Administrative Levels Research Articles

The effect of lavender oil use on pain and comfort level in intramuscular injection administration: A single blind randomized controlled study

ContextThe fact that the concept of quality in health care services has come to the fore and that evidence-based practices have become widespread made such concepts as patient satisfaction and comfort important and priority parameters in determining the quality of health services. ObjectivesThe aim of the study is to determine the effects of using lavender oil in intramuscular injection on injection pain, comfort level, blood pressure, pulse rate and respiratory rate. MethodsThe study was designed as a prospective, single-blind randomized controlled trial. The research was conducted in accordance with the CONSORT Checklist guide. In our study, a total of 160 individuals were included in the sample, 80 of whom were control and 80 were intervention. Structured Information Form, Visual Analog Scale and Comfort Scale were used to collect the data of the research. Mann Whitney U, Kruskal Wallis test and Wilcoxon test were used to evaluate the data. ResultsIt was determined that the mean pain scores of the individuals who received intramuscular injection by applying lavender oil were statistically significantly lower than the individuals in the control group. Again, the comfort score averages of the individuals who were applied lavender oil were found to be statistically significantly higher than the control group. It was determined that the blood pressure, pulse rate and respiratory rate before the injection of the individuals in the control group increased statistically significantly according to the post-injection measurements, while the blood pressure, pulse rate and respiratory rate in the lavender oil group decreased significantly after the injection and remained within their normal values. ConclusionAs a result, it was determined that the application of lavender oil in intramuscular injection had a positive and significant effect on the blood pressure, pulse rate and respiratory rate of the individuals on the injection pain and comfort level.

The Role of Financial Oversight in Enhancing the Efficiency of Public Spending in the Kingdom of Saudi Arabia

This study aimed to determine the extent of the impact of financial control on the efficiency of public spending in the Kingdom of Saudi Arabia to regulate corruption, reduce waste of public funds, enhance transparency, and assess the effectiveness of current financial control legislation and agencies, and the procedures included therein, to understand their responsiveness, efficiency, and their impact on diversifying income sources, reducing unemployment rates, and their effect on economic growth through the analysis and study of international and local reports and indicators regarding financial control. Additionally, this study reviews the most distinguished international experiences in financial control and how to benefit from them to enhance the efficiency of control over the implementation of the general budget in the Kingdom. This study adopts the descriptive-analytical approach to reveal the effectiveness of current financial control over the public budget in the Kingdom of Saudi Arabia, and its impact on the efficiency of spending, relying on three important indicators that represent the growth rate, unemployment rate, and diversification of income sources, through the review and analysis of international and local reports and indicators during the period covered by the Open Budget Index in the Kingdom, starting from 2008 to 2023. The study revealed the necessity of financially and administratively independent financial control agencies, granting them the necessary powers to carry out their tasks, making all administrative levels accountable, with the need for continuous updating of financial control legislation and laws in the Kingdom, activating what has recently been introduced of systems, working on integrating control agencies, in addition to the importance of exercising preventive control before preparing the budget to avoid budget deficit crises and preserve public funds. The researcher believes, through what has been discussed, that this study provides a valuable contribution to the development of financial control policies in the Kingdom of Saudi Arabia.

Social credit system construction and entrepreneurial activity: A quasi-natural experiment from China

This study investigates the impact of the improved social credit environment on entrepreneurial activity. We conduct the time-varying difference-in-differences model based on the quasi-natural experiment of constructing China’s Social Credit System (SCS) and find that the implementation of this institution significantly improves entrepreneurial activity, which remains robust to a series of tests. Mechanism tests reveal that the SCS influences entrepreneurial activity through material, human, and social capital agglomeration effects, as well as by alleviating information asymmetry. Heterogeneity analysis demonstrates that the positive impact of SCS is more obvious in promoting entrepreneurial activity within private enterprises, high-tech, and manufacturing industries. Furthermore, this entrepreneurial effect is more pronounced in cities with lower administrative levels and on the southeast side of the Hu Huanyong Line.

MONDEP: A unified SpatioTemporal MONitoring Framework for National DEPression Forecasting

Depression has become a prevalent mental disorder that significantly affects a person's emotions, behaviors, physical health, ability to perform daily tasks, and ability to maintain healthy relationships. Untreated depression can escalate the risk of suicide, making the situation even worse. Despite an abundance of models previously proposed for forecasting depression, the issue of foretelling the overall number of patients at each administrative level remains under-investigated. Therefore, in this paper, we propose a simple but effective SpatioTemporal Monitoring Framework for National Depression Forecasting (MONDEP). In particular, we analyze national depression statistics data in Thailand as a case study and create prediction models for a real-time depression forecasting system using machine learning and deep learning approaches. In order to forecast the prevalence of depression at various administrative levels, we use the hierarchical structure of depression aggregation. The proposed framework consists of three modules: Data Pre-processing to extract and pre-process the raw data, Exploratory Data Analysis (EDA) to visualize and analyze the data to get insight, and Model Training and Testing to predict future depression cases. The objective of our research is to construct a comprehensive MONDEP framework that utilizes machine learning and deep learning to predict depression profiles at the district and national levels using multivariate time series across various administrative levels. Our study illustrates the considerable association between a spatial-temporal component and demonstrates how depression profiles may be represented by employing lower administrative-level data to estimate the general level of mental health across the nation. Additionally, the best performance across all criteria is obtained when a deep learning model is used to exploit multivariate time series, showing a 13% improvement in MAE measure compared to the SARIMAX baseline. We believe the proposed framework could be used as a point of reference for decision-making regarding the management of depression and has the potential to be incredibly helpful for policymakers in successfully managing mental health services on time.

استخدام تكنولوجيا المعلومات في دعم الأداء الاستراتيجي لمؤسسات القطاع الحكومي

Government institutions seek to find ways to adapt to modern changes in the work environment and keep pace with continuous developments by applying new methods and technologies. This study aims to demonstrate the relationship between effective information technology and supporting strategic performance in the Transport Authority in the Arab Republic of Egypt. The study used the descriptive analytical approach, and a questionnaire was designed and applied to a study sample of 179 individuals from different administrative levels in the Authority. The study reached several results, the most important of which is the need to pay attention to information technology and improve the level of training of workers in this field to support and raise the quality of the Authority's strategic performance.

The Impact of Land Marketization on Urban Resilience: Empirical Evidence from Chinese Cities

Enhancing urban resilience (UR) is the pivotal strategy for achieving sustainable development. Given that land serves as the cornerstone of urban activities, it is imperative to examine the relationship between land marketization (LM) and urban resilience amidst the profound market-oriented land reforms in China. After establishing the conceptual framework of urban resilience, this paper assesses the temporal and spatial dynamics and empirically investigates the impact of land marketization on urban resilience, drawing on data from 282 cities across China, spanning from 2001 to 2021. Our findings reveal several important insights. First, due to its public bidding and competitive pricing mechanisms, land marketization is a powerful measure to foster urban resilience and enables cities to flexibly respond to various challenges and changes. Second, the indirect mechanisms, including optimizing resource allocation, upgrading industrial structure, and fostering technological innovation, are crucial pathways through which land marketization affects urban resilience. Finally, the impact of land marketization on urban resilience varies across regions and city size. Cities with better geographic locations, larger population sizes, and lower administrative levels are more significantly affected than others. These findings reveal the importance of land marketization in strengthening urban resilience, thereby providing theoretical guidance and empirical references for cities to enhance urban resilience through land marketization.

Minding the gap between public administration curriculum and practice: The studio of public reasoning

It has always been a crucial question as to what kind of education should be provided to practitioners working at different levels of public administration, starting from the street level onwards, and what kind of interactions should be used to develop their competencies once in office. However, especially in the last 30 years, as we have entered a period of accelerating technological and institutional transformations, this issue has gained a dimension beyond the discussions on higher education and training for service. In addition to how public administration education will relate to practice as seen in traditional debates, new questions have emerged, such as how this engagement with practice can provide a perspective on institutional transformation, how those working in institutions can perceive their transformation processes more accurately, and ultimately, what kind of interaction can be achieved between those receiving public administration education and those working in public institutions. To answer these questions, an innovative model called “studio of public reasoning” was developed in 2009 for a university in public administration education in Turkey to create a platform for interaction with the external stakeholders of the university through an applied course. This Program has been implemented continuously for 15 years at the same university and more than 1000 students, about 100 public institutions of different scales and about 300 public administrators have benefited from the Program. In this paper, based on this experience, the gains of innovative teaching practices in public administration discipline in interacting with external stakeholders are critically evaluated through interviews with students, academics and administrators to assess whether alternatives are possible in establishing non-hierarchical external stakeholder interaction together with formal higher education for public administration.

Can the construction of smart cities promote the capital allocation efficiency: Evidence from China

Based on the panel data of 284 prefecture-level city in China from 2005 to 2019, this paper measures the urban capital allocation efficiency and takes smart city construction as a quasi-natural experiment. The multi-period difference-in-differences (DID) model has been built to verify the internal mechanism and practical effect of smart city construction driving the optimal allocation of capital. The results show that the construction of smart cities has significantly improved the efficiency of capital allocation, and the conclusion remains valid after a series of robustness tests; Mechanism analysis shows that strengthening environmental regulations and improving innovation capabilities, together with the construction of smart cities, have promoted the improvement of capital allocation efficiency; The heterogeneity analysis indicates that the effect of smart city construction on capital allocation efficiency is influenced by the administrative level and regional heterogeneity characteristics of the city. This paper provides empirical evidence for the policy effectiveness of smart city construction and provides policy enlightenment on how to optimize capital allocation.

Analyzing multiscale associations and couplings between integrated development and eco-environmental systems: A case study of the central plains urban agglomeration, China

In the Anthropocene, urban agglomeration is increasingly recognized as a crucial facilitator in advancing urbanization to more developed stages, requiring comprehension of the multiscale associations and couplings supporting urban agglomeration integrated development and eco-environmental systems. This study introduces a novelty research framework for analyzing the intricate associations and couplings between the degree of integrated development and eco-environmental quality in the Central Plains Urban Agglomeration (CPUA), which operates simultaneously at the city, county, and landscape scales. The results suggest that the CPUA degree of integration is moderately low, with areas exhibiting a high degree of integration comprising <1% and predominantly located within the sphere of influence of core cities, such as Zhengzhou. Regions with high eco-environmental quality are located in regions with natural advantages in the northwestern, southwestern, and southeastern regions. It is worth noting that a generally inverse coupling relationship was observed between the urban agglomeration degree of integration and eco-environmental quality, exhibiting varied characteristics across different spatial scales and regional contexts. Stakeholders should focus more on environmental management and policy-making at the county administrative level. This study proposes a multiscale approach for revealing the complex associations and couplings between integrated development and eco-environmental systems, offering valuable insights into the sustainable development of urban agglomerations that encompass natural, social, and economic dimensions.

City Regionalism in the Global South: Evidence from Sub-Saharan Africa

This study investigates city regionalism within the context of state restructuring in postcolonial Ghana. To understand Ghana’s emerging city regionalism, first, we argue that planning is marshaled as an institutional instrument to materialize the state’s vision of remaking national territory and internationalizing the state. Second, city regionalism is a political process leveraged by a unique power geometry. The study adopts Ghana’s Northern Savannah Ecological Zone (NSEZ) regional plan to elucidate city regionalism in the Global South. Our findings reveal the central government’s inclination toward endogenous territorial restructuring, by which city region development is centrally orchestrated and state guided. In addition, city regionalism is influenced by the geostrategic ambitions of international capital, especially Chinese capital, which seeks to draw investment into the built environment and infrastructure. The central government’s customization of a regional governance agency, the Northern Development Authority (NDA), and the decentralization of land resources give rise to a “dumbbell” power structure. The concentration of legal and cohesive power in the central government and an overly privatized land ownership regime characterize this dumbbell power structure. The operation of the NDA is thus a scaffolding with no substantial power. The central government exercises restrictive fiscal regulation over regional and local states in the NSEZ. These two dimensions hamper the effective implementation of the regional plan. Collaboration between different levels of state administration, traditional authorities, and civil society actors is imperative to address the complexities of city regionalism in postcolonial Ghana.

Shared patient information and trust: a qualitative study of a national eHealth system

BackgroundIn Norway, as in other countries, national eHealth systems, such as the Summary Care Record (SCR), have been implemented to improve the collaboration around patients by sharing patient information between health professionals across healthcare institutions and administrative levels. Although widely implemented across the health and care services in Norway, evaluations of the SCR indicate less use than expected. There is a need for analysis that lays out the visions and expectations of the SCR and contrasts these with detailed observations of use in everyday health professional work. This study adds to the eHealth research field by exploring this reality.MethodThis paper has a qualitative design with an ethnographic approach, including participant observation, qualitative interviews, and a document review. Qualitative individual interviews with 22 health professionals and six weeks of participant observation were conducted, and eight documents were reviewed. The field notes and the interview-transcriptions were analyzed following a stepwise-deductive induction analysis.ResultsThe document review identified the expectations and visions of the SCR, including an underlying assumption of trust in shared patient information. However, this assumption is implicit and not recognized as a crucial element for success in the documents. In our observation and interview data, we found that health professionals do not necessarily trust information in the SCR. In fact, several procedures and routines to assess the trustworthiness of SCR information were identified that complicate and disturb the expected use. In our analysis, two main themes characterize the health professionals' handling of the SCR: adapting to workflow and dealing with uncertainty.ConclusionOur study illustrates that unconditional trust in shared patient information is an implicit assumption in SCR policy documents, but in their everyday work health professionals do not necessarily unconditionally trust shared patient information. Rather, sharing patient information through technology, such as the SCR, requires of health professionals to critically assess the digital information. The information in the SCR, as all sources of information presented to health professionals, becomes an item for their constant trust-work. Our study is of value to policymakers, health information systems developers, and the field of practice both nationally and internationally.

Artificial intelligence and public administration: Understanding actors, governance, and policy from micro, meso, and macro perspectives

Artificial Intelligence (AI) has become one of the most prominent topics in public policy and administration studies over the last years. Despite the attention to AI in this field isn’t entirely new, the universality of these group of technologies has radically increased the attention of scholars around the globe. This expansion of AI in the public sector entails the exploration of renovated foundations of analysis, not only to understand the novelty of these technologies, but also to connect these processes of adoption and implementation with other debates in public policy and administration. To do so, in this article we debate the need of an analytical framework of AI in the public sector based on the three levels of public administration: macro, meso, and micro. Also, we review the state-of-the-art in the field using the articles presented in the special issue on Artificial Intelligence and Public Administration: Actors, Governance, and Policy. Form here, we propose studying AI using a combination of macro, meso, and micro levels of public administration. We assume this will help to broadly apprehend how and why people, policies, and institutions interrelate with AI in public sector settings, and which effects can be expected from these processes in public administration.

The Relationship of PCLR Therapy on Hemoglobin Levels in Anemia Patients at BDRS MMC Jakarta (January-April 2022)

Anemia is generally characterized by a decrease in hemoglobin levels. In terms of function, a decrease in hemoglobin causes a reduction in the body's need for oxygen in sufficient quantities. PCLR (Packed Red Cell Leukoreduced) is a concentrated red blood cell product obtained through the process of reducing leukocytes, so PCLR transfusion is expected to increase Hb levels in anemia patients. This study aims to determine the relationship between PCLR administration and hemoglobin levels in anemia patients and to determine the increase in hemoglobin levels after PCLR transfusion at MMC Hospital Blood Bank (BDRS MMC) Jakarta. Quantitative (analytical) research methods. The sample in this study was 140 data from anemia patients who underwent PCLR transfusion (January-April 2022). Data analysis was carried out univariate and bivariate. The research was carried out at MMC Jakarta Hospital in July 2022. Research results: the majority of patients were elderly (56-&lt;65 years) 67 people (47.9%), the majority gender was female 82 people (58.6%); there was an increase in Hb levels after PCLR transfusion, namely 1.89 gr/dL with an average use of 2 bags; and there is a relationship between PCLR administration and hemoglobin levels in anemia patients at BDRS MMC Jakarta. Suggestion: to achieve an increase in hemoglobin in anemia patients, PCLR can be used as a blood component of choice for transfusion at the right dose.

Vertical fiscal imbalances, environmental regulations and resource allocation — in the Chinese context

ABSTRACT Vertical fiscal imbalances (VFI) in China have created significant challenges for resource allocation and environmental governance. This study investigates the impact of VFI on resource allocation in Chinese cities. Results show that VFI intensifies resource misallocation, particularly at the provincial compared to the municipal level. And VFI influences resource allocation via informal and formal environmental regulations, with public and administrative regulations mitigating effects, while supervisory regulations exacerbate them. The negative impact of VFI is especially pronounced in declining cities, non-industrial hubs, and regions with severe resource misallocation. Additionally, VFI and resource misallocation demonstrate negative spatial spillover effects. Our findings provide valuable insights into the influence of VFI across different administrative levels in China, highlighting the need for policy reforms to address these fiscal disparities.

Exploring spatial non-stationarity of child labour and its related factors: A multiscale geographically weighted regression study of India

The relationships between various factors and child labour have been explored in the literature but, despite findings that suggest the predictive factors of child labour can vary according to context, there has been little research that has used spatial methods of analysis or attempted to estimate local relationships between covariates and the prevalence of child labour. This paper seeks to address this knowledge gap by using geographically weighted regression (GWR) and multiscale geographically weighted regression (MGWR) models. Using India 2011 Census Data as a case study, the findings show that GWR and MGWR models both perform significantly better than a global regression model across the whole of India. The study also finds significant spatial non-stationarity in the relationships between child labour and its covariates, with the association between district-level child labour rates and both the Muslim population and the child sex ratio found to have opposite directions in different parts of the country. Using MGWR, it was also possible to demonstrate that different covariates interact with child labour at various spatial scales, suggesting that interventions aiming to address varying aspects of the child labour problem may need to be deployed at different administrative levels to maximise their efficacy.

Navigating the Predictive Landscape: DiaRem's Role in Unveiling Outcomes for Diabetes Remission following ESG.

Rising obesity and type 2 diabetes mellitus (T2DM) rates can be mitigated by various strategies, with a 10% total body weight loss (TBWL) threshold often required for T2DM remission. T2DM remission rates after bariatric surgery like Roux-en-Y gastric bypass (RYGB) are well established; endoscopic sleeve gastroplasty (ESG) is a less invasive option that averages 15% TBWL and allows for T2DM remission. This study explores the DiaRem (Diabetes Remission post-RYGB) score's ability to predict T2DM remission 1-year post-ESG. We conducted a retrospective cohort study on 39 individuals with T2DM who underwent ESG. Age, utilization of diabetes medications, insulin administration, and hemoglobin A1c levels were used to calculate the DiaRem score. The area under the receiver operating characteristic curve (AUC) was employed to evaluate the discriminative ability of DiaRem in distinguishing diabetes remission. Among the 39 patients with a median hemoglobin A1c of 6.7, 12.8% required insulin, and 43.6% used diabetes medication. At 1-year post-ESG, 69.2% of patients experienced diabetes remission with a median %TWBL of 12.7. The DiaRem score's ability to detect diabetes resolution for ESG patients had a sensitivity of 100% and a specificity of 58.3%, at the optimal cutoff value of 10. The AUC was 0.779 (95% CI 0.546-0.959). Our study demonstrated the DiaRem score's predictive value for T2DM remission post-ESG, highlighting its utility in clinical decision-making for ESG-related outcomes. Further investigation is needed to identify alternative indicators that may enhance predictive accuracy, thus refining personalized decision-making for this patient group.

Negotiating peace education: the dynamics of bottom-up/top-down integrated/bilingual education initiatives in Israel

ABSTRACT This paper delves into the intricacies of fostering bottom-up educational initiatives aimed at addressing power imbalances in societies marked by intractable conflicts. Focusing on the establishment of a Palestinian-Jewish integrated bilingual education program in Israel, the study examines archival materials and stakeholder interviews to uncover the divergent motivations of politicians, educators, and administrators. It highlights the multifaceted nature of NGO-government negotiations, emphasizing the entanglement of contexts and the presence of internal conflicts within each entity. By exploring the ideological and operational challenges faced at different administrative levels, from national ministries to local municipalities, the paper provides a nuanced understanding of the support mechanisms for integrated bilingual schools. Findings call for an in-depth examination of these complex dynamics and their broader implications for educational policy and practice in conflict-affected settings.

Effect of extracellular matrix stiffness on efficacy of Dapagliflozin for diabetic cardiomyopathy

BackgroundExtracellular matrix (ECM) stiffness is closely related to the progress of diabetic cardiomyopathy (DCM) and the response of treatment of DCM to anti-diabetic drugs. Dapagliflozin (Dapa) has been proven to have cardio-protective efficacy for diabetes and listed as the first-line drug to treat heart failure. But the regulatory relationship between ECM stiffness and treatment efficacy of Dapa remains elusive.Materials and methodsThis work investigated the effect of ECM stiffness on DCM progression and Dapa efficacy using both in vivo DCM rat model and in vitro myocardial cell model with high glucose injury. First, through DCM rat models with various levels of myocardial injury and administration with Dapa treatment for four weeks, the levels of myocardial injury, myocardial oxidative stress, expressions of AT1R (a mechanical signal protein) and the stiffness of myocardial tissues were obtained. Then for mimicking the stiffness of myocardial tissues at early and late stages of DCM, we constructed cell models through culturing H9c2 myocardial cells on the polyacrylamide gels with two stiffness and exposed to a high glucose level and without/with Dapa intervention. The cell viability, reactive oxygen species (ROS) levels and expressions of mechanical signal sensitive proteins were obtained.ResultsThe DCM progression is accompanied by the increased myocardial tissue stiffness, which can synergistically exacerbate myocardial cell injury with high glucose. Dapa can improve the ECM stiffness-induced DCM progression and its efficacy on DCM is more pronounced on the soft ECM, which is related to the regulation pathway of AT1R-FAK-NOX2. Besides, Dapa can inhibit the expression of the ECM-induced integrin β1, but without significant impact on piezo 1.ConclusionsOur study found the regulation and effect of biomechanics in the DCM progression and on the Dapa efficacy on DCM, providing the new insights for the DCM treatment. Additionally, our work showed the better clinical prognosis of DCM under early Dapa intervention.

Parameters Predictive of Propofol-Associated Acute Pancreatitis in Critically Ill Patients with COVID-19 Pneumonia: A Retrospective Cohort Study.

Propofol, a commonly used agent for short- and long-term sedation, is associated with acute pancreatitis. The main indirect mechanism of propofol-associated acute pancreatitis is by inducing hypertriglyceridemia. Patients with severe coronavirus disease 2019 (COVID-19) pneumonia often require prolonged mechanical ventilation and sedation. We examined the incidence rate of acute pancreatitis among critically ill adults with COVID-19 pneumonia on mechanical ventilation receiving propofol. In addition, we attempted to determine cutoff levels of serum triglycerides and doses of propofol that are predictive of propofol-associated acute pancreatitis. This was a multicenter retrospective cohort study using a large dataset of hospitalized patients with COVID-19. The collected data included the number of days on propofol, cumulative doses of propofol, peak levels of serum triglycerides, serum lipase levels, and abdominal imaging findings. We used receiver-operating characteristic analysis in conjunction with Youden's index to identify the optimal thresholds for propofol administration parameters and levels of triglycerides that would provide maximal sensitivity and specificity for predicting acute pancreatitis. Out of 499 critically ill patients with COVID-19 pneumonia, 154 met the inclusion criteria. Six (4%) patients had suspected acute pancreatitis based on elevated serum lipase levels. Cutoff values greater than 688 mg/dL for peak level of triglycerides, 4.5 days on propofol, 3007 mg/day for average daily propofol dose, and 24 113 mg for cumulative propofol dose were associated with high risk of suspected acute pancreatitis. The negative predictive values for suspected acute pancreatitis using these cutoffs ranged from 98% to 100%. Propofol use in critically ill COVID-19 patients is associated with a low incidence rate of acute pancreatitis. We identified cutoff values for serum triglycerides and cumulative propofol dose that are linked to higher risk of propofol-associated pancreatitis. More research is needed to examine the true incidence of propofol-associated pancreatitis and help develop optimal cutoff values for certain parameters to help guide safe propofol administration.

Subnational Investments in Mitigation and Adaptation to Climate Change: Some Financing and Governance Issues

Meeting climate change goals requires steadfast action at all levels of government in terms of both mitigation (measures to reduce greenhouse gas emissions) and adaptation (measures to reduce the impacts of climate change on economies and societies). Against this background, this paper discusses the role of subnational investment, including funding and financing options, as well as governance arrangements. It fills a gap in scholarly work on the principles guiding subnational investment in climate change mitigation and adaptation, identifies areas for future work, and underscores the need for cross-country comparable information on policy instruments and outcomes at the subnational levels of administration that could be used in more systematic hypothesis testing in this area. JEL classification codes: H11, H70, Q54.