Examining the Challenges of Procurement Professionals in a Public Institution: The Case of WA Polytechnic, in the Upper West Region of Ghana

The research work was titled “Examining the Challenges of Procurement Professionals in a Public institution, “WA Polytechnic, in the Upper West Region of Ghana was chosen as a case of study.The research work was organized into five coherent chapters. Chapter one was basically the introductory part of the research work. An extensive literature on the research work was piled up at chapter two.Methodology such as the use of questionnaires and interviews were used to collect data for the research.Interesting findings such as problems faced by procurement professionals in public institutions were discovered from the research. Some of these problems included long and cumbersome procurement procedure, low threshold, inadequate funds from Ghana.Education Trust Fund(GetFund)  to complete Getfund projects, no representation of procurement managers to serve on entity tender committees in public institutions, Inadequate funds to support projects, Political interference from government and many others.Benefits that accrued from procuring of goods, works and services at WA polytechnic were also revealed from the research.The research was concluded with the statement that even though the work of procurement professionals come with a lot of challenges, their presence is necessary in every business entity since they help in ensuring better utilization of funds and many others.The research finally ended with recommendations that, The Government of Ghana should endeavor to review the Public procurement Act, 2003(Act 663) to limit the number of steps in the procurement process so as to reduce the level of bureaucracy in the system.Moreover, government subventions allocated to WA polytechnic should be paid on time and the actual budget amount or funds needed to support projects should be given much consideration by government in order to undertake and support projects successfully. Keywords: Procurement Professionals, Challenges, Public Institution, Ghana Education Fund (GETFUND)  

Determinants of Capital Structure: Evidence from Ghanaian Firms

This paper investigates the determinants of capital structure using dataset from 33 listed and non-listed companies during the period 2003 – 2007 in Ghana.  A multiple regression analysis of pooled-cross sectional and time-series observations have been employed in the analysis.  The results identify long-term debt to be irrelevant component of capital structure of large unquoted and quoted firms in Ghana as there is a greater reliance on equity.  Furthermore, profitability, size, business risk and tangible assets have positive correlation with level of gearing of companies in Ghana.  On the other hand, growth, and tax indicate a negative correlation with the level of gearing. Keywords: Capital structure, financing decisions, listed, non-listed, Ghana

Multivariate generalised linear mixed-effects models for analysis of clinical trial-based cost-effectiveness data

Economic evaluations conducted alongside randomized controlled trials are a popular vehicle for generating high-quality evidence on the incremental cost-effectiveness of competing health care interventions. Typically, in these studies, resource use (and by extension, economic costs) and clinical (or preference-based health) outcomes data are collected prospectively for trial participants to estimate the joint distribution of incremental costs and incremental benefits associated with the intervention. In this article, we extend the generalized linear mixed-model framework to enable simultaneous modeling of multiple outcomes of mixed data types, such as those typically encountered in trial-based economic evaluations, taking into account correlation of outcomes due to repeated measurements on the same individual and other clustering effects. We provide new wrapper functions to estimate the models in Stata and R by maximum and restricted maximum quasi-likelihood and compare the performance of the new routines with alternative implementations across a range of statistical programming packages. Empirical applications using observed and simulated data from clinical trials suggest that the new methods produce broadly similar results as compared with Stata’s merlin and gsem commands and a Bayesian implementation in WinBUGS. We highlight that, although these empirical applications primarily focus on trial-based economic evaluations, the new methods presented can be generalized to other health economic investigations characterized by multivariate hierarchical data structures

Case study of a method of development of a selection process for community health workers in sub-Saharan Africa

Background Choosing who should be recruited as a community health worker (CHW) is an important task, for their future performance partly depends on their ability to learn the required knowledge and skills, and their personal attributes. Developing a fair and effective selection process for CHWs is a challenging task, and reports of attempts to do so are rare. This paper describes a five-stage process of development and initial testing of a CHW selection process in two CHW programmes, one in Malawi and one in Ghana, highlighting the lessons learned at each stage and offering recommendations to other CHW programme providers seeking to develop their own selection processes. Case presentation The five stages of selection process development were as follows: (1) review an existing selection process, (2) conduct a job analysis, (3) elicit stakeholder opinions, (4) co-design the selection process and (5) test the selection process. Good practice in selection process development from the human resource literature and the principles of co-design were considered throughout. Validity, reliability, fairness, acceptability and feasibility—the determinants of selection process utility—were considered as appropriate during stages 1 to 4 and used to guide the testing in stage 5. The selection methods used by each local team were a written test and a short interview. Conclusions Working with stakeholders, including CHWs, helped to ensure the acceptability of the selection processes developed. Expectations of intensiveness—in particular the number of interviewers—needed to be managed as resources for selection are limited, and CHWs reported that any form of interview may be stressful. Testing highlighted the importance of piloting with CHWs to ensure clarity of wording of questions, interviewer training to maximise inter-rater reliability and the provision of guidance to applicants in advance of any selection events. Trade-offs between the different components of selection process utility are also likely to be required. Further refinements and evaluation of predictive validity (i.e. a sixth stage of development) would be recommended before roll-out

Three-Dimensional Reconstructions of Tadpole Chondrocrania from Historical Sections

Reconstructing three dimensional structures (3DR) from histological sections has always been difficult but is becoming more accessible with the assistance of digital imaging. We sought to assemble a low cost system using readily available hardware and software to generate 3DR for a study of tadpole chondrocrania. We found that a combination of RGB can1era, stereomicro­scope, and Apple Macintosh PowerPC computers running NIH Image, Object Image, Rotater, and SURFdriver software provided acceptable reconstruc­tions. These are limited in quality primarily by the distortions arising from histological protocols rather than hardware or software

Quality Assessment of Artemether-Lumefantrine Samples and Artemether Injections Sold in the Cape Coast Metropolis

Most prescribers and patients in Ghana now opt for the relatively expensive artemether/lumefantrine rather than artesunate-amodiaquine due to undesirable side effects in the treatment of uncomplicated malaria. The study sought to determine the existence of substandard and/or counterfeit artemether-lumefantrine tablets and suspension as well as artemether injection on the market in Cape Coast. Six brands of artemether-lumefantrine tablets, two brands of artemether-lumefantrine suspensions, and two brands of artemether injections were purchased from pharmacies in Cape Coast for the study. The mechanical properties of the tablets were evaluated. The samples were then analyzed for the content of active ingredients using High Performance Liquid Chromatography with a variable wavelength detector. None of the samples was found to be counterfeit. However, the artemether content of the samples was variable (93.22%−104.70% of stated content by manufacturer). The lumefantrine content of the artemether/lumefantrine samples was also variable (98.70%–111.87%). Seven of the artemether-lumefantrine brands passed whilst one failed the International Pharmacopoeia content requirements. All brands of artemether injections sampled met the International Pharmacopoeia content requirement. The presence of a substandard artemether-lumefantrine suspension in the market should alert regulatory bodies to be more vigilant and totally flush out counterfeit and substandard drugs from the Ghanaian market

Three-Dimensional Reconstructions of Tadpole Chondrocrania from Histological Sections

Reconstructing three dimensional structures (3DR) from histological sections has always been difficult but is becoming more accessible with the assistance of digital imaging. We sought to assemble a low cost system using readily available hardware and software to generate 3DR for a study of tadpole chondrocrania. We found that a combination of RGB camera, stereomicroscope, and Apple Macintosh PowerPC computers running NIH Image, Object Image, Rotater. and SURFdriver software provided acceptable reconstructions. These are limited in quality primarily by the distortions arising from histological protocols rather than hardware or software

Cardiopulmonary ultrasound for critically ill adults improves diagnostic accuracy in a resourceâ limited setting: the AFRICA trial

ObjectiveTo assess the effects of a cardiopulmonary ultrasound (CPUS) examination on diagnostic accuracy for critically ill patients in a resourceâ limited setting.MethodsApproximately half of the emergency medicine resident physicians at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, were trained in a CPUS protocol. Adult patients triaged to the resuscitation area of the emergency department (ED) were enrolled if they exhibited signs or symptoms of shock or respiratory distress. Patients were assigned to the intervention group if their treating physician had completed the CPUS training. The physician’s initial diagnostic impression was recorded immediately after the history and physical examination in the control group, and after an added CPUS examination in the intervention group. This was compared to a standardised final diagnosis derived from post hoc chart review of the patient’s care at 24 h by two blinded, independent reviewers using a clearly defined and systematic process. Secondary outcomes were 24â h mortality and use of IV fluids, diuretics, vasopressors and bronchodilators.ResultsOf 890 patients presenting during the study period, 502 were assessed for eligibility, and 180 patients were enrolled. Diagnostic accuracy was higher for patients who received the CPUS examination (71.9% vs. 57.1%, Î 14.8% [CI 0.5%, 28.4%]). This effect was particularly pronounced for patients with a â cardiacâ diagnosis, such as cardiogenic shock, congestive heart failure or acute valvular disease (94.7% vs. 40.0%, Î 54.7% [CI 8.9%, 86.4%]). Secondary outcomes were not different between groups.ConclusionsIn an urban ED in Ghana, a CPUS examination improved the accuracy of the treating physician’s initial diagnostic impression. There were no differences in 24â h mortality and a number of patient care interventions.ObjectifEvaluer les effets de l’examen échographique cardioâ pulmonaire (CPUS) sur la précision du diagnostic chez les patients gravement malades dans un cadre à ressource limitée.MéthodesEnviron la moitié des médecins résidents en médecine d’urgence à la Komfo Anokye Teaching Hôpital (KATH) à Kumasi, au Ghana ont été formés pour un protocole de CPUS. Les patients adultes triés dans l’unité de ressuscitation des soins intensifs ont été inscrits s’ils présentaient des signes ou des symptômes de choc ou d’une détresse respiratoire. Les patients ont été assignés au groupe d’intervention si leur médecin traitant avait suivi la formation CPUS. Le diagnostic initial du médecin a été enregistré immédiatement après l’anamnèse et l’examen physique dans le groupe témoin, et après un examen CPUS ultérieur dans le groupe d’intervention. Cela a été comparé à un diagnostic final standard dérivé de l’analyse postâ hoc en aveugle des dossiers de soins du patient à 24 heures par deux examinateurs indépendants, au moyen d’un processus clairement défini et systématique. Les résultats secondaires étaient la mortalité de 24 heures et l’utilisation de fluides en IV, de diurétiques, de vasopresseurs et de bronchodilatateurs.RésultatsSur 890 patients présentés au cours de la période dâ étude, 502 ont été évalués pour lâ éligibilité et 180 patients ont été inscrits. La précision du diagnostic était plus élevée chez les patients ayant reçu l’examen CPUS (71,9% contre 57,1%, Î 14,8% [IC: 0,5% à 28.4%]). Cet effet était particulièrement marquée pour les patients avec un diagnostic «cardiaque», tel que le choc cardiogénique, l’insuffisance cardiaque congestive ou une maladie aiguë valvulaire (94,7% contre 40,0%, Î 54,7% [IC: 8,9% à 86,4%]). Les résultats secondaires nâ étaient pas différents entre les groupes.ConclusionsDans un service de soins intensifs urbain au Ghana, un examen CPUS améliorait la précision du diagnostic initial du médecin traitant. Il n’y avait aucune différence dans la mortalité de 24 heures et dans le nombre des interventions de soins.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141626/1/tmi12992.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141626/2/tmi12992_am.pd

Erratum to 'Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries' [BJA Open 7 (2023) 100207]

[This corrects the article DOI: 10.1016/j.bjao.2023.100207.].</p