Suchergebnisse

Introduction: Governance in the health system refers to a range of decision making, and implementation undertakings conducted by decision-makers as they find ways to achieve national health policy objectives that are favourable to each country's health system. Currently, there are different types of frameworks that have been developed and these frameworks try to operationalize and assess how principles of governance at different levels of a health system are administered. While a number of frameworks for assessing governance in the health sector have been proposed, their application is often constrained by impractical indicators that are often not well-grounded, resulting in limited pragmatic work on governance in the health systems itself.Methods: Adopting a scoping review method, articles were identified using these databases namely BMC, Emerald, Elsevier, PubMed, Science Direct, Sage, Springer, Taylors & Francis, WHO and Wiley. Only articles written and published in English from 2009 to 2019 were included.Results: 5 of the frameworks have actually been tested and operationalized in practice from the 13 identified and reviewed frameworks that are largely theoretically based.Conclusion: A multitude of frameworks to assess health systems governance exist, however, there are not many examples of their application in the literature and healthcare systems with well-grounded proven results. Consequently, to facilitate a more comprehensive assessment and peruse of governance frameworks in health systems, the health system should have clear goals with continuous and committed support by accountable decision-makers pivoted by principles of good governance.

Background: Osteoporosis has significant impact on healthcare costs and quality of life. Amongst the models for collaborative disease state management services published internationally, there is sparse evidence regarding the role of community pharmacists in the provision of osteoporosis care. Hence, the aim of our study was to explore community pharmacists' opinions (including the barriers and facilitators) and scope of osteoporosis disease state management services by community pharmacists in Malaysia, informing a vision for developing these services. Methods: Semi-structured individual interviews and focus groups discussions were conducted with community pharmacists from October 2013 to July 2014. Three trained researchers interviewed the participants. Interviews were recorded and transcribed verbatim. Data were analyzed thematically using an interpretative description approach. Results: Nineteen community pharmacists with 1-23 years of experience were recruited (in depth interviews: n = 9; focus group discussions: n = 10). These participants reflected on their experience with osteoporosis-related enquiries, which included medication counseling, bone density screening and referral of at-risk patients. Key barriers were the lack of numerous factors: public awareness of osteoporosis, accurate osteoporosis screening tools for community pharmacists, pharmacists' knowledge on osteoporosis disease and medications, time to counsel patients about bone health, collaboration between pharmacists and doctors, and support from the government and professional body. The pharmacists wanted more continuing education on osteoporosis, osteoporosis awareness campaigns, a simple, unbiased osteoporosis education material, and inter-professional collaboration practices with doctors, and pharmacists' reimbursement for osteoporosis care. Conclusions: The involvement of community pharmacists in the provision of osteoporosis disease state management was minimal. Only ad-hoc counseling on osteoporosis prevention was performed by community pharmacists. Development and trial of collaborative osteoporosis disease state management services in community pharmacy could be facilitated by training, support and remuneration.

Enhancing the competitive advantage of the international logistics industry is vital for a country. While most literature addresses the competitive advantage of individual organisations from the resource-based view, relatively few studies assess various governmental influences on providing a competitive advantage to the logistics industry. Drawing on the institutional theory and resource-based view, this study empirically identifies the critical drivers that affect competitive advantage in the international logistics industry. From the initial findings and a review of the relevant literature, this study identifies infrastructure, technology, integration, and regulation as the main drivers. Empirical data were collected from 149 international logistics firms or service providers in Taiwan. The study results show that the logistics industry in Taiwan is satisfied with technology and infrastructure. Using structural equation modelling (SEM), this study finds that regulation and integration have a positive impact on the competitive advantage of the international logistics industry, whereas technology has a positive impact on integration. In addition, based on the results of bootstrapping analysis, integration has a mediating effect on the relationship between technology and competitive advantage of the international logistics industry. Theoretical, managerial, and policy implications are discussed to reinforce the competitive advantage of the international logistics industry.

Recently, monoclinic Ga2O3 (beta-Ga2O3) photodetectors (PDs) have been extensively studied for various commercial and military applications due to the merits of intrinsic solar rejection, high gain, and great compactness. In this work, c-plane sapphire substrates were annealed under different temperatures in a vacuum furnace prior to the molecular beam epitaxy (MBE) of beta-Ga2O3 thin film, which yielded a smoother surface and even a terraceand- step-like morphology on the substrate, resulting in improved crystallinity of the epitaxial film. Accordingly, both the dark and photo currents of beta-Ga2O3 metal-semiconductor-metal (MSM) PDs were increased by the enhanced carrier mobility (mu) of the more crystalline film. However, the substrate-annealing temperature must be sufficiently high to offset the rise of the dark current and thus achieve a remarkable improvement in the photodetection properties. As a result, the PD fabricated on the 1050 degrees C-annealed substrate exhibited extremely high sensitivity, for example, high responsivity (R) of 54.9 A/ W and large specific detectivity (D*) of 3.71 x 10(14) Jones. Both parameters were increased by one order of magnitude because of the combined effects of the dramatic increase in mu and the effective reduction in defect-related recombination centers. Nevertheless, the latter also prolonged the recovery time of the PD. These findings suggest another way to develop beta-Ga2O3 PD with extremely high sensitivity. (C) 2017 Optical Society of America