Adherence to antiretroviral therapy, virologic failure and workload at the Rustenburg Provincial Hospital

Background: Adherence to antiretroviral therapy (ART) is a strong predictor of progression to AIDS and death. It remains the most important potentially alterable factor that determines treatment outcomes.Methods: The study is a cross-sectional survey of self-reported adherence to ART and associated factors. It included a randomly selected sample of 100 adult patients who began ART between June 2006 and December 2007. A modified Adult AIDS Clinical Trials Group questionnaire was used. The analysis compared self-reported adherence levels by factor and viral load test results.Results: Only 71% of patients had an adherence > 95%. Poor adherence was related to changes in daily routines (being away from home [21%] and busy with other things [17%]). All patients with symptoms suggestive of clinical depression had virologic failure. More unemployed patients (50.7%) had virologic failure than did employed patients (40%) (p = < 0.05). The clinic had a tenfold increase in patient enrolment and a ninefold decline in staff-to-patient ratio, and the proportion of patients lost to follow-up doubled in the preceding four years.Conclusion: Adherence to ART was poor. The capacity of the clinic to manage patients adequately has declined significantly. Decentralisation of ART services to primary health care facilities should be considered.Keywords: adherence; ART; HIV; human resource; South Afric

Welcome to the Excerpts in Pharmacy Research Journal

The editorial board at Cedarville University School of Pharmacy welcomes you to the inaugural issue of the Excerpts in Pharmacy Research Journal (ISSN 2374-4693)

Food and nutrition security situation in Ghana: Nutrition implications for national development

Achieving food and nutrition security is fundamental to the Sustainable Development Goals (SDGs) due to its strong interdependence with economic growth and development. Eradicating hunger and all forms of malnutrition (SDG 2) remain high on the global agenda and is at the forefront of high panel deliberations because poor dietary intake has long term negative consequences on individuals and economic advancement. The goal to end hunger and malnutrition can be achieved when food and nutrition insecurity is properly tackled through investment in agriculture parallel to economic and social protection programmes. In Ghana, about 1.5 million of the population are estimated to be food insecure while undernutrition, overnutrition and micronutrient deficiencies persist across the life stages. Challenges to food and nutrition security in Ghana have been identified as: poverty, climate change, rapid urbanization and population growth, gender inequalities and poor infrastructure. Poor economic growth, health, education, hygiene and environmental&nbsp; exploitation are implications of these challenges. Addressing these implications sets long-term foundation for the development of the nation by prioritising policies that are nutrition sensitive which directly address the complexity of malnutrition. The level of food and nutrition insecurity in Ghana can be reduced through a national commitment towards addressing the four pillars of food security coupled with programmes that bring about resilience through sustainable systems. To this end, intervention programmes have been introduced by government to reduce the poverty burden on households. These programmes are in the form of social interventions, governmental flagship projects, and research-driven agricultural interventions to improve yield that withstand the effect of climate change. This review is aimed to present the food and nutrition security situation in Ghana and emphasise the challenges that exacerbate the problem while bringing to light the nutritional implications to national development. It is hoped that the recommendations from this review will help the government in achieving food and nutrition security in Ghana

Hospital based maternity care in Ghana - findings of a confidential enquiry into maternal deaths

Background: In Ghana, a universal free delivery policy was implemented to improve access to delivery care in health facilities, thereby improving access to skilled attendance and reducing maternalmortality. Objective: A confidential enquiry was conducted to ascertain if changes had occurred in the care provided by reviewing the care given to a sample of maternal deaths before and after introduction of the policy. Method: Twenty women who died as a result of pregnancy-related complications (maternal deaths) in selected hospitals in two regions were assessed by a clinical panel, guided by a maternal deathassessment form. Unlike the traditional confidential enquiry process, both adverse and favourable factors were identified. Findings: Clinical care provided before and after the introduction of the fee exemption policy did not change, though women with complications were arriving in hospital earlier after the introduction of the policy. On admission, however, they received very poor care and this, the clinical paneldeduced could have resulted in many avoidable deaths; as was the case before the implementation of the policy. Consumables, basic equipment and midwifery staff for providing comprehensive emergency obstetric care were however found to be usually available. Conclusion: Our findings suggest that the already poor delivery care services women received remained unchanged after introduction of the policy

The Impact of Household Possessions on Youth\u27s Academic Achievement in the Ghana YouthSave Experiment

Households play an important role in youth’s academic achievement. Household assets as part of youth’s family background have been found to have a significant impact on youth’s academic achievement. In this study, the impact of household possessions on youth’s academic achievement in the Ghana YouthSave experiment is investigated. Findings support the hypothesized positive direction of the impact of household possessions on academic achievement of youth. Using propensity score optimal matching and matching estimators, results show youth from households that reported owning at least one of the five household items measured scored almost 1 unit higher on English than their peers from households that do not own any. However, results indicate ownership of household possessions do not have a statistically significant impact on Math scores of youth in the Ghana YouthSave experiment. Although the impact of ownership of household possessions on English scores is consistent across different tests used in this study, the impact of ownership of household possessions on Math scores is less conclusive. Policy implications are discussed

Internet Phishing and Current Trend Ghana

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A Flexible Framework For Implementing Multi-Nested Software Transaction Memory

Programming with locks is very difficult in multi-threaded programmes. Concurrency control of access to shared data limits scalable locking strategies otherwise provided for in software transaction memory. This work addresses the subject of creating dependable software in the face of eminent failures. In the past, programmers who used lock-based synchronization to implement concurrent access to shared data had to grapple with problems with conventional locking techniques such as deadlocks, convoying, and priority inversion. This paper proposes another advanced feature for Dynamic Software Transactional Memory intended to extend the concepts of transaction processing to provide a nesting mechanism and efficient lock-free synchronization, recoverability and restorability. In addition, the code for implementation has also been researched, coded, tested, and implemented to achieve the desired objectives

Transactions Processing Subsystems for Databases Based On ARIES Write-Ahead Logging for The Client-Server Architecture Approach

This paper proposes a formal framework specification that applies an advanced recovery mechanism, functional in a client-server architecture while addressing atomicity and consistency issues. Another palpable issue in using such dominant architectures is recovery. This paper also addresses this issue in context with the client-server architecture using extensions of the original ARIES algorithm and concepts of Software Transaction Memory. This novelty has been successfully implemented and tested for propriety and applicability

Development of a Novel Aspirin Suppository Formulation and Evaluation of the Acetylation of COX-1 Via a HT-29/Caco-2 Cell Absorption Assay Used to Detect the Absorption of Aspirin Formulated With Various Bases and Excipients

As the baby-boomer population ages, hospitalization rates will rise, increasing the number of patients who are NPO. Research indicates that aspirin use also increases with advanced age. With the increased prevalence of this demographic, there continues to be a growing need for alternative dosage forms for aspirin administration. A common and limited-risk alternative is rectally administered aspirin. However, there appears to be only one commercially available aspirin suppository and it has yielded erratic results as shown in previous research. Aspirin is considered a pro-drug; once it is inside the body, the acidic environment cleaves the aspirin molecule down to salicylic acid, its active form. Rectal cells may not provide an acidic environment needed to cleave the aspirin molecule into salicylic acid, thereby inhibiting the absorption and rate of onset of the drug. With this thought in mind and with the erratic results from the literature, the aim of this study, to be completed by summer of 2015, is to create a novel aspirin suppository. The study will be a prospective preclinical in-vitro design conducted in the Cedarville University Pharmaceutical Sciences lab. The samples will include two colonic adenocarcinoma cell lines, Caco-2 and HT-29. A standard curve will be developed as a baseline by using a 12(S)-HETE ELISA Assay using purified 12(S)-HETE. The two cell lines will be cultured, then incubated. Aspirin will be added to the samples and incubated again for 30 minutes. After incubation, medium samples will be taken and the same ELISA Assay will be performed on the results. The cell line that yields the most consistent results will be selected. The various aspirin formulations will be tested on this cell line in the same fashion. The ELISA assay will be performed and the concentration of 12(S)-HETE will be determined, plotted, and compared to the standard curve. A repeated-measures ANOVA will then be performed to analyze statistical significance