188,930 research outputs found
Pictures of some of the drones used by Zipline (pictures taken by Bonsu F.O).
No full textPictures of some of the drones used by Zipline (pictures taken by Bonsu F.O).</p
Adherence to Antithrombotic Therapy for Patients Attending a Multidisciplinary Thrombosis Service in Canada – A Cross-Sectional Survey
No full textKwadwo Osei Bonsu,1 Stephanie Young,1,2 Tiffany Lee,1,2 Hai Nguyen,1 Rufaro S Chitsike3,4 1School of Pharmacy, Memorial University of Newfoundland and Labrador, St John’s, NL, A1B 3V6, Canada; 2Pharmacy Program, Eastern Region Health Authority, St John’s, NL, A1B 3V6, Canada; 3Division of Medicine (Hematology), Memorial University of Newfoundland and Labrador, St John’s, NL, A1B 3V6, Canada; 4Division of Hematology, Eastern Region Health Authority, St John’s, NL, A1B 3V6, CanadaCorrespondence: Kwadwo Osei Bonsu, School of Pharmacy, Memorial University of Newfoundland and Labrador, 300 Prince Philip Drive, St John’s, NL, A1B 3V6, Canada, Email [email protected]: Poor medication adherence puts patients who require antithrombotic therapy at greater risk of complications. We started a multidisciplinary Adult Outpatient Thrombosis Service in 2017 in a Canadian health authority and were interested in the level of medication adherence in the population attending.Aim(S): The aim of this study is to assess adherence to antithrombotic medications for patients attending a multidisciplinary Thrombosis Service.Methods: We conducted a cross-sectional survey of outpatients seen at the Thrombosis Service between 2017 and 2019 using the 12-item validated Adherence to Refills and Medications Scale (ARMS) to assess adherence to antithrombotic (anticoagulants and antiplatelet) therapy. Linear regression analysis examined the factors associated with adherence to antithrombotic therapy.Results: Of 1058 eligible patients, 53.2% responded to the survey. Seventeen were excluded from the analysis for missing more than 6 responses to the 12 items on the ARMS. About 55% (n = 297) were on direct oral anticoagulants (DOACs), 19% (n = 102) on warfarin, 5.0% (n = 27) on low molecular weight heparin, 3.3% (n = 18) on antiplatelet therapy and 18% (n = 96) were no longer on antithrombotic therapy. Nearly half (47%, n = 253) had taken antithrombotic therapy for 1– 5 years while 28% (n = 150) and 25% (n = 137) had taken antithrombotic treatments for 5 years, respectively. Most patients (87%, n = 475) were ≥ 50 years and half (51%, n = 277) were male. The mean adherence score was 13.9 (SD± 2.2) and 88% (n = 481) of participants were adherent to antithrombotic treatment (ARMS = 12– 16). Multivariable linear regression showed that patients with post-graduate education had 0.4% lower adherence to antithrombotic therapy as compared with elementary education (β = 0.0039, p = 0.048). Patients with prior antithrombotic agent use > 5 years had 0.5% lower adherence to antithrombotic treatment compared to patients with < 1 year (β = 0.0047, p = 0.0244).Conclusion: Self-reported adherence to antithrombotic therapy was high (88%) within a multidisciplinary Thrombosis Service. Patients with advanced education and prolong duration of antithrombotic therapy were more likely to have lower self-reported adherence to antithrombotic treatment.Keywords: medication adherence, self-reported adherence, multidisciplinary care, thrombosis service, anticoagulation management program, antithrombotic therap
Molecular epidemiology of Mycobacterium africanum in Ghana
No full textBACKGROUND: Mycobacterium africanum comprises two phylogenetic lineages within the M. tuberculosis complex (MTBC) and is an important cause of human tuberculosis (TB) in West Africa. The reasons for this geographic restriction of M. africanum remain unclear. Here, we performed a prospective study to explore associations between the characteristics of TB patients and the MTBC lineages circulating in Ghana.
METHOD: We genotyped 1,211 MTBC isolates recovered from pulmonary TB patients recruited between 2012 and 2014 using single nucleotide polymorphism typing and spoligotyping. Associations between patient and pathogen variables were assessed using univariate and multivariate logistic regression.
RESULTS: Of the 1,211 MTBC isolates analysed, 71.9 % (871) belonged to Lineage 4; 12.6 % (152) to Lineage 5 (also known as M. africanum West-Africa 1), 9.2 % (112) to Lineage 6 (also known as M. africanum West-Africa 2) and 0.6 % (7) to Mycobacterium bovis. Univariate analysis revealed that Lineage 6 strains were less likely to be isoniazid resistant compared to other strains (odds ratio = 0.25, 95 % confidence interval (CI): 0.05-0.77, P < 0.01). Multivariate analysis showed that Lineage 5 was significantly more common in patients from the Ewe ethnic group (adjusted odds ratio (adjOR): 2.79; 95 % CI: 1.47-5.29, P < 0.001) and Lineage 6 more likely to be found among HIV-co-infected TB patients (adjOR = 2.2; 95 % confidence interval (CI: 1.32-3.7, P < 0.001).
CONCLUSION: Our findings confirm the importance of M. africanum in Ghana and highlight the need to differentiate between Lineage 5 and Lineage 6, as these lineages differ in associated patient variables
Global Implementation Practices of Public-Private Partnership
No full textSince the inception of the PPP concept, an increasing number of governments globally has shown strong enthusiasm towards the implementation of the policy. However, not all countries are on the same level of implementation, while some countries have seen significant boost in their PPP markets, others are yet to establish the enabling framework required for the implementation of the PPP policy. This chapter explores the evolution of PPP and its global implementation practices from developed and developing countries’ perspective. Further, the chapter discusses the experience of high-profiled international cases to explore the failure and success factors
Introduction to the Public-Private Partnership Concept
No full textAfter the emergence of the public-private partnership (PPP) concept, several definitions and models have emerged globally. Further, different parties are involved in the delivery of PPP project. This chapter presents an introduction to the concept of PPP by looking at the various definitions and PPP models that have emerged globally. Further, the chapter explores the international process of procuring PPP projects and the key project parties involved in PPP project arrangements
Prevalence of preferences for end of life place of care and death among cancer patients in low- and middle-income countries: a systematic review and meta-analysis
No full textPURPOSEThere is limited information on preferences for place of care and death among patients with cancer in low- and middle-income countries (LMICs). The aim was to report the prevalence and determinants of preferences for end-of-life place of care and death among patients with cancer in LMICs and identify concordance between the preferred and actual place of death.METHODSSystematic review and meta-analysis guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses was conducted. Four electronic databases were searched to identify studies of any design that reported on the preferred and actual place of care and death of patients with cancer in LMICs. A random-effects meta-analysis estimated pooled prevalences, with 95% CI, with subgroup analyses for region and risk of bias.RESULTSThirteen studies were included. Of 3,837 patients with cancer, 62% (95% CI, 49 to 75) preferred to die at home; however, the prevalence of actual home death was 37% (95% CI, 13 to 60). Subgroup analyses found that preferences for home as place of death varied from 55% (95% CI, 41 to 69) for Asia to 64% (95% CI, 57 to 71) for South America and 72% (95% CI, 48 to 97) for Africa. The concordance between the preferred and actual place of death was 48% (95% CI, 41 to 55) for South Africa and 92% (95% CI, 88 to 95) for Malaysia. Factors associated with an increased likelihood of preferred home death included performance status and patients with breast cancer.CONCLUSIONThere is very little literature from LMICs on the preferences for end-of-life place of care and death among patients with cancer. Rigorous research is needed to help understand how preferences of patients with cancer change during their journey through cancer.</p
Reasons for Governments Adoption of Public-Private Partnership
No full textFollowing the evolvement of the PPP concept in the early 1990s, governments globally have shown strong enthusiasm towards the adoption of this concept in various infrastructure sectors. It is however not clear as to the motivations of these governments towards the adoption of the PPP concept. Many critics suggest that the main reason is due to the lack of funds, but is that the only reason? Further, different jurisdictions/economies have different conditions and political agendas, therefore it is possible that there could be some differences in the motivations of governments adoption of the PPP concept particularly among developing and developed economies. This chapter seeks to explore the above raised concerns and discuss comprehensively on the differences and similarities in reasons/motivation for PPP adoption by governments in developing and developed economies based on empirical data
Executive compensation, corporate governance and corporate performance: A simultaneous equation approach
No full textThis paper investigates the association between executive compensation and performance. It uniquely utilises a comprehensive set of corporate governance mechanisms within a three-stage least squares (3SLS) simultaneous equation framework. Results based on estimating a conventional single equation model indicate that the executive pay and performance sensitivity is relatively weak, whereas those based on estimating a 3SLS model generally suggest improved executive pay and performance sensitivity. Our findings highlight the need for future research to control for possible simultaneous interdependencies when estimating the executive pay and performance link. The findings are generally robust across a raft of econometric models that control for different types of endogeneities, executive pay and performance proxies.<br/
Spectroscopic (analytical) approach to gunshot residue analysis for shooting distance estimation: a systematic review
No full textPublished online: 16 November 2021Background: The determination of the shooting distance using gunshot residue (GSR) analysis is crucial in the investigation and reconstruction of firearm-related crimes. However, the conventional chemographic method for GSR analysis is destructive and has limited sensitivity and selectivity. While the spectroscopic method has potential in GSR analysis for crime investigation, there is a current lack of consistency in the spectroscopic results obtained for shooting distance estimation via GSR analysis. Addressing such limitations will enhance the forensic capabilities of law enforcement and provide an added advantage to crime laboratories during an investigation. It will also reinforce the use of such spectroscopic data in a criminal investigation. Main text: We obtained all peer-reviewed articles relevant to shooting distance estimation from searching Scopus, Web of Science, PubMed, and Google Scholar databases. We specifically searched the databases using the keywords “shooting distance,” “range of fire,” “gunshot residue,” “firearm discharge residue,” and “firearm-related crime” and obtained 3811 records. We further filtered these records using a combination of two basic keywords “gunshot residue” and “shooting distance estimations” yielding 108 papers. Following a careful evaluation of the titles, abstracts, and full texts, 40 original peer-reviewed articles on shooting distance estimation via GSR analysis were included in the study. The forgoing included additional sources (n = 5) we obtained from looking through the reference lists of the forensic articles we found. Short conclusion: This paper discusses the current scope of research concerning the chemographic and spectroscopic analysis of GSR for shooting distance estimation. It also examines the challenges of these techniques and provides recommendations for future research.Maxwell Abedi, Dan O. M. Bonsu, Isaac K. Badu, Richmond Afoakwah and Pooja Ahuj
- …
