Evidence-Based Best Practice for Transitions of Care: A Policy Review on Medication Reconciliation Standards

Practice Problem: Medication reconciliation (MR) is crucial in care transitions among healthcare facilities. Developing evidence-based discharge planning strategies, improving communication, optimizing electronic health record intelligence interoperability, and stakeholder engagement will promote a better transition process for patients and healthcare providers. PICOT: The PICOT question that guided this project was: In an urban-based adult skilled nursing facility, how does an evidence-based structured review, and revision of current MR policy and procedures, compared to the existing MR policy, affect the clarity of the process for communication between clinicians during transitions of care over a 10-week review cycle? Evidence: Fifteen pertinent studies identified include the similarities in nursing homes\u27 discoveries, electronic health record use, and pharmacy participation in MR efforts. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals Model (JHNEBP) and the Centers for Disease Control (CDC) Policy Process (POLARIS) Framework were used in appraising the literature and guiding the policy evaluation and recommendations. Intervention: The three best practice themes include nursing home vulnerability, electronic medication records, and pharmacy participation. A Policy Evaluation Tool was developed to evaluate the current MR policy against best practices criteria found in the evidence. Outcome: The recommendations were provided to each organization to incorporate into current practice. Policy templates were specific to each healthcare organization, with recommended revisions to current policy and discharge communication workflow, and provided to each organization to incorporate into current practice. Conclusion: The evaluation was beneficial to ensure the MR process was current and relevant and promoted best-practice methods

Sociodemographic characteristics and spatial distribution of Malaria in Nigerian children

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree ofMaster of Science in Epidemiology in the field of Epidemiology and Infectious Diseases March 2018.Background Malaria is a significant public health concern in the world. It causes mortality and morbidity especially in children under five years of age and pregnant women. Nigeria contributes about 25% to the malaria burden in Africa, with one million lives lost annually. Several factors including poverty, ownership of bed nets, socioeconomic status are associated with malaria morbidity. This study aimed to determine the factors associated with malaria morbidity and its spatial distribution in Nigerian regions among children under five years in 2010. Methods This study used cross-sectional data from the 2010 Nigeria Malaria Indicator Survey (NMIS) which was downloaded from DHS website. The primary sampling unit (PSU) which was referred as the cluster for the 2010 NMIS was defined based on the enumeration areas (EAs) from the 2006 EA census frame. The 2010 NMIS sample was selected using a stratified, two -stage cluster design consisting of 240 clusters, 83 clusters in the urban areas and 157 in the rural areas. The research was restricted to children under five years (6-59 months). The outcome variable was defined as the presence or absence of malaria. It was measured using rapid diagnostic test and microscopic examination of blood smear. Clustered adjusted Pearson’s chi-square test was used to show associations between explanatory variables and malaria. A clustered t-test was used to determine differences in the mean for continuous variables.Multilevel logistic regression models, taking into account random effects were fitted. Choropleth maps were used to display the distribution of malaria by geopolitical zones. Results There were 5137 children aged 6-59 months for this study out of 5612 children that were selected for the survey, 41.97%had malaria, and there was no difference in prevalence between males and females. The mean age was 34.96±0.33 months. There was a higher prevalence (60.19%) of malaria in the areas where there was no LLIN campaign coverage compared to areas with LLIN coverage (39.81%) (OR 0.65, 95% CI 0.43-0.97). Children from rural areas were three times more likely to have malaria than those from urban areas (OR 3.13,95%CI 2.18-4.49). The odds of malaria increased significantly with increasing age in months (OR 1.02, 95% CI 1.02-1.03, P-value<0.0001). The richest household children were less likely to have high prevalence of malaria compared to children from the poorest households (OR 0.23, 95%CI 0.15-0.37). Choropleth maps showed a high prevalence in the North-West and North-Central regions and lowest prevalence in the South-East region. Conclusion Although efforts have been made to control malaria in Nigeria, its elimination is not forthcoming. The prevalence in children under five years was high. Those who live in the rural areas, wealth index, geopolitical region and child’s age were the determining factors associated with the high prevalence of malaria in those children. There was a regional variation of malaria prevalence among the children. Children from the North-Central and North-West regions had the highest prevalence of malaria. All these factors could be as a result of policy issues, policy formulations, management, implementation, compliance and sustenance issues. However, a lot can be done in the malaria control and prevention programme in Nigeria towards vaccine development, policy formulation and implementation based on evidence, increased public health and environmental education, incorporation of the communities in activities towards malaria control, mapping of the spatial distribution of malaria as well as stepping up of ongoing control programmes. Keywords: children under five years, spatial analysis, Nigeria.LG201

Habermas and Argumentation In the Philippine Context

The article critically analyzes the perception on the incompatibility of the Filipino self-understanding as kapwa with Habermas\u27s notion of argumentative discourse that champions autonomy and individuality. It argues that this apparent incompatibility is more due to the absence of an imagination of non-Western forms of rationalization processes and reflexivity, than to the commonly held claim of the incommensurability of lifeworlds. The key to this imagination is to locate potential rationalization processes from within modes of communication that reinforce kapwa solidarity. In the end, the article shows that kwentuhan, which is the mode of communication that is integrated with kapwa solidarity, contains enabling components for reflexivity, and thereby makes individuals more open and receptive to the process of argumentation as a rational and inclusive procedure for resolving conflicts

Effectiveness of Microlearning-based Lessons in Teaching Grade 9 Chemistry

Microlearning-based lessons are still new in the field of education because it primarily focuses on corporate training and adult learning. Hence, limited research was conducted in basic education even in higher education. Microlearning-based lessons are designed and delivered in the form of small, bite-sized information which allows students to achieve a certain learning objective. The main purpose of this research is to determine the effectiveness of Microlearning-based Lessons in Chemistry in the level of academic performance of 18 Grade 9 students under the online learning modality. Moreover, the research instrument used was a researcher-made pretest-posttest based on the learning competencies of the Most Essential Learning Competency (MELC) consisting of 25 multiple choice items along the topics in Grade 9 Chemistry during the Second Quarter of the school year 2020-2021. Mean and paired t-tests were used as tools for analysis. Findings reveal that students’ exposure to Microlearning-based Lessons in Teaching Grade 9 Chemistry improved their level of academic performance in Chemistry. This implies that students perform better when they use microlearning-based lessons in learning Chemistry. Thus, it can be concluded that the level of performance in Chemistry of Grade 9 students greatly improved after exposure to microlearning-based lessons. Furthermore, this shows the effectiveness of the intervention material in improving their level of academic performance, thus the microlearning-based lessons be adopted in teaching Chemistry is recommended

What is the cost benefit ratio of sending adeno-tonsillar tissues for histology: does adenoid/tonsillar tissue in children undergo malignant transformation?

Due to the enormous amount spent on histology of adenoid and tonsillar samples from children with adeno-tonsillectomy with no confirmed result of malignancy, it has become expedient to reconsider sending such tissues for histology. Objectives: this study is aimed at determining the necessity of sending tissues of adenoid and tonsils for histology by means of ascertaining the prevalence of malignancy among children with adeno-tonsillectomy. This was a retrospective study done in three private hospitals that provide care for children in Enugu. Data was obtained from the medical records of 72 patients who had undergone tonsillectomy and/or adenoidectomy from September 2011 to May 2018. All the surgical cases done had their samples sent immediately for histology. A total of 72 adeno-tonsillar tissues were taken for histology of which all showed lymphoid hyperplasia with none showing any form of malignancy. Age group ranged from 6 months-18 years with 57 males and 15 females. Histology of the adeno-tonsillar tissue specimen was done among all the children with each costing 9000 Naira (26 US dollars). There were 3 tonsillectomies, one adenectomy and 68 adeno-tonsillectomies done. Indications for surgery were mainly upper air way obstruction for 69 cases and recurrent tonsillectomy for 3 cases. Histology revealed lymphoid hyperplasia for all cases. None of the patients in our study had histologic evidence of malignancy. Routine histopathologic examination in adeno-tonsillectomy specimens among children may be dispensable as it showed a negative cost-benefit ratio

Global Economic Recession: The Place of Biotechnology

Human cytomegalovirus (CMV) is a leading cause of congenital infections worldwide Women infected for the first time during pregnancy are especially likely to transmit CMV to their fetuses and has been proposed as a risk factor for preterm birth. The seroprevalence of CMV in adults and the incidence of congenital CMV infection are highest in developing countries (1 to 5% of births) 90% of infected infants are asymptomatic at birth and are not recognized as at risk for CMV-associated infection. This study was carried out to determine the prevalence rate of CMV infection among pregnant women attending an antenatal clinic. In this study, Two-hundred and eighty eight (288) pregnant women were enrolled. Questionnaires were issued to volunteer subjects after due consent was sought, to determine demographic and other relevant data. 5mls of blood was collected by venous puncture from the antecubital fossa and dispensed into plain containers; sera were collected after centrifugation of the blood. Sera obtained were screened for the presence of CMV (IgM) antibodies using ELISA technique (Clinotec Laboratories Canada).Result showed that out of the 288 women tested, 54 (18.8%) were positive for CMV antibodies while 234 (81.2%) tested negative. With regards to age group distribution, women within 15 – 20 years had a prevalence rate of 4.5%, 21 – 30 years both had 3.5%, 31 – 35 had 3.1%, 36 – 40 years had 1.3% while 41 – 45 years had a prevalence rate of 2.8%, all the age groups had no statistical significant (P>0.05) result. With regards to trimester of the volunteer subjects screened, 1st, 2nd and 3rd trimester subjects recorded a prevalence rate of 3.1%, 9.4% and 6.2% respectively which was statistically significant (P0.05).Occupational status of subjects studied recorded no statistical significant (P0.05) result obtained showed that unemployed subjects recorded a prevalence of 5.6% compared to the self-employed with 4.9%, farmers recorded 3.8%, while students had a prevalence of 1.7% however subjects who are civil servants recorded a prevalence of 2.8%. Location of volunteer subjects studied showed that pregnant in rural areas had a prevalence rate of 12.2% while those living in urban areas recorded 6.6% prevalence without any statistical significant (P0.05).Records from this study indicates the of presence of CMV (Igm) antibodies amongst the subjects screened. Hence the need for early detection of the virus in pregnant women

DEVELOPMENT OF A NIGERIAN CULTURAL ATTIRE RECOGNITION SYSTEM

This paper presents the development of a system to automatically recognize Nigerian traditional attire worn by major ethnic groups. Samples of clothing images depicting the cultural groups were obtained from publicly available online sources and an architecture to classify the images classes was designed using the Convolutional Neural Network (CNN) model. Performance evaluation results from experiment show that the model can classify images accordingly, achieving a validation accuracy score of 86 %. A web application interface was also implemented to validate the model’s accuracy which shows good potential when integrated in commercial clothing applications

“Leaving no one behind”: COVID-19 Response in Black Canadian Communities

Despite the universal healthcare system in Canada, Canadians of African Descent (CAD) still face numerous problems that place them at higher risk to pandemics such as COVID-19. From the struggles of working as frontline workers, to challenges compounded by pre-existing chronic medical conditions such as Diabetes, CAD may face unique issues, further weighing on their existing and potential health outcomes. This situation calls for closer attention to the specific needs of CAD who may be at greater risk of late diagnosis and delayed treatment for COVID-19. Historically, marginalized communities such as CAD must be included in healthcare considerations and planning, so as to avoid further leaving them behind during and after the storm. Past evidence has shown that structural inequities shape who is affected by disease and its economic fallout. Therefore, the unique needs of CAD must be considered in healthcare planning with the ongoing COVID-19 response. Keywords: pandemic, marginalized, healthcare, COVID-19, Canadians of African Descen

LEARNING PREFERENCES AND VACCINATION STATUS OF STUDENTS IN A TERTIARY INSTITUTION: BASIS FOR FLEXIBLE LEARNING IMPLEMENTATION 2.0

The objective of this study is to determine the learning preferences and vaccination status of students from a local college in Olongapo City, Philippines. The investigators employed a descriptive-survey research among 5,021 students who were currently enrolled in the academic year of 2021-2022.  Results show that 94.7% prefer online mode of learning; 79.7% show intention to enroll for the next semester of the new academic year; however only 51.7% of the students wanted a face-to-face class and 61.4% of the students’ parents/guardian approve their son/daughter to attend face-to-face classes. In terms of vaccination status, 95.3% of the students have their vaccinations shots already (fully vaccinated) and Pfizer was the brand of choice of the 38% students. The study concluded that students are still prefer online mode of learning. Also, majority of the students were fully vaccinated. The study recommends continue and enhance the implementation of flexible learning of the institution