associations to provide support to facilitate psychologists' adherence with EBP in ordinary clinical settings

Enhanced physical endurance and improved memory performance following taurine administration in rats

Energy drinks enhance physical endurance and cognitive ability. The ingredients present in these drinks are considered as ergogenic and have memory boosting effects. In the present study effects of taurine administration for one week was monitored on physical exercise and memory performance in rats. Animals were divided into two groups namely control and test. Taurine was injected intraperitoneally to the test group at the dose of 100mg/kg. After one week of treatment rats were subjected to physical exercise and memory task. Results of this study revealed that rats injected with taurine for one week exhibited improved muscular strength as well as enhanced memory performance in Morris water maze and elevated plus maze. Biomarker of lipid peroxidation was significantly reduced in brain and plasma of test animals. Taurine administration also resulted in higher levels of corticosterone in this study. The results highlight the significance of taurine ingestion in energy demanding and challenging situations in athletes and young subjects

Seed priming alleviates salt stress in two fenugreek (Trigonella foenum-graecum l.) Cultivars

Salinity is globally considered a widespread problem of the irrigated soils in arid and semi-arid areas. To minimize the negative effect of salinity seed priming technique is proved as a useful by improve germination and seedling growth. Therefore, the current study was conducted to evaluate the effect of different priming techniques on fenugreek under saline conditions. The priming treatments were potassium nitrate (KNO3), polyethylene glycol (PEG), gibberellic acid (GA), hydrogen peroxide (H2O2), salicylic acid (SA) and distilled water (D/W). Two fenugreek cultivars i.e. Kasuri methi and Local methi were evaluated under two salinity levels viz. 0 mM and 100 mM. In Kasuri methi (V1), priming with GA3 and PEG enhanced germination index (37.52%) and energy of emergence (98.33%) as compared with other treatments. Final emergence percentage (100%) was increased in control plants of both cultivars when treated with SA. Morphological characteristics such as number of leaves (57.50), number of branches (19.16), shoot length (18.03cm), root length (8.98cm), plant fresh (2.34g) and dry biomass (1.21g) was increased in control plants of Kasuri methi (V1) when primed with SA. Leaf chlorophyll “a” (1.06 mg/g) and chlorophyll “b” (1.30 mg/g) was significantly increased in control plants of Local methi (V2) primed with SA. Antioxidant activity, antioxidant capacity and proline contents in leaves as well as in roots were also increased when treated with SA under salt stress. It is concluded that seeds of Kasuri methi should be treated with SA in order to reduce the effect of salinity and improve the germination, morphological and biochemical characteristic

Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS)

Background Sepsis is a major contributor to neonatal mortality, particularly in low-income and middle-income countries (LMICs). WHO advocates ampicillin–gentamicin as first-line therapy for the management of neonatal sepsis. In the BARNARDS observational cohort study of neonatal sepsis and antimicrobial resistance in LMICs, common sepsis pathogens were characterised via whole genome sequencing (WGS) and antimicrobial resistance profiles. In this substudy of BARNARDS, we aimed to assess the use and efficacy of empirical antibiotic therapies commonly used in LMICs for neonatal sepsis. Methods In BARNARDS, consenting mother–neonates aged 0–60 days dyads were enrolled on delivery or neonatal presentation with suspected sepsis at 12 BARNARDS clinical sites in Bangladesh, Ethiopia, India, Pakistan, Nigeria, Rwanda, and South Africa. Stillborn babies were excluded from the study. Blood samples were collected from neonates presenting with clinical signs of sepsis, and WGS and minimum inhibitory concentrations for antibiotic treatment were determined for bacterial isolates from culture-confirmed sepsis. Neonatal outcome data were collected following enrolment until 60 days of life. Antibiotic usage and neonatal outcome data were assessed. Survival analyses were adjusted to take into account potential clinical confounding variables related to the birth and pathogen. Additionally, resistance profiles, pharmacokinetic–pharmacodynamic probability of target attainment, and frequency of resistance (ie, resistance defined by in-vitro growth of isolates when challenged by antibiotics) were assessed. Questionnaires on health structures and antibiotic costs evaluated accessibility and affordability. Findings Between Nov 12, 2015, and Feb 1, 2018, 36 285 neonates were enrolled into the main BARNARDS study, of whom 9874 had clinically diagnosed sepsis and 5749 had available antibiotic data. The four most commonly prescribed antibiotic combinations given to 4451 neonates (77·42%) of 5749 were ampicillin–gentamicin, ceftazidime–amikacin, piperacillin–tazobactam–amikacin, and amoxicillin clavulanate–amikacin. This dataset assessed 476 prescriptions for 442 neonates treated with one of these antibiotic combinations with WGS data (all BARNARDS countries were represented in this subset except India). Multiple pathogens were isolated, totalling 457 isolates. Reported mortality was lower for neonates treated with ceftazidime–amikacin than for neonates treated with ampicillin–gentamicin (hazard ratio [adjusted for clinical variables considered potential confounders to outcomes] 0·32, 95% CI 0·14–0·72; p=0·0060). Of 390 Gram-negative isolates, 379 (97·2%) were resistant to ampicillin and 274 (70·3%) were resistant to gentamicin. Susceptibility of Gram-negative isolates to at least one antibiotic in a treatment combination was noted in 111 (28·5%) to ampicillin–gentamicin; 286 (73·3%) to amoxicillin clavulanate–amikacin; 301 (77·2%) to ceftazidime–amikacin; and 312 (80·0%) to piperacillin–tazobactam–amikacin. A probability of target attainment of 80% or more was noted in 26 neonates (33·7% [SD 0·59]) of 78 with ampicillin–gentamicin; 15 (68·0% [3·84]) of 27 with amoxicillin clavulanate–amikacin; 93 (92·7% [0·24]) of 109 with ceftazidime–amikacin; and 70 (85·3% [0·47]) of 76 with piperacillin–tazobactam–amikacin. However, antibiotic and country effects could not be distinguished. Frequency of resistance was recorded most frequently with fosfomycin (in 78 isolates [68·4%] of 114), followed by colistin (55 isolates [57·3%] of 96), and gentamicin (62 isolates [53·0%] of 117). Sites in six of the seven countries (excluding South Africa) stated that the cost of antibiotics would influence treatment of neonatal sepsis

Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached$8. 8 trillion (95% uncertainty interval UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total,$40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this,$13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and$1.4 billion was repurposed from existing health projects. $3.1 billion (22.4$2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7$1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd

Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019.

The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.Funding/Support: The Institute for Health Metrics and Evaluation received funding from the Bill & Melinda Gates Foundation and the American Lebanese Syrian Associated Charities. Dr Aljunid acknowledges the Department of Health Policy and Management of Kuwait University and the International Centre for Casemix and Clinical Coding, National University of Malaysia for the approval and support to participate in this research project. Dr Bhaskar acknowledges institutional support from the NSW Ministry of Health and NSW Health Pathology. Dr Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, which is funded by the German Federal Ministry of Education and Research. Dr Braithwaite acknowledges funding from the National Institutes of Health/ National Cancer Institute. Dr Conde acknowledges financial support from the European Research Council ERC Starting Grant agreement No 848325. Dr Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia, IP under the Norma Transitória grant DL57/2016/CP1334/CT0006. Dr Ghith acknowledges support from a grant from Novo Nordisk Foundation (NNF16OC0021856). Dr Glasbey is supported by a National Institute of Health Research Doctoral Research Fellowship. Dr Vivek Kumar Gupta acknowledges funding support from National Health and Medical Research Council Australia. Dr Haque thanks Jazan University, Saudi Arabia for providing access to the Saudi Digital Library for this research study. Drs Herteliu, Pana, and Ausloos are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. Dr Hugo received support from the Higher Education Improvement Coordination of the Brazilian Ministry of Education for a sabbatical period at the Institute for Health Metrics and Evaluation, between September 2019 and August 2020. Dr Sheikh Mohammed Shariful Islam acknowledges funding by a National Heart Foundation of Australia Fellowship and National Health and Medical Research Council Emerging Leadership Fellowship. Dr Jakovljevic acknowledges support through grant OI 175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. Dr Katikireddi acknowledges funding from a NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_00022/2), and the Scottish Government Chief Scientist Office (SPHSU17). Dr Md Nuruzzaman Khan acknowledges the support of Jatiya Kabi Kazi Nazrul Islam University, Bangladesh. Dr Yun Jin Kim was supported by the Research Management Centre, Xiamen University Malaysia (XMUMRF/2020-C6/ITCM/0004). Dr Koulmane Laxminarayana acknowledges institutional support from Manipal Academy of Higher Education. Dr Landires is a member of the Sistema Nacional de Investigación, which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación. Dr Loureiro was supported by national funds through Fundação para a Ciência e Tecnologia under the Scientific Employment Stimulus–Institutional Call (CEECINST/00049/2018). Dr Molokhia is supported by the National Institute for Health Research Biomedical Research Center at Guy’s and St Thomas’ National Health Service Foundation Trust and King’s College London. Dr Moosavi appreciates NIGEB's support. Dr Pati acknowledges support from the SIAN Institute, Association for Biodiversity Conservation & Research. Dr Rakovac acknowledges a grant from the government of the Russian Federation in the context of World Health Organization Noncommunicable Diseases Office. Dr Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. Dr Sheikh acknowledges support from Health Data Research UK. Drs Adithi Shetty and Unnikrishnan acknowledge support given by Kasturba Medical College, Mangalore, Manipal Academy of Higher Education. Dr Pavanchand H. Shetty acknowledges Manipal Academy of Higher Education for their research support. Dr Diego Augusto Santos Silva was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil Finance Code 001 and is supported in part by CNPq (302028/2018-8). Dr Zhu acknowledges the Cancer Prevention and Research Institute of Texas grant RP210042

Understanding the barriers affecting psychologists' adherence to evidence-based treatment guidelines from a stakeholder standpoint

Psychologists’ adherence with evidence-based guidelines based on the biopsychosocial premise in the management of musculoskeletal injuries is influenced by the actions by General Practitioners (GPs), insurers, and injured patients’ actions. For data collection, we interviewed GPs (n = 6), insurers (n = 6), and injured people (n = 15) from the two personal injury compensation schemes in New South Wales. Thematic analysis yielded the following: GPs were reticent to access psychological services that represented a poor fit between their practice and treatment guidelines, insurers lacked trust in the validity of “secondary psychological injury” claims’. Injured peoples’ willingness to engage with treatment was impaired by a poor fit between the treatment guidelines and their experience of insurers’ and psychologists’ practices