Miracle-dz/UniFAR-FTUs huggingface dataset:
Are Psychiatrists Equipped for Management Roles in Mental Health Services?

Objective: To promote the discussion of leadership and management skills development among psychiatrists in Australia and New Zealand. Method: A key informant survey of fellows of the Royal Australian and New Zealand College of Psychiatrists was conducted via a semi-structured interview. This canvassed views about leadership and management issues including levels of confidence and needs for additional skills. Results: There was widespread support for psychiatrists to be in management roles in mental health services; however, on entering management positions, psychiatrists often felt inadequately trained and prepared for their new role. Furthermore, many who had made the transition to management perceived a lack of support from their clinical colleagues. Clinicians appeared to believe that management was not difficult to learn and could be done by any experienced clinician. The provision of short courses and mentoring programmes is the preferred option for most psychiatrists seeking to acquire leadership and management skills. Conclusions: For psychiatrists to maximize their potential as leaders in Australian and New Zealand mental health services, greater attention to promoting the acquisition of relevant skills throughout training and in the post-fellowship years is required. Psychiatrists need to be supported and encouraged to pursue further education, training and research in this area. Failure to address this issue risks psychiatrists continuing to feel disadvantaged in management roles and hence reluctant to undertake the challenge.
Early changes in hepatitis C viral quasispecies during interferon therapy predict the therapeutic outcome

Despite recent treatment advances, the majority of patients with chronic hepatitis C fail to respond to antiviral therapy. Although the genetic basis for this resistance is unknown, accumulated evidence suggests that changes in the heterogeneous viral population (quasispecies) may be an important determinant of viral persistence and response to therapy. Sequences within hepatitis C virus (HCV) envelope 1 and envelope 2 genes, inclusive of the hypervariable region 1, were analyzed in parallel with the level of viral replication in serial serum samples obtained from 23 patients who exhibited different patterns of response to therapy and from untreated controls. Our study provides evidence that although the viral diversity before treatment does not predict the response to treatment, the early emergence and dominance of a single viral variant distinguishes patients who will have a sustained therapeutic response from those who subsequently will experience a breakthrough or relapse. A dramatic reduction in genetic diversity leading to an increasingly homogeneous viral population was a consistent feature associated with viral clearance in sustained responders and was independent of HCV genotype. The persistence of variants present before treatment in patients who fail to respond or who experience a breakthrough during therapy strongly suggests the preexistence of viral strains with inherent resistance to IFN. Thus, the study of the evolution of the HCV quasispecies provides prognostic information as early as the first 2 weeks after starting therapy and opens perspectives for elucidating the mechanisms of treatment failure in chronic hepatitis C.
A 1.4µA reset current phase change memory cell with integrated carbon nanotube electrodes for cross-point memory application

A cross-point phase change memory (PCM) cell working close to its ultimate scaling limit is demonstrated for the first time with an ultra low reset current of 1. 4µA and set current of 0. 5µA. This is the lowest value ever reported. Carbon nanotubes (CNTs) are utilized as the bottom electrode of the cell, which bring the lithography-independent critical dimension down to 1.2nm. Good electrical characteristics obtained demonstrate the functionality and potential viability of PCM for highly scaled ultra-dense memory at 2.5nm node.
Assessment of Factors Predisposing to Acute Malnutrition Among Under-Five Children Attending Tertiary Care Hospital .

Maternal nutrition, Low birth weight and recurrent infections are other important factors that lead to malnutrition. The aim of the present study is to assess the predisposing factors association in relation to the Malnutrition children, especially Severe Acute Malnutrition. A total of 108 patients presenting with features of Malnutrition were selected as per WHO growth standards. All the details regarding children and their family details were entered in excel sheet and results were analyzed. Among 108 study children, Severe Acute Malnutrition (SAM) were observed in 61 children (56.4%) and Moderate Acute Malnutrition (MAM) was observed in 47 children(43.5%). Among SAM children males (67.2%) were predominantly observed when compared to females (32.7%). Severe Acute Malnutrition was observed in more number among not immunized children (68.7%), low birth weight children (63.6%), < 2 years interval between two pregnancies (68.4%), children with medical complications (65.2%). Children with or without medical complications in relation to SAM and MAM is statistically significant. Malnutrition incidence can be decreased with simple measures by educating mothers about health care, hygiene measures, Feeding habits, immunization, seeking treatment at right time.
Strengths and Weaknesses of African Trade Unions in the Neoliberal Period with a Sierra Leone Case Study

This article provides an overview of the weaknesses and strengths of trade unions in Africa, as neoliberal economic policies continue to spread across the continent. The Power Resources Approach is used as a conceptual framework. Five problems affecting the ability of trade unions to formulate effective policies and practices are outlined and discussed: poor organisational ability, low financial capacity, an over-emphasis on representing formal sector workers, inadequate enforcement of legislation protecting labour rights and the absence of effective central bargaining units. Two strengths of African labour organisations are highlighted: first, their representation, in many cases, of significant numbers of the working class. Second, the will and capacity demonstrated by some trade unions to undertake concerted actions against policies that have adversely affected the labour force. In addition, two points of leverage trade unions have in negotiating with the state and representatives of capital are assessed. First, the wide gap that has developed in Africa between the incomes of a rich minority and the large numbers of the workforce who continue to live in poverty. Second, the rising amount of profits that are being repatriated by foreign investors, exploiting lucrative economic sectors. This is exposing the emptiness of continued arguments by governments that labour movements must subordinate their claims on behalf of members to those of the greater ‘national interest’. To illustrate these issues empirically, a case study of trade unions in Sierra Leone is examined. The work, in particular, of the Sierra Leone Labour Congress (SLLC) and the Sierra Leone Teachers Union (SLTU) is discussed. The case study analysis highlights the substantive difficulties facing the SLLC and the SLTU in defending effectively the rights and interests of workers.
Steady-state levels of vasoactive intestinal peptide ( VIP ) mRNA in goat ovaries and the effect of VIP on the in vitro development of isolated preantral follicles

The aims of this study were to verify the steady-state level of vasoactive intestinal peptide (VIP) mRNA in goat follicles at various developmental stages and to investigate the influence of VIP on the survival, antrum formation and growth of secondary follicles cultured for 6 days. Primordial, primary and secondary goat follicles and small and large antral follicles were obtained to quantify VIP mRNA by real-time reverse transcription with the polymerase chain reaction. The influence of VIP and the presence or absence of folliclestimulating hormone (FSH) on the development of secondary follicles and on mRNA expression for VIP and FSH receptor (FSHR) were determined after 6 days of culture. Survival, antrum formation and follicular diameter were evaluated every other day of culture. The levels of VIP mRNA in primary and secondary follicles were significantly higher than in primordial follicles. Cumulus–oocyte complexes (COCs) from both small and large antral follicles had significantly higher levels of VIP mRNA than their respective granulosa/theca cells. During culture, the addition of VIP and/or FSH had no effect on follicular development. However, the presence of FSH and/or VIP in the culture medium significantly reduced VIP mRNA levels, but did not alter FSHR mRNA levels. In conclusion, VIP mRNA was detected in all goat follicular categories and cellular types, VIP and/or FSH did not affect the development of secondary follicles and reduce the expression of VIP mRNA levels.
After the gold rush: industrial re-configuration in the UK television production sector and content

Recent technological and market changes in the television industry appear to have transformed the corporate configurations which conduce to economic success in the production industry. As a result, many leading independent television production companies in the United Kingdom and elsewhere across Europe have become prime targets for corporate activity and many have been subject to takeover, often by the US media groups. Does this matter? Does the concept of ‘national’ television content still have any relevance in the digital era? Drawing on a multiple-case-study-based analysis of several UK-based television production companies over recent years, this article examines how corporate takeovers in the production sector may affect creative decision-making and impact on the nature and quality of television content. Against a background of increased investment interest from multinationals in indigenous players in the United Kingdom and across Europe, the analysis presented makes a timely and policy-relevant contribution to knowledge.
Predictors for the functional incapacity of the elderly in primary health care.

Objectives: to assess the predictors for the functional incapacity of the elderly in primary health care. Method: cross-sectional study, of which 388 older people participated, conducted in three Primary health care Units, using the Katz index and Lawton's scale. The research project was approved by the Research Ethics Committee. Results: regarding the degree of dependency for Basic Activities, 90.2% were less independent for dressing themselves; and for Instrumental Activities, 77.1% of the elderly were less independent for doing handwork. The functional incapacity for basic activities was associated with age and color; for instrumental activities, with age, education, income of the elderly and self-assessment of health. Conclusion: attention should be paid to the overall assessment of the elderly person, in order to tailor care plans geared towards the preservation of their autonomy and the promotion of active ageing.
Understanding the mHealth implementation and adoption impact: a FVM perspective

Successful adoption and implementation of Mobile Health applications (mHealth) has been the subject of extensive research as can be evidenced by the large body of research literature on this topic. However, the fit and viability perspective issues have been less widely studied, perhaps because of the difficulty and complexity of healthcare services and delivery factors and their studies. In today’s global business environment this remains a key issue and critical success factor. Hence, this paper explains how challenging the mHealth application implementation success is for organizations government and patients. Furthermore, it is also very important to assess a fit and viability of mHealth application implementations in diverse environment. By drawing upon multiple streams of theory building, a framework, from the Fit-Viability Model (FVM) perspective, is developed. The framework provides important and valuable guiding principles for the decisions on adoption and deployment of mHealth applications. Grounded on the fit-viability framework, the paper advocates the use of a multi-case study approach to examine the success or failure of mHealth applications adoption and implementation. Managers and researchers can use the developed framework to identify the fit and viability of mHealth applications implementations to increase the possibility of success.
Corporate Social Responsibility and Profit Shifting

In this work we investigate the relationship between corporate social responsibility (CSR) and profit shifting. First, we employ worldwide data for parent firms and their foreign subsidiaries to derive a profit shifting measure. Then, drawing on legitimacy theory and risk-management strategy, we find corporate social responsibility to be positively correlated with profit shifting. In addition, we find this relationship to be stronger in parent firms in countries under the territorial tax system. We perform a battery of sensitivity tests and robustness checks to corroborate our findings. By and large, our results suggest that multinational firms with higher CSR scores shift larger amounts of profits to their low-tax foreign subsidiaries, potentially indicating strategic planning in the choice of CSR investments by multinational enterprises.
Developmental Regulation of the Cytokine Repertoire in Human Macrophages: IL‐1, IL‐6, TNF‐α, and M‐CSF

We were interested in the dependence of constitutive and stimulated cytokine secretion on the stage of macrophage (MAC) differentiation in vitro. Elutriation‐purified blood MO were cultured up to 28 days and their secretory repertoire was analyzed under adherence conditions at various culture stages. For each of the cytokines tested, interleukin (IL)‐1β, IL‐6, tumor necrosis factor (TNF)‐α, and macrophage colony‐stimulating factor (M‐CSF), a different pattern of regulation was observed. During the initial phase of maturation (up to day 7 in culture) within which the characteristics of normal MO to MAC transformation are achieved, M‐CSF was the only cytokine to be secreted constitutively. From the LPS‐dependent cytokines, IL‐1β and IL‐6 were downregulated whereas TNF‐α levels increased severalfold. For the release of IL‐1β, IL‐6, and TNF‐α a synergistic effect of interferon‐gamma (IFN‐g) and lipopolysaccharide (LPS) was observed. M‐CSF release increased until day 7 in culture with LPS being stimulatory for this particular cytokine only during the first days of differentiation. Upon further cultivation of MAC up to 28 days, LPS‐induced IL‐1β levels remained very low, but IL‐6 levels increased again reaching that of blood MO, and TNF‐α continued to rise reaching levels up to 30‐fold higher than in blood MO. M‐CSF secretion stayed high with LPS even suppressing constitutive secretion. Long‐term cultured MAC started to release IL‐6 and TNF‐α also in the absence of a stimulus and, furthermore, became responsive to IFN‐g alone. Our data show that the release of each cytokine investigated is differently regulated during maturation. These results document the functional plasticity of human MAC and emphasize the impact that MO to MAC differentiation may have in vivo.
Observed information in semi-parametric models

In many semi-parametric models, 'regular' parameters can be estimated by (semi-parametric) maximum likelihood estimators. The asymptotic theory for such estimators has been developed for a number of models of practical interest, and is similar to the asymptotic theory for maximum likelihood estimators in classical parametric models. In particular, the maximum likelihood estimators are asymptotically normal, where the inverse of the 'efficient Fisher information matrix' gives the asymptotic covariance matrix. The latter matrix is the Fisher information matrix corrected for the presence of an infinite-dimensional nuisance parameter. See, for example, Bickel et al. (1993) for an extensive review of information bounds. See Gill (1989), Chang (1990), Gu and Zhang (1993), Qin (1993), van der Laan (1993), Qin and Lawless (1994), van der Vaart (1994a; 1994b; 1994c; 1996), Murphy (1995), Gill et al. (1995), Huang (1996), Parner (1998), Qin and Wong (1996) and Mammen and van de Geer (1997) for results on the asymptotics of particular maximum likelihood estimators. It is natural to use the asymptotic normality of the estimator in order to form confidence intervals and test statistics. This requires an estimator of the standard error or equivalently of the Fisher information matrix. In some specific cases the efficient Fisher information matrix is of closed form. For example, under the assumption that the observation time is independent of the covariates, Huang (1996) gives an explicit estimator of the asymptotic variance in a proportional hazards model applied to current status data. Sometimes the 'efficient score' or 'efficient influence function' is explicit. Then since the efficient Fisher information matrix is the covariance of the efficient score function, one may estimate the
The Relationship Between Firm Size And Financial Leverage Of Commercial Banks In Kenya

v LIST OF TABLES . ix LIST OF FIGURES . x ABBREVIATIONS AND ACRONYMS . xi CHAPTER ONE: INTRODUCTION . 1 1.1 Background of the Study . 1 1.1.1 Firm Size . 2 1.1.2 Financial Leverage . 3 1.1.3 The Relationship between Firm Size and Financial Leverage. 4 1.1.4 Commercial Banks in Kenya . 5 1.2 Research Problem . 7 1.3 Objective of the Study . 8 1.4 Value of the Study . 8 CHAPTER TWO: LITERATURE REVIEW . 10 2.
Nonsteroidal Antiinflammatory Drugs and the Risk of Operative Site Bleeding After Tonsillectomy: A Quantitative Systematic Review

The use of nonsteroidal antiinflammatory drugs (NSAIDs) for analgesia after tonsillectomy is controversial because NSAIDS, through platelet inhibition, may increase the risk of perioperative bleeding. We systematically searched for randomized, controlled trials that reported on the incidence of perioperative bleeding attributable to the use of NSAIDs in patients undergoing tonsillectomy. As secondary outcome measures, we analyzed the quality of pain relief and the incidence of postoperative nausea and vomiting. Twenty-five studies with data from 970 patients receiving a NSAID and 883 receiving a non-NSAID treatment or a placebo were analyzed. Data were combined using a fixed-effect model. Of four bleeding end points (intraoperative blood loss, postoperative bleeding, hospital admission, and reoperation because of bleeding), only reoperation happened significantly more often with NSAIDs: Peto-odds ratio, 2.33 (95% confidence interval [CI], 1.12–4.83) and number-needed-to-treat, 60 (95% CI, 34–277). Compared with opioids, NSAIDs were equianalgesic, and the risk of emesis was significantly decreased (relative risk, 0.73; 95% CI, 0.63–0.85; numbers-needed-to-treat, 9; 95% CI, 5–19).
Efficacy of Intrauterine Resuscitation Techniques in Improving Fetal Oxygen Status During Labor

OBJECTIVE: To evaluate the efficacy of 3 common intrauterine resuscitation techniques used during labor. METHODS: Intrauterine resuscitation techniques were prospectively evaluated in healthy women during labor. Forty-two women were randomized to either a 500-mL or 1,000-mL intravenous (IV) fluid bolus over 20 minutes. Fifty-one women were randomized to 1 of 6 position sequences including supine with the head elevated 30°, left lateral and right lateral for 15 minutes each in succession. Forty-nine women received 10 L/min of oxygen (O2) via nonrebreather face mask for 15 minutes. Differences in fetal oxygen saturation (FSpO2) were evaluated before, during, and after each intervention. RESULTS: An IV fluid bolus of 1,000 mL had a greater effect on FSpO2 than an IV fluid bolus of 500 mL (500 mL: mean increase 3.7; 1,000 mL: mean increase 5.2; P = .05). Fetal oxygen saturation was higher in a lateral position (left mean 48.3%, right mean 47.7%) than in a supine position (mean supine 37.5%, P = .03). Oxygen administration increased FSpO2 (mean increase 8.7, P = .03). The effect persisted for more than 30 minutes after the O2 was discontinued (P = .03). For fetuses with FSpO2 less than 40% before maternal O2 administration, the increase was greater (mean increase 11.4) than for those with FSpO2 of 40% or greater (mean increase 7.6, P = .03). CONCLUSION: An intravenous fluid bolus of 1,000 mL, lateral positioning, and O2 administration at 10 L/min via nonrebreather face mask are effective in increasing FSpO2 during labor. LEVEL OF EVIDENCE: II-2
CLINICIAN BELIEFS AND PRACTICES RELATED TO INCREASING RESPONSIVITY TO THE NEEDS OF MAORI WITH ALCOHOL AND DRUG PROBLEMS

Culturally responsive treatments are often cited as essential for successfully addressing substance use-associated problems in indigenous and other ethnicgroups. However, there has been little investigation of the support for this assertion among alcohol and drug-user treatment workers, or how it might translate into clinical practice. The current paper reports on the results of a survey of the New Zealand alcohol and drug-user treatment field, which canvassed these issues. Eighty-six percent of respondents advocated adjustment of clinical practice when working with Maori. Two key strategies were referral to specialist Maori groups or individuals and/or contacting/meeting with whanau (family). Comparisons were made between respondents who referred clients on and those who provided intervention themselves. Implications of results, limitations and future research are discussed.
Posttraumatic stress and depression: potential pathways to disease burden among heart failure patients

Background and Objectives: Posttraumatic stress disorder (PTSD) and Major Depressive Disorder (MDD) are associated with high disease burden. Pathways by which PTSD and MDD contribute to disease burden are not understood. Design: Path analysis was used to examine pathways between PTSD symptoms, MDD symptoms, and disease burden among 251 low-income heart failure patients. Methods: In Model 1, we explored the independent relationship between PTSD and MDD symptoms on disease burden. In Model 2, we examined the association of PTSD symptoms and disease burden on MDD symptoms. We also examined indirect associations of PTSD symptoms on MDD symptoms, mediated by disease burden, and of PTSD symptoms on disease burden mediated by MDD symptoms. Results: Disease burden correlated with PTSD symptoms (r = .41; p < .001) and MDD symptoms (r = .43; p < .001) symptoms. Both models fit the data well and displayed comparable fit. MDD symptoms did not mediate the association of PTSD symptoms with disease burden. Disease burden did mediate the relationship between PTSD symptoms and MDD symptoms. Conclusions: Results support the importance of detection of PTSD in individuals with disease. Results also provide preliminary models for testing longitudinal data in future studies.
A Major Challenge for Recreation, Parks and Tourism Education: An Importance Performance Analysis of Factors that Influence the Recruitment and Retention of Faculty

Abstract Recruitment and retention of parks and recreation faculty has become a challenge in today's job market. The purpose of this study was to evaluate how faculty in recreation, parks, and tourism academic departments felt about their work environment through the use of an Importance-Performance analysis. Survey participants were Society of Parks and Recreation Educators members. Overall, academic departments/programs seem to be satisfactorily providing job attributes that are important to faculty members in both their decisions to join and remain with an academic department. Respondents deemed every job attribute as more important to the decision to remain with a department than it was in influencing a faculty member's initial decision to join a department. Further analysis explored differences between faculty members' with and without administrative duties, as well as those who work for Research Extensive/Intensive institutions and “Other” institutions as defined by the Carnegie Institute.