Noncompliance to medication in psychiatric patients : a literature review

One in four people globally will be affected by mental disorders at some point in their life. Currently approximately 450 million people worldwide suffer from this conditions. The aim of this project is to produce evidence based knowledge for nursing students and practicing nurses in the specialty of mental health about the reasons of noncompliance to medication in psychiatric patients. What are the main reasons for noncompliance to medication in psychiatric patients?. Methods, this research entailed systematic literature review utilizing electronic searches to gather relevant articles to answer the research question. These databases include CINAHL from the Nell portal. The search terms used were antipsychotic medication, compliance, concordance, adherence, psychiatric and mental health. six articles were selected. Results: side effects, lack of family support, lack of patient to identify the disease, instability and homelessness, and fear of addiction to medication were the main reasons for medication noncompliance

Discounting in the evaluation of the cost-effectiveness of a vaccination programme: A critical review.

Discounting future costs and health benefits usually has a large effect on results of cost-effectiveness evaluations of vaccination because of delays between the initial expenditure in the programme and the health benefits from averting disease. Most guidelines currently recommend discounting both costs and health effects at a positive, constant, common rate back to a common point in time. A review of 84 published economic evaluations of vaccines found that most of them apply these recommendations. However, both technical and normative arguments have been presented for discounting health at a different rate to consumption (differential discounting), discounting at a rate that changes over time (non-constant discounting), discounting intra-generational and inter-generational effects at a different rate (two-stage discounting), and discounting the health gains from an intervention to a different discount year from the time of intervention (delayed discounting). These considerations are particularly acute for vaccines, because their effects can occur in a different generation from the one paying for them, and because the time of vaccination, of infection aversion, and of disease aversion usually differ. Using differential, two-stage or delayed discounting in model-based cost-effectiveness evaluations of vaccination raises technical challenges, but mechanisms have been proposed to overcome them

SELECTED FACTORS INFLUENCING THE IMPLEMENTATION OF SUBSIDISED PUBLIC SECONDARY SCHOOL EDUCATION IN BURETI SUB- COUNTY, KERICHO COUNTY, KENYA

In the last decade, the government of Kenya has emphasized the provision of education as a leading policy initiative. As a result, the government instituted the Free Primary Education (FPE) in the year 2003, which resulted in high enrolment of the pupils at the Primary level. However, costly school fees were found to be a major reason that the vast majority of primary graduates could not attend Secondary schools because their families could not afford the cost. The provision of Subsidized Secondary Education (SSE) is very important in Kenya given that the country is a low income one. SSE policy was launched in 2008 with an aim of ensuring that all primary pupils from class eight are able to continue well with secondary education. There are limited studies on the SSE programme currently and it is against this background that this study sought to shed more light on the programme. The purpose of this study was to establish factors influencing implementation of SSE policy on access and retention of education in public secondary schools in Bureti Sub-County. The study aimed at establishing the factors that influence effective implementation of free secondary education in public schools in Buret Sub-County, in Kericho County, Kenya. The study adopted a descriptive survey research design. The target population was the school Principals/Deputy Principals, Teachers, Sub-County Director of Education, District Quality Assurance and Standard Officer. Simple random, systematic and stratified sampling procedures were used. Both qualitative and quantitative data was collected from the study. Data analysis was done using descriptive statistics after data cleaning and coding. Quantitative data was analyzed using frequency counts, means and percentages while qualitative data was analyzed thematically. Results of data analysis were presented using frequency distribution tables, bar graphs and pie charts. SPSS program was used in the analysis. The findings show that the major challenges facing implementation of FSE includes; Delay in disbursing the SSE funds, over enrolment of students leading to strained physical facilities, inadequate facilities, lack of funds from the government for expansion, acute teacher shortage, poor cost sharing strategies. Key intervention measures for mitigating the identified challenges includes; Government to release funds in good time to avoid straining relations between suppliers and schools management, increasing bursaries support from M.O.E, NGOS, CDF for continuing students, providing clear policy on fund disbursement and increasing FSE allocation per student among others

Health literacy knowledge and experiences of nursing students at a South African university

A worldwide high prevalence of low health literacy has been reported, and despite the emergence of health literacy as a better determinant of health than socio-economic status, it is alarming that little attention is being accorded to training health workers on health literacy practices. This study thus sought to describe the health literacy knowledge and experiences of nursing students gained duringtraining in order to establish a basis that will inform future health literacy training.A descriptive cross-sectional survey was carried out using a questionnaire to establish the health literacy knowledge and experienceof 82nursing students.Data wereanalysed using descriptive as well as inferential statistics. The students exhibited unsatisfactory health literacy knowledge as measured by the questionnaire, with an average score of 73per cent, with knowledge gaps in some areas–for example with regard to the effectof low health literacy on patient health outcomes and identification of patients with low health literacy

Performance of Rapid Immunochromatographic Test on Malaria Infecton Among Expectant Women in Kericho County, Kenya

Background: Microscopy is the gold standard method currently acceptable in diagnosis of malaria in a clinical setting but is subject to diagnostic bias as it cannot detect malaria parasites as they are very low or absent in peripheral circulation. Rapid immunochromatographic test (ICT) can detect the parasite antigen in peripheraral circulation and thus may be a suitable complementary epidemiological tool for malaria diagnosis among the expectant women in low parasitaemia areas. However, the sensitivity and accuracy of rapid ICT in diagnosis of malaria in pregnancy has not been established. Methods: A laboratory based cross sectional study was used. Blood samples from 314 pregnant women attending the antenatal clinic were screened for malaria parasites using microscopy, rapid ICT and polymerase chain reaction (PCR). Results: Out of the 314 samples analyzed for malaria, 44 samples (14.0%) were positive for P. falciparum by microscopy while 62 (19.7%) were positive by rapid ICT. The sensitivity and specificity of rapid ICT was 84.4% and 96.8% respectively while that of microscopy was 68.8% and 100.0% respectively. There was a moderate level of agreement between results of rapid ICT and microscopy and high level of agreement when rapid ICT results were compared against microscopy and PCR results (κ = 0.517; p <0.001 and κ = 0.821; p <0.001) respectively. Conclusion:The findings of this study suggest the potential adoption of rapid ICT as a complementary epidemiology tool for malaria diagnosis among expectant women in areas of low parasitaemia and where microscopy is difficult to implement

Health literacy knowledge and experience of bachelor nursing students at a university in the Western Cape

Magister Curationis - MCurBackground: Health literacy is defined as the degree to which an individual has the capacity of obtaining, processing, and understanding basic health information and services needed for one to make appropriate decisions with relation to health. Health literacy is currently emerging as a major determinant of health outcomes yet it is not receiving enough attention, especially among health professionals. It is now considered a stronger predictor of health outcomes than social and economic status, education, and gender. Since nurses play a major role in providing healthcare information to patients and clients, it is imperative that nurses be prepared to face the challenges presented by individuals with poor health literacy skills. The nursing discipline is the largest segment of the health-oriented workforce and therefore, nurses have the largest responsibility of providing patient education, however, there are no education efforts targeting health professionals with regard to health literacy in South Africa. It is, therefore, imperative to establish the knowledge and experience of nurses in training in order to forge a way forward in nursing education. Aim: The overall aim of the study was to establish the health literacy knowledge and experiences of bachelor nursing students at a University in the Western Cape. Methodology: A quantitative, descriptive survey design was applied and data collection was carried out using a self-administered questionnaire. Total population sampling technique was done, the final sample was (n=82) of the fourth-year nursing students. Data was analyzed using SPSS version 23, descriptive and inferential statistics were employed. Ethics: Ethical approval was granted by the ethics research committee, thereafter permission to conduct the study at the University was obtained from the Registrar and the Director of The School of Nursing. The researcher maintained the principles of anonymity and confidentiality throughout the study. Participation was voluntary and informed consent was signed by the respondents. Results: The study found that bachelor of nursing students in Western Cape exhibited satisfactory health literacy knowledge as measured by the questionnaire, the score was 73%, with a cut-off of 70%. Knowledge gaps however existed in some areas - for example with regards to the impact of low health literacy on patient health outcomes and identification of patients with low health literacy. Their health literacy experience was, however, lacking, with students only reporting some experience in the use of written materials in providing patient education. There was a weak negative, but statistically significant relationship between health literacy knowledge and experience. Conclusion: Exposure to health literacy within the nursing curriculum needs to be more comprehensive, since the results portray that the emphasis of health literacy in the curriculum failed to have an effect on the health literacy knowledge scores, deeming it insufficient

Assessment of cold chain management practices in immunisation centres in Kacheliba division, Pokot County, Kenya

Background: Immunisation contributes significantly to the achievement of MDGs. It is one of the eight elements and success stories of primary health care. Proper utilisation of Immunisation services is associated with improved child health outcomes. The WHO targets Immunisation coverage of 90% for urban areas and 80% for rural areas.Objectives: To assess the cold chain management practices that could affect  potency of vaccines and its utilisation by under five year old children in Kacheliba Division.Design: A cross-sectional descriptive study.Setting: All health facilities in Kacheliba Division, Kenya.Subjects: Parents/guardians of under-five year old children and all the health facility level within Kacheliba Division.Results: Seven (87.5%) health facilities reported that they collect vaccines at intervals of more than one month. Four (50%) health institution were located 20 kilometers from the local vaccine store - Kacheliba District Hospital. Kacheliba District Hospital gets their vaccine stocks from Eldoret KEMSA depot, an estimated 90 kilometers away. Completely melted ice packs during transportation of vaccine were encountered only in one (12.5%) centre- Kacheliba mobile dispensary. Major source of power for the refrigerators was the gas (75%), and electricity (28.6%). During electricity power block out, the right temperature intervals were then generated using gas. It was found that all the eight health facilities did not have a stand by biomedical technician who maintains and repair refrigerators. Furthermore there was no budgetary allocation for the refrigerators maintenance and repair among all the health facilities. Problems related to cold chain were observed in all the eight facilities in Kacheliba Division. Inadequate air circulation was seen in seven (87.5%) facilities, water bottles were kept inside the cold boxes and fridges in three (37.5%) facilities, Food and drinks were kept in cold boxes and fridges in 4(50%) facilities and vaccines were not kept in proper compartment in three (37.5%) facilities.Conclusion: The cold chain management practices among health facilities in Kacheliba Division of Pokot County were not upto the standards set by the Kenya Extended Programmeme on Immunisation (KEPI)) Guidelines. Cold chain  management should be improved through continuous medical educational  programmemes and sufficient budgetary allocation

Development and utilization of a decision support tool for the optimization of fertilizer application in smallholder farms in Uganda

This paper presents the development and pilot of the Fertilizer Optimization Tool (FOT), a decision support tool for use by extension agents in  advising smallholder farmers in Uganda in applying optimum (rather than maximum) fertilizer by considering the farmers’ financial abilities. The FOT is made up of three components which includes, the optimizer tool, the nutrient substitution table, and a fertilizer calibration tool. The FOT was developed using field trial data collected on specific agro-ecological zones and mapped using global positioning systems in 13 Sub-Saharan Africa countries. The FOT provides site- and farmer-specific fertilizer recommendations, providing both economic and environmental benefits. Results are based on a survey of 241 households, 57 technical personnel and tracking of 33 FOT users over a 3-season period. Results show a progressive shift in farmers’ attitude towards the value of fertilizer. More FOT users (71%) disagreed with the statement that fertilizers destroy soils, compared with  non-FOT users (52%). Crop yields (tons/ha) were significantly higher for crops receiving fertilizers compared to those not. While it is generally accepted that using fertilizer improves crop response and achieves better yields, the value of FOT was reported in terms of rationalization of investment by farmers. The average seasonal investment was approx. $43, giving a return on investment of over 107%. Given the evidence  generated from Uganda, there is a need for considering out scaling the FOT technology to other countries in Africa, which are faced with the same challenges of low fertilizer use among smallholder farmers. Using the mobile FOT app provides a further cost-effective opportunity to out scale the approach to benefit more smallholder farmers in sub-Saharan Africa. Further development of the FOT is suggested, particularly in the wake of increased focus on multi-nutrient fertilizer blends, and the need to adjust for soil PH, moisture, and long-term impacts of nutrient substitution. Key words: decision support tool, fertilizer optimization tool, precision agriculture, site-specific fertilizer recommendation

ICDP workshop on the Deep Drilling in the Turkana Basin Project:Exploring the link between environmental factors and hominin evolution over the past 4 Myr

Scientific drill cores provide unique windows into the processes of the past and present. In the dynamic tectonic, environmental, climatic, and ecological setting that is eastern Africa, records recovered through scientific drilling enable us to look at change through time in unprecedented ways. Cores from the East African Rift System can provide valuable information about the context in which hominins evolved in one of the key regions of hominin evolution over the past 4 Myr. The Deep Drilling in the Turkana Basin (DDTB) project seeks to explore the impact of several types of evolution (tectonic, climatic, biological) on ecosystems and environments. This includes addressing questions regarding the region’s complex and interrelated rifting and magmatic history, as well as understanding processes of sedimentation and associated hydrothermal systems within the East African Rift System. We seek to determine the relative impacts of tectonic and climatic evolution on eastern African ecosystems. We ask, what role (if any) did climate change play in the evolution of hominins? How can our understanding of past environmental change guide our planning for a future shaped by anthropogenic climate change? To organize the scientific community’s goals for deep coring in the Turkana Basin, we hosted a 4-day ICDP supported workshop in Nairobi, Kenya in July 2022. The team focused on how a 4 Myr sedimentary core from the Turkana Basin will uniquely address key scientific research objectives related to basin evolution, paleoclimate, paleoenvironment, and modern resources. Participants also discussed how DDTB could collaborate with community partners in the Turkana Basin, particularly around the themes of access to water and education. The team concluded that collecting the proposed Pliocene to modern record is best accomplished through a 2-phase drilling project with a land-based transect of four cores spanning the interval from 4 Ma to Middle/Late Pleistocene (<0.7 Ma) and a lake-based core targeting the interval from ~1 Ma to present. The second phase, while logistically more challenging due to the lack of drilling infrastructure currently on Lake Turkana, would revolutionize our understanding of a significant interval in the evolution and migration of Homo sapiens for a time period not currently accessible from the Kenyan part of the Turkana Basin. Collectively, the DDTB project will provide exceptional tectonic and climatic data directly associated with one of the world’s richest hominin fossil localities

ICDP workshop on the Deep Drilling in the Turkana Basin Project:Exploring the link between environmental factors and hominin evolution over the past 4 Myr

Scientific drill cores provide unique windows into the processes of the past and present. In the dynamic tectonic, environmental, climatic, and ecological setting that is eastern Africa, records recovered through scientific drilling enable us to look at change through time in unprecedented ways. Cores from the East African Rift System can provide valuable information about the context in which hominins evolved in one of the key regions of hominin evolution over the past 4 Myr. The Deep Drilling in the Turkana Basin (DDTB) project seeks to explore the impact of several types of evolution (tectonic, climatic, biological) on ecosystems and environments. This includes addressing questions regarding the region’s complex and interrelated rifting and magmatic history, as well as understanding processes of sedimentation and associated hydrothermal systems within the East African Rift System. We seek to determine the relative impacts of tectonic and climatic evolution on eastern African ecosystems. We ask, what role (if any) did climate change play in the evolution of hominins? How can our understanding of past environmental change guide our planning for a future shaped by anthropogenic climate change? To organize the scientific community’s goals for deep coring in the Turkana Basin, we hosted a 4-day ICDP supported workshop in Nairobi, Kenya in July 2022. The team focused on how a 4 Myr sedimentary core from the Turkana Basin will uniquely address key scientific research objectives related to basin evolution, paleoclimate, paleoenvironment, and modern resources. Participants also discussed how DDTB could collaborate with community partners in the Turkana Basin, particularly around the themes of access to water and education. The team concluded that collecting the proposed Pliocene to modern record is best accomplished through a 2-phase drilling project with a land-based transect of four cores spanning the interval from 4 Ma to Middle/Late Pleistocene (<0.7 Ma) and a lake-based core targeting the interval from ~1 Ma to present. The second phase, while logistically more challenging due to the lack of drilling infrastructure currently on Lake Turkana, would revolutionize our understanding of a significant interval in the evolution and migration of Homo sapiens for a time period not currently accessible from the Kenyan part of the Turkana Basin. Collectively, the DDTB project will provide exceptional tectonic and climatic data directly associated with one of the world’s richest hominin fossil localities