8 research outputs found
Early use of mammalian target of rapamycin inhibitors is an independent risk factor for incisional hernia development after liver transplantation.
No full textIncisional hernias (IHs) are common complications after liver transplantation (LT) with a reported incidence of 1.7\% to 34.3\%. The purpose of this retrospective study was to evaluate the risk factors for IH development after LT with a focus on the role of immunosuppressive therapy during the first month after LT. We analyzed 373 patients who underwent LT and divided them into 2 groups according to their postoperative course: an IH group (121 patients or 32.4\%) and a no-IH group (252 patients or 67.6\%). A univariate analysis demonstrated that the following were risk factors related to IH development: male sex (P = 0.03), a body mass index ≥ 29 kg/m(2) (P = 0.005), LT after 2004 (P = 0.02), a Model for End-Stage Liver Disease (MELD) score ≥ 22 (P = 0.01), and hepatitis B virus infection (P = 0.01). The highest incidence of IHs was found in patients treated with mammalian target of rapamycin (mTOR) inhibitors (54.5\%, P = 0.004). A multivariate analysis revealed male sex (P = 0.03), a pretransplant MELD score ≥ 22 (P = 0.04), and the use of mTOR inhibitors (P = 0.001) to be independent risk factors for IHs after LT. In conclusion, immunosuppressive therapy with mTOR inhibitors is an important independent risk factor for IH development after LT. To reduce the incidence of IHs, mTOR inhibitors should be avoided until the fourth month after LT unless their use is deemed to be strictly necessary
\ud Foreign Aid, Child Health, and Health System Development in Tanzania and Uganda, 1995-2009 \ud
No full textAs donors have scaled up efforts to improve health in sub-Saharan African, African countries have diverged sharply in their health performance: Some countries have made rapid progress while others have stagnated. Yet the reasons for these divergences are often not well understood. In this dissertation I present in-depth case studies of two such divergent countries, Tanzania and Uganda, over the 1995-2007 period. Over this period, Tanzania reduced its under-5 mortality rate by 35%, while Uganda’s mortality rate decline was less than half as rapid; between 12% and 15% over virtually the same period. This occurred despite the fact that both countries received similar amounts of foreign aid for health, implemented virtually identical health sector reforms, and saw comparable rates of growth in GDP per capita and similar trends in other socioeconomic indicators. Explanations for such differences often vary by academic discipline. Public health scholars often focus on coverage levels of critical child health interventions, while political scientists emphasize variation in the quality of governance institutions. I show that coverage of child survival interventions did indeed differ between Tanzania and Uganda, particularly in the area of malaria control, but that the ultimate determinant of these differences can be traced to political economy factors. Specifically, regime maintenance dynamics and the differing composition of political patronage coalitions in the two countries determined the relative success of health sector programming in Tanzania and Uganda. In addition to outcomes such as under-5 mortality, I also analyze the results of broader health system strengthening efforts in Tanzania and Uganda over the 1995-2009 period. To structure this comparison, a new theoretical framework for health system performance is developed and tested, based on previous theory developed by Pritchett and Woolcock (2002) and Fukuyama (2004). The same political economy dynamics that contributed to Tanzania’s stronger performance on child mortality reduction also enabled its greater progress on health system strengthening. Furthermore, Tanzania’s experience demonstrates the potential for “second best” strategies for health system strengthening that can be implemented in conditions of relatively low state capacity.\u
The Federal Approach to FiscalDecentralisation: Conceptual Contours for Policy Makers
No full textChanchal Kumar Sharma,in his paper demonstrates that in order for fiscal decentralisation to be effective, it must be approached federally. A federal approach is not a decentralised approach but a dynamically balanced approach; one that constantly keeps on adjusting the contrasting forces of centralisation and decentralisation to create a system that can ensure good governance in accordance with the rapidly changing global and local scenario. According to the author, the good governance of the present time has to be federally flexible and dynamically decentralised and institutions of fiscal federalism are crucial for achieving such a dynamic equilibrium. Fiscal decentralisation cannot be detached from the broader principles of fiscal federalism if it is to be successful, irrespective of the fact of whether it is being carried out in a federal or non-federal country. He argues that too much decentralisation or an overly strong central federal government precludes the survival of a constitutional federal state.Federalism; Fiscal Decentralization; centralization
The impact of the economic crisis on media framing : evidence from three elections in Ireland
No full textMedia coverage of elections in Europe and North America has increasingly focused on the campaign as a game rather than a policy debate. This is often explained by the changes in media pressures. It may also reflect the narrowing of policy space between left and right and the comparative prosperity enjoyed in Europe and North America. But the relevance of politics varies. The global economic crisis might have led to an increased interest in policy among voters and focus on it by media. Ireland experienced both extremes of boom and crisis between the late 1990s and 2011. The Irish case allows us to test the impact of the crisis on media framing of elections. This article uses original data from the three most recent national elections in Ireland, with a research design that holds other pertinent variables constant. We find empirical support for the theoretical expectation that the context of the election affects the relative focus on campaign or horserace versus substantive policy issues
In, out and after care: Young adults' views on their lives, as children, in a therapeutic residential establishment
No full textChildren who have been severely maltreated may be placed in therapeutic children's homes (also known as residential treatment centres) in order that their often acute emotional and behavioural needs can be addressed. There is little data on process within these settings, especially outside the US. This article contains findings from interviews carried out with 16 young adults who had been placed in a therapeutic children's home in England. These former residents were asked for their views concerning the care they had received. The respondents were, in general, positive about their experiences, particularly in terms of their relationships with staff, life story work, leisure activities and the contact they had with staff after leaving the homes. Some of them were also happy with their experiences in relation to therapy, school, friendships and preparations for leaving the placement but others were less contented in these respects. The evidence from this research is that this highly disadvantaged group of children can be provided with a good quality of care within therapeutic children's homes
Recommended from our members
The process of developing innovative capabilities in biotechnology: the case of UK firms
No full textThe advent of born-global bio-tech firms signal the genesis of a new business model that is emerging in the biotechnology sector. Born globals are small firms whose knowledge supply-chain includes global resources from multiple countries. Their innovation ‘ecosystems’ consists of experienced scientists, science parks, academics, well-established bio-pharmaceutical firms and government institutions. The firms plan their business based on global strategic perspectives and this significantly increases their productivity and innovativeness. But surprisingly, little is known about their capability development processes in the specialised networks of the biotechnology sector. As a result, this study explores the connectivity of various elements, within their knowledge supply-chain, and how they influence their capacity to generate new scientific knowledge and technical know-how. The study employs a multi-case approach. It examines five cases of bio-tech firms from the East Midlands region of the United Kingdom which have an entrepreneurial flair synonymous with born-global firms. The findings from within and across cases, secondary data analysis and results from a ‘pilot study’ led to the construction of a new conceptual framework of knowledge and innovative capability development. The model is created from the ideas of Freeman and others and it contributes to an understanding of the concepts of dynamic capabilities and network theories
Recommended from our members
Effects of organisational policies and practices on job satisfaction among employees of international non-governmental organisations (INGOs)
No full textSince International Non-Governmental Organisations (INGOs) gained United Nations’ recognition in the 1950s, they have continued to grow in stature as key global players. Consequently, a lot of research attention has been devoted to the global influence of INGOs and the management challenges that they face. Despite steady increase in the number of research publications that focus on a wide range of INGO issues, employee job satisfaction has yet to receive serious research attention. This study seeks to fill that gap by examining forms and levels of job satisfaction among INGO employees in the United Kingdom and Africa. The study explores the influence of INGO mission, culture, structure and HRM policies and practices on employee job satisfaction. The questions addressed in this research focus on how employees perceive their jobs and the performance of INGOs in executing corporate missions, application of principles and values, working relations between headquarters and field locations and HRM policies and practices. Data collection involved 35 in-depth interviews with employees in various INGOs in the UK and Africa. The secondary method for data collection is questionnaire administration. Findings from this research contribute to what is currently known about job satisfaction in the INGO sector. Interpreting accounts of work experiences through dialectical mechanisms represents a unique and dynamic approach to the study of job satisfaction. Furthermore, the finding that effective application of corporate principles and values remains a critical factor as far as job satisfaction among INGO employees is concerned challenges the thinking that ‘corporatisation’ and ‘professionalization’ have robbed the sector of its values
A New Form of Authoritarianism? Rethinking Military Politics in Post-1999 Nigeria
No full textDespite the vast research that has been done on the Nigerian military, virtually all of these studies have failed to critically examine the accepted role of the military in the democratising phase. This is important because the relationship between the political elite and the military in post-military authoritarian states guarantees either democratic consolidation, or its reversal. In Nigeria, despite an appearance of significant progress in subordinating the military institution to democratic civilian authority, the military remains a crucial political actor in the polity. It appears that the military has yet to accept the core democratic principles of civilian oversight of the institution. This thesis, therefore, explores whether a new form of military authoritarianism is emerging in Nigeria, with the aim of understanding Nigeria’s military behaviour in a transitional phase, from prolonged military authoritarianism to democratisation. To examine this military behaviour, Alfred Stepan’s concept of military prerogatives that was used to understand the military’s behaviour in a transitional phase in Latin America is applied to Nigeria.
A crucial understanding of authoritarianism in Nigeria is initially discussed in this study using mainly document analysis strategy to examine whether multi-ethnic states, such as Nigeria, tend to have authoritarian systems. Six hypotheses form the core analysis of this thesis: first, that the military has retained significant military prerogatives; second, that retired military officers are gaining influential political and economic positions; third, autonomous military involvement in human rights abuses since 1999; and fourth, that civilian government oversight remains weak, and facilitates military authoritarianism. These hypotheses are primarily analysed using the elite interview technique. During the first half of 2011, the author conducted field research where serving and retired military officers were interviewed. The fifth hypothesis is that the military has intervened in politics post-1999. The examination of this hypothesis relies primarily on key security-related media reports (mostly newspaper editorials) on the military after 1999. The examination of the final hypothesis, that increases in military expenditures might facilitate a new form of military authoritarianism, relies primarily on descriptive statistical analysis. In addition, this study collated relevant historical materials that relate to the military, utilising national archival collections.
The empirical findings of this research did not identify a new form of military authoritarianism in Nigeria. The study, however, argues that the unrestricted institutional framework accorded the military has contributed significantly to authoritarian practices in the post-military era in Nigeria. This study discovered that there were similarities between the Brazilian and Nigerian militaries in regard to their military spending during their period in power. Both countries had lower defence budgets. Just as in Brazil, it appears that part of the reason the Nigerian military decided to relinquish power in 1999 had to do with its desire to gain a higher budget, something that was precluded in a military government struggling to retain a sense of legitimacy. The military needed a higher budget to modernise and re-professionalise its institution after more than a decade in power. This feature, which the Nigerian military shares with the Brazilian military, appears to justify the application to Nigeria of Alfred Stepan’s concept of military prerogatives.
