Knowledge and Attitude towards Ebola Virus Disease among Secondary School Students in Abakaliki, South-east, Nigeria

Introduction: Ebola virus disease (EVD) is an acute haemorrhagic fever. It is also a zoonotic disease which has posed a serious public health problem in the West African Sub-Region. The study was conducted to determine the level of knowledge and attitude towards EVD among Secondary School Students in Abakaliki, Ebonyi State, Nigeria. Methods: A cross-sectional descriptive study was carried out among 318 secondary school students in Abakaliki, Ebonyi State, selected through multistage sampling method. Information and permission were obtained from the State Ministry of Education, Informed consent from the principals of the schools and their class teachers. Assent was obtained from selected students prior to the study. Data was collected with pre-tested semi-structured questionnaires and analyzed using statistical package for the social science (SPSS) version 20. Results were treated with strict confidentiality. Results: Majority of the respondents (85.5%) were between 15 to 19 years. Students in SSS 2 constituted the greatest proportion of respondents, 57.0% and 48.8% for public and private schools respectively. One hundred percent of the respondents had heard about EVD. Knowledge of EVD was generally poor for majority of the students in both schools, the proportion being higher in the public (65.8%), compared to the private schools (40.6%). Greater proportion (70.6%) of those in private schools had positive attitude to EVD compared to 53.8% in public schools. Conclusion: Respondents from private schools were more knowledgeable and exhibited more positive attitude than respondents from public schools. Recommendation: Sensitisation and health education of secondary school students on EVD

Is This Transfer Shock ? Examining the Perceptions of Engineering Students Who Articulate Within the Irish Higher Education Context.

Abstract—“Transfer shock” is a well-known phenomenon during the process of articulation, when students move from short-cycle applied programs to more academic longer-cycle study programs. In the US context this problematic transition has been observed in students transferring from community colleges into the traditional university system. In Ireland’s binary higher education structure, one set of institutions, known as Institutes of Technology (IoTs) allow for this transition to take place entirely within individual institutions. This paper is part of an ongoing investigation into one such IoT, where engineering students who achieve high grades at the end of 3-year (so-called Level 7) “ordinary degree” programs frequently transfer into the 3rd year of 4-year Level 8 “honors degree” programs, with surprisingly successful outcomes. One surprise derives from the fact that the students who enter Level 7 engineering programs are deemed at the outset to be academically less able, particularly in mathematics, than those who go directly into Level 8 programs from secondary school. Relatively little work has been done on this transition to date. In the 3rd and 4th year of many honors engineering programs within this institution it is not unusual to have 30-50% of the students coming from an ordinary degree background, the majority from within the institution itself – with others transferring from other IoTs in Ireland. Previous research has shown that students from this background initially struggle in the 3rd year of the honors degree program when compared with students who have proceeded directly through the honors program, before going on to successfully graduate. Can this be attributed to ‘transfer shock’; even though most of these students are continuing in an institution and with faculty that they are already familiar with? In order to examine this phenomenon we interview students from several engineering disciplines at various points in this transition. We explore the perceptions of the students regarding this transition and, based on the information coming from the interviews, we conduct a large scale survey to be administered to articulating students across engineering programs in the institution. The preliminary results of this survey are also presented here

Putting the private sector at the centre of climate-smart agriculture

This brief draws on three cases to show how the private sector contributes to the conceptualisation, design, delivery and evaluation of climate-smart agricultural interventions and can help bring them to scale. Engaging the private sector in CSA interventions enhances the applicability – and thus the sustainability of interventions, increases uptake and delivers a triple win for donors, beneficiaries and the private sector. They emphasise that private-sector players will be more likely to engage in scaling-up of CSA when they can see a compelling business case to justify their investments

Mettre le secteur privé au coeur de l'agriculture intelligente face au climat

Le récent atelier du CTA sur « la mise en oeuvre de solutions intelligentes face au climat pour l’agriculture de nouvelle génération dans les pays ACP » a identifié quatre défis fondamentaux à relever : renforcer l’adoption d’interventions et de solutions, démontrer de manière plus convaincante aux agriculteurs les avantages des interventions climato-intelligentes, promouvoir des cadres et processus politiques appropriés, améliorer l’information, la communication et le feedback pour encourager la sensibilisation des acteurs et leur implication dans les interventions. Les interventions efficaces étaient axées sur cinq priorités : étoffer les données probantes, développer des cadres politiques favorables, renforcer les institutions, mettre au point des options de financement alternatives et donner la priorité aux interventions centrées sur l’exploitation agricole

One-year outcomes of the ARTISAN-SNM study with the Axonics System for the treatment of urinary urgency incontinence

Aims: Sacral neuromodulation (SNM) is a guideline-recommended treatment for voiding dysfunction including urgency, urge incontinence, and nonobstructive retention as well

Management staff’s perspectives on intervention strategies for workplace violence prevention in a tertiary health facility in Nigeria: a qualitative study

IntroductionHealth workers have increasingly become victims of workplace violence. However, negligible action has been given to developing workplace violence (WPV) prevention programs in hospital settings in low-middle-income countries. An effective workplace violence prevention program is crucial for preventing violence and managing the consequences of incidents. This study assessed management staff perspectives on intervention strategies for workplace violence prevention in a tertiary health facility in Nigeria.MethodsA qualitative study design was employed to explore the intervention strategies for preventing and managing workplace violence at a tertiary health facility in southeast Nigeria. Six focus group discussions were conducted with thirty-eight management-level staff. The interview transcripts were manually coded according to six predefined constructs of workplace violence: creating interdisciplinary harmony and WPV experiences, causes, prevention, program/policy contents, and implementation strategies. A manual thematic analysis approach was adopted, and the results were presented as narratives.ResultsThe findings revealed recognition, welfare, administrative control, and security as vital strategies for the WPV prevention program. The participants agreed that unanimity among staff could be promoted through respect for all cadres of staff and for people’s perspectives (creating interdisciplinary harmony). Assaults and staff intimidation/victimization (experiences), attributed to unethical/poor health workers’ behaviour and ethnic discrimination (causes), were viewed as preventable by ensuring patients’/caregivers’ welfare through respectful and timely care and staff’s welfare through incentives/remunerations and discouraging intimidation (prevention strategies). Furthermore, the staff expressed that the WPV program should employ administrative controls, including instituting WPV policy/unit, codes of ethics, and standard operating procedures across all workplace facets (program/policy contents), which should be implemented through awareness creation, enforcement of sanctions, and provision of appropriate and adequate security presence in the hospital (policy implementation strategies).ConclusionRespect, patient/staff welfare, administrative control, and security are strong mechanisms to prevent workplace violence in tertiary hospitals. Hospital management should institutionalize workplace violence prevention programs/policies and ensure compliance

Genetički polimorfizmi u dijabetesu: Utjecaj na terapiju oralnim antidijabeticima

Due to new genetic insights, etiologic classification of diabetes is under constant scrutiny. Hundreds, or even thousands, of genes are linked with type 2 diabetes. Three common variants (Lys23 of KCNJ11, Pro12 of PPARG, and the T allele at rs7903146 of TCF7L2) have been shown to be predisposed to type 2 diabetes mellitus across many large studies. Individually, each of these polymorphisms is only moderately predisposed to type 2 diabetes. On the other hand, monogenic forms of diabetes such as MODY and neonatal diabetes are characterized by unique clinical features and the possibility of applying a tailored treatment. Genetic polymorphisms in drug-metabolizing enzymes, transporters, receptors, and other drug targets have been linked to interindividual differences in the efficacy and toxicity of a number of medications. Mutations in genes important in drug absorption, distribution, metabolism and excretion (ADME) play a critical role in pharmacogenetics of diabetes. There are currently five major classes of oral pharmacological agents available to treat type 2 diabetes: sulfonylureas, meglitinides, metformin (a biguanide), thiazolidinediones, and α-glucosidase inhibitors. Other classes are also mentioned in literature. In this work, different types of genetic mutations (mutations of the gene for glucokinase, HNF 1, HNF1ß and Kir6.2 and SUR1 subunit of KATP channel, PPAR-γ, OCT1 and OCT2, cytochromes, direct drug-receptor (KCNJ11), as well as the factors that influence the development of the disease (TCF7L2) and variants of genes that lead to hepatosteatosis caused by thiazolidinediones) and their influence on the response to therapy with oral antidiabetics will be reviewed.Dijabetes tipa 2 dosegao je proporcije epidemije u SAD (> 18 milijuna) i cijelom svijetu (170 milijuna oboljelih osoba) te ima tendenciju daljnjeg dramatičnog rasta. Stoga se u posljednje vrijeme ulažu napori da se otkriju i razviju novi farmakološki agensi za liječenje ove bolesti. Klasifikacija šećerne bolesti proširena je uspjesima istraživača na području genetike. Da bismo razumjeli farmakogenetiku antidijabetika neophodno je razumjeti genetiku samog dijabetesa. Kao što će biti prikazano u ovom radu veliki broj gena koji su povezani s razvojem dijabetesa takođe utječu i na odgovor na terapiju antidijabeticima. S druge strane, mutacije gena koji utječu na ADME (apsorpcija, distribucija, metabolizam i ekskrecija) lijeka imaju značajan utjecaj na farmakogenetiku oralnih antidijabetika. Utvrđeno je da je dijabetes genetički heterogena bolest. Uobičajeni oblici dijabetesa su gotovo uvijek poligenski i za razvoj same bolesti vrlo su značajne snažne interakcije među različitim genima kao i između gena i okoliša. Zbog toga mutacije ili polimorfizmi koji u manjoj mjeri utječu na funkciju gena mogu postati klinički značajni samo u slučaju kada se kombiniraju s drugim faktorima odnosno genima. Smatra se da u razvoju dijabetesa mogu sudjelovati stotine pa čak i tisuće gena. Do 2006. identificirano je nekoliko uobičajenih alela koji povećavaju rizik za razvoj dijabetesa, od kojih su najznačajniji PPARG (Pro12), KCNJ11 (Lys23) i TCF7L2 (T na rs7903146). Do danas je najveći uspjeh postignut u identifikaciji gena odgovornih za razmjerno rijetke oblike ove bolesti poput ”Maturity-onset diabetes of the young” (MODY) i neonatalnog dijabetesa. Monogenske oblike dijabetesa odlikuju jedinstvene kliničke karakteristike i mogućnost primjene individualnog tretmana. Genetički polimorfizmi enzima koji utječu na metabolizam lijekova, transportera, receptora i drugih ciljeva djelovanja lijekova povezani su s interindividualnim razlikama u efikasnosti i toksičnosti mnogih lijekova. Vrlo je važno da se na temelju farmakogenetičkih istraživanja mogu predvidjeti neki neželjeni efekti lijekova. Trenutačno postoji pet glavnih klasa oralnih antidijabetika: sulfoniluree, meglitinidi, metformin (bigvanid), tiazolidindioni i inhibitori α-glukozidaze. U literaturi se također spominju inhibitori dipeptidil peptidaze IV (DPP-IV), selektivni antagonisti kanabinoidnog receptora 1 (CB-1), glukagonu slični peptid 1 mimetici i amilin mimetici. Razumijevanje mehanizama koji rezultiraju disfunkcijom β stanica na fiziološkom i molekularnom nivou neophodno je za napredak u razumijevanju tretmana dijabetesa. U ovom radu dat je pregled različitih genetičkih mutacija (mutacije gena za glukokinazu, HNF 1, HNF1ß, Kir6.2 i SUR 1 podjedinicu KATP kanala ß stanica, PPAR-γ, OCT1 i OCT2, citohrome, KCNJ11, faktore koji utječu na razvoj bolesti (TCF7L2) i varijante gena koji dovode do hepatosteatoze uzrokovane tiazolidindionima) te njihov utjecaj na odgovor na terapiju oralnim antidijabeticima

Renal artery sympathetic denervation:observations from the UK experience

Background: Renal denervation (RDN) may lower blood pressure (BP); however, it is unclear whether medication changes may be confounding results. Furthermore, limited data exist on pattern of ambulatory blood pressure (ABP) response—particularly in those prescribed aldosterone antagonists at the time of RDN. Methods: We examined all patients treated with RDN for treatment-resistant hypertension in 18 UK centres. Results: Results from 253 patients treated with five technologies are shown. Pre-procedural mean office BP (OBP) was 185/102 mmHg (SD 26/19; n = 253) and mean daytime ABP was 170/98 mmHg (SD 22/16; n = 186). Median number of antihypertensive drugs was 5.0: 96 % ACEi/ARB; 86 % thiazide/loop diuretic and 55 % aldosterone antagonist. OBP, available in 90 % at 11 months follow-up, was 163/93 mmHg (reduction of 22/9 mmHg). ABP, available in 70 % at 8.5 months follow-up, was 158/91 mmHg (fall of 12/7 mmHg). Mean drug changes post RDN were: 0.36 drugs added, 0.91 withdrawn. Dose changes appeared neutral. Quartile analysis by starting ABP showed mean reductions in systolic ABP after RDN of: 0.4; 6.5; 14.5 and 22.1 mmHg, respectively (p < 0.001 for trend). Use of aldosterone antagonist did not predict response (p < 0.2). Conclusion: In 253 patients treated with RDN, office BP fell by 22/9 mmHg. Ambulatory BP fell by 12/7 mmHg, though little response was seen in the lowermost quartile of starting blood pressure. Fall in BP was not explained by medication changes and aldosterone antagonist use did not affect response

Elite Suppressors Harbor Low Levels of Integrated HIV DNA and High Levels of 2-LTR Circular HIV DNA Compared to HIV+ Patients On and Off HAART

Elite suppressors (ES) are a rare population of HIV-infected individuals that are capable of naturally controlling the infection without the use of highly active anti-retroviral therapy (HAART). Patients on HAART often achieve viral control to similar (undetectable) levels. Accurate and sensitive methods to measure viral burden are needed to elucidate important differences between these two patient populations in order to better understand their mechanisms of control. Viral burden quantification in ES patients has been limited to measurements of total DNA in PBMC, and estimates of Infectious Units per Million cells (IUPM). There appears to be no significant difference in the level of total HIV DNA between cells from ES patients and patients on HAART. However, recovering infectious virus from ES patient samples is much more difficult, suggesting their reservoir size should be much smaller than that in patients on HAART. Here we find that there is a significant difference in the level of integrated HIV DNA in ES patients compared to patients on HAART, providing an explanation for the previous results. When comparing the level of total to integrated HIV DNA in these samples we find ES patients have large excesses of unintegrated HIV DNA. To determine the composition of unintegrated HIV DNA in these samples, we measured circular 2-LTR HIV DNA forms and found ES patients frequently have high levels of 2-LTR circles in PBMC. We further show that these high levels of 2-LTR circles are not the result of inefficient integration in ES cells, since HIV integrates with similar efficiency in ES and normal donor cells. Our findings suggest that measuring integration provides a better surrogate of viral burden than total HIV DNA in ES patients. Moreover, they add significantly to our understanding of the mechanisms that allow viral control and reservoir maintenance in this unique patient population