Knowledge, attitude and practice of Libyan females attending primary health care centers regarding breast cancer in Benghazi / 2017

Introduction: Breast cancer is the most common cancer among women. The occurrence of breast cancer in the female Libyan population is strongly associated with young age with nearly 70.9% of cases arising in female individuals who are 50 years or younger. In 2004 breast cancer in Libya was the most common malignancy in females as recorded by Benghazi Cancer Registry. Aim: To determine the knowledge, attitudes, and practices (KAP) of Libyan females attending primary health care centers in Benghazi regarding breast cancer. Methodology: A cross – sectional descriptive study, total of 500 women attending health care centers in Benghazi. Result: Nearly all participants 499 (99.8%) had heard about breast cancer, 295(59%) of participants had never heard about breast self-examination (BSE), the majority of them had not practiced BSE 344 (68.8%), 137 (27.4%) underwent screening by CBE, most of them 442 (88.4%) had not performed mammogram examination. Conclusion: The result revealed that the Libyan women attending the selected health care institutions had a good knowledge level about basic information regarding breast cancer, its signs, symptoms and its risk factors. It revealed they had poor knowledge for BSE, CBE and mammography, and had positive attitudes but poor practice

Gaining Competitive Intelligence through Social Media in B2B Context

Competitive Intelligence (CI) as the process of collecting data, analyzing it, and disseminating intelligence to decision-makers to improve the assessment of threats, risks, and opportunities relies on various source of data collection. Among such sources are the Internet and its increasingly popular offspring Social Media (SM). This quantitative research with an abductive approach used a descripto-explanatory model adapted from Schmidt (2000) and Teo (2001) to examine the effectiveness of CI when gained from SM for business-to-business (B2B) purposes.A Survey adapted from Chen et al. (2002), and Dey (2011) was used to collect 88 B2B business managers’ responses in Canada, the United States, and Sweden. Differences were seen between the efficiency of CI used in different types of decision-making. The findings of the study showed that among the three main types of decision making (strategic, tactical, and operational), SM can contribute to CI which supports tactical decision-making in areas such as regional biases, customer segmentation, popularity of products, and the popularity of products. However, they rank below other CI sources in supporting strategic and operational decisions in areas such as industry warning, country risk, and price fluctuations. As such, when extracting data and mining them for internal use in a B2B organization, managers and CI experts should consider the applicability and reliability of SM data before disseminating them to decision-making processes. The study proposed a framework for examining the role of SM in decision-making processes in a B2B context, which can be applied for further investigation into the implications of such data.Validerat; 20160607 (marikav

Morphological characteristics and health of beech trees by diameter more than one meter (case study, Guilan province)

For investigation of morphological characters of health of beech trees by diameter more than one meter at breast height, 33 trees were selected in Guilan province, Sistan district. Studied morphological characters were crown shape, spiral growth, nodes, collar rot, red wood heart, trees height, trunk height, crown height and trunk decay. Results showed that collar rot had significant correlation with trunk decay in the trees (

Outpatient management of urinary tract infections by medical officers in Nairobi, Kenya: lack of benefit from audit and feedback on adherence to treatment guidelines

Abstract Introduction Acute uncomplicated urinary tract infections are common in outpatient settings but are not treated optimally. Few studies of the outpatient use of antibiotics for specific diagnoses have been done in sub-Saharan Africa, so little is known about the prescribing patterns of medical officers in the region. Methods Aga Khan University has 16 outpatient clinics throughout the Nairobi metro area with a medical officer specifically assigned to that clinic. A baseline assessment of evaluation and treatment of suspected UTI was performed from medical records in these clinics. Then the medical officer from each of the 16 clinics was recruited from each clinic was recruited with eight each randomized to control vs. feedback groups. Both groups were given a multimodal educational session including locally adapted UTI guidelines and emphasis on problems identified in the baseline assessment Each record was scored using a scoring system that was developed for the study according to adequacy of history, physical examination, clinical diagnosis matching recorded data, diagnostic workup and treatment. Three audits were done for both groups; baseline (audit 1), post-CME (audit 2), and a final audit, which was after feedback for the feedback group (audit 3). The primary analysis assessed overall guideline adherence in the feedback group versus the CME only group. Results The overall scores in both groups showed significant improvement after the CME in comparison to baseline and for each group, the scores in most domains also improved. However, audit 3 showed persistence of the gains attained after the CME but no additional benefit from the feedback. Some deficiencies that persisted throughout the study included lack of workup of possible STI and excess use of non-UTI laboratory tests such as CBC, stool culture and H. pylori Ag. After the CME, the use of nitrofurantoin rose from only 4% to 8% and cephalosporin use increased from 49 to 67%, accompanied by a drop in quinolone use. Conclusion The CME led to modest improvements in patient care in the categories of history taking, treatment and investigations, but feedback had no additional effect. Future studies should consider an enforcement element or a more intensive feedback approach

Characteristics of corticosteroid inhibition of adrenocorticotrophin release from the anterior pituitary gland of the rat

The occurrence and nature of corticosteroid inhibition of ACTH secretion at the rat anterior pituitary gland was investigated using three experimental models: animals bearing lesions of the basal hypothalamus, and two preparations of the gland incubated in vitro; these were tissue segments and collagenase-dispersed cells. Release of ACTH in the experiments was provoked using one of three distinct stimuli: acid extracts of whole hypothalami, corticotrophin releasing activity released by serotonin from hypothalami incubated in vitro and synthetic ovin corticotrophin releasing factor. Irrespective of whether ACTH was measured directly by radioimmunoassay (in the experiments in vitro) or indirectly in terms of corticosterone production (in the lesioned animals), its stimulated release from the anterior pituitary gland was inhibited by corticosterone. Two phases of inhibition were observed; these had some of the characteristics inferred previously from experiments with intact animals and designated fast feedback and delayed feedback. However, the fast feedback demonstrable in lesioned animals did not show the rate-sensitivity shown previously in intact animals. 11-Deoxycortisol (or 11-deoxycorticosterone) and prednisolone proved to be agonists of corticosterone in provoking fast feedback in lesioned animals, whereas they had been shown respectively to act as an antagonist or to have no effect in intact rats. Several steroids were able to cause delayed feedback in lesions rats, but beclomethasone dipropionate (shown to be an agonist of corticosterone in intact rats) proved to have no inhibitory effect at the anterior pituitary gland of lesioned animals. It is concluded that the dynamics of corticosteroid feedback mechanisms at the anterior pituitary gland, as indicated by experiments in lesioned animals, differ from those operative in the intact animals. Other work suggests that a more important site for such inhibitory mechanisms in vivo is the hypothalamus

The Kamil Crater in Egypt

We report on the detection in southern Egypt of an impact crater 45 meters in diameter with a pristine rayed structure. Such pristine structures are typically observed on atmosphereless rocky or icy planetary bodies in the solar system. This feature and the association with an iron meteorite impactor and shock metamorphism provides a unique picture of small-scale hypervelocity impacts on Earth’s crust. Contrary to current geophysical models, ground data indicate that iron meteorites with masses of the order of tens of tons can penetrate the atmosphere without substantial fragmentation

Macular hole in retinitis pigmentosa patients: microincision vitrectomy with polydimethylsiloxane as possible treatment

Purpose To investigate long-term retinal changes after microincision pars plana vitrectomy surgery (MIVS) for macular hole (MH) in retinitis pigmentosa (RP) patients. Retrospective and observational study. Methods Three RP patients suffering from MH were evaluated by means of best corrected visual acuity (BCVA), anterior and posterior binocular examination, spectralis high-resolution optical coherence tomography (SD-OCT), MP-1 microperimetry (MP-1), and full-field electroretinogram (ERG), before MIVS and during the 36 months follow-up. Patients underwent to simultaneous MIVS and microincision cataract surgery (MICS); IOL was positioned in capsular bag. Patients were hospitalized for two days after the surgery. Surgical procedure was performed according the following schedule: surgical removal of crystalline lens, MIVS with 23-gauge sutureless system trocars, core vitreous body removal, peeling of the inner limiting membrane (ILM), and balanced sterile saline solution-air-micro-structured polydimethylsiloxane (PDMS) exchange. PDMS tamponade, after 6 months starting from MIVS, was removed. Results In all patients visual acuity increased after vitrectomy as a consequence of complete MH closure and restoration of retinal architecture. None of the patients developed ocular hypertension, or re-opening of MH during the 3-year-follow up. MP-1 bivariate contour ellipse area (BCEA) was reduced in its dimensions and improved in all patients demonstrating a better fixation. Conclusions MIVS could be an effective treatment in RP patients with MH if medical therapy is not applicable or not sufficient. Finally more studies will be needed to improve knowledge about this genetic disease