Predictors of Employee Motivation in a Pharmaceutical Company

The researcher sought to find out the predictors of employee motivation in the Taro Pharmaceutical Company. The research design for this study was a cross-sectional descriptive survey with a close ended questionnaire which was used to provide answers to the research questions. The independent variable in the study is HR Strategies and the dependent variable in the study is employee motivation. The study employed Statistical Package for Social Sciences (SPSS) version 20.0 to analyze the data gathered on the basis of descriptive statistics such as Mean and Standard deviation and inferential statistics thus, Pearson correlation and regression and the result was discussed. Systematic and proportionate sampling techniques were used in selecting 242 respondents. 215 questionnaires were retrieved and used for the analysis. To test hypotheses H1-H2, bivariate regression analyses was carried out. Also, Pearson correlation was done to find out the existing relationship between HR Strategies and employee motivation. HR Strategies was significantly related to employee motivation. in the simple regression analysis, all the dimensions of HR Strategies significantly impacted employee motivation with communication being the highest predictor of motivation. The results revealed that, at the Taro Pharmaceutical Company, HR Strategies include communication, reward and recognition, work systems, staffing and training and development. The results proved that; all the dimensions of HR Strategies were significantly related to employee motivation which shows that employees were highly motivated. staffing and training and development followed with reward and recognition as well as work system. The highest of the challenges is non-regularization of a general staff meeting. Also, the absence of lucrative incentives was a major challenge to the employees. Inadequate change within work unit was also key. Even though employees were motivated generally, Low comprehension of company strategy and poor coordination amongst management was evident in the results of the analysis. Based on the findings, the researcher recommends that, Management should consider regularizing general meetings with the entire staff. Certain concerns of low-profile staff may be better understood at a general meeting even though there are structured ways of presenting their grievances. Management should also consider incentivizing lower ranked employees and other employees who fall outside the top management bracket. It is research based and healthy for employees to be incentivized intermittently. Keywords: Human Resource Strategy, Employee Motivation DOI: 10.7176/EJBM/13-3-12 Publication date: January 31st 202

Patient Choice and Willingness Toward Gatekeepers as First-Contact Medical Institutions in Chinese Tiered Healthcare Delivery System: A Cross-Sectional Study

Introduction: Gatekeeping mechanism of primary care institutions (PCIs) is essential in promoting tiered healthcare delivery system in China. However, patients seeking for higher-level institutions instead of gatekeepers as their first contact has persisted in the past decade. This study aims to explain patients' choice and willingness and to provide potential solutions.Methods: A survey was conducted among residents who had received medical care within the previous 14 days. Patients' choice and willingness of PCIs for first contact together with influencing factors were analyzed using binary logistic regression.Results: Of 728 sampled patients in Hubei, 55.22% chose PCIs for first contact. Patients who are older, less educated, with lower family income, not living near non-PCIs, with better self-perceived health status, only buying medicines, and living in rural instead of urban area had significantly higher probability of choosing PCIs. As of willingness, over 90% of the patients inclined to have the same choice for their first contact under similar health conditions. Service capability was the primary reason limiting patients' choice of PCIs.Conclusions: The gatekeeper system did not achieve its goal which was 70% of PCIs among all kinds of institutions for first contact. Future measures should aim to improve gate-keepers' capability

The lifetime cost estimation of human papillomavirus-related diseases in China : a modeling study

Objectives: To estimate the lifetime treatment costs of patients with human papillomavirus (HPV) infection-related diseases in China and to provide cost estimates for the economic evaluation of HPV intervention strategies. Methods: We extracted real-world hospital data from 2012 to 2019 and screened for subjects who met the criteria of clinical diagnosis of HPV-related diseases to obtain country-specific inputs into a Markov decision model. The model simulated lifetime treatment costs for HPV from the perspective of a national payer. A 5% discount rate was applied. Costs were converted and inflated to 2020 US dollars (USD) Results: Using 2021 as the base year, the lifetime costs per patient for carcinoma in situ, local metastasis, and distant metastasis cervical cancer are $24,208 (95$19,562 (95%CI: 14,456-25,567), and $17,599 (95$17,593 (95%CI: 14,962-23,596), $17,120 (95$22,411 (95%CI: 12,172-22,249), respectively. The base-case lifetime cost per patient for different stages of vulvar cancer/penile cancer/anal cancer/oral cancer/oropharyngeal cancer/laryngeal cancer falls within $17,120-$58,236. Conclusions: Using real-world data, we calculated lifetime treatment costs of HPV-related cancer in China and found that the lifetime cost for patients exceeded $17,000 for various stages of disease. The national burden of HPV-related disease could be significantly reduced by eliminating HPV infection

Development and visualization of a risk prediction model for metabolic syndrome: a longitudinal cohort study based on health check-up data in China

AimOur study aimed to construct a practical risk prediction model for metabolic syndrome (MetS) based on the longitudinal health check-up data, considering both the baseline level of physical examination indicators and their annual average cumulative exposure, and to provide some theoretical basis for the health management of Mets.MethodsThe prediction model was constructed in male and female cohorts, separately. The shared set of predictive variables screened out from 49 important physical examination indicators by the univariate Cox model, Lasso-Cox model and the RSF algorithm collectively was further screened by Cox stepwise regression method. The screened predictors were used to construct prediction model by the Cox proportional hazards regression model and RSF model, respectively. Subsequently, the better method would be selected to develop final MetS predictive model according to comprehensive comparison and evaluation. Finally, the optimal model was validated internally and externally by the time-dependent ROC curve (tdROC) and concordance indexes (C-indexes). The constructed predictive model was converted to a web-based prediction calculator using the “shiny” package of the R4.2.1 software.ResultsA total of 15 predictors were screened in the male cohort and 9 predictors in the female cohort. In both male and female cohorts, the prediction error curve of the RSF model was consistently lower than that of the Cox proportional hazards regression model, and the integrated Brier score (IBS) of the RSF model was smaller, therefore, the RSF model was used to develop the final prediction model. Internal validation of the RSF model showed that the area under the curve (AUC) of tdROC for 1 year, 3 years and 5 years in the male cohort were 0.979, 0.991, and 0.983, and AUCs in the female cohort were 0.959, 0.975, and 0.978, respectively, the C-indexes calculated by 500 bootstraps of the male and female cohort RSF models are above 0.7. The external validation also showed that the model has good predictive ability.ConclusionThe risk predictive model for MetS constructed by RSF in this study is more stable and reliable than Cox proportional hazards regression model, and the model based on multiple screening of routine physical examination indicators has performed well in both internal and external data, and has certain clinical application value

DGKZ Acts as a Potential Oncogene in Osteosarcoma Proliferation Through Its Possible Interaction With ERK1/2 and MYC Pathway

Osteosarcoma (OS) is one of the most common primary bone tumors in children and young adults. The majority of osteosarcoma patients have limited alternative therapeutic options and metastatic patients generally have a poor prognosis. Thus, it is important to explore novel effective therapeutic targets in the treatment of osteosarcoma. Diacylglycerol kinase zeta (DGKZ) is a recently identified gene potentially associated with certain human carcinogenesis. However, the role of DGKZ in proliferation of osteosarcoma is still unclear. In this study, DGKZ's expression was firstly investigated in OS tumor samples and correlated with poor outcome in OS patients. Silence of DGKZ by shRNA hampered osteosarcoma cell growth and promoted cell apoptosis in vitro. In vivo, DGKZ's knockout also suppressed xenograft tumor proliferation as determined by bioluminescence imaging and weight/volume measurements. Meanwhile, Affymetrix GeneChip and Ingenuity Pathway Analysis (IPA) revealed that DGKZ knockdown resulted in a decreased activity of MYC pathway, and several target genes expression in MYC pathway were altered, including CCND1, CDKN2B, CDK6, PCNA, and EGR1. Furthermore, immunoprecipitation coupled with mass spectrometry (IP-MS) analysis was used to identify proteins that interacted with DGKZ in OS cells and revealed ERK1/2, a key MYC-interactor, to associate with DGKZ. Together, our study demonstrated that DGKZ might act as an oncogene in osteosarcoma via its possible interaction with ERK1/2 and MYC pathway

Cost-effectiveness analysis of atezolizumab in patients with non-small-cell lung cancer ineligible for treatment with a platinum-containing regimen: a United Kingdom health care perspective

BackgroundCost-effectiveness of atezolizumab, as a treatment for advanced non-small-cell lung cancer (NSCLC) patients who cannot receive a platinum-containing regimen,was still unknown. Our objective was to evaluate the cost-effectiveness of atezolizumab vs. chemotherapy in this indication from the perspective of UK healthcare system.MethodsFrom the global, randomised, open-label, phase III IPSOS trial, clinical inputs and patient characteristics were obtained. A partitioned survival model with three health states was built: Progression-free survival, progressed disease and death. A lifetime time horizon was applied, with an annual discount rate of 3.5%. Additionally, the willingness-to-pay threshold of £50,000/QALY was utilized. Primary outcomes were quality-adjusted life-year (QALY), costs, and incremental cost-effectiveness ratio (ICER). Sensitivity, scenario, and subgroup analyses were used to assess the reliability of base-case results. Price simulations were carried out in order to provide information for the pricing strategy at specific willingness-to-pay threshold.ResultsIn the base-case analysis, atezolizumab resulted in a gain of 0.28 QALYs and an ICER of £94,873/QALY compared to chemotherapy, demonstrating no cost-effectiveness. Price simulation results revealed that atezolizumab would be preferred at a price lower than £2,215 (a reduction of 41.8%) at the willingness-to-pay threshold of £50,000. Sensitivity, scenario and subgroup analyses revealed these conclusions were generally robust, the model was most sensitive to the price of atezolizumab and subsequent medication. Furthermore, atezolizumab was found to be more cost-effective for patients displaying a positive PD-L1 expression, with an ICER of £72,098/QALY as compared to chemotherapy.ConclusionAtezolizumab is not cost-effective for patients with advanced NSCLC ineligible for platinum-containing regimen, potential price reduction is necessary

The role of oxidized phospholipids in bleomycin-induced pulmonary fibrosis

Oxidized phospholipids (OxPLs), which are generated with the presence of oxidative stress, are proven to be pro-inflammatory and pro-atherogenic, but their roles in bleomycin-induced pulmonary fibrosis remains unknown. In this study, I show that bleomycin treatment induces expression of fibrogenic and inflammatory genes and accumulation of OxPL in mouse alveolar macrophages. Accumulation of OxPL occurs in prior to elevation of inflammatory and fibrotic genes, which suggests that OxPL might have to be first generated to promote fibrogenic response in response to bleomycin in alveolar macrophages. I also demonstrate OxPAPC induces expression of fibrogenic and inflammatory genes in mouse alveolar macrophages, which further confirms a potential fibrogenic role of OxPL. My study might provide a new direction for therapies that aims to attenuate bleomycin-induced pulmonary fibrosis during chemotherapy

The role of oxidized phospholipids in bleomycin-induced pulmonary fibrosis

Oxidized phospholipids (OxPLs), which are generated with the presence of oxidative stress, are proven to be pro-inflammatory and pro-atherogenic, but their roles in bleomycin-induced pulmonary fibrosis remains unknown. In this study, I show that bleomycin treatment induces expression of fibrogenic and inflammatory genes and accumulation of OxPL in mouse alveolar macrophages. Accumulation of OxPL occurs in prior to elevation of inflammatory and fibrotic genes, which suggests that OxPL might have to be first generated to promote fibrogenic response in response to bleomycin in alveolar macrophages. I also demonstrate OxPAPC induces expression of fibrogenic and inflammatory genes in mouse alveolar macrophages, which further confirms a potential fibrogenic role of OxPL. My study might provide a new direction for therapies that aims to attenuate bleomycin-induced pulmonary fibrosis during chemotherapy

Analysing a Chinese Regional Integrated Healthcare Organisation Reform Failure using a Complex Adaptive System Approach

Introduction: China’s organised health system has remained outdated for decades. Current health systems in many less market-oriented countries still adhere to traditional administrative-based directives and linear planning. Furthermore, they neglect the responsiveness and feedback of institutions and professionals, which often results in reform failure in integrated care. Complex adaptive system theory (CAS) provides a new perspective and methodology for analysing the health system and policy implementation.  Methods: We observed the typical case of Qianjiang’s Integrated Health Organization Reform (IHO) for 2 years to analyse integrated care reforms using CAS theory. Via questionnaires and interviews, we observed 32 medical institutions and 344 professionals. We compared their cooperative behaviours from both organisational and inter-professional levels between 2013 and 2015, and further investigated potential reasons for why medical institutions and professionals did not form an effective IHO. We discovered how interested parties in the policy implementation process influenced reform outcome, and by theoretical induction, proposed a new semi-organised system and corresponding policy analysis flowchart that potentially suits the actual realisation of CAS.  Results: The reform did not achieve its desired effect. The Qianjiang IHO was loosely integrated rather than closely integrated, and the cooperation levels between organisations and professionals were low. This disappointing result was due to low mutual trust among IHO members, with the main contributing factors being insufficient financial incentives and the lack of a common vision.  Discussion and Conclusions: The traditional 'organised health system' is old-fashioned. Rather than being completely organised or adaptive, the health system is currently more similar to a s'emi-organised system'. Medical institutions and professionals operate in a middle ground between complete adherence to administrative orders from state-run health systems and completely adapting to the market. Thus, decision-making, implementation and analysis of health policies should also be updated according to this current standing. The simplest way to manage this 'new system' is to abandon linear top-down orders and patiently wait for an explicit picture of IHO mechanisms to be revealed after complete and spontaneous negotiation between IHO allies is reached. In the meantime, bottom-up feedback from members should be paid attention to, and common benefits and fluid information flow should be prioritised in building a successful IHO