Abstract:

INTRODUCTION

Culture and social status are key determinate of attitude and behaviour towards prevention and control of many diseases of Public health importance including HIV.

OBJECTIVES

This study determines socio-cultural barriers to early diagnosis and prevention of HIV among women of reproductive age in Southwestern Nigeria

METHODS

Descriptive cross sectional qualitative study among women of reproductive age group and health care givers concerning socio and cultural factors influencing diagnosis and prevention of HIV. Five Focus Group Discussions (FGD) of 8 eligible respondents each were conducted using a pretested FGD guide in collecting data from the randomly selected subjects. Data was analyzed using simple content analysis.

RESULTS

Cultural and social factors influencing HIV vulnerability and transmission identified include low education status, poor awareness among women, low employment and economic power, adverse religious beliefs and practices, reluctance to accept teaching of FLHE in schools and the public, stigma and discrimination even from the health care workers affecting health seeking behaviour. Other factors include polygamy, male dominance, low decision power and value of women, remarrying after divorce, widowhood rights, wife inheritance and sharing, early marriage, and some cultural breastfeeding practices encouraging HIV transmission

CONCLUSION

Raising community awareness by traditional, cultural and religious gatekeepers becomes imperative to circumvent many of the identified social and cultural factors constituting barriers and influencing HIV diagnosis and prevention

KEY WORD

Socio-cultural factors, HIV, STIs, women of reproductive age

References:

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2.      Adebimpe WO and Asekun-Olarinmoye EO. A comparative study of contraceptive use among rural and urban women in Osun state, Nigeria. International Journal of Tropical disease and Health, 2012;2(3):214-224

3.      Adebimpe WO, Olugbenga-Bello AI, Pattern of use of traditional and alternative medical therapy among clients on ARVs in Southwestern Nigeria. Journal of Medicine and Biomedical Sciences, 2012;3(1):20-23

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Abstract:

Cleome viscose (L.) belonging to family (Capperdiceae), commonly called “Sticky spider flower”, is a terrestrial, annual, erect, aromatic herb. The plant has high medicinal value as it is traditionally used for its antiemetic, wound healing, antimicrobial, hepatoprotective and anti-oxidant properties. The aim of the proposed work is to evaluate the therapeutical potential of Cleome viscosa in alleviating diabetes by assessment of liver and kidney function and lipid profile parameters in alloxan-induced diabetic rats. A significant elevation (P<0.001) of blood glucose, SGPT, SGOT, ALP, urea, uric acid, creatinine and lipid profile in control groups was observed as compared to normal groups. However, there was significant reduction (P<0.001 and P<0.001) in the tested biochemical parameters in both the groups treated with extract as compared to the control group and the effect was compared with the standard drug, Metformin. From these results, it can be concluded that the methanol extract of Cleome viscosa possesses significant ability to reduce the diabetes complications

KEY WORDS

Cleome viscosa, diabetes, complications, neuropathic pain, lipid profile, liver and kidney function.

References:

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2.      Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care.1997; 20: 1183–119.

3.      Fossati P, Principe L, Berti G. Use of 3,5-dichloro-2-hydroxybenzene sulphonic acid-4-aminophenazone chromogenic system in direct assay of uric acid in serum and urine. ClinicalChemistry. 1980; 26: 227-231.

4.      Galigher AE, Kozloff EN. Essentials o f Practical Microtechnique. 2ed, Lea and Febiger, Philadelphia, 1971; 77.

5.      Govindarajan R, Vijayakumar M, Singh M, Rao CV, Shirwaikar A, Rawat AKS, Pushpangadan P. Antiulcer and antimicrobial activity of Anogeissuslatifolia. Journal of Ethanopharmacology. 2006: 106: 57-61.

6.      Ghosh T, Maity TK, Das M, Bose A, Dash GK. Hepatoprotective activity of Bacopamonnieri L. against ethanol-induced hepatotoxicity in rats. Pharmacognosy Magazine. 2007: 3(10): 95-100.

7.      JeyarajAnovraj, et al. In vitro regeneration of Cleome viscosa – an important medicinal herb.

8.      Johnson D, Palumbo P, Chu C. Diabetic ketoacidosis in a community-based population Mayo Clinic Proc. 1980; 55: 85-88.

9.      Lakshmi SP, Bindu RN. Proximate composition, mineral elements and anti-nutritional factors in Cleome viscosa L. and Cleome burmanni W. & A International Journal of Pharmacy and Pharmaceutical Sciences. 2013; 5(1): 398-402.

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11.  Niramathi KL, Karunanithi M, Brindha P. Phytochemical and in vitro screening of aerial parts of Cleome viscosa extracts. International Journal of Pharmacy and Pharmaceutical Sciences. 2012; 4(2):

12.  Padmaja Udaykumar. Medicinal Pharmacology.CBS publishers & Distributors, New Delhi.2013; 574.

13.  Panduraju T, Paravthi B, Rammohan M. Wound healing propertied of Cleome viscosa. Hygeia Journal for Drugs and Medicines. 2011; 3(1): 41-45.

14.  Panduraju T, Paravthi B, Rammoha M. Wound healing propertied of Cleome viscosa. Hygeia Journal for Drugs and Medicines. 2011; 3(1): 41-45.

15.  Pomory CM. Color development time of the Lowry protein assay. Analytical Biochemistry. 2008; 378:216-7.

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19.  Upadhayay, et al. Antimicrobial effects of Cleome viscose and Trigeonellafoenum see dextracts. Journal of Cell and Tissue Research. 2008; 8(2): 1355-1360.

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Abstract:

This review critically reviews the article ‘Contextual Behavioral Science: Creating a science more adequate to the challenge of the human condition’ in the journal Science Direct Journal. The review will first summarise the article. Secondly, it will briefly analyse the effectiveness of the article’s structure, investigating how the information is set out and whether the reader can access it efficiently. Thirdly, the review will critique the article, evaluating its authority, currency, accuracy. Overall the article was well written, clear and relevant.

References:

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2.      Aveling EL (2011) Mediating between international knowledge and local knowledge: The critical role of local field officers in an HIV prevention intervention Journal of Community & Applied Social Psychology 21: 95–110.CrossRefWeb of Science

3.      Aveling EL (2012) Making sense of ‘gender’: From global HIV/AIDS strategy to the local Cambodian ground. Health & Place 18(3): 461–467. CrossRefMedlineOrder article via InfotrieveWeb of Science

4.      Bauer MW, Gaskell G (2008) Social representations: A progressive research programme for social psychology. Journal for the Theory of Social Behaviour 29(2):163–186.

5.      Benjamin J (1993) The Bonds of Love: Psychoanalysis, Feminism and the Problem of Domination. London: Virago.

6.      Campbell C (2003) ‘Letting them Die’: Why HIV/AIDS Prevention Programs Fail. Oxford: International African Institute.

7.      Campbell C, Jovchelovitch S (2000) Health, community and development: Towards a social psychology of participation. Journal of Community & Applied Social Psychology 10(4): 225–270.

8.      Castro P, Batel S (2009) A social representational approach to the communication between different spheres: An analysis of the impact of two discursive formats. Journal for the Theory of Social Behaviour 39(4): 415–433.

9.      Cornish F(2006) Empowerment to participate: A case study of participation by Indian sex workers in HIV prevention. Journal of Community & Applied Social Psychology 16(4): 301–315.

10.  Cornish F, (2012) From brothel to boardroom: Prospects for community leadership of HIV interventions in the context of global funding practices. Health & Place 18(3): 468–474.

11.  Crisp N (2010) Turning the World Upside down: The Search for Global Health in the 21^st Century. London: Royal Society of Medicine Press.

12.  Dowling B (2004) Conceptualising successful partnerships. Health & Social Care in the Community 12(4): 309–317.

13.  Duveen G (2000) Introduction: The power of ideas. In: Moscovici S (ed.) Social Representations: Explorations in Social Psychology. Cambridge: Polity Press, pp.1–17.

14.  Foucault M (1980) Power/Knowledge: Selected Interviews and Other Writings, 1972–1977. Brighton: Harvester.

15.  Fowler A (2000) Partnerships – Negotiating relationships: A resource for NGOs. INTRAC. Available at: http://www.intrac.org/resources.php?action=resource&id=54 (accessed 10 October 2009).

16.  Gillespie A (2008) Social representations, alternative representations and semantic barriers. Journal for the Theory of Social Behaviour 38(4): 375–391.

17.  Jovchelovitch S (2007) Knowledge in Context: Representation, Community and Culture. London: Routledge.

18.  Jovchelovitch S, Priego-Hernandez J (2012) Underground sociabilities: Identity, culture and resistance in Rio De Janeiro’s favelas. London School of Economics and Political Science, London. Available at: http://eprints.lse.ac.uk/46492/

19.  Landau I (2008) Law and civil society in Cambodia and Vietnam: A Gramscian perspective. Journal of Contemporary Asia 38(2): 244–258.

20.  Li TM (1999) Compromising power: Development, culture and rule in Indonesia. Cultural Anthropology 14(3): 295–322.

21.  Markova I (2003) Dialogicality and Social Representations: The Dynamics of Mind. Cambridge: Cambridge University Press.

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23.  Mosse D (2005) Cultivating Development: Ethnography of Aid Policy and Practice. London: Pluto Press.

24.  Nair Y, Campbell C (2008) Building partnerships to support community-led HIV/AIDS management: A case study from rural South Africa. African Journal of AIDS Research 7(1): 45–53.

25.  Nelson G, Pancer SM, Hayward K, et al. (2004) Partnerships and participation of community residents in health promotion and prevention. Journal of Health Psychology 9(2): 213–227.

Abstract:

The immune response is an essential network of cells, tissues, and organs that work together to provide a defence mechanism for the host organism. The primary targets of the immune system are microbes, parasites, and fungi that can cause infections. However, the system may become defective, disorganized or overactive, reacting to host tissues and causing disorders such as arthritis, allergic reactions and implicated in other conditions such as diabetes melittus[16] among others, probably due to the recently identified Th 17. With such vital role, a mechanism of modulating the action of the system is essential.

The immune system is composed of two arms that work closely together, the innate immune system being more active early in an immune response while the adaptive immunity becomes progressively dominant over time.

Current medications used to modulate the immune system mainly exploit the mechanism of action of the immune system, blocking or enhancing some essential steps in the immune response cascade to provide their actions.

In the critically ill patient, the role of the immune system becomes even more evident as various conditions may come into play simultaneously, hence the essence of the current study.

During the review of the article, ‘Immunomodulation in the critically ill’ a publication of the British Journal of Anaesthesia, the reviewer will provide a summary of the article, then analyse the structure followed by a critique of the work. This will be followed by an analysis of the objectivity and stability of the article. The review will also analyse the tables presented in the article. Recent advances related to the topic will also be examined followed by a conclusion of the article review.

References:

1.      Abraham E, Reinhart K, Opal S, et al. Efficacy and safety of tifaco-gin (recombinant tissue factor pathway inhibitor) in severe sepsis:a randomized controlled trial. Journal of American Medical Association 2003; 290:238 – 47

2.       Anne L Astier: T-cell regulation by CD46 and its relevance in multiple sclerosis. Immunology. 2008 June; 124(2): 149–154. doi:  10.1111/j.1365-2567.2008.02821.x

3.      Arnason BG: Long-term experience with interferon beta-1b (Betaferon) in multiple sclerosis.  Journal of Neurology 2005;252(Suppl 3):iii28

4.      Dermot Gleeson, Michael A. Heneghan. British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis. Gut, 2010 doi:10.1136/gut.2010.235259

5.      Galley HF, El Sakka NE, Webster NR, Lowes DA, Cuthbertson BH. Activated protein C inhibits chemotaxis and interleukin-6 release by human neutrophils without affecting other neutrophil functions. Br J Anaesth2008;100: 815 –9

6.      Gerards AH et al: Cyclosporine A monotherapy versus cyclosporine A and methotrexate combination therapy in patients with early rheumatoid arthritis: A double blind randomised placebo controlled trial.  Annals of the Rheumatic Diseases  2003;62:291.

7.      Goodman & Gilman’s. Manual of Pharmacology and Therapeutics, Professor of Pharmacology & Medicine University of California, 5^th ed. San Diego LaJolla, California 2008; 262-279.

8.      Gottstein R, Cooke RW. Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn. Arch Dis Child Fetal Neonatal Ed. 2003;88:F6-10

9.      Janeway C et al: Immunobiology: The Immune System in Health and Disease, 6th ed. Current Biology Publications, 2005.

10.  Jolles S et al: Clinical uses of intravenous immunoglobulin.  Clinical and Experimental  Immunology 2005;142:1.

11.  James M. Ritter, Lionel D. Lewis, Timothy GK. Mant and Albert Ferro. A textbook of Clinical Pharmacology and Therapeutics 5^th ed. London, 2008; 399-407

12.  Katzung GB, Trevor JA. Basic and Clinical Pharmacology 11^th edition. 2009; 363-435.

13.  McMurray RW, Harisdangkul V: Mycophenolate mofetil: Selective T cell inhibition. The  American Journal of Medical Science. 2002 Apr;323(4):194-6.

14.  Poiret et al.; Reduced plasma levels of soluble interleukin-7 receptor during graft-versus-host disease (GVHD) in children and adults. BMC Immunology 2014, 15:25  doi:10.1186/1471-2172-15-25

15.  Rang HP and Dale MM. Rang and dale Pharmacology. 6^th edition. Churchill Livingestone Elsevier 2007; 481-488, 538-541

16.  ten Oever et al.; The discriminative capacity of soluble Toll-like receptor (sTLR)2 and sTLR4 in inflammatory diseases. BMC Immunology 2014, 15:55  doi:10.1186/s12865-014-0055-y

17.  U.S. Patil, A.V. Jaydeokar, D.D. Bandawane. Immunomodulators: A pharmacological review. International Journal of Pharmacy and Pharmaceutical Sciences, vol 4, suppl 1, 2012 

Abstract:

This paper is a clinical as well as diagnostic description of the presentation, investigation and pharmacological management of an 18-year-old young woman with first episode of mental illness; and recently diagnosed pituitary microadenoma (prolactin secreting type).

It brings to light the possible role of prolactin in the development of psychosis, the treatment difficulties commonly encountered in the choice of antipsychotics and / dopamine agonists and the need for an interdisciplinary team approach when patients presents with such complex symptoms.

References:

1.      Brom, S. and Barraclough, B. “Causes of the excess mortality of Schizophrenia”. British Journal of Psychiatry, vol. 177, pp.212-217, 2000.

2.      Boyd, A. “Bromocriptine and psychosis- a literature review”, Psychiatric Quarterly, Vol 66, No 1, pp. 87-93, 1995.

3.      Chang, S.C., Chen, C.H., and Lu, M.L. “Cabergoline-induced psychotic exacerbation in schizophrenia patients”. General Hospital Psychiatry, Vol 30, No 4, pp. 378-380, 2008.

4.      Dunkley, M.J., and Reveley, M.A. “Successful treatment of refractory schizophrenia with combined olanzapine and quetiapine in a patient with a prolactin secreting pituitary microadenoma”. Journal of psychopharmacology, Vol 19, 1, pp 97-104, 2005.

5.      Frye, P.E., Parise, S.F., Kim, M.H. and O’Shaughnessy, R.O. “Bromocriptine associated with symptoms exacerbation during narcoleptic’s treatment of Schizo- affective Schizophrenia”. Journal of Clinical Psychiatry, Vol. 43, No 6, pp 252-253, 1982.

6.      Gtrome, L. “Current guidelines and their recommendations for prolactin monitoring in psychosis”. Journal of psychopharmacology, Vol. 22, No 2, pp 90-97, 2008.

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14.  Sigma, M. and During, K. “Treatment complexities of a young woman suffering psychosis and pituitary Adenoma”. Case report in psychiatry, Vol. 2011.

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Abstract:

BACKGROUND

Clinical trial monitoring is broadly based on protecting the rights and the well-being of the human research subjects, overseeing the progress of the trial, and ensuring that the trial is conducted in compliance with the applicable regulations, SOPs and study documents ^[1]. The systematic application of the recently introduced Risk Based Monitoring (RBM) technique is facilitating a collaborative vigilance approach, and a new definition of clinical trial monitor is evolving. A clinical trial monitor no longer seems to be a single entity but a group of people from cross functional teams that share joint accountability for overall data monitoring and quality governance framework.

OBJECTIVE

To explore the evolving role of a clinical trial monitor and other key study team members in the Risk Based Monitoring landscape.

METHOD

A literature search was conducted, followed by several discussions and brain storming sessions with key functional study team members currently working in the RBM pilot trials. Some limitations with this methodology were a lack of available literature specific to the topic under study, as well as the lack of sufficient industry experience in the implementation of the RBM practices at present.

CONCLUSION

Conventional monitoring was based mostly on data review in silos by the monitors. RBM and the associated technologies have created an opportunity to assess the study and center specific risks at each level of the data hierarchy by the appropriately qualified study team members for a continuous governance of clinical study data. The roles and responsibilities of these core study team members are continuously shifting and it is likely that this shift, along with training and continuous adaptation, will re-define the face of a clinical trial monitor while also leveraging the quality of clinical trial outcomes overall.

References:

1.      Clinical Trials Transformation Initiative. Effective and efficient monitoring as a component of quality. Available at: https://www.ctti-clinicaltrials.org/project­topics/study-quality/effective-and-efficient-monitoring-as-a-component-of-quality. Accessed July 7, 2014.

2.      Cognizant. Risk-Based Monitoring Strategies for Improved Clinical Trial Performance. Available at: http://www.cognizant.com/InsightsWhitepapers/Risk-based-Monitoring­Strategies-for-Improved-Clinical-Trial-Performance.pdf. Accessed Oct 3, 2014.

3.      E6 Good Clinical Practice: Consolidated guidance for the industry, April 1996. Available at: http://www.fda.gov/downloads/Drugs/Guidances/ucm073122.pdf. Accessed Oct 2, 2014.

4.      European Medicines Agency. Reflection paper on risk based quality management in clinical trials. Available at: http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2013/11/WC500155491.pdf. Accessed Jul 29, 2014.

5.      Food and Drug Administration. Guidance for Industry: Oversight of Clinical Investigations — A Risk-Based Approach to Monitoring. Available at: http://www.fda.gov/downloads/Drugs/.../Guidances/UCM269919.pdf. Accessed Jul 07, 2014.

6.      Kumar P; Dalal, J; Jadhav, M Risk Based Monitoring-Current Challenges with Implementation. Postdoc Journal, Vol.2, No.11, November 2014. Available at: http://www.postdocjournal.com/file_journal/762_18921190.pdf. Accessed Nov 21, 2014.

7.      Morrison B, Cochran C, Giangrande J, et al. 2011. Monitoring the Quality of Conduct of Clinical Trials: A Survey of Current Practices. Clinical Trials, 8:342–349.

8.      PMDA. Basic Rules of the Risk-Based Approach to Monitoring Clinical Trials. Available at: http://www.dmb-asso.org/wp­content/uploads/2014/02/JapanGuidanceforRBMJuly2013.pdf. Accessed October 10, 2014.

9.      Quintiles. The Role of Data Management in Risk-Based Monitoring: A Critical Element in Data-driven Trials. August 2014. http://www.youtube.com/watch?v=SsDQ952rSBw. Assessed July 22, 2014

10.  Stokols D, Hall KL, Taylor BK, Moser RP (2008). "The science of team science: overview of the field and introduction to the supplement." Am J Prev Med 35 (2 Suppl): S77–89. Doi: 10.1016/j.amepre.2008.05.002. PMID 18619407

11.  TransCelerate Biopharma Inc. Position Paper: Risk-Based Monitoring Methodology, September 2013. http://www.transceleratebiopharmainc.com/rbm-resources/

Abstract:

The aim of this study is to identify ethical issues and challenges in clinical research in India. This study provides clear picture of special ethical issues in clinical research such as conflict of interest, post trial access to investigational product and use of placebo. We examined clinical research professional perceptions on those issues.

Individuals (N=385) working in field of clinical research in India have participated in the study. This study involves self administered survey research for collection of data and information from participants through their responses. The survey questionnaire was validated by colleagues and guides and experts in the field. The survey elicited responses based on general experience and opinions of clinical research professionals. Participants were given the option to complete the survey on the internet. Surveys completed via the internet were stored in Microsoft excel. For data analysis SPSS software have been used and descriptive analysis have been conducted.

A total of 389 surveys were received, of which 385 were considered complete and used for this analysis. The respondents were from India, currently working in clinical research field. Demographic information pertaining to respondents such as education, type of organization age, experience etc have been collected, whether they had ethics training ever, and if yes which type of training they had. The data shows that majority have responded that they are not favouring post trial access to investigational product or it is not ethical. Further to that, participants were asked to select reasons for their opinion on post trial access to investigational product. If participant believes that post trial access to investigational drug is ethical, they have selected applicable reasons for their opinion. Majority of respondents favour use of placebo in clinical trials in general. If participant is favouring the use of placebo, further they have provided their opinion on possible steps to be taken care of in placebo controlled trial. Participants has been asked to rate the factors which can promote or causes conflict of interests in clinical trials. As per data, financial gain is the most affecting factor causing conflict of interests. Comparing responses employer wise, CROs, ECs and Study sites are rating “recruitment target” more than sponsors. The data shows that industry influence, patent or other commercial benefits are not highly affecting.

KEY WORDS

Placebo, Conflict of interest, post trial access, ethics

References:

1.      Adequate and well-controlled studies. Code of Federal Regulations, 21 Part 314.126. Revised as of 1 April 2000. Washington, DC: U.S. Government Printing Office; 2000.

2.      Amery W, Dony J. A clinical trial design avoiding undue placebo treatment. J Clin Pharmacol. 1975;15:674-.9.

3.      Benatar SR, Fleischer T. Ethical and policy implications of clinical drug trials conducted in developing countries. Harvard Health Pol Rev. 2005;6(1):97-105.

4.      Council for International Organizations of Medical Sciences (CI- OMS), in collaboration with the World Health Organization (WHO). International Ethical Guidelines for Biomedical Research Involving Human Subjects. CIOMS, Geneva; 2002.

5.      Cohen M, O’Neill M, Joffres M, Upshur G, Mills E. Reporting of informed consent, standard of care and post-trial obligations in global randomized intervention trials: a systematic survey of registered trials. Dev World Bioeth. 2008;9(4):74-80.

6.      Ethical and policy issues in research involving human participants. Vol. 1. Bethesda, Md.: National Bioethics Advisory Commission, August 2001. https://bioethicsarchive.georgetown.edu/nbac/human/overvol2.html, accessed on 20 Sep 2014.

7.      Ellenberg S, Temple T. Placebo-controlled trials and active-control trials in the evaluation of new treatments. Part 2: Practical issues and specific cases. Ann Intern Med. 2000;133:464-70.

8.      Ezekiel J. Emanuel, Ending Concerns About Undue Inducement, 32 J.L. MED. & ETHICS 100 (2004) (Abstract).

9.      Grady C. Ethics of international research: what does responsiveness means? Ethics J Am Med Assoc. 2006;8(4):235-40.

10.  Hillman J, Joseph A, Mabel R, Sunshine H, Kennedy D, Noelher M. Frequency and costs of diagnostic imaging in office practice: a comparison of self referring and radiologist referring physicians. N Engl J Med 1990;323:1504-8.

11.  Helen Frankish, WVMA Postpones Decision to Amend Declaration of Helsinki, 362 THE LANCET 963 (2003) (Abstract).

12.  International Conference on Harmonization: choice of control group in clinical trials. Federal Register. 1999;64:51767-80.

13.  Jones B, Jarvis P, Lewis A, Ebbutt F. Trials to assess equivalence: the importance of rigorous methods. BMJ. 1996;313:36-9. 32. Martin T, John D, Reynolds M, Andrew M, Henry M, When placebo controlled trials are essential and equivalence trials are inadequate. BMJ. 1998;317:875-80.

14.  Jintanat Ananworanich et al., Creation of a Drug Fund for Post-Clinical Trial Access to Antiretrovirals, 364 THE LANCET 101 (2004) (Abstract).

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Abstract:

BACKGROUND

Promoting clinical research is important, considering the shortage of clinical investigators and the increasing need for large number of multicenter studies. Participation of clinical Investigators in research is crucial to achieve this goal. Saudi Arabian provinces have infrastructure to promote the research activities. But that is not the case, as the growth of the clinical industry is sluggish as compared with the other MENA region. The objective of this study was to explore attitudes of clinical investigators towards the conducting of clinical trials in Saudi Arabia and the barriers faced by them.

METHODS

A questionnaire based survey was administered to 100 Clinical researchers from different therapeutic background that has clinical research experience at least one or above. The survey was carried out in various hospitals from different province Saudi Arabia. It consisted of questions/ statements on previous research experience, interests and barriers. Responses were either Yes/No answers or graded according to the 5-point Likert scale.

CONCLUSIONS

The majority of Clinical Researchers working at therapeutic department of various academic hospitals were interested in conducting research. But the lack of time, financial compensation and encouragement were perceived as significant barriers.

KEYWORDS

Saudi Arabia, Perception, Barrier, Financial compensation

References:

1.      Available at https://clinicaltrials.gov/ct2/search/map/click?map.x=471&map.y=193. Accessed on 8^th October 2014.

2.      E6 Good Clinical Practice: Consolidated Guidance, April 1996. Available at www.fda.gov/downloads/Drugs/Guidances/ucm073122.pdf Accessed on 8^th October 2014.

3.      Lowe B, Hartmann, Wild B et.al. Effectiveness of a 1-year resident training program in clinical research: a controlled before-and-after study. J Gen Intern Med; 2008, 23(2):122-8.

4.      Rani Abraham. MENA: The Dawn of a New Era. Applied Clinical Trials Online, April 1, 2011.

5.      Sherman HB, McGaghie et.al. Teaching pediatrics residents how to obtain informed consent. Acad Med; 2005, 80(10 Suppl):S10-3.

Abstract:

Blended learning (face-to-face plus online learning) is now part of the learning landscape in Higher Education, not just for campus-based courses but also for courses designed for students studying at a distance (Distance Education). This paper focuses on exploring blended learning as an approach to the teaching and learning of mathematics in Higher Education. Its provide insight and understanding of current and future trends regarding how conventional face-to-face instruction in mathematics is influenced by web-based/computer-supported learning. Practical pedagogical issues related to mathematics and blended learning in Higher Education are also discussed. The researcher recommends that higher institutions could utilize blended learning environment such as WebCT in the teaching and learning of mathematics in Higher Education.

KEYWORDS

Blended learning environment, Higher education, Mathematics, WebCT.

References:

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2.      Albano, G. (2012). Mathematics education: teaching and learning opportunities in blended learning. Retrieved on 06/07/13 from www.igi-global.com/chapter/mathematics-education-teaching-learning-opportunities/57934

3.      Albano, G., & Maresca, G. (2010). A blended learning course in mathematics education: a case study. Proceedings of the 7^th PAN-Hellemi Conference with International Participant (ICT Education). 1(1), (pp. 245-252).

4.      Azizan, F. Z. (2010). Blended learning in higher education institution in Malaysia. Proceedings of Regional Conference on Knowledge Integration in ICT.

5.      Boyle, T., Bradley, C., Chalk, P., Jones, R., & Picard, P. (2003). Using blended learning to improve student success rates in learning to program. Journal of Educational Media, 28(2-3), (pp. 102-178). DOI: 10.1080/135816503200015316

6.      Chin, P. (2003). Virtual learning environment: learning and teaching support network. LTSN Physical Sciences Centre, Available on www.physsci.Itsn.ac.uk

7.      Downes, S. (2010). Learning networks and connective knowledge. In H. H. Yang & S. C. Yuen, Collective intelligence and e-learning 2.0: implication of web-based communities and networking, (pp.1-26). Retrieved on 03/07/2013 from www.igi-global.com/chapter/learning-networks-connective-knowledge/37067 DOI: 10.4018/978-1-160566-729-4

8.      Dziuban, C., Hartman, J., Juge, F., Moskal, P.& Sorg, S.(2006). Blended learning enters the mainstream. In C. J. Bonk & C. R. Graham (Eds), Handbook of blended learning: global perspectives, local designs, (pp. 195-208). San Francisco, CA: Pfeitter.

9.      Garrison, D. R., & Vaughan, N. D. (2004). Blended learning in higher education: framework, principles, and guidelines. San Francisco, CA: Jossey-Bass.

10.  Groen, L., & Carmody, G (2005). Blended learning in a first year mathematics subject. Proceedings of Uniserve Science Blended Learning Symposium, (pp.50-55). Retrieved on 24/09/14 from www.uniserve.edu.au/pubs/procs/wshop10/2005Groen.pdf

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Abstract:

This paper intends to give an introduction how to test vulnerabilities. This is based on the OWASP testing guide or an audit approach and concepts used by penetration testers testing in a web environment. Our main disciplines automating a simple guide testing algorithms were developed. Each corresponds to two methods of algorithms of this guide, the algorithms were run on a non-automated process. So, with this work we want to give facilities present or also give more tools for complex tests. Tests were performed in a prepared with errors, such as broken OWASP Web Application Project environment.

KEYWORDS

OWASP, Test Guide, Pentester, XSS, IT Security

References:

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5.      FFIEC, Federal Financial Institutions Examination Council; Authentication in an Internet Banking Environment; http://www.ffiec.gov/pdf/authentication_guidance.pdf; Access:Jan.2014

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Abstract:

Growth of firms, their improvement, efficiency and profitability are cardinal benefits expected from mergers and acquisitions (M&A). This research is an attempt to seek for the effects of mergers and acquisitions on the performance of firms in the Ghanaian Stock Market from 2002 to 2012. The study was accounting based and used univariate analysis with t-testing as well as panel data methodology for the analysis. The univariate analysis revealed dwindling profitability after the merger for all the firms with the t-test showing significant difference in profitability before and after merger. The evidence from panel methodology indicates that M&A has significant negative effect on the profitability of firms. It is therefore imperative that M&As are properly planned, executed and evaluated. Specifically, efforts should be made to attract and retain key personnel of the merged firms through performance contracts or bonuses, proper conflict resolution measures should be put in place and conscious effort made to reap the expected returns of the merger. This is because gains from mergers and acquisitions do not just occur. Additionally, our results indicate that risk and firm size have a considerable effect on profitability of firms while debt capital and firm growth enhance firm profitability.

KEYWORDS

Merger and Acquisition, Profitability, Ghana

References:

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10.  Choi, J. and Russell J., (2004). Economic Gains around Mergers and Acquisitions in the Construction.

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53.  Yeh, T. and. Y. Hoshino, (2002). Productivity and Operating Performance of Japanese Merging Firms: Keiretsu-Related and Independent Mergers, Japan and the World Economy 14, pp. 347-366.

Abstract:

The aim of the study was to see the relationship between organizational role stress and job satisfaction in public and private bank employees. It was hypothesized there would be a relationship between organizational role stress and job satisfaction in public and private bank employees. The sample comprised of 150 managers, operation managers and cashiers (M age=33. 9, SD=6. 15) selected from different public and private banks of Lahore. Perceived Stress Scale (Cohen, Mermelstein & Kamarck, 1983) and Job Satisfaction Survey (Spector, 1994) were used to measure role stress and job satisfaction. Results demonstrated a significant negative relationship between organization role stress and job satisfaction. The results of the current study will help in diminishing stress related to role (job) of bankers and promoting job satisfaction in them which would increase their productivity.

KEYWORDS

 Role stress, Job Satisfaction, Employees of banking sector

References:

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Abstract:

This study investigated knowledge, attitude and practice toward premarital/prenatal genetic testing among young people of 15-45years of age in Sapele Local Government Area in Delta State Nigeria. Descriptive survey research design was used. The population of the study consisted of the members of four major communities (Amukpe, Amuogoddo, Okirighwe and Uguanja). The respondents were selected by simple random sampling method. The research instrument was a self-constructed questionnaire. A total of 50 respondents were selected. A total 50 questionnaire were distributed and same retrieved. The objectives of the study were to determine level of knowledge of premarital/prenatal genetic testing among young people, to assess the level of practice and to identify factors influencing their attitude towards premarital/prenatal genetic testing. The rational is to enhance young people’s knowledge about premarital/prenatal genetic testing, encourage premarital/prenatal genetic screening and also reduces some of the factors influencing attitudes of young people towards premarital/prenatal genetic testing. Data collected were analyzed using frequency and percentages and were presented using tables and graphs. The study shows that 30% of the respondent level of knowledge of premarital/premarital genetic testing is of high level, 70% of the respondents have low level of knowledge and the source of information was through media (20%), health personnel (40%), friends (6%) etc. The study also showed that the level of practice is low as 80% of the respondent does not practice premarital/prenatal genetic testing, only 20% practiced it. it also shows that there are some factors influencing their attitudes towards premarital/prenatal genetic testing which include lack of knowledge (66%), non affordability (20%), non Accessibility (55) and also as a result of non availabilities of centers (15%) where premarital/prenatal genetic testing should be carried out. In conclusion, lack of basic knowledge, negative attitude and practice has a negative impact on the young people, their family, their community and the society as a whole. It is therefore recommended that effort should be made by government, parents, and health personnel to improve knowledge, attitude and practice towards premarital/prenatal genetic testing thereby reducing the incidence rate of having children with genetic defect.

References:

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8.      Boss, B.K (2012): Elevated Maternal Serum Alpha-Fetoprotein (MSAFP): Interpretation and Follow-up. In R. M. Pitkin. Jr. & J. R. Scott (eds), Clinical Obstetrics and Gynecology. 31. 293-205.

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34.  Marteeau, T. M. (2009). Psychological Costs of Screening. British Medical Journal, 299, 527.

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Abstract:

This study was on perceived effects of pregnancy on the academic performances of female nursing students in Imo State University, Owerri, Imo State. Nigeria. The objectives of this study was to determine the level of awareness of challenges of pregnancy on the academic performance of nursing students, types of academic challenges due to pregnancy and the effects of pregnancy on the academic performance of nursing students in IMSU. Three research questions were formulated to guide the work. Literature was reviewed based on the objectives. A descriptive survey design was used in which 62 respondents were selected using census survey. Questionnaire was used to collect data that was analyzed using frequency, percentages and charts. Pilot study was conducted and reliability coefficient of 0.8 was obtained. The study revealed that 50 (80.6%) of the pregnant nursing students are aware of the challenges of pregnancy on academic, the students experience challenges such as physical discomfort in 24(38.7%), reduced concentration span in 17(17.7%) and missing of lectures in 53 (85.5%). These affect their academics as they result in (30.6%) absenteeism, (27.4%) low academic performance, (24.2%) difficulty adjusting to motherhood as pregnant students and (17.7%) rewriting of courses.

Conclusion was drawn based on the findings. Recommendations and suggestions were made for further studies were made.

References:

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2.      Bhana, D, Morrefl, R., Shefer, T. and Ngabaza, S. (2010). South Africa teachers responses to teenage pregnancy and teenage mothers in school. Culture, Health and Sexuality, 12 (8):871-883.

3.      Bruggerman, P.,M.(2005). Andragogy and aural rehabilitation. New York: pergamm

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9.      Effie, D.,S. (2011). The impact of pregnancy and child care responsibilities on academic performance among school going mothers. Retrieved from http://handle.net)

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15.  Kerra, M.,& Lee, M. (2012). Human capital consequence of teenage bearing in South Africa. Population Research bureau. www.prb.org

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Abstract:

The elderly generation, coexists with the rest of the population of the world (Jared T. Scott 2010).They suffer a great deal of several kinds of pain including lower back pain. In most cases this condition in the elderly is not managed by use of nursing interventions rather managed with other medical remedies, and yet the client spend most of their times with nurses, than, other health workers. This case study addressed the gap that could be filled by nurses by using innovative means in nursing to relieve pain of lower back in the elderly by ideal assessment then given specified nursing interventions to a specific individual, so as to avoid disabilities. Sackett et al (2000).

Conclusion: Disabilities in elderly related conditions can be assessed and managed by nursing intervention hence preventing disabilities in the geriatric patients.

Recommendations: Nurses needs to be trained with more contemporary skills in assessing LBP, suggesting that the knowledge of nurse with higher qualification is paramount to meet the fourth coming challenges in the management of the elderly with LBP.

References:

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Abstract:

OBJECTIVE

Mental health disorders are prevalent in HIV-infected populations, ranging from 43-56%, compared to about 30% of the general population. This comorbidity may exacerbate the progression to HIV/AIDS by increasing viral load, reducing CD4 count, and reducing adherence to ARVs. Despite the well established relationship between mental health and HIV/AIDS, and the World Health Organization (WHO) recommendation that attention to the psychosocial needs (which includes the prevention and treatment of mental health problems) of people with AIDS should be an integral part of HIV care, mental healthcare is yet to be integrated into primary care HIV treatment programmes in South Africa and other poor resource countries.

DESIGN AND PROCEDURE

The Rorschach inkblot test was conducted on a convenience sample of four South African HIV positive participants. Furthermore, a situational analysis was conducted from 2011-2013 to determine the context of mental health/HIV services in the Tshwane-Metsweding area, South Africa.

RESULTS AND RECOMMENDATIONS

Outcomes suggest that there is a high rate of psychological comorditity in HIV infected individuals (such as mood disorders, personality disorders etc.), that there is a need to further develop and pilot test appropriate materials and models of delivery of mental healthcare within the parameters of affordability, acceptability and availability, and to advocate for the advancement of mental health and HIV policy integration.

KEY TERMS

HIV, AIDS, mental health, South Africa, Rorschach inkblot test, systems strengthening, policy advancement

References:

1.      Adewuya, A. O., Afolabi, M. O., Ola, B. A., Ogundele, O. A., Ajibare, A. O. & Oladipo, B. F. (2007). Psychiatric disorders among the HIV-positive population in Nigeria: a control study. Journal of Psychosomatic Research, 63: 203-206.

2.      American Psychiatric Association. (2013). Diagnostic and statitical manual of mental disorders (5^th ed.). American Psychiatric Publishing: Washington, DC.

3.      Atkinson, J. H. & Grant, I. (1994). Natural history of neuropsychiatric manifestations of HIV disease. Psychiatric Clinics of North America, 17: 17-33.

4.      Berkman, L.F., Blumenthal, J., Burg, M., Carney, R.M., Catellier, D., Cowan, M.J., Czajkowski, S.M., DeBusk, R., Hosking, J., Jaffe, A., Kaufmann, P.G., Mitchell, P., Norman, J., Powell, L.H., Raczynski, J.M. & Schneiderman, N. (2003). Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA, 289: 3106-16.

5.      Burnam, M. A., Bing, E. G., Morton, S. C., Sherbourne, C., Fleishman, J. A., London, A. S., Vitiello, B., Stein, M., Bozzette, S. A. & Shapiro, M. F. (2001). Use of mental health and substance abuse treatment services among adults with HIV in the United States. Archives of General Psychiatry, 58: 729-736.

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8.      Collins, P. Y., Berkman, A., Mestry, K. & Pillai, A. (2009). HIV prevalence among men and women admitted to a South African public psychiatric hospital. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, 21: 863-867.

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13.  Glassman, A.H., O'Connor, C.M., Califf, R.M., Swedberg, K., Schwartz, P., Bigger, J.T., Krishnan, K.R., Van Zyl, L.T., Swenson, J.R., Finkel, M.S., Landau, C., Shapiro, P.A., Pepine, C.J., Mardekian, J., Harrison, W.M. &Barton, D. (2002). Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA, 288: 701-709.

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15.  Katon, W.J., Von Korff, M., Lin, E.H., Simon, G., Ludman, E., Russo, J., Ciechanowski, P., Walker, E. &Bush, T. (2004). The Pathways Study: a randomized trial of collaborative care in patients with diabetes and depression. Archives General Psychiatry, 61:1042-1049.

16.  Laperriere, A., Ironson, G.H., Antoni, M.H., Pomm, H., Jones, D., Ishii, M., Lydston, D., Lawrence, P., Grossman, A., Brondolo, E., Cassells, A., Tobin, J.N., Schneiderman, N. &Weiss, S.M. (2005). Decreased depression up to one year following CBSM+ intervention in depressed women with AIDS: the smart/EST women’s project. Journal of Health Psychology, 10:223-231.

17.  Lechner, S.C., Antoni, M.H., Lydston, D., LaPerriere, A., Ishii, M., Devieux, J., Stanley, H., Ironson, G., Schneiderman, N., Brondolo, E., Tobin, J.N. &Weiss S. (2003). Cognitive-behavioral interventions improve quality of life in women with AIDS. Journal of Psychosomatic Research, 54:253-261.

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22.  Mast, T. C., Kigozi, G., Wabwire-mangen, F., Black, R., Sewankambo, N., Serwadda, D., Gray, R., Wawer, M. & Wu, A. W. (2004). Measuring quality of life among HIV-infected women using a culturally adapted questionnaire in Rakai district, Uganda. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, 16: 81-94.

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26.  Nakimuli-Mpungu, E., Mutamba, B., Othengo, M. & Musisi, S. (2009). Psychological distress and adherence to highly active anti-retroviral therapy (HAART) in Uganda: a pilot study. Africa Health Sciences, S1: S2-7.

27.  Olley, B. O., Gxamza, F., Seedat, S., Theron, H., Taljaard, J., Reid, E., Reuter, H. & Stein, D. J. (2003). Psychopathology and coping in recently diagnosed HIV/AIDS patients - the role of gender. South African Medical Journal, 93: 928-931.

28.  Olley, B. O., Seedat, S. & Stein, D. J. (2006). Persistence of psychiatric disorders in a cohort of HIV/AIDS patients in South Africa: a 6-month follow-up study. Journal of Psychosomatic Research, 61: 479-484.

29.  Osborn, R.L. &Demoncada, A.C. (2006). Feuerstein M. Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. International Journal of Psychiatry in Medicine, 36:13-34.

30.  Owe-Larsson, B., Sall, L., Salamon, E. & Allgulander, C. (2009). HIV infection and psychiatric illness. African Journal of Psychiatry, 12:115-128.

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35.  Rees, K., Bennett, P., West, R., Davey, S.G. & Ebrahim, S. (2004). Psychological interventions for coronary heart disease. Cochrane Database System Review; 2: CD002902.

36.  Säll, L., E Salamon, E., Allgulander, C. & Owe-Larsson, B. (2009). Psychiatric symptoms and disorders in HIV infected mine workers in South Africa: A retrospective descriptive study of acute first admissions. African Journal of Psychiatry, 12: 206-212.

37.  Saxena, S., Thornicroft, G., Knapp, M. & Whiteford, H. (2007).^a Global Mental Health 2: Resources for mental health: scarcity, inequity, and inefficiency. Lancet, 370: 878–89

38.  Stein, D. J., Chiu, W. T., Hwang, I., Kessler, R.C., Sampson, N., Alonso, J., Borges, G., Bromet, E., Bruffaerts, R., De Girolamo, G., Florescu, S., Gureje, O., He, Y., Kovess-Masfety, V., Levinson, D., Matschinger, H., Mneimneh, Z., Nakamura, Y., Ormel, J., Posada-Villa, J., Sagar, R., Scott, K.M., Tomov. T., Viana, M.C., Williams, D.R. & Nock, M.K. (2010). Cross-national analysis of the associations between traumatic events and suicidal behavior: findings from the WHO World Mental Health Surveys. PLoS One, 5: e10574.

39.  Thom, R.F.M. (2008). Depression and anxiety in HIV infected individuals attending HIV treatment facilities at various sites in South Africa: occurrence and related factors. A descriptive-analytic study. Unpublished doctoral thesis. University of Witwatersrand, Johannesburg: South Africa.

40.  World Health Organisation. (2009). Mental health systems in selected low- and middle-income countries: a WHO-AIMS cross-national analysis. Geneva: World Health Organization.

Abstract:

Efforts geared towards strengthening health systems and improving health outcomes necessitated the co-operation between developed and developing countries for long term international developmental assistance for the latter. These efforts climaxed with the signing of the United Nations millennium development goals which created a platform for the ‘injection’ of billions of dollars of donor funds, technical assistance, inter alia, into countries with great need. Accordingly, there are reflections of marked achievements towards achieving the envisaged objective(s) in recipient countries such as Nigeria. In fact, the impact of donor support for health system strengthening in Nigeria has being remarkable with funding to combat major health problems reaching unprecedented levels in recent times with improvements on certain fronts. Of such include, decrease in the prevalence of HIV/AIDS, Tuberculosis and the eradication of guinea worm, as well as capacity development and health facility infrastructural upgrades. Nevertheless, these obvious gains have not being without issues of concern hitherto. Cardinal amongst these is that not all the developmental support is reaching communities with the greatest of needs or being delivered in a manner that is proving effective. More so, are the issues of corruption, abdication of co-operate social responsibilities by the government in certain instances to donor partners, as well as the rising ‘ineptitude’ in many of the recipient communities that has fast created a climate were self-reliance is being ebbed into a place called the past. The argument therefore is that the merits and demerits of donor support for health system strengthening in Nigeria has created debates, needing further reflections thereof.

References:

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7.      Ejughemre U.J. Accelerated reforms in healthcare financing: the need to scale up private sector participation in Nigeria. International Journal of Health Policy and Management, 2014, 2(1), 1–7.

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Abstract:

Since the Alma Ata declaration of 1978, Community participation (CP) has been recognized as one of the core strategies of achieving the goals of Health for All (HFA). The benefits of CP are numerous to the communities, the health systems and Governments, This review article described the nature and dimensions of Community Participation (CP) and its role and scope in successful implementation of different components of Primary Health Care. With the near collapse of PHC system in Nigeria, health care systems had suffered with most emphasis on curative health care that does not involve inputs from the local communities. Community participation is not without challenges but most are surmountable, thus it is important to appreciate the various levels in Nigeria in order to be able to operationalize CP towards realizing of set goals and objective.

References:

1.      Curry LA¹, Alpern R, Webster TR, Byam P, Zerihun A, Tarakeshwar N et al. Community perspectives on roles and responsibilities for strengthening primary health care in rural Ethiopia. Glob Public Health. 2012;7(9):961-73. doi: 10.1080/17441692.2012.686114. Epub 2012 May 23.

2.      Choudhury SN. Holistic Modality of Participatory Interface Mechanism for Integrated Health Care in Rural West Bengal, Institute of Child Health Calcutta (Mimeo.) 1985;2(4)45-60

3.      Kironde S, Klaasen S. What motivates lay volunteers in high burden but resource-limited tuberculosis programmes? Perceptions from the Northern Cape province, South Africa. Int J Tuberc Lung Dis. 2001

4.      Mchunu GG¹, Gwele NS. The meaning of community involvement in health: the perspective of primary health care communities. Curationis. 2005 May;28(2):30-7.

5.      Preston R1, Waugh H, Larkins S, Taylor J.. Community participation in rural primary health care: intervention or approach? Aust J Prim Health. 2010;16(1):4-16.

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Abstract:

A cross-sectional study using focus group discussions with 3 different categories of key stakeholders at a riverine local government area in southwest Nigeria. The objective was to highlight the factors affecting the health of the residents in this area with the possibility of using this information to improve the health status of the people. Among the factors identified as affecting health seeking behaviour of the residents were inaccessibility either due to lack of health services or poor roads network, illiteracy, poverty and cultural or religious beliefs that are inimical to good health. Suggestion of community based social health insurance program (CBSHIP) as a means of defraying the cost of healthcare was not too acceptable to majority of the dwelllers. However, many residents still prefer patronising private hospitals instead of the public health facilities.

KEYWORDS

Riverine, Behaviour, Focus group discussion (FGD), Community based social health insurance programme (CBSHIP)

References:

1.      A rapid assessment of health seeking behaviour in relation to sexually transmitted disease; SEF/PRS/STD -GPA/WHO June1995 Draft protocol CPRC tool box Section 5, Analysing data Ondo EseOdo Local Government:  www. http://eseodolga.gnbo.com.ng/Geo+-+Ecological+Profile

2.      Understanding social determinants of health seeking behaviours, providing a rational framework for health policy and systems development; Babar T. Shaikh  ( Liverpool School of Tropical Medicine, University of Liverpool, Pembroke Place; Liverpool, UK ) Journal of Pakistan medical association

3.      U.S. Department of the Interior, U.S. Geological Survey http://water.usgs.gov/edu/earthhowmuch.html

Abstract:

The objective of this study was to assess the level of awareness amongst non doctor hospital staff in Bassa L.G.A of Kogi state on the subject of Ebola Virus Disease.

Methodology: A descriptive cross sectional study design was used. A well structured self-administered questionnaire was given to 278 consenting health staff in Bassa L.G.A selected by a multistage sampling technique comprising of clustering and simple random sampling. The results were collated and analyzed manually.

Results: A total of 278 health staff drawn from different departments completed the questionnaire. 58.2% of respondents respectively, were between the ages of 21 and 30 years and first degree holders. All the respondents have heard of Ebola Virus Disease. 83.5% heard of it from electronic media such as radio and television. 74.8% respectively knew that  it is caused by Ebola virus, can occur both in the rural and urban areas, putting on protective wears each time one visits an Ebola patient or during routine clinical work can protect one from the virus and that Ebola has no cure. 66.5% knew that everyone is at risk of contracting the disease and that confirmation is by laboratory assays. 91.7% knew that the incubation period is between 2 and 21 days, the same number knew that high fever is an early symptom. 50% of the respondents knew vomiting and bloody diarrhea as late symptoms. None of the respondents knew the location of the laboratories in Nigeria.

Conclusions: the result shows a below average awareness about Ebola virus Disease among these health workers. However, more awareness is needed in certain areas.

KEYWORDS

Ebola virus disease, Awareness. 

References:

1.      Ebola virus disease, What you should know: Nigeria centre for Disease Control and Prevention,(FMOH, Abuja) 2014.emedicine.medscape.com/article/216288.workup accessed on December 16^th 2014.

2.      Osuala E.C. (2005). Introduction to Research Methodology (3^rd Ed.).p134, Onitsha, Nigeria: Africana First Publishers Limited WHO/ Ebola virus disease-Fact sheet. Updated September 2014

Abstract:

INTRODUCTION

The World Health Organization strongly recommended test algorithm for diagnosis of Human Immunodeficiency Virus (HIV) infection. In either parallel or serial algorithms, discordance is commonly encountered and the final result has to be determined by the use of a tie breaker.

OBJECTIVE

The objective of this study is to evaluate the accuracy of HIV rapid test results resolved by tie breaker in a serial algorithm using Western Blot as gold standard.

METHODOLOGY

A total of 110 remnant samples reactive as positive by Determine but giving discordant result with Unigold were collected and retested by national (serial) algorithm from January 2013 to July 2013. Samples were collected in either plain bottles or EDTA container by staff conducting HIV rapid test and transported/stored at 2-8 degree Celsius. Samples were tested according to manufactures leaflet insert. The final result obtained with the serial algorithm was verified with Western Blot technique.

RESULT

Out of the 10 discordant results, 9 were confirmed HIV positive by serial algorithm but only 8 were confirmed positive by Western Blot technique. Thus, there was 1(11%) false positive obtained with serial algorithm. Samples that were reactive by Determine were 110 (100%), 94(85.5%) reactive for Unigold and 93(85%) reactive results with Stat Pak.

CONCLUSION

One out of every 9 HIV results resolved by tie breaker as positive is false positive. This accounts for 11%. There is need therefore to introduce further means of verifying positive results resolved by tie breaker to avoid placing patients on anti retro vial drugs wrongly and subjecting people to psychological trauma.

References:

1.      Aghokeng, A., et. al. (2009). “Inaccurate Diagnosis of HIV-1 Groupe M and O is a Key Challenge for Ongoing Universal Access to Antiretroviral Treatment and HIV Prevention in Cameroon.” PLUS One. 4.11 (2009). Accessed on 2 November 2010. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0007702

2.      Gray, R., et al (2007). “Limitations of rapid HIV-1 tests during screening for trials in Uganda: diagnostic test accuracy study.” BMJ.335.7612 (2007): 335. Accessed on 2 November 2010. <http://www.bmj.com/content/335/7612/188.full>

3.      Heneke, M. “An analysis of HIV-related law in South Africa: progressive in text, unproductive in practice.” Transnational Law & Contemporary Problems 18.3 (2009): 751. Accessed on 9 November 2010. <http://find.galegroup.com.libdb.fairfield.edu/gtx/infomark.do?&contentSet=IAC-Documents&type=retrieve&tabID=T002&prodId=AONE&docId=A211453847&source=gale&srcprod=AONE&userGroupName=a04fu&version=1.0>

4.      Lihana R.W., Ssemwanga D., Abimiku A., Ndembi N., (2012). Update on HIV 1 Diversity in Africa: A Decade in Review. AIDS Rev 14:83-10. Available [online] at http://www.aidsreviews.com/files/2012_14_2_083-100.pdf

5.      McCutchan FE, Carr JK, Bajani M, Sanders-Buell E, Harry TO, Stoeckli TC, Robbins KE, Gashau W, Nasidi A, Janssens W, Kalish ML. (1999). Subtype G and multiple forms of A/G intersubtype recombinant human immunodeficiency virus type 1 in Nigeria. Virology., 254:226-234

6.      Peeters M, Esu-Williams E, Vergne L, Montavon C, Mulanga-Kabeya C, Harry T, Ibironke A, Lesage D, Patrel D, Delaporte E. (2000). Predominance of subtype A and G HIV type 1 in Nigeria, with geographical differences in their distribution. AIDS Res Hum Retroviruses. 16(4):315-25.

Abstract:

This is a study carried out to gauge the perception of market men and women about Ebola virus disease and its transmission. It is a cross-sectional questionnaire based study, in which 126 market men and women were involved. This study became imperative going by the fact that Nigeria was just recently let off the hook of the ravages of the virus, and the government of Nigeria pellucid engagement in mass media campaign to enlighten the citizens about the symptoms and various modes of transmission of the disease, because the virus still causes serious devastation in nearby West African countries of Liberia, Sierra Leone, Guinea, and most recently Mali, and as not to make a ludicrous mistake of allowing another Ebola panic in the country.

The analysis of the data was done using IBM SPSS; descriptive statistics to get the general characteristics of the study participants. Chi-square test was used to determine the level of significance of groups of categorical variables. P values < 0.05 were considered significant.

The data analysis showed that 126 out of the 150 respondents returned the questionnaires completely filled, representing 84% of the respondents. The respondents showed a poor knowledge of animal to man mode of transmission, 20.7% of this mode chosen by the respondents is that EVD can be transmitted through the eating of well cooked meat of the known EVD infected animals. 72.3% of the respondent identified at least two man to man modes of transmission and 68.7% of the symptoms of Ebola identified include at least one of the early symptoms of EVD.

The study concluded that the knowledge shown by the respondents is mixed; there was a good knowledge of man to man mode of transmission while the knowledge of the animal to man mode of transmission is poor while that of the symptoms of the disease is average.

KEYWORDS

Ebola Viral Disease, Nigerian traders, Symptoms, Transmission.

References:

1.      Catholic Relief Service, UN Children’s Fund (2014). Study on Public Knowledge, Attitudes, and Practices Relating to Ebola Virus Disease (EVD), Prevention and Medical Care in Sierra Leone. September, 2014

2.      Centre for Disease Control and Prevention, CDC (2014). Ebola (Ebola Virus Disease): Signs and Symptoms. Nov. 2014. Retrieved from, www.cdc.gov/vhf/Ebola/symptoms/index.html

3.      Joseph Adeniran Adedeji, Joseph Akinlabi Fadamiro, Abiodun Oluyemi Adeoye (2014). Spatial Implications of Street Trading in Osogbo Traditional City Centre, Nigeria. Architecture Research. Vol.4, No1A,2014.pp 34-44. Doi:10.59326/s arch.201401.05.

4.      Leroy E.M., Kumulungui B., Pourrut X., Rouquet P., Hassanin A., Yaba P., et al.(2005). Fruits bats as reservoir of Ebola virus. Nature 2005; 438:575-576.

5.      Leroy E.M., Rouquet P., Formenty P., Souquière S., Kilbourne A., Froment J.M., et al. (2004). Multiple Ebola virus transmission events and rapid decline of central African wildlife. Science 2004;303:387-390.

6.      Leroy E.M., Epelboin A., Mondonge V., Gonzalez J.P., Muyembe-Tamfum J.J., Formenty P. (2007). Human Ebola outbreak resulting from direct exposure to fruit bats in Luebo, Democratic Republic of Congo, 2007. Vector Borne Zoonotic Dis 2009. 10.1089/vbz.2008.0167.

7.      Nkoghe D., Formenty P., Leroy E.M., Nnegue S., Obame Edou S.Y., Iba Ba J., et al. (2002). Plusieurs épidémies de fièvre hémorragique due au virus Ebola au Gabon, d'octobre 2001 à avril 2002. Bull Soc Pathol Exot 2005;98:224-229.

8.      Nkoghé D., Formenty P., Nnégué S., Toung Mvé M., Hypolite I., Léonard P., et al. (2004). Practical guidelines for the management of Ebola infected patients in the field. Med Trop 2004;64:199-204.

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Abstract:

Patient satisfaction is a multidimensional aspect, represents a vital key marker for the quality of health care. The objective of the study was to compare the level of patients’ satisfaction among public and private hospital. A cross sectional comparative was conducted in two hospitals of Morang District i.e. one public and one private hospital selected purposively. Patients discharged from different wards were selected by consecutive sampling method and exit interview was performed. The sample of study was 220. The written consent was taken before the interview. 5 points Likert scale was used for measuring patients’ satisfaction. Discharged slip was checked for the maintaining validity and Chronbach’s Alfa was calculated for ensuring reliability of tools. Coding, entry and analysis was done in SPSS version 16. A median score of 148 was used as the cutoff point for defining the level of patients’ satisfaction. Patients in public hospital were more satisfied (61.8%) than those of private hospital (37.27%) and the difference in level of satisfaction and type of hospital found to be statistically significant (p<0.001).Moreover, the patients in public hospital were more satisfied with overall cost of health services (OR=30.83, CI 95%:13.014-73.05), laboratory and registration facilities (OR=2.805, CI 95%:1.628-4.833) and other facilities of hospital (OR=8.35, CI 95%:4.31-16.196) compared to private hospitals. Patients in public hospital were more likely to be good satisfied compared to public hospital and the important reasons for this was found to be high cost of health services in private hospitals and lack of health insurance provision.

KEY WORDS

Patients Satisfaction, Comparative, Public, Private, Hospital

References:

1.      Jadoo SAA, Puteh SEW, Ahmed Z, Jawdat A. Level of patients' satisfaction toward National Health Insurance in Istanbul City-Turkey. BMC Public Health. 2012;12(Suppl 2):A5.

2.      kwesiga D. A Comparative Analysis of Client Satisfaction Among People Receiving HIV/AIDS Care from Public and Private Health Facilities in Kabale District[Internet]. 2010.[cited 2013 oct 15]Retrived from:http://docs.mak.ac.ug/sites/default/files/Kwesiga Doris.pdf

3.      Khattak A, Alvi MI, Yousaf MA, Shah SZ-u-A, Turial D, Akhter S. Patient Satisfaction–A Comparison between Public & Private Hospitals of Peshawar. International Journal of Collaborative Research on Internal Medicine & Public Health. 2012; 4(5):713-722

4.      Qadri SS, Pathak R, Singh M, Ahluwalia S, Saini S, Garg P. An Assessment of Patients Satisfaction with Services Obtained From a Tertiary Care Hospital in Rural Haryana. International Journal of Collaborative Research on Internal Medicine & Public Health. 2012; 4(5)

5.      Sharma SK, Kamra PK. Patient satisfaction with Nursing Care in Public and Private Hospitals. International Journal of Nursing Care. 2013;1(2):134-9.

6.      Tengilimoglu D, Kisa A, Dziegielewski SF. Patient satisfaction in Turkey: differences between public and private hospitals. Journal of Community Health. 1999;24(1):73-91

Abstract:

Natural disasters have affected Botswana with varying regularity and intensity. The United Nations General Assembly of 2005 (WCNDR) called upon all Governments to establish national platforms or focal points for disaster reduction, encouraging Governments to strengthen platforms were they already existed. In Botswana the National Committee on Disaster management and the National Disaster Management Technical Committee acts as the above platform. Disaster management is coordinated by the National Disaster Management Office (NDMO) which is within the President’s Office. At village and district levels, disaster committees report to the NDMO. There is no legal instrument on disaster management in Botswana but the office of the President has overall responsibility for disaster management with disaster committees at all levels. The HFA outlined 5 key priority areas that international countries agreed to adopt to build better resilience of communities to national disasters. The progress reports show that Botswana is doing well with the country’s Disaster management policy providing guidelines for all the sectors and institutional levels to implement disaster preparedness and emergency response. However the lack of budget allocations means that the NDMO is under resourced and lacks the capacity to actively engage private sector community and non – governmental organizations. Where progress has been enormous such as the awareness campaigns and training programmes coordinated by the NDMO throughout the country, there has not been tools and sufficient resources to assess effectiveness. Overall Botswana has built a good foundation that can be continually improved on to build resilience towards natural disasters as well as reducing hazards and vulnerability; ultimately reducing the disaster risks.

References:

1.      American Psychological Association (APA): Natural disaster. (n.d.). Dictionary.com's 21st Century Lexicon. Retrieved April 03, 2014, from Dictionary.com website: http://dictionary.reference.com/browse/natural disaster

2.      Botswana country report submitted to the African regional consultations on disaster reduction workshop, June 2-3, 2004, Midrand, South Africa

3.      Botswana National Risk Reduction Strategy, 2013 – 2018

4.      Botswana: National Progress Report on the Implementation of Hyogo Framework for Action 2009-2011

5.      Climate Data and weather info for every country in the World http://www.whatstheweatherlike.org/botswana/

6.      National policies and Laws – Botswana: http://limpoporak.com/en/governance/water+governance+in+the+limpopo+basin/national+policies+and+laws/botswana.aspx

7.      National Disaster management Office, Office of the President Beyond vulnerability – Towards resilience

8.      Natural Disasters and Development in Botswana: What can communities do to cushion themselves against the adverse effects of floods? Maripe K and Tapologo Maundeni, University of Botswana

9.      Small Seo Tools – Plagiarism checker http://smallseotools.com/plagiarism-checker/

10.  UNISDR – Hyogo Framework for Action http://www.unisdr.org/we/coordinate/hfa

11.  UNDP in Botswana: About Botswana http://www.undp.org/content/botswana/en/home/countryinfo/

Abstract:

As HIV rapid testing expands to non-laboratory settings, ensuring the quality and accuracy of HIV test results becomes more critical in HIV diagnosis, care and treatment. A number of tools to monitor and improve test accuracy such as hands-on workshop, liquid or dried tube specimen-based proficiency testing programs, retesting strategies, and supervisory visits have been implemented as part of a national quality assurance (QA) program in resource limited settings.

Dried Tube Specimen (DTS) is a QA tool which was developed by GAP/International laboratory Branch at CDC (Centers for Disease Control and Prevention) for monitoring and evaluating the quality of HIV testing in laboratories. It is especially adapted for use in resource limited countries because it is lyophilized and can be stored at room temperature for up to four weeks.

The standardized logbook was developed as an ongoing QA tool to monitor and evaluate the performance of the HIV testing sites, personnel competence, view testing trends and evaluate the different types of tests used. The goal of the logbook database is to capture all data from the monthly summaries and provide a detailed analysis that will identify key areas of improvement at the site, district, or national level.

References:

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3.      Bino S, Cavaljuga S, Kunchev A, Lausevic D, Kaic B, Pistol A, et al. Southeastern European Health Network (SEEHN) communicable diseases surveillance: a decade of bridging trust and collaboration. Emerging Health Threats. 2013;6 doi: http://dx.doi.org/10.3402/ehtj.v6i0.19950.

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5.      Gershy-Damet GM, Rotz P, Cross D, Belabbes EH, Cham F, Ndihokubwayo JB, Fine G, Zeh C, Njukeng PA, Mboup S, Sesse DE PhD7, Messele T, Birx DL, Nkengasong JN.

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7.      Masanza MM, Nqobile N, Mukanga D, Gitta SN. Laboratory capacity building for the International Health Regulations (IHR[2005]) in resource-poor countries: the experience of the African Field Epidemiology Network (AFENET) BMC Public Health. 2010;10(Suppl 1):S8. [PMC free article] [PubMed]

8.      McClurea K, Arbiqueb J, Rendellb A, Rizzo-Pricec P. CLSI: Building Laboratory Capacity in Africa. Clin Micro News. 2009;31(13):95–99. doi: 10.1016/j.clinmicnews.2009.06.001.

9.      Mukanga D, Namusisi O, Gitta SN, Pariyo G, Tshimanga M, Weaver A, Trostle M. Field Epidemiology Training Programmes in Africa- Where are the graduates? Human Resources for Health. 2010;8:18. doi: 10.1186/1478-4491-8-18. [PMC free article] [PubMed]

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Abstract:

BACKGROUND

This study sought to analyse the magnitude and factors associated with antiretroviral therapy defaulting using the patient electronic medical record system in Mabutsane health district.

OBJECTIVES

Objectives of the study are: to establish the factors associated with defaulting ARV and to analyse the outcomes of ARV defaulter.

METHODOLOGY

A retrospective cross-sectional survey was conducted. The target population for this research is adult clients on antiretroviral therapy registered in Mabutsane between December 2011 and December 2013. Descriptive statistics, x2 test and cross tabulation was used to analyse data.

RESULTS

Mabutsaneclinic has a defaulter rate of 11.3%. .More males (64.3%) defaulted treatment than females (35.7%). Majority 13 clients (92.9%) were on treatment for more than 1 year before defaulting.

Reasons for defaulting ART are as follow: Substances abused 42.9%, side effect of drugs 21.4%, Transport 14.3%, Work 14.3% and Religion7.1%. Mortality rate among defaulter stand at 21.4%.

No significant statistic relation between social economic variables (sex, substances abused, marriage status, and employment status) and variable defaulter was found in our study.

CONCLUSIONS

Mabutsane health district has a lower defaulter rate as compared to most of the African countries; however this rate is above the Botswana one in 2013.

No significant association between social economic variables and defaulter was found.

Factors such as substances abused, work, transport etc…have been mentioned as reasons for defaulting.

Case fatality rate among defaulters was low than what was observed in most of the Sub Saharan Africa countries.

KEY WORDS

Mabutsane has a low defaulter rate.

References:

1.      AkaluA : Reasons(2009) for defaulting from public art sites in ADDIS ABABA 2009

2.      Assefa Y, Jerene D, Lulseged S, Ooms G, Van Damme W: Rapid scale-up of antiretroviral treatment in Ethiopia: successes and system-wide effects. PLoS Med 2009, 6(4):e1000056.

3.      Bonolo PF, César CC, Acurcio FA, et al.: Non-adherence among patients initiating antiretroviral therapy: a challenge for health professionals in Brazil23.

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5.      Byakika‐Tusiime J et al. (2003). Ability to purchase and secure stable therapy are significant predictors of non‐adherence to antiretroviral therapy in Kampala, Uganda. 10th Conference on Retroviruses and Opportunistic Infections. Boston, USA. 10‐14 February 2003. Abstract no. 170.

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Abstract:

OBJECTIVE

Effect of Dietary diversity and other intervention in prevalence and determinants of anaemia amongst tea tribe adolescent girls.

DESIGN

A community based before after intervention study was conducted covering 16 tea estates of Dibrugarh District, Assam.

PROCEDURE

Variables includes socio-demographic, environmental, anthropometry, history of present and past illness, clinical examination and laboratory investigation including haemoglobin, serum ferritin, haemoglobin typing and routine stool examination and dietary survey using 24 hour recall method and food frequency questionnaire. Interventions given were dietary diversification, health promotion by monthly NHED, cooking demonstration, cooking competition and kitchen garden promotion and counselling to improve IFA compliance and remove barriers and directly observed weekly IFA supplementation. SPSS and EpiInfo software, used to calculate of rates, ratios, chi-square test, Fisher Exact test and multiple logistic regression analysis.

RESULTS

Enrolments were 802, with mean age, 14.8 years. Anaemia prevalence was 96.3% with median serum ferritin, 22.9 ng/ml. Prevalence of Sickle cell anaemia was,12% and helminthiasis 84.20%, night blindness (5.6%), weakness (62.1%), loss of appetite (37.5%), gum bleeding (23.6%), loose motion (13%), loss of weight (9.9%), menstrual problem (19.3%) was common. Following intervention mean haemoglobin difference was 1.48 gm/dl with 13.5% difference in prevalence. Significant association found with worm infestation, lower serum ferritin, insanitary water-sanitation facility and extra salt use, indicating infection, infestation and iron deficiency as major cause of anaemia. Dietary diversification found effective.

CONCLUSIONS

High anaemia prevalence requires urgent attention. Implementation of different intervention in an integrated manner was found effective.

KEYWORDS

Dietary diversification, Anaemia, tea tribe, adolescent girls, Iron folic acid supplementation (IFA), Assam.

References:

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