What motivates physicians to propose private services in a mixed private-public healthcare system? A mixed methods study

Background Implementation of private elements, including private insurances, in public healthcare system is now common in many countries, and its impacts have been well studied. Little, however, is known about the motives leading physicians, major role players in the system, to promote the usage of private services. The aim of this study was to explore the various motives leading physicians within public systems to propose private services to their patients, while examining the possible associations to their specialty and level of commitment. Methods A total of 197 physicians from specialisms loaded more to private/public sectors participated in a cross-sectional telephone survey regarding their attitudes on their practices, private insurances, access to healthcare, and job satisfaction. The association between the likert scale questions to their recommendation to purchase private insurance, and the commitment they felt towards patients were analyzed using Generalized Estimating Equations (GEE) as well as logistic regression models. Results Our findings suggest physicians engaged in dual practice are less likely to promote private insurances among their patients if they are satisfied with their public job (OR = 0.92, 95%CI 0.89,0.94). Physicians perceived private insurances as beneficial for patients, were found likely to promote them (OR = 1.65, %95CI 1.16, 2.35). The commitment physicians felt toward patients who paid out-of-pocket money was associated to their sense of being trusted and valued (OR = 1.99, 95%CI 1.33, 2.88; OR = 1.5, 95%CI 1.05, 2.13 respectively). Conclusion This study suggests a deeper understanding of physicians’ daily experience of the private-public mix and it’s consequences, and could provide a platform for future studies. Further studies on physician’s role in health privatization processes are needed, and could aid policymakers in their efforts to strengthen healthcare systems around the world.

Student Character Building and Behaviour Through Islamic Value-Based Teaching

This chapter used qualitative methods to collect data on the influence of Islamic values in teaching in building student character in Malaysia schools. The population consisted of different schoolteachers from Selangor and Kuala Lumpur. Online interview was used to explore those teachers' perceptions on the inculcation of Islamic values in teaching on student character building. Data were analysed using thematic analysis. From the reports, inculcation of Islamic values was found to help in building students' good character, but to make it happen, teachers are seen as role players and models. Additionally, environment, parents, and peer support also played big roles in the inculcation of Islamic values in students. Media is reported to be used wisely to help children such as showing children the programs that promote Islam and its beauties. As an implication and conclusion, for schools to have good organizational behaviour, Islamic values must be inculcated in teaching to impact positively student behaviour and attitude while becoming good persons with Islamic adab and akhlaq.

Legacy Economics and Meta-Management of Creativity in Destinations

The concept of “Legacy” might have many interpretations, going from tangible to intangible, and accordingly, it can include a series of items that can be bequeathed to different kind of “heirs.” Either the giver or the community as main role players involved, the legacy is a bond for public administrations and destination managers. Legacy economics will be here connected to the innovative management of cultural destinations, where several and multi-goals-holders connect in order to provide resilience of villas, museums, and cultural assets together with increasing audiences and tourists. The collection of data about resilient creativity in Como (in the North of Italy) will show connections between legacy and management of public-private organizations for the last decade. A versatile and wide range of public and private interests together with national and international relevance will emerge. Community-type destinations will result as an original and innovative governance for resilience of culture and creativity connected with legacies and meta-management.

Using blockchain technology to facilitate property transactions

Background: As a medium of exchange, money enables the transfer of economic value and forms the basis of financial transactions. The transition from the third to the fourth industrial revolution has brought about technologies such as blockchain and cryptocurrencies that are transforming monetary transactions and methods of payments.Objectives: This article discusses an exploratory qualitative study into the use of the blockchain technology to facilitate the processes and payments related to land and landed property administration.Method: Nineteen semi-structured face-to-face interviews were conducted with role-players who are involved in an authoritative capacity in the current property transfer process.Findings: The findings show that blockchain technologies could significantly improve the processes involved in maintaining the electronic records associated with landed property. Blockchain technology has only been associated with cryptocurrencies before, and the argument advanced is that fiat currency should be able to be used with the same technology. To maintain the integrity of the property register, the deeds office and the South African Reserve Bank (SARB) must remain in control of the processes. Irrevocable payments should be made against registration confirmation, thus replacing the current paper-based processes with electronic records.

Guest Houses, Drought and Water Management Strategies in the Cape Winelands, South Africa

Tourism is a dynamic system essentially connected to all aspects of human and natural environments. Among these tourism systems and products, providers of tourist accommodation stand out. Within this context, water provision is crucial for tourist accommodation. Unfortunately, climate variability, and therefore, water availability, can and does impact tourism systems and tourism products, perhaps disproportionately so. In South Africa generally, and in an established tourism destination region such as the Cape Winelands in particular, guest houses are key role-players in the tourist industry. Nonetheless, from 2015 to 2018, this destination region experienced a crippling long-lasting drought, leading to fears of an imminent “Day Zero” – a point at which taps run dry. This would have been calamitous for tourism. To avert this, various water management strategies were implemented by Stellenbosch guest houses – the focal point of the Cape Winelands tourism region – to cope with and adapt to the drought. This study sought to examine the water management strategies manifested in the study region. It is concluded that various strategies were followed, and some appear to be permanent, rather than once-off responses. While these strategies might lead to more responsible water management strategies in tourist accommodation going forward, it appears that adopting sustainable water use practices was only done under duress and serious resistance from some guests resulted. It may be that water supply augmentation is the only way to preserve the tourism industry.

The Geographies of Artists and Stall holders at Afrikaans Arts Festivals, South Africa

South African arts festivals have been the subject of considerable research, with a focus on the economics, attendee patterns and impacts on local communities. Importantly, numerous role-players (stall holders, artists, festival attendees, amongst others) contribute to the diversity, origin and character of these arts festivals. Despite this, little is known of their mobility, spatiality and geographies. To this end, artists and stall holders across five large Afrikaans Language Arts festivals were interviewed to establish their itineraries, travel behaviours, festival involvement and cultural expression. On this basis, this study hopes to enable a better understanding of the geographies of Afrikaans arts festivals. Results suggest that artists and stall holders contribute significantly to shaping the geographies of these arts festivals as they are the most mobile of all participants. Their mobility creates a shared or communal festival geography – albeit now severely disrupted by COVID-19 – across Afrikaans arts festival boundaries. Unfortunately, this shared geography may also undermine the local flavour, authenticity, and regional diversity of such arts festivals.

TECHNIQUES, STRATEGIES AND CRIME PREVENTION APPROCHES FOR CRIME REDUCTION IN NIGERIA

The primary role of the government is to provide safety and security of members of the society and must ensure that this particular constitutional mandate is achieved. Holistic measures are required to address crime and insecurity that is prominent in all communities in Nigeria. Crime prevention is a proactive activities and synergies between government, criminal justice system and the other role players. These activities are geared towards prevention and reduction of crime and fear of crime. It is crucial to identify root causes of crime and disorderly events, thereafter, develop crime prevention strategies and plans to address and reduce crime and its potential consequences. The paper focuses on the evaluation of strategies and approaches adopted by the criminal justice system and law enforcement in addressing crime in Nigeria communities. The study adopted qualitative methodology. Interview technique was used to collect data from carefully selected participants. Finding reveals that crime prevention includes all activities which reduce, deter, or prevent the occurrence of crime, cooperation with the community is mandated in the form of community policing, sector policing in addressing issues like poverty and unemployment through government’s redistributions strategy, criminal justice officials are not implementing crime prevention approaches effectively. Recommendation includes; specialized training for police and partners involved in crime prevention, educate role players and partners on the implementation of effective crime prevention approaches, techniques and strategies, crime problem must be addressed from the grass-root, need to recognize crime victims, the environment, the predisposing and precipitating factors that led to crime, when developing plans and intervention, need to adopt technology in the fight against crime and crime prevention.

Interactive workshops as a learning and teaching method for primary healthcare nurses

Background: Traditionally, learning by and teaching for primary healthcare (PHC) nurses use didactic, teacher-centred approaches. Hence, the feasibility of interactive workshops in non-threatening PHC environments to refresh nurses’ knowledge on patient care needs exploring.Aim: To describe interactive workshops as a learning and teaching method for PHC nurses.Setting: Primary healthcare clinics.Methods: Systematic literature search followed by an exploratory experimental pre or post-test control group design. Random clinic sampling (n = 26) led to clinic inclusion at the control (n = 5) and experimental (n = 5) sites. Nurses (n = 42) were conveniently selected for the control (n = 21) and experimental (n = 21) groups. Experimental participants (n = 21) attended interactive workshops (n = 5) where various strategies were applied, whilst addressing key diabetes messages. Both groups completed a questionnaire aligned to diabetes messages pre- and post-workshop. Additionally, a Likert scale questionnaire was posed to the experimental group post-workshop. Data was analysed statistically and presented as descriptive statistics, frequencies and percentages.Results: Articles reviewed (n = 20) identified types of interactive activities, role players, learning content covered, feasibility and duration of the interactive workshops. Pre or post-testing results of the workshops participants indicate improved knowledge related to peripheral sensation (0.03) and ( 0.01). Results from the questionnaire revealed participants’ satisfaction with the interactive workshops.Conclusion: Interactive workshops as a learning and teaching method could lead to change in knowledge, and participant satisfaction. However, using a combination of interactive workshops and other teaching modalities may enhance learning and teaching further.Contribution: Interactive workshops are a feasible instructional method during refresher courses for healthcare providers.

Investigating neutrophil cell death in TB pathogenesis

Background: Neutrophils are one of the major early role players in antimycobacterial immunity. Upon infection, neutrophils can undergo NETosis, a cell death characterized by release of neutrophil extracellular traps (NETs). The role of NETosis in TB progression remains poorly characterized. We aim to characterize mechanisms underlying NETosis during TB pathogenesis by identifying genes that drive the cell death, and to determine their potential as markers of disease progression in high-risk individuals. Finally, we intend to evaluate neutrophil associated genes as targets for host directed therapy to reduce pathological damage caused by NETosis. Methods: Quantitative PCR will be used to quantify expression of specific genes identified in the blood of individuals with active lung disease (n=30), compared to those from healthy (n=30) and latently infected individuals (LTBI) (n=30). In addition, temporal events associated with NETosis will be measured using live microscopy in a neutrophil in vitro model of Mycobacterium tuberculosis (Mtb) infection. Candidate genes found to be associated with NETosis will be targeted with pharmaceutical inhibitors. Conclusion: Genes associated with neutrophil mediated cell death may serve as potential biomarkers of pathological damage and disease progression, as well as targets for host-directed therapy.

A Simple and Efficient Protocol for Hairy Root Culture of Arabidopsis Thaliana

Hairy root culture (HRC) is a valuable biotechnological tool for the production of plant secondary metabolites. Secondary metabolome study of Arabidopsis thaliana can be helpful in understanding the biological roles of various secondary metabolites present in it and HRC constructs the base of such study. The present work deals with the establishment of Agrobacterium rhizogenes strains transformed HRC of A. thaliana with very high transformation frequency resulting in long term hairy root cultures grown in hormone free media. Optimization of culture medium and standardisation of co-cultivation period are the key role players in obtaining high frequency of hairy roots. Four days of preculture in CIM medium and five min of co-cultivation in the bacterial suspension were found to be optimal conditions for root induction. This protocol could become a powerful tool for transcriptomics and proteomics-based studies for different transgenic root lines of A. thaliana.