Physical factors contributing to rural water supply functionality performance in Uganda

This report communicates the findings generated from one of the project surveys – deconstruction and forensic analysis of 50 individual water points in Uganda. The report presents the new data generated to Uganda’s groundwater resource potential; the nature and condition of hand-pump borehole installations; and the significance of both of these factors to service performance. Based on the evidence collected, the main physical factors affecting functionality performance within Uganda are the poor condition of handpump components, and the complex aquifer resource. The impact of these factors can be mitigated through appropriate material choice for handpump components (non GI), increased investment in borehole siting and testing, and adequate accessibility to repairs and maintenance capacity with breakdowns. These factors should not be considered to be the only driving forces of functionality outcomes in these regions of Uganda, however, and the results of this survey need to be examined alongside the wider project findings. Wider institutional arrangements, resources and dynamics, are likely to play a significant role in the implementation of appropriate borehole construction, siting and design; procurement processes; and the management capacity available for water points at national to local levels

Acute toxicity, antipyretic and antinociceptive study of the crude saponin from an edible vegetable: Vernonia amygdalina leaf

Vernonia amygdalina is commonly used for food and health purposes. Processing of the leaf for food is aimed at removing bitter tasting antinutritional principles like saponins. This study was designed to determine the antipyretic and antinociceptive property of the crude saponin from Vernonia amygdalina leaf. Standard procedure for antipyretic study using Saccharomyces cerevisiae induced pyrexia in rats; and acetic acid induced writhe, hot plate and cold tail flick tests for antinociceptive study in mice were used. Data for the crude saponin showed significant (P ≤ 0.05) dose dependent anal temperature decrease. The antinociceptive data in mice was significant (P ≤ 0.05) in the writhing test contrary to the cold tail flick test. In acute toxicity study, an LD50 of 5.1523 g/kg using oral route indicated it was practically non-toxic. Finding suggests that Vernonia amygdalina leaf prepared as diet could be of potential benefit to ailing persons with fever and/or pains, if processing technique adopts minimal loss of principles like saponins.Keywords: Mice, oral, pain, pyrexia, ra

UPGro Hidden Crisis Research Consortium. Survey 1 Country Report, Uganda

Statistics on the functionality of water points from the Hidden Crisis project in Uganda are presented. The survey, undertaken in 2016, was focussed on boreholes equipped with handpumps (HPBs) within the 112 districts of Uganda. A stratified two stage random sampling approach was adopted and 10 districts identified to sample. A tiered definition of functionality was applied, and all which enabled more nuanced definitions to be reported: The results from the survey indicate: • 55% of HPBs were working on the day of the survey (compared to national figure of 86% for rural water supply ) • 34% of HPBs passed the design yield of 10 litres per minute • 23% passed the design yield and also experienced < 1 month downtime within a year. • 18% passed the design yield and reliability criteria and also water quality criteria The results of the survey indicate the utility of carrying out more detailed assessments of functionality to help unpack national statistics. A linked survey of the performance of the water management arrangements at water points showed that for 70% of the sites water management arrangements were judged to be weak

The impact of cardiovascular medication use on patients’ daily lives: a cross-sectional study

Introduction The management of multiple long-term medicines use in patients with chronic diseases creates a burden for patients. However, limited research is performed on patients’ experienced medication-related burden and its impact on daily lives. Therefore, the aim of this study was to explore the impact of cardiovascular medication on different aspects of patients’ daily lives and to examine the differences of these aspects between adherent and non-adherent patients. Methods A cross-sectional study was performed in two community pharmacies in the Netherlands. Patients (?45 years) using cardiovascular medication participated. Data were collected by means of the Living with Medicines Questionnaire (LMQ-2) measuring the burden of medicines use on patients’ daily lives. Two equally group-sized samples of patients non-adherent to prescribed medicines as assessed with pharmacy refill data, and patients adherent to prescribed medicines were selected. Results In total, 196 patients participated (51% male, 71.0±10.6 years), of whom 96 patients were non-adherent to cardiovascular medication. Substantial proportions of patients experienced medication-related burden on different daily life aspects. This burden was mainly related to the acceptance of long-term medication use, medication-related concerns or dissatisfaction, the interference of medicines with social and daily lives, and the interaction and communication with health care providers. No statistically significant results were found when comparing the impact on patients’ daily lives between the adherent and non-adherent sample. Conclusion Health care providers should acknowledge the impact of multiple long-term medicine use on patient’s daily lives and should make an effort to diminish patients’ medication-related burden by improving patient-provider relationships and by providing adequate treatment information incorporating patients’ individual circumstances and preferences. This may facilitate the integration of long-term medicines use in patients’ daily lives

UPGro Hidden Crisis Research Consortium : project approach for defining and assessing rural water supply functionality and levels of performance

This technical brief is aimed at sharing the learning and approaches developed by the UPGro Hidden Crisis Research Project to look at how the functionality and performance levels of boreholes equipped with handpumps (HPBs), can be assessed using a common set of definitions and methods. A tiered approach to defining and measuring functionality is found to be useful to examining functionality for different scales and purposes of monitoring. This report is aimed at national and regional actors involved in the provision and monitoring of rural water supply functionality. The brief sets out the tiered functionality definitions, and accompanying survey methods, which were developed by the project and have been applied in functionality surveys across Ethiopia, Uganda and Malawi [5-7]. The brief provides a summary of: • The tiered approach to defining and measuring the functionality and performance levels of boreholes equipped with handpumps (HPBs). • A series of survey methods which were found to be useful by the Hidden Crisis project to collect sufficient data to assess HPB functionality across the tiered definition approach. • A series of guidelines which could form core criteria for assessing functionality and performance levels of water points . This summary should be read in conjunction with the appendices which provide details of the methods and approaches described

Shared decision making and experiences of patients with long-term conditions : has anything changed?

Background Medication problems among patients with long-term conditions (LTCs) are well documented. Measures to support LTC management include: medicine optimisation services by community pharmacists such as the Medicine Use Review (MUR) service in England, implementation of shared decision making (SDM), and the availability of rapid access clinics in primary care. This study aimed to investigate the experience of patients with LTCs about SDM including medication counselling and their awareness of community pharmacy medication review services. Methods A mixed research method with a purposive sampling strategy to recruit patients was used. The quantitative phase involved two surveys, each requiring a sample size of 319. The first was related to SDM experience and the second to medication counselling at discharge. Patients were recruited from medical wards at St. George’s and Croydon University Hospitals.The qualitative phase involved semi-structured interviews with 18 respiratory patients attending a community rapid access clinic. Interviews were audio-recorded and transcribed verbatim. Thematic analysis using inductive/deductive approaches was employed. Survey results were analysed using descriptive statistics. Results The response rate for surveys 1 and 2 survey was 79% (n = 357/450) and 68.5% (240/350) respectively. Survey 1 showed that although 70% of patients had changes made to their medications, only 40% were consulted about them and two-thirds (62.2%) wanted to be involved in SDM. In survey 2, 37.5% of patients thought that medication counselling could be improved. Most patients (88.8%) were interested in receiving the MUR service; however 83% were not aware of it. The majority (57.9%) were interested in receiving their discharge medications from community pharmacies. The interviews generated three themes; lack of patient-centered care and SDM, minimal medication counselling provided and lack of awareness about the MUR service. Conclusion Although patients wanted to take part in SDM, yet SDM and medication counselling are not optimally provided. Patients were interested in the MUR service; however there was lack of awareness and referral for this service. The results propose community pharmacy as a new care pathway for medication supply and counselling post discharge. This promotes a change of health policy whereby community-based services are used to enhance the performance of acute hospitals

Sex in the shadow of HIV:A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIVpositive adolescents and youth in sub-Saharan Africa

Background Evidence on sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa is urgently needed. This systematic review synthesizes the extant research on prevalence, factors associated with, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. Methods Studies were located through electronic databases, grey literature, reference harvesting, and contact with researchers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Quantitative studies that reported on HIV-positive participants (10-24 year olds), included data on at least one of eight outcomes (early sexual debut, inconsistent condom use, older partner, transactional sex, multiple sexual partners, sex while intoxicated, sexually transmitted infections, and pregnancy), and were conducted in sub-Saharan Africa were included. Two authors piloted all processes, screened studies, extracted data independently, and resolved any discrepancies. Due to variance in reported rates and factors associated with sexual risk-taking, meta-analyses were not conducted. Results 610 potentially relevant titles/abstracts resulted in the full text review of 251 records. Forty-two records (n=35 studies) reported one or multiple sexual practices for 13,536 HIV-positive adolescents/youth from 13 sub-Saharan African countries. Seventeen cross-sectional studies reported on individual, relationship, family, structural, and HIV-related factors associated with sexual risk-taking. However, the majority of the findings were inconsistent across studies, and most studies scored Conclusions Sexual risk-taking among HIV-positive adolescents and youth is high, with inconclusive evidence on potential determinants. Few known studies test secondary HIV-prevention interventions for HIV-positive youth. Effective and feasible low-cost interventions to reduce risk are urgently needed for this group.</p

Cassava Spectral and Image Dataset

We present a spectral dataset, procedures and steps we adopted to collect disease data in a controlled environment aiming at early disease detection in cassava. As a baseline, we extended these procedures to an open-field experiment. We collected visible and near-infrared spectra captured from leaves infected with two common cassava diseases. Together we collected plant image data from leaves where spectral data was captured. In this experiment, biochemical data was collected and taken as the ground truth. Finally, agricultural experts provided a disease score for each plant where data was collected. The process of disease monitoring and data collection took 19 and 15 consecutive weeks for screen house and open field respectively until disease symptoms were visibly seen by the human eye