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Accountable hospital governance structure rules in Iran: a qualitative document analysis

PurposeHospital governance accountability structures in Iran, similar to other countries, have undergone various reforms with different goals. The current study aimed to identify the rules and regulations of the hospital governance structure in Iran and how they pay attention to accountability.Design/methodology/approachThis qualitative document content analysis study was conducted using hospital governance structure documents in Iran using the Ready materials, Extract data, Analyze data and Distil (READ) document analysis framework. 2,921 documents were extracted from the official government websites of Iran. After screening, seven documents related to the hospital governance structure were selected. A directed content analysis approach was used. The findings were finally future purification matched with the original documents.FindingsThe findings showed that documents had not addressed the inclusive governance structure of the hospital comprehensively. The medical staff organization structure is not considered in the documents, and its duties are assigned to a technical or a clinical director. Most documents addressed financial accountability. The documents did not require the hospital’s governance to have an inclusive accountability structure. However, they paid more attention to the administrative and financial autonomy of hospitals.Practical implicationsAccountability is one of the most essential components in the hospital's governance structure. It can increase the success of hospital efficiency, effectiveness, vision and mission fulfillment. The study result can help health services policymakers and managers formulate better organization structure rules and regulations for hospital governance accountability.Originality/valueThis study is the first qualitative analysis of accountable governance structure documents in Iranian hospitals. We used the READ method as a comprehensive approach for document analysis.

Factors That Influence Financial Performance with Capital Expenditure as a Moderating Variable in the Regency / City Government of Sumatera Utara Province

This study aims to analyze and evaluate (1) comprehensive regional development to produce regional growth that is in line with the regional budget; (2) making good and appropriate financial management so that the improvement of the economic development process has an impact after the implementation of the regional autonomy policy; (3) Each region can be responsible for regional authority in regional development so that good financial management is expected to be a reality for local governments to support their growth and development; (4) Increasing the potential of financial performance and this ability is indicated by compliance with specific rules and regulations as stipulated by SAP when managing financial. This research was conducted in the district /city government in the area of ​​North Sumatra Province. The population used was 33 districts/cities (25 districts and eight cities) with the year of observation for five years starting from 2018 to 2022 the number of observations was obtained as many as 165, the data used was secondary data, the data collection method which was the data documentation method was obtained From the Directorate General of Finance Balance of the Ministry of Finance of the Republic of Indonesia, the website of the Central Statistics Agency, the website of each regional government that is the research sample, and other related sources. The results of this study indicate that (1) Local own-source revenue has a significant positive effect on financial performance; (2) operating expenditure has a significant positive effect on financial performance; (3) Revenue sharing fund has a significant positive effect on financial performance; (4) General Allocation Fund has no significant effect on financial performance; (5) Special Allocation Fund has a significant positive effect on financial performance; (6) the working period of regional heads has no significant effect on financial performance; (7) capital expenditure can moderate the effect of local own-source revenue on financial performance; (8) Capital expenditure cannot moderate the effect of operating expenditure on financial performance; (9) Capital expenditure can moderate the effect of revenue sharing fund on financial performance; (10) Capital expenditure cannot moderate the effect of general allocation funds on financial performance; (11) Capital expenditure can moderate the effect of special allocation funds on financial performance; (12) Capital expenditure cannot moderate the effect of the working period of regional heads on financial performance. Keywords: good governance, financial management system, regional autonomy policy, financial performance.

Navigating the Labyrinth of Pregnancy-Related Coverage for Undocumented Immigrants: An Assessment of Current State and Federal Policies.

Insurance coverage for prenatal care, labor and delivery care, and postpartum care for undocumented immigrants consists of a patchwork of state and federal policies, which varies widely by state. According to federal law, states must provide coverage for labor and delivery through Emergency Medicaid. Various states have additional prenatal and postpartum coverage for undocumented immigrants through policy mechanisms such as the Children's Health Insurance Program's "unborn child" option, expansion of Medicaid, and independent state-level mechanisms. Using a search of state Medicaid and federal government websites, we found that 27 states and the District of Columbia provide additional coverage for prenatal care, postpartum care, or both, while 23 states do not. Twelve states include any postpartum coverage; 7 provide coverage for 12 months postpartum. Although information regarding coverage is available publicly online, there exist many barriers to access, such as lack of transparency, lack of availability of information in multiple languages, and incorrect information. More inclusive and easily accessible policies are needed as the first step toward improving maternal health among undocumented immigrants, a population trapped in a complicated web of immigration policy and a maternal health crisis. (Am J Public Health. Published online ahead of print August 15, 2024:e1-e10. https://doi.org/10.2105/AJPH.2024.307750).

Achieving Canada's Nationally Determined Contribution: Assessing the Cost of Reducing GHG Emissions

Amidst the growing urgency of climate change, this study delves into Canada's commitment to reducing greenhouse gas (GHG) emissions as part of its Nationally Determined Contributions (NDCs) under the Paris Agreement. It aims to comprehensively understand the economic dimensions of Canada's NDC goals. Through an extensive literature review, the research establishes the groundwork for examining emission reduction targets, policy effectiveness, technological feasibility, and socio- political factors. Building on this foundation, a conceptual framework is developed, outlining key relationships among NDC targets, policies, economics, feasibility, socio-political contexts, and international cooperation. The research employs a multifaceted methodology, incorporating data collection and a marginal cost of abatement analysis to assess cost-effectiveness across emission reduction options. We expect to build the marginal cost of abatement curve based on the results from research institutions, government websites, and other NGOs. All in all, this research contributes nuanced insights into Canada's emission reduction pursuits, unveiling the intricate dynamics between policies, economics, and technology.

O impacto da Implemetação De Tecnologias Da Informação e Comunicação – TIC – para a transparência dos atos governamentais na Administração Pública Brasileira

The implementation of information and communication technologies (ICT) in the Brazilian public administration has been the subject of study and reflection due to the impacts they can bring to the transparency of government acts. This qualitative-explanatory study aimed to investigate the impact of ICT on transparency in the Brazilian public administration, identifying barriers and benefits regarding its implementation. This research was carried out with reference to the keywords: transparency, electronic governance, public administration, information and communication technology; and as a database for the search of articles Google Scholar, Scielo, Capes and Anpad Steel, in addition to government websites and transparency portals; During the research, current legislation, government policies and publications in the period from 2010 to 2024 were considered. In this vein, preliminary results indicate significant advances in the use of ICT in the Brazilian public administration, demonstrating improvements in the efficiency of operations, transparency and quality of the services provided through the automation of processes, improvement in decision-making and greater integration with regard to the coordination of activities. However, despite the advances observed, challenges to be overcome were identified, such as issues involving cybersecurity, inequality between levels of access to information, and resistance to change on the part of some actors involved. In addition, the study, in addition to dealing with a current and relevant topic, also observes gaps and provides data that may be important for other research that is being carried out.

Naming the abyss: The symbolic politics of the oceanic toponymic frontier

AbstractWith the recent, constantly growing interest in the critical geography of the oceans and critical toponymy, there is still plenty of space for theoretical, methodological and practical interconnections between these emerging subfields. Despite some sporadic examples of critical analysis of the names of the islands and seas, the ocean floor and the open ocean remain unexplored spaces in critical toponymic investigations. This paper aims to fill this gap by introducing the concept of the toponymic frontier, focusing on the spatial‐political dimension of the names of the natural submarine features (bathyonyms). Drawing on critical toponymy and critical geography of the oceans' theoretical literature and using the empirical database of more than 5000 bathyonyms and the secondary resources represented by the international media, official reports and governmental websites, this paper develops a base for a conceptual framework for analysing the marine place names as (geo)politically and political‐economically motivated symbolic elements of the oceanic voluminous realm. Finally, the paper paves the way for future debates related to the politics of place naming in the contested spaces of the hydrosphere and the generation of reinvigorated productive insights in critical toponymic studies.

The landscape of Medicare policies for gender-affirming surgeries in Canada: an environmental scan

BackgroundMany studies have described barriers to gender-affirming surgery (GAS) in Canada; however, few have explored why these barriers persist. To address this knowledge gap, we sought to describe documents related to public health insurance (Medicare) for GAS to identify the types of procedures covered, variations in coverage across provinces and territories, and changes in policy over time.MethodsWe conducted a descriptive cross-sectional study using an environmental scan approach. We queried 23 government websites, the Google search engine, and an online legal database between July 2022 and April 2024 to gather gray literature documents related to GAS and Medicare. Variables from relevant documents were compiled to create a present, at-glance overview of GAS Medicare coverage for all provinces and territories and a timeline of policy changes across Canada. ResultsEight provinces and three territories had documents or websites related to GAS Medicare coverage (85%). We identified 15 GAS procedures that were covered variably across Canada. Yukon (n = 14) covered the most types of GAS, while Quebec and Saskatchewan covered the least (n = 6). Mastectomy and genital surgeries were covered across Canada, but other GAS were rarely covered. Five provinces and territories provided coverage for travel-related costs. Our GAS Medicare timeline showed differential expansion of GAS coverage in Canada over the last 25 years.Conclusions We provide previously unreported information regarding GAS Medicare coverage in Canada. We hope our findings will help patients and healthcare providers navigate a complicated public healthcare system. We also highlight barriers within GAS Medicare documents and make recommendations to alleviate those barriers.

Peran Diaspora Armenia dalam Konflik Nagorno Karabakh Tahun 2020-2022

The Nagorno-Karabakh conflict from 2020 to 2022 highlights the significant role of the Armenian diaspora in supporting Armenia across various dimensions. The research aims to determine the extent to which the Armenian diaspora's support influences the Armenian government's capacity to handle the conflict. The study utilizes theories of public diplomacy and diaspora engagement, employing a mixed-methods approach that includes qualitative data from secondary data processing such as journals and written results containing data about Armenian Diaspora, official website of the Armenian government, and quantitative data from financial contributions and diplomatic records. Findings indicate that the Armenian diaspora's political lobbying and advocacy efforts have secured significant diplomatic support, while economically providing substantial remittances, investments, and humanitarian aid. Socially, the diaspora has shaped international public opinion through campaigns and cultural activities, and intellectually, it has offered strategic insights enhancing the government's approach to the conflict. Additionally, the mobilization of human resources by the diaspora has provided direct assistance in Armenia. This research offers a comprehensive understanding of the dynamics between the Armenian diaspora and the Armenian government, demonstrating the substantial impact of multidimensional diaspora support on the government's capacity to manage the Nagorno-Karabakh conflict.

Pengaruh Budget Transparency dan Fiscal Autonomy terhadap Financial Sustainability: Studi Empiris pada Kabupaten dan Kota di Indonesia

The purpose of this study is to analyze the effect of budget transparency and fiscal autonomy on the financial sustainability of local governments in Indonesia. The data in this study were sourced from the Local Government Financial Statements obtained from the official website of the local government and the BPK RI website and TPAD data viewed on the official website of the local government. The sample collection method uses a purposive sampling method calculated using the Slovin formula. Hypothesis testing in this study uses multiple linear regression analysis. The results showed that budget transparency has no significant effect on financial sustainability and fiscal autonomy has a significant effect on financial sustainability.

Analysis of Factors in College Enrollment Using Regressions

College enrollment, the process in which families make investments for the future, individuals receive higher education and seek self-improvement, and an aspect closely related to the lives of everyone in a modern society. The trends of college enrollment have been fluctuating due to various factors throughout history, mostly due to socioeconomic factors. In this article, multiple linear regression models are constructed to analyze and evaluate how some possible factors are correlated with the fluctuations of college enrollment in the United States each year from 1973 to 2022. Data for dependent and independent variables were gathered from government and non-profit organization websites such as the Federal Reserve Bank of St. Louis, the United States Census Bureau, and the Educational Data Initiative. The results have shown that many factors are influencing the fluctuations, with GDP and income being the main factors; this article provides a supporting role in making admission policies and country developments.

Experiences of loneliness and isolation among people with visual impairment: A review of literature (2016–2023)

According to the UK Government, people with a disability or long-term health condition are more likely to experience chronic loneliness than the general population. However, government figures do not disaggregate data on loneliness among different types of health conditions or disabilities, and it remains unclear how this affects people with visual impairment (VI). This review examines experiences of loneliness and isolation among people with VI. Six databases (CINAHL, PubMed, Scopus, Sage, APA Psycharticles, and Psychology and Behavioural Sciences Collection) were searched using a Population, Interest and Outcome (PIO) framework, yielding a total of 2476 articles. A total of 29 articles were selected and appraised for quality using JBI appraisal tools. These articles represented studies from 14 countries. Relevant Government and voluntary sector organisation websites were also considered. Findings showed widespread experiences of isolation and exclusion among people with VI, but subjective experiences of loneliness did not necessarily align with this. Further research is needed to gain a better understanding of the relationship between VI and loneliness and experiences of loneliness for people with VI within both LGBTQ+ communities and within Black, Asian, and Ethnically Minoritised communities, where research remains notably scant. Studies about the impact of the COVID-19 pandemic showed its heightened effect on isolation and loneliness among the VI community. Further research is needed to understand the long-term effects of this. While technology holds promise in mitigating loneliness and isolation among individuals with VI, accessibility issues persist. Future research is needed to understand how technology-based interventions might address loneliness and isolation for individuals with VI and the accessibility barriers associated with the implementation of these. For loneliness and isolation to be minimised, recognising the diversity within the VI population is imperative for tailoring interventions and initiatives effectively.

Challenges in Disseminating Evidence-Based Health Promotion Programs in Faith Community Settings: What We Need to Include.

Effective dissemination of information about evidence-based programs (EBPs) is essential for promoting health equity. Faith-based and other community organizations have difficulty locating EBPs for implementation in their settings. A research team engaged in a systematic search to identify a menu of EBPs that could be offered to African American FBOs as part of a community-engaged implementation study. Methods. A four-stage process was developed to search for EBPs meeting seven inclusion criteria for dissemination in faith-based organizations (FBOs). Criteria included relevance to identified health disparity topics, endorsement on a federal website, free access to downloadable program materials, facilitator guidance, no requirements for health care providers, and culturally relevant materials for African American communities. Nineteen government websites were searched. Sixty-six potential EBPs were identified. Six EBPs met all inclusion criteria. The search for EBPs that met seven criteria for implementation in African American FBOs demonstrated challenges that have been described in the literature. Researchers encountered a lack of standardized terminology for identifying EBPs on federal websites, frequent requirement for health care providers or clinics and/or fees for training and materials. FBOs are supportive and safe places to offer EBPs to promote health, and EBPs need to be designed and disseminated to meet the needs and preferences of FBOs. Including members of FBOs and others in the community in EBP development, design, and dissemination, such as searchable health promotion EBP registries, can increase the likelihood that effective programs intended to address health disparities are readily accessible to FBOs for implementation.

Nurse Practitioners (NPs) as Game Changers in Tanzania Health Delivery System: Lessons Learnt from Fujita Bantane Hospital in Japan

AbstractShortage of physicians/doctors in the primary health care system has been evidenced in various countries. Among other things, these countries deployed nurse practitioners (NPs) in the health care delivery system to address this shortage. Countries in America, Europe, and Asia use NPs to address physicians/doctors shortage in the primary health care delivery systems. Various studies have shown that NPs have been deployed in primary health care facilities to curb these shortages.While in Tanzania shortage of physicians/doctors and other health professionals is evidenced in every sector of the health care system, nurses play a crucial role to cover this shortage by providing care and support for individuals and communities. Nurses work in various settings from being a nurse, counselor, laboratory technologist, social worker, educationist, and physician, to name a few. Nurses play a key role in preventing, diagnosing, and attending to common health problems. The question is, “When will the Tanzanian health delivery system recognize the pivotal role of these nurses and upgrade them to NPs?” This study suggests that deployment of NPs in Tanzania's health care systems could be a “game changer.” As a fellow on Critical Care Nursing Course at Fujita Health University Bantane Hospital in Japan, witnessed deployment of NPs in health care delivery and the reaped benefits are enormous; increased access to health care services, reduction in health care costs, reduced hospital stays, and customer satisfaction through client empowerment and comfort. This is an observational study of tasks performed by NPs in Fujita Health University Bantane Hospital and their relevance as a positive innovation to curb physician shortages for effective health care delivery. The duration of the study at Bantane Hospital was 2 months from January 15 to March 16, 2024. One-to-one interviews with NPs on duty were conducted. Also, collected and reviewed information from Tanzanian government Web sites, published government documents, and academic literature. Results show that NPs perform a lot of procedures that physicians/doctors were supposed to do. In the wards, theater, laboratories, and clinics, they play a pivotal role to curb shortage of physicians/doctors in health settings. NPs are an effective addition to medical facilities. They perform various procedures in the absence of the doctors. The findings from this study have important implications for improving health care delivery in Tanzania. NPs could be “game changers” in the health care landscape in Tanzania. Investment on nurses' education, proper training, and policy changes in nurse practice regulations are key for this to succeed.

Portrait of e-Government Implementation in Public Complaints Services in Indonesia

Public complaints are a form of public services provided by governments. Its function is to facilitate the public in submitting complaints related to public services. Public complaint channels: SMS, telephone number, email, form, and website. Based on website searches, various implementations of complaints were found in government websites. They are vary in term of number and implementation. For example, one website provides 2 channel, other website provides none. Two website provide 2 channel, but differs in attributes. Apart of this diversity, the portrait of implementing public complaints is unexplored. This research aims to map the implementation of public complaints in provincial governments in Indonesia. Official website is used as primary data. Documentation and website analysis is conducted to each websites. Keywords, such as complaints, complaints, public services, and public complaints, are used in website content analysis. The content analysis is classified into the Gartner stage model: presence, interaction, transaction, and transformation. The results show that of the 38 provincial governments, 6 provincial governments are at the presence stage, 23 at the interaction stage, 4 at the transaction stage, and 5 provincial governments at the transformation stage.

Women's Needs and Experiences of Using Digital Technologies for Gestational Diabetes: An Integrative Systematic Review.

An integrative review methodology including quantitative, qualitative and mixed-method studies from electronic databases, grey literature, and government websites. Women's experiences and needs of using GDM digital technologies were synthesised into five overarching themes: educational information, coaching components, data management, healthcare professional remote services, peer support features, and functionality and features. This systematic review gives information on the variation of available features across technologies and specific features that were preferred/disliked by the women.

Risk coupling analysis of causal factors in construction fall-from-height accidents

PurposeConstruction fall-from-height accidents are not only caused by a single factor but also by the risk coupling between two or more factors. The purpose of this paper is to quantitatively analyze the risk coupling relationships between multiple factors and identify critical factors in construction fall-from-height accidents.Design/methodology/approachA cause analysis framework was established from the perspective of human, machine, material, management and environmental factors. The definition, the classification and the process of risk coupling were proposed. The data from 824 historical accident reports from 2011 to 2021 were collected on government websites. A risk coupling analysis model was constructed to quantitatively analyze the risk coupling relationships of multiple factors based on the N-K model. The results were classified using K-means clustering analysis.FindingsThe results indicated that the greater the number of causal factors involved in risk coupling, the higher the risk coupling value and the higher the risk of accidents. However, specific risk coupling combinations occurred when the number of their coupling factors was not large. Human, machine and material factors were determined to be the critical factors when risk coupling between them tended to pose a greater risk of accidents.Originality/valueThis study established a cause analysis framework from five aspects and constructed a theoretical model to quantitatively analyze multi-factor coupling. Several suggestions were proposed for construction units to manage accident risks more effectively by controlling the number of factors and paying more attention to critical factors coupling and management and environmental factors.

First aid training using virtual reality

This work considers the use of virtual reality (VR) technology to self-teach first aid training. It is known that VR provides realistic experiences to train individuals. We created interactable first aid lessons using the Unity engine and a VR interaction framework, and provided hands-on experience, with tests based on practical exercises. The VR application materials, with the first aid knowledge gathered from many government and hospital websites, consisted of 10 lessons and 7 tests. The lessons were appraised by 14 learners, resulting in a total average satisfaction score of 9.1. The post training first aid knowledge test scores increased by 35% from pre-course level. All learners reported having greater confidence, with their practical test scores improving by an average of 22% after multiple tests, demonstrating that the application could be effectively used for learning and practice purposes.

MAJULI RAAS MAHOTSAV AND ITS PRESENT-DAY RELEVANCE WITH RESPECT TO SOCIO-ECONOMIC DEVELOPMENT OF MAJULI

Majuli, the world's largest river island (Guinness World Records) situated in the Brahmaputra River in Assam, India, hosts an annual cultural extravaganza in the month of November known as the Raas Mahotsav. This research article explores the historical and cultural significance of the Majuli Raas Mahotsav and analyses its present-day relevance in contributing to the socio-economic development of Majuli. For this study secondary data is collected through review of academic literature, from government reports, government websites and media articles. The study provides a comprehensive analysis of how the festival contributes to local economic growth, cultural preservation, and community cohesion. By examining the impact of the festival on tourism, local businesses, and community engagement, this study aims to shed light on the potential of cultural events like Majuli Raas Mahotsav as catalysts for regional development. This research contributes to the ongoing discourse on leveraging cultural heritage for sustainable development and offers valuable insights for policymakers, researchers, and cultural enthusiasts alike.

New southern policy as South Korea's defence diplomacy in the Southeast Asia Region

President Moon Jae In announced the New Southern Policy as South Korea's foreign policy in 2017. The policy aims to strengthen the special relationship between South Korea and India and countries in the Southeast Asian region. The New Southern Policy has three pillars (3P) People, Prosperity, and Peace which are the direction of South Korea's foreign policy. In carrying out this policy, South Korea also carries out defense diplomacy through military assistance, sales, and transfer of weapons technology to countries in the Southeast Asian region. This article explains why South Korea uses the New Southern Policy as South Korea's defense diplomacy to Southeast Asian countries through arms sales and transfers. This study uses the velvet challenge framework from Gregory Winger with a qualitative approach and methods of collecting literature study data from books, journals, official government websites, scientific reports/papers, and online news media. The results of this study indicate that South Korea's economic strength through its defense industry has succeeded in introducing weapons products and acquiring new purchasers as indicated by the increasing volume of weapons sales to countries in the Southeast Asian region.

The Use of COVID-19 Mobile Apps in Connecting Patients with Primary Healthcare in 30 Countries: Eurodata Study.

The COVID-19 pandemic has necessitated changes in European healthcare systems, with a significant proportion of COVID-19 cases being managed on an outpatient basis in primary healthcare (PHC). To alleviate the burden on healthcare facilities, many European countries developed contact-tracing apps and symptom checkers to identify potential cases. As the pandemic evolved, the European Union introduced the Digital COVID-19 Certificate for travel, which relies on vaccination, recent recovery, or negative test results. However, the integration between these apps and PHC has not been thoroughly explored in Europe. To describe if governmental COVID-19 apps allowed COVID-19 patients to connect with PHC through their apps in Europe and to examine how the Digital COVID-19 Certificate was obtained. Design and setting: Retrospective descriptive study in PHC in 30 European countries. An ad hoc, semi-structured questionnaire was developed to collect country-specific data on primary healthcare activity during the COVID-19 pandemic and the use of information technology tools to support medical care from 15 March 2020 to 31 August 2021. Key informants belong to the WONCA Europe network (World Organization of Family Doctors). The data were collected from relevant and reliable official sources, such as governmental websites and guidelines. Patient's first contact with health system, governmental COVID-19 app (name and function), Digital COVID-19 Certification, COVID-19 app connection with PHC. Primary care was the first point of care for suspected COVID-19 patients in 28 countries, and 24 countries developed apps to complement classical medical care. The most frequently developed app was for tracing COVID-19 cases (24 countries), followed by the Digital COVID-19 Certificate app (17 countries). Bulgaria, Italy, Serbia, North Macedonia, and Romania had interoperability between PHC and COVID-19 apps, and Poland and Romania's apps considered social needs. COVID-19 apps were widely created during the first pandemic year. Contact tracing was the most frequent function found in the registered apps. Connection with PHC was scarcely developed. In future pandemics, connections between health system levels should be guaranteed to develop and implement effective strategies for managing diseases.