Psykososiale faktorer altruisme og arbeidsengasjement. En krysskulturell studie

This is a cross-cultural study of organisations founded in positive psychology. The samples of 289 subjects are from South Africa (91) and Norway (198). The study is a tentative mapping of psychosocial factors related to work engagement where altruism was tested as a moderating factor. There were no significant differences on the general level of work engagement for the two countries, but relating to the three subscales there were two significant differences. Work absorption was higher in the South-African sample, and the Norwegian sample was higher on vigour. The South-African population was significant higher on altruism compared to the Norwegian population, but altruism showed no direct effect on work engagement. The psychosocial factors were shown to be a variable of predictive value of 49.9 % of the variance shown in work-engagement. The most contributing single psychosocial factors related to work-engagement were emotional load, social support, role-conflict and need for recovery. There were also found interacting effects on four of the psychosocial factors related to work engagement. Neither culture nor altruism was shown to have effect on the relation between psychosocial factors and work engagement

End-user centeredness in antiretroviral therapy services in Nigerian public health facilities

OBJECTIVE: To describe the perception of end users with regard to end-user centeredness in antiretroviral therapy (ART) service provision in Nigerian public health facilities. DESIGN: A qualitative design was followed. SUBJECTS: and setting: Unstructured focus group discussions were conducted with end users (n = 64) in six locations across the six different geopolitical zones of Nigeria. OUTCOME MEASURES: Data were analysed using the framework approach and Weft QDA® version 1.0.1. qualitative data analysis software. RESULTS: The results focused on end users’ participation in their care, ranging from understanding their diagnosis, choosing from available treatment options and places, and caring for their colleagues and themselves. CONCLUSION: End-user focused ART service provision positions end users to play key roles in decision-making with regard to their care. The findings of this study will be useful for nurses and other healthcare workers when promoting end-user centeredness in ART service provision.Department of HE and Training approved lis

Regional Variation in Attitude of Mental Health Professionals Towards Tackling Illicit Drug-use and Drug-related Disorders

This study sought to assess the attitudes of Mental Health Professionals (MHPs) towards tackling illicit drug use and drug-related disorders in Nigeria and to explore regional variations in attitude. Based on the validated Substance Abuse Attitude Survey (SAAS), a quantitative cross-sectional survey was conducted in a randomized sample of 292 MHPs practicing in neuropsychiatric hospitals and mental health departments of teaching hospitals from four geopolitical zones of Nigeria. A response rate of 81.1% was achieved. MHPs tended towards non-permissive, moralistic and stereotypic spectrum and exhibited distinctly defined attitude towards their professional role. The Kruskal-Wallis analysis established significant regional variation in the attitude of multidisciplinary MHPs, H (3)=18.727, p< .0001 reflecting a stochastic domination across the region; therefore a step-down follow-up analysis was conducted. This analysis revealed that the distribution of attitude total-score varies significantly between the South-south and the Southwestern region (p< .0001), the northeastern and southwestern region of the country (p< .028). A holistic approach towards standardization of drug treatment and care that takes into consideration possible regional variation in attitudes of MHPs should be implemented to foster the reintegration and rehabilitation of drug-using populations into the mainstream society

To research (or not) that is the question: ethical issues in research when medical care is disrupted by political action: a case study from Eldoret, Kenya

While considerable attention has been focused on understanding the myriad of ethical analysis in international research in low and middle income countries, new issues always arise that have not been anticipated in guidelines or studied extensively. The disruption of medical care arising as a direct result of political actions, including strikes, postelection violence and related activities, is one such issue that leaves physician-researchers struggling to manage often conflicting professional responsibilities. This paper discusses the ethical conflicts that arise for physician-researchers, particularly when disruption threatens the completion of a study or completion is possible but at the expense of not addressing unmet medical needs of patients. We review three pragmatic strategies and the ethical issues arising from each: not starting research, stopping research that has already started, and continuing research already initiated. We argue that during episodes of medical care disruption, research that has been started can be continued only if the ethical standards imposed at the beginning of the study can continue to be met; however, studies that have been approved but not yet started should not begin until the disruption has ended and ethical standards can again be assured

Prevalence of Trachoma in Bauchi State, Nigeria: Results of 20 Local Government Area-Level Surveys.

PURPOSE: To determine the prevalence of trachomatous inflammation - follicular (TF) and trichiasis in each of the 20 local government areas (LGAs) of Bauchi State, Nigeria. METHODS: We undertook a population-based prevalence survey in each LGA in Bauchi State, employing the Global Trachoma Mapping Project methodology. We used a 2-stage, systematic and quasi-random sampling strategy. Using probability proportional to size, we selected 25 clusters, in each of which 25 households were selected by random walk. All residents of selected households 1 year and older were examined for TF, trachomatous inflammation - intense, and trichiasis, using the World Health Organization simplified grading scheme. RESULTS: Only two LGAs in Bauchi State had TF prevalences in 1-9-year-olds over 5%, with none having TF prevalences of 10% or greater. Only one LGA had a trichiasis prevalence in adults below the elimination threshold; all the others had trichiasis at levels suggestive of public health significance. In all 20 LGAs, more than 60% of households were within 1 km of an improved source of water for hygiene. CONCLUSION: Efforts need to be made in Bauchi State to provide trichiasis surgery in order to avert trachomatous blindness. Water supplies needs to be sustained and good personal hygiene practices assured so that elimination of trachoma as a public health problem will be achieved and sustained

Challenges of biobanking in South Africa to facilitate indigenous research in an environment burdened with human immunodeficiency virus, tuberculosis, and emerging non-communicable diseases

The high burden of infectious diseases and the growing problem of noncommunicable and metabolic disease syndromes in South Africa (SA) forces a more focused research approach to facilitate cutting-edge scientific growth and public health development. Increased SA research on these diseases and syndromes and the collection of associated biospecimens has ensured a plethora of biobanks created by individuals, albeit without the foresight of prospective and collective use by other local and international researchers. As the need for access to high-quality specimens in statistically relevant numbers has increased, so has the necessity for the development of national human biobanks in SA and across the Continent. The prospects of achieving sustainable centralized biobanks are still an emerging and evolving concept, primarily and recently driven by the launch of the H3Africa consortium, which includes the development of harmonized and standardized biobanking operating procedures. This process is hindered by a myriad of complex societal considerations and ethico-legal challenges. Efforts to consolidate and standardize biological sample collections are further compromised by the lack of full appreciation by national stakeholders of the biological value inherent in these collections, and the availability of high quality human samples with well-annotated data for future scientific research and development. Inadequate or nonexistent legislative structures that specifically regulate the storage, use, dispersal, and disposal of human biological samples are common phenomena and pose further challenges. Furthermore, concerns relating to consent for unspecific future uses, as well as access to information and data protection, are all new paradigms that require further consideration and public engagement. This article reviews important fundamental issues such as governance, ethics, infrastructure, and bioinformatics that are important foundational prerequisites for the establishment and evolution of successful human biobanking in South Africa.Web of Scienc

The impact of rapid malaria diagnostic tests upon anti-malarial sales in community pharmacies in Gwagwalada, Nigeria

Background Rapid diagnostics tests for malaria (RDT) have become established as a practical solution to the challenges of parasitological confirmation of malaria before treatment in the public sector. However, little is known of their impact in private health sector facilities, such as pharmacies and drug shops. This study aimed to assess the incidence of malaria among unwell patients seeking anti-malarial treatment in two community pharmacies in Nigeria and measure the impact RDTs have on anti-malarial sales. Methods This was a comparison study of two pharmacies located in the suburbs of Gwagwalada, in the Federal Capital Territory of Nigeria, between May and July 2012. In the intervention arm, patients seeking to purchase anti-malarials had an RDT performed before treatment while the control pharmacy continued normal routine practice. Results A total of 1,226 participants were enrolled into the study. The incidence of malaria in the intervention arm (n = 619) was 13.6% and adolescent participants had a statistically significant higher incidence (26.0%) compared to adults (11.9%) (P = 0.001). A history of fever in the last 48 hours was associated with a statistically significant higher incidence of malaria (28.3%) (P < 0.001). Having a RDT test reduced the chance of purchasing an anti-malarial by 42% (95% CI: 38%-46%) compared to not having a test. 51.6% (276) of the study participants with a RDT negative result still purchased anti-malarials, especially if anti-malarials had been recommended by a health professional (58.9%) compared to self-referral (44.2%) (P = 0.001). Patients with RDT negative results were also more likely to purchase an anti-malarial if there was a reported malaria positive laboratory test prior to presentation (66.2%; P = 0.007), a history of fever in the last 48 hours (60.5%; P = 0.027), and primary school education or less (69.4%; P = 0.009). After adjusting for age group and gender differences, having at least a secondary school education reduced the chance of buying an anti-malarial (OR 0.504 (95% CI: 0.256-0.993)) compared to having primary education or lower. Conclusion The study highlights the enormous potential for improving appropriate prescription of anti-malarials in pharmacies and preventing unnecessary use of artemisinin combination therapy (ACT)

Prevalence of Trachoma in Katsina State, Nigeria: Results of 34 District-Level Surveys.

PURPOSE: To determine the local government area (LGA)-level prevalence of trachoma in all 34 LGAs of Katsina State. METHODS: A population-based prevalence survey was conducted in each LGA of Katsina State, using the Global Trachoma Mapping Project methodology. We used a 3-stage cluster random sampling strategy to select 25 households from each of 25 clusters. We examined all residents of selected households aged 1 year and older for the clinical signs of trachomatous inflammation-follicular (TF), trachomatous inflammation-intense and trichiasis, using the World Health Organization (WHO) simplified grading scheme. RESULTS: We examined 129,281 persons. Six LGAs had a TF prevalence ≥10%, and another six LGAs had a TF prevalence between 5% and 9.9%; all 12 require mass drug administration with azithromycin plus other interventions. The prevalence of trichiasis was ≥1.0% in 13 LGAs, and there is a need to perform trichiasis surgery in over 26,000 persons to reach targets set by the WHO for elimination of trichiasis. CONCLUSION: The prevalence of TF is generally low in Katsina state, but urgent steps must be taken to implement the full SAFE strategy (surgery, antibiotics, facial cleanliness, environmental improvement) in at least 12 LGAs while also stepping up efforts to provide community-based trichiasis surgery throughout the whole state, in order to make trachoma elimination by 2020 a reality

Trachoma Mapping in Gombe State, Nigeria: Results of 11 Local Government Area Surveys.

PURPOSE: To determine the need or otherwise for establishment of a trachoma elimination program in Gombe State, Nigeria, by estimating the population-based prevalence of trachoma in each Local Government Area (LGA) of Gombe. METHODS: Using a multi-stage, systematic, random, and quasi-random sampling approach and Global Trachoma Mapping Project support, we selected 25 clusters in each LGA. In each cluster, we selected 25 households and all consenting residents aged 1 year and older were examined for trachomatous inflammation-follicular (TF) and trichiasis, using the World Health Organization simplified grading scheme. RESULTS: No LGA in Gombe State had a TF prevalence ≥5% in 1-9-year-olds. All LGAs had trichiasis prevalences above the elimination threshold and should be targeted for community-based delivery of trichiasis surgery. Only three LGAs had household-level improved wash water access of greater than 80%. Access to improved sanitation facilities was also poor as household access to improved sanitation facilities was above 80% in only one LGA. CONCLUSION: A trachoma program focused on delivery of trichiasis surgery is required in Gombe. Improvements in water and sanitation, through engagement with other sectors, are necessary