The Effects of Behavioral Determinants and Sociodemographic Factors on Homeowners\u27 Intent to Conserve Energy

Greenhouse gas emissions are caused, in part, by human activities. However, consumers may assume that the burden of environmental problems, such as carbon emissions reduction through sustainable energy practices, should be borne by the entire society. The purpose of this cross-sectional study was to test whether behavioral determinants and demographic factors could influence homeowners\u27 intent to conserve energy. Empirical data were collected from 436 sampled homeowners in the Northeast region of the United States using an online survey questionnaire. The survey instrument was adapted from Ajzen\u27s theory of planned behavior instrument. Variables aligned with the theory of planned behavior, alongside sociodemographic factors, were used to explain any impact the predictors had on the outcome. A multiple ordinary least squares regression model was used to answer the 3 research questions. According to the study findings, the most significant positive relationship was found between homeowners\u27 beliefs about energy conservation and the intent to conserve energy. There was also a significant positive relationship between the other predictors and the outcome at varying levels. Policymakers could generate support for energy efficiency and conservation by educating consumers about alternative energy options as a means of mitigating carbon emissions and air pollution. This study may lead to a positive social change by supporting regional policymakers in designing and promoting cost-effective behavioral solutions and demographic change support systems as an alternative policy tool that could encourage a sustainable energy consumption practice at the household level

Dérivation du haut appareil urinaire par une sonde JJ: indications et résultatsdansuneétude rétrospective et monocentrique

No Abstrac

T-cell epitope polymorphisms of the Plasmodium falciparum circumsporozoite protein among field isolates from Sierra Leone: age-dependent haplotype distribution?

<p>Abstract</p> <p>Background</p> <p>In the context of the development of a successful malaria vaccine, understanding the polymorphisms exhibited by malaria antigens in natural parasite populations is crucial for proper vaccine design. Recent observations have indicated that sequence polymorphisms in the C-terminal T-cell epitopes of the <it>Plasmodium falciparum </it>circumsporozoite protein (Pf<it>csp</it>) are rather low and apparently stable in low endemic areas. This study sought to assess the pattern in a malaria endemic setting in Africa, using samples from Freetown, Sierra Leone.</p> <p>Methods</p> <p>Filter-paper blood samples were collected from subjects at a teaching hospital in Freetown during September–October 2006 and in April–May 2007. The C-terminal portion of the Pf<it>csp </it>gene spanning the Th2R and Th3R epitopes was amplified and directly sequenced; sequences were analysed with subject parameters and polymorphism patterns in Freetown were compared to that in other malaria endemic areas.</p> <p>Results and Discussion</p> <p>Overall, the genetic diversity in Freetown was high. From a total of 99 sequences, 42 haplotypes were identified with at least three accounting for 44.4% (44/99): the 3D7-type (19.2%), a novel type, P-01 (17.2%), and E12 (8.1%). Interestingly, all were unique to the African sub-region and there appeared to be predilection for certain haplotypes to distribute in certain age-groups: the 3D7 type was detected mainly in hospitalized children under 15 years of age, while the P-01 type was common in adult antenatal females (Pearson Chi-square = 48.750, degrees of freedom = 34, <it>P </it>= 0.049). In contrast, the single-haplotype predominance (proportion > 50%) pattern previously identified in Asia was not detected in Freetown.</p> <p>Conclusion</p> <p>Haplotype distribution of the T-cell epitopes of Pf<it>csp </it>in Freetown appeared to vary with age in the study population, and the polymorphism patterns were similar to that observed in neighbouring Gambia, but differed significantly at the sequence level from that observed in Asia. The findings further emphasize the role of local factors in generating polymorphisms in the T-cell epitopes of the <it>P. falciparum </it>circumsporozoite protein.</p

'Once there is life, there is hope' Ebola survivors' experiences, behaviours and attitudes in Sierra Leone, 2015.

BACKGROUND: In Sierra Leone, over 4000 individuals survived Ebola since the outbreak began in 2014. Because Ebola survivorship was largely unprecedented prior to this outbreak, little is known about survivor experiences during and post illness. METHODS: To assess survivors' experiences and attitudes related to Ebola, 28 in-depth interviews and short quantitative surveys with survivors from all four geographic regions of Sierra Leone were conducted in May 2015. RESULTS: Survivor experiences, emotions and attitudes changed over time as they moved from disease onset to treatment, discharge and life post-discharge. Survivors mentioned experiencing acute fear and depression when they fell ill. Only half reported positive experiences in holding centres but nearly all were positive about their treatment centre experiences. Survivor euphoria on discharge was followed by concerns about their financial situation and future. While all reported supportive attitudes from family members, about a third described discrimination and stigma from their communities. Over a third became unemployed, especially those previously engaged in petty trade. Survivor knowledge about sexual transmission risk reflected counselling messages. Many expressed altruistic motivations for abstinence or condom use. In addition, survivors were strongly motivated to help end Ebola and to improve the healthcare system. Key recommendations from survivors included improved counselling in holding centres and long-term government support for survivors, including opportunities for participation in Ebola response efforts. CONCLUSIONS: Survivors face myriad economic, social and health challenges. Addressing survivor concerns, including the discrimination they face, could facilitate their reintegration into communities and their contributions to future Ebola responses

Establishing an antimicrobial stewardship program in Sierra Leone: a report of the experience of a low-income country in West Africa

Antimicrobial Resistance (AMR) is a growing global health challenge that threatens to undo gains in human and animal health. Prevention and control of AMR requires functional antimicrobial stewardship (AMS) program, which is complex and often difficult to implement in low- and middle-income countries. We aimed to describe the processes of establishing and implementing an AMS program at Connaught Hospital in Sierra Leone. The project involved the setting up of an AMS program, capacity building and performing a global point prevalence survey (GPPS) at Sierra Leone's national referral hospital. Connaught Hospital established a multidisciplinary AMS subcommittee in 2021 to provide AMS services such as awareness campaigns, education and training and review of guidelines. We performed a GPPS on 175 patients, of whom more than half (98, 56.0%) were prescribed an antibiotic: 63 (69.2%) in the surgical wards and 53 (51.2%) in the medical wards. Ceftriaxone (60, 34.3%) and metronidazole (53, 30.3%) were the most common antibiotics prescribed to patients. In conclusion, it is feasible to establish and implement an AMS program in low-income countries, where most hospitalized patients were prescribed an antibiotic

Ureteroscopie Retrograde: Expérience de l’Hôpital Général Grand Yoff de Dakar

But: Présenter les résultats de la pratique de l’urétéroscopie à l’Hôpital Général Grand Yoff (HOGGY) de Dakar (Sénégal).Sujets et méthodes: Il s’agit d’une étude descriptive de 91 urétéroscopies effectuées dans le service d’Urologie de l’Hôpital Général Grand Yoff de janvier 2012 à décembre 2013. Les variables de l’étude étaient l’indication, l’âge, la nature de l’urétéroscopie associées ou non au laser, les résultats de la lithotripsie.Résultats: Sept urétéroscopies diagnostiques et 84 urétéroscopies thérapeutiques ont été effectuées. L’âge moyen des patients était de 44,7 ans + - 13,9 ans. L’urétéroscope semi rigide a été utilisé dans 43 cas, l’urétéroscope souple dans 15 cas, l’urétéroscope rigide dans 9 cas. La topographie du calcul était pyélique dans 30 cas, lombaire dans 28 cas, pelvienne dans 13 cas, calicielle dans 10 cas et iliaque dans 3 cas. Le nombre de calcul fragmenté au laser était de 87 calculs. Les complications étaient dominées par les fausses routes dans 8 cas. Le succès global de l’urétéroscopie était de 85,7%.Conclusion: La pratique courante de l’urétéroscopie constitue un défi pour l’urologue en Afrique subsaharienne. Elle est devenue le traitement de choix de la lithiase de la voie excrétrice supérieure.Mots clés: ithiase; Urétéroscopie; Laser; Sonde JJEnglish AbstractObjective: To present the results of the ureteroscopy at the GrandYoff General Hospital (Hoggy) in Dakar (Senegal).Subjects and methods: This is a descriptive study of 91 ureteroscopy procedures performed at the Urology department of Grand Yoff General Hospital from January 2012 to December 2013. The variables of the study were indication, age, type of ureteroscopy associate or no laser, results of lithotripsy.Results: Seven diagnostic ureteroscopy and 84 therapeutic ureteroscopy were done. The average age of the patients was 44.7 years + - 13,9 years. Semi-rigid ureteroscope was used in 43 cases, flexible ureteroscope in 15 cases and rigid ureteroscope in 9 cases. The location of the stones was renal pelvis in 30 cases, upper ureter in 28 cases, distal ureter in 13 cases, calix in 10 cases and middle ureter in 3 cases. The number of laser (Nd:Yag) fragmented stones was 87. Complications were dominated by false passages in 8 cases. The overall success of endoscopic treatment was 85.7%.Conclusion: The current practice of endoscopic treatment for upper urinary tract stone is quite challenging to the urologist practising in sub- Sahara Africa. The effectiveness and lesser morbidity of laser lithotripsy has made it the treatment of choice for upper urinary tract stones.Keywords: Lithiasis; Ureteroscopy; Laser; JJ sten

Barriers to maternal health services during the Ebola outbreak in three West African countries: a literature review

Introduction The Ebola virus disease (EVD) outbreak in West Africa, affecting Guinea, Liberia and Sierra Leone from 2014 to 2016, was a substantial public health crisis with health impacts extending past EVD itself. Access to maternal health services (MHS) was disrupted during the epidemic, with reductions in antenatal care, facility-based deliveries and postnatal care. We aimed to identify and describe barriers related to the uptake and provision of MHS during the 2014–2016 EVD outbreak in West Africa. Methods In June 2020, we conducted a scoping review of peer-reviewed publications and grey literature from relevant stakeholder organisations. Search terms were generated to identify literature that explained underlying access barriers to MHS. Published literature in scientific journals was first searched and extracted from PubMed and Web of Science databases for the period between 1 January 2014 and 27 June 2020. We hand-searched relevant stakeholder websites. A ‘snowball’ approach was used to identify relevant sources uncaptured in the systematic search. The identified literature was examined to synthesise themes using an existing framework. Results Nineteen papers were included, with 26 barriers to MHS uptake and provision identified. Three themes emerged: (1) fear and mistrust, (2) health system and service constraints, and (3) poor communication. Our analysis of the literature indicates that fear, experienced by both service users and providers, was the most recurring barrier to MHS. Constrained health systems negatively impacted MHS on the supply side. Poor communication and inadequately coordinated training efforts disallowed competent provision of MHS. Conclusions Barriers to accessing MHS during the EVD outbreak in West Africa were influenced by complex but inter-related factors at the individual, interpersonal, health system and international level. Future responses to EVD outbreaks need to address underlying reasons for fear and mistrust between patients and providers, and ensure MHS are adequately equipped both routinely and during crises

How can health systems be strengthened to control and prevent an Ebola outbreak? a narrative review

The emergence and re-emergence of infectious diseases are now more than ever considered threats to public health systems. There have been over 20 outbreaks of Ebola in the past 40 years. Only recently, the World Health Organization has declared a public health emergency of international concern (PHEIC) in West Africa, with a projected estimate of 1.2 million deaths expected in the next 6 months. Ebola virus is a highly virulent pathogen, often fatal in humans and non-human primates. Ebola is now a great priority for global health security and often becomes fatal if left untreated. This study employed a narrative review. Three major databases MEDLINE, EMBASE, and Global Health were searched using both ‘text-words’ and ‘thesaurus terms’. Evidence shows that low- and middle-income countries (LMICs) are not coping well with the current challenges of Ebola, not only because they have poor and fragile systems but also because there are poor infectious disease surveillance and response systems in place. The identification of potential cases is problematic, particularly in the aspects of contact tracing, infection control, and prevention, prior to the diagnosis of the case. This review therefore aims to examine whether LMICs’ health systems would be able to control and manage Ebola in future and identifies two key elements of health systems strengthening that are needed to ensure the robustness of the health system to respond effectively

Modelling outcomes after paediatric brain injury with admission laboratory values: a machine-learning approach.

BACKGROUND: Severe traumatic brain injury (TBI) is a leading cause of mortality in children, but the accurate prediction of outcomes at the point of admission remains very challenging. Admission laboratory results are a promising potential source of prognostic data, but have not been widely explored in paediatric cohorts. Herein, we use machine-learning methods to analyse 14 different serum parameters together and develop a prognostic model to predict 6-month outcomes in children with severe TBI. METHODS: A retrospective review of patients admitted to Cambridge University Hospital's Paediatric Intensive Care Unit between 2009 and 2013 with a TBI. The data for 14 admission serum parameters were recorded. Logistic regression and a support vector machine (SVM) were trained with these data against dichotimised outcomes from the recorded 6-month Glasgow Outcome Scale. RESULTS: Ninety-four patients were identified. Admission levels of lactate, H+, and glucose were identified as being the most informative of 6-month outcomes. Four different models were produced. The SVM using just the three most informative parameters was the best able to predict favourable outcomes at 6 months (sensitivity = 80%, specificity = 99%). CONCLUSIONS: Our results demonstrate the potential for highly accurate outcome prediction after severe paediatric TBI using admission laboratory data