Primary Care Patient Experience in Pneumonia Patient and the Effects of Readmissions

Patient primary care experience is an essential component of patient care. Research has consistently demonstrated that patient experience correlates with clinical processes of care for prevention and disease management and with better health outcomes. Patients who are admitted to the hospital face numerous challenges upon discharge, including high readmission rates. In fact, one-fifth of Medicare patients admitted to the hospital will be readmitted within 30 days of discharge. With the Affordable Care Act’s creation of the Hospital Readmission Reduction Program (HRRP), hospitals are now penalized for excess readmission rates for common admitting diagnoses such as pneumonia. The purpose of this study was to examine how patients’ baseline primary care experiences relate to the likelihood of readmission. Patients diagnosed with pneumonia were identified during their initial hospitalization and administered the CG-CAHPS 3.0 and Supplementary CAHPS PCMH. The results of these surveys were compared between readmitted and non-readmitted patients. Also, the differences between the primary care experiences of the pneumonia patient cohort and patients at the hospital system’s primary care sites were examined. Results showed that 5 patients out of the 33 patients surveyed were readmitted with non-pneumonia related causes. Patients across 18 primary care sites report higher levels of satisfaction with their PCP (88.7%) compared to patients hospitalized for Pneumonia (66.7%; X2 =14.9,

Civil Society Organisations Contributions to National Development in Ghana

This report analyses the role and contributions of civil society organisations (CSOs)1 to Ghana's national development. In doing so, the report focuses on CSOs' engagements with and contributions to the Coronavirus disease (COVID-19) responses and post-pandemic recovery. It also discusses the barriers facing CSOs in their attempt to contribute to national development and towards a desired future post COVID-19 in Ghana.

Designing a 2D RZ Venture Model for Neutronic Analysis of the Nigeria Research Reactor-1 (NIRR-1)

A 2D RZ VENTURE model has been developed for the Nigeria Research Reactor-1 (NIRR-1) and this model was used to perform neutronic analysis for the system using the code “VENTURE-PC”. The major homogenized regions in the 2D VENTURE model include the active fuel region and the control region while the remaining components in the system geometry where modelled as closely as possible. The reactor physics parameters generated from the neutronic calculations include excess reactivity, control rod worth, shim worth, shutdown margin. The model predictions of these parameters for NIRR-1 system were in good agreement with experimental results as well as the results from similar calculations using different nuclear analysis tools. This 2D RZ VENTURE model gives an excellent simulation of the Nigeria Research Reactor-1 and the model will be very helpful in the future analysis of the system, as well for developing an LEU core model for future conversion of NIRR-1 from HEU to LEU fuelled research reactor. Keywords: Model, Neutronics, geometry, code, Design, Reactor, Simulation, Calculations, NIRR-1, Shim, Control, Shutdown, Physics. Peak, Density, Power, Flux, Neutro

Acute ecotoxicity of aqueous and ethanolic extract of leaves of Khaya senegalensis on chironomid larvae

Protection of aquatic habitat requires an understanding of both the sensitivity of invertebrates to contaminants and their ecological requirements. Phyto-chemical screening of the leaves of extract of Khaya senegalensis revealed the presence of active constituents. Acute ecotoxicities of aqueous and ethanolic extracts of leaves of Khaya senegalensis to Chironomid larvae were evaluated by static bioassay. Bioactivity of the ethanolic extract was found to be greater than the aqueous extract. The LC50 of aqueous and ethanolic extracts were 1.39g/l and 1.20g/l respectively. Stressful behaviors exhibited by the chironomids include deformity of mouthparts, certain body segments being filled with black particles and change in body coloration. All behaviors were dose-dependent. The larvae were not repelled by the extract, indicating that antifeedant activity was not a mortality factor. Mortality was probably due to the disappearance of the reddish coloration of the hemoglobin component. The results were discussed and compared with those of other studies.Protection of aquatic habitat requires an understanding of both the sensitivity of invertebrates to contaminants and their ecological requirements. Phyto-chemical screening of the leaves of extract of Khaya senegalensis revealed the presence of active constituents. Acute ecotoxicities of aqueous and ethanolic extracts of leaves of Khaya senegalensis to Chironomid larvae were evaluated by static bioassay. Bioactivity of the ethanolic extract was found to be greater than the aqueous extract. The LC50 of aqueous and ethanolic extracts were 1.39g/l and 1.20g/l respectively. Stressful behaviors exhibited by the chironomids include deformity of mouthparts, certain body segments being filled with black particles and change in body coloration. All behaviors were dose-dependent. The larvae were not repelled by the extract, indicating that antifeedant activity was not a mortality factor. Mortality was probably due to the disappearance of the reddish coloration of the hemoglobin component and consequently impaired metabolism of the larvae. The results were discussed and compared with those of other studies

Novel encapsulated calcium butyrate supplement enhances on-farm dairy calf growth performance and body conformation in a pasture-based dairy production system

The effect of supplementing neonatal heifer calves with varying levels of ECAB on pre-weaning growth performance was investigated. Post-weaning growth was also measured, to determine any carry-over effect of pre-weaning supplementation of ECAB. Forty-eight heifer calves (7 ± 0.4 days old, average liveweight of 39.3 ± 5.3 kg) were utilized in a complete randomised experimental design, comprising 16 calves per pen, randomly allocated to one of the following three treatments: (1) Basal commercial calf starter mix without ECAB (Control); (2) control plus 4 kg/ton of ECAB (Low); and (3) control plus 6 kg/ton of ECAB (High). Calves were group-fed ad libitum for 77 days (11 weeks, pre-weaning period) with free choice access to water and 5.5 litres of milk per head per day through an automated feeder. Calves were weighed weekly during the pre-weaning period, after which all calves were then weaned onto the same ryegrass pasture as one group. At approximately 9 months of age, calves were weighed to estimate post-weaning body weight gain. During the pre-weaning period, average daily dry matter feed intake was similar for 4 kg/ton and 6 kg/ton calves (649 g versus 688 g, respectively) and both were greater than that of the control calves (382 g). Average daily gain (ADG) was significantly higher for 4 kg/ton calves compared to 6 kg/ton calves or control calves (0.83 ± 0.03 kg, 0.74 ± 0.03 kg and 0.71 ± 0.03 kg, respectively; p = 0.0001). Similarly, 4 kg/ton calves had significantly increased chest girth (95.9 ± 0.7 cm), withers height (88.9 ± 0.5 cm), body length (82.9 ± 0.6 cm), and body condition score (1.99 ± 0.12) compared to 6 kg/ton calves (93.4 ± 0.7 cm, 87.4 ± 0.7, 81.5 ± 0.6 cm, and 1.67 ± 0.10, respectively) or control calves (92.9 ± 0.7 cm, 88.2 ± 0.5 cm, 80.1 ± 0.6 cm, and 1.30 ± 0.08, respectively). There was significant treatment x week interaction for all pre-weaning growth parameters. Breed differences were detected but there was no treatment x breed interaction. Post-weaning, 4 kg/t calves and 6 kg/t calves had significantly higher ADG compared to control calves (0.80 ± 0.03 kg, 0.85 ± 0.03 kg versus 0.70 ± 0.03 kg, respectively; p = 0.0047). It is concluded that under the conditions of this study, supplementing heifer calves with ECAB during pre-weaning period resulted in improved growth performance and there appears to be a post-weaning carry-over effect

A review of the antimalarial, antitrypanosomal, and antileishmanial activities of natural compounds isolated from Nigerian flora.

The West African country Nigeria features highly diverse vegetation and climatic conditions that range from rain forest bordering the Atlantic Ocean in the South to the Desert (Sahara) at the Northern extreme. Based on data from the World Conservation Monitoring Center of the United Nations Environmental Protection, Nigeria, with ~5,000 documented vascular plants, ranks amongst the top 50 countries in terms of biodiversity. Such a rich biodiversity implies that the country is rich in diverse secondary metabolites—natural products/unique chemicals produced by the plant kingdom to confer selective advantages to them. Like many tropical countries, Nigeria is also endemic to numerous infectious diseases particularly those caused by parasitic pathogens. These phytochemicals have been exploited for the treatment of diseases and as a result, a new branch of chemistry, natural product chemistry, has evolved, to try to reproduce and improve the therapeutic qualities of particular phytochemicals. In this review, we have compiled a compendium of natural products, isolated from Nigerian flora, that have been reported to be effective against certain protozoan parasites with the aim that it will stimulate interests for further investigations, and give impetus to the development of the natural products into registered drugs. In total 93 structurally characterized natural compounds have been identified with various levels of anti-parasite activity mainly from Nigerian plants. The synthesis protocol and molecular target for some of these natural anti-parasite agents have been established. For instance, the anti-plasmodial compound fagaronine (7), a benzophenanthridine alkaloid from Fagara zanthoxyloides has been successfully synthesized in the laboratory, and the anti-trypanosomal compound azaanthraquinone (55) elicits its effect by inhibiting mitochondrial electron transfer in trypanosomes. This review also discusses the barriers to developing approved drugs from phytochemicals, and the steps that should be taken in order to accelerate the development of new antiparasitics from the highlighted compounds

AIDS-related stigmatisation in the healthcare setting: a study of primary healthcare centres that provide services for prevention of mother-to-child transmission of HIV in Lagos, Nigeria

Objective: To assess AIDS stigmatising attitudes and behaviours by prevention of mother-to-child transmission (PMTCT) service providers in primary healthcare centres in Lagos, Nigeria. Design: Cross-sectional survey. Setting: Thirty-eight primary healthcare centres in Lagos, Nigeria. Participants: One hundred and sixty-one PMTCT service providers. Outcome measures PMTCT service providers' discriminatory behaviours, opinions and stigmatising attitudes towards persons living with HIV/AIDS (PLWHAs), and nature of the work environment (HIV/AIDS-related policies and infection-control guidelines/supplies). Results: Reported AIDS-related stigmatisation was low: few respondents (4%) reported hearing coworkers talk badly about PLWHAs or observed provision of poor-quality care to PLWHAs (15%). Health workers were not worried about secondary AIDS stigmatisation due to their occupation (86%). Opinions about PLWHAs were generally supportive; providers strongly agreed that women living with HIV should be allowed to have babies if they wished (94%). PMTCT service providers knew that consent was needed prior to HIV testing (86%) and noted that they would get in trouble at work if they discriminated against PLWHAs (83%). A minority reported discriminatory attitudes and behaviours; 39% reported wearing double gloves and 41% used other special infection-control measures when providing services to PLWHAs. Discriminatory behaviours were correlated with negative opinions about PLWHAs (r=0.21, p<0.01), fear of HIV infection (r=0.16, p<0.05) and professional resistance (r=0.32, p<0.001). Those who underwent HIV training had less fear of contagion. Conclusions: This study documented generally low levels of reported AIDS-related stigmatisation by PMTCT service providers in primary healthcare centres in Lagos. Policies that reduce stigmatisation against PLWHA in the healthcare setting should be supported by the provision of basic resources for infection control. This may reassure healthcare workers of their safety, thus reducing their fear of contagion and professional resistance to care for individuals who are perceived to be at high risk of HIV.Fulbright Scholar program, a program of the United States Department of State, Bureau of Educational and Cultural AffairsOpen access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Introgression progress for phenotypic traits and parent-progeny diversity at advanced segregation population from Oryza barthii and O. glaberrima/O. sativa crosses

Oryza barthii has candidature for some significant economic traits but its utilization in rice breeding is rare. This study traced introgression of heritable traits in the offspring of O. barthii with an Africa-Asian progenitor to F8 and assessed diversity between the parents and the F8 population. Significant (P<0.05) genotypic variation existed for some traits. Grains per panicle and days to 50% flowering had respective least (3.34%) and highest (96.32%) broad sense heritability. Genotypic Coefficient of Variation (GCV) was lower than Phenotypic Coefficient of Variation (PCV) in all traits. Grains per panicle and tiller number had respective least (5.28% and 8.05%) and highest (90.8% and 98.1%) GCV and PCV. Progenies significantly differ in panicles and grains sizes, shapes, colours, presence or absence of awns. Five principal components explained 80.1% of the total variance. Plant height at maturity was the only trait with significant (p ≤ 0.01) correlation and regression between F6 and F7. Progenies resemblance to P1 retrogressively declined while offspring similarity to P2 progressively increased from F6 to F8. The present diversity study discovered three heterotic groups: the O. barthii (11%), O. sativa (67%) and the intermediate group (22%). This research has added to rice genetic resources, making investigation of the nutritional status of the different progenies interesting research for further studies

Effect of Cutting Parameters on Surface Finish when Turning Nitronic 33 Steel alloy

Nitronic 33 steel alloys are metallic alloys that exhibit characteristics such as high strength-to-weight ratio, outstanding corrosion and erosion resistant properties, and the ability to withstand cryogenic conditions and elevated temperatures. These characteristics of Nitronic 33 steel alloys make it popular in the fabrication of chemical processing, pollution control, aerospace equipment, and for steam and autoclave applications. Nitronic 33 steel alloy is classified as difficult-to-cut materials because of its high nitrogen content and the capability to form martensite as a result of high temperatures generated during mechanical machining and other subtractive manufacturing processes. This resulted in increased capacity and tooling cost during manufacturing. Therefore, there is the need to evaluate the optimum parameters when machining this alloy for sustainable and resource efficient machining. In this work, tool life, tool wear, surface roughness, cutting forces and power demand when turning Nitronic 33 steel alloy under different cutting environment were investigated. The result presented an optimum turning conditions at which Nitronic 33 steel alloy can be manufactured with minimum tool wear and surface integrity. The research outcome also addresses some of the problems encountered during the high speed machining of Nitronic 33 steel alloy that could influence manufacturing cost reduction. This work will also aid the general understanding of Nitronic 33 steel alloy with respect to sustainable and resource efficient machining