scholarly journals Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settings

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Ahmed Alatawi ◽  
Sayem Ahmed ◽  
Louis Niessen ◽  
Jahangir Khan
Keyword(s):  
Public Hospital ◽  
Meta Analysis ◽  
Hospital Efficiency ◽  
Public Hospitals ◽  
Quality Data ◽  
Risk Level ◽  
Gulf Region ◽  
Substantial Impact ◽  
Gcc Countries ◽  
Strategic Plans

Abstract Background The assessment of hospital efficiency is attracting interest worldwide, particularly in Gulf Cooperation Council (GCC) countries. The objective of this study was to review the literature on public hospital efficiency and synthesise the findings in GCC countries and comparable settings. Methods We systematically searched six scientific databases, references and grey literature for studies that measured the efficiency of public hospitals in appropriate countries, and followed PRISMA guidelines to present the results. We summarised the included studies in terms of samples, methods/technologies and findings, then assessed their quality. We meta-analysed the efficiency estimates using Spearman’s rank correlations and logistic regression, to examine the internal validity of the findings. Results We identified and meta-analysed 22 of 1128 studies. Four studies were conducted in GCC nations, 18 came from Iran and Turkey. The pooled technical-efficiency (TE) was 0.792 (SE ± 0.03). There were considerable variations in model specification, analysis orientation and variables used in the studies, which influenced efficiency estimates. The studies lacked some elements required in quality appraisal, achieving an average of 73%. Meta-analysis showed negative correlations between sample size and efficiency scores; the odd ratio was 0.081 (CI 0.005: 1.300; P value = 0.07) at 10% risk level. The choice of model orientation was significantly influenced (82%) by the studied countries’ income categories, which was compatible with the strategic plans of these countries. Conclusions The studies showed methodological and qualitative deficiencies that limited their credibility. Our review suggested that methodology and assumption choices have a substantial impact on efficiency measurements. Given the GCC countries’ strategic plans and resource allocations, these nations need further efficiency research using high-quality data, different orientations and developed models. This will establish an evidence-based knowledge base appropriate for use in public hospital assessments, policy- and decision-making and the assurance of value for money.

Decreased Flow-Mediated Dilatation in Children With Type 1 Diabetes: A Systematic Review and Meta-Analysis

Angiology ◽  
2021 ◽  
pp. 000331972110100
Author(s):  
Lei Cao ◽  
Miao Hou ◽  
Wanping Zhou ◽  
Ling Sun ◽  
Jie Shen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Endothelial Function ◽  
Meta Analysis ◽  
Quality Data ◽  
Cochrane Library ◽  
Healthy Children ◽  
Healthy Controls ◽  
Flow Mediated Dilatation

Type 1 diabetes (T1DM) is a strong risk factor for the development of cardiovascular disease. Flow-mediated dilatation (FMD) is an early noninvasive marker of endothelial function and it predicts future cardiovascular disease. However, the changes in FMD among T1DM children are still controversial. The present meta-analysis aimed to investigate whether FMD is impaired in children with T1DM. PubMed, EMBASE, Cochrane library, and Web of Science were searched for studies comparing FMD in children with T1DM and healthy controls. The Newcastle-Ottawa quality assessment scale for case–control studies was used to assess study quality. Data were pooled using a random effects models to obtain the weighted mean differences (WMD) in FMD and 95% CIs. Overall, 19 studies with 1245 patients and 872 healthy controls were included in this meta-analysis. Children with T1DM had significantly lower FMDs compared with healthy controls (WMD: −2.58; 95% CI: −3.36 to −1.81; P < .001). Meta-regression analysis revealed that low-density lipoprotein cholesterol levels impacted the observed difference in FMD between T1DM and healthy children. This meta-analysis showed that T1DM children have impaired endothelial function, which indicates they are at higher risk of developing cardiovascular disease in later life.

scholarly journals Cannabis and its derivatives for the use of motor symptoms in Parkinson’s disease: a systematic review and meta-analysis

2021 ◽  
Vol 14 ◽  
pp. 175628642110185
Author(s):  
Susan J. Thanabalasingam ◽  
Brandan Ranjith ◽  
Robyn Jackson ◽  
Don Thiwanka Wijeratne
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Function ◽  
Observational Studies ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Motor Symptom ◽  
Quality Data ◽  
Symptom Improvement ◽  
Motor Symptoms

Background: Recent changes to the legal status of cannabis across various countries have renewed interest in exploring its use in Parkinson’s disease (PD). The use of cannabinoids for alleviation of motor symptoms has been extensively explored in pre-clinical studies. Objective: We aim to systematically review and meta-analyze literature on the use of medical cannabis or its derivatives (MC) in PD patients to determine its effect on motor function and its safety profile. Methods: We reviewed and analyzed original, full-text randomized controlled trials (RCTs) and observational studies. Primary outcomes were change in motor function and dyskinesia. Secondary outcomes included adverse events and side effects. All studies were analyzed for risk of bias. Results: Fifteen studies, including six RCTs, were analyzed. Of these, 12/15 (80%) mention concomitant treatment with antiparkinsonian medications, most commonly levodopa. Primary outcomes were most often measured using the Unified Parkinson Disease Rating Scale (UPDRS) among RCTs and patient self-report of symptom improvement was widely used among observational studies. Most of the observational data lacking appropriate controls had effect estimates favoring the intervention. However, the controlled studies demonstrated no significant motor symptom improvement overall. The meta-analysis of three RCTs, including a total of 83 patients, did not demonstrate a statistically significant improvement in UPDRS III score variation (MD −0.21, 95% CI −4.15 to 3.72; p = 0.92) with MC use. Only one study reported statistically significant improvement in dyskinesia ( p < 0.05). The intervention was generally well tolerated. All RCTs had a high risk of bias. Conclusion: Although observational studies establish subjective symptom alleviation and interest in MC among PD patients, there is insufficient evidence to support its integration into clinical practice for motor symptom treatment. This is primarily due to lack of good quality data.

scholarly journals Longitudinal Evaluation on the Operation Index Applied to Public Hospitals in Pudong New District of Shanghai, China

2018 ◽  
Vol 55 ◽  
pp. 004695801879059
Author(s):  
Shanshan Liu ◽  
Jiaoling Huang ◽  
Yanting Li ◽  
Jincheng Fan ◽  
Hong Liang ◽  
...  
Keyword(s):  
Financial Risk ◽  
Public Hospital ◽  
Risk Index ◽  
Condition Index ◽  
Public Hospitals ◽  
Operating Index ◽  
The Public ◽  
Management Condition ◽  
Service Operation ◽  
Public Hospital Reform

The public hospital reform has lasted 5 years in China; however, the operation development status and trends of public hospitals have not been systematically evaluated in Pudong New District. We first applied the technology of longitudinal index to assess the development of public hospitals there. The quantitative data were mainly gathered by taking health statistics database from 2009 to 2014. The results showed that overall operating index presented a down-up trend, with the highest point in 2014 and the lowest point in 2012. Overall operating index, development foundation index, and management condition index were found to be statistically different ( P = .010, P = .016, P = .031) in different years, whereas the service operation index and financial risk index were not so ( P = .543, P = .228). Moreover, the results demonstrated that no obvious difference was observed in the overall operating index between the general and specialized hospitals ( P = .327), which was the same in the 4 first-class indexes. However, there were statistical differences in the overall operating index and development foundation index among these 5 years ( P = .018, P = .036), but none in the service operation index, management condition index, and financial risk index ( P = .503, P = .062, P = .177). No interaction effects were discovered between year and hospital categories in the current study ( P = .673, P = .375, P = .885, P = .152, P = .288).

E-Government Adoption in the U.K.

2013 ◽  
Vol 9 (2) ◽  
pp. 101-119 ◽  
Author(s):  
Rania Mousa
Keyword(s):  
Decision Makers ◽  
Electronic Government ◽  
Quality Data ◽  
Adoption Process ◽  
Government Information ◽  
Business Reporting ◽  
The United Kingdom ◽  
Strategic Plans ◽  
Agent Of Change ◽  
Government Initiative

Electronic government is one of the strategic innovations which have become a powerful agent of change for developing better government information and services and supporting the modernization of government’s operations. This paper investigates a remarkable e-government initiative represented by the adoption process of the Extensible Business Reporting Language (XBRL) at Companies House (CH) in the United Kingdom. Based on the application of Rogers’ framework, the research identifies CH’s motivation, vision and process to use XBRL to achieve efficiency and produce better quality data to enhance and streamline the electronic filing process. The novelty of this research is based on the usage of a well-established innovation adoption framework to examine XBRL adoption as a process –rather than a product- innovation that remains to be an under-researched area. This research provides valuable implications and conclusions that can help decision makers and IT experts in government agencies to devise meaningful strategic plans to adopt future e-government initiatives and develop existing ones.

scholarly journals Effectiveness and safety of herbal medicines for induction of labour: a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022499 ◽  
Author(s):  
Collins Zamawe ◽  
Carina King ◽  
Hannah Maria Jennings ◽  
Chrispin Mandiwa ◽  
Edward Fottrell
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Herbal Medicines ◽  
Risk Of Bias ◽  
Induction Of Labour ◽  
Quality Data ◽  
Eligibility Criteria ◽  
Significant Difference

ObjectiveThe use of herbal medicines for induction of labour (IOL) is common globally and yet its effects are not well understood. We assessed the efficacy and safety of herbal medicines for IOL.DesignSystematic review and meta-analysis of published literature.Data sourcesWe searched in MEDLINE, AMED and CINAHL in April 2017, updated in June 2018.Eligibility criteriaWe considered experimental and non-experimental studies that compared relevant pregnancy outcomes between users and non-user of herbal medicines for IOL.Data extraction and synthesisData were extracted by two reviewers using a standardised form. A random-effects model was used to synthesise effects sizes and heterogeneity was explored through I2statistic. The risk of bias was assessed using ‘John Hopkins Nursing School Critical Appraisal Tool’ and ‘Cochrane Risk of Bias Tool’.ResultsA total of 1421 papers were identified through the searches, but only 10 were retained after eligibility and risk of bias assessments. The users of herbal medicine for IOL were significantly more likely to give birth within 24 hours than non-users (Risk Ratio (RR) 4.48; 95% CI 1.75 to 11.44). No significant difference in the incidence of caesarean section (RR 1.19; 95% CI 0.76 to 1.86), assisted vaginal delivery (RR 0.73; 95% CI 0.47 to 1.14), haemorrhage (RR 0.84; 95% CI 0.44 to 1.60), meconium-stained liquor (RR 1.20; 95% CI 0.65 to 2.23) and admission to nursery (RR 1.08; 95% CI 0.49 to 2.38) was found between users and non-users of herbal medicines for IOL.ConclusionsThe findings suggest that herbal medicines for IOL are effective, but there is inconclusive evidence of safety due to lack of good quality data. Thus, the use of herbal medicines for IOL should be avoided until safety issues are clarified. More studies are recommended to establish the safety of herbal medicines.

scholarly journals GCC Media Roles during the 2011 Arab Spring: An Analytical and Critical Overview

2016 ◽  
Vol 7 (2) ◽  
pp. 53 ◽  
Author(s):  
Abdullah K. Al-Kindi
Keyword(s):  
Arab Spring ◽  
Main Question ◽  
Gulf Region ◽  
The Public ◽  
Gcc Countries ◽  
The Media ◽  
Contextual Characteristics ◽  
The Arab Spring ◽  
Critical Overview

The central aim of this paper is to critically analyze the role of the media during public protests that occurred in the GCC countries during 2011. These protests were part of what came to be called the “Arab Spring”, which started in late 2010. Particular focus will be on how the Arab Spring resulted in fundamental changes and how various institutions played roles in this. The study draws on Gulf region literature about the Arab Spring in order to offer a critical and informed overview on the topic under discussion. The paper’s main question is: what are the main roles played by the GCC media (old/new) during the public protests of 2011? The paper argues that the role of the media in the 2011 protests, while important, was rather limited and affected by the unique contextual characteristics of the media environment in the GCC countries. 

scholarly journals Wounds research for patient benefit: a 5-year programme of research

2016 ◽  
Vol 4 (13) ◽  
pp. 1-304 ◽  
Author(s):  
Nicky Cullum ◽  
Hannah Buckley ◽  
Jo Dumville ◽  
Jill Hall ◽  
Karen Lamb ◽  
...  
Keyword(s):  
Data Collection ◽  
Meta Analysis ◽  
Research Programme ◽  
Quality Data ◽  
Mixed Treatment Comparison ◽  
Prevalence Survey ◽  
Treatment Comparison ◽  
Mixed Treatment ◽  
Complex Wound ◽  
Complex Wounds

BackgroundComplex wounds are those that heal by secondary intention and include lower-limb ulcers, pressure ulcers and some surgical wounds. The care of people with complex wounds is costly, with care mainly being delivered by community nurses. There is a lack of current, high-quality data regarding the numbers and types of people affected, care received and outcomes achieved.ObjectivesTo (1) assess how high-quality data about complex wounds can be captured effectively for use in both service planning and research while ensuring integration with current clinical data collection systems and minimal impact on staff time; (2) investigate whether or not a clinical register of people with complex wounds could give valid estimates of treatment effects, thus reducing dependence on large-scale randomised controlled trials (RCTs); (3) identify the most important research questions and outcomes for people with complex wounds from the perspectives of patients, carers and health-care professionals; (4) evaluate the potential contributions to decision-making of individual patient data meta-analysis and mixed treatment comparison meta-analysis; and (5) complete and update systematic reviews in topic areas of high priority.MethodsTo meet objectives 1 and 2 we conducted a prevalence survey and developed and piloted a longitudinal disease register. A consultative, deliberative method and in-depth interviews were undertaken to address objective 3. To address objectives 4 and 5 we conducted systematic reviews including mixed treatment comparison meta-analysis.ResultsFrom the prevalence survey we estimated the point prevalence of all complex wounds to be 1.47 per 1000 people (95% confidence interval 1.38 to 1.56 per 1000 people). Pressure ulcers and venous leg ulcers were the most common type of complex wound. A total of 195 people with a complex wound were recruited to a complex wounds register pilot. We established the feasibility of correctly identifying, extracting and transferring routine NHS data into the register; however, participant recruitment, data collection and tracking individual wounds in people with multiple wounds were challenging. Most patients and health professionals regarded healing of the wound as the primary treatment goal. Patients were greatly troubled by the social consequences of having a complex wound. Complex wounds are frequently a consequence of, and are themselves, a long-term condition but treatment is usually focused on healing the wound. Consultative, deliberative research agenda setting on pressure ulcer prevention and treatment with patients, carers and clinicians yielded 960 treatment uncertainties and a top 12 list of research priorities. Of 167 RCTs of complex wound treatments in a systematic review of study quality, 41% did not specify a primary outcome and the overall quality of the conduct and reporting of the research was poor. Mixed-treatment comparison meta-analysis in areas of high priority identified that matrix hydrocolloid dressings had the highest probability (70%) of being the most effective dressing for diabetic foot ulcers, whereas a hyaluronan fleece dressing had the highest probability (35%) of being the most effective dressing for venous ulcers; however, the quality of this evidence was low and uncertainty is high.ConclusionsComplex wounds are common and costly with a poor evidence base for many frequent clinical decisions. There is little routine clinical data collection in community nursing. A prospective complex wounds register has the potential to both assist clinical decision-making and provide important research evidence but would be challenging to implement without investment in information technology in NHS community services. Future work should focus on developing insights into typical wound healing trajectories, identifying factors that are prognostic for healing and assessing the cost-effectiveness of selected wound treatments.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

Relationship between different sources of geopolitical risks and stock markets in the GCC region: a dynamic correlation analysis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Abdullah Alqahtani ◽  
Shawkat Hammoudeh ◽  
Refk Selmi
Keyword(s):  
Stock Returns ◽  
Stock Markets ◽  
Risk Index ◽  
Saudi Arabian ◽  
Gulf Region ◽  
Content Type ◽  
Dynamic Correlation ◽  
Hedging Strategies ◽  
Gcc Countries ◽  
Geopolitical Risks

PurposeThe findings would help in designing useful and relevant hedging strategies against geopolitical risks (GPRs), which are rampant in the Gulf Cooperation Council (GCC) region.Design/methodology/approachThis study focuses on the regional and global costs of GPRs for businesses in the Gulf region.FindingsThe results of the analysis show that the time-varying conditional correlation between the stock returns of the GCC countries and the Saudi Arabian geopolitical risk is consistently negative, suggesting that the Saudi Arabian geopolitical risk hurts the GCC stock markets, thus underscoring the importance of studying regional GPRs.Originality/valueThe contribution of this paper is twofold: First, it uses a newly geopolitical risk index that includes recent geopolitical events not included in the Caldara and Iacoviello (2018) index. In addition to war threats and acts, terrorist threats and acts and nuclear threats, the authors consider global trade tensions (GTTs), Saudi Arabia's geopolitical risk and OPEC news mainly related to OPEC oil production levels. Second, it assesses whether Saudi Arabia, which is the largest economy in the region and the main global oil exporter, is really a risk exporter to the rest of the GCC countries.

Users' Satisfaction with the Electronic Health Record (EHR) in the Kingdom of Bahrain

2016 ◽  
Vol 7 (3) ◽  
pp. 29-51
Author(s):  
Aysha Ebrahim Abdulla ◽  
Shurooq Yousif Ahmed ◽  
Maryam Abdulrahman Alnoaimi ◽  
Hayat Ali
Keyword(s):  
Service Quality ◽  
Electronic Health Record ◽  
Online Survey ◽  
Healthcare Providers ◽  
Health Sector ◽  
Public Hospitals ◽  
Health Record ◽  
Record System ◽  
Substantial Impact ◽  
Electronic Health

Today, many hospitals seek to adopt the latest and most sophisticated technologies in order to raise the service quality and users' satisfaction. The Electronic Health Record (EHR) had a substantial impact on the health sector and has enhanced the efficiency and effectiveness of healthcare providers. The purpose of this research is to examine the factors that affect users' satisfaction with the current Health Record System in the Kingdom of Bahrain. A research model was built based on three popular models of users' satisfaction toward information systems. Toward achieving the research objective, a quantitative approach was followed to collect data from an online survey. Accordingly, 152 responses were collected from the users of EHR in public hospitals and health centres in Bahrain. The results of the survey were analyzed using SPSS and SmartPLS 3.0. It was concluded that the most effective factors in the users' satisfaction with EHR were directly service quality and technical support, with system and information quality indirectly through trust.

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