Efficacy of behavioural graded activity compared with conventional exercise therapy in chronic nonspecific low back pain: Implication for direct health care cost

Background: The relative efficacy of conventional exercise therapy (CET) and behavioural graded activity (BGA) has not been fully established to inform the preference in clinical practice.Objective: To compare CET and BGA on the treatment outcome of chronic non-specific low back pain (LBP).Methodology: Participants were assigned into either BGA or CET group in this randomized feasibility intervention. The CET group received supervised exercise therapy while BGA group engaged in individually prescribed sub-maximal activities based on timecontingent principles. Interventions were carried out twice weekly and over a period of 12 weeks. Outcome measures were numerical rating scale and RAND 36- item health survey which were administered at baseline, week 4 and week 12. Health care cost questionnaire was also administered to evaluate physiotherapy cost after 12 weeks. Mixed design two-way ANOVA with level of significance set as priori at p<0.05 was used to compare both groups.Results: Seventy-seven and half percent (62) participants (CET=29 and BGA=33) with mean ages 45.0±12.2 and 43.1±13.2years respectively, completed the study. Both groups improved significantly (p<0.001) during the intervention. However, there were no significant differences (p>0.05) between the treatment groups at any time points and for any measures assessed. Therapeutic benefits in both groups have bearing on direct health care costs.Conclusion: The results indicate that CET and BGA have similar outcomes in patients with chronic nonspecific LBP with regard to the pain and quality of life. Effective application may however be hampered by the cost-related factors thus suggesting evaluation of health care system in Ghana.Key words: Pain; Cognitive Therapy; Exercise Therapy; Quality of life; direct cost

How safe are school and bus environments? Parents’ perception of risks and hazards in the emirate of Dubai

© 2020 Institution of Occupational Safety and Health. The increasing numbers of school bus injuries in the United Arab Emirates have generated concerns over children’s safety on school buses and around school premises. A survey was administered on 550 parents or guardians, whose children use the school bus in public and private schools of Dubai. The main objective was to assess parental perceptions of the school bus and school environments. Parents identified several factors that pose a threat to bus safety including speeding cars, poor driving, lack of seat belt use enforcement, lack of supervision, motorists’ lack of understanding of school bus stop law, and children behaviour. Results suggest a deficiency in the communication of information regarding bus safety and behavioural policies. The study also highlights parents’ concerns over safety in relation to the school bus transport and around school premises, and emphasizes the need for safety education, as well as proper provision and communication of safety policies

Coinfection of cutaneous leishmaniasis and hiv infection

Cutaneous leishmaniasis has recently been discovered in some parts of Ghana. The case of an HIV infected patient presenting with cutaneous leishmaniasis at the Korle-Bu Teaching Hospital is discussed. The diagnosis of leishmaniasis was con-firmed by histology. Also highlighted is the fact that this is the first reported case of dual infection of HIV and Leishmaniasis in Ghana. The possibility of rapid spread to other members of the community, both immunecompetent and immunesuppressed in view of the large numbers of organisms present in the lesion is discussed

Diagnosis of dual human immunodeficiency virus types 1 & 2 infections in a resouce-limited setting

Background: The presence of dual HlV-l/HIV-2 infection in Ghana and the different drug requirements for the treatment of HlV-1 and HIV-2 presents difficulties for the treatment of dual infections with both viruses.Objectives: To determine the prevalence of the dual sero-positive profile in treatment naive patients at a principal ART Clinic in Accra, Ghana and to investigate if rapid screening assays could be useful for diagnosis.Design: A cross-sectional study.Setting: A principal antiretroviral treatment centre in Accra, Ghana.Subjects: Three hundred and twenty eight antiretroviral treatment naive patients.Results: A total of 12 (3.7%) of patients seen were dual seropositive. There was a slight tendency of dual seropositive females being older than their HIV-l counterparts (p=0.088, CI=-l 0.833 to 0.753). Eight of the 12 of the dual seropositives were reactive for Genie II and were considered as possibly infected with both HIV-I and HIV-2. Seven (87.5%) of Genie II dual seropositives had strong intensities (> 1+) on both HIV-2 specific bands (sgp105 and gp36) on Innolia. CD4 counts were not significantly different in dual seropositives as compared to HIV-1 infected patients.Conclusions: Dual HIV-l/HIV-2 seropositives (and possibly infections) may be common especially in older women. The Genie II will be useful as a supplemental rapid test for rapid and accurate differentiation of HIV-l and HIV-2 antibodies at treatment centres

Results of the Kentucky Worksite Assessment: Utilization of the CDC’s Health ScoreCard

Study Objectives and Research Approach A Health Impact Assessment (HIA) conducted in 2011-2012 of a proposed Kentucky Worksite Wellness Tax Credit highlighted gaps in the data available on worksite wellness programs in the Commonwealth of Kentucky. Conducting a state-wide assessment of worksite wellness programs was a recommendation that resulted from this HIA. The purpose of the assessment is to: 1) Identify the number of comprehensive worksite health promotion programs in Kentucky. 2) Determine the health needs of worksites in Kentucky. By Identifying current wellness practices in Kentucky, better tools and support can be provided at a state level to assist organizations to implement results-oriented wellness programs. As worksite wellness science continues to advance and the expectations of successful outcomes continue to increase, more will be required of those in charge of these programs. Upon receiving approval from WKU’s Institutional Review Board (IRB), 1,200 randomly drawn businesses received a questionnaire via email. Two-week increments were allowed for workplaces that needed reminders or more time to complete the survey. The survey began in May 2013 and closed in October 2013. Data was analyzed for outstanding themes, which will form the bases for decisions made on the needs of worksite-wellness programs in Kentucky. Data was analyzed further — descriptively and inferentially — to determine worksite factors that contribute to the increasing trends of chronic diseases in the workplace

Cutaneous Involvement of Hodgkin Lymphoma in a Child – Case Report

Specific cutaneous involvement in Hodgkin Lymphoma is rare and has not been reported in the younger paediatric age group. We report a case of a ten year old girl who presented with specific cutaneous involvement, confirmed using immunohistochemical stains. Treatment with combination chemotherapy resulted in rapid disappearance of the lesions and contrary to the generally poor prognosis associated with most other such reported cases in adults, she has clinically remained disease free two and a half years post treatment. Obtaining an accurate pathological diagnosis is essential to ensure appropriate treatment even in resource limited settings as illustrated by this case

Causes of Death in Hospitalized HIV Patients in the Early Anti-Retroviral Therapy Era

Objective: To establish the cause(s) of death among persons with HIV and AIDS admitted to the Fevers Unit of the Korle-Bu Teaching Hospital (KBTH) in 2007 and to determine whether they were AIDS-relatedin the era of availability of HAARTMethod: Retrospective chart review of all deaths that occurred in the year 2007 among inpatients with HIV infection. Cause of Death (COD) was established with post mortem diagnosis, where not available ICD-10 was reviewed independently by two physicians experienced in HIV medicine and a consensus reached as to the most likely COD.Results: In the year under review, 215 (97%) of the 221 adult deaths studied were caused by AIDS and HIV-associated illnesses. Of these, 123 (55.7%) were due to an AIDS-defining illness as described in CDC Category 3 or WHO stage 4. Infections accounted for most of the deaths 158 (71.5%), many of them opportunistic 82 (51.8%). Tuberculosis was the commonest COD. Clinical diagnosis of TB was accurate in 54% of deaths, but was not validated by autopsy in 36% of deaths. There were few deaths (14.5%) in patients on HAART.Conclusion: In a developing country like Ghana where HAART was still not fully accessible, AIDS-related events remained the major causes of death in persons living with HIV. Total scale-up of the ART programme with continuous availability of antiretrovirals is therefore imperative to reduce deaths from AIDS and HIV associated illnesses. There is need for interventions for early diagnosis as well as reduction in late presentation and also better diagnostic tools for tuberculosis.Keywords Cause of death, HIV, AIDS, HAART, Ghana, Tuberculosi

Second-Hand Smoke in a University Campus: Attitudes and Perceptions of Faculty, Staff and Students

Purpose: To examine the attitudes and perceptions of faculty, staff and students concerning tobacco policies at a university campus in a tobacco producing state. Methods: A questionnaire was administered to faculty, staff and students to assess knowledge, attitudes and beliefs related to smoking and exposure to second-hand smoke on campus. A 3-wave e-mailing was used to send the questionnaire. Results: A total of 2,914 individuals responded to the questionnaire. Majority (60%) of the participants believed a smoke free policy would be a positive move and could possibly improve the quality of life for the campus community, while not negatively affecting student enrollment status. Conclusion: Implementing a smoke free policy in university campuses in North America could be acceptable to faculty, staff and students and is unlikely to reduce students enrolment. Our findings have the potential to support efforts to implement smoke free policies on university campuses in North America