Evaluation of an alternative informed consent procedure for clinical trials conducted in The Gambia

Background: Comprehension of informed consent poses greater challenges to clinical trial participants in The Gambia because of low literacy and absence of standardised formats for writing the local languages. This thesis reports the development and evaluation of a locally developed informed consent tool that addresses these challenges. Objectives: 1. Develop and validate an audio digitised tool for assessment of comprehension of informed consent. 2. Develop a multimedia consent tool for Gambian research participants. 3. Evaluate acceptability and ease of use of the multimedia tool. 4. Assess the effectiveness of the multimedia tool compared to ‘standard’ consent among participants in a clinical trial. Methods: A 34-item questionnaire was developed and audio-recorded in three major Gambian languages. This was digitised and validated among clinical trial participants in Gambian urban and rural areas. The informed consent document of a malaria drug trial was developed into a multimedia tool which integrated video, animations and audio narrations in three major Gambian languages. Acceptability and ease of use of the tool were assessed using quantitative and qualitative methods. Participants in the drug trial were randomised to either receive consent information through the multimedia tool or ‘standard’ procedure. Participant comprehension was assessed using the digitised questionnaire at baseline and follow-up visits. Results: The questionnaire was deemed to be valid and reliable (Cronbach’s alpha: 0.73- 0.79). Majority of the participants (70%) reported that the multimedia tool was clear and easy to understand. Participants in the intervention arm had significantly higher comprehension scores than those in the control arm at baseline and follow-up visits. Higher comprehension scores were associated with being a male participant (p=0.03), resident in a peri-urban area (p=0.02) and having basic formal education (p=0.005). Male participants (OR = 0.29, 95% CI: 0.12-0.70, p=0.006) and living in a peri-urban area (OR= 0.33, 95% CI: 0.13-0.82, p=0.017) were independent predictors of comprehension. Survival analysis showed that participants in the intervention arm took longer time to drop to 50% of the baseline comprehension scores than those in the control arm (hazard ratio=0.22, 95% CI: 0.16-0.31). Conclusions: A customised multimedia tool was more effective in delivering consent information and sustaining participant comprehension than ‘standard’ consent procedure. Further research is needed to compare the tool with conventional consent method in other sub-Saharan Africa settings

Relationship between Viable Bacterial Counts and Physicochemical Properties of Cocoa Powders and Powdered Cocoa Beverages purchased in Nigerian Supermarkets

Cocoa powders (CPs) and powdered cocoa beverages (PCBs) are largely consumed as health and vitality drinks in Nigeria. In view of the recent reports that these food products supported bacterial growth, this study determined whether there could be definite relationship between viable bacterial counts and physicochemical properties of five brands of CPs and PCBs purchased from supermarkets in Ibadan and Lagos in South West, Nigeria. The pH and titratable acidity of the products were measured by using pH meter and colorimetric acidity titration respectively. The moisture contents were determined by drying method at 105ºC in oven and ash by mineralization at 550ºC using furnace. No definite type of relationship was established between viable bacterial counts and pH, titratable acidity (lactic acid, acetic acid), moisture and ash contents vis-à-vis powdery and granular natures of the cocoa food products. Only the two PCBs tightly packed in the polythene sachets had acceptable mean viable bacterial counts, which did not exceed 5.0 x 103 cfu/ml specified for cocoa powders in food industries. Also, only two of the five brands had acceptable moisture contents, which did not exceed the national specification of 3.10% for cocoa powders. Furthermore, the ash contents of all the brands exceeded the acceptable national specification of 2.60%. Significant variations (P<0.05) were obtained in the mean pH, titratable acidity, viable bacterial counts, moisture and ash contents within and between products containing only cocoa powders and those containing additives. In conclusion, the results from this study showed that the physicochemical properties of cocoa powders and powdered cocoa beverages could not be used to predict the viable bacterial counts of these food products. Key words: Cocoa Powders, Powdered Cocoa Beverages, Physicochemical Properties, Viable Bacterial Counts

Using Users' Expectations to Adapt Business Intelligence Systems

This paper takes a look at the general characteristics of business or economic intelligence system. The role of the user within this type of system is emphasized. We propose two models which we consider important in order to adapt this system to the user. The first model is based on the definition of decisional problem and the second on the four cognitive phases of human learning. We also describe the application domain we are using to test these models in this type of system

Considering users' behaviours in improving the responses of an information base

In this paper, our aim is to propose a model that helps in the efficient use of an information system by users, within the organization represented by the IS, in order to resolve their decisional problems. In other words we want to aid the user within an organization in obtaining the information that corresponds to his needs (informational needs that result from his decisional problems). This type of information system is what we refer to as economic intelligence system because of its support for economic intelligence processes of the organisation. Our assumption is that every EI process begins with the identification of the decisional problem which is translated into an informational need. This need is then translated into one or many information search problems (ISP). We also assumed that an ISP is expressed in terms of the user's expectations and that these expectations determine the activities or the behaviors of the user, when he/she uses an IS. The model we are proposing is used for the conception of the IS so that the process of retrieving of solution(s) or the responses given by the system to an ISP is based on these behaviours and correspond to the needs of the user

Business intelligence systems and user's parameters: an application to a documents' database

This article presents earlier results of our research works in the area of modeling Business Intelligence Systems. The basic idea of this research area is presented first. We then show the necessity of including certain users' parameters in Information systems that are used in Business Intelligence systems in order to integrate a better response from such systems. We identified two main types of attributes that can be missing from a base and we showed why they needed to be included. A user model that is based on a cognitive user evolution is presented. This model when used together with a good definition of the information needs of the user (decision maker) will accelerate his decision making process

Petrogenetic characterisation and paleo-climatic study of some clay occurrences over pre-Cambrian basement complex in Southwestern Nigeria

Bulk clay chemistry from specific areas underlain by Precambrian rocks composed of migmatitic gneiss, schist, charnockite and granite in Ekiti, Southwest Nigeria, was studied for their elemental compositions in order to assess petrogenesis and paleoclimatic conditions. Eleven representative clay samples were collected from various clay occurrences based on the underlying geology. The clay samples were prepared and analysed using X-ray Fluorescence (XRF). The XRF data on eleven representative samples revealed major oxides (wt. %) and trace element (ppm) concentrations. SiO values ranged from 41.29 to 58.03 while Al2O3 and Fe2O3 values ranged from 15.86 to 36.61 and 0.27 to 13.05 respectively. Standard deviation (S.D) values of SiO2 (4.2), Al2 O3 (6.7) and Fe2O3 (4.8) suggested variable mobility. Average value of K2O (1.46) is observed to be lower than average Upper Continental Crustal UCC) value (3.39) and may be due to intense weathering. Average concentration values of Zr (634.53 ppm), Nb (76.45 ppm) and Ta (29.19 ppm) were higher than their corresponding average values reported for UCC. Average values of Chemical Index of Alteration (CIA) and Plagioclase Index of Alteration (PIA) (CIA, 70 and PIA, 73) showed moderate to high intensity weathering. Ba/Sr vs Y/Sr values discriminated the clay occurrences over schist from migmatitic gneiss and granitoids. Kaolinisation in moderate to high weathering intensities under a dominant oxic condition was inferred from the plots of A-CN-K and Ni/Co vs Mafic Index of Alteration (MIA)

Biochemical response of sweet potato to bemul-wax coating combined with calcium chloride treatment during ambient storage

Sweet potato (Ipomoea batatas Linn) tuber is a very nutritious but highly perishable crop that is subject to high wastages due to non-availability of appropriate storage techniques. This work assessed the effectiveness of treating the tubers with calcium chloride dip (CCD), bemul-wax (B-wax) and their combinations (CCD/B-wax) at ambient storage conditions (24.9 ± 4.0°C and 44.6 ± 18.4% RH). Some biochemical parameters of each treated sample were assessed and compared with the control for 20 days storage period. There were significant reductions (P < 0.05) in weight loss by B-wax and CCD/Bwax. CCD and CCD/B-wax caused significant reductions in pH, total amino acid and pectin esterase. Also, all the treatments caused significant reductions in ascorbic acid, phenylalanine ammonia lyase,�A-Amylase and alcohol dehydrogenase activities. There were significant reductions in polyphenol oxidase activity by B-wax. In conclusion, while all the treatments proved to be effective to varying degrees,CCD/B-wax seemed to be the most effective in preventing spoilage in the tuber

Parks Provision and Management in Urban Areas on Nigeria: The Example of Akure, Ondo State

This paper examined the availability and management of parks in urban spaces in developing societies utilising the situation in Akure, Ondo State, Nigeria as a case study. It identified and discussed the challenges associated with parks development and maintenance in the study area and suggested how to improve the prevailing situation. The paper draws extensively from a systematic survey and examination of the existing parks in the city. In-depth interviews were conducted with selected individuals and professionals in built environment on the availability, use and management of parks in the city. Officials of government Ministries and Agencies such as Ministry of Housing and Urban Development, Ministry of Environment, Ondo State Development and Property Corporation and Akure South Local Government were also interviewed to obtain essential information. The perception of the city dwellers on the management of the parks were sought through the use of 800 questionnaires which were administered purposively on users. The study found low patronage of parks in the study area and that conscious efforts have not been made in recent times to create parks as part of urban amenity in the city. Besides, the traditional parks and those created by colonial government have been encroached upon and in some cases converted to other uses. Moreover the few ones were not effectively managed repaired and maintained and have fallen to a states of obsolescence. There is therefore gross inadequacy of parks in the city which the paper argued has denied urban dwellers access to quality recreational facilities and has therefore reduced the liveability of the city. There is a need for the creation of an agency that will take on development and maintenance of parks in the city. Keywords: Built environment, Urban parks, Parks development, Parks maintenanc

Roles of family dynamics on adherence to highly active antiretroviral therapy among people living with HIV/AIDS at a tertiary hospital in Osogbo, south-west Nigeria

Background: Adherence to highly active antiretroviral therapy (HAART) has been proven to be the only effective treatment for HIV/AIDS worldwide. Good adherence to HAART might require good family support.Objective: To determine the family dynamics and social support of people living with HIV/AIDS (PLWHA) and its roles on HAART adherence at an ARV treatment clinic in Osogbo, NigeriaMethod: Descriptive cross-sectional study. Consenting PLWHA on HAART were interviewed using pre-tested semistructured questionnaire incorporating Perceived Social Support- Family Scale and Family APGAR. HAART adherence was measured using patient self report.Results: A total of 379 PLWHA were interviewed. Their mean age was 40.8 (SD=9.9) years. Most (60.7%) were females. More than half (55.7%) were currently married and the majority (72.1%) had secondary education and were Yoruba (86.3%). Most respondents (95.5%) were adherent to HAART. Over 90% were satisfied with support received from their family while 82.3% were treated like other family members. Most attributed their HAART adherence to the care and support received from their family.Conclusion: Most PLWHA had good social support and were adherent to HAART.Keywords: Family dynamics; HAART adherence; NigeriaAfrican Health Sciences 2013; 13(4): 920 - 92