Target Population Research Articles

Health economic evaluation of rehabilitative short-term care : Analysis of the costs of geriatric patients with and without rehabilitative short-term care after inpatient hospital stay

Geriatric patients requiring rehabilitation and admitted to short-term care after an acute inpatient hospital stay seldom receive rehabilitative services later. Rehabilitative short-term care (REKUP) supplements short-term care with rehabilitative measures, aiming to prevent functional restrictions and long-term care. To conduct acost and cost-effectiveness analyses of REKUP and provide data for anationwide rollout. Anon-randomized controlled prospective study was carried out. The intervention group (IG) was paired 1:2 with acontrol group (KG), resulting in the formation of three collectives with follow-up periods of either 30,90 or 180 days (each with IG and KG). Using administrative claims data from the AOK Baden-Württemberg, the mean total costs from the perspective of the health insurance were calculated. Apotential impact of the intervention on costs was analyzed using the difference in differences approach. The analysis comprised 129 patients (IG43; KG86). During the follow-up periods, the IG presented higher rates of rehabilitation and lower rates of long-term care and mortality. Regarding costs, no statistically significant differences were found between the IG and KG in any of the three collectives. For nursing care and medication costs, costs were significantly higher in the follow-up period for the KG, whereas costs for rehabilitation were significantly higher for the IG (p < 0.001). Patients receiving REKUP utilize rehabilitation services more often and have alower likelihood of requiring nursing care or dying with no statistically significant differences in costs. There are potential advantages of REKUP in the target population, which warrant further investigation due to methodological limitations.

To weight or not to weight? The effect of selection bias in 3 large electronic health record-linked biobanks and recommendations for practice.

To develop recommendations regarding the use of weights to reduce selection bias for commonly performed analyses using electronic health record (EHR)-linked biobank data. We mapped diagnosis (ICD code) data to standardized phecodes from 3 EHR-linked biobanks with varying recruitment strategies: All of Us (AOU; n = 244071), Michigan Genomics Initiative (MGI; n = 81243), and UK Biobank (UKB; n = 401167). Using 2019 National Health Interview Survey data, we constructed selection weights for AOU and MGI to represent the US adult population more. We used weights previously developed for UKB to represent the UKB-eligible population. We conducted 4 common analyses comparing unweighted and weighted results. For AOU and MGI, estimated phecode prevalences decreased after weighting (weighted-unweighted median phecode prevalence ratio [MPR]: 0.82 and 0.61), while UKB estimates increased (MPR: 1.06). Weighting minimally impacted latent phenome dimensionality estimation. Comparing weighted versus unweighted phenome-wide association study for colorectal cancer, the strongest associations remained unaltered, with considerable overlap in significant hits. Weighting affected the estimated log-odds ratio for sex and colorectal cancer to align more closely with national registry-based estimates. Weighting had a limited impact on dimensionality estimation and large-scale hypothesis testing but impacted prevalence and association estimation. When interested in estimating effect size, specific signals from untargeted association analyses should be followed up by weighted analysis. EHR-linked biobanks should report recruitment and selection mechanisms and provide selection weights with defined target populations. Researchers should consider their intended estimands, specify source and target populations, and weight EHR-linked biobank analyses accordingly.

Improving alcohol and substance use screening in school-age children: translation, adaptation and psychometric evaluation of the CRAFFT tool for Lumasaaba, Uganda

BackgroundChildren at risk of substance use disorders (SUD) should be detected using brief structured tools for early intervention. This study sought to translate and adapt the Car, Relax, Alone, Forget, Family/Friends, Trouble (CRAFFT) tool to determine its diagnostic accuracy, and the optimum cut-point to identify substance use disorders (SUD) risk in Ugandan children aged 6 to 13 years.MethodsThis was a sequential mixed-methods study conducted in two phases. In the first qualitative phase, in Kampala and Mbale, the clinician-administered CRAFFT tool version 2.1 was translated into the local Lumasaaba dialect and culturally adapted through focus group discussions (FGDs) and in-depth interviews, in collaboration with the tool’s authors. Expert reviews and translations by bilingual experts provided insights on linguistic comprehensibility and cultural appropriateness, while pilot testing with the target population evaluated the tool’s preliminary effectiveness. In the second phase, the CRAFFT tool, adapted to Lumasaaba, was quantitatively validated against the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) for diagnosing SUD in Mbale district, through a survey. Participants, chosen randomly from schools stratified according to ownership, location, and school size, were assessed for the tool’s reliability and validity, including comparisons to the MINI KID as the Gold Standard for diagnosing SUD. Data were analyzed using STATA-15. Receiver-operating-characteristic analysis was performed to determine the sensitivity, specificity, and criterion validity of the CRAFFT with the MINI-KID.ResultsOf the 470 children enrolled, 2.1% (n = 10) had missing data on key variables, leaving 460 for analysis. The median age and interquartile range (IQR) was 11 (9–12) years and 56.6% were girls. A total of 116 (25.2%) children had consumed alcohol in the last twelve-month period and 7 (1.5%) had used other substances. The mean CRAFFT score for all the children (n = 460) was 0.32 (SD 0.95). The prevalence of any alcohol use disorder (2 or more positive answers on the MINI KID) in the last 12 months was 7.2% (n = 32). The Lumasaaba version of the CRAFFT tool demonstrated good internal consistency (Cronbach’s α = 0.86) and inter-item correlation (Spearman correlation coefficient of 0.84 (p < 0.001). At a cut-off score of 1.00, the CRAFFT had optimal sensitivity (91%) and specificity (92%) (Area Under the Curve (AUC) 0.91; 95% CI 0.86–0.97) to screen for SUD. A total of 62 (13.5%) had CRAFFT scores of > 1.ConclusionThe Lumasaaba version of the CRAFFT tool has sufficient sensitivity and specificity to identify school-age children at risk of SUD.

Influence of Retirement Experiences on Psychological Well-Being of Retired Teachers in East Gonja Municipality, Ghana

Purpose: The purpose of the study was to examine the influence of retirement experiences on psychological well-being of retired teachers in the East Gonja Municipality. The study employed a quantitative approach underpinned by analytical cross-sectional design. The target population of the study comprised of retired teachers in the East Gonja Municipality. A total of 320 retired teachers from East Gonja Municipality were purposively selected to constitute the sample for the study. Methodology: Scale of Positive and Negative Experience (SPANE) and Psychological Well-Being Scale were adopted for data collection. Data was analysed using means and standard deviation and linear regression. Findings: The study found that most of the retired teachers in the East Gonja Municipality in the Savannah Region of Ghana experience positive emotions, express optimism, and are satisfied with their lives in their retirement phase of life. Unique contribution to theory, policy and practice: The study concludes that retirement experiences are unique and can be a liberating experience for retired teachers, where they can pursue their interests and hobbies without any restrictions. It is recommended that retirement should be a time for retired teachers to focus on their health and well-being, a time they can pursue activities that promote physical and mental health. This study recommends to education system to provide pre-retirement counselling and post-retirement support programmes, focusing on mental health and well-being. Also, the study recommends to pension and retirement agencies to develop and implement workshops and peer support programmes to promote retired teachers’ psychological well-being, addressing issues of social isolation and identity loss.

Statistical assessment of reliability of anthropometric measurements in the multi-site South African National Dietary Intake Survey 2022.

Anthropometric data quality in large multicentre nutrition surveys is seldom adequately assessed. In preparation for the South African National Dietary Intake Survey (NDIS-2022), this study assessed site leads' and fieldworkers' intra- and inter-rater reliability for measuring weight, length/height, mid-upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC). Standardised training materials and measurement protocols were developed, and new anthropometric equipment was procured. Following two training rounds (12 site lead teams, 46 fieldworker teams), measurement reliability was assessed for both groups, using repeated measurements of volunteers similar to the survey target population. Reliability was statistically assessed using the technical error of measurement (TEM), relative TEM (%TEM), intra-class correlation coefficient (ICC) and coefficient of reliability (R). Agreement was visualised with Bland-Altman analysis. By %TEM, the best reliability was achieved for weight (%TEM = 0.260-0.923) and length/height (%TEM = 0.434-0.855), and the poorest for MUAC by fieldworkers (%TEM = 2.592-3.199) and WC (%TEM = 2.353-2.945). Whole-sample ICC and R were excellent ( > 0.90) for all parameters except site leads' CC inter-rater reliability (ICC = 0.896, R = 0.889) and fieldworkers' inter-rater reliability for MUAC in children under two (ICC = 0.851, R = 0.881). Bland-Altman analysis revealed no significant bias except in fieldworkers' intra-rater reliability of length/height measurement in adolescents/adults ( + 0.220 (0.042, 0.400) cm). Reliability was higher for site leads vs. fieldworkers, for intra-rater vs. inter-rater assessment, and for weight and length/height vs. circumference measurements. NDIS-2022 site leads and fieldworkers displayed acceptable reliability in performing anthropometric measurements, highlighting the importance of intensive training and standardised measurement protocols. Ongoing reliability assessment during data collection is recommended.

Examining the Relationship between Work Environment and Students' Academic Performance in Mandera East Sub-County, Kenya

The objective of the study was to establish the relationship between work environment and students' academic performance in Mandera east sub-county, Kenya, this study was anchored on Scarcity theory. The research employed a pragmatic research philosophy and adopted a survey research design. The target population was 62 (comprising 54 teachers and 8 principals of secondary schools in Mandera East Sub-County). While the teachers responded to the questionnaire, the principals participated in interviews as key interview informants. Since the target population wase small, manageable and accessible the study used a census where the sample size was 62 respondents; comprising the 54 teachers and 8 principals of secondary schools in Mandera East Sub-County. Interviews and questionnaires were used in secondary schools in Mandera East sub-county, Kenya, as a data collection method. The questionnaire was tested for validity using content validity and reliability using Cronbach’s Alpha. The study revealed that at α=0.05, work environment, was an estimators of students’ academic performance in Mandera east sub-county, Kenya. The study recommends that schools in Mandera east sub-county, Kenya should; create strategies for enhancing their work environment by providing incentives to drive teacher’s satisfaction with the work environment, review their strategies on supply of teachers through ensuring that they have the number of teachers they require at any given time and develop strategies to mitigate teacher turnover strategies.

Evaluation of the toxicity of a new series of α-aminophosphonate derivatives in a target (Ephestia Kuehniella) and non-target (Lumbricus rubellus) population

Evaluation of the toxicity of a new series of α-aminophosphonate derivatives in a target (Ephestia Kuehniella) and non-target (Lumbricus rubellus) population

The Effects of Convalescent Plasma Transfusion on Serum Levels of Macrophage-Associated Inflammatory Biomarkers in Patients with Severe COVID-19.

As an antibody-based therapy, plasma therapy has been used as an emergency therapeutic strategy against severe acute respiratory syndrome coronavirus type 2 infection. Due to the critical role of macrophages in coronavirus disease-19 (COVID-19)-associated hyperinflammation, the main objective of this study was to assess the effect of plasma transfusion on the expression levels of the inflammatory biomarkers involved in activation and pulmonary infiltration of macrophages. The target population included 50 severe hospitalized COVID-19 patients who were randomly assigned into 2 groups, including intervention and control. Serum levels of chemokine (C-C motif) ligand (CCL)-2, CCL-3, tumor necrosis factor (TNF)-α, and interleukin (IL)-6 were measured by enzyme-linked immunosorbent assay. Moreover, quantitative real-time polymerase chain reaction (PCR) was carried out to assess the relative expression of nuclear factor (NF)-κB1, NF-κB2, nuclear factor erythroid 2 p45-related factor 2 (NRF-2), and thioredoxin-interacting protein genes. Sampling was done at baseline and 72 h after receiving plasma. The intervention group demonstrated significantly lower serum levels of IL-6, TNF-α, and CCL-3. In addition, real-time PCR data analyses showed that the relative expression of NF-κB2 was significantly declined in the patients who received plasma. The use of convalescent plasma probably has a significant inhibitory effect on the cytokines, chemokines, and inflammatory genes related to macrophage activation, which are closely associated with the worsening of clinical outcomes in severe COVID-19.

Financial Accounting Controls and Financial Reporting Quality: An Empirical Analysis of Public Educational Agencies in Nigeria

This study examined financial accounting controls and financial reporting quality: an empirical analysis of public educational agencies in Nigeria. This study adopted a cross-sectional descriptive survey design because it provides a clear outcome and the characteristics associated with it at a specific point in time. The target population for this study constituted the total number of employees in the accounting/finance, administration, and operations departments in the four educational examination agencies. The number of staff in the accounts/finance, administration, and operations departments in the four regulatory agencies totaled one hundred and thirty-seven (137). The sample size derived with the Cochran sample size derivation statistic yielded one hundred and one (101). For this study, primary data was employed. The data were collected with the aid of a questionnaire that was properly drafted using the 5-point Likert scale for the questionnaire. The study adopted the use of frequency tables and percentages to analyze the questions and employed linear regression with the application of the ordinary least squares to test the hypotheses of the study. The major findings that were extracted from the analysis reveal that detective accounting controls have a significant effect on the financial reporting quality of selected educational regulatory agencies in Nigeria and preventive accounting controls have no significant effect on the financial reporting quality of selected educational regulatory agencies in Nigeria. It is therefore the recommendation of the study that regulatory agencies should sustain the use of detective accounting control systems through proper optimization and regulatory agencies should ensure they make consistent periodic financial reconciliations as a complement to preventive accounting control.

Relationship between Teacher Professional Development and use for ICT in Teaching and Learning in Primary Schools in Sabuli Sub-County, Wajir County

Information and communication technology use in education has become an indispensable aspect in the contemporary education system. This explains why many governments including Kenya government have invested in information and communication technology to foster the quality of education. However, despite efforts to avail information and communication technology resources, their use and impact on instructional delivery has been minimal, especially in primary schools in Kenya. Consequently, there has been concern on relationship between availability of information and communication technology and teacher professional development in primary schools. This situation has necessitated the proposed study which is aimed at assessing the relationship between teacher professional development and use for ICT in teaching and learning in primary schools in Sabuli sub-county, Wajir County, Kenya. The study used correlation research design. The target population 94 teacher comprising 30 head teachers and 64 teachers of primary schools in Sabuli sub-county, Wajir County. Given the small number of teachers in public primary schools in Sabuli sub county, the study purposively selected all teachers and head teachers as participant to avoid reducing the ambiguity of a study. Thus, the sample population was 94 respondents. The researcher gathered data using questionnaires from teachers and used semi-structured interview for head-teachers. Data was analysed using descriptive and regression statistics. The findings highlight a statistically significant positive relationship between teacher professional development and ICT use, indicating a direct relationship between the two variables.

Management of innovation and technology to guide financial education for guayaquil families

The work presented addresses the field of financial education and its necessity, starting from the identification of gaps within the surveyed population among families in the city of Guayaquil. There is a significant demand among young adults and those with lower incomes, indicating the urgency to provide tools and resources to improve personal financial management. Additionally, the widespread preference for interactive learning methods, such as applications and games, underscores the need to integrate technology and innovative approaches into financial education programs to increase participation and engagement. The diversity in educational and socioeconomic levels within the sample emphasizes the importance of designing programs that are accessible and adaptable to different demographic profiles, which implies offering a variety of resources and learning modalities to meet the individual needs of the population. Lastly, the low prior participation in financial education programs highlights the need to increase awareness and promotion of these programs among the population, involving implementing effective dissemination strategies to inform people about the availability and benefits of financial education. Taken together, these findings support the importance of developing financial education programs that are accessible, innovative, and tailored to the needs of the target population, in order to promote greater financial literacy and contribute to overall economic well-being.

An Assessment of the Critical Success Factors of Microfinance Institutions (MFIs) in Lusaka, Zambia

This research focuses on the critical success and failure factors of microfinance institutions (MFIs) in Lusaka, Zambia, addressing a vital aspect of the financial landscape that impacts small businesses and low-income individuals. Despite the positive role of MFIs in providing financial assistance to entrepreneurs, recent closures of six institutions in Zambia underscore the need to understand the factors influencing their success or failure. The problem statement highlights the potential consequences of MFI closures, such as negative impacts on women, increased poverty levels, income inequality, child labor, and barriers to sustainable local economic development. Notably, the study aims to fill a research gap by assessing factors affecting MFIs' operations in Zambia, particularly those leading to closures, which the Bank of Zambia has not yet addressed or documented. The research objectives are clear and specific, intending to assess both critical failure factors from MFIs that have closed in Lusaka and critical success factors for the functioning of MFIs in the region. Additionally, the study aims to suggest measures to enhance the application of these critical success factors. Moving into the research methodology, an exploratory research design is chosen, providing a foundation for assessing the critical success factors of MFIs in Zambia. The mixed-method approach, incorporating qualitative and quantitative strategies, enhances the comprehensiveness of the study. The target population comprises 29 registered MFIs in Lusaka, and a one-stage cluster sampling technique is applied to select 10 MFIs with 60 key informants. The use of questionnaires for data collection, both open and closed-ended, facilitates the gathering of both qualitative and quantitative information. Ethical considerations are diligently addressed, ensuring informed consent, confidentiality, justice, anonymity, and protection from harm. In the discussion of findings, a demographic analysis reveals important characteristics of the respondent base, emphasizing the predominantly male representation and the prevalence of tertiary education among participants. Objective one focuses on assessing critical failure factors, with limited access to funding, operational efficiency, and limited financial literacy emerging as primary challenges. Objective two delves into critical success factors, highlighting financial stability, marketing strategies, technology adoption, and outreach to the underserved population as significant considerations. Objective three provides insights into measures employed by MFIs, such as technology integration, capacity building, customer-centric approaches, and risk management systems. The recommendations emphasize diversification of funding sources, tailored financial literacy initiatives, operational efficiency optimization, and enhanced community engagement to address identified challenges. In summary, this study contributes valuable insights into the dynamics of MFIs in Lusaka, offering practical recommendations for their sustained success and impact on local communities.

Effect of the Management Accounting on the Financial Performance of Small and Medium Enterprises in Rwanda: A Case of Small and Medium Entreprises in Gasabo District

Management accounting provides an excellent opportunity for companies to compete in the market by offering superior products and services at reasonable prices to customers. The general objective of this study was to study the effects of management accounting practices on the Financial Performance of Small and Medium Enterprises in Gasabo district, Rwanda. This study adopted a correlation study design. The target population for this study was the 171 small and medium enterprises in Gasabo district Stratified random sampling method was applied to come up with the sample size, since the population in different Small and Medium Enterprises was considered heterogeneous, implying that a simple random sample is unrepresentative. The study therefore involved 171 Small and Medium Enterprises in Gasabo district. The study collected primary data from the respondents. The data collected was both quantitative and qualitative. Qualitative data is descriptive and non-numerical, while quantitative data is numerical. The study found that Budgeting was the most widely used management accounting practices, including budgeting for planning, activity-based budgeting, flexible analysis, zero-based budgeting, and budgeting for controlling costs. costing systems were the second most widely used management accounting practice, including separation of variable, incremental, and fixed costs; plant-wide overhead rate; activity-based costing; target costing; and cost of quality. Information for decision making was also used by respondents, including stock control models, customer satisfaction analysis reports, product profitability analysis reports, risk analysis reports, and investment analysis reports. Strategic analysis was also highly used by respondents. The study further concludes that the most important elements of management accounting practices amongst the Small and Medium Enterprises in Gasabo district are; the management accounting function identifies key factors that influence Financial Performance and management accounting practices have increased return on equity (ROE), which is a measure of how profitable a company is for its shareholders. This is because management accounting practices help companies to identify and improve risky areas, which can lead to increased profits. This study recommends the creation and enhancement of awareness among firms of the importance of Information for decision making practices as this is the most highly used management accounting practice amongst the Small and Medium Enterprises in Gasabo district. Keywords: Management Accounting Practices, Costing Systems, Budgeting, Information for Decision Making, Strategic Analysis, Financial Performance, Small And Medium Enterprises

Sociodemographic and Lifestyle Characteristics Associated with Maternal Dietary Patterns in Mexico

There is scarce evidence on sociodemographic and lifestyle characteristics that may explain adherence to different dietary patterns (DPs) during pregnancy. Our aims were to identify dietary patterns in a sample of pregnant Mexican women and to describe their association with selected sociodemographic and lifestyle characteristics. This is a secondary cross-sectional analysis of 252 mothers of children that participated as controls in a hospital-based case–control study of childhood leukemia. We obtained parents’ information about selected sociodemographic characteristics, as well as alcohol and tobacco consumption. We also obtained dietary information during pregnancy. We identified DPs using cluster and factor analyses and we estimated their association with characteristics of interest. We identified two DPs using cluster analysis, which we called “Prudent” and “Non healthy”, as well as three DPs through factor analysis, namely “Prudent”, “Processed foods and fish”, and “Chicken and vegetables”. Characteristics associated with greater adherence to “Prudent” patterns were maternal education, older paternal age, not smoking, and being a government employee and/or uncovered population. Likewise, the “Processed foods and fish” pattern was associated with greater maternal and paternal education, as well as those with less household overcrowding. We did not identify sociodemographic variables related to the “Chicken and Vegetables” pattern. Our results may be useful to identify target populations that may benefit from interventions aimed to improve individual dietary decisions during pregnancy.

Learning about treatment effects in a new target population under transportability assumptions for relative effect measures.

Investigators often believe that relative effect measures conditional on covariates, such as risk ratios and mean ratios, are "transportable" across populations. Here, we examine the identification of causal effects in a target population using an assumption that conditional relative effect measures are transportable from a trial to the target population. We show that transportability for relative effect measures is largely incompatible with transportability for difference effect measures, unless the treatment has no effect on average or one is willing to make even stronger transportability assumptions that imply the transportability of both relative and difference effect measures. We then describe how marginal (population-averaged) causal estimands in a target population can be identified under the assumption of transportability of relative effect measures, when we are interested in the effectiveness of a new experimental treatment in a target population where the only treatment in use is the control treatment evaluated in the trial. We extend these results to consider cases where the control treatment evaluated in the trial is only one of the treatments in use in the target population, under an additional partial exchangeability assumption in the target population (i.e., an assumption of no unmeasured confounding in the target population with respect to potential outcomes under the control treatment in the trial). We also develop identification results that allow for the covariates needed for transportability of relative effect measures to be only a small subset of the covariates needed to control confounding in the target population. Last, we propose estimators that can be easily implemented in standard statistical software and illustrate their use using data from a comprehensive cohort study of stable ischemic heart disease.

Non-communicable diseases, digital education and considerations for the Indian context – a scoping review

IntroductionThe increasing ageing of the population with growth in NCD burden in India has put unprecedented pressure on India’s health care systems. Shortage of skilled human resources in health, particularly of specialists equipped to treat NCDs, is one of the major challenges faced in India. Keeping in view the shortage of healthcare professionals and the guidelines in NEP 2020, there is an urgent need for more health professionals who have received training in the diagnosis, prevention, and treatment of NCDs. This paper conducts a scoping review and aims to collate the existing evidence on the use of digital education of health professionals within NCD topics.MethodsWe searched four databases (Web of Science, PubMed, EBSCO Education Research Complete, and PsycINFO) using a three-element search string with terms related to digital education, health professions, and terms related to NCD. The inclusion criteria covered the studies to be empirical and NCD-related with the target population as health professionals rather than patients. Data was extracted from 28 included studies that reported on empirical research into digital education related to non-communicable diseases in health professionals in India. Data were analysed thematically.ResultsThe target groups were mostly in-service health professionals, but a considerable number of studies also included pre-service students of medicine (n = 6) and nursing (n = 6). The majority of the studies included imparted online learning as self-study, while some imparted blended learning and online learning with the instructor. While a majority of the studies included were experimental or observational, randomized control trials and evaluations were also part of our study.DiscussionDigital HPE related to NCDs has proven to be beneficial for learners, and simultaneously, offers an effective way to bypass geographical barriers. Despite these positive attributes, digital HPE faces many challenges for its successful implementation in the Indian context. Owing to the multi-lingual and diverse health professional ecosystem in India, there is a need for strong evidence and guidelines based on prior research in the Indian context.

First Generations and Gender Survey in Finland

The first Generations and Gender Survey in Finland was collected in 2021/2022 as a web-based survey. In addition to the standard GGS-questionnaire, the Finnish survey included two new modules: the Miller Instrument, which captures childbearing motivations, and Global uncertainties, which enquires about perceptions of future threats. To further advance research on family dynamics, data from GGS Finland is linked to administrative records. This allows researchers to explore employment and family trajectories until 2026. Analyses of core socio-demographic characteristics and well-established fertility indicators reveal that the sample, by and large, represents the target population.

Risk Management Techniques on Financial Performance of State-Owned Sugar Companies in Kenya

Financial performance of sugar companies in Kenya is generally poor and has been fluctuating over a long period. The state-owned sugar companies are worse compared to the privately owned companies. The sugar sector has been orbiting around sugar scarcity, inefficiencies, failure to pay farmers, failure to renovate and modernize production unit, failure to battle with imported sugar, recurrent losses and political interference. The main objective of this study was to evaluate the effect of risk management techniques on financial performance of state-owned sugar companies in Kenya. The specific objectives guiding the study were; to establish the effect of risk avoidance on financial performance of state-owned sugar companies in Kenya, and to assess the effect of risk acceptance on financial performance of state-owned sugar companies in Kenya. The study was anchored on the risk management theory, model risk management and the theory of financial control. The study adopted a descriptive research design with a target population of fifty four respondents being employees from the six state-owned sugar companies in Kenya. Questionnaires were the main data collection tool. Data was analyzed with the help of statistical package for social science version 28, Analysis of Variances, Correlation and regression analysis tools were used to establish the relationship between the variables. The findings of the study revealed a statistically significant regression effect and indicative of accomplished prediction of financial performance of state-owned sugar factories through the F-calculated value which showed that the model was significant. Risk avoidance explained 53.9% of financial performance and risk acceptance explained 61.9% of financial performance of state-owned sugar factories in western Kenya. The findings of the study will provide an insight to finance practitioners on the risk management techniques and their relationship with organizational financial performance as well as contributing to the scholarly literature on risk management techniques in other sectors of the economy. Keywords: Risk, Risk Avoidance, Risk Acceptance, Financial Performance, Risk management Techniques

Study on HIV Status Disclosure and Treatment Adherence Amongst Support Group Members in Mushin Local Government Area (LGA), Lagos State

Human Immunodeficiency Virus (HIV) remains a significant global health concern, particularly in sub-Saharan Africa, where the burden of the epidemic is highest. Lagos State, in Southwest Nigeria, faces a significant challenge with HIV prevalence, particularly in the Mushin Local Government Area (LGA). This study investigates the relationship between HIV status disclosure and adherence to Antiretroviral Therapy (ART) medication among members of the God is Good Support Group in Mushin LGA, Lagos State, Nigeria. The study used a qualitative framework design and conducted semi-structured interviews with twenty members of the support group who were purposely selected due to the specific nature of the target population. Collected data was manually transcribed, while thematic analysis was used to analyze the interview data. The results showed that the majority of participants in the support group had disclosed their HIV status to their partners, and those who hadn&amp;apos;t disclosed often confided in children or close relatives. Participants reported receiving strong support from their confidantes after disclosure. Participants believed that effective treatment adherence is crucial for achieving viral suppression, and a significant majority believed that disclosing their HIV status helped them achieve viral suppression. Most participants had positive experiences disclosing their status to partners, with nearly all reporting supportive partners. Only a small minority reported negative impacts on their sexual life, suggesting that disclosure may not necessarily harm relationships. Based on these findings, the study concludes that there is a high level of disclosure among support group members, and participants with good adherence were more likely to have disclosed their status. Disclosure was associated with achieving viral suppression, potentially due to the support received. The study suggests that strengthening support groups through funding from local, state, and international organizations could be beneficial in encouraging disclosure and improving health outcomes for individuals living with HIV.

A Pilot Survey Linking Antecedents of LMX Relationships and PWDs Institutions Performance: An Assessment of PWDs Institutions in Kenya

The modern working world has made strides in building a stronger equitable society. There has been great resilience in including policies that ensure persons living with disability play their economic role. The current study was guided by two objectives: effect of transformational leader-characteristics as antecedents of LMX on organization performance in PWDs in Mombasa and Kilifi Counties and moderating effect of organization culture on LMX and organization performance in PWDs institution in Mombasa and Kilifi Counties; Leader-Member exchange theory and social exchange theory formed the theoretical foundation of this study. A conceptual framework showing the correlation of the study’s variables is also given. The study applied descriptive research design and the target population of the study was managers and subordinates at all levels within the organizations. Stratified sampling, convenience sampling and random sampling techniques were used to generate the sample size. A sample size of twenty-five (25) respondents two (2) to three (3) employees from every department. Semi-structured questionnaires were used for the study. The study conducted and applied Cronbach alpha reliability estimate. The study used quantitative and qualitative methods to analyze data. The study results provided a good governance framework of engaging their business networks within their localities. Statistical Package for Social Sciences (SPSS) for windows version 21 was used. One of the significant findings was the realization that there was an increment in leader-characteristics of leaders in organizations. One of the conclusions of the study was that when leaders believe in their own abilities this often-enhanced LMX relationships hence improved organizational performance. A key recommendation of this study was the need for the Government ministries concerned with PWDs mainstreaming in the organizations have specific leadership practices that help build effective LMX relationships in organizations.