511 research outputs found
Agribusiness innovation: A pathway to sustainable economic growth in Africa
The paper considers the factors that drive a strong and competitive agri-business sector with particular attention to investment in research and development (R&D) for technological innovation as well as the broader drivers and risk factors of influence. It develops a case study and in particular contrasts the very successful value chain in Thailand with the weak one in Nigeria in order to highlight the implications for Nigerian government policy if it wishes to exploit the potential for a strong cassava agri-business sector
Improving Postoperative Pain Control After Cesarean Delivery with Enhanced Recovery in Patients on Buprenorphine Therapy
Abstract:
Introduction:
Prescription drug abuse presents a significant challenge to the management of post operative pain.Pain control amongst the opioid addicted patient can be especially challenging. We aimed to improve pain control after caesarian delivery with enhanced recovery in patients who are on buprenorphine medication-assisted therapy for the treatment of opioid addiction.
Materials and Methods:
We conducted a pilot study by implementing a protocol using liposomal bupivacaine injected at the time of cesarean delivery. Patients were then given 500mg acetaminophen every 4 hours, 800mg ibuprofen every 8 hours and 0.3mg IV buprenorphine every 6 hours as needed. The patients’ maintenance dosing of buprenorphine was divided into doses throughout the day. In addition, patients were ambulated 4 hours after surgery and had their catheter removed from their bladder as soon as they could safely ambulate. Eleven patients were prospectively recruited and then compared to a retrospective sample of seventeen patients.
Results:
Patients in the treatment group reported 27% lower pain scores (p
Discussion:
Our enhanced recovery protocol is an effective alternative to traditional pain control and is associated with a significant reduction in both pain scores and use of breakthrough IV buprenorphine as well as lower charges
The image of nursing, as perceived by Iranian male nurses
The stereotypical public image of nursing is a major concern for male nurses around the world. In this study, we explored how Iranian male nurses perceived the public view of nurses, and their perceptions of themselves. A qualitative descriptive design and content analysis were used to obtain data from 18 purposely-selected male hospital nurses with a baccalaureate nursing degree in Tabriz, Iran. Semistructured interviews were conducted and analyzed. Two main themes emerged: (i) the outsider's view of nursing, which referred to the participants' perceptions of their public image; and (ii) the insider's view, which related to the male nurses' perceptions of themselves. Results included personal transition into a positive professional self-image through the educational process, and continued public perception of nursing as a female profession ill-suited for a man. Strategies to improve the insider's and outsider's views of nursing are listed to help recruit and retain more Iranian male nurses
The era of sustainable agricultural development in Africa: Understanding the benefits and constraints
Sustainable agriculture has the potential to address some of the fundamental challenges facing agricultural practices in Africa especially in Sub-Saharan Africa (SSA). The agriculture sector plays an important role as the engine of economic growth in SSA. In this paper, we ask the following key question: can sustainable agriculture save Africa from poverty and food insecurity? To address this fundamental question, we examine and critique evidence of the benefits and challenges associated with the adoption of sustainable agricultural practices in Africa. Improving agricultural sustainability is fundamental to food security and poverty reduction, particularly in achieving elements of the sustainable development goals (SDGs) by 2030, but it will not solve all these problems alone. In consort, African governments and the international community must increase their efforts in tackling problems such as conflicts, civil war, political instability, and disease. Therefore agricultural policy at the national, regional and local levels and institutional reforms must be designed to benefit food security, poverty reduction and income growth at the household level
Defects in Crystalline Packings of Twisted Filament Bundles: II. Dislocations and Grain Boundaries
Twisted and rope-like assemblies of filamentous molecules are common and
vital structural elements in cells and tissue of living organisms. We study the
intrinsic frustration occurring in these materials between the two-dimensional
organization of filaments in cross section and out-of-plane interfilament twist
in bundles. Using non-linear continuum elasticity theory of columnar materials,
we study the favorable coupling of twist-induced stresses to the presence of
edge dislocations in the lattice packing of bundles, which leads to a
restructuring of the ground-state order of these materials at intermediate
twist. The stability of dislocations increases as both the degree of twist and
lateral bundle size grow. We show that in ground states of large bundles,
multiple dislocations pile up into linear arrays, radial grain boundaries,
whose number and length grows with bundle twist, giving rise to a rich class of
"polycrystalline" packings.Comment: 10 pages, 7 figure
Reducing Postoperative Opioids After Minimally Invasive Hysterectomy with Enhanced Recovery
I
Introduction:
We evaluated the efficacy of various strategies utilized for the control of postoperative pain after minimally invasive hysterectomy. The primary enhanced recovery after surgery (ERAS) protocol of interest utilized premedication (acetaminophen, celecoxib and pregabalin), then intraoperative subcutaneous liposomal bupivacaine followed by scheduled oral acetaminophen and ibuprofen postoperatively. Patients also had tramadol and oxycodone as needed for moderate or severe breakthrough pain, respectively.
Materials and Methods:
We conducted a retrospective cohort study that included all patients who underwent minimally invasive hysterectomy (total laparoscopic hysterectomy and laparoscopic-assisted vaginal hysterectomy) for both benign and oncologic indications over a 2-year period. We then compared six protocols, with 3 being ERAS protocols and 3 as traditional pain control methods. The control group was comprised of the traditional pain control group without intraoperative placement of local analgesia. Patient medical records were evaluated for demographics, surgical characteristics, opioid type and dose, pain scores, length of stay and complications. Opioids were converted to oral morphine dose equivalents.
Results:
954 patients were included within the 6 protocols. Median opioid usage was the lowest in the ERAS group with premedication and highest in the control group (22.5mg versus 55.0mg, p
Discussion:
ERAS protocol with premedication was associated with significant reductions in postoperative opioid use and median pain scores when compared to traditional methods
Pbx proteins in Cryptococcus neoformans cell wall remodeling and capsule assembly
The cryptococcal capsule is a critical virulence factor of an important pathogen, but little is known about how it is associated with the cell or released into the environment. Two mutants lacking PBX1 and PBX2 were found to shed reduced amounts of the capsule polysaccharide glucuronoxylomannan (GXM). Nuclear magnetic resonance, composition, and physical analyses showed that the shed material was of normal mass but was slightly enriched in xylose. In contrast to previous reports, this material contained no glucose. Notably, the capsule fibers of pbxΔ mutant cells grown under capsule-inducing conditions were present at a lower than usual density and were loosely attached to the cell wall. Mutant cell walls were also defective, as indicated by phenotypes including abnormal cell morphology, reduced mating filamentation, and altered cell integrity. All observed phenotypes were shared between the two mutants and exacerbated in a double mutant. Consistent with a role in surface glycan synthesis, the Pbx proteins localized to detergent-resistant membrane domains. These results, together with the sequence motifs in the Pbx proteins, suggest that Pbx1 and Pbx2 are redundant proteins that act in remodeling the cell wall to maintain normal cell morphology and precursor availability for other glycan synthetic processes. Their absence results in aberrant cell wall growth and metabolic imbalance, which together impact cell wall and capsule synthesis, cell morphology, and capsule association. The surface changes also lead to increased engulfment by host phagocytes, consistent with the lack of virulence of pbx mutants in animal models
A qualitative study of the infant feeding beliefs and behaviours of mothers with low educational attainment
© 2016 Russell et al. Background: Infancy is an important period for the promotion of healthy eating, diet and weight. However little is known about how best to engage caregivers of infants in healthy eating programs. This is particularly true for caregivers, infants and children from socioeconomically disadvantaged backgrounds who experience greater rates of overweight and obesity yet are more challenging to reach in health programs. Behaviour change interventions targeting parent-infant feeding interactions are more likely to be effective if assumptions about what needs to change for the target behaviours to occur are identified. As such we explored the precursors of key obesity promoting infant feeding practices in mothers with low educational attainment. Methods: One-on-one semi-structured telephone interviews were developed around the Capability Opportunity Motivation Behaviour (COM-B) framework and applied to parental feeding practices associated with infant excess or healthy weight gain. The target behaviours and their competing alternatives were (a) initiating breastfeeding/formula feeding, (b) prolonging breastfeeding/replacing breast milk with formula, (c) best practice formula preparation/sub-optimal formula preparation, (d) delaying the introduction of solid foods until around six months of age/introducing solids earlier than four months of age, and (e) introducing healthy first foods/introducing unhealthy first foods, and (f) feeding to appetite/use of non-nutritive (i.e., feeding for reasons other than hunger) feeding. The participants' education level was used as the indicator of socioeconomic disadvantage. Two researchers independently undertook thematic analysis. Results: Participants were 29 mothers of infants aged 2-11 months. The COM-B elements of Social and Environmental Opportunity, Psychological Capability, and Reflective Motivation were the key elements identified as determinants of a mother's likelihood to adopt the healthy target behaviours although the relative importance of each of the COM-B factors varied with each of the target feeding behaviours. Conclusions: Interventions targeting healthy infant feeding practices should be tailored to the unique factors that may influence mothers' various feeding practices, taking into account motivational and social influences
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