An Online Mixed-Methods Study Assessing Nurses’ Training, Attitudes, Knowledge, Skill/Ability, and Perceived Barriers With Regard to Adherence to the National Pressure Ulcer Advisory Panel’s Clinical Practice Guidelines

The problem this study addresses is the need for nurses to adhere to guidelines on pressure ulcer prevention and treatment, so patients best possible health outcomes. This study created and utilized a new tool to assess nurses’ training, attitudes, knowledge, and skill/ability for adhering to practice guidelines of the National Pressure Ulcer Advisory Panel. The study sought to identity significant predictors of Personal Knowledge Rating Scale (TPKRS-101) and Personal Skill/Ability Rating Scale (TPS/ARS-101). The online study’s convenience sample of nurses (n=190) was 80.5% (n=153) female, 59.5% (n=113) Black, and 18.4% (n=35) Asian—with mean age of 40.27 years (min 23, max 73, SD=10.95). Some 53.2% (n=101) were not born in the US, while 16.8% (n=32) were from Ghana, 7.9% (n=15) from Jamaica, and 7.4% (n=14) from Philippines. Annual household income mean was $50,000 to$99,999 (mean=4.43, category 4, min=2, max=10, SD=1.00). Mean years working in nursing was 8-10 years (mean=4.34, category 4, min=1, max=9, SD=2.14). Nurses rated themselves “good” for performing pressure ulcer care tasks, as follows: (a) Nursing Training Rating Scale (TNRS-101) with global mean of 4.11 (SD=0.60, min= 1.94, max=5.00), or good; (b) Personal Knowledge Rating Scale (TPKRS-101) with global mean of 4.15 (SD=0.57, min=2.79, max=5.00), or good; and, (c) Personal Skill/Ability Rating Scale (TPS/ARS-101) with global mean of 4.13 (SD=0.62, min=2.56, max=5.00), or good. Higher Personal Knowledge Rating Scale (TPKRS-101) scores were significantly predicted by: more positive Attitudes Regarding Practice Guidelines-Relevance Scale (ARPG-R-5) (b = .067, SEB = .029, p = .022); and, higher level of Social Desirability (13 items) (b = .030, SEB = .013, p =.023). For this regression model, R2=.063, and AdjR2=.053, meaning that 5.3% of the variance was explained by model. Personal Skill/Ability Rating Scale (TPS/ARS-101) scores were significantly predicted by: higher level of Social Desirability (13 items) (b = .051, SEB = .014, p = .000). For this regression model, R2=.064, and AdjR2=.059, meaning that 5.9% of the variance was explained by model. Finally, the quantitative data were augmented by qualitative findings for barriers nurses experience to pressure ulcer prevention and treatment, as follows: Category I-External Barriers; and, Category II-Internal Barriers

Canadian Immigration Experience: Any Lessons for Europe?

This paper reviews and analyzes the effects of Canada?s post World War II immigration policies with the perspective of what European policy makers can learn from this experience. Impact of Immigration on natives? employment and earnings, as well as, immigrants? labor market experiences are discussed. The advantages of Canada?s equal share rule of the allocation of immigrant visas are argued. The importance of language skills for economic integration and success is also stressed. The importance of the right human capital mix and experience are found to be needed to guarantee positive labor market outcomes in the host country

Cycles in the ecological development of Valley View University, Accra, Ghana

Valley View University (VVU), a private Ghanaian institution, has adopted a holistic approach in developing a sustainable eco-university. Ecological cycles, ecological settling and buildings and encompassing quality management are included in the concept. The cycles are closed locally, bringing collected urine and grey-water to the eco-farming area for use as fertilizer. Intensive training of staff and students is part of the endeavours. An ecological engineering study is proposed as part of the plans to intensify education of communities and interested individuals. As a preliminary result it can be stated, that the holistic approach is essential for the sustainability of such projects and in the case of Valley View University the approach is largely accountable for the success attained so far

Methylergometrine Poisoning In The Newborn: Report Of Two Cases

Methylergometrine is probably the most commonly used drug in obstetric care at all levels of the health care system. Many communities in Africa lack skilled birth attendants and adequate health systems; medication errors are more likely to occur and go unreported in these settings. The morbidity and mortality that result from these errors can be reduced if health care workers are better informed. We report two cases of medication error with methylergometrine and suggest guidelines for health care workers at the primary and secondary levels of health care

Influence of Method of Residue Application and Moisture Content on Water Soluble Nitrogen in a RhodicKandiustalf Amended with Different Fallow Plant Materials

Use of plant residues as nutrient sources presents a viable option to resource poor farmers who sparsely use mineral fertilizer in crop production. A study was conducted to gain an insight into how different application methods of residues from different fallow management systems under two moisture regimes would affect soluble N release in a Rhodic Kandiustalf. Three residue types viz, elephant grass from a natural fallow (T1) and another as a fallow following a previously fertilized maize (T2) and a fallow legume (T3) were surface applied and incorporated in a Rhodic Kandiustalf at both field capacity (FC) and 60% field capacity over a sixteen-week period. Incorporation of mucuna residues and elephant grass from previously fertilized maize fallow released similar soluble N levels which were higher than levels from the natural elephant grass amendments. At 60% FC, both mucuna and elephant grass from the fertilized maize fields that were surface applied had slower N releases than the grass from the natural fallow, suggesting the elephant grass from the natural fallow field could be used as an N source amidst light watering to avoid leaching in the dry season

Challenges of developing a peri-urban water supply strategy in Ghana

This paper discusses the efforts to fashion a strategy for peri-urban water supply in Ghana with financial support from Agence Francaise de Developpment. It posits that the institutional weakness of the Water Directorate of the erstwhile Ministry of Water Resources, Works and Housing as the policy formulation unit for the water sector created too much space for the Ghana Water Company Limited to abort the process for the successful implementation of the pilot project and the replication of an appropriate model. The paper however sees the creation of a new Ministry for Sanitation and Water Resources as an opportunity to strengthen the Water Directorate and the eventual development of an appropriate strategy for the peri- urban areas so as to minimise the problem of the missing middle

Molecular epidemiology of Mycobacterium africanum in Ghana

BACKGROUND: Mycobacterium africanum comprises two phylogenetic lineages within the M. tuberculosis complex (MTBC) and is an important cause of human tuberculosis (TB) in West Africa. The reasons for this geographic restriction of M. africanum remain unclear. Here, we performed a prospective study to explore associations between the characteristics of TB patients and the MTBC lineages circulating in Ghana. METHOD: We genotyped 1,211 MTBC isolates recovered from pulmonary TB patients recruited between 2012 and 2014 using single nucleotide polymorphism typing and spoligotyping. Associations between patient and pathogen variables were assessed using univariate and multivariate logistic regression. RESULTS: Of the 1,211 MTBC isolates analysed, 71.9 % (871) belonged to Lineage 4; 12.6 % (152) to Lineage 5 (also known as M. africanum West-Africa 1), 9.2 % (112) to Lineage 6 (also known as M. africanum West-Africa 2) and 0.6 % (7) to Mycobacterium bovis. Univariate analysis revealed that Lineage 6 strains were less likely to be isoniazid resistant compared to other strains (odds ratio = 0.25, 95 % confidence interval (CI): 0.05-0.77, P < 0.01). Multivariate analysis showed that Lineage 5 was significantly more common in patients from the Ewe ethnic group (adjusted odds ratio (adjOR): 2.79; 95 % CI: 1.47-5.29, P < 0.001) and Lineage 6 more likely to be found among HIV-co-infected TB patients (adjOR = 2.2; 95 % confidence interval (CI: 1.32-3.7, P < 0.001). CONCLUSION: Our findings confirm the importance of M. africanum in Ghana and highlight the need to differentiate between Lineage 5 and Lineage 6, as these lineages differ in associated patient variables

Feasibility of smartphone colorimetry of the face as an anaemia screening tool for infants and young children in Ghana

Background Anaemia affects approximately a quarter of the global population. When anaemia occurs during childhood, it can increase susceptibility to infectious diseases and impair cognitive development. This research uses smartphone-based colorimetry to develop a non-invasive technique for screening for anaemia in a previously understudied population of infants and young children in Ghana. Methods We propose a colorimetric algorithm for screening for anaemia which uses a novel combination of three regions of interest: the lower eyelid (palpebral conjunctiva), the sclera, and the mucosal membrane adjacent to the lower lip. These regions are chosen to have minimal skin pigmentation occluding the blood chromaticity. As part of the algorithm development, different methods were compared for (1) accounting for varying ambient lighting, and (2) choosing a chromaticity metric for each region of interest. In comparison to some prior work, no specialist hardware (such as a colour reference card) is required for image acquisition. Results Sixty-two patients under 4 years of age were recruited as a convenience clinical sample in Korle Bu Teaching Hospital, Ghana. Forty-three of these had quality images for all regions of interest. Using a naïve Bayes classifier, this method was capable of screening for anaemia (<11.0g/dL haemoglobin concentration) vs healthy blood haemoglobin concentration (≥11.0g/dL) with a sensitivity of 92.9% (95% CI 66.1% to 99.8%), a specificity of 89.7% (72.7% to 97.8%) when acting on unseen data, using only an affordable smartphone and no additional hardware. Conclusion These results add to the body of evidence suggesting that smartphone colorimetry is likely to be a useful tool for making anaemia screening more widely available. However, there remains no consensus on the optimal method for image preprocessing or feature extraction, especially across diverse patient populations

Perception and risk factors for cervical cancer among women in northern Ghana

Objective: This study assessed the perception of risk of cervical cancer and existence of risk factors for cervical cancer based on five known risk factors among women attending the Tamale Teaching Hospital in Tamale, Ghana.Methods: A consecutive sample of 300 women was interviewed using a semi structured questionnaire to inquire about risk factors and perception of risk of cervical cancer. Specific risk factors that were explored included early coitarche, multiple sexual partners, polygamous relationships, history of smoking, and having a current partner who had multiple sexual partners.Results: Sixty-one per cent of women reported that they had no personal risk for cervical cancer. 27% of respondents were in polygamous relationships, and of those, more than half didn’t think they were at an increased risk of cervical cancer. 2 women had a total of ≥ 5 sexual partners in their lifetime and neither believed they were at any risk for cervical cancer. 23% said their current partner had had at least 2 sexual partners in his lifetime, and of those, (61%) thought they were at no risk for cervical cancer. 46% of respondents reported not having any of the risk factors listed in the study. 23% of respondents reported having one risk factor while 21% had two risk factors and 11% had three or more risk factors.Conclusion: Women’s perception of personal risk for cervical cancer is lower than their actual risk based on the five behavioural risk factors assessed and a lack of knowledge of the personal factors for the diseaseFunding: This project was supported by NIH Research Training Grant #R25 TW009345 funded by the Fogarty International Centre, in partnership with several NIH Institutes (NIMH, NIGMS, NHLBI, OAR and OWH)Keywords: Cervical Cancer, Risk, Perceptions, Northern Ghan

Smoke-Free Policy in Vermont Public Housing Authorities

Introduction. Millions of adults and children living in public housing face exposure to second hand smoke from adjacent apartments. These tenants are less able to escape smoke exposure by moving, and Housing Authorities are beginning to implement smoke-free policies. We assessed the status of smoke-free policy in Vermont public housing, and explored the experience of tenants and managers in Burlington who recently implemented such a policy.https://scholarworks.uvm.edu/comphp_gallery/1080/thumbnail.jp