Ghanaian construction projects encounter a number of challenges, including low health, safety, and environmental requirements, poor performance, and time and cost overruns. To provide value for money (VFM) on governme...Ghanaian construction projects encounter a number of challenges, including low health, safety, and environmental requirements, poor performance, and time and cost overruns. To provide value for money (VFM) on government infrastructure projects in Ghana, this research assesses the roles of project consultants, specifically architects and quantity surveyors, and highlights important obstacles. A cross-sectional survey design involving architects and quantity surveyors yielded a 96% response rate after 100 questionnaires were distributed. Consultants’ responsibilities also include monitoring standards compliance, providing advice on delays, controlling budgets, and advising on project completion dates. Difficulties encompass a lack of promptness in decision-making, unethical conduct, political pressure, and inadequate focus on contract administration and construction audits. Project urgency, longevity, political clout, timely decision-making, and team experience are important variables that impact VFM. Policy makers and construction management practitioners should take note of the implications for Ghana’s public infrastructure projects.展开更多
Introduction: Job stress and job satisfaction play a key role in the work environment of an organization. These influence the behaviour of a doctor towards his or her co-workers, administration and, most importantly t...Introduction: Job stress and job satisfaction play a key role in the work environment of an organization. These influence the behaviour of a doctor towards his or her co-workers, administration and, most importantly towards the patients. Objective: To assess job stress among consultants working in Colombo group of hospitals and to identify the factors that affect job satisfaction. Methods: A descriptive cross sectional study was conducted by using postal questionnaire on 262 consultants working in Colombo group of hospitals. Hospital consultants job stress and job satisfaction questionnaire developed by Amanda Ramirez et al. was used with their permission. Results: Of the 262 questionnaires mailed 171 were returned. Of total responded 84.6% reported extremely satisfied or satisfied with their work. Nearly 92% agreed intellectual stimulation by teaching contributed to their job satisfaction. Nearly 80% reported having a high level of responsibility, being perceived to do the job well by the colleagues, being able to bring about positive changes to the unit, having a high level of autonomy contributed to their job satisfaction. Poor administration and lack of facilities e.g. computers, filing procedures caused job stress in 73%. Threat of being sued for malpractice or having to deal with distressed relatives did not contribute to stress in nearly 80%. Conclusion: In Sri Lanka nearly 85% consultants reported they were satisfied with their job and teaching medical undergraduates and post graduates was one of the major contributory factors. However 73% indicated factors such as lack of resources, and poor administration cause stress at work. Providing computers and basic stationery for patient documentation and efficient and effective administration will improve the work output of consultants by reducing their stress levels.展开更多
Background: Inappropriate prescribing can lead to errors in dispensing medications and serious problems for patients. Objectives: Prescription analysis can identify such drawbacks of prescribing, increase awareness of...Background: Inappropriate prescribing can lead to errors in dispensing medications and serious problems for patients. Objectives: Prescription analysis can identify such drawbacks of prescribing, increase awareness of prescribers of rational prescribing and consequently lead to proper delivery of pharmaceutical care and enhance therapeutic outcomes. Methods: In the present study, prescriptions issued by consultants from a hospital and by general practitioners from private practice in Sharjah-United Arab Emirates were analyzed using indicators suggested by World Health Organizations. These include information with regard to prescriber, patient and the medication prescribed. We also determined the average number of drugs/encounter and % of prescriptions with antibiotics and those with injections. Data were collected and analyzed using Microsoft Excel and expressed in terms of both counts and percentages. Results: Almost all prescriptions were handwritten with easily readable ones being 65% for consultants and 46% for general practitioners. Average number of drugs/encounter was 2.1 and 2.8 for consultants and general practitioners, respectively. Antibiotics were prescribed in 27% and 44%;generic prescribing was 5% and 10% by consultants and general practitioners respectively and 8% of prescriptions by consultants contained injections. Variable results were obtained on information regarding the patient but consultants seem to be better in documenting patient’s age and gender. Consultants and general practitioners tend to prescribe 3 drugs and more in 35% and 25% respectively. The most commonly prescribed therapeutic classes for both groups of prescribers were NSAIDs and antibiotics with ibuprofen and amoxicillin-clavulanic acid combination being the most commonly prescribed drugs of each class. Conclusion: To improve prescription writing, interventions must include, among others, incorporation of topics on prescription writing in medical curriculum and programs of continuing medical education.展开更多
As discovered, today’s Rwandan construction industry is developing day by day, which plays a very important role in the country’s economic growth. In the construction industry, project consultants play a very signif...As discovered, today’s Rwandan construction industry is developing day by day, which plays a very important role in the country’s economic growth. In the construction industry, project consultants play a very significant role in providing services for such projects. The project consultants provide services from the beginning of the project to the completion of the project. Using project consultants is very useful for construction projects because it can ameliorate project efficiency and effectiveness. The main purpose of this paper is to investigate the relationship between project consultants’ performance and project success in the Rwandan construction industry. The data used in this study were obtained from primary and secondary sources. The secondary data was attained through an elaborated literature review of various books, articles, and papers related to this research to outlining and describing the chief ideas of this research title. The primary data was compiled through a questionnaire survey that was directed to 110 selected professionals in the construction projects in Rwanda to collect data from the site for statistical analysis of the research to test the hypothesis. However, a total of 90 usable responses were received within the scheduled period representing the response rate of 81.82%, which is likely to be representative and acceptable. Data collected from the questionnaire surveys were analyzed using the Statistical Package for Social Scientists (SPSS), excel spreadsheets, and Relative Importance Index (RII), which provide more merit presentations. The survey results show that even if there are many obstacles in the use of project consultants in the Rwandan construction industry such as lack of knowledge and practice in project consulting, lack of well-trained project consulting professionals, lack of training opportunities in project consulting, lack of knowledge and experience in addition to the senior management opposition, and lack of local project consulting guidelines and information;they are needed in the construction project to make it more successful through reducing and saving the overall project’s life cycle cost according to client’s wishes, keeping time of construction project, improving quality of the project products in the present and future, removing major variations that affect construction project with its attendant cost overrun, and advising on construction project process. Therefore, it is more important to remark that the good performance of the project consultants in any industry especially in the construction industry will contribute to the successful implementation of the project. From the results of the study, the performance of project consultants is closely related to the success of the construction industry in Rwanda. The project consultants’ leading skills and knowledge automatically guide the project to complete with accurate time, budget, and quality to make the project successful. In this paper, we will also consider the project success criteria;the role and responsibility of project consultants;the factors affecting the performance of project consultants;and the reasons that hinder the implementation of project consulting in the Rwandan construction industry.展开更多
China has become a "hot spot" of foreign investment based on sustained development of its economy and huge potential market since implementing the reform and opening policy. In order to offer quality profess...China has become a "hot spot" of foreign investment based on sustained development of its economy and huge potential market since implementing the reform and opening policy. In order to offer quality professional consultant service to foreign businessmen, the Beijing Guo Xun International Consultants Co., Ltd. was established in October 1993 by展开更多
Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal cl...Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal clinics as recommended by the WHO. The general objective of this study was to study the norm in terms of Antenatal Consultation (ANC) frequency as well as the determinants of the frequency among women who gave birth in the maternity hospitals of Agbangnizoun. Our research was a cross-sectional, descriptive, retrospective and quantitative type, which was carried out among 335 women in Agbangnizoun, Benin from 1 February to 3 April 2020 (3 months), in order to find out the general or specific characteristics of women that we associate with the frequency of prenatal consultation. At the end of the study, we found that 60%, 68% and 15% of the surveyed population had received ANC in the first, second and third trimesters, respectively. Ethnicity, income level of spouses over the three trimesters as well as the level of their knowledge and overall practice of ANC are determinants of the frequency of prenatal consultation.展开更多
Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework ...Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework for UC diagnosis and treatment.However,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been defined.Moreover,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the disease.In this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging situations.The key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational issues.The key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational issues.The role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.展开更多
目的探讨多学科会诊(multiple disciplinary team,MDT)联合问题导向教学法(problem based learning,PBL)+案例教学法(case based learning,CBL)教学模式在肝癌临床教学中的应用效果。方法选择2019年10月—2022年6月入院实习的128名临床...目的探讨多学科会诊(multiple disciplinary team,MDT)联合问题导向教学法(problem based learning,PBL)+案例教学法(case based learning,CBL)教学模式在肝癌临床教学中的应用效果。方法选择2019年10月—2022年6月入院实习的128名临床医学专业学生为研究对象,采用抽签法将其分为对照组64名和观察组64名,对照组采取传统教学模式,观察组采取MDT联合PBL+CBL教学模式。对比两组学生考核成绩、对教学效果的认同度、教学满意度。结果观察组考核成绩得分[理论知识(89.01±6.39)分、病例分析(84.16±5.04)分、技能操作(85.19±6.08)分]均高于对照组[理论知识(80.14±5.63)分、病例分析(76.69±5.60)分、技能操作(75.93±5.47)分],差异有统计学意义(P<0.05)。观察组对MDT联合PBL+CBL教学模式能激发学习兴趣(95.31%)、加深对理论知识的理解(100.00%)、提升临床思维能力(93.75%)和临床分析能力(96.88%)、提高理论联系实践的能力(100%)、提升自学能力(96.88%)和团队协作能力(95.31%)的认同度均高于对照组(56.25%、60.94%、39.06%、62.50%、43.75%、35.94%、35.94%),差异有统计学意义(P<0.05)。观察组对教学的满意度(92.19%)高于对照组(51.56%),差异有统计学意义(P<0.05)。结论MDT联合PBL+CBL的肝癌临床教学模式能提高教学质量,提升学生的综合素质。展开更多
文摘Ghanaian construction projects encounter a number of challenges, including low health, safety, and environmental requirements, poor performance, and time and cost overruns. To provide value for money (VFM) on government infrastructure projects in Ghana, this research assesses the roles of project consultants, specifically architects and quantity surveyors, and highlights important obstacles. A cross-sectional survey design involving architects and quantity surveyors yielded a 96% response rate after 100 questionnaires were distributed. Consultants’ responsibilities also include monitoring standards compliance, providing advice on delays, controlling budgets, and advising on project completion dates. Difficulties encompass a lack of promptness in decision-making, unethical conduct, political pressure, and inadequate focus on contract administration and construction audits. Project urgency, longevity, political clout, timely decision-making, and team experience are important variables that impact VFM. Policy makers and construction management practitioners should take note of the implications for Ghana’s public infrastructure projects.
文摘Introduction: Job stress and job satisfaction play a key role in the work environment of an organization. These influence the behaviour of a doctor towards his or her co-workers, administration and, most importantly towards the patients. Objective: To assess job stress among consultants working in Colombo group of hospitals and to identify the factors that affect job satisfaction. Methods: A descriptive cross sectional study was conducted by using postal questionnaire on 262 consultants working in Colombo group of hospitals. Hospital consultants job stress and job satisfaction questionnaire developed by Amanda Ramirez et al. was used with their permission. Results: Of the 262 questionnaires mailed 171 were returned. Of total responded 84.6% reported extremely satisfied or satisfied with their work. Nearly 92% agreed intellectual stimulation by teaching contributed to their job satisfaction. Nearly 80% reported having a high level of responsibility, being perceived to do the job well by the colleagues, being able to bring about positive changes to the unit, having a high level of autonomy contributed to their job satisfaction. Poor administration and lack of facilities e.g. computers, filing procedures caused job stress in 73%. Threat of being sued for malpractice or having to deal with distressed relatives did not contribute to stress in nearly 80%. Conclusion: In Sri Lanka nearly 85% consultants reported they were satisfied with their job and teaching medical undergraduates and post graduates was one of the major contributory factors. However 73% indicated factors such as lack of resources, and poor administration cause stress at work. Providing computers and basic stationery for patient documentation and efficient and effective administration will improve the work output of consultants by reducing their stress levels.
文摘Background: Inappropriate prescribing can lead to errors in dispensing medications and serious problems for patients. Objectives: Prescription analysis can identify such drawbacks of prescribing, increase awareness of prescribers of rational prescribing and consequently lead to proper delivery of pharmaceutical care and enhance therapeutic outcomes. Methods: In the present study, prescriptions issued by consultants from a hospital and by general practitioners from private practice in Sharjah-United Arab Emirates were analyzed using indicators suggested by World Health Organizations. These include information with regard to prescriber, patient and the medication prescribed. We also determined the average number of drugs/encounter and % of prescriptions with antibiotics and those with injections. Data were collected and analyzed using Microsoft Excel and expressed in terms of both counts and percentages. Results: Almost all prescriptions were handwritten with easily readable ones being 65% for consultants and 46% for general practitioners. Average number of drugs/encounter was 2.1 and 2.8 for consultants and general practitioners, respectively. Antibiotics were prescribed in 27% and 44%;generic prescribing was 5% and 10% by consultants and general practitioners respectively and 8% of prescriptions by consultants contained injections. Variable results were obtained on information regarding the patient but consultants seem to be better in documenting patient’s age and gender. Consultants and general practitioners tend to prescribe 3 drugs and more in 35% and 25% respectively. The most commonly prescribed therapeutic classes for both groups of prescribers were NSAIDs and antibiotics with ibuprofen and amoxicillin-clavulanic acid combination being the most commonly prescribed drugs of each class. Conclusion: To improve prescription writing, interventions must include, among others, incorporation of topics on prescription writing in medical curriculum and programs of continuing medical education.
文摘As discovered, today’s Rwandan construction industry is developing day by day, which plays a very important role in the country’s economic growth. In the construction industry, project consultants play a very significant role in providing services for such projects. The project consultants provide services from the beginning of the project to the completion of the project. Using project consultants is very useful for construction projects because it can ameliorate project efficiency and effectiveness. The main purpose of this paper is to investigate the relationship between project consultants’ performance and project success in the Rwandan construction industry. The data used in this study were obtained from primary and secondary sources. The secondary data was attained through an elaborated literature review of various books, articles, and papers related to this research to outlining and describing the chief ideas of this research title. The primary data was compiled through a questionnaire survey that was directed to 110 selected professionals in the construction projects in Rwanda to collect data from the site for statistical analysis of the research to test the hypothesis. However, a total of 90 usable responses were received within the scheduled period representing the response rate of 81.82%, which is likely to be representative and acceptable. Data collected from the questionnaire surveys were analyzed using the Statistical Package for Social Scientists (SPSS), excel spreadsheets, and Relative Importance Index (RII), which provide more merit presentations. The survey results show that even if there are many obstacles in the use of project consultants in the Rwandan construction industry such as lack of knowledge and practice in project consulting, lack of well-trained project consulting professionals, lack of training opportunities in project consulting, lack of knowledge and experience in addition to the senior management opposition, and lack of local project consulting guidelines and information;they are needed in the construction project to make it more successful through reducing and saving the overall project’s life cycle cost according to client’s wishes, keeping time of construction project, improving quality of the project products in the present and future, removing major variations that affect construction project with its attendant cost overrun, and advising on construction project process. Therefore, it is more important to remark that the good performance of the project consultants in any industry especially in the construction industry will contribute to the successful implementation of the project. From the results of the study, the performance of project consultants is closely related to the success of the construction industry in Rwanda. The project consultants’ leading skills and knowledge automatically guide the project to complete with accurate time, budget, and quality to make the project successful. In this paper, we will also consider the project success criteria;the role and responsibility of project consultants;the factors affecting the performance of project consultants;and the reasons that hinder the implementation of project consulting in the Rwandan construction industry.
文摘China has become a "hot spot" of foreign investment based on sustained development of its economy and huge potential market since implementing the reform and opening policy. In order to offer quality professional consultant service to foreign businessmen, the Beijing Guo Xun International Consultants Co., Ltd. was established in October 1993 by
文摘Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal clinics as recommended by the WHO. The general objective of this study was to study the norm in terms of Antenatal Consultation (ANC) frequency as well as the determinants of the frequency among women who gave birth in the maternity hospitals of Agbangnizoun. Our research was a cross-sectional, descriptive, retrospective and quantitative type, which was carried out among 335 women in Agbangnizoun, Benin from 1 February to 3 April 2020 (3 months), in order to find out the general or specific characteristics of women that we associate with the frequency of prenatal consultation. At the end of the study, we found that 60%, 68% and 15% of the surveyed population had received ANC in the first, second and third trimesters, respectively. Ethnicity, income level of spouses over the three trimesters as well as the level of their knowledge and overall practice of ANC are determinants of the frequency of prenatal consultation.
文摘Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework for UC diagnosis and treatment.However,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been defined.Moreover,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the disease.In this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging situations.The key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational issues.The key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational issues.The role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.
文摘目的探讨多学科会诊(multiple disciplinary team,MDT)联合问题导向教学法(problem based learning,PBL)+案例教学法(case based learning,CBL)教学模式在肝癌临床教学中的应用效果。方法选择2019年10月—2022年6月入院实习的128名临床医学专业学生为研究对象,采用抽签法将其分为对照组64名和观察组64名,对照组采取传统教学模式,观察组采取MDT联合PBL+CBL教学模式。对比两组学生考核成绩、对教学效果的认同度、教学满意度。结果观察组考核成绩得分[理论知识(89.01±6.39)分、病例分析(84.16±5.04)分、技能操作(85.19±6.08)分]均高于对照组[理论知识(80.14±5.63)分、病例分析(76.69±5.60)分、技能操作(75.93±5.47)分],差异有统计学意义(P<0.05)。观察组对MDT联合PBL+CBL教学模式能激发学习兴趣(95.31%)、加深对理论知识的理解(100.00%)、提升临床思维能力(93.75%)和临床分析能力(96.88%)、提高理论联系实践的能力(100%)、提升自学能力(96.88%)和团队协作能力(95.31%)的认同度均高于对照组(56.25%、60.94%、39.06%、62.50%、43.75%、35.94%、35.94%),差异有统计学意义(P<0.05)。观察组对教学的满意度(92.19%)高于对照组(51.56%),差异有统计学意义(P<0.05)。结论MDT联合PBL+CBL的肝癌临床教学模式能提高教学质量,提升学生的综合素质。
