Physician use of updated anti-virus software in a tertiary Nigerian hospital

While physicians are becoming increasingly dependent on computers and the internet, highly lethal malware continue to be loaded into cyberspace. We sought to assess the proportion of physicians with updated anti-virus software in Jos University Teaching Hospital Nigeria and to determine perceived barriers to getting updates. We used a pre-tested semi-structured selfadministered questionnaire to conduct a cross-sectional survey among 118 physicians. The mean age (±SD) of subjects was 34(±4) years, with 94 male and 24 female physicians. Forty-two (36.5%) of 115 physicians with anti-virus software used an updated program (95%CI: 27, 45). The top-three antivirus software were: McAfee 40(33.9%), AVG 37(31.4%) and Norton 17(14.4%). Common infections were: Trojan horse 22 (29.7%), Brontok worm 8(10.8%), and Ravmonlog.exe 5(6.8%). Internet browsing with a firewall was an independent determinant for use of updated anti-virus software [OR 4.3, 95%CI, 1.86, 10.02; P< 0.001]. Busy schedule, 40(33.9%) and lack of credit card 39(33.1%) were perceived barriers to updating antivirus software. The use of regularly updated anti-virus software is sub-optimal among physicians implying vulnerability to computer viruses. Physicians should be careful with flash drives and should avoid being victims of the raging arms race between malware producers and anti-virus software developers.Keywords: Anti-virus software; Computer security; Updates; Physicians; Nigeri

Understanding Parents\u27 Views toward the Newly Enacted HPV Vaccine School Entry Policy in Puerto Rico: A Qualitative Study

BACKGROUND: The Human papillomavirus vaccine (HPV) is an essential tool for the prevention of HPV-related cancers. In Puerto Rico, the Secretary of Health established a school entry requirement of at least one dose of HPV vaccination in girls and boys aged 11 and 12 years, taking effect in August 2018. Our study aimed to examine parents\u27 and guardians\u27 views of unvaccinated children about the process of implementation of the new HPV vaccination school entry policy in Puerto Rico and identify potential barriers and facilitators related to the implementation of this requirement. METHODS: During April through November 2019, we conducted three focus groups (n = 12) and eight in-depth semi-structured interviews with parents of children aged 11 and 12 who had not yet initiated the HPV vaccine series. The interview topics addressed were: perception of vaccination, HPV vaccine and it is inclusion as new school entry requirement practice, procedure of the sources of information, influencers, and willingness to change. The interviews were recorded and transcribed by our staff members. We identified emergent themes through thematic analysis. RESULTS: The participants\u27 perspective on the HPV vaccine school requirement was mixed. Lack of information of the HPV vaccines and lack of communication about the school-entry requirement were the themes most mentioned in the interviews. Moreover, previous negative experiences from friends or family members and adverse effects deterred some participants from vaccinating their kids. We discussed barriers in the process of soliciting an exemption. CONCLUSION: Most barriers mentioned by study participants are modifiable. Information about the HPV vaccine mandate\u27s implementation and educational materials regarding HPV vaccine safety need to be provided to address parents\u27 concerns related to the vaccine\u27s side effects. Schools (teachers, principal directors, and administrative staff), the government, and parent organizations need to be part of these efforts. This multilevel approach will help to improve disseminating information about HPV vaccination to clarify doubts and misinformation among parents

Content Analysis of Digital Media Coverage of the Human Papillomavirus Vaccine School-Entry Requirement Policy in Puerto Rico

BACKGROUND: In August 2018, Puerto Rico (PR) became the 4th state or territory in the United States to adopt a human papillomavirus (HPV) vaccine school-entry requirement, for students 11-12 years old. Evidence suggests that the content of media coverage may impact people\u27s perception of HPV vaccine and their willingness to vaccinate. This study aimed to analyze the content of digital news coverage related to the implementation of the policy in PR. METHODS: A content review was conducted of digital media published from January 2017 through December 2018. The content reviewed was carried out in two steps: 1) creating a matrix to summarize each article\u27s content about the policy and 2) qualitative analysis using a grounded theory approach. RESULTS: The search resulted in 34 articles obtained from 17 online local and international news outlets that reported the policy\u27s implementation. Analyses showed that 61% of the news articles did not mention the number of required doses, and 79% discussed the new policy concerning cancer prevention. In 2017, news coverage focused mostly on describing the policy, while 2018 coverage focused on controversies surrounding the implementation. Neutral emergent codes included: 1) Description of the policy; 2) Information about HPV related cancers; and 3) General information about HPV vaccine. Negative emergent codes included: 1) infringement to patient and parental autonomy; 2) Hesitancy from the political sector, and 3) Hesitancy from groups and coalitions. Positive content included: 1) knowledge and acceptance of HPV vaccine for cancer prevention; 2) importance of education and protective sexual behaviors; and 3) new vaccination law proposal. CONCLUSIONS: Most of the media coverage in PR was neutral and included limited information related to the vaccine, HPV, and HPV-related cancers. Neutral and negative themes could influence public concerns regarding the new policy, as well as HPV vaccination rates in PR

Institutional capacity for health systems research in East and Central African Schools of Public Health: strengthening human and financial resources

BACKGROUND: Despite its importance in providing evidence for health-related policy and decision-making, an insufficient amount of health systems research (HSR) is conducted in low-income countries (LICs). Schools of public health (SPHs) are key stakeholders in HSR. This paper, one in a series of four, examines human and financial resources capacities, policies and organizational support for HSR in seven Africa Hub SPHs in East and Central Africa. METHODS: Capacity assessment done included document analysis to establish staff numbers, qualifications and publications; self-assessment using a tool developed to capture individual perceptions on the capacity for HSR and institutional dialogues. Key informant interviews (KIIs) were held with Deans from each SPH and Ministry of Health and non-governmental officials, focusing on perceptions on capacity of SPHs to engage in HSR, access to funding, and organizational support for HSR. RESULTS: A total of 123 people participated in the self-assessment and 73 KIIs were conducted. Except for the National University of Rwanda and the University of Nairobi SPH, most respondents expressed confidence in the adequacy of staffing levels and HSR-related skills at their SPH. However, most of the researchers operate at individual level with low outputs. The average number of HSR-related publications was only <1 to 3 per staff member over a 6-year period with most of the publications in international journals. There is dependency on external funding for HSR, except for Rwanda, where there was little government funding. We also found that officials from the Ministries of Health often formulate policy based on data generated through ad hoc technical reviews and consultancies, despite their questionable quality. CONCLUSIONS: There exists adequate skilled staff for HSR in the SPHs. However, HSR conducted by individuals, fuelled by Ministries’ of Health tendency to engage individual researchers, undermines institutional capacity. This study underscores the need to form effective multidisciplinary teams to enhance research of immediate and local relevance. Capacity strengthening in the SPH needs to focus on knowledge translation and communication of findings to relevant audiences. Advocacy is needed to influence respective governments to allocate adequate funding for HSR to avoid donor dependency that distorts local research agenda.DFI

How to Write a Manuscript in the Biomedical Sciences

The authors have been using this syllabus for more than a dozen years to teach a 35-hour workshop entitled How to write a manuscript in the biomedical scientists\u27 to graduate and undergraduate students in Biochemistry and Molecular Biology, Chemistry and Nutrition in the U.S., and to PhD-basic scientists and clinical faculty at teaching hospitals in Nigeria, Turkey, India and Taiwan. The purpose of the syllabus is to educate investigators about the overall organization of a manuscript and the structure and function of each of the components, including: Title Page, Abstract, Introduction, Materials and Methods, Discussion, References and Tables and Figures. Participants in the workshop are expected to write from a corpus of their own data and by the end of the program to have generated a complete and polished manuscript suitable for submission to a peer-reviewed journal. The syllabus also discusses ethical issues associated with authorship and provides advice about how to optimize one\u27s writing environment and psychology.\u2

Skilled Attendance: The Key Challenges to Progress in Achieving MDG-5 in North Central Nigeria

The importance of skilled attendance at delivery, as reflected in the MDG 5, is being promoted in developing countries to address the high  maternal/perinatal morbidity and mortality. Evaluation of personnel skills and availability of material resources are central to elimination of barriers to delivery of basic Emergency Obstetric Care (EOC) to the community. We designed a semi-structured, interviewee-administered questionnaire for 54 certified Nurse-Midwives working in Primary Health Care (PHC) clinics in Nasarawa State, central Nigeria, and examined their knowledge and  competencies in the five major areas responsible for maternal mortality in sub-Saharan Africa, including power supply, referral linkages and  motivation to work. Majority 51 (94.4%) of PHCs neither used the  Partograph nor performed manual vacuum aspiration. Referral systems and feedback mechanisms were practically non-existent, 38 (70.4%) of facilities were &gt;5km from the nearest referral centre, with 14(29.5%) connected to the national grid. Majority (68.5%) of respondents would want to work abroad. The quality of skilled attendance is low and basic EOC facilities are lacking, a situation further threatened by potential emigration to greener pastures. Governments and development partners need to address facility and skilled manpower shortages in developing countries to make a modest attempt at meeting the MDG on maternal health (Afr. J. Reprod. Health 2010; 14[2]: 129-138). KEYWORDS: Skill attendance, maternal mortality, midwifery skills, MDGs, Nigeria

Présence des accoucheurs qualifiés : les défis clé au progrès dans l&apos;accomplissement des ODM – 5 au nord central du Nigéria

The importance of skilled attendance at delivery, as reflected in the MDG 5, is being promoted in developing countries to address the high maternal/perinatal morbidity and mortality. Evaluation of personnel skills and availability of material resources are central to elimination of barriers to delivery of basic Emergency Obstetric Care (EOC) to the community. We designed a semi-structured, interviewee-administered questionnaire for 54 certified Nurse-Midwives working in Primary Health Care (PHC) clinics in Nasarawa State, central Nigeria, and examined their knowledge and competencies in the five major areas responsible for maternal mortality in sub-Saharan Africa, including power supply, referral linkages and motivation to work. Majority 51 (94.4%) of PHCs neither used the Partograph nor performed manual vacuum aspiration. Referral systems and feedback mechanisms were practically non-existent, 38 (70.4%) of facilities were >5km from the nearest referral centre, with 14(29.5%) connected to the national grid. Majority (68.5%) of respondents would want to work abroad. The quality of skilled attendance is low and basic EOC facilities are lacking, a situation further threatened by potential emigration to greener pastures. Governments and development partners need to address facility and skilled manpower shortages in developing countries to make a modest attempt at meeting the MDG on maternal health.L&apos;importance de la présence du personnel qualifié pendant l&apos;accouchement, tel que cela figure dans les ODM–5 est reconnue et encouragée dans les pays en voie de développement pour aborder la haute mortalité et la morbidité périnatale. L&apos;évaluation de la compétence du personnel et la disponibilité des ressources matérielles jouent un rôle essentiel dans l&apos;élimination des obstacles à la prestation des services obstétriques d&apos;urgence de base (SOUB) à la communauté. Nous avons formulé un questionnaire semi–structuré pour 54 sages–femmes qui travaillent dans des cliniques des services médicaux primaires (SMP) dans l&apos;état de Nassarawa, dans la région centrale du Nigéria. Nous avons étudié leur connaissance et compétences dans les cinq domaines principaux qui sont responsables de la mortalité maternelle en Afrique sub–saharéenne y compris l&apos;alimentation électrique, les liaisons des services d&apos;orientation des malades vers un spécialiste et la motivation pour travailler. La majorité des SMPs (94,4%) n&apos;ont pas utilisé le partographe et ils n&apos;ont pas fait l&apos;aspiration pneumatique manuelle. Il n&apos;existait pratiquement pas de systèmes d&apos;orientations vers les spécialistes et des mécanismes pour des réactions. 38(70,4%) établissements étaient situés à>5km du centre des orientations le plus proche, alors que 14 (29,5%) étaient reliés au réseau électrique national. La majorité (68,5%) des interviewés aimeraient travailler à l&apos;étranger. La qualité du personnel qualifié est basse et les structures de base manquent, une situation qui est davantage menacée par la possibilité de la migration ver les cieux plus cléments +++++v Il est nécessaire que les gouvernements et les partenaires en matière de développement abordent les problèmes du manque de structures et de personnel dans les pays en voie de développement afin d&apos;essayer, d&apos;une manière modeste, d&apos;accomplir les ODMs dans le domaine de la santé maternelle