Do Health Workers' Preferences Influence their Practices? Assessment of Providers' Attitude and Personal use of new Treatment Recommendations for Management of Uncomplicated Malaria, Tanzania.

\ud \ud Due to growing antimalarial drug resistance, Tanzania changed malaria treatment policies twice within a decade. First in 2001 chloroquine (CQ) was replaced by sulfadoxine-pyrimethamine (SP) for management of uncomplicated malaria and by late 2006, SP was replaced by artemether-lumefantrine (AL). We assessed health workers' attitudes and personal practices following the first treatment policy change, at six months post-change and two years later. Two cross-sectional surveys were conducted in 2002 and 2004 among healthcare workers in three districts in South-East Tanzania using semi-structured questionnaires. Attitudes were assessed by enquiring which antimalarial was considered most suitable for the management of uncomplicated malaria for the three patient categories: i) children below 5; ii) older children and adults; and iii) pregnant women. Practice was ascertained by asking which antimalarial was used in the last malaria episode by the health worker him/herself and/or dependants. Univariate and multivariate logistic regression was used to identify factors associated with reported attitudes and practices towards the new treatment recommendations. A total of 400 health workers were interviewed; 254 and 146 in the first and second surveys, respectively. SP was less preferred antimalarial in hospitals and private health facilities (p<0.01) in the first round, and the preference worsened in the second round. In the first round, clinicians did not prefer SP for children below age of 5 and pregnant women (p<0.01), but two years later, they did not prefer it for all patient scenarios. SP was the most commonly used antimalarial for management of the last malaria episode for health workers and their dependants in both rounds, in the public sector (p<0.01). Health workers in the dispensaries had the highest odds of using SP for their own treatment [adjusted OR- first round: 6.7 (95%CI: 1.9-23.4); crude OR- second round: 4.5 (1.5-13.3)]. Following changes in malaria treatment recommendations, most health workers did not prefer the new antimalarial drug, and their preferences worsened over time. However, many of them still used the newly recommended drug for management of their own or family members' malaria episode. This indicates that, other factors than providers' attitude may have more influence in their personal treatment practices

Packaging of RF Mems Switching Functions on Alumina Substrate

Recently the strong demands in wireless communication requires expanding development for the application of RF MEMS (Radio Frequency micro electro mechanical systems) sensing devices such as micro-switches, tunable capacitors because it offers lower power consumption, lower losses, higher linearity and higher Q factors compared with conventional communications components. To accelerate commercialisation of RF MEMS products, development for packaging technologies is one of the most critical issues should be solved beforehand.Comment: Submitted on behalf of TIMA Editions (http://irevues.inist.fr/tima-editions

Double precision trajectory program /DPTRAJ 2.2C/

Four part program computes trajectory of space probe moving in solar system and subject to variety of forces

Optimization of mix composition of cement-less wastepaper-based lightweight block (CWLB)

The development of cement-less wastepaper-based lightweight block (CWLB) is another important step towards the production of eco-friendly building materials from wastepaper. This block which was designed to be used for non-load bearing/non-structural application was developed without the use of hydraulic cement. This study was conducted to optimize the mix composition of CWLB for the purpose of maximizing its compressive strength. This aim was achieved by employing the Taguchi statistical optimization technique in conjunction with laboratory experimentation. The result indicated that water/binder ratio had the most significant effect on the compressive strength of CWLB. The analysis of result establishes the CWLB specimen with optimal parameter to be that which was made from; 2.5 WPA/Sand ratio, 0.75 Water/binder ratio, and 3.5 Metric ton (i.e. 13.7MPa) compacting force. Also, the optimal CWLB displayed; an average compressive strength of 2.71MPa which indicated an increase of 402% compared to the 0.50MPa displayed by the worst parameter combination and an average density of 901.5kg/m3. The compressive strength and the density of the optimal CWLB was found to maximally satisfy the requirements for non-load bearing lightweight blocks. Considering the high amount (typically, 75%) of waste content in the composition of CWLB, it was reckoned as a viable eco-friendly lightweight block suitable for non-load bearing application. Future work will investigate other relevant properties of CWLB which include; Elastic modulus, water absorption, thermal conductivity, and reaction to fire. Key-Words: - Taguchi method, compressiv

Health Worker Factors Associated with Prescribing of Artemisinin Combination Therapy for Uncomplicated Malaria in Rural Tanzania.

Improving malaria case management is partially dependent on health worker compliance with clinical guidelines. This study assessed health worker factors associated with correct anti-malarial prescribing practices at two sites in rural Tanzania. Repeated cross-sectional health facility surveys were conducted during high and low malaria transmission seasons in 2010 and collected information on patient consultations and health worker characteristics. Using logistic regression, the study assessed health worker factors associated with correct prescription for uncomplicated malaria defined as prescription of artemisinin-based combination therapy (ACT) for patients with fever and Plasmodium falciparum asexual infection based on blood slide or malaria rapid diagnostic test (RDT) according to national treatment guidelines. The analysis included 685 patients with uncomplicated malaria who were seen in a health facility with ACT in stock, and 71 health workers practicing in 30 health facilities. Overall, 58% of malaria patients were correctly treated with ACT. Health workers with three or more years' work experience were significantly more likely than others to prescribe correctly (adjusted odds ratio (aOR) 2.9; 95% confidence interval (CI) 1.2-7.1; p = 0.019). Clinical officers (aOR 2.2; 95% CI 1.1-4.5; p = 0.037), and nurse aide or lower cadre (aOR 3.1; 95% CI 1.3-7.1; p = 0.009) were more likely to correctly prescribe ACT than medical officers. Training on ACT use, supervision visits, and availability of job aids were not significantly associated with correct prescription. Years of working experience and health worker cadre were associated with correct ACT prescription for uncomplicated malaria. Targeted interventions to improve health worker performance are needed to improve overall malaria case management

Operand Value Based Modeling and Estimation of Dynamic Energy Consumption of Soft Processors in FPGA

This thesis presents a novel method for estimating the dynamic energy consumption of soft processors in FPGA, using an operand-value-based model. The processor energy model is created at the instruction-level, which enables fast, early and accurate energy estimation. The modeling heuristic is based on the observation that the energy required to execute instructions on an FPGA implementation of a soft processor has a strong dependence on the operand values. Our energy model contains three components: the instruction base energy, the maximum variation in the instruction energy due to input data, and the impact of one’s density of the operand values during software execution. The one’s density refers to the number of operand bits that are set to one. We use post-place and route processor simulations as a reference to evaluate the accuracy of our model, and that of other existing instruction-level energy models, for several benchmarks. We demonstrate that our model has only 4.7% average error and 12% worst case error compared to the reference, and is more than twice as accurate as existing instruction-level models. Key Words: Energy modeling, Soft processors, system-level design, Power estimation

Seasonal preference of Awassi sheep for Atriplex shrubs suitable for Mediterranean rangelands

The relative preference of Awassi sheep for four promising Atriplex species, A. halimus, A. nummularia, A. canescens and A. lentiformis was tested in cafeteria trials. Atriplex species were offered to sixteen sheep in cafeteria-type experiments during two seasons, spring and autumn. After an adaptation period of 7 days, sheep were offered the species over eight consecutive days. The species were placed in troughs for two hours in the morning after overnight fasting. Sheep were housed individually in pens adjacent to each other. In both seasons, whole species and their botanical fractions were evaluated for chemical composition and in vitro digestibility. The variability of nutritive value among species was not dependent on season or botanical fraction. Time series analysis showed that intake levels and ranking of species did not change over the eight days. Average daily proportions (%) of whole shrub eaten were A. halimus (70.9) A. nummularia (70), A. lentiformis (65.3), and A. canescens (57.9). In autumn, the same order of consumption was maintained, though intake levels tended to be lower compared to spring. The behavioral pattern revealed that the number of return visits to troughs and time spent feeding on species did not influence intake levels. The botanical structure of species explained 20% of the variation in proportion of intake of whole species. The proportion of leaf was the major contributor to variation in proportion of intake of whole species. Relative preference of whole species was explained by intake, nutritive value and fractional proportions of the botanical fractions

Crime and gambling disorders: A systematic review

It is generally believed that there is an instrumental relationship between problem gambling and crime such that some gamblers resort to illegal activity to recoup financial shortfalls resulting from their gambling. However, a clear understanding of the risk factors for the commission of crimes beyond financial stresses is absent in the literature. The aim of this review was to identify the nature of crimes perpetrated by problem gamblers and the factors that contribute to the commission of gambling-related crimes. A systematic review adhering to guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement searching eight databases – PsycINFO, Westlaw AU, Heinonline, Legal Source via Ebsco, Legaltrac via Gale, PubMed, Scopus, and Medline – was conducted. A total of 21 papers were included after screening and application of exclusion criteria. All studies examined reported crimes committed by problem gamblers, with a validated assessment tool measuring problem gambling. The review provided evidence that gambling-related crime typically consists of non-violent, income-generating offences. However, it also revealed that problem gamblers may commit violent crimes at a higher than expected rate, which may have been concealed by deliberate and unintentional under-reporting of gambling-related crimes. The causal relationship between problem gambling and violent crime, however, remains uncertain. Based on this review, suggestions are offered for the evaluation of perpetrators of gambling-related crime on a case-by-case basis, to better understand the relationship between gambling and crime and facilitate more frequent application of therapeutic jurisprudence in future.This work was supported by funding provided by the School of Psychology, Science Faculty, the University of Sydney. This work was supported by an Australian Research Council Discovery Early Career Research Award [DE1060100459] awarded to Dr. Sally Gainsbury