Association of Work Related Factors and Retention of Medical Officers of Health (MOH) In the Colombo District, Sri Lanka

Medical Officers are one of the key staff categories in the healthcare service. Globally there is high demand for medical officers and the government as well as private organizations have major task in retaining the services of highly trained and competent medical staff. Preventive health sector plays a vital role in the healthcare system. Medical Officers of Health (MOH) are the Medical Officers providing preventive health services in Sri Lanka. This study was carried out to explore the factors affecting retention of Medical Officers of Health in the preventive health sector in Sri Lanka.

Contextual Barriers and Enablers to Safewards Implementation in Victoria, Australia: Application of the Consolidated Framework for Implementation Research

Background: Safewards is a complex psychosocial intervention designed to reduce conflict and containment on inpatient mental health units. There is mounting international evidence of the effectiveness and acceptability of Safewards. However, a significant challenge exists in promising interventions, such as Safewards, being translated into routine practice. The Consolidated Framework for Implementation Research (CFIR) provides a framework through which to understand implementation in complex health service environments. The aim was to inform more effective implementation of Safewards using the CFIR domains and constructs, capitalizing on developing an understanding of variations across wards.Method: Seven Safewards Leads completed the Training and Implementation Diary for 18 wards that opted in to a trial of Safewards. Fidelity Checklist scores were used to categorize low, medium and high implementers of Safewards at the end of the 12-week implementation period.Results: Qualitative data from the diaries were analyzed thematically and coded according to the five CFIR domains which included 39 constructs. Twenty-six constructs across the five domains were highlighted within the data to have acted as a barrier or enabler. Further analysis revealed that six constructs distinguished between low, medium, and high implementing wards.Discussion: Our findings suggest that for implementation of Safewards to succeed, particular attention needs to be paid to engagement of key staff including managers, making training a priority for all ward staff, adequate planning of the process of implementation and creating an environment on each inpatient unit that prioritize and enables Safewards interventions to be undertaken by staff regularly.

Organizational contextual factors that predict success of a quality improvement collaborative approach to enhance integrated HIV-tuberculosis services: a sub-study of the Scaling up TB/HIV Integration trial

Background A quality improvement (QI) collaborative approach to enhancing integrated HIV-Tuberculosis (TB) services may be effective in scaling up and improving the quality of service delivery. Little is known of the role of organizational contextual factors (OCFs) in influencing the success of QI collaboratives. This study aims to determine which OCFs were associated with improvement in a QI collaborative intervention to enhance integrated HIV-TB services delivery. Methods This is a nested sub-study embedded in a cluster-randomized controlled trial. Sixteen nurse supervisors (clusters) overseeing 40 clinics were randomized (1:1) to receive QI training and mentorship, or standard of care support (SOC). In the QI arm, eight nurse supervisors and 20 clinics formed a “collaborative” which aimed to improve HIV-TB process indicators, namely HIV testing, TB screening, isoniazid preventive therapy (IPT) initiations, viral load testing, and antiretroviral therapy for TB patients. OCFs measured at baseline were physical infrastructure, key staff, flexibility of clinic hours, monitoring data for improvement (MDI), and leadership support. Surveys were administered to clinic staff at baseline and month 12 to assess perceptions of supportiveness of contexts for change, and clinic organization for delivering integrated HIV-TB services. Linear mixed modelling was used to test for associations between OCFs and HIV-TB process indicators. Results A total of 209 clinic staff participated in the study; 97 (46.4%) and 112 (53.6%) from QI and SOC arms, respectively. There were no differences between the QI and SOC arms scores achieved for physical infrastructure (78.9% vs 64.7%; p = 0.058), key staff (95.8 vs 92; p = 0.270), clinic hours (66.9 vs 65.5; p = 0.900), MDI (63.3 vs 65; p = 0.875, leadership support (46.0 vs 57.4; p = 0.265), and perceptions of supportiveness of contexts for change (76.2 vs 79.7; p = 0.128 and clinic organization for delivering integrated HIV-TB services (74.1 vs 80.1; p = 0.916). IPT initiation was the only indicator that was significantly improved in the parent study. MDI was a significantly associated with increasing IPT initiation rates [beta coefficient (β) = 0.004; p = 0.004]. Discussion MDI is a practice that should be fostered in public health facilities to increase the likelihood of success of future QI collaboratives to improve HIV-TB service delivery. Trial registration Clinicaltrials.gov, NCT02654613. Registered 01 June 2015.

On the Issue of Improving Remuneration System in Budget Organizations of the Republic of Kazakhstan

Budget organizations are created by public authorities, they are non-profit organizations whose activities are related to the provision of various types of services. They are financed by the state budget on the basis of financing plans of higher-level organizations. The main goal of budget organizations is the implementation of socio-cultural, managerial, scientific and technical projects, non-commercial in nature, which and funded by the state budget. The article describes the peculiarities of accounting in budget organizations and analyzes the implementation of an individual financing plan, provides a vertical analysis of the remuneration of key staff of an enterprise, along with the analysis of the number and quality of the staff and its movement in a budget organization. The purpose of the research is to determine the features of accounting and analysis of wages and salaries in budget organizations. To achieve this goal, the tasks were set to determine, on the basis of the analysis, the degree of supply of high-qualified specialists in budget organization; if an organization’s human resources are used effectively and efficiently; to identify the urgent problems in labor accounting and analysis of wages; to develop the main ways to improve accounting processes and increase the efficiency of the use of labor resources in budget organizations. Various research methods were used such as comparative, statistical methods and a structural analysis. In the context of globalization of the economy, the effective and rational use of personnel has a direct impact on the well-being of the people, labor productivity of employees of enterprises of all forms of ownership, including budget organizations. The article proposes the methodology to assess the effectiveness of labor resources within each structural unit, as well as for each employee personally by applying such methods as questioning, testing, appraisal interviews and others. The problems of accounting and analysis at enterprises in the context of international financial reporting standards are currently relevant, consequently it is necessary to work further to improve the organization of accounting and analysis of staff remuneration in budget organizations.

Experiences of psychiatrists assessing under 18s on an “all age” rota. An evaluation of the current service

AimsGloucestershire Health Care Trust operates an “all age” out of hours on-call rota, staffed by Registrars and Consultants who cross-cover all psychiatric sub-specialities. Our aim was to understand the challenges faced by psychiatrists of different professional backgrounds when assessing under 18 year olds in a health-based Place of Safety (POS).MethodWe circulated a survey to all psychiatrists on the on-call rota, to gather quantitative and qualitative information on the challenges posed by assessments of under-18s in a POS and assess whether an under-18 specific policy was needed.ResultOut of the 50 psychiatrists invited, 27 completed this survey (during February 2021). 33.3% of respondents reported that they had completed a POS assessment of an under 18-year-old when a Consultant Child and Adolescent Psychiatrist/Registrar was not available to join. 33.3% of respondents had been asked to complete such an assessment as the sole psychiatrist joining the AMHP, with 24% of those respondents reporting feeling uncomfortable doing these assessments without a second doctor present, and an additional 24% feeling comfortable only sometimes. 48.1% of the doctors surveyed did not invite parents or carers to take part in the assessment, despite this being considered best practice, citing reasons such as: being unaware that this was a possibility, assessments conducted at unsociable hours, safeguarding concerns involving the parents, and social distancing in the context of COVID-19. 41% of respondents had assessed vulnerable young people (children looked after or with a diagnosis of an autism spectrum condition) in the POS and reported that these assessments posed significant challenges to safe discharge planning and identifying appropriate placements. 81.5% felt that a tailored policy for young people was needed. Qualitative findings suggest psychiatrists think such a policy should include clear procedures (flowcharts), potential outcome scenarios/options for safe discharge, referral criteria for CAMHS, contact details for key staff members, a handover protocol. Respondents felt a shared policy with all stakeholders (AMHP service, Mental Health Services, police) was required.ConclusionOur survey highlights the challenges for non-CAMHS specialists assessing under 18s in a health-based POS and the need for an under-18 policy to support safe practice. Major themes will be further explored in a focus group to guide policy development.

The Emergence of an Auction Category: Iranian Art at Christie’s Dubai, 2006–2016

The expansion of the British auction houses Christie’s, Sotheby’s and Bonhams to markets in the Middle East has played a crucial role in building an international market for art from the region. They have also been essential in providing an international platform for the sale of art from Iran, a country whose economy is otherwise isolated from global markets. In this paper, I address the growth of the market for Iranian art specifically via Christie’s auctions in Dubai. Through close analysis of auction catalogs, ethnographic data drawn from live auctions and interviews with key staff members, I document the emergence of Iranian art into the international arena and the solidification of both Iranian and Middle Eastern art as a distinct category of sales. In particular, I explore the notion of “seeing with the other eye”, a way that auction specialists nudge local collectors into the arena of “international” taste. Through analysis of the particular tropes used to narrate artist biographies in auction catalogs, I demonstrate how artists are painted as interpreters and translators of “local” and “global” aesthetic registers.

Developmental Language Disorder (DLD) in Young People Leaving Care in England: A Study Profiling the Language, Literacy and Communication Abilities of Young People Transitioning from Care to Independence

Research indicates children and young people in care have a high prevalence of Developmental Language Disorder (DLD) as part of a complex set of vulnerabilities. This study describes the profile of language, literacy and communication abilities of a cohort of care leavers. The language, literacy and communication abilities of 44 young people leaving care between the ages of 16 and 26 years were assessed using standardized measures. Demographic data about the young people was collected along with a survey to key staff to capture their perceptions and experiences of the language and communication abilities of these young people. Ninety percent of the care leavers’ language abilities were below average and over 60% met criteria for DLD in combination with literacy difficulties, developmental disorders and social, emotional and mental health difficulties (SEMH). The implications of unidentified DLD on the lives of young people leaving care is discussed. Earlier identification of DLD is advocated to enable services to intervene to facilitate more positive outcomes and life chances for this very vulnerable population.

Implementation of a Pilot SMS-Based Crisis Support Service in Australia

Background: Australia's first short message service (SMS) crisis support service was launched by Lifeline Australia in July 2018. The pilot program was independently evaluated over a 240-day period. Aims: We aimed to examine the experiences of key staff employed in the Lifeline Text pilot and identify the skills and types of support required to deliver a high-quality SMS-based crisis support service. Method: In total, 22 interviews were conducted with 14 Lifeline Text crisis supporters and in-shift supervisors (supervisors) at two time points in September 2018 and March 2019. A modified framework approach was adopted to undertake qualitative data analyses. Results: Delivering crisis support via text was initially challenging as a result of the need to translate skills from telephone crisis support to the SMS platform. This was compounded by the high degree of suicidality of help-seekers and volatility in demand for the service. Limitations: The independent evaluators were not involved in the design of the pilot. Conclusion: Lifeline text is providing an important and necessary service, using a novel mode of delivery in Australia. Maintaining service quality at peak demand, with many distressed and suicidal help-seekers, requires specialized training, experience, and exceptional skills.

The Centre Cannot Hold

This chapter illustrates how most of the killings, 'disappearances', and other human rights abuses people associate with Idi Amin occurred in the central years of his rule. It was then that Amin's eccentric behaviour and statements came to worldwide attention and the first books about him were published; in effect, it was the time in which his myth was created, and he became Africa's icon of evil. However, this period was also one for which there is little primary evidence. Between 1973 and the end of Amin's regime, contemporary sources of information increasingly fade away. Gradually, almost all Uganda's academics, journalists, writers, and other intellectuals left the country. Some joined the exile groups based in Tanzania, Kenya, and Zambia, others went to the UK or North America. The British High Commission, whose records are, despite their bias and prejudices, by far the most important source of contemporary material on Amin's Uganda, was operating under severe limitations from 1973 onwards, with frequent expulsions of key staff, and restrictions on travel outside Kampala. Above all, though, it is important to focus on the severe human rights violations that took place in this period.

Seven Barriers to U.S. Business Leadership on Climate Policy and How to Break Them Down

This paper identifies barriers that prevent corporations in the United States from advocating for climate policy so that companies can break them down and embrace climate advocacy. We find companies face seven key barriers to comprehensively adopting a science-based climate policy agenda. None of these barriers are an excuse for inaction. The purpose of this paper is to help individuals within a company anticipate and overcome these obstacles. In the conclusion, we offer a checklist of specific actions and strategies to clear multiple barriers (e.g., conducting a risk analysis) and to help advance essential public policies that address climate change. The audience for this paper is C-suite and other key staff members within large (Fortune 500) companies that strive to be climate leaders. Though the United States grants companies of all sizes the right to engage in political lobbying and campaign financing, those that have larger operations and revenue have a greater capacity, empowered by greater resources, to directly participate in the federal policymaking process. Similarly, this paper focuses on political influence at the federal level.