Access to assistive technology among students with visual impairment in higher education institutions in Tanzania: challenges and coping mechanisms

Access to assistive technology (AT) among students with visual impairment is highly dependent on their availability and the technical know-how of the users. This study reports the challenges students with visual impairment experience in accessing assistive technology and their coping mechanisms in Tanzania’s higher education institutions. The study used semi-structured interview and an open-ended questionnaire to collect data from17 students with visual impairment and four transcribers. The resultant qualitative data was subjected to descriptive and thematic analyses. The study has identified lack of knowledge on how to apply assistive technologies, limited ICT infrastructures, and shortage of assistive technology tools as major challenges for students with visual impairment when accessing AT in higher education institutions. Two major categories of problem-focused coping—social support networks and personal efforts—emerged. The former covers support from skilled/sighted peers and institutions in terms of training on assistive technology. The later deals with private learning through the Internet and other sources, sharing of available resources, use of smart phones, utilisation of alternative devices and borrowing of AT devices from other colleagues. Thus, the study recommends higher education institutions to provide sufficient and sustainable financial investment in AT in addition to improving their affordability to ensure that students with VI attain education equity. Similarly, students with visual impairment and their transcribers need regular training on assistive technology to enhancet heir accessing of assistive technologies

Realisation of multiuser access to School Management System(SMS)

The purpose of the research was to realize multiuser access to the School Management System which will provides authorization to available data in the system and those data will be only accessed to intended users. When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/3168

Effect of Annona Formulations on Non-target Invertebrates and on Physicochemical Water Parameters at Semi-field Condition

Plant extracts from the genus Annona exhibit insecticidal properties and thus, may offer an alternative to synthetic insecticides. In the present study larvicidal efficacy of formulations of Annona squamosa and A. montana were evaluated against Anopheline and Culicine larvae in the laboratory and semi-field conditions. In the laboratory there was no significant difference (t=0.5313, p>0.05) in the effectiveness of the A. squamosa formulation at 50 μg/ml and above between An. gambiae and Culex quinquefasciatus by day 4. Significant difference (t= 2.649, p<0.05) was observed for A. montana formulation at higher concentration than 50 μg/ml since An. gambiae was more susceptible than Cx. quinquefasciatus. In semi-field condition the efficacy of the two formulations against Anopheline was not quite significant (t= 2.504, p>0.05). The activity of A. montana leaf powder against Culicines was significantly lower compared to A. squamosal (t=3.827, P<0.05). The variation in water parameters had no significant effect on the efficacy of the formulations. The formulations did not affect the survival of the 9 invertebrate groups tested during the period of study except for the Order Ephemeroptera (Mayflies) whose mortalities was more than 85%. The\ud formulations have proven to offer an alternative to synthetic insecticides

The usage of Oracle database for creation School managment system

The purpose of the research was to elaborate the problems which can happen during the design of School Management System Application in Visual studio by using Database designed in Oracle 10g Express Edition and to elaborate the solution for those problems. When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/2863

Public and Private Maternal Health Service Capacity and Patient Flows in Southern Tanzania: Using a Geographic Information System to Link Hospital and National Census data.

Background : Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective : To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design : A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results : The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions : We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health programming. Inclusive partnerships could increase integration of FBOs into the public health care system and improve coordination and use of scarce resources

Genetic variants of CYP3A5, CYP2D6, SULT1A1, UGT2B15 and tamoxifen response in postmenopausal patients with breast cancer

INTRODUCTION: Tamoxifen therapy reduces the risk of recurrence and prolongs the survival of oestrogen-receptor-positive patients with breast cancer. Even if most patients benefit from tamoxifen, many breast tumours either fail to respond or become resistant. Because tamoxifen is extensively metabolised by polymorphic enzymes, one proposed mechanism underlying the resistance is altered metabolism. In the present study we investigated the prognostic and/or predictive value of functional polymorphisms in cytochrome P450 3A5 CYP3A5 (*3), CYP2D6 (*4), sulphotransferase 1A1 (SULT1A1; *2) and UDP-glucuronosyltransferase 2B15 (UGT2B15; *2) in tamoxifen-treated patients with breast cancer. METHODS: In all, 677 tamoxifen-treated postmenopausal patients with breast cancer, of whom 238 were randomised to either 2 or 5 years of tamoxifen, were genotyped by using PCR with restriction fragment length polymorphism or PCR with denaturing high-performance liquid chromatography. RESULTS: The prognostic evaluation performed in the total population revealed a significantly better disease-free survival in patients homozygous for CYP2D6*4. For CYP3A5, SULT1A1 and UGT2B15 no prognostic significance was observed. In the randomised group we found that for CYP3A5, homozygous carriers of the *3 allele tended to have an increased risk of recurrence when treated for 2 years with tamoxifen, although this was not statistically significant (hazard ratio (HR) = 2.84, 95% confidence interval (CI) = 0.68 to 11.99, P = 0.15). In the group randomised to 5 years' tamoxifen the survival pattern shifted towards a significantly improved recurrence-free survival (RFS) among CYP3A5*3-homozygous patients (HR = 0.20, 95% CI = 0.07 to 0.55, P = 0.002). No reliable differences could be seen between treatment duration and the genotypes of CYP2D6, SULT1A1 or UGT2B15. The significantly improved RFS with prolonged tamoxifen treatment in CYP3A5*3 homozygotes was also seen in a multivariate Cox model (HR = 0.13, CI = 0.02 to 0.86, P = 0.03), whereas no differences could be seen for CYP2D6, SULT1A1 and UGT2B15. CONCLUSION: The metabolism of tamoxifen is complex and the mechanisms responsible for the resistance are unlikely to be explained by a single polymorphism; instead it is a combination of several mechanisms. However, the present data suggest that genetic variation in CYP3A5 may predict response to tamoxifen therapy

Results of a randomized, double blind, placebo controlled, crossover trial of melatonin for treatment of Nocturia in adults with multiple sclerosis (MeNiMS)

© 2018 The Author(s). Background: Nocturia is a common urinary symptom of multiple sclerosis (MS) which can affect quality of life (QoL) adversely. Melatonin is a hormone known to regulate circadian rhythm and reduce smooth muscle activity such as in the bladder. There is limited evidence supporting use of melatonin to alleviate urinary frequency at night in the treatment of nocturia. The aim of this study was to evaluate the effect of melatonin on the mean number of nocturia episodes per night in patients with MS. Methods: A randomized, double blind, placebo controlled crossover trial was conducted. 34 patients with nocturia secondary to multiple sclerosis underwent a 4-day pre-treatment monitoring phase. The patients were randomized to receive either 2 mg per night (taken at bedtime) of capsulated sustained-release melatonin (Circadin®) or 1 placebo capsule for 6 weeks followed by a crossover to the other regimen for an additional 6 weeks after a 1-month washout period. Results: From the 26 patients who completed the study, there was no significant difference observed in the signs or symptoms of nocturia when taking 2 mg melatonin compared to placebo. The primary outcome measure, mean number of nocturia episodes on bladder diaries, was 1.8/night at baseline, and 1.4/night on melatonin, compared with 1.6 for placebo (Medians 1.70, 1.50, and 1.30 respectively, p = 0.85). There was also no significant difference seen in LUTS, QoL and sleep quality when taking melatonin. No significant safety concerns arose. Conclusions: This small study suggests that a low dose of melatonin taken at bedtime may be ineffective therapy for nocturia in MS. Trial registration: (EudraCT reference) 2012-00418321 registered: 25/01/13. ISRCTN Registry: ISRCTN38687869

Neoadjuvant Endocrine Therapy in Breast Cancer Upregulates the Cytotoxic Drug Pump ABCG2/BCRP, and May Lead to Resistance to Subsequent Chemotherapy

Introduction: Neoadjuvant treatments for primary breast cancer are becoming more common; however, little is known about how these impact on response to subsequent adjuvant therapies. Conveniently, neoadjuvant therapy provides opportunities to consider this question, by studying therapy-induced expression changes using comparisons between pre- and posttreatment samples. These data are relatively lacking in the context of neoadjuvant endocrine therapy, as opposed to the more common neoadjuvant chemotherapy. Here, we investigate the relevance of expression of the xenobiotic transporter ABCG2/BCRP, a gene/protein associated with chemoresistance, in the context of neoadjuvant endocrine therapy and particularly with reference to subsequent chemotherapy treatment. Materials and Methods: ABCG2/BCRP expression was assessed by immunohistochemistry or by expression arrays in matched patient samples pre- and post-neoadjuvant endocrine therapy. Cell culture was used to model the impact of endocrine therapy-induced changes in ABCG2/BCRP on subsequent chemotherapy response, using Western blots, quantitative polymerase chain reaction, survival assays, and cell cycle analyses. Results: ABCG2/BCRP was commonly and significantly upregulated in breast cancers after treatment with neoadjuvant endocrine therapy in 3 separate cohorts encompassing a total of 200 patients. Treatment with the endocrine therapeutic tamoxifen similarly induced ABCG2/BCRP upregulation in a relevant model cell line, the estrogen receptor-positive line T47D. Critically, this upregulation was associated with significantly increased chemoresistance to subsequent treatment with epirubicin, an anthracycline commonly used in breast cancer adjuvant chemotherapy. Conclusion: Our data suggest that neoadjuvant endocrine therapy may induce poor responses to adjuvant chemotherapy, and therefore, that clinical outcomes following this treatment sequence warrant further study