The Implications of Insurance Status on Presentation, Surgical Management and Mortality among Non-Metastatic Breast Cancer Patients in Indiana

Background The National Breast and Cervical Cancer Early Detection Program seeks to reduce health care disparities by providing uninsured and underinsured women access to screening mammograms. The objective of this study is to identify the differences in presentation, surgical management, and mortality among nonmetastatic uninsured patients diagnosed through Indiana's Breast and Cervical Cancer Program compared with patients with private and government (Medicare or Medicaid) insurance. Methods Study data were obtained using the Indiana state cancer registry and Indiana's Breast and Cervical Cancer Program. Women aged 50 to 64 with an index diagnosis of stage 0 to III breast cancer from January 1, 2006 to December 31, 2013, were included in the study. Bivariate intergroup analysis was conducted. Kaplan-Meier estimates between insurance types were compared using the log rank test. All-cause mortality was evaluated using a mixed effects model. Results The groups differed significantly for sociodemographic and clinical variables. Uninsured Indiana Breast and Cervical Cancer Program patients presented with later disease stage (P < .001) and had the highest overall mortality (hazard ratio 2.2, P = .003). Surgical management only differed among stage III patients (P = .012). Conclusion To improve insurance-based disparities in Indiana, implementation of the Breast and Cervical Cancer Program in conjunction with expansion of insurance coverage to vulnerable low-income populations need to be optimized

Urban sprawl and land use/land-cover transition probabilities in peri-urban Kumasi, Ghana

This paper examines Land Use and Land Cover (LULC) transition probabilities and its implications for Kumasi Metropolis using remote sensing image analysis technique. Methods used for the study include sub-setting of satellite images for the metropolis using the metropolitan shapefile boundary and classification of the images using maximum likelihood image classification algorithm. A Markov Model was applied to predict probabilities of LULC changes in 15 years (2016 - 2031). Study results show the probability of urban lands changing to agricultural land as low and so is the probability of farmland transitioning to urban land use. Vegetation however shows a high probability of change to built-up area while the likelihood of change from water to other land cover types is not a possibility. The study recommends enforcement of relevant land use policies backed by vigorous public education to make sustainable urban land use in the Metropolis a reality. Also, vertical rather than horizontal construction of buildings could stem the sprawling city

Packaging Research Outputs into Extension and Training Materials: Experiences and Lessons Learned in Development of Grains in Ghana

La recherche engendre beaucoup de technologies qui restent sous-dissemineés. Donc l'objectif principal de propager les résultats de la recherche aux utilisateurs n'est jamais achevé. Le papier décritles expériences et les leçons apprises lors du conditionnement des résultats de la recherche en matériau de la formation et la vulgarisation pour l'utilisation des paysans et des vulgarisations sous le prójet du dévéloppement des grains au Ghana. Basé sur les expériences et les leçons apprises, une série de récommendations sont proposées pour améliorer le processus de la production du matériau de la formation et la vulgarisation. Ce sont:i) déterminer le type du matériau à produire et pourquoi,ii) appliquer un plan efficace d'écriture et de rédaction,iii) employer les dessins appropriés,iv) évaluer les matériaux pendant et après la production.Research generates numerous technologies that remain under-disseminated. As a result one primary objective of research to develop improved production systems and get the research results out to the user is not achieved. This paper describes the experiences and lessonslearned in packaging research outputs into extension and training materials for use by extension workers and farmers under the Ghana Grains Development Project. Based on the experiences and lessons learned, a series of recommendations are made for improving theproduction process of extension and training materials. These emphasize (i) determining the type of material to be produced and why, (ii) applying effective writing and editing guidelines, (iii) using appropriate designs and (iv) to evaluate materials during and after production

Aetiological Agents of Ear Discharge: A Two year Review in a Teaching Hospital in Ghana

Background: The discharging ear is a common presentation in medical practice affecting all age groups but primarily children. This study shows the current aetiological causes of ear discharge and their antibiograms, data which would guide empirical treatment of ear infections, and also form a basis for further research.Methodology: This was a retrospective review of laboratory records of all ear swabs submitted for culture over a two year period in the Korle Bu Teaching Hospital Accra, Ghana. Data was obtained on demographic characteristics of patients, clinical diagnosis, isolated organisms and antibiotic susceptibility patterns of the isolated organisms. Data was analyzed by simple descriptive statistics.Results: A total of 351 ear swabs were received by the laboratory for processing over the two year period. Of these 277(78.9%) had microorganisms isolated. A significant number127 (47%) was obtained from children under five years. Pseudomonas spp was the commonly isolated organism 121(46%) followed by Staphylococcus aureus 33(12.5%) and Proteus spp 32(12.2%). Candida was the commonest isolated fungi  9 (69.2%). Susceptibility of Pseudomonas spp to commonly used ototopics (ciprofloxacin &amp; gentamicin) was 93% and 74% respectively.Conclusions: Most cases of the discharging ear were found in children under the age of five years. The most common bacteriologic cause of the discharging ear was Pseudomonas spp followed by Staphylococcus aureus. Candida species was the commonest fungal cause of ear discharge. Ciprofloxacin and gentamicin are effective ototopic antimicrobial agents for empirical treatment of the discharging ear.Key words: Ear discharge, antimicrobial agents, susceptibility, ototopics, Korle-Bu teaching hospita

Fungi associated with sweet potato tuber rot at CSIR - PGRRI, Bunso, Eastern Region, Ghana

Rotten sweet potato root tuber samples were collected from a barn and experimental field of the CSIR - Plant Genetic Resources Research Institute (PGRRI), Bunso. Isolation and identification of the fungi associated with the samples were carried out at the Plant Pathology Laboratory of the same institute. In all, six fungal species belonging to four genera, namely Fusarium solani, Sclerotium rolfsii, Lasiodiplodia theobromae, Aspergillus ochraceus, Aspergillus flavus and Aspergillus niger were isolated from the samples from both the barn and the experimental field of CSIR - PGRRI. Fusarium solani and Aspergillus niger were frequently isolated from the sweet potato tuber samples from both the field and the barn. Pathogenicity tests carried out using the six fungal isolates on fresh and healthy sweet potato tubers showed that all the six fungi isolated were pathogenic in causing rot of sweet potato tubers with Lasiodiplodia theobromae being the most virulent

Computational and Experimental Study on Undoped and Er-Doped Lithium Tantalate Nanofluorescent Probes

We present a combined density functional theory (DFT) and experimental work on lithium tantalate LiTaO3 (LT) and its Er-doped counterparts. We calculate the electronic and optical properties for both LT and LT:Er+3, with Er occupying either Li or Ta sites, at 4.167 mol%. The generalized gradient approximation (GGA) calculations show that the Er-4 f bands appear closer to the conduction band bottom and to the valance band top, for the first and second doped configurations, respectively. This agrees with changes in the imaginary part of the frequency dependent dielectric function between the doped configurations. There are striking differences between the GGA and the hybrid functional HSE06 calculations for the band structures of the doped configurations. HSE06 accurately predicts the location in energy for all Er-4 f orbitals: These are now spread in energy and appear above and below the Fermi energy. We synthesized LT:Er+3 nanoparticles, validated through X-ray diffraction and Scanning Electron Microscopy. Differential scanning calorimetry and thermogravimetric analysis confirmed increases in the activation energy and lowering of the reaction temperature due to Er+3 doping. The LT:Er+3photoluminescence showed strong f–f emission in the visible and near-infrared regions, in an excellent agreement with the HSE06 electronic information

Global Prevalence of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

1. Abstract 1.1. Background: Evidence suggests that diabetes in all forms are on the rise especially gesta-tional diabetes mellitus which increases the risk of maternal and neonatal morbidities; however global prevalence rates and geographical distribution of GDM remain uncertain. The aim of this study is to examine the global burden of gestational diabetes mellitus. 1.2. Methods: A systematic review and meta-analysis of studies reporting Randomised Clinical Trials (RCTs) in pregnant women who have GDM was conducted. Cochrane (Central), PubMed, Scopus, JBI, Medline, EMBASE and reference lists of retrieved studies were searched from inception to March 2019. Publications on prevalence of GDM irrespective of the baseline criteria used to diagnose GDM were included in the study. Studies were limited to English language, randomised control trials and women aged between 19-44 years inclusive. 1.3. Results: Eleven RCTs met the inclusion criteria for this review. The included studies collectively reported GDM rates of 13,450 pregnant women from 7 countries. The diagnostic criteria used in the studies were World Health Organisation (WHO) 1985 and 1999, International Association of Diabetes, Pregnancy Study Group (IADPSG), National Diabetes Data Group (NDDG), Carpenter-Coustan (C&C) and O'Sullivan's criteria. Seven RCTs screened for GDM in comparison with different diagnostic criteria in the same population while three studies used the same criteria for different groups. One study compared 100g, 3h OGTT to 75g, 2h OGTT for diagnosing GDM using Carpenter and Coustan criteria. All seven RCTs that compared different diagnostic criteria in the same population detected different prevalence rates of GDM. Three RCTs measured prevalence of GDM in the same population using WHO 1999 and IADPSG 2013 criteria. Using random effect model, data from three studies that compared IADPSG criteria to WHO 1999 showed an Odds Ratio (OR) of 0.52(0.15, 1.84), 95% Confidence Interval (CI) and high heterogeneity of 99%. In all three studies, prevalence of GDM measured by IADPSG criteria was higher than WHO 1999 criteria, although not significant (p= 0.31). Combining all the studies gave a global estimated prevalence of GDM to be 10.13% (95% CI, 7.33-12.94) with moderate heterogeneity of 27%. The highest prevalence of GDM wit

Gender differences in beliefs about health:A comparative qualitative study with Ghanaian and Indian migrants living in the United Kingdom

Background There is a well-established association between migration to high income countries and health status, with some groups reporting poorer health outcomes than the host population. However, processes that influence health behaviours and health outcomes across minority ethnic groups are complex and in addition, culture ascribes specific gender roles for men and women, which can further influence perspectives of health. The aim of this study was to undertake a comparative exploration of beliefs of health among male and female Ghanaian and Indian migrants and White British participants residing in an urban area within the UK. Methods Thirty-six participants (12 each Ghanaian, Indian and White British) were recruited through community settings and participated in a semi-structured interview focusing on participant’s daily life in the UK, perceptions of their own health and how they maintained their health. Interviews were analyzed using a Framework approach. Results Three super ordinate themes were identified and labelled (a) beliefs about health; (b) symptom interpretation and (c) self-management and help seeking. Gender differences in beliefs and health behaviour practices were apparent across participants. Conclusions This is the first study to undertake a comparative exploration of health beliefs among people who have migrated to the UK from Ghana and India and to compare with a local (White British) population. The results highlight a need to consider both cultural and gender-based diversity in guiding health behaviours, and such information will be useful in the development of interventions to support health outcomes among migrant populations

Linking Structural Racism and Discrimination and Breast Cancer Outcomes: A Social Genomics Approach

We live in a society where individuals and communities are marginalized because of their race or ethnicity. This structural inequity extracts enormous health and societal costs, decreasing access to cancer care and increasing health disparities, especially among the most vulnerable. In an effort to identify causes of disparities, we have incorporated individual sociodemographic characteristics (eg, income and education) and other social determinants of health (eg, access to care, insurance, and transportation needs), as well as biologic markers (eg, genetic predisposition to disease) that can serve as therapeutic targets into our research