The integrated health service model: the approach to restrain the vicious cycle to chronic diseases

Abstract Background In life time, nearly each person succumbs to some sort of chronic disease and many develop complicated chronic diseases. It is critical to focus on preventive services with a relatively high health impact and favorable cost effectiveness. During routine health facility visits, it is advisable to evaluate both symptomatic and asymptomatic patients for their needs of health promotion and disease prevention services. This necessitates the development of an integrated health service (IHS) approach that incorporates health promotion, disease prevention and curative services. Methods There were two phases for the study. The first phase explored the degree of promotive and preventive health care delivery at the health centers and hospitals. Phase two, utilizing the Delphi strategy, centered on looking for agreement on the finding from phase 1 and on IHS approach. Delphi questions were created based on the results of phase 1, and the reply choices were tied to a five point Likert scale. Consensus was considered come to when 75% of the experts concurred on an issue. From that point, advance clarification and agreement was looked for by implies of a second-round assessment for scores between 50 and 75%. Agreement on proposed IHS model, application of case finding and Periodic Health Examination (PHE) approaches were also sought. This study focuses on finding from phase 2. Result Of the twenty experts, 90% (n = 18) agreed that the IHS framework shows the causal relationship of diseases and included plausible intervention approaches. Experts reached consensus (90%;n = 18) that case finding testing,screening patients for conditions other than the medical care they sought at a particular time, can be performed at health facilities. All experts (100%; n = 20) recommended conducting periodic health examinations in selected diseases for patients who are apparently not sick. Conclusion The Integrated Health Service (IHS) framework was agreed by experts to be a plausible method in describing the causal relationship of chronic non-communicable, communicable, and nutrition-related diseases. The framework can play a vital role by preventing the acquiring, progression, suffering or dying from diseases through restraining the vicious cycle of chronic diseases

Social media policy in South Africa

Social media use is a growing trend worldwide. It is viewed as a revolution in electronic communications and an effective business marketing tool. Despite the business benefits, social media is viewed as a risk within organisations. This study examines the perceptions of CAEs (Chief Audit Executives) on the state of development and implementation of social media policies in companies in South Africa. The study reveals that even though social media is perceived to be a risk, most of the organisations surveyed have not implemented a social media policy. This might be because social media policies are not perceived to be effective, or because social media is classified as a lower priority risk within the organisations. The study reveals that social media is not part of the internal audit universe in most organisations, supporting two perceptions: that it might be viewed as a lesser risk; and that the organisations and internal audit functions have not yet fully understood the nature and potential negative impact social media usage can have on business.http://reference.sabinet.co.za/sa_epublication/sajaaram201

South African national household survey of HIV/AIDS prevalence, behavioural risks and mass media impact-detailed methodology and response rate results

Objectives. To describe the methodology used in a recent survey of HIV/AIDS in South Africa and to present the response rates.Methods. A cross-sectional, national household-based survey was conducted using second-generation surveillance procedures. A complex multistage sampling technique was used to create a master sample of 1 000 census enumerator areas out of a total of 86 000 nationally. Aerial photographs were taken and used to randomly select more than 10 197 households and ultimately 13 518 individuals from a sampling frame of 31 321 people. Phase 1 of the study involved notifying the household residents about the study and collecting key demographic information on respondents aged 2 years and older. This information was used to randomly select up to 3 respondents from each household: 1 adult (25 years and older), 1 youth (15- 24 years), and 1 child (2- 14 years). In phase 2 nurses interviewed respondents and collected oral fluid specimens for HIV testing. In the case of children aged 2 - 11 years, parents or guardians were interviewed, but HIV testing was performed on the selected children. Questionnaire data were anonymously linked with HIV test results.Results. A total of 9 963 persons agreed to be interviewed and 8 840 were tested for HIV, yielding a response rate of 73.7% and 65.4% respectively. However, only 8 428 (62.3%) HIV test results were correctly matched with behavioural data. The results showed that those tested for HIV did not differ from those not tested in terms of key determinants.Conclusion. It is possible to use community-based surveys to study the prevalence of HIV in the general population

Micromechanical homogenization of a hydrogel-filled electrospun scaffold for tissue-engineered epicardial patching of the infarcted heart: a feasibility study

For tissue engineering applications, accurate prediction of the effective mechanical properties of tissue scaffolds is critical. Open and closed cell modelling, mean-field homogenization theory, and finite element (FE) methods are theories and techniques currently used in conventional homogenization methods to estimate the equivalent mechanical properties of tissue-engineering scaffolds. This study aimed at developing a formulation to link the microscopic structure and macroscopic mechanics of a fibrous electrospun scaffold filled with a hydrogel for use as an epicardial patch for local support of the infarcted heart. The macroscopic elastic modulus of the scaffold was predicted to be 0.287 MPa with the FE method and 0.290 MPa with the closed-cell model for the realistic fibre structure of the scaffold, and 0.108 MPa and 0.540 MPa with mean-field homogenization for randomly oriented and completely aligned fibres. The homogenized constitutive description of the scaffold was implemented for an epicardial patch in a FE model of a human cardiac left ventricle to assess the effects of patching on myocardial mechanics and ventricular function in the presence of an infarct. Epicardial patching was predicted to reduce maximum myocardial stress in the infarcted LV from 19 kPa (no patch) to 9.5 kPa (patch) and to marginally improve the ventricular ejection fraction from 40% (no patch) to 43% (patch). This study demonstrates the feasibility of homogenization techniques to represent complex multiscale structural features in a simplified but meaningful and effective manner

The time to extinction for an SIS-household-epidemic model

We analyse a stochastic SIS epidemic amongst a finite population partitioned into households. Since the population is finite, the epidemic will eventually go extinct, i.e., have no more infectives in the population. We study the effects of population size and within household transmission upon the time to extinction. This is done through two approximations. The first approximation is suitable for all levels of within household transmission and is based upon an Ornstein-Uhlenbeck process approximation for the diseases fluctuations about an endemic level relying on a large population. The second approximation is suitable for high levels of within household transmission and approximates the number of infectious households by a simple homogeneously mixing SIS model with the households replaced by individuals. The analysis, supported by a simulation study, shows that the mean time to extinction is minimized by moderate levels of within household transmission

Entanglement in the quantum Ising model

We study the asymptotic scaling of the entanglement of a block of spins for the ground state of the one-dimensional quantum Ising model with transverse field. When the field is sufficiently strong, the entanglement grows at most logarithmically in the number of spins. The proof utilises a transformation to a model of classical probability called the continuum random-cluster model, and is based on a property of the latter model termed ratio weak-mixing. Our proof applies equally to a large class of disordered interactions

Numerical Study of a Field Theory for Directed Percolation

A numerical method is devised for study of stochastic partial differential equations describing directed percolation, the contact process, and other models with a continuous transition to an absorbing state. Owing to the heightened sensitivity to fluctuationsattending multiplicative noise in the vicinity of an absorbing state, a useful method requires discretization of the field variable as well as of space and time. When applied to the field theory for directed percolation in 1+1 dimensions, the method yields critical exponents which compare well against accepted values.Comment: 18 pages, LaTeX, 6 figures available upon request LC-CM-94-00

Effects of Aflatoxin B1 and Fumonisin B1 on Blood Biochemical Parameters in Broilers

The individual and combined effects of dietary aflatoxin B1 (AFB1) and fumonisin B1 (FB1) on liver pathology, serum levels of aspartate amino-transferase (AST) and plasma total protein (TP) of broilers were evaluated from 8 to 41 days of age. Dietary treatments included a 3 × 3 factorial arrangement with three levels of AFB1 (0, 50 and 200 μg AFB1/kg), and three levels of FB1 (0, 50 and 200 mg FB1/kg). At 33 days post feeding, with the exception of birds fed 50 mg FB1 only, concentrations of AST were higher (p < 0.05) in all other treatment groups when compared with controls. Plasma TP was lower (p < 0.05) at six days post feeding in groups fed 200 μg AFB1/kg alone or in combination with FB1. At day 33 days post feeding, with the exception of birds fed the highest combination of AFB1 and FB1 which had higher plasma TP than control birds, plasma TP of birds fed other dietary treatments were similar to controls. Broilers receiving the highest levels of AFB1 and FB1 had bile duct proliferation and trabecular disorder in liver samples. AFB1 singly or in combination with FB at the levels studied, caused liver damage and an increase in serum levels of AST