QUALITY MANAGEMENT IN A CHANGING ORGANIZATIONAL ENVIRONMENT: LOOKING FOR NEW CONVERSATION TOOLS

Teaching/Communication/Extension/Profession,

BSE and the US Economy: Input-Output Model Perspective

The potential impact of a BSE outbreak on the US economy is modeled in input-output setting using 2002 US IMPLAN data. An outbreak of BSE would hurt the US beef industry, other agriculturally-related industry, and the rest of the economy as a whole. The worse effects occur in the beef cattle and farming industries. Generally, the economy of every county would be hurt given the fact that cattle are produced in all the 50 states. But it is apparent that the damage would be substantial in those regions and households which already suffer the severest economic damage.Livestock Production/Industries,

Guidance on Performing Focused Ethnographies with an Emphasis on Healthcare Research

Focused ethnographies can have meaningful and useful application in primary care, community, or hospital healthcare practice, and are often used to determine ways to improve care and care processes. They can be pragmatic and efficient ways to capture data on a specific topic of importance to individual clinicians or clinical specialties. While many examples of focused ethnographies are available in the literature, there is a limited availability of guidance documents for conducting this research. This paper defines focused ethnographies, locates them within the ethnographic genre, justifies their use in healthcare research, and outlines the methodological processes including those related to sampling, data collection and maintaining rigour. It also identifies and provides a summary of some recent focused ethnographies conducted in healthcare research. While the emphasis is placed on healthcare research, focused ethnographies can be applicable to any discipline whenever there is a desire to explore specific cultural perspectives held by sub - groups of people within a context - specific and problem - focused framework

Multi-couple group and self-directed PREP formats enhance relationship satisfaction and improve anger management skills in Air Force couples

This study examined the effectiveness of delivering the Prevention and Relationship Enhancement Program (PREP) to volunteer couples in the U.S. Air Force in either a six-week instructional multi-couple group condition or a self-directed book condition. A standardized pre/post protocol was employed and outcomes included relationship satisfaction and anger management skills, two known risk factors for partner maltreatment. Significant improvement was found for the group condition in both relationship satisfaction and anger management skills, but only for anger management skills in the self-directed book condition. Finally, the group condition reported greater program satisfaction. Implications are discussed

The impact of a computerised test of attention and activity (QbTest) on diagnostic decision-making in children and young people with suspected ADHD: single-blind randomised controlled trial

Background: Diagnosis of attention deficit hyperactivity disorder (ADHD) relies on subjective methods which can lead to diagnostic uncertainty and delay. This trial evaluated the impact of providing a computerised test of attention and activity (QbTest) report on the speed and accuracy of diagnostic decision making in children with suspected ADHD. Methods: Randomised, parallel, single-blind controlled trial in mental health and community paediatric clinics in England. Participants were 6-17 years-old and referred for ADHD diagnostic assessment; all underwent assessment-as-usual, plus QbTest. Participants and their clinician were randomised to either receive the QbTest report immediately (QbOpen group) or the report was withheld (QbBlind group). The primary outcome was number of consultations until a diagnostic decision confirming/excluding ADHD within six-months from baseline. Health economic cost-effectiveness and cost utility analysis was conducted. Assessing QbTest Utility in ADHD: A Randomised Controlled Trial was registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT02209116). Results: One hundred and thirty two participants were randomised to QbOpen group (123 analysed) and 135 to QbBlind group (127 analysed). Clinicians with access to the QbTest report (QbOpen) were more likely to reach a diagnostic decision about ADHD (Hazard Ratio 1.44, 95% CI 1.04 to 2.01). At six-months, 76% of those with a QbTest report had received a diagnostic decision, compared with 50% without. QbTest reduced appointment length by 15% (Time Ratio 0.85, 95% CI 0.77 to 0.93), increased clinicians’ confidence in their diagnostic decisions (Odds Ratio 1.77, 95% CI 1.09 to 2.89) and doubled the likelihood of excluding ADHD. There was no difference in diagnostic accuracy. Health economic analysis showed a position of strict dominance, however cost savings were small suggesting that the impact of providing the QbTest report within this trial can best be viewed as ‘cost neutral’. Conclusion: QbTest may increase the efficiency of ADHD assessment pathway allowing greater patient throughput with clinicians reaching diagnostic decisions faster without compromising diagnostic accuracy

Solar thermochemical production of ammonia from water, air and sunlight: Thermodynamic and economic analyses

Ammonia is an important input into agriculture and is used widely as base chemical for the chemical industry. It has recently been proposed as a sustainable transportation fuel and convenient one-way hydrogen carrier. Employing typical meteorological data for Palmdale, CA, solar energy is considered here as an inexpensive and renewable energy alternative in the synthesis of NH3 at ambient pressure and without natural gas. Thermodynamic process analysis shows that a molybdenum-based solar thermochemical NH3 production cycle, conducted at or below 1500 K, combined with solar thermochemical H2 production from water may operate at a net-efficiency ranging from 23 to 30% (lower heating value of NH3 relative to the total energy input). Net present value optimization indicates ecologically and economically sustainable NH3 synthesis at above about 160 tons NH3 per day, dependent primarily on heliostat costs (varied between 90 and 164 dollars/m2), NH3 yields (ranging from 13.9 mol% to stoichiometric conversion of fixed and reduced nitrogen to NH3), and the NH3 sales price. Economically feasible production at an optimum plant capacity near 900 tons NH3 per day is shown at relative conservative technical assumptions and at a reasonable NH3 sales price of about 534 ± 28 dollars per ton NH3

Partner alcohol consumption and intimate partner violence among women in Papua New Guinea: a cross-sectional analysis of Demographic and Health Survey.

OBJECTIVE: We examined the association between partner alcohol consumption and the experience of intimate partner violence among women in Papua New Guinea. DESIGN: We performed a cross-sectional analyses of data extracted from the 2016-2018 Papua New Guinea Demographic and Health Survey. We included 3319 women in sexual unions. Multilevel binary logistic regression analysis was used to examine the association between partner alcohol consumption and intimate partner violence, controlling for the covariates. Results from the regression analysis were presented using the crude odds ratios (cORs) and adjusted odds ratios (aORs), with 95% confidence intervals (CIs). SETTING: Papua New Guinea. PARTICIPANTS: Women aged 15-49 years in sexual unions. OUTCOME MEASURES: Physical, emotional, and sexual violence. RESULTS: The prevalence of physical, emotional and sexual violence among women in sexual unions in Papua New Guinea were 45.9% (42.4 to 47.7), 45.1% (43.4 to 46.8) and 24.3% (22.9 to 25.8), respectively. The level of partner alcohol consumption was 57.3%. Women whose partners consumed alcohol were more likely to experience physical violence (aOR=2.86, 95% CI=2.43 to 3.37), emotional violence (aOR=2.89, 95% CI=2.44 to 3.43) and sexual violence (aOR=2.56, 95% CI=2.08 to 3.16) compared with those whose partners did not consume alcohol. CONCLUSION: This study found a relatively high prevalence of intimate partner violence among women in Papua New Guinea. Most importantly, this study found partner alcohol consumption to be significantly and positively associated with intimate partner violence. The study, therefore, recommends that interventions seeking to reduce intimate partner violence among women in Papua New Guinea should intensify behaviour change and education on reducing or eliminating partner alcohol consumption

In vitro anti-malarial interaction and gametocytocidal activity of cryptolepine

YesBackground: Discovery of novel gametocytocidal molecules is a major pharmacological strategy in the elimination and eradication of malaria. The high patronage of the aqueous root extract of the popular West African anti-malarial plant Cryptolepis sanguinolenta (Periplocaceae) in traditional and hospital settings in Ghana has directed this study investigating the gametocytocidal activity of the plant and its major alkaloid, cryptolepine. This study also investigates the anti-malarial interaction of cryptolepine with standard anti-malarials, as the search for new anti-malarial combinations continues. Methods: The resazurin-based assay was employed in evaluating the gametocytocidal properties of C. sanguinolenta and cryptolepine against the late stage (IV/V) gametocytes of Plasmodium falciparum (NF54). A fixed ratio method based on the SYBR Green I fluorescence-based assay was used to build isobolograms from a combination of cryptolepine with four standard anti-malarial drugs in vitro using the chloroquine sensitive strain 3D7. Results: Cryptolepis sanguinolenta ( IC50 = 49.65 nM) and its major alkaloid, cryptolepine ( IC50 = 1965 nM), showed high inhibitory activity against the late stage gametocytes of P. falciparum (NF54). In the interaction assays in asexual stage, cryptolepine showed an additive effect with both lumefantrine and chloroquine with mean ΣFIC50s of 1.017 ± 0.06 and 1.465 ± 0.17, respectively. Cryptolepine combination with amodiaquine at therapeutically relevant concentration ratios showed a synergistic effect (mean ΣFIC50 = 0.287 ± 0.10) whereas an antagonistic activity (mean ΣFIC50 = 4.182 ± 0.99) was seen with mefloquine. Conclusions: The findings of this study shed light on the high gametocytocidal properties of C. sanguinolenta and cryptolepine attributing their potent anti-malarial activity mainly to their effect on both the sexual and asexual stages of the parasite. Amodiaquine is a potential drug partner for cryptolepine in the development of novel fixed dose combinations

Analysis of seed yam varieties, sources and quantity demanded by farmers in major yam producing districts in Ghana

The study analysed the varieties, sources and quantities of seed yam demanded by farmers for cultivation in order to inform policies aimed at ensuring adequate supply of quality seed yam of desirable varieties at an affordable price to boost yam productivity for improved income and livelihoods. A structured questionnaire was administered to 380 randomly selected yam farmers in three major yam producing districts in Ghana in 2015. The data analysis was done using STATA statistical software. The study identified Pona/Punjo, Lariboko, Asana, Afebetuye, Dente, Olondo and Kparinjo as the yam varieties mainly cultivated by farmers in a reducing order with high market demands by consumers. Own production remains the major source of seed yam for farmers. The estimated monetary value of quantity of seed yam used by farmers for cultivation in 2014 farming season was GH¢ 198, 552,841.0 (USD 51,706,469.0) in the study locations. About GH¢ 5,679,979.0 (USD 1,479,161.2) worth of quantities of seed yam was obtained from the market and other sources. The results demonstrate the existence of market potential for commercial seed yam production and supply in Ghana. Commercial seed yam certification system and yam breeding activities should target the identified yam varieties

Risk factors associated with the coexistence of stunting, underweight, and wasting in children under 5 from 31 sub-Saharan African countries.

OBJECTIVE: This study investigated the risk factors associated with the coexistence of stunting, underweight, and wasting among children under age 5 in sub-Saharan Africa (SSA). DESIGN: Data of 127, 487 under-5 children from 31 countries in SSA were pooled from the Demographic and Health Surveys collected between 2010 and 2019. We examined the risk of coexistence of stunting, underweight, and wasting using multinomial logistic regression models. The results were presented using relative risk ratios (RRR) with corresponding confidence intervals (CIs). SETTING: Thirty-one sub-Saharan African countries. PARTICIPANTS: Children under age 5. OUTCOME MEASURES: The outcome variables were three child anthropometrics: stunting (height-for-age z-scores); underweight (weight-for-age z-scores) and wasting (weight-for-height z-scores). RESULTS: The prevalence of coexistence of stunting, underweight, and wasting varied across countries, with the highest (12.14%) and lowest (0.58%) prevalences of coexistence of stunting, underweight and wasting in Benin and Gambia respectively. The risk of coexistence of the three indicators of undernutrition was higher among children aged 1 year (RRR=3.714; 95% CI 3.319 to 4.156) compared with those aged 0. The risk of coexistence of the three dimensions was lower among female children (RRR=0.468 95% CI 0.420 to 0.51), but higher for those with small size at birth (RRR=3.818; CI 3.383 to 4.308), those whose mothers had no education (RRR=3.291; 95% CI 1.961 to 5.522), not working (RRR=1.195; 95% CI 1.086 to 1.314), had no antenatal visits during pregnancy (RRR=1.364; 95% CI 1.20 to 1.541), children delivered at home (RRR=1.372; CI 1.232 to 1.529), those from poor households (RRR=1.408; 95% CI 1.235 to 1.605), those whose mothers had no access to media (RRR=1.255; 95% CI 1.144 to 1.377) and living in households with an unimproved toilet facility (RRR=1.158; 95% CI 1.032 to 1.300). CONCLUSIONS: Findings suggest the urgent need for consideration of the coexistence of stunting, wasting and underweight among under-5 children in policy design and programming of interventions to eradicate child malnutrition in SSA. In the short-term, national-level policies and interventions need to be well tailored considering the compositional characteristics