Effective screening programmes for cervical cancer in low- and middle-income developing countries.

Cervical cancer is an important public health problem among adult women in developing countries in South and Central America, sub-Saharan Africa, and south and south-east Asia. Frequently repeated cytology screening programmes--either organized or opportunistic--have led to a large decline in cervical cancer incidence and mortality in developed countries. In contrast, cervical cancer remains largely uncontrolled in high-risk developing countries because of ineffective or no screening. This article briefly reviews the experience from existing screening and research initiatives in developing countries. Substantial costs are involved in providing the infrastructure, manpower, consumables, follow-up and surveillance for both organized and opportunistic screening programmes for cervical cancer. Owing to their limited health care resources, developing countries cannot afford the models of frequently repeated screening of women over a wide age range that are used in developed countries. Many low-income developing countries, including most in sub-Saharan Africa, have neither the resources nor the capacity for their health services to organize and sustain any kind of screening programme. Middle-income developing countries, which currently provide inefficient screening, should reorganize their programmes in the light of experiences from other countries and lessons from their past failures. Middle-income countries intending to organize a new screening programme should start first in a limited geographical area, before considering any expansion. It is also more realistic and effective to target the screening on high-risk women once or twice in their lifetime using a highly sensitive test, with an emphasis on high coverage (>80%) of the targeted population. Efforts to organize an effective screening programme in these developing countries will have to find adequate financial resources, develop the infrastructure, train the needed manpower, and elaborate surveillance mechanisms for screening, investigating, treating, and following up the targeted women. The findings from the large body of research on various screening approaches carried out in developing countries and from the available managerial guidelines should be taken into account when reorganizing existing programmes and when considering new screening initiatives

Simulation of Li-ion Battery using MATLAB-Simulink for Charging and Discharging

The optimization of batteries has increased in EV and HEV applications out of which Li-ion batteries are widely used for green technology applications as an energy storage system due to its high power and energy density. In electric vehicle applications, drawbacks are observed during charging interval time on the storage system. In such situations, the multi-state charging is considered to be the ideal solution. This paper tells us about the state charging of lithium-ion battery and its criteria of charging/discharging for good battery life using MATLAB Simulink tool. The state-of-charge (SOC), measured and applied for measuring charging/discharging characteristics is an important parameter for defining the performance of a battery. Thus, accurate estimation of SOC is necessary which will protect the battery and prevent its overcharging and discharging. This will also help in improving the life span of the battery. For applications requiring higher efficiency, multi-state charging is applied

Awakening the Pharmacist in You(th): The Design and Evaluation of a Pharmacy Career Awareness Program

Objectives: The Exploring Pharmacy as a Career awareness program was developed to provide a means to expose high school students to pharmacy careers and opportunities. The purpose of this study was to evaluate this program and its impact on participants. Method: A six-week long evening program was developed for high school students to raise awareness and provide opportunities to learn about the pharmacy profession. Three sessions were reserved for pharmacy career information, pharmacy school admission requirements and related pharmacy topics. The remaining three sessions were devoted to active learning opportunities; participants visited both community and institutional pharmacies and completed hands-on activities in the compounding laboratory of the School of Pharmacy. At the completion of the program, a thirteen-question anonymous survey instrument including Likert-type (1 = Low, 5 = High) and open-ended questions was administered to the participants for the purpose of program evaluation and improvement. Results: Of the 25 participants, 17 (68%) completed the survey. Participants responded positively in all question areas, with mean scores ranging from 3.47 – 4.94. Compiled data from respondents indicated their interest in the pharmacy profession increased throughout the program, increasing from 4.06 before the program to 4.41 after completion. Responses to Likert-type and open-ended questions revealed that the compounding laboratory exercises and visits to the hospital pharmacy were the program highlights. Implications: In addition to efforts to recruit qualified college students, Schools/Colleges of Pharmacy, using programs such as the Exploring Pharmacy as a Career, can stimulate primary demand for pharmacy education as well as provide a valued service to the local communit

A Continuous Professional Development Process for First-Year Pharmacy Students

Objectives. To develop, pilot test, and evaluate a continuous professional development (CPD) process for first-year pharmacy (P1) students. Design. Students and faculty members were introduced to the important elements of the CPD process via a live training program. Students completed the year-long 4-step CPD cycle by identifying a learning objective, creating a plan, completing the learning activity, evaluating their learning outcome, documenting each step, and meeting with their faculty advisor for feedback and advice. Assessment. Seventy-five first-year students (100%) successfully completed the CPD process during the 2009-2010 academic year. The students spent an average of 7 hours (range 2 to 20 hours) on the CPD process. The majority of faculty members (83%) completing the survey instrument found the process valuable for the students and would like to see the program continued. Conclusion. Integrating a CPD requirement for students in a college or school of pharmacy is feasible and valuable to students’ developing life-long learning skills. Effective and frequent training of faculty members and students is a key element in the CPD process

Awakening the Pharmacist in You(th): The Design and Evaluation of a Pharmacy Career Awareness Program

Objectives: The Exploring Pharmacy as a Career awareness program was developed to provide a means to expose high school students to pharmacy careers and opportunities. The purpose of this study was to evaluate this program and its impact on participants. Method: A six-week long evening program was developed for high school students to raise awareness and provide opportunities to learn about the pharmacy profession. Three sessions were reserved for pharmacy career information, pharmacy school admission requirements and related pharmacy topics. The remaining three sessions were devoted to active learning opportunities; participants visited both community and institutional pharmacies and completed hands-on activities in the compounding laboratory of the School of Pharmacy. At the completion of the program, a thirteen-question anonymous survey instrument including Likert-type (1 = Low, 5 = High) and open-ended questions was administered to the participants for the purpose of program evaluation and improvement. Results: Of the 25 participants, 17 (68%) completed the survey. Participants responded positively in all question areas, with mean scores ranging from 3.47 – 4.94. Compiled data from respondents indicated their interest in the pharmacy profession increased throughout the program, increasing from 4.06 before the program to 4.41 after completion. Responses to Likert-type and open-ended questions revealed that the compounding laboratory exercises and visits to the hospital pharmacy were the program highlights. Implications: In addition to efforts to recruit qualified college students, Schools/Colleges of Pharmacy, using programs such as the Exploring Pharmacy as a Career, can stimulate primary demand for pharmacy education as well as provide a valued service to the local communit

Early detection of cervical cancer with visual inspection methods: a summary of completed and on-going studies in India

India is a high-risk country for cervical cancer which accounts a quarter (126 000 new cases, 71 000 deaths around 2 000) of the world burden. The age-standardized incidence rates range from 16-55 per 100 000 women in different regions with particularly high rates in rural areas. Control of cervical cancer by early detection and treatment is a priority of the National Cancer Control Programme of India. There are no organized cytology screening programmes in the country. The technical and financial constraints to organize cytology screening have encouraged the evaluation of visual inspection approaches as potential alternatives to cervical cytology in India. Four types of visual detection approaches for cervical neoplasia are investigated in India: a) naked eye inspection without acetic acid application, widely known as 'downstaging'; b) naked eye inspection after application of 3-5% acetic acid (VIA); c) VIA using magnification devices (VIAM); d) visual inspection after the application of Lugol's iodine (VILI). Downstaging has been shown to be poorly sensitive and specific to detect cervical neoplasia and is no longer considered as a suitable screening test for cervical cancer. VIA, VIAM and VILI are currently being investigated in multicentre cross-sectional studies (without verification bias), in which cytology and HPV testing are also simultaneously evaluated, and the results of these investigations will be available in 2003. These studies will provide valuable information on the average, comparative test performances in detecting high-grade cervical cancer precursors and cancer. Results from pooled analysis of data from two completed studies indicated an approximate sensitivity of 93.4% and specificity of 85.1% for VIA to detect CIN 2 or worse lesions; the corresponding figures for cytology were 72.1% and 91.6%. The efficacy of VIA in reducing incidence of and mortality from cervical cancer and its cost-effectiveness is currently being investigated in two cluster randomized controlled intervention trials in India. One of these studies is a 4-arm trial addressing the comparative efficacy of VIA, cytology and primary screening with HPV DNA testing. This trial will provide valuable information on comparative detection rates of CIN 2-3 lesions by the middle of 2003. The expected outcomes from the Indian studies will contribute valuable information for guiding the development of public health policies on cervical cancer prevention in countries with different levels of socio-economic and health services development and open up new avenues of research