CIRCUMSTANCES CONTRIBUTING TO SUICIDES AMONG PREGNANT, POSTPARTUM AND NON-PREGNANT WOMEN (15 - 54 YEARS) IN RURAL AND URBAN COUNTIES IN THE U.S., NVDRS 2003-2012

Abstract withheld upon request

Quality Assurance and Employability of Graduates in a Ghanaian University

The study examined factors important for professional success of graduates. It examined the state of graduates’ employment considering generic skills acquired during course of studentship at the Wisconsin International University College. The relevance academic programmes offered by the University College in helping graduates’ maintain their jobs was also explored. An online based questionnaire was used to tap graduates views on their employment status and factors that have made them into successful professionals. Two hundred and thirty graduates who had graduated from the University College from 2000 to 2012 completed the questionnaire. The study revealed that 84% of graduates are in gainful employment while 2.5% report they had never worked since graduation. Also 13.5% report that they are not employed at the time of completing the questionnaire. Fifty six percent of graduates are employed in the private sector with 17% occupying top management positions, 40% in mid level management positions and 14% as first line managers. Communication skills, critical thinking skills, computer skills, problem solving skills, entrepreneurial and research skills are mentioned as generic skills picked up during their training in WIUC that has helped them remain successful in their professions. Quality teaching, core course mix and quality of student workload are mentioned among others as strengths of the WIUC programmes. It was interesting to note that in spite of the weaknesses observed by graduates in facilities, support services, and WIUC’s linkages with industry, graduates are still very confident that the quality of training, of teaching and learning and the programmes WIUC offered them did prepare them adequately for the world of work

Ensuring Equitable Application of Interventions to Vulnerable Subpopulations in the Kentucky Consortium for Accountable Health Communities (KC-AHC)

Introduction: The Centers for Medicare and Medicaid Services (CMS) has funded the Accountable Health Communities (AHC) model to test whether systematically identifying and addressing the health-related social needs (HRSNs) of individuals would impact healthcare utilization and total cost of care for Medicare and Medicaid beneficiaries. Toward this effort, AHCs implement screening, referral, and community navigation services in their local areas. There are 28 CMS-funded AHCs nationwide, including the Kentucky Consortium for Accountable Health Communities (KC-AHC). Purpsoe: This study aims to assess the equity of KC-AHC model activities in three vulnerable sub-populations: dual enrollees, disabled individuals, and women. Methods: Twenty-eight primary care clinical sites across 19 healthcare organizations administered (in-person or telephonic) the AHC screening instrument from August 2018 to April 2021. Every six months, social needs positivity rates, navigation eligibility, service opted-in rates and delivery data were monitored among dual enrollees, disabled persons, and women. Subpopulations were compared to their comparisons (for example, non-dual enrollees) and to available benchmarked data. Results: All proportions of subpopulation in screened beneficiaries approximated or exceeded regional benchmarks. While needs among groups fluctuated over time, most reflected positivity rates in excess of comparisons: (1) rates among females ranged from 29.6% to 36.1%, but tended to narrow (relative to males) over time; (2) disabled individuals’ positivity rate ranged from 27.8% to 36.1% but also lessened over time compared with non-disabled counterparts; and (3) positive rates among the dually-enrolled ranged from 34.7% to 42.4%, with the disparity to non-dual enrollees remaining relatively stable. Rates of opt-in and receipt of navigation in dual enrollees and women did not show disparities. There was a persistent gap in opt-in rates between disabled and non-disabled beneficiaries, though one was not identified in receipt. Implications: Results suggest that the KC-AHC adequately screened dual enrollees, disabled individuals, and women during model implementation. The AHC Model may have helped to narrow gaps in social needs between sub-populations and comparison groups, with beneficiaries becoming better connected to community services

Bedside Nurses\u27 Perceptions of Effective Nurse-Physician Communication in General Medical Units: A Qualitative Study

Background There is a dearth of research on successful interventions to improve nurse-physician communication (NPC). An important step is identifying what matters to bedside nurses and their perceptions of effective NPC communications and actions. Methods We conducted three focus groups with a total of 19 medical unit nurses across two hospitals in one academic medical center in the United States. Using a convenience sampling strategy, five to eight nurses voluntarily participated in each focus group. The recording was transcribed verbatim and two independent coders performed coding and resolved any discrepancies in codes. Qualitative content analysis was pursued to identify themes and associated quotes. Results The presence of direct communication between physicians and nurses was identified as the first theme and perceived by nurses as very important. Additional themes related to physician communication and attributes emerged including collegiality and respect (e.g., engaging nurses as partners in patient care), attentiveness and responsiveness (e.g., listening carefully and addressing concerns), and directness and support (e.g., backing nurses up in difficult situations). Effective NPC is further facilitated by organizational structure, relationship development separate from patient care, and consistent/timely use of technology. Conclusions Hospital bedside nurses provided valuable insight into improved physician communication and what attributes contribute to more effective NPC. Most importantly, they emphasized the significance of physicians in supporting them with difficult patients

Bedside nurses\u27 perceptions of effective nurse-physician communication in general medical units: A qualitative study

Background There is a dearth of research on successful interventions to improve nurse-physician communication (NPC). An important step is identifying what matters to bedside nurses and their perceptions of effective NPC communications and actions. Methods We conducted three focus groups with a total of 19 medical unit nurses across two hospitals in one academic medical center in the United States. Using a convenience sampling strategy, five to eight nurses voluntarily participated in each focus group. The recording was transcribed verbatim and two independent coders performed coding and resolved any discrepancies in codes. Qualitative content analysis was pursued to identify themes and associated quotes. Results The presence of direct communication between physicians and nurses was identified as the first theme and perceived by nurses as very important. Additional themes related to physician communication and attributes emerged including collegiality and respect (e.g., engaging nurses as partners in patient care), attentiveness and responsiveness (e.g., listening carefully and addressing concerns), and directness and support (e.g., backing nurses up in difficult situations). Effective NPC is further facilitated by organizational structure, relationship development separate from patient care, and consistent/timely use of technology. Conclusions Hospital bedside nurses provided valuable insight into improved physician communication and what attributes contribute to more effective NPC. Most importantly, they emphasized the significance of physicians in supporting them with difficult patients

Omega-3 Fatty Acids Reduce Adipose Tissue Macrophages in Human Subjects with Insulin Resistance

Fish oils (FOs) have anti-inflammatory effects and lower serum triglycerides. This study examined adipose and muscle inflammatory markers after treatment of humans with FOs and measured the effects of ω-3 fatty acids on adipocytes and macrophages in vitro. Insulin-resistant, nondiabetic subjects were treated with Omega-3-Acid Ethyl Esters (4 g/day) or placebo for 12 weeks. Plasma macrophage chemoattractant protein 1 (MCP-1) levels were reduced by FO, but the levels of other cytokines were unchanged. The adipose (but not muscle) of FO-treated subjects demonstrated a decrease in macrophages, a decrease in MCP-1, and an increase in capillaries, and subjects with the most macrophages demonstrated the greatest response to treatment. Adipose and muscle ω-3 fatty acid content increased after treatment; however, there was no change in insulin sensitivity or adiponectin. In vitro, M1-polarized macrophages expressed high levels of MCP-1. The addition of ω-3 fatty acids reduced MCP-1 expression with no effect on TNF-α. In addition, ω-3 fatty acids suppressed the upregulation of adipocyte MCP-1 that occurred when adipocytes were cocultured with macrophages. Thus, FO reduced adipose macrophages, increased capillaries, and reduced MCP-1 expression in insulin-resistant humans and in macrophages and adipocytes in vitro; however, there was no measureable effect on insulin sensitivity. Diabetes 62:1709–1717, 201

Generation of a functional network around a single kinase highlights its involvement in unsuspected biological processes

Bioinformatics is the application of computational techniques to the field of biology. Computational techniques can be used to analyze large quantities of compiled data. The budding yeast, Saccharomyces cerevisiae, has vast biological databases that are regularly curated and easily accessible, making it an ideal system for bioinformatic analysis (Dwight 2004). In this study we constructed a ‘panoramic\u27 gene-centered network around the SPorulation-Specific gene, SPS1 (Percival-Smith and Segall 1986). Sporulation is the process by which diploid Saccharomyces cerevisiae cells survive during times of nutritional starvation. Upon induction of sporulation, meiosis occurs and is followed by de novo formation of environmentally resistant spore walls (Neiman 2011). In cells lacking SPS1, meiosis proceeds normally, but there are defects during spore morphogenesis (Friesen et al. 1994). In order to elucidate the mechanism(s) of action of SPS1, we used a number of bioinformatic applications to integrate the massive datasets that exist for the model organism with in-house generated mass spectrometry data for the protein Sps1. Using these methods we were able to functionally cluster the majority of the proteins that interact with Sps1. By doing so we generated an Sps1-centered functional network that we believe captures aspects of Sps1 function during different stages of the yeast life-cycle; the analysis of which suggested a novel role of vacuolar involvement with Sps1. We argue this type of bioinformatic analysis can be used to examine biological data independent of gene, model system, technique or assay

The Characteristics of Effective Cancer Education Media Interventions among African Americans: A Systematic Review

Cancer incidence and mortality is a significant area of health disparity between African Americans and Caucasians. In the current article the authors used a systematic review design to examine the characteristics of different cancer media education intervention (CMEI) to increase access to cancer screenings for African Americans within a 30 year period (1980–2010). Ten computerized databases were searched using inclusion–exclusion criteria. Consequently, 179 potential studies were identified, and later reduced to 41 eligible studies through the inclusion–exclusion criteria. The eligible studies had a combined sample size of N = 12,764 respondents. The findings revealed that multi-media intervention strategies were the most common media intervention that led to increased cancer screenings among African Americans. The authors conclude with a call for social workers to be more involved in developing and following up with culturally appropriate media strategies that can increase the likelihood of early detection and successful treatment, thus reducing this important area of health disparity

Chronique

Chronique. In: Annales du Midi : revue archéologique, historique et philologique de la France méridionale, Tome 51, N°203, 1939. pp. 326-332

Under-reporting of adverse drug reactions: Surveillance system evaluation in Ho Municipality of the Volta Region, Ghana.

BackgroundAdverse Drug Reactions (ADRs) can occur with all medicines even after successful extensive clinical trials. ADRs result in more than 10% of hospital admissions worldwide. In Ghana, there has been an increase of 13 to 126 ADR reports per million population from 2012 to 2018. ADR Surveillance System (ADRSS) also known as pharmacovigilance has been put in place by the Ghana Food and Drugs Authority (FDA) to collect and manage suspected ADR reports and communicate safety issues to healthcare professionals and the general public. The ADRSS in Ho Municipality was evaluated to assess the extent of reporting of ADRs and the system's attributes; determine its usefulness, and assess if the ADRSS is achieving its objectives.MethodsWe evaluated the ADRSS of the Ho Municipality from January 2015 to December 2019. Quantitative data were collected through interviews and review of records. We adapted the updated CDC guidelines to develop interview guides and a checklist for data collection. Attributes reviewed included simplicity, data quality, acceptability, representativeness, timeliness, sensitivity, predictive value positive and stability.ResultsWe found a total of 1,237 suspected ADR during the period, of which only 36 (3%) were reported by healthcare professionals in the Ho Municipality to the National Pharmacovigilance Centre (NPC). Only 43.9% of health staff interviewed were familiar with the ADRSS and its reporting channel. Staff who could mention at least one objective of the ADRSS were 34.2%, and 12.2% knew the timelines for reporting ADR. Reports took a median time of 41 (IQR = 25, 81) days from reporter to NPC. Reports sent on time constituted 37.5%. Fully completed case forms constituted 77.1% and the predictive value positive (PVP) was 20%. About 53% of ADRs were reported for female patients. Up to 88.9% of ADRs were classified as drug related. Anti-tuberculosis agents and other antibiotics constituted (40.6%) and (18.8%) of all reports. The ADRSS was not integrated into the disease surveillance and response system of Ghana's Health Service and so was not flexible to changes. A dedicated ADR surveillance officer in regions helped with the system's stability. Data from Ghana feeds into a WHO database for global decision making.ConclusionsThere was under-reporting of ADRs in the Ho Municipality from January 2015 to December 2019. The ADR surveillance system was simple, stable, acceptable, representative, had a strong PVP but was not flexible or timely. The ADRSS was found useful and partially met its objectives