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,

“Discourse” and “Discourse Analysis”: Front-burner Notions

In this study, we examine front-burner notions in two discrete terms: “discourse” and “discourse analysis”. Discourse analysis is not a new field of language study. This is why numerous notions abound therein, for the elucidation of language-related phenomena in human communication across genres. Some of the phenomena are so contentious that critical notions in discourse and discourse analysis continue to evolve. Discourse is human interaction. It has structure which is analyzed to reveal not just meanings, but also the underpinnings of such meanings. Linguistic conventions and extra-linguistic nuances underpin textual meanings to provide rich insights into the dynamics of language use in texts. A discourse analyst is interested in the discourse strategies deployed by speakers and writers for the purpose of effective communication. In this study, notions presented and examined are essentially explanative in terms of elucidating communicative strategies of language users. This view establishes the similarity between discourse analysis and pragmatics. The study concludes that discourse analysis is: context-based, functional, socially realistic, organizational structure, part of a whole, on-going communication and cross-disciplinar

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

Young Adults Stroke Survivor’s Experiences with Psychological Support in High-Income Countries -Qualitative Systematic Review

Background. The widely held view that stroke is a condition suffered mainly by older people makes it difficult for people to believe the experiences of younger stroke survivors. Hence, young stroke survivors suffer several forms of emotional stress during a stroke and at the commencement of rehabilitation. Study aims and Objectives. This study aimed to comprehensively review the experiences of young stroke survivors in high-income countries with post-stroke psychological support alongside the significant barriers to and enablers of these supports. It also compares these experiences between studies carried out in the UK and other selected high-income countries. Methods. A qualitative evidence synthesis study design is carried out. A comprehensive literature search of the selected five databases and other sources was conducted for eligible studies. The extraction of data and quality appraisal of the papers were performed using the CASP checklist and the JBI framework, respectively. The data was extracted following a two-stage data extraction process. Lastly, a thematic three-staged approach was utilised to synthesise the findings with aimed insights into the research questions. Results A total of 846 records were identified from all searched sources and screened, with 12 studies selected for synthesis that met the eligibility criteria. From the synthesis of findings, descriptive themes and later four analytical themes emerged, namely I) invalidation due to age; ii) difficulty accessing health services; iii) the effectiveness of rehabilitation and community support, and (iv) facilitators and barriers to recovery. Conclusion, Recommendation, and Implication of key findings Results from this review revealed the diverse experiences of young adult stroke survivors with psychological support in high-income countries. It also recommends that interventions and all forms of support should be designed to accommodate young stroke patients. Using the social-ecological model (SEM) as adopted from McLeroy et al. (1988) stated that the role of interaction between influential factors such as individual, social, and environmental in health promotion initiatives drives the desired behavioral change to seek psychological support. This could also be leveraged by organisational, national, and international stakeholders in designing effective age-specific stroke care programs and policies to prioritise stroke care among young adults in high-income regions

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

Determinants of Utilization of Family Planning Services Among Women Of Child-Bearing Age Attending Family Planning Clinic In Primary Health Centre, Felele, Ibadan, Oyo-State.

Low uptake of various recommended modern family planning methods is associated with inadequate family planning literacy among potential beneficiaries of the methods. As such, understanding factors affecting family planning literacy is key to addressing this problem. This study, therefore, explored factors that influence the utilization of family planning services among women of child-bearing age in the study area. The study used a cross-sectional survey design, and data were collected using a structured questionnaire. A total of 110 women of child-bearing age were recruited for the study. The majority of respondents to the research (92.7%) were married, and their average age was 34.45. 64.5% of respondents identified as Christians, and 35% as Muslims. According to the report, injectable account for 60.9% of all contraceptive methods used, followed by pills (20.0%) and condoms (10.9%). The study also discovered that lack of understanding about family planning (27.3%) and fear of adverse effects (30.9%) were the two most frequent reasons given for not using family planning services. The study found a number of variables that affect how often women in the study area who are of childbearing age use family planning services. Age, education, occupation, income, religion, and parity are some of these variables. According to the study, women who were older, more educated, and had better incomes used family planning services more frequently. The study also discovered that Muslim women used family planning services less frequently than Christian women. The study indicated that compared to women who had fewer children, those who had more children were less likely to use family planning services than women who had fewer children. The study recommends that efforts should be made to increase awareness about family planning services among women of child-bearing age in the study area. The study suggests that health education programs should be developed to address the fear of side effects and the lack of knowledge about family planning

Knowledge and Attitudes towards Epilepsy among Parents in Osogbo Lga Osun State, Nigeria

Background Epilepsy is a disease characterized by abnormal brain activities causing seizures or unusual behavior, feelings and sometimes loss of awareness. It has neurological, cognitive, psychological and social after-effects and it affects people of all ages, race, social classes, and geographical location. It constitutes a major portion of the global burden of disease, affecting around 50 million people worldwide. This study therefore aims to explore the knowledge and attitudes towards epilepsy among parents in Osogbo LGA Osun state, Nigeria. MATERIALS AND METHODS:  A descriptive cross-sectional study design was used and 234 participants living in Osogbo Local Government Area were used. The data collected was on knowledge of and attitude towards epilepsy. Data was analyzed using SPSS version 23. Chi square and binary logistic regression were used. RESULTS:  Most respondents (94%) have heard of epilepsy with their main sources of information from mass media, health worker, relations/friends and internet. 95.3% of respondents had good knowledge of epilepsy, while 59% had positive attitude to epilepsy. Predictors of respondents’ attitude towards people living with epilepsy, respondents with age group of 36-45 years (OR= 0.316, Cl= 0.146 – 0.686, P= 0.004). Also respondents with good knowledge are eight times more likely (8.597) to have poor attitude towards people living with epilepsy. CONCLUSION: In conclusion, parents living in Osogbo local government area as represented by the study sample have a good level of knowledge on epilepsy and good attitude towards epilepsy in general. There is still a need for continuous community education about epilepsy with the aim of improving the knowledge and attitude of members of the community towards the diseas