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يهدف البحث الى تشخيص مستويات توفر ابعاد قيادة الازمات والمناعة التنظيمية والتحقق من دور قيادة الازمات في المناعة التنظيمية في الجامعات التقنية في اقليم كوردستان العراق من خلال تحليل دور ابعاد قيادة الازمات في المناعة التنظيمية فيها، تم اعتماد المنهج الوصفي التحليلي لتشخيص متغيرات البحث التي اجريت في الجامعات التقنية في اقليم كوردستان العراق ( جامعة التقنية- دهوك، جامعة التقنية- اربيل ، جامعة التقنية- السليمانية ) وكانت عينة البحث مكونة من( 234) من اعضاء هيئة التدريس في الجامعات المبحوثة الذين ابدوا رأيهم من خلال مستويات اتفاقهم على فقرات الاستبانة والتي كانت الاداة الرئيسة لجمع بيانات الميدانية، تم تحليل البيانات بالاعتماد على عدد من الادواة الاحصائية منها المتوسطات الحسابية والانحرافات المعيارية ومعامل الارتباط والانحدار، توصل البحث الى وجود علاقة ارتباط معنوية بين قيادة الازمات والمناعة التنظيمية وان المناعة التنظيمية في الجامعات المبحوثة تقترن مع توفر المؤشرات التي تتبلور ضمن ابعاد قيادة الازمات لدى القيادات الادارية في الجامعات المبحوثة، وان بعدي المسؤولية والتعلم من الازمة لدى القادة تساهمان بمستويات عالية في تعزيز المناعة التنظيمية، فضلا عن وجود تأثير معنوي لجميع الابعاد الاخرى لقيادة الازمات في المناعة التنظيمية، واوصى البحث بضرورة سعي الجامعات بتعزيز المناعة التنظيمية لديهم بالتركيز على ابعاد قيادة الازمات لدى القادة وخاصة بعدي اخذ المسؤولية والتعلم من الازمة فضلا عن اقتراح اجراء دراسات مستقبلية في بيئات اخرى واختبار مهارات قيادة الازمات ومتغيرات اخرى يمكن ان تؤثر في تعزيز المناعة التنظيمية ضمن اطار الدراسات المستقبلية.

The study aimed to investigate the impact of leadership learning practices on the work locus of control among heads of departments at public universities in the Kurdistan Region-Iraq. More precisely, the study concentrated on investigating the impact of selected leadership learning practices; self-managed, practice-based, and formal learning practices on work locus of control. Data were collected from 207 heads of departments from different public universities in the Kurdistan Region-Iraq. A self-administered questionnaire of three parts was sent online to the participants to collect the primary data from the sample under the research. Descriptive and inferential statistics were utilized to analyze the collected data and test the research hypotheses using SPSS (25.0). The empirical results showed a positive relationship between leadership learning practices and locus of control. The Pearson correlation analysis revealed that all three leadership learning practices (self-managed, practice-based, and formal learning) were significantly related to the locus of control. The results of regression analysis supported these findings and revealed that leadership learning practices collectively explained 24% of the variance in the locus of control. The practice-based learning and formal learning practices were found to have the strongest positive impact on locus of control, while self-managed learning had a weak and insignificant impact. Hence, it can be said that these results assert the importance of leadership learning practices in promoting individuals’ locus of control. It is also suggested that investing in formal and practice-based leadership learning programs may positively influence the individual’s locus of control, which can have significant implications for personal and professional development. The findings indicate a positive relationship between leadership learning practices and locus of control. The Pearson correlation analysis revealed that all three leadership learning practices (self-managed, practice-based, and formal learning) were significantly related to locus of control. The results of regression analysis supported these findings and revealed that the three sub-dimensions of leadership learning practices significantly predict the locus of control, explaining 24% of the total variance. The practice-based learning and formal learning practices were found to have the strongest positive impact on locus of control, while self-managed learning had a weak and insignificant impact. Hence, it can be said that these results assert the importance of leadership learning practices in promoting individuals’ locus of control. The study also suggests that investing in formal and practice-based leadership learning programs may positively influence the individual’s locus of control, which can have significant implications for personal and professional development.

هدف البحث الى التعرف على التأثير ابعاد المالية السلوكية المتمثلة بـ ( المعرفة المالية و المواقف المالية والعوامل السلوكية ) في الثقة الريادية، وجرى اختيار عدد من الشركات ومكاتب الصيرفة في محافظة دهوك لاجراء الجانب الميداني في البحث وشمل البحث(73) من المدراء العاملين في تلك الشركات ومكاتب الصيرفة كأفراد المبحوثين، واعتمد البحث على استمارة الاستبيان كاداة رئيسة لجمع البيانات في الجانب الميداني، وتم تحليل بيانات الاستمارة بواسطة البرنامج الاحصائي (SPSS .V. 21) في جانبها العملي، وقد توصل البحث الى مجموعة من الاستنتاجات اهمها وجود تأثير معنوي لابعاد المالية السلوكية في الثقة الريادية على المستوى الكلي ، فضلا عن وجود تاثير غير معنوي للعوامل السلوكية في الثقة الريادية على المستوى الفرعي ، واقترح البحث مجموعة من المقترحات اهمها استحضار وتفعيل اليات اكتساب المعرفة المالية والمواقف المالية واعتمادها كونها تساهم في تعزيز الثقة الريادية .

يتناول البحث احدى المواضيع المعاصرة في المجال التنظيمي ، إذ تعد القيادة الرقمية احدى اهم الانماط القيادية التي تعتمدها قادة المنظمات المعاصرة والتي تترك اثراً ايجابيا في أداء الوظيفي للتابعين وانعكاسها في الاداء المنظمي ككل خاصة في هذه الحقبة الزمنية المتازمة التي تمر بها العالم والتي افرزتها التباعد الاجتماعي ، والفكرة الأساسية لهذا البحث تتمحور حول نمط القيادة الرقمية وانعكاساتها في الأداء الوظيفي لدى رؤساء الاقسام والمقررين في الأقسام العلمية من خلال تشخيص ابعاد القيادة الرقمية وتأثيرها على الأداء الوظيفي في الأقسام العلمية لعدد من الجامعات في اقليم كوردستان العراق التي تطبق نظام بولونا في التعليم والتي يتطلب ادوات رقمية للتعامل معها ، ويتمثل مجتمع البحث بجميع رؤساء الاقسام والمقررين في جامعة زاخو و جامعة جرمو وجامعة التنمية البشرية ، ومن أجل الاختبار الفرضيات تم تصميم استمارة الاستبانة بالاستناد الى الدراسات السابقة ، وتم اختيار عينة عشوائية مكونة من (62) من رؤساء الاقسام والمقررين في تلك الجامعات، وتم اخضاع (56) استمارة صالحة للتحليل لتشكل عينة البحث ، ومن اجل التحقق من اهداف البحث تم تشخيص وتحليل البيانات بالاعتماد على برنامج(SPSS V-17). خلص البحث بوجود حالة الارتباط بين عناصر القيادة الرقمية (الرؤية الرقمية، التنمية المهنية للأفراد، القابليات الرقمية، توليد الشبكات الرقمية) والاداء الوظيفي ، ومعنوية العلاقة التأثيرية للقيادة الرقمية في الأداء الوظيفي على المستوى الكلي والجزئي ، وخلصت الدراسة بضرورة الاستفادة من نموذج العلاقة بين القيادة الرقمية والأداء الوظيفي اضافة الى تقديم بعض الاقتراحات منها التركيز على استحضار عناصر القيادة الرقمية نظرا لتأثيرها الايجابي الاداء الوظيفي في الاقسام العلمية في الجامعات .

Abstract Background False negative and indeterminate Interferon Gamma Release Assay (IGRA) results are a well documented problem. Cigarette smoking is known to increase the risk of tuberculosis (TB) and to impair Interferon-gamma (IFN-γ) responses to antigenic challenge, but the impact of smoking on IGRA performance is not known. The aim of this study was to evaluate the effect of smoking on IGRA performance in TB patients in a low and high TB prevalence setting respectively. Methods Patients with confirmed TB from Denmark (DK, n = 34; 20 smokers) and Tanzania (TZ, n = 172; 23 smokers) were tested with the QuantiFERON-TB Gold In tube (QFT). Median IFN-γ level in smokers and non smokers were compared and smoking was analysed as a risk factor for false negative and indeterminate QFT results. Results Smokers from both DK and TZ had lower IFN-γ antigen responses (median 0.9 vs. 4.2 IU/ml, p = 0.04 and 0.4 vs. 1.6, p Conclusions Cigarette smoking was associated with false negative and indeterminate IGRA results in both a high and a low TB endemic setting independent of HIV status.

Abstract Background Due to the association between diabetes and pulmonary tuberculosis (TB), diabetes may threaten the control of TB. In a prospective cohort study nested in a nutrition trial, we investigated the role of diabetes on changes in anthropometry, grip strength, and clinical parameters over a five months follow-up period. Methods Among pulmonary TB patients with known diabetes status, we assessed anthropometry and clinical parameters (e.g. haemoglobin) at baseline and after two and five months of TB treatment. A linear mixed-effects model (repeated measurements) was used to investigate the role of diabetes during recovery. Results Of 1205 TB patients, the mean (standard deviation) age was 36.6 (13.0) years, 40.9% were females, 48.9% were HIV co-infected, and 16.3% had diabetes. TB patients with diabetes co-morbidity experienced a lower weight gain at two (1.3 kg, CI95% 0.5; 2.0, p = 0.001) and five months (1.0 kg, CI95% 0.3; 1.7, p = 0.007). Similarly, the increase in the level of haemoglobin was lower among TB patients with diabetes co-morbidity after two (Δ 0.6 g/dL, CI95% 0.3; 0.9 p Conclusion TB patients initiating TB treatment with diabetes co-morbidity experience delayed recovery of body mass and haemoglobin, which are important for the functional recovery from disease.

Abstract Background The interaction of HIV and tuberculosis (TB) on CD4 levels over time is complex and has been divergently reported. Methods CD4 counts were assessed from time of diagnosis till the end of TB treatment in a cohort of pulmonary TB patients with and without HIV co-infection and compared with cross-sectional data on age- and sex-matched non-TB controls from the same area. Results Of 1,605 study participants, 1,250 were PTB patients and 355 were non-TB controls. At baseline, HIV was associated with 246 (95% CI: 203; 279) cells per μL lower CD4 counts. All PTB patients had 100 cells per μL lower CD4 counts than the healthy controls. The CD4 levels were largely unchanged during a five-month of TB treatment. HIV infected patients not receiving ART at any time and those already on ART at baseline had no increase in CD4 counts after 5 months of TB treatment, whereas those prescribed ART between baseline and 2 months, and between 2 and 5 months increased by 69 (22;117) and 110 (52; 168) CD4 cells per μL after 5 months. Conclusions The increase in circulating CD4 levels observed in PTB in patients is acquired after 2 months of treatment irrespective of HIV status. Initiation of ART is the strongest factor correlated with CD4 increase during TB treatment. Trial registration number Clinical trials.gov: NCT00311298

Abstract Background In tuberculosis (TB) endemic parts of the world, patients with pulmonary symptoms are managed as "smear-negative TB patients" if they do not improve on a two-week presumptive, broad-spectrum course of antibiotic treatment even if they are TB microscopy smear negative. These patients are frequently HIV positive and have a higher mortality than smear-positive TB patients. Lack of access to diagnose Pneumocystis jirovecii pneumonia might be a contributing reason. We therefore assessed the prevalence of P. jirovecii by PCR in oral wash specimens among TB patients and healthy individuals in an HIV- and TB-endemic area of sub-Saharan Africa. Methods A prospective study of 384 patients initiating treatment for sputum smear-positive and smear-negative TB and 100 healthy household contacts and neighbourhood controls. DNA from oral wash specimens was examined by PCR for P. jirovecii. All patients delivered sputum for TB microscopy and culture. Healthy contacts and community controls were clinically assessed and all study subjects were HIV tested and had CD4 cell counts determined. Clinical status and mortality was assessed after a follow-up period of 5 months. Results 384 patients and 100 controls were included, 53% and 8% HIV positive respectively. A total number of 65 patients and controls (13.6%) were at definitive risk for PCP based on CD4 counts 3 and no specific PCP prophylaxis. Only a single patient (0.3% of the patients) was PCR positive for P. jirovecii. None of the healthy household contacts or neighbourhood controls had PCR-detectable P. jirovecii DNA in their oral wash specimens regardless of HIV-status. Conclusions The prevalence of P. jirovecii as detected by PCR on oral wash specimens was very low among TB patients with or without HIV and healthy individuals in Tanzania. Colonisation by P. jirovecii was not detected among healthy controls. The present findings may encourage diagnostic use of this non-invasive method.

Abstract Background Directly observed therapy (DOT) remains the cornerstone of the global tuberculosis (TB) control strategy. Tanzania, one of the 22 high-burden countries regarding TB, changed the first-line treatment regimen to contain rifampicin-containing fixed-dose combination for the full 6 months of treatment. As daily health facility-based DOT for this long period is not feasible for the patient, nor for the health system, Tanzania introduced patient centred treatment (PCT). PCT allows patients to choose for daily DOT at a health facility or at their home by a supporter of choice. The introduction of fixed dose combinations in the intensive and continuation phase made PCT feasible by eliminating the risk of selective drug taking by patients and reducing the number of tablets to be taken. The approach was tested in three districts with the objective to assess the effect of this strategy on TB treatment outcomes Methods Cohort analysis comparing patients treated under the PCT strategy (registered April-September 2006) with patients treated under health-facility-based DOT (registered April-September 2005). The primary outcome was the cure rate. Differences were assessed by calculating the risk ratios. Associations between characteristics of the supporters and treatment outcomes in the group of patients opting for home-based DOT were assessed through logistic regression. Results In the PCT cohort there were 1208 patients and 1417 were included in the historic cohort. There was no significant difference in cure rates between the cohorts (risk ratio [RR]: 1.06; 95% confidence interval [CI]: 0.96-1.16). In the PCT cohort, significantly more patients had successful treatment (cure or treatment completed; RR: 1.10; 95%CI: 1.01-1.15). There were no characteristics of supporters that were associated with treatment outcome. Conclusion The PCT approach showed similar cure rates and better treatment success rates compared to daily health-facility DOT. The results indicate that there are no specific prerequisites for the supporter chosen by the patient. The programmatic setting of the study lends strong support for scaling-up of TB treatment observation outside the health facility.

Abstract Background A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Methods Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Results Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Conclusion Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey.