Administrative Tools Research Articles

Assessment of Real-Time Natural Language Processing for Improving Diagnostic Specificity: A Prospective, Crossover Exploratory Study.

Background Reliable, precise, timely, and clear documentation of diagnoses is difficult. Poor specificity or the absence of diagnostic documentation can lead to decreased revenue and increased payor denials, audits, and queries to providers. Nuance's Dragon Medical Advisor (DMA) is a computer-assisted physician documentation (CAPD) product. Natural language processing is used to present real-time advice on diagnostic specificity during documentation. Objectives This study assessed the feasibility, acceptability, and preliminary efficacy of real-time CAPD in improving diagnostic specificity and in turn reducing clinical documentation improvement burden. Methods This prospective, crossover trial recruited 18 hospitalists employed by Lifespan Health System and assigned them randomly to two groups. Each group first completed documentation using either traditional clinical documentation improvement (CDI) methods or CDI + DMA real-time advice for eight weeks and then crossed over. Metrics from Epic's EMR and Nuance administrative tools as well as anonymous surveys and one-on-one interviews were collected and analyzed. Results Hospitalists had 29% fewer standard CDI queries using DMA with CDI (IRR: 0.71; 95% CI: 0.37,1.39). Self-reported ability to predict clarification requests improved by 1 point on average (1.00; 95% CI: 0.32,1.67) on the Likert scale. This benefit was kept even after DMA was stopped and the group reverted back to CDI only. Qualitative survey reports indicated overall ease of use and educational benefits. Additional work needs to be done to determine if there is significant increase in note-writing time or reimbursement. Conclusions Hospitalists using DMA spent less time responding to In-basket queries. There was a strong educational opportunity, and the tool was easy to use. DMA offers promise for improving diagnostic specification while minimally impacting provider workflow.

Governance strategies for university-level education amidst Ukraine’s postwar reconstruction and growth

The restoration and optimisation of higher education institutions have become a priority task for those engaged in the field of academia. The necessity for this research arises from the requirement to safeguard Ukraine's educational system and its intellectual capital, as well as to maintain the country's national identity. Furthermore, the aspiration to integrate into the European educational space serves to intensify this relevance. The objective of this research is to analyse the vectors of state policy in higher education in the context of postwar reconstruction and development in Ukraine. The research objectives were achieved through the application of general scientific methods, including abstraction, comparison, analysis, synthesis, induction, and deduction. This article examines the potential of public administration tools in the higher education system to facilitate the innovative development of the national educational space. The study identifies four key areas for improvement in the administrative mechanisms in question: target orientation, regulation, information, and economics. The research reveals that the implementation of algorithmic governance mechanisms and long-term international funding can facilitate the optimal development of the higher education system. This can be achieved through the delineation of powers among institutions, the granting of autonomy in the management of the educational process, and the creation of a competitive environment in higher education.

Administrative and legal support for the functioning of the System 112

The article examines the issue of administrative and legal support for the functioning of the emergency assistance system for the population under the single number 112 in Ukraine. Considering global trends towards digitalization and automation of emergency services, creating an effective and reliable the System 112 is of particular importance for ensuring the safety and health of citizens. In Ukraine, as in many other European countries, developing a unified emergency response system is strategically important for improving the process of providing medical, fire, police, and other types of emergency assistance. One of the main reasons for implementing the System 112 is to ensure fast and convenient communication between citizens and emergency services. In the modern world, where response time is crucial for saving lives and protecting health, the System 112 reduces the time required to detect an emergency, quickly directing appropriate resources to provide assistance. Establishing such a system in Ukraine is an important step toward ensuring citizens’ safety and improving the quality of emergency assistance. Administrative and legal tools play a key role in regulating the functioning of the System 112. These include regulatory legal acts that define the rights and responsibilities of system participants, procedures for their interaction, and mechanisms for controlling the effectiveness of emergency assistance provision. Ukrainian legislation should ensure clear regulation of the interaction between state bodies, emergency services, local authorities, and other participants in the assistance process. This includes rules for coordinating the actions of emergency services, an information exchange system, and criteria for evaluating the effectiveness of the entire system. Adopting such norms ensures the proper functioning of all components of the System 112 , effective response to emergencies, and guarantees citizens’ right to timely emergency assistance. Such a comprehensive approach not only ensures proper organization of work but also allows for effective responses to any challenges that may arise during the functioning of the System 112.

TERRITORIAL BRANDING TOOLS IN THE PUBLIC ADMINISTRATION SYSTEM: THEORETICAL AND PRACTICAL ASPECTS

This study addresses the significant role of territorial branding as a strategic tool in public administration, particularly in the context of increasing globalization and regional competition. As regions strive to distinguish themselves on the global stage, the establishment of unique territorial brands emerges as a means to enhance economic growth, social development, and the overall quality of life for local populations. The paper discusses the necessity of territorial branding in fostering a positive regional image, bolstering regional identity, and attracting investments while promoting tourism and local businesses. Despite the growing interest in this field, there remains a gap in the theoretical understanding of territorial branding and practical guidelines for its implementation within public governance frameworks. This research aims to explore the essence, functions, and mechanisms of territorial branding, providing insights into its impact on shaping a region's image and identity. It emphasizes the importance of developing comprehensive branding strategies that consider the socio-cultural and economic nuances of each area. The analysis includes a review of contemporary scholarly works, highlighting contributions from leading researchers in Ukraine. The findings suggest that successful territorial branding relies on local community engagement, effective communication, and the alignment of branding initiatives with the region's unique cultural and economic resources. The study ultimately advocates for the integration of innovative branding practices into public administration to address contemporary challenges and leverage opportunities for sustainable regional development. Through a methodical examination of existing literature and theoretical models, this paper identifies key factors influencing effective territorial branding, such as cultural heritage, natural resources, economic opportunities, infrastructure, and overall quality of life. By synthesizing these aspects, the research offers practical recommendations for policymakers and public administrators to enhance the effectiveness of territorial branding efforts in Ukraine and beyond. This study serves as a foundational resource for further exploration of territorial branding as an essential component of regional development strategies.

Methotrexate in Pediatric Clinical Practice: Therapeutic Monitoring and Toxicological Aspects

Chemotherapy plays a pivotal role in treating childhood cancer, involving various molecules. Methotrexate, widely used in pediatric oncology at doses exceeding 1 g/m², exhibits high inter-individual pharmacokinetic variability and significant toxicity. Regular monitoring of methotrexatemia levels may prove beneficial. Our study aims to demonstrate the value of therapeutic methotrexate monitoring for assessing toxicity and optimizing folic acid dosing based on methotrexatemia rates. We conducted this study on 12 children with acute lymphocytic leukemia, osteosarcoma, and nonHodgkin’s lymphoma. Methotrexate dosing employed the EMIT immunoenzymatic method. Among 48 dosages, 25% exceeded the toxicity threshold, with methotrexate directly implicated in effects for only one patient. Comparing recommended folic acid dosages to those prescribed by pediatricians revealed a 20% excess in folic acid use. Biochemical assessment-based methotrexate monitoring is a valuable tool for safe chemotherapy administration, facilitating toxic effect monitoring and proper folic acid supplementation.

Status in a Nutshell. A Praxeological/Phenomenological Approach to Seals as Power Accessories

Abstract In the course of their long history in Aegean societies, seals acquired a polyvalent significance that arose from their active ‘participation’ in different social spheres and manifested itself in a superb level of technique and virtuosity. This paper examines the role of Minoan and Mycenaean seals as status symbols, highlighting not their creation but rather the practices of wearing, displaying, using, and perceiving them. The discussion spans two main chronological periods: the Second Palace Period (mid-17th to mid-15th century BCE) and the Third Palace Period (14th-13th century BCE), during which seals served different functions as status mediators. In the earlier period, a notable tension in the social significance of seals is evident when comparing evidence from Crete and the Greek Mainland. While Minoan seals were used as sphragistic tools, Mycenaean seals were not. In the later period, the use of seals in Mainland Greece was driven by their role as administrative tools within the palatial sphere. This dynamic analysis sheds light on the evolving roles and transformations of seals, influenced by varying social environments and demonstrating the multiple ways these artifacts embodied and mediated power. Additionally, it shows how their symbolic potential could express individual or collective identities.

Developing HIV indicators for clinical care quality assessment: relevance and practicality evaluated by healthcare practitioners in South Africa and Democratic Republic of Congo

BackgroundThe use of quality indicators in healthcare systems is one of the factors that improve the quality of health services. However, indicators for assessing HIV clinical care in the context of low- and middle-income countries are not fully explored. Some existing indicators were established within the context of developed countries and are primarily defined for community care, with limited emphasis on the hospital setting. Additionally, these indicators often do not account for the local practicality and relevance of quality measures in the context of low- and middle-income countries.AimTo assess the clinical significance and practical applicability of these indicators from the perspective of healthcare professionals specialising in HIV care in South Africa and Democratic Republic of Congo.MethodsAfter performing a systematic review of quality indicators employed in the evaluation of clinical care for individuals with HIV, we conducted an observational, cross-sectional study. In this research, 30 physicians filled out two questionnaires with a core set of indicators, to establish the most pertinent and practically indicators for evaluation of the HIV clinical care. A Likert scale was used to rank the indicators. Kendall’s tau-B rank correlation analysis was also performed.ResultsFrom the initial list of 88 quality indicators, 43 were identified as the most relevant and practical in HIV clinical care. Healthcare professionals deemed the monitoring and therapy domain to be the most pertinent and useful indicators out of the seven different clinical domains, followed by the functional organisational structure domain.ConclusionThis instrument may be a tool for healthcare professionals and hospital administrators to improve the quality of HIV clinical care.

Teacher Professional Development in Academic Supervision: A Qualitative Study at “Madrasah Tsanawiah”

This research aims to examine the implementation, supporting and inhibiting factors, and follow-up actions of the principal’s academic supervision in improving teacher performance. A descriptive qualitative method was used for this study. The research participants included 24 teachers and the school principal, with teachers serving as the main informants. Data were collected through documentation, interviews, and observations. Data analysis was performed using the interactive model of Miles and Huberman, which involves data collection, reduction, display, and conclusion drawing. The findings of the research reveal that: 1) the implementation of academic supervision by the principal involves planning, execution, monitoring, and evaluation based on supervision instruments, which include learning administration tools such as annual programs, semester programs, syllabi, lesson plans, educational calendars, lesson schedules, and a Learning Implementation Plan (RPP); 2) the supporting factors for effective supervision include the availability of school facilities and the teachers’ awareness and preparedness, while the inhibiting factors include the principal's busy schedule and academic background; 3) follow-up supervision is conducted by the teacher coordinator through an assignment letter. The results of this study provide valuable insights into the principal's role in academic supervision and its impact on teacher performance improvement at MTs Mathalibul Huda Jepara.

Community Service Program for the Munsalo Farmers Group, Kuansing Regency, Riau

Purpose: The primary aim of this community service initiative is to address the lack of bookkeeping among farmers in the Munsalo Kopah Farmers Group and the inadequate packaging of their rice, currently sold in used sacks and black plastic bags. This research is significant as it seeks to enhance the farmers' administrative practices and product presentation, improving income management and marketability.Method: The initiative employs training sessions on administrative management and effective packaging. Workshops focus on bookkeeping techniques and creating appealing packaging. Additionally, administrative tools and branded sacks for the Munsalo Kopah Farmers Group's rice are provided.Practical Applications: The initiative's outcomes have practical implications, enabling farmers to manage their finances better and enhance their product presentation. Improved packaging increases market competitiveness, providing significant advantages for better sales and customer engagement.Conclusion: This community service initiative effectively resolves key issues in administration and product packaging for the Munsalo Kopah Farmers Group. The positive feedback received highlights its importance, contributing to a better understanding of the need for enhanced practices in agricultural communities and promoting the farmers' economic well-being.

Community Service Program for Tuna Fishermen's Group in East Dumai Subdistrict, Dumai City

Purpose: This study aims to address administrative challenges within the Tuna Fishermen's Group in Dumai City, including manual record-keeping, reliance on external administrative support, damaged fishing equipment, and the group's inability to develop CSR proposals for additional funding.Method: The study used a community service approach (PKM) that involved socialization, provision of administrative tools and fishing equipment, educational workshops, and training. An evaluation was conducted to assess the program's effectiveness.Practical Applications: The findings can help improve the fishermen's administrative practices, reduce external dependency, enhance equipment management, and guide them in securing CSR funding for sustainability.Conclusion: The PKM activities were well-implemented and supported by the Tuna Fishermen's Group, leading to improved operational efficiency and addressing the group's key issues.

TECNOLOGIA E GESTÃO PÚBLICA: IMPACTOS DA INSERÇÃO DO SISTEMA ELETRÔNICO DE INFORMAÇÕES (SEI) COMO FERRAMENTA ADMINISTRATIVA EM UMA ESCOLA PÚBLICA

This article analyzes the impacts of implementing the Electronic Information System (SEI), an electronic document management system, as an administrative tool in a state school located in the city of Cujubim/RO. Based on the knowledge acquired during the Higher Education Course in Public Management Technology, we will address the changes that have occurred in the processing of administrative documents, as well as the organizational changes caused by its implementation in the unit under study. We will present here the importance of technology for Public Administration by comparing the advances achieved in recent years and the improvements that technological innovations can provide to organizations, including efficiency and speed in the processing of administrative processes, avoiding frequent loss of documents and, consequently, delays in returns. On the other hand, we have observed resistance and exclusion from some groups that are unable to keep up with the accelerated pace of technological innovations experienced in recent decades. Thus, the main objective of this article is to present, in a succinct manner, the relationship between public administration, technology and innovation as a challenging and productive factor in the execution of administrative activities in the public sector, based on the literature available in academic communication vehicles, observations and opinions/testimonies of the agents involved, providing a brief analysis and reflection on the importance of this theme for today’s public administrator.

In-Depth Examination of the Functionality and Performance of the Internet Hospital Information Platform: Development and Usability Study.

Internet hospitals (IHs) have rapidly developed as a promising strategy to address supply-demand imbalances in China's medical industry, with their capabilities directly dependent on information platform functionality. Furthermore, a novel theory of "Trinity" smart hospital has provided advanced guidelines on IH constructions. This study aimed to explore the construction experience, construction models, and development prospects based on operational data from IHs. Based on existing information systems and internet service functionalities, our hospital has built a "Smart Hospital Internet Information Platform (SHIIP)" for IH operations, actively to expand online services, digitalize traditional health care, and explore health care services modes throughout the entire process and lifecycle. This article encompasses the platform architecture design, technological applications, patient service content and processes, health care professional support features, administrative management tools, and associated operational data. Our platform has presented a set of data, including 82,279,669 visits, 420,120 online medical consultations, 124,422 electronic prescriptions, 92,285 medication deliveries, 6,965,566 prediagnosis triages, 4,995,824 offline outpatient appointments, 2025 medical education articles with a total of 15,148,310 views, and so on. These data demonstrate the significant role of IH as an indispensable component of our physical hospital services, with deep integration between online and offline health care systems. The upward trends in various data metrics indicate that our IH has gained significant recognition and usage among both the public and healthcare workers, and may have promising development prospects. Additionally, the platform construction approach, which prioritizes comprehensive service digitization and the 'Trinity' of the public, healthcare workers, and managers, serves as an effective means of promoting the development of Internet Hospitals. Such insights may prove invaluable in guiding the development of IH and facilitating the continued evolution of the Internet healthcare sector.

LEVERAGING ENVIRONMENTAL PERFORMANCE IN ALGERIAN ECONOMIC INSTITUTIONS FOR SUSTAINABLE DEVELOPMENT

Purpose: The study explored how environmental performance contributes to sustainable development, focusing on its role in achieving key dimensions of sustainability. Theoretical Framework: It emphasized that essential administrative tools for environmental protection are primarily found within the legal and institutional framework, which includes various national bodies established to support sustainable development. These organizations play a significant role in raising awareness, providing training, and emphasizing the importance of adhering to environmental standards through preventive, conservation, and regulatory measures, all backed by legal authority. Additionally, civil society has a crucial role in fostering environmental awareness, particularly within economic institutions. Design/Methodology/Approach: The designof the study is descriptive and analytical. Data for this study were collected from official Algerian sources. Findings: Cleaner Production this approach is a practical implementation of sustainable development, enabling greater efficiency in production while minimizing the use of raw materials and resources, all while protecting the environment.

Motivating Medical Students: Adaptation of the Academic Motivation Scale within the Framework of the Self-Determination Theory

Introduction: Motivation plays a crucial role in the academic success and professional development of medical students. Understanding the intricacies of motivation within the context of medical education is essential for designing effective interventions and support systems. The aim of this study was to explore the adaptation of the Academic Motivation Scale within the framework of the self-determination theory and of the self-efficacy theory to assess motivation among medical students.Methods: The study adapted the Academic Motivation Scale to the Portuguese context, drawing upon insights from the self-determination theory. Two existing Portuguese scales, MATAMS and Ribeiro et al scale, served as foundational frameworks for the adaptation process. The study included qualitative interviews, which informed the creation of the Minho Medical Academic Motivation Scale – Minho-MEDAMS. This scale was applied to 281 medical students. To assess the scale’s validity, we used the exploratory and confirmatory factor analyses, and the Cronbach’s alpha to measure internal consistency.Results: The exploratory factor analysis showed strong results with a KMO of 0.862, leading to five factors and the removal of two items. The initial confirmatory factor analysis indicated poor fit, prompting the removal of items with low R-squared values. The final Minho-MEDAMS includes 18 items: six for intrinsic motivation, nine for extrinsic motivation and three for amotivation. This refined scale demonstrates high internal consistency (α = 0.831), making it a reliable tool for assessing medical students’ motivation.Conclusion: The successful adaptation of the Academic Motivation Scale within the self-determination theory framework presents a valuable instrument for assessing motivation in medical students. The Minho-MEDAMS offers a comprehensive understanding of motivational dynamics, facilitating targeted interventions and support mechanisms to enhance student engagement and success. Its validity and reliability render it a practical tool for educators, administrators, and researchers in the field of medical education. Ultimately, the Minho-MEDAMS contributes to the advancement of strategies aimed at cultivating motivated and proficient healthcare professionals.

Delirium and Cognitive Screening in National Hip Fracture Registries: Scoping Review Protocol

Background Delirium and cognitive impairment are common in hip fracture populations and are associated with significant adverse patient outcomes. National hip fracture registries facilitate improvements in patient outcomes and care quality, such as reduced mortality and the development of specialist multidisciplinary services. However, there is substantial variation in the data collected and reported in relation to delirium and cognition, which impedes international comparison and may reduce quality of care. Objective This scoping review aims to identify delirium and cognition data items currently collected by hip fracture registries internationally, to identify associated registry guidance that exists for the administration of delirium and cognitive screening tools, and report outcomes of these data items across the most recently published annual reports of identified hip fracture registries. Methods This scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-ScR). We will search the following databases: Medline Ovid; Embase; CINAHL EBSCOHost. Relevant websites such as the Fragility Fracture Network (FFN) will also be searched. Study selection and review will be carried out independently by two researchers, with discrepancies resolved by a third researcher. Data extraction and synthesis will be conducted by one reviewer and checked for accuracy and omissions by another. The scoping review findings will be informed and validated through engagement with the FFN Hip Fracture Audit Special Interest Group. Conclusion By identifying existing heterogeneity in delirium and cognitive screening tool use and administration, it is hoped that administration and specific screening tool use will become standardised to optimise comparability across countries and ensure that high quality and reliable data are included across international registry reports.

Development of micromodels for improvements in driving safety using as a case study a university campus in Panama

This research focuses on addressing critical driving safety issues on university campuses, particularly vehicular congestion, inadequate parking, and hazards arising from the interaction between vehicles and pedestrians. These challenges are common across campuses and demand effective solutions to ensure safe and efficient mobility. To address these issues, the study developed detailed microsimulation models tailored to the Victor Levi Sasso campus of the Technological University of Panama. The primary function of these models is to evaluate the effectiveness of various safety interventions, such as speed reducers and parking reorganization, by simulating their impact on traffic flow and accident risk. The models provide calculations of traffic parameters, including speed and travel time, under different safety scenarios, allowing for a comprehensive assessment of potential improvements. The results demonstrate that the proposed measures significantly enhance safety and traffic efficiency, proving the model’s effectiveness in optimizing campus mobility. Although the model is designed to tackle specific safety concerns, it also offers broader applicability for addressing general driving safety issues on university campuses. This versatility makes it a valuable tool for campus planners and administrators seeking to create safer and more efficient traffic environments. Future research could expand the model’s application to include a wider range of safety concerns, further enhancing its utility in promoting safer campus mobility.

How policy satisfaction affects residents’ low-carbon behavior: the mediating role of place attachment

ABSTRACT Policy interventions can effectively promote the public’s low-carbon behaviors (LCBs), provided the public already understands and perceives the policy. The extent to which the public gets to know the policy is easily overlooked in relevant studies. Based on a survey conducted in Hangzhou, China, this paper compares the residents’ satisfaction with the policies promoting LCBs. Furthermore, the impact of different levels of policy satisfaction on the willingness to engage in LCBs with place attachment as a mediator is also investigated. The results show that respondents’ policy satisfaction is moderately high, with female respondents (3.479) slightly higher than males (3.430). The policy satisfaction, from high to low, is administrative regulations (3.515), technical interventions (3.463), information tools (3.457), and economic incentives (3.384). Policy satisfaction has a significant effect on willingness to engage in LCBs and place attachment, and place attachment has a positive effect on willingness to engage in LCBs. Place attachment plays a partial mediating role in the influence path of policy satisfaction on the willingness of LCBs. The study provides insights for policymakers on enhancing policy dissemination and engagement, particularly in the context of gender differences, and offers a comprehensive view of the dynamics driving sustainable behavior change in urban China.

State special transport service in the system of subjects of the Ministry of Defense of Ukraine: directions of influence and the role of public administration for their implementation

It was emphasized that in the conditions of ongoing Russian aggression, the issue of effective and stable functioning of the system of the Ministry of Defense of Ukraine has become important. It is noted that such an intention is possible only thanks to the systematically effective work of all subjects of this system. The exceptional role of the State Special Service of Transport in this aspect is emphasized, given the subject orientation of the latter. We are talking about the transport component, which is one of the basic prerequisites for the successful implementation of the lion’s share of measures by subjects not only of the ministry system, but also of the entire security and defense sector. The position of the State Special Service of Transport as a subject of public-legal relations at the current stage of law-making is highlighted in general outlines. It was found that it is appropriate to talk about an institution endowed with the status of a specialized military formation, which carries out a number of defense measures peculiar only to it. Despite its regulatory specifics, it is advisable to talk about a number of similar parameters, compared to the rest of the institutions. The essence of the directions of the analyzed body’s work, including under the current situation, is outlined and disclosed. Arguably, it is emphasized that such directions are derived from the functions of the institution, which the latter’s officials implement in practice. The legislator’s position on their gradation into two fundamental groups was supported and developed: 1) peacetime; 2) a special period. Based on this, the author’s vision of the quantitative and specific composition of the areas of work of the State Special Service of Transport is proposed, followed by their general characteristics. The problems of the importance of public administration tools in the framework of the implementation of management functions performed by this specialized military formation have been studied. It is emphasized that the presence of these tools is a prerequisite for the implementation of management steps. The above constitutes a critical and unalternative position from the point of view of the application of appropriate measures within the limits of one or another outlined direction. Based on the preliminary results, an attempt was made to determine the place of the State Special Transport Service in the structure of the Ministry of Defense system. Based on the competence of the institution, directions of influence and awareness of the role of the stability of the transport component, a well-argued assumption is made about the uniquely important role of this institution.

8765 Assessment of the Social Vulnerability Index of a 10-Year Retrospective Cohort of Youth with Prediabetes

Abstract Disclosure: D. Somerville: None. R.H. Kolagani, MHS: None. C.E. McCrory: None. S. Budakoti: None. V.M. Chinchilli, PhD: None. J. Joseph: None. D.E. Hale: None. N. Raja-Khan: None. L.P. Huerta Saenz: None. Background: The incidence of prediabetes (preD) is rising among youth in the US. While there are known metabolic risk factors linked to preD development, we were interested in exploring the role of social determinants of health (SDoH) in the development of pediatric preD. The social vulnerability index (SVI) is a tool developed by the CDC to stratify SDoH risk for communities based on 14 factors such socioeconomic status (SES), household composition, race and transportation access. By understanding the role of SVI in the development of preD in youth, we may be able to plan interventions to prevent progression to Type 2 Diabetes (T2D). Objective: Our study goal was to determine the relationship between SVI and preD in youth receiving care at our institution, a large pediatric referral center in Central Pennsylvania. Methods: We conducted a 10-year retrospective chart review of electronic medical records (EMRs) to identify children/youth aged 6-17 years old diagnosed with preD at our pediatric health system between 01/2010 and 01/2020. We used the American Diabetes Association definitions of preD (one or more sub-type): 1) Impaired fasting glucose (IFG), 2) Impaired glucose tolerance (IGT), and 3) Elevated hemoglobin A1c (HA1C). ICD10 codes were used for initial chart identification (R73.01, R73.02, R73.03 and R73.09). The second phase of identification of youth with preD included the review of biological measures of glycemia of the initial identified charts to support the reported ICD10 diagnosis (either isolated subtypes or combinations). Social, demographic characteristics, and residence setting (urban vs. rural) were also investigated. SVI was assessed on a 0-1 scale, with high SVI (0.5-1) indicating greater social vulnerability and low SVI (0-0.49) indicating lower social vulnerability. Rurality was determined per the Health Resources and Services Administration Tool (HRSA). SAS frequencies were calculated. Fisher’s exact tests were applied to compare the frequencies of the aforementioned groups with respect to IFG, IGT, and HA1C. Results: We identified 2700 charts of youth with preD per ICD10 codes search, but only 552 had confirmed preD diagnosis supported by biological data registered in EMRs. The most common preD isolated subtype was HA1C (87.3%), while 12% and 4% had isolated IFG and IGT, respectively. Most youth had high SVI (66.9%) and only 5.8% were rural (p > 0.05). Neither SVI or rurality were associated with isolated preD subtypes, but 8.2% of low-SVI youth had composite [IFG +HA1C] subtypes compared to 3.5% of high-SVI youth (p=0.02). Conclusions: SVI was not significantly associated with any isolated preD subtype. However, youth with the combined preD subtypes [IFG + HA1C] had lower SVI. As T2D is more prevalent in youth from low SES, addressing SDoH at earlier stages of T2D (preD phase) is needed in the effort to prevent the progression of the disease. Presentation: 6/1/2024

Resource rents, ethnic fractionalization and redistributive public sector employment

The resource curse literature often posits that public employment in resource-rich economies tends to be large, driven by motivations beyond public goods provision. One set of theories attributes this phenomenon to (ethnic) clientelism, but lacks robust empirical support. Another set of theories challenges the notion of (ethnic) clientelism, suggesting that the expansion of public sector employment serves as a form of social insurance in the absence administrative tools to redistribute income. This study diverges from the conventional story of an invariably positive association between resource abundance and public sector employment. Instead, I show that the positive correlation between resource abundance and public sector employment only holds when ethnic fractionalization is low. In countries with high levels of ethnic fractionalization, the relationship weakens and can even reverse. This is because an increase in public sector employment tends to dilute public sector wages, diminishing the attractiveness of public sector jobs as clientelist rewards. The empirical analysis supports this claim: when ethnic fractionalization is low, more resource rents correspond to higher public sector employment and lower (or even negative) public sector wage premiums; when ethnic fractionalization is high, the opposite holds: more resource rents correspond to fewer public sector jobs but larger public sector wage premiums.