Family Medicine needs assessment: Studying the clinical work of general practitioners in Ethiopia

Background and Objective: Some universities in sub-Saharan Africa have initiated Family Medicine (FM) residency programs. This study was conducted by FM colleagues at Addis Ababa University (AAU) in Ethiopia and the University of Toronto, Canada to inform the FM residency curriculum at AAU. It was designed to determine the clinical problems that family physicians in Ethiopia may encounter.Methods: We used a mixed methods approach: Modified time-motion study and brief interviews. We observed 46 general practitioners (GPs) across ten sites in Ethiopia. Trained observers recorded time-motion data while GPs conducted their daily work. This data was supplemented by brief interviews with the GPs.Findings: Clinical encounters occupied 82% of GP work. The common symptoms were digestive-abdominal pain (21% visits), respiratory-cough (16%), and general-fever and chills (16%). The common diagnoses were infectious (22% visits), genitourinary (12%), circulatory (10%), and endocrine (10%). Challenges identified were lack of clinical resources (57% of GPs), difficulties in communication (48%) and excessive workload (33%). Most common requests were for information technology (78%) and HIV (46%) training.Conclusion: The profile of common symptoms and diagnoses indicated the competencies family physicians in the regions should have. This information will be used to develop an appropriate FM curriculum at AAU

Drop Traffic in Microfluidic Ladder Networks with Fore-Aft Structural Asymmetry

We investigate the dynamics of pairs of drops in microfluidic ladder networks with slanted bypasses, which break the fore-aft structural symmetry. Our analytical results indicate that unlike symmetric ladder networks, structural asymmetry introduced by a single slanted bypass can be used to modulate the relative drop spacing, enabling them to contract, synchronize, expand, or even flip at the ladder exit. Our experiments confirm all these behaviors predicted by theory. Numerical analysis further shows that while ladder networks containing several identical bypasses are limited to nearly linear transformation of input delay between drops, mixed combination of bypasses can cause significant non-linear transformation enabling coding and decoding of input delays.Comment: 4 pages, 5 figure

Interdroplet bilayer arrays in millifluidic droplet traps from 3D-printed moulds

In droplet microfluidics, aqueous droplets are typically separated by an oil phase to ensure containment of molecules in individual droplets of nano-to-picoliter volume. An interesting variation of this method involves bringing two phospholipid-coated droplets into contact to form a lipid bilayer in-between the droplets. These interdroplet bilayers, created by manual pipetting of microliter droplets, have proved advantageous for the study of membrane transport phenomena, including ion channel electrophysiology. In this study, we adapted the droplet microfluidics methodology to achieve automated formation of interdroplet lipid bilayer arrays. We developed a ‘millifluidic’ chip for microliter droplet generation and droplet packing, which is cast from a 3D-printed mould. Droplets of 0.7–6.0 μL volume were packed as homogeneous or heterogeneous linear arrays of 2–9 droplets that were stable for at least six hours. The interdroplet bilayers had an area of up to 0.56 mm2, or an equivalent diameter of up to 850 μm, as determined from capacitance measurements. We observed osmotic water transfer over the bilayers as well as sequential bilayer lysis by the pore-forming toxin melittin. These millifluidic interdroplet bilayer arrays combine the ease of electrical and optical access of manually pipetted microdroplets with the automation and reproducibility of microfluidic technologies. Moreover, the 3D-printing based fabrication strategy enables the rapid implementation of alternative channel geometries, e.g. branched arrays, with a design-to-device time of just 24–48 hours

Recent advances in optical fiber devices for microfluidics integration

This paper examines the recent emergence of miniaturized optical fiber based sensing and actuating devices that have been successfully integrated into fluidic microchannels that are part of microfluidic and lab-on-chip systems. Fluidic microsystems possess the advantages of reduced sample volumes, faster and more sensitive biological assays, multi-sample and parallel analysis, and are seen as the de facto bioanalytical platform of the future. This paper considers the cases where the optical fiber is not merely used as a simple light guide delivering light across a microchannel, but where the fiber itself is engineered to create a new sensor or tool for use within the environment of the fluidic microchannel

Development and collaborations of a nursing workgroup within a bilateral global medical consortium

We describe the formation of a bilateral nursing workgroup within a global medical consortium of North American and Kenyan healthcare providers and detail our collaboration to advance nursing care, education, and research to improve patient outcomes across a variety of specialties in acute care and community settings in both countries

Electrochemistry of nanozeolite-immobilized cytochrome c in aqueous and nonaqueous solutions

peer-reviewedThe electrochemical properties of cytochrome c (cyt c) immobilized on multilayer nanozeolite-modified electrodes have been examined in aqueous and nonaqueous solutions. Layers of Linde type-L zeolites were assembled on indium tin oxide (ITO) glass electrodes followed by the adsorption of cyt c, primarily via electrostatic interactions, onto modified ITO electrodes. The heme protein displayed a quasi-reversible response in aqueous solution with a redox potential of +324 mV (vs NHE), and the surface coverage (Gamma*) increased linearly for the first four layers and then gave a nearly constant value of 200 pmol cm(-2). On immersion of the modified electrodes in 95% (v/v) nonaqueous solutions, the redox potential decreased significantly, a decrease that originated from changes in both the enthalpy and entropy of reduction. On reimmersion of the modified electrode in buffer, the faradic response immediately returned to its original value. These results demonstrate that nanozeolites are potential stable supports for redox proteins and enzymes.ACCEPTEDpeer-reviewe

Profiling of dynamics in protein–lipid–water systems: a time-resolved fluorescence study of a model membrane protein with the label BADAN at specific membrane depths

Profiles of lipid-water bilayer dynamics were determined from picosecond time-resolved fluorescence spectra of membrane-embedded BADAN-labeled M13 coat protein. For this purpose, the protein was labeled at seven key positions. This places the label at well-defined locations from the water phase to the center of the hydrophobic acyl chain region of a phospholipid model membrane, providing us with a nanoscale ruler to map membranes. Analysis of the time-resolved fluorescence spectroscopic data provides the characteristic time constant for the twisting motion of the BADAN label, which is sensitive to the local flexibility of the protein–lipid environment. In addition, we obtain information about the mobility of water molecules at the membrane–water interface. The results provide an unprecedented nanoscale profiling of the dynamics and distribution of water in membrane systems. This information gives clear evidence that the actual barrier of membranes for ions and aqueous solvents is located at the region of carbonyl groups of the acyl chains

Processes used by urban black women to prepare for childbirth : a grounded theory

textWomen prepare for childbirth in a variety ways. These preparations include visits to healthcare providers, seeking information from family, friends, and the media, and attendance at childbirth classes. Documentation of birth preparation comes primarily from studies of middle class white women. Few researchers have identified or included middle class black women in their samples. Instead, research with black women often highlights pregnancy problems in low income populations. Also unexamined, except tangentially, is how the social context impacts childbirth for black women. Therefore, nursing practice knowledge lacks an understanding of the processes black women use to prepare for birthing within their social context. The aim of this qualitative study was to identify a theory that described the processes used by urban black women to prepare for childbirth. Also explored was the social context within which these processes occurred. Women in the last four months of pregnancy were recruited through churches, hair salons, newspapers, radio and internet web sites. Data were collected from five focus groups and two individual interviews (n=22). More than half the women reported income adequate for daily needs, were partnered or married, were employed, had at least a high school education and were younger than 23 years. Data analysis followed the grounded theory methods advocated by Strauss and Corbin (1998). The theory describing the processes used by the participants was weighing the impact on me. These women actively engaged in determining the best course of action for themselves. They weighed and considered advice from others, what relationships were crucial, what information was most important to them, and many other issues. Woven throughout were the importance of relationships and the social context in which the women lived. The processes used for birth preparation were divided into four, discovering pregnancy, managing pregnancy, preparing for delivery, and experiencing personal change. These processes were not sequential but represented the dynamic and constant need to assess and decide the best choices in preparing for childbirth. Building on this theory, future research should identify ways in which black women can more readily access the quality healthcare and services they so desire.Nursin

Examining adaptability of individuals in complex, virtual ecosystems

Natural ecosystems are dynamic and complex, with many being threatened by human activity. However, humans can also be at the root of a solution to this problem by developing ecosystem engineering which can be used to design, construct, modify, upgrade, repair, remediate, and maintain ecosystems. The aim of this project was to improve virtual ecosystems that can be used to increase the knowledge base for ecological engineering by studying adaptability as a factor for the success of species. This was done by analysing adaptive species in a virtual ecosystem, a computer application with which various configurations can be designed and studied in a closed environment. The virtual ecosystems used in this project represent ecosystems in general rather than any specific ecosystem, and allow for repeatable test cases to be run so that ecosystem dynamics can be studied. Adaptability was defined as the ability of an individual to adjust to a short term environmental pressure according to two factors: the adaptation speed, which is how fast an individual can respond to a change in environment, and the adaptive capacity, which is a quantitative indicator of how much the individual is able to adapt. In this project, experiments were performed to determine the effects of adaptability when applied to one aspect of individuals in an ecosystem. From the results of the experiments it was seen that the adaptation speed value could affect the success of a producer species in an ecosystem both positively and negatively. It was also found that ecosystems with both a consumer and producer species could persist longer when adaptability was incorporated into the individuals of the consumer species