Core Pillars Research Articles

FACTORS INFLUENCING HIV/AIDS CLIENT SATISFACTION AT COMPREHENSIVE CARE CENTRES IN WAJIR COUNTY, KENYA

Service delivery is one of the core pillars of health systems building blocks and client satisfaction is one of the parameters that is used to assess the status of services offered in an institution. This study investigated the factors that influence HIV/AIDS Client satisfaction at the Comprehensive Care Centre’s (CCCs) in Wajir County. Specific objectives were to assess the influence of availability of HIV/AIDS testing services, availability of HIV drugs, availability of care and support system and the availability of the institutional support towards HIV/AIDS at the CCCs on clients’ satisfaction. A descriptive cross-sectional study was employed where both quantitative and qualitative data were gathered through survey questionnaires and key informant interview guide. Out of the targeted 157 clients at the sub-County and county referral hospitals about 147 positively responded, leading to a 93.6% response rate. SPSS version 24 was used to code and analyze the collected data. Chi-square and Logistic regression analysis were done to determine the relationship between and among the variables. Bivariate analysis revealed a significant relationship between client satisfaction and predictor variables. The results indicated the probability of being satisfied with services in the Comprehensive Care Centre’s was 51.3 per cent higher for people who reported availability of HIV testing services and 56.9 per cent higher for people who reported accessibility of HIV care and social support. Based on the findings, the study’s policy recommendations are hospitals management needs to ensure sufficient HIV testing services are available and accessible to patients. Further, stakeholder collaboration with hospital management is recommended for strengthening service delivery at CCCs in Wajir County.

There Is No Place like Home! How Willing Are Young Adults to Move to Find a Job?

The European Union (EU) has undergone significant economic crises in recent years. Therein, young people were amongst the hardest hit groups, with youth unemployment rising as high as 50% in some member states. Particularly high rates of youth unemployment were often observed in rural areas, where labour market supply in relation to demand were notably divergent. One of the core pillars of the EU’s agenda is to tackle the persistent problem of youth unemployment. Since the recent crisis, this has been via the “Youth on the Move” initiative, which involves the promotion of intra- and international mobility of young adults in order to gain access to job opportunities. However, what has received little attention so far is the question of what the general willingness of young adults to move is like, and to what extent this varies, for example, depending upon the area they live in. This paper therefore asks if rural youth differ from youth in urban areas in relation to their willingness to move for a job within their country or to another country. Moreover, what influences the general willingness to be mobile? Based on the Cultural Pathways to Economic Self-Sufficiency and Entrepreneurship (CUPESSE) Survey, which includes data on 18–35-year-olds in a sample of 11 European countries, it is shown that living in a rural area is strongly associated with the willingness to move. Furthermore, it shows that rural youth are more willing to move within the country but less willing to move to another country. Based on the presentation of the various factors, which promote or curb mobility readiness, the results make it clear that the success of EU initiatives depends on the preferences and willingness of the target group in question.

Orthopedic Research: A golden opportunity to improve patient outcomes

Orthopedic Research: A golden opportunity to improve patient outcomes

The five strategic core pillars that every aesthetic business needs to succeed

In this article, Harry Singh explores the five pillars that he deems necessary to running a successful medical aesthetics business: marketing, sales and the patient consultation, operation, finances and talent

Cultural heritage and disasters risk: A machine-human coupled analysis

Natural hazards represent a major threat to cultural heritage. Literature has analyzed this nexus using different approaches depending on their focus. To provide a comprehensive understanding of the core pillars structuring the field, we use a machine-human methodology that combines bibliometric and machine-learning text analysis. We focus on a sample of 565 peer-reviewed documents published between 1988 and 2020. Results prove there is increasing interest in the topic, covering different types of hazards depending on the area of interest and its most frequently associated risks. To enhance the granularity of the analysis we apply machine learning to the publications abstracts and we classify documents based on their core topics. We find that the field is highly diverse and includes conservation, restoration and management of historical sites and cultural heritage. Scholars use sophisticated tools and innovative methodologies to account for this heterogeneity. We highlight the need for stronger interdisciplinarity in the field and we call for further progresses in spatial-explicit analysis. Finally, we point towards more inclusion of humanities in the area to account for the cultural aspects of heritage protection.

An online educational model in andrology for student training in the art of scientific writing in the COVID-19 pandemic.

In 2020, the COVID‐19 pandemic led to the suspension of the annual Summer Internship at the American Center for Reproductive Medicine (ACRM). To transit it into an online format, an inaugural 6‐week 2020 ACRM Online Mentorship Program was developed focusing on five core pillars of andrology research: scientific writing, scientific methodology, plagiarism understanding, soft skills development and mentee basic andrology knowledge. This study aims to determine mentee developmental outcomes based on student surveys and discuss these within the context of the relevant teaching and learning methodology. The mentorship was structured around scientific writing projects established by the team using a student‐centred approach, with one‐on‐one expert mentorship through weekly formative assessments. Furthermore, weekly online meetings were conducted, including expert lectures, formative assessments and social engagement. Data were collected through final assessments and mentee surveys on mentorship outcomes. Results show that mentees (n = 28) reported a significant (p < .0001) improvement in all criteria related to the five core pillars. These results illustrate that the aims of the online mentorship program were achieved through a unique and adaptive online educational model and that our model has demonstrated its effectiveness as an innovative structured educational experience through the COVID‐19 crisis.

Parks: A vital community condition

Parks and green spaces serve as integral components of the fabric that comprises social determinants of health. These “green drug stores” are upstream factors that provide physical, mental and social, and environment-related health and well-being benefits. Yet, 100 million people in the United States lack access to a park within a 10-minute walk of their homes. These natural or semi-natural outdoor public spaces hold significant underexplored potential for the health of communities. Decisionmakers across the spectrum of community members, practitioners, researchers, and policymakers have the opportunity to leverage parks as a proactive tool for healthy, resilient, and more equitable places. This article aims to highlight the role of parks and green space in generating community health. It includes a brief review of benefits offered as described in the health literature, challenges experienced in elevating parks for health, potential innovative solutions, and three short case studies and lessons learned about parks and community well-being. The overarching conclusions emphasize (a) access, quality, and inclusion as core pillars in advancing the work, (b) placing community voice at the center, and (c) furthering cross-sectoral partnerships in the design of public spaces.

The Concept of Tarkib Isnadi In Arabic Grammatical Thought and Its Equivalence In Indonesian: A Contrastive Analysis

This paper aims to explain the concept of Tarkib Isnadi in Arabic grammar and describe the equivalent concept and its components in Indonesian grammar. In the realm of Arabic grammar, Tarkib Isnadi is a core component in the structure of clauses or sentences in Arabic. A good understanding of Tarkib Isnadi in Arabic and its equivalent in Indonesian will make it easier for Arabic learners (L2) who come from native Indonesian speakers (L1) to identify clause and sentence structures in various Arabic discourses. The methods used in data analysis in this study are distribution and identity-referential methods. Based on observations, it is found that the concept of Tarkib Isnadi in Arabic has a concept equivalent to a clause in Indonesian because both have the core constituents or pillars of the sentence. On the other hand, there are also some differences in the concept of Tarkib Isnadi in Arabic with the concept of clauses in Indonesian. The difference mainly lies in terms of the formation of the concept and the filling components of their syntactic functions.

Political Cycles and Yardstick Competition in the Recycling of Waste. Evidence From Italian Provinces

Recycling and the recovery of waste are crucial waste management strategies. In light of the new EU circular economy approach, these strategies remain core pillars of a competitive and sustainable waste value chain. Local governments have an important role in controlling and checking the implementation of waste management policies. We study the spatial determinants of waste recovery by using a dataset of 102 Italian provinces from the years 2001-2014. We exploit the political cycle of the provinces to isolate the effects of waste recovery in one province on neighboring provinces. We find that provinces mimic their own neighbors’ in the separate collection of waste aimed at recycling and recovery, with this effect being fully guided by provinces where the president can run for re-election (consistent with the yardstick competition hypothesis) but only when waste management policies become politically salient, that is, after the transposition of the 2008 EU Waste Framework Directive.

Will the "Legal Singularity" Hollow Out Law's Normative Core?

This Article undertakes a critical examination of the unintended consequences for the legal system if we arrive at the futurist dream of a legal singularity—the moment when predictive, mass-data technologies evolve to create a perfectly predictable, algorithmically-expressed legal system bereft of all legal uncertainty. It argues that although the singularity would surely enhance the efficiency of the legal system in a narrow sense, it would also undermine the rule of law, a bedrock institution of any liberal legal order and a key source of the legal system’s legitimacy. It would do so by dissolving the normative content of the two core pillars of the rule of law: the predictability principle and the universality principle, each of which has traditionally been conceived as a bulwark against arbitrary government power. The futurists heralding the legal singularity privilege a weak-form predictability principle that emphasizes providing notice to legal subjects about the content of laws over a strong-form variant that also emphasizes the prevention of arbitrary governmental action. Hence, an inattentive and hurried embrace of predictive technologies in service of the (only weak-form) predictability principle will likely attenuate the rule of law’s connection to the deeper (strong-form) predictability principle. The legal singularity will also destabilize law’s universality principle, by reconceiving of legal subjects as aggregations of data points rather than as individual members of a polity. In so doing, it will undermine the universality principle’s premise that the differences among legal subjects are outweighed by what we—or, better still, “We the People” who are, as Blackstone put it, the “community in general”—have in common. A cautionary directive emerges from this analysis: that lawyers should avoid an uncritical embrace of predictive technologies in pursuit of a shrunken ideal of predictability that might ultimately require them to throw aside much of the normative ballast that has kept the liberal legal order stable and afloat.

English

The Government of Ghana introduced Planting for Food and Jobs (PFJ) program in 2017 to help raise farm productivity, improve food security, create jobs and modernize agriculture. Among the core pillars of PFJ program include the provision of modernized extension service to farmers. This study analyzed the productivity difference between beneficiaries and non-beneficiaries of the modernized extension service among rice farmers in the Talensi District of Ghana using Independent Samples t-test. Productivity is measured as output per acre (kg/acre). A multi-stage sampling technique was used to draw representative samples during the 2019 production season for the study. The results showed that farmers who benefitted from the modernized extension service were more productive than the non-beneficiary farmers. Specifically, average yield of modernized extension service beneficiaries was about 140kg/acre higher than that of non-beneficiary farmers. Key words: Planting for food and jobs, modernized extension service system, independent samples t-test.

Abstract PO-028: Role of community outreach activities in cancer prevention in Kenya

Abstract Background: International Cancer Institute (ICI) is a leading organization with a pro- actively evolving approach in care, research, training and advocacy with a focus on cancer control in sub-Saharan Africa. ICI was started in May 2019 and is working in more than 15 counties in Kenya. The goal of ICI is to produce quality patient outcomes working with a team of highly qualified healthcare professionals. Treatment and care for Non-Communicable Diseases (NCDs) in sub-Saharan Africa and specifically for cancer is expensive and not accessible to the entire population. There is evidence that most cases are diagnosed at stage 3 and 4 making intervention options minimal at that level. However, early screening for cancers ensures early diagnosis as well as awareness creation on the need for continuous screening. Aim: To conduct community outreach activities with an aim of promoting prevention, early diagnosis and linkage to care for cancer. Strategy: ICI, using advocacy, as one of its core pillars, raises awareness at local and national levels through mass public health education on NCDs and screening. This is conducted by the ICI outreach team which is multidisciplinary and includes Clinicians, an Oncology Pharmacist, an Oncology Nurse, a Palliative care Nurse, a Patient Care coordinator, a Monitoring and evaluation expert, Program management technical experts, Data management expert as well as a Histotechnician. The ICI team works with counties to develop and plan for community mass screening events. Program Process: Counties partner with ICI for support in the establishment of county NCD treatment and care programs. A technical working group (TWG) with representatives from both the County health management team and ICI is then formed to guide the integrated NCD program implementation process. Outcomes: Establishment of comprehensive cancer centers where routine screening for cervical, breast and prostate cancers as well as diabetes and hypertension can be done in addition to diagnosis and treatment at county level. Coordination of community mass screening events in selected sub-county hospitals is then done from the established cancer centers. The integrated NCD program partnership offers capacity building for County healthcare providers (HCPs) through mentorship and skills training in cancer screening, diagnosis, treatment, palliative care and survivorship. Conclusion: Comprehensive community outreach activities are avenues for awareness creation and early detection of cancers. Integrated NCD programs incorporating diabetes and hypertension in cancer programs creates wider community impact and plays a great role in reducing the number of cases being diagnosed at late stages. Citation Format: Gloria Kitur, Emmah Achieng, Fredrick Chite Asirwa, Edwin Odoyo, Andrew Koech. Role of community outreach activities in cancer prevention in Kenya [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-028.

Preface

Preface

Organisational Climate and the Work-related Learning of Employees

The aim of this mixed methods research was to distinguish and to examine models of organisational climate regarding the work-related learning of employees. The theoretical rationale is found in the reflections of the learning supportive organisational climate as the main prerequisite of the process of participatory planning in adult education and learning, and as one of the core pillars in the process of building a learning organisation. For the purposes of triangulation and of complementarity, we adopted quantitative and qualitative methodology. The research was performed online from May to December 2018 and included employees from different companies in the Republic of Serbia. By using an explanatory sequential mixed methods research design with nested samples for the quantitative (Nqn=687) and the qualitative components (Nql=85), three models of organisational climate regarding the work-related learning of employees have been distinguished: the organisational climate of the fear of repression, the service-oriented organisational climate, and the learning supportive organisational climate.

The Implications of COVID‐19 for Nonmarket Strategy Research

Abstract The COVID-19 virus ignited social and economic turmoil around the world Not since the Spanish Flu of 1918 had we seen a pandemic of such scale and severity The resultant global transformation of industries, supply chains, work, communication, and institutional frameworks suggests we are entering a period of non-ergodic change, in which the future cannot be extrapolated from the past (North, 1999) This means that we do not know the probability distribution or the outcomes from the virus So, we must find a way to coexist and build our resilience

Teleoncology: The Youngest Pillar of Oncology.

The core pillars of multimodal care of patients with cancer are surgical, radiation, and medical oncology. The global pandemic of coronavirus disease 2019 (COVID-19) has suddenly resurrected a new pillar in oncology care: teleoncology. With oncologists reaching out to patients through telemedicine, it is possible to evaluate and fulfill patients’ needs; triage patients for elective procedures; screen them for influenza-like illness; provide them with guidance for hospital visits, if needed; and bridge oral medications and treatments when a hospital visit is not desirable because of any high risk-benefit ratio. Teleoncology can bring great reassurance to patients at times when reaching an oncology center is challenging, and more so in resource-constrained countries. Evidence-based treatment protocols, dispensable by teleoncology, already exist for many sites of cancer and they can provide a bridge to treatment when patients are unable to reach cancer centers for their standard treatment. The young pillar of teleoncology is going to remain much longer than COVID-19.

Embedding the Pillars of Quality in Health Information Technology Solutions Using "Integrated Patient Journey Mapping" (IPJM): Case Study.

BackgroundHealth information technology (HIT) and associated data analytics offer significant opportunities for tackling some of the more complex challenges currently facing the health care sector. However, to deliver robust health care service improvements, it is essential that HIT solutions be designed by parallelly considering the 3 core pillars of health care quality: clinical effectiveness, patient safety, and patient experience. This requires multidisciplinary teams to design interventions that both adhere to medical protocols and achieve the tripartite goals of effectiveness, safety, and experience.ObjectiveIn this paper, we present a design tool called Integrated Patient Journey Mapping (IPJM) that was developed to assist multidisciplinary teams in designing effective HIT solutions to address the 3 core pillars of health care quality. IPJM is intended to support the analysis of requirements as well as to promote empathy and the emergence of shared commitment and understanding among multidisciplinary teams.MethodsA 6-month, in-depth case study was conducted to derive findings on the use of IPJM during Learning to Evaluate Blood Pressure at Home (LEANBH), a connected health project that developed an HIT solution for the perinatal health context. Data were collected from over 700 hours of participant observations and 10 semistructured interviews.ResultsThe findings indicate that IPJM offered a constructive tool for multidisciplinary teams to work together in designing an HIT solution, through mapping the physical and emotional journey of patients for both the current service and the proposed connected health service. This allowed team members to consider the goals, tasks, constraints, and actors involved in the delivery of this journey and to capture requirements for the digital touchpoints of the connected health service.ConclusionsOverall, IPJM facilitates the design and implementation of complex HITs that require multidisciplinary participation.

The case for open science: rare diseases.

The premise of Open Science is that research and medical management will progress faster if data and knowledge are openly shared. The value of Open Science is nowhere more important and appreciated than in the rare disease (RD) community. Research into RDs has been limited by insufficient patient data and resources, a paucity of trained disease experts, and lack of therapeutics, leading to long delays in diagnosis and treatment. These issues can be ameliorated by following the principles and practices of sharing that are intrinsic to Open Science. Here, we describe how the RD community has adopted the core pillars of Open Science, adding new initiatives to promote care and research for RD patients and, ultimately, for all of medicine. We also present recommendations that can advance Open Science more globally.

Functional framework for change leaders: results of a qualitative study

BackgroundHealthcare organisations are increasingly placing the onus on care providers to lead change initiatives to improve patient care. This requires care providers to perform tasks in addition to their core...

Market regulation between economic and ecological values: Regulatory authorities and dilemmas of responsiveness

The regulation of markets emerged as one of the core pillars of government policies during the 1990s. However, the ascendance of ecological values and issues, such as sustainability and security in the following decades challenge some of the basic tenets of the underlying neo-liberal ideas. We argue in this paper that market and competition regulators have come under pressures to uphold the market and economic values of the prevailing anti-trust policies while being responsive to societal pressures that cherish non-economic values. Competition authorities find themselves locked-in to economic theories of regulation and find little room for engaging with ecological issues. We illustrate this with the case of the Dutch competition authority's approach to managing the balance between economic and sustainability and animal welfare values.