Large Private Research Articles

COVID-19 policies and tuberculosis services in private health sectors of India, Indonesia, and Nigeria

IntroductionThe COVID-19 pandemic created unprecedented challenges in the field of global health. Nigeria, Indonesia and India are three high tuberculosis (TB) burden countries with large private health sectors. Both TB and the private health sector faced challenges in these countries because of COVID-19. This study aimed to compare the COVID-19 control measures and policies in the provision of TB care services and gain insights from policymakers on how the pandemic affected the provision of TB services in the private healthcare sector, how each country adapted, and identify lessons learned for health system preparedness MethodsQualitative, in-depth interviews were conducted among a purposive sample of 11 national and sub-national policymakers in each country. Thematic content analysis was conducted on the data collected using an adapted WHO Health Equity Policy Framework. ResultsResults revealed three policy dimensions under costs, access, and quality. Under healthcare costs, policymakers highlighted resource allocation and diversion of TB resources to COVID response, and increased operational costs for private provider. Under healthcare access, key themes included key themes included reduced TB case detection due to fear of COVID-19, disrupted diagnostic services, and adaptations such as extended medicine supplies and virtual consultations. Under healthcare quality, themes included compromised TB diagnostic accuracy due to similar respiratory symptoms with COVID-19, and strain on laboratory infrastructure due to competing demands from both diseases. Policymakers across the three countries pointed to the need for strengthening private–public partnerships (PPP) for healthcare service delivery and continued private sector investment to facilitate the continuity of TB care within a pandemic context. ConclusionThe results of this study provide an overview of the impact of the pandemic from the perspective of private facilities and policymakers in Nigeria, Indonesia and India, which can inform future policy and ways forward in strengthening PPP for healthcare service delivery in high TB burden countries.

Mechanisms of Control and Media Protagonism in Management

Objective: The objective of this study is to investigate the mechanisms of control and media protagonism in the management of epidemics in order to demonstrate the influence that the media in association with the State and large private corporations exert on human behavior. Theoretical Framework: In this topic, the main concepts and theories that underlie the research are presented. The issue of fear arising from contagion in a scenario of disease outbreaks, aspects of collective behavior and the use of institutional and media control methods are highlighted, providing a solid basis for understanding the context of the investigation. Method: The methodology adopted for this research comprises the survey and selection of journalistic texts containing national and international coverage of outbreaks of contagious diseases to organize the corpus of comparative analysis of the influence on the process of legitimization of prophylaxis, surveillance and control measures. Results and Discussion: The results obtained revealed that the media is established with other possibilities besides surveillance, in which control is something even more present, and its role will be that of control through discourse. In the discussion section, these results are contextualized in the light of the theoretical framework, highlighting the implications and relationships identified. Possible discrepancies and limitations of the study are also considered in this section. Research Implications: The practical and theoretical implications of this research are discussed, providing insights into how the results can be applied or influence practices in the fields of communication and health, in relation to the construction of the media narrative about public health with possible developments in relation to the vaccination campaigns that followed the epidemic and the pandemic that are the objects of this study. Originality/Value: This study contributes to the literature by demonstrating, in different scenarios separated from each other by a decade, but characterized by the worldwide dissemination of contagious diseases, the performance of the same logic of control and media protagonism. The relevance and value of this research are evidenced by the demonstration of the need for the journalist to perceive in his professional practice the asphyxiating implications arising from the control by the discourse imposed by the media on society.

Présence, statut et variétés du français dans le paysage linguistique du Maroc

Abstract The aim of this exploratory research is to map the presence of the French language in Morocco. To this proposal, we update the linguistic demographic profile of Moroccan francophones on the basis of numbers provided by international organisations and classify them according to the varieties used: basilectal, mesolectal and acrolectal. In this respect, we consider two important factors for the learning and use of French in Morocco: education and migratory flows. In addition, we draw on linguistic landscape studies to examine the traces that these linguistic practices leave in the public space, as this approach provides data on the functions, status and varieties of this language. Our approach is based on data collected in five main Moroccan cities, documenting, on the one hand, the highly standardised display used by public authorities and large private companies and, on the other, signs written in a more or less formatted manner by individual citizens. Our results allow us to corroborate the process of the ‘sédentarisation’ of French in Morocco on the basis of its visible traces. In addition, our sample illustrates the multilingualism displayed and the coexistence of several languages in Morocco. In the future, further in-depth studies could broaden our documentary bases, systematise the results and revise the conclusions that close this article.

Assessing and Improving Medical-Spanish Language Proficiency Among Nursing Students.

Introduction: Language discordance among health care providers and patients has been shown to result in poor patient outcomes. Health care providers who identify as being proficient in the native language of their patients may decline the use of professional interpreters due to their self assessment of language proficiency. More information is needed about whether providers who speak Spanish are proficient in medical Spanish. This study measured medical-Spanish language proficiency among nursing students. Methods: A quantitative pretest posttest evaluation (N = 30) at a large private university in the northeastern U.S. compared student and faculty assessment of student language proficiency after taking a medical-Spanish course using the Interagency Language Roundtable (ILR). T-tests compared student's final, self-assessed ILR scores with faculty's final ILR scores. Results: A significant difference was noted between students' self assessments and faculty assessments of student language proficiency (Rater 1: t(29) = -2.660, p = 0.013; Rater 2: t(29) = -2.693, p = 0.012) with high interrater reliability (kappa = 0.875). There was a significant difference between students' self-assessment of language abilities before and after the course (t(29) = -3.694; p < 0.001). Conclusion: Objective assessment of medical-Spanish language proficiency following a medical Spanish course may more accurately measure proficiency than self-assessment alone.

Cautionary lessons from the COVID-19 pandemic: Healthcare systems grappled with the dual responsibility of delivering COVID-19 and non-COVID-19 care.

During the COVID-19 pandemic, hospitals were challenged to provide both COVID-19 and non-COVID treatment. A survey questionnaire was designed and distributed via email to hospitals empanelled under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana(AB-PMJAY), the world's largest National Health Insurance Scheme. Telephonic follow-ups were used to ensure participation in places with inadequate internet. We applied support vector regression to quantify the hospital variables that affected the use vs. non-use of hospital services (Model-1), and factors impacting COVID-19 revenue and staffing levels (Model-2).We quantified the statistical significance of important input variables using Fisher's exact test. The survey, conducted early in the pandemic, included 461 hospitals across 20 states and union territories. Only 55.5% of hospitals were delivering emergency care, 26.7% were doing elective surgery and 36.7% providing obstetric services. Hospitals with adequate supplies of PPE, including N95 masks, and separate facilities designated for COVID-19 patients were more likely to continue providing emergency surgeries and services effectively. Data analysis revealed that large hospitals (> 250 beds) with adequate PPE and dedicated COVID-19 facilities continued both emergency and elective surgeries. Public hospitals were key in pandemic management, large private hospital systems were more likely to conduct non-COVID-19 surgeries, with not-for-profit hospitals performing slightly better. Public and large private not-for-profit hospitals faced fewer staff shortages and revenue declines. In contrast, smaller hospitals (< 50 beds) experienced significant staff attrition due to anxiety, stress and revenue losses. They requested government support for PPE supplies, staff training, testing kits, and special allowances for healthcare workers. The inclusion of COVID-19 coverage under AB-PMJAY improved access to healthcare for critical cases. Maintaining non-COVID-19 care during the pandemic indicates healthcare system resiliency. A state-wide data-driven system for ventilators, beds, and funding support for smaller hospitals, would improve patient care access and collaboration.

Шляхи залучення фінансових ресурсів державними банками для відбудови економіки України

Introduction. The analysis of the availability and quality of financial resources involves identifying sources of funding, established practices of state-owned banks, international programs and funds, criteria for ensuring the quality and sustainability of reconstruction, urgent needs for funding and its availability, ensuring the participation of economic actors in the planning and monitoring of reconstruction programs, accountability mechanisms and ensuring economic, social and environmental sustainability. Problem Statement. The need to expand the sources of term resources on local and international markets, and to distribute them through a system of financial partnerships between state-owned banks and authorized financial organizations to support small and medium-sized businesses, requires coordinated actions among all stakeholders. Although households' long-term funds account for only a small share of the overall financing structure, they are becoming increasingly important in the context of globalization, especially in view of economic recovery and political stability. The purpose is to examine the volume, dynamics and structure of sources of funds raised by state-owned banks in the local market for the purpose of rebuilding Ukraine's economy. Methods. The study used a systematic approach, the principles of systematization of statistical and analytical data, graphical analysis, scientific synthesis, induction and deduction. Results. The article analyzes the volumes, dynamics and structure of attracting credit resources by state-owned banks in partnership with authorized financial organizations, in particular through the loan programs of the Entrepreneurship Development Fund (EDF) and the NBU's refinancing programs for commercial banks. It was found that the amount of resources attracted from the EDF is insignificant compared to the loan portfolios of state-owned banks. To access the EDF loans, state-owned banks invest in government debt instruments (government bonds), which is inefficient in terms of supporting economic recovery, as high interest rates on such instruments cause liquidity to flow into government debt obligations, which puts pressure on the state budget and additional default risks for issuers of such securities. Special attention in the study is paid to the analysis of the dynamics of customers' term deposits by banking groups, including state-owned and private banks, as well as banks with foreign capital. The dynamics of attracting funds from individuals and legal entities of state-owned banks in comparison with large private banks and banks with foreign capital is presented. This made it possible to assess how successfully banks maintain their liquidity and retain customer confidence. Conclusions. In times of war, state-owned banks play a key role in stabilizing the financial system. Business support programs, social payments, and government guarantees have made these banks important to customers, which explains the significant growth in deposit portfolios in 2023-2024. The volume of bank refinancing (collateral, terms, purpose) indicates a change in the NBU's strategy aimed at reducing banks' dependence on the central bank and moving to more market-based liquidity mechanisms. The gradual integration of Ukraine into the EU opens up prospects for state-owned banks to access large-scale and cheap financing under targeted programs, so it is advisable to orient the banks' resource policy towards the relevant mechanisms. In times of war and global uncertainty, state and international guarantees are an important tool for attracting additional financial resources. At the same time, this tool is used to a limited extent. Among the state-owned banks, only Ukreximbank has received direct guarantees from the Ukrainian government to secure creditors' claims. It is necessary to consider the possibility of attracting guarantees from international organizations as a less burdensome and more effective tool for expanding and reducing the cost of funding.

Persuading large investors

A regulator who designs a public stress test to avert default of a distressed bank via private investment must account for large investors' private information on the bank's state. We provide conditions for crowding-in (crowding-out) so that the regulator offers an endogenous more (less) informative signal to better-informed investors. We show that crowding-in occurs as long as investors remain responsive to public news and they are sufficiently well informed: the regulator's test perfectly reveals the state as investors' become privately perfectly informed. Investors' value from more precise private signals may come from their effect on the public test's precision.

Assessing Experiential Learning Program Design and Delivery Using Institutional Mission and Professional Standards

BackgroundHigh-impact practices (HIPs), such as mentored research, Capstone projects, study abroad, and field experiences, have been shown to improve college student engagement through experience-based learning. Research indicates that these practices can have high impact when they are intentionally designed and delivered to align with institutional mission and professional standards. The administrative structure of a HIP initiative may not consider how to assess program effectiveness. Few close examples exist in the literature to guide program staff to understand whether the HIPs supported by their programs are being designed and delivered for high impact. Our study details the efforts of one unit at a large private university to evaluate the implementation of an experiential learning initiative intended to support faculty to design and deliver high-impact practices to students. PurposeThis qualitative case study responds to the call for assessment to ensure that HIPs qualify as high impact. It illustrates a standards-based approach to evaluating a program of co-curricular, experientially based high-impact practices by determining how educational design and delivery aligns with the institution’s mission and professional standards for best practice. Methodology/approachTo qualitatively evaluate how well our HIP program aligned with institutional mission and HIP standards, we collected narrative data drawn from six faculty projects, faculty interviews, and reflections from 70 participating students. We used the institutional mission and established HIP professional standards as confirmatory themes to code the narrative and observe levels of coverage. Administrative directives were mapped against the confirmatory themes to identify areas of high and low emphasis and emergent themes that fell outside specific mission and standards language were considered for meaning. Findings/conclusionsOur qualitative assessment of a HIP program revealed program strengths and areas in need of improvement. By evaluating the concentration of institutional mission and professional standard themes across the project narratives and within the way the program was structured and administered, we found strong alignment existed in the areas of intellectual growth and interaction with faculty and peers. When we found that other mission themes and standards were present at lower levels, we mapped the administrative directives to the themes and discovered that the high concentration themes occurred more frequently in the directives. This insight led us to observe that addressing all mission and professional standard themes more clearly in the design phase could serve to align administrative directives more closely. In addition to the presence of confirmative themes across the data, we found emergent themes that had meaning to study participants but fell outside of the mission and industry standards. The evaluative process taught us important lessons around how administration-to-faculty program directives can impact the design and delivery of pedagogical practice. RecommendationsEducational leaders should consistently use institutional mission and professional standard language in directives to faculty and staff; training faculty in designing HIPs to meet professional standards can benefit underserved students; and recognizing meaningful themes that emerge through program evaluation can illuminate important unanticipated outcomes.

Reform of the Irish health system towards Universal Health Coverage and the role of the private sector

Abstract Introduction Ireland stands as a compelling case study of a High Income Country setting out on Universal Health Coverage (UHC) reforms. The Irish health system has historically been a two-tier system with a large private sector and a high proportion of the population holding private health insurance (48% in 2023). The reform programme Sláintecare, adopted as a policy direction by all political parties, aims to introduce UHC, strengthen primary care capacity, address inequitable access and decentralise decision-making. The overall aim of this study is to chart the progress of the Sláintecare reforms, from their introduction in May 2017 up to December 2023, and to explore how they have changed throughout implementation. Methods A document analysis was undertaken using the READ approach. Department of Health publications, Budget reports, Service Plans, National Development plans, minutes of Health Service Executive committee meetings and transcripts of the Joint Committee of Health sessions in the Irish parliament were uploaded to NVivo and a content analysis was conducted, utilising predetermined themes. Results Areas that have made the most significant progress include the expansion of community care and lowering of some out-of-pocket costs. Since implementation began, one approach the government has taken has been to use the private sector to fill capacity gaps in the public system. For example, strategies for reducing waiting lists and using community diagnostics have largely used the private sector. However, through using the private sector, money is taken away from building capacity in the public system, which was the original goal of Sláintecare. Conclusions The private sector plays a significant role in providing care in Ireland and leveraging this for the benefit of public patients could play a positive role towards UHC, provided that funding for a purchaser-providers type model for some services from the government could be guaranteed into the future.

ANALYZING THE IMPACT OF INDONESIAN SUSTAINABLE PALM OIL (ISPO) CERTIFICATION AND THE FACTORS THAT INFLUENCE CRUDE PALM OIL (CPO) EXPORTS VOLUME

This study examines the impact of Indonesian Sustainable Palm Oil (ISPO) certification on Indonesian Crude Palm Oil exports and other factors, such as commodity production and prices, exchange rates, and production levels. The data covers total CPO volume (HS codes 15111000 and 15119000) from January 2006 to December 2022, focusing on ISPO certification for large State-owned and Private Enterprises in palm oil cultivation and processing. The analysis employs the Difference-in-Differences (DID) method and multiple linear regression (MLR) to identify the linear relationship between the dependent and independent variables. The DID analysis revealed that Indonesian CPO production and global CPO prices significantly affected CPO export volumes, while soybean oil prices and effective exchange rates were not statistically significant in the regression model. The results provide valuable insights for policymakers and industry stakeholders in developing strategies that support sustainable growth, enhance competitiveness, and maintain Indonesia's leading position in the global palm oil market. Policymakers should focus on encouraging broader adoption of ISPO among palm oil producers through incentives, training, and technical support, especially for smaller producers.

Five paradoxes navigated by incumbent private sector firms moving towards climate-oriented innovation in food systems

The role of large private sector firms in rerouting our food systems towards sustainability through climate-oriented innovation is highly contested. The contestation has resulted in a portrayal in academic literature of these incumbents as either the key driver of sustainability transitions or as fundamentally contradictory to addressing climate change in food systems. Controversies and tensions can reinforce stalemates, which hamper progress towards climate-oriented innovation. This study explores the utility of a paradox lens which shifts the research gaze to the emergence of unavoidable and persistent tensions in encounters of distinct logics and lines of action, and opens space to examine how these encounters can nevertheless be used productively and creatively in overcoming stalemates. Based on reflexive practice and interviews with professionals from seven purposefully selected incumbent private sector firms in the agri-food sector, we identify five paradoxes: the paradox of direction—between mitigation and adaptation; the paradox of justification—between exploration and exploitation; the paradox of internal alignment—between mainstreaming and specialization; the paradox of external alignment—between collaboration and competition; and the paradox of evidence—between accountability and learning. Our analysis of how agri-food firms navigate paradoxes focuses on considerations, tensions, and decisions in organizing climate-oriented innovation. In our discussion, we examine whether and how paradoxical thinking enables civil society practitioners to accelerate climate-oriented innovation in food systems through interactions and collaborations with the private sector. We conclude that a paradox lens affords researchers, practitioners, and policymakers to move beyond the binary view on the role of incumbents’ climate-oriented innovation, and instead provides strategic insights for engaging incumbents and their inherent contradictions in transforming our food systems under a changing climate.

A-072 Growth hormone stimulation tests: experience of a large cohort from a Brazilian diagnostic medical center

Abstract Background Growth hormone (GH) stimulation tests are used to diagnose short stature in children and to assess hypothalamic-pituitary axis in adults. The most frequently stimulation tests are: oral clonidine (CLO), insulin-induced hypoglycemia (ITT), glucagon (GLU) and exercise (EXE). Well-known side effects are hypotension, nausea and vomiting. The aim of this study was to evaluate side effects and intercurrences observed during the performance of GH stimulation tests and to identify their possible predisposing factors. Methods From April/2022 to May/2023, in a large private laboratory located in 8 different sites, 3,006 GH stimulation tests were performed, with 266 patients with two or more GH stimulation tests. Results Considering only patients aged &amp;lt; 18 years (95% of the tests), the mean age was 10.3 ± 2.7 years (median 10.6 years), with 62.5% being male. GH stimulation test was distributed as follows: 64% CLO, 27.6% ITT, 7% GLU and 1.4% EXE. Patients with a history of asthma, allergies, seizure and heart disease were reported in 3%, 1.7%, 0.9% and 0.6%, respectively. More than 2 punctures for venous access were necessary in 9.3% of the cases, particularly in CLO test. The age of patients submitted to GLU was significantly lower compared to CLO and ITT (9.5 ± 3.3 years vs 10.3 ± 2.7 years and 10.6 ± 2.6 years, p &amp;lt; 0.001). Side effects were noted in only 5.1% of the total tests (145/2,863 tests), most frequent in the GLU (50/197 tests, 25%) and none observed in the EXE. There was no correlation of reported side effects with age and weight. As expected, hypotension was more frequent in CLO (27%), not associated with the oral clonidine administered dose (0.1 or 0.150 mg/SC). Nausea and vomiting occurred in 23% of the GLU tests. Symptomatic hypoglycemia that needed glucose administration (oral or parenteral) occurred in 8% of the ITT. Cough was observed in 6 patients during CLO, with no previous history of asthma or allergies. There were no occurrences that hospital transfer was need. Conclusions GH stimulation tests are safe and rarely cause serious side effects, certainly due to the presence of a prepared team for promptly support.

A Critical look at the Governance of Universities in the Face of Challenges: Passeism v/s Smart Governance with Data Sciences. Case of Lebanese Universities

The Lebanese private universities must respond to the current and future challenges within the framework of the globalization process. This requires important reforms with a high cost. This article analyzes the modes of governance of these universities, the risks involved and the management tools. A semi-structured interview survey was conducted among large private universities on current practices. It aims to dissects the different elements of governance, as well as the use of data science and key performance indicators in five sections: research, teaching, international relations, budget and financing, and finally student life and its environment. The analysis of the results shows that governance arrangements in universities are played out from two angles: there is a clear divergence between official arrangements and the real play of power. It also highlights fairly similar, if not identical, general structures, but very specific variations in the competencies of the supreme administrative councils, and the pivotal role played by the Presidents of these councils as orchestral conductors. In the second part of the survey, the analysis of the indicators reveals a dual aspect of reliability, on the one hand, but above all under-utilization, or limited utilization, on the other. These results will encourage the use of data science and artificial intelligence in decision making.

Multi-objective optimal sizing and techno-economic analysis of on- and off-grid hybrid renewable energy systems for EV charging stations

Integrating electric vehicle charging stations (EVCSs) with renewable energy systems requires the consideration of several factors during the planning stage, including environmental impact, economic viability, grid reliability, and self-sufficiency. Therefore, this study conducts a multi-objective optimal sizing of on- and off-grid hybrid renewable energy systems for EVCSs. The sizing problem is solved using the Non-dominated Sorting Genetic Algorithm (NSGA-II). Subsequently, the best suitable solutions from the obtained non-dominated solutions are selected using the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method, prioritizing the objective functions based on diverse interests of different stakeholders (large and small private investors and governmental entities). Finally, a techno-economic analysis is made considering payback period, profitability index (PI), and internal rate of return (IRR). The results show that on-grid systems show high economic viability with payback periods between 1.98 and 7.72 years, an average PI of 5.07 and an average IRR of 23.97%. Although off-grid systems present lower economic viability with payback periods between 8.77 and 22.42 years, an average PI of 1.68 and an average IRR of 4.91%, in certain cases they reach investable levels with payback periods below 10 years, PI above 2, and IRR above the interest rate.

From authentic leadership to knowledge sharing and knowledge worker retention: mediating role of psychological empowerment

ABSTRACT This study explores how leaders can reduce employees’ intention to quit and stimulate knowledge sharing in knowledge-based companies. Grounded in intrinsic motivation theory, it investigates the impact of authentic leadership on these outcomes, analyzing the mediating role of psychological empowerment. We tested the hypotheses in a sample of 123 professionals from a large private company operating in Brazil’s digital communication sector, employing structural equation modelling with Bayesian estimation. Results show that authentic leadership decreases the intention to quit and increases knowledge sharing. Additionallly, psychological empowerment fully mediates the relationship between authentic leadership and follower knowledge sharing but does not affect the intention to quit. This study highlights the role of positive forms of leadership in leveraging knowledge management and the importance of psychological empowerment as a critical mechanism through which authentic leaders promote knowledge sharing. Lastly, it underscores the association between authentic leadership and decreased turnover intention among knowledge workers.

The Productivity Spectrum: An Individual-Level Examination of Servers’ Reactions to Workload and Overwork

Purpose: This study explores the diverse reactions of human servers to variations in workload and overwork, focusing on how these stressors influence service time in a call center setting.Study design/methodology/approach: OLS regressions with fixed effects and clustered standard errors were used to analyze the impact of workload and overwork on service time at both aggregate and individual levels.Sample and data: This research utilizes archival data from a call center at a large Kuwaiti private hospital, covering 58,460 calls handled by 23 agents during October 2016.Results: At the aggregate level, workload has a negative effect on service time, indicating a general speedup response, while overwork shows no significant effect. At the individual level, responses vary significantly among agents, with some agents speeding up, others slowing down, and some demonstrating non-linear responses to workload. Overwork responses also vary, with some agents slowing down, others speeding up, and some showing flat responses.Originality/value: This study contributes to the behavioral queuing literature by emphasizing the importance of individual-level analysis in understanding server responses to workload and overwork. The findings reveal that aggregate analyses can mask significant variations in individual behaviors, crucial for optimizing call center performance. By exposing the spectrum of individual reactions, the study provides deeper theoretical and practical insights into the complex dynamics of service time under different work stressors.Research limitations/implications: The findings provide insights for optimizing call center performance, but further research is needed to validate and generalize these findings across different settings and call center environments.

Trends in patient age at planned oocyte cryopreservation

PurposeThe outcome of planned oocyte cryopreservation (POC) is inversely related to the age at the time of oocyte cryopreservation commencing in the mid-30 s. We sought to evaluate whether the age of women undergoing POC has changed over the last decade.MethodsThe study employed a retrospective, observational multicenter design. It included all women who had at least one POC cycle in two large private IVF units belonging to the same medical organization in Israel. The main outcome measure was age at the first cycle. Data on the total number of women each year and their age at the first cycle were recorded.ResultsBetween 2011 and the end of 2023, 4488 women underwent POC. The average age at the first retrieval was 36.2 years (± 2.4). In 2011, the average age was 38.3 years (± 2.6), which decreased to 35.4 years (± 2.5) in 2023. The trendline indicates a decline in the average age of 3.0 months per year (β = − 0.252, F = 301.8, p < 0.001). The proportion of women aged < 36 at their first POC cycle increased from 14% in 2011 to 54% in 2023.ConclusionsThe age at the time of POC has significantly declined over the past decade. This trend may potentially lead to higher overall birth rates from POC, though further research is needed to confirm this hypothesis.

Professional Competence among Indian Executives

The present paper is an empirical inquiry into the implications of personal and organizationalvariables of the executives in achieving their professional targets. The study is based on the empirical datapertaining to 126 executives functioning in 126 large scale, public and private manufacturing and serviceorganization in the state of Karnataka.The study indicates, the executives in the Indian context exhibit high level of professional competence.Further, the finding indicate that, professional competence is the function of age, as the age ofrespondents increases the level of professional competence also increases. The urban background ofthe respondents seems to be distant advantage in determining the professional competence.Coming to the organizational variables the findings indicate that, executives in manufacturing firms tendto be more competent then executives in service organizations.However, the level of professional competence seems to vary in depend of sector and age of theorganization. The findings refute the general belief that, executives in the private sector are morecompetent. Further, the findings seem to suggest such beliefs are unfounded and such generalizationsare unwarranted

Capsular Waves: A Warning Indicator for Potentially Malpositioned Intraocular Lenses.

To share examination findings of the lens capsule which may act as an indicator for malpositioned intraocular lenses (IOL). Single large multi-specialty private practice, Houston, Texas, USA. Focused, observational case series. A review of pre-operative images of malpositioned single-piece IOLs with at least one haptic in the ciliary sulcus was conducted. The review included five cases who were referred to a single large multi-specialty private practice from June 2023 to December 2024 for an evaluation of posterior capsular opacification (PCO) and potential Nd:YAG capsulotomy. A total of five eyes which previously had undergone cataract surgery and were referred for Nd:YAG capsulotomy for PCO were identified on slit lamp examination to have capsular waves, defined as a centripetal and circumferential striated pattern of PCO that results from a fused anterior and posterior capsule with at least part of the IOL anterior to the capsule. While one eye exhibited transillumination defects and pigment dispersion, the remainder of eyes did not. In some cases, the capsular wave was the only clue to IOL malpositioning due to a small pupil. These eyes had single-piece IOLs with at least one haptic in the sulcus and required subsequent IOL repositioning or exchange. If capsular waves are seen on slit lamp exam, a thorough inspection of IOL placement should be conducted, especially before treatment with Nd:YAG capsulotomy. Capsular waves result from anterior and posterior capsule contact with an anteriorly situated IOL. This finding is a potential indicator of at least part of an IOL positioned anterior to the anterior capsule.

Comparing revision rates and survival of pyrocarbon and non-pyrocarbon heads in total shoulder and hemi-shoulder arthroplasty

This retrospective, observational study aimed to assess the revision rates and survival curves in total shoulder arthroplasty (TSA) and hemi-shoulder arthroplasty (HSA) patients, including a sub analysis to investigate the impact of pyrocarbon humeral head in revision rates. Data from 92 primary HSA and 508 primary TSA patients performed by seven surgeons at a large private clinic, were analyzed. The study focused on revision rates and identified factors leading to revisions, including rotator cuff insufficiency, dislocation, aseptic loosening, implant material, and glenoid erosion. The overall revision rate for HSA was found to be significantly higher at 7.6% compared to TSA at 1.2% with a maximum follow-up of seven years. Sub-analysis within the HSA group revealed a notably higher revision rate in cases involving a metal head (cobalt-chrome or titanium) at 12.8% compared to those with a pyrocarbon head (2.3%). This study underscores the importance of distinguishing between TSA and HSA when evaluating shoulder arthroplasty outcomes. The significantly higher revision rate in HSA, particularly with metal heads, suggests the need for careful consideration of implant selection to optimize long-term success in shoulder arthroplasty procedures.