Resource allocation in a university environment : a test of the Ruefli, Freeland, and Davis goal programming decomposition algorithms / BEBR No. 735

Bibliography: p. 20-22

Developing R&D capacity in a primary care trust : use of the R&D culture index

There has traditionally been a low level of engagement of primary care practitioners with research. In the UK, primary care trusts (PCTs) now have some responsibility for the encouragement of research and development in primary care. The aim of this study was to assess the current level of research activity and capacity for research within a PCT. A questionnaire, incorporating a recently developed and validated research and development culture index, was sent to all 572 health care professionals and staff under the auspices of North Tyneside Research PCT. Data analysis used nonparametric tests of association including chi-squared, Mann–Whitney U and Spearman's rank order correlation. There was a 50.3 per cent response rate to the questionnaire. Groups more likely to show an increased capacity for research included those with postgraduate qualifications and those in post for the least time. General practitioners were less likely than other professional groupings to declare personal skills or aptitude for research. The two most important factors thought to contribute towards the development of a culture of R&D were having access to people to support development and changes in professional practice and having access to training and development opportunities. The use of the R&D culture index enabled groups to be identified that may be more research interested and can therefore be targeted to increase research capacity. The R&D culture index could be used by other PCTs wishing to define and develop research capacity in primary care

Divergence of opinion and risk : an empirical analysis of the Ex Ante beliefs of institutional investors

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Health-Care Associated Infection Rates among Adult Patients in Bahrain Military Hospital: A cross sectional survey

Background/Objective: Health-care associated infections cause substantial morbidity and mortality with their prevalence varying between countries and hospitals. There are no published studies of health-care associated infections in hospitals in Bahrain and few in general military hospitals.Setting: Bahrain Defense Force Hospital.Design: Survey.The aim study is to establish the prevalence of health-care associated infections in a general military hospital in Bahrain.Method: A cross-sectional survey of a random sample of 500 medical records in the Bahrain Defence Force Hospital was carried out to ascertain the prevalence of health-care associated infections.Result: Four health-care associated infections were recorded – a prevalence of 0.87% (95% CI 0.34-2.22). Two of the infections were surgical site infections while the other two were skin infections.Conclusion: This study revealed that the prevalence of health-care associated infections is lower than recorded in most published studies

Quality of life of Bahraini women with breast cancer: a cross sectional study.

BACKGROUND: Breast cancer can impact survivors in many aspects of their life. Scarce information is currently available on the quality of life of cancer survivors in Bahrain. The objective of this study is to describe the quality of life of Bahraini women with breast cancer and its association with their sociodemographic and clinical data. METHODS: This is a cross sectional study in which the European Organization for Research and Treatment of Cancer Quality of Life Cancer Specific version translated into Arabic was administered to a random sample of 337 Bahraini women with breast cancer. Relevant descriptive statistics were computed for all items. The equality of means across the categories of each categorical independent variable was tested using parametric tests (ANOVA and independent t-test) or non-parametric tests (Kruskal Wallis and Mann Whitney tests) of association where appropriate. RESULTS: Of the total sample, 239 consented to participation. The mean and median age of participants were 50.2 (SD ± 11.1) and 48.0 respectively. Participants had a mean score for global health of 63.9 (95% CI 61.21-66.66). Among functional scales, social functioning scored the highest (Mean 77.5 [95% CI 73.65-81.38]) whereas emotional functioning scored the lowest (63.4 [95% CI 59.12-67.71]). The most distressing symptom on the symptom scales was fatigability (Mean 35.2 [95% CI 31.38-39.18]). Using the disease specific tool it was found that sexual functioning scored the lowest (Mean 25.9 [95% CI 70.23-77.90]). On the symptom scale, upset due to hair loss scored the highest (Mean 46.3 [95% CI 37.82-54.84]). Significant mean differences were noted for many functional and symptom scales. CONCLUSION: Bahraini breast cancer survivors reported favorable overall global quality of life. Factors associated with a major reduction in all domains of quality of life included the presence of metastases, having had a mastectomy as opposed to a lumpectomy and a shorter time elapsed since diagnosis. Poorest functioning was noted in the emotional and sexual domains. The most bothersome symptoms were fatigability, upset due to hair loss and arm symptoms. This study identifies the categories of women at risk of poorer quality of life after breast cancer and the issues that most need to be addressed in this Middle East society

The use of complementary and alternative medicine by patients with diabetes mellitus in Bahrain: a cross-sectional study

BACKGROUND: CAM use is widespread, especially among patients with diabetes. The Gulf States have a high prevalence of diabetes, alongside a long tradition of CAM use. The aim of this study is to establish the prevalence of CAM use among patients with diabetes mellitus in Bahrain and to examine the characteristics of the CAM users. METHODS: A questionnaire was developed and administered to a convenience sample of patients with diabetes (n = 402) above the age of 20 attending two hospital diabetes clinics. Data were analysed using descriptive statistics and non-parametric tests of association. RESULTS: 63% of responders utilized CAM within the previous 12 months. CAM users were more likely to be female, to have had diabetes for longer and to have complications of their diabetes. 64% of CAM users stated that they had used CAM for managing their diabetic condition, with 46% of these having used it solely for their diabetes. Respondents using CAM to manage their diabetes were more likely to be male, to be using CAM on a daily basis and to have informed their physician of their CAM use. CONCLUSIONS: There is a high rate of CAM use in patients with diabetes attending two hospital diabetes clinics in Bahrain. There is also a high rate of non-disclosure of CAM use to physicians. There is a continuing need for health professionals to be more aware and better trained in order to inform their decision making and communication related to CAM use

Reducing health risk in family members of patients with type 2 diabetes: views of first degree relatives

BACKGROUND: Patients with type 2 diabetes can have an important role in discussing health risk within families. This study aimed to establish the acceptability to first degree relatives towards their relative with type 2 diabetes intervening as health promoters in their own families, using the Health Belief Model as a theoretical framework for evaluation. METHODS: Cross-sectional questionnaire design. Survey questionnaire for first degree relative (sibling or child) mailed to a random sample of patients with type 2 diabetes registered with an urban hospital diabetes clinic (n = 607 eligible patients). Patients were asked to pass on questionnaires to one to two first degree relatives. RESULTS: Questionnaires were returned from 257 families (42% response rate) with two responses provided by 107 families (a total of 364 questionnaires). The majority (94%) of first degree relatives of patients with type 2 diabetes would like to be informed about reducing their risk. Half (48%) of respondents reported being spoken to by a relative with type 2 diabetes about their risk of diabetes. Those spoken to were more likely to see themselves at risk of diabetes, to worry about developing diabetes and to view diabetes as a serious condition. CONCLUSIONS: A role for patients with type 2 diabetes in discussing health risk in their family appears to be acceptable to many relatives. Discussion of risk and interventions to reduce health risk with their relatives should be encouraged in patients with type 2 diabetes

Political Polarization as a Constraint on Corruption: A Cross-National Comparison

Efforts to explain corruption have increased dramatically in recent years. The interest stems from the increasing weight economists assign to corruption when explaining economic growth. Much research focuses on how political institutions influence perceptions of corruption. We move this debate in a new direction by addressing a previously ignored dimension: ideological polarization. We contend perceptions of corruption are determined not only by specific institutional features of the political system–such as elements of voting systems, ballot structures, or separation of powers–but by who sits at the controls. We employ panel data from a broad variety of countries to test our theoretical argument. Contrary to recent findings by both economists and political scientists, we show that ideological polarization predicts perceptions of corruption

The thermal stability of the tryptic fragment of bovine microsomal cytochrome b5 and a variant containing six additional residues

AbstractThermally induced denaturation has been measured for both oxidised and reduced forms of the tryptic fragment or bovine microsomal cytochrome b5 using spectrophotometric methods. In the oxidised state, the tryptic fragment of cytochrome b5 (Ala7-Lys90) denatures in a single cooperative transition with a midpoint temperature (Tm) of ∼ 67°C (pH 7.0). The reduced form of the tryptic fragment of cytochrome b5 shows a higher transition temperature of ∼ 73°C at pH 7.0 and this is reflected in the values of ΔHm, ΔSm, and Δ(ΔG) of ∼ 310kJ · mol−1, 900J · mol−1 · K−1 and 5 kJ · mol−1. Increased thermal stability is demonstrated for a variant protein that contains the first 90 amino acid residues of cytochrome b5. These novel increases in stability are observed in both redox states and result from the presence of six additional residues at the amino-terminus. The two forms of cytochrome b5 do not differ significantly in structure with the results suggesting that the reorganisation energy (λ) of the variant protein, as measured indirectly from redox-linked differences in conformational stability, is small. Consequently the reported subtle differences in reactivity between variants of cytochrome b5 may result from the presence of additional N-terminal residues on the surface of the protein

Clinical Audit of Diabetes Care in the Bahrain Defence Forces Hospital

Objectives: Primary care audits in Bahrain have consistently revealed a failure to meet recognised standards of delivery of process and outcome measures to patients with diabetes. This study aimed to establish for the first time the quality of diabetes care in a Bahraini hospital setting. Methods: A retrospective clinical audit was conducted of a random sample of patients attending the Diabetes and Endocrine Center at the Bahrain Defence Forces Hospital over a 15-month period which ended in June 2010. The medical records of 287 patients with diabetes were reviewed electronically and manually for process and outcome measures, and a statistical analysis was performed. Results: Of the patients, 47% were male, with a median age of 54 years, and 5% had type 1 diabetes. Measured processes, including haemoglobin A1c, blood pressure, lipids, creatinine and weight, were recorded in over 90% of the patients. Smoking (8%) and the patient’s body mass index (19%) were less frequently recorded. Screening for complications was low, with retinal screening in 42%, foot inspection in 22% and microalbuminuria in 23% of patients. Conclusion: This study shows that the implementation of recognised evidence-based practice continues to pose challenges in routine clinical care. Screening levels for the complications of diabetes were low in this hospital diabetes clinic. It is important to implement a systematic approach to diabetes care to improve the quality of care of patients with diabetes which could lead to a lowering of cardiovascular risk and a reduction in healthcare costs in the long term