Emergency Contraception Among Women With Abortion At University Teaching Hospital In Lusaka, Zambia

Background: The maternal mortality ratio for Zambia is 591/100 000 live births. Globally between 15 – 30% of the maternal deaths are due to unsafe abortions. According to the Zambian demographic health survey (ZDHS), the contraceptive prevalence rate was 34% (CSO, 2003). The unmet need for family planning was 27%. Emergency contraception pill (ECP) was officially launched in Zambia in 1998 by the Ministry of Health with the aim of strengthening reproductive health. It can be obtained free of charge at public health institutions and also as an over the counter drug.Objective: To determine knowledge, Practice and attitude towards Emergency Contraception (EC) among women with abortion at the University Teaching Hospital (UTH), Lusaka, Zambia.Design: A cross-sectional descriptive study design and an interview schedule were administered to 200 women admitted to UTH with abortion aged between 18 – 49 years old.Main outcome measure: Emergency contraception awareness among women with abortions at UTH, Lusaka.Results: The median age of the participants was 19 years. Only 7.5% had ever heard of emergency contraceptive pills (ECPs). Majority (70%) were married with the majority reporting being married for less than 5 years. The contraceptive ever use rate was 78.5%and 58% the participants had their first pregnancies as teenagers. Almost a third (31%) was nulliparous. The most common sources of information about EC were friends (80%). Level of education was significantly associated with the outcome of EC awareness (OR = 9.5; 95% CI [3.06 – 29.87] (P value 0.001). Another factor that was significantly associated with the outcome of EC awareness was the level of EC knowledge (OR = 0.00; 95% CI [0.00 – 0.02](P value 0.001). Other factors such as age, place of residence and marital status were not significantly associated with EC awareness.Conclusion: Knowledge about Emergency Contraception (EC) among women with abortions admitted to UTH is low. Friends are an important source of EC information. Awareness and knowledge of EC should be increased

Keep me from sinking down: a thematic catalog of the violin works by Samuel Coleridge-Taylor

This study aims to analyze and catalog all the violin works of Samuel Coleridge-Taylor, a composer from the late 1800s who was prominent during his time, but has been scarcely remembered. This catalog provides important information about his works for the violin, and attempts to increase the dissemination of Coleridge-Taylor's music and allow it to be increasingly performed, as violinists incorporate his pieces into their repertoire. An overview of Coleridge-Taylor's historical importance, including discussions about the African influences in his compositions as well as his contributions to Pan-Africanism, is provided in Chapter II. The American virtuoso violinist Maud Powell is also discussed in Chapter III, given her significant impact on the composer’s career. Previous research indicates that Coleridge-Taylor's primary instrument was the violin and that he wrote a considerable amount of pieces for the instrument. The most complete catalog of Coleridge-Taylor's works up to this point was written by Dr. Dominique-René de Lerma, described in Chapter IV; however, not all of his violin works are present. The methodology for the groundwork of this study, which reviews and updates the Lerma's catalog, is given in Chapter V. The Thematic Catalog of Violin Works is presented in Chapter VI, with important information to help violinists incorporate these pieces into their repertoire, followed by the complete list of violin works by difficulty level, in Chapter VII. More pertinent materials are given in the four Appendices, such as relevant correspondences and compositions' prefaces. The findings of this study show that while the majority of Coleridge-Taylor's works for the violin are at an intermediate level, a small number are for beginners, and some are truly difficult level masterpieces. As shown in the Conclusion, after careful analysis, it can be inferred that Coleridge-Taylor’s violin works deserve to be known, incorporated into the repertoire of modern violinists, and performed more frequently

Students’ Evolving Meaning About Tangent Line with the Mediation of a Dynamic Geometry Environment and an Instructional Example Space

In this paper I report a lengthy episode from a teaching experiment in which fifteen Year 12 Greek students negotiated their definitions of tangent line to a function graph. The experiment was designed for the purpose of introducing students to the notion of derivative and to the general case of tangent to a function graph. Its design was based on previous research results on students’ perspectives on tangency, especially in their transition from Geometry to Analysis. In this experiment an instructional example space of functions was used in an electronic environment utilising Dynamic Geometry software with Function Grapher tools. Following the Vygotskian approach according to which students’ knowledge develops in specific social and cultural contexts, students’ construction of the meaning of tangent line was observed in the classroom throughout the experiment. The analysis of the classroom data collected during the experiment focused on the evolution of students’ personal meanings about tangent line of function graph in relation to: the electronic environment; the pre-prepared as well as spontaneous examples; students’ engagement in classroom discussion; and, the role of researcher as a teacher. The analysis indicated that the evolution of students’ meanings towards a more sophisticated understanding of tangency was not linear. Also it was interrelated with the evolution of the meaning they had about the inscriptions in the electronic environment; the instructional example space; the classroom discussion; and, the role of the teacher

Are lay people good at recognising the symptoms of schizophrenia?

©2013 Erritty, Wydell. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.This article has been made available through the Brunel Open Access Publishing Fund.Aim: The aim of this study was to explore the general public’s perception of schizophrenia symptoms and the need to seekhelp for symptoms. The recognition (or ‘labelling’) of schizophrenia symptoms, help-seeking behaviours and public awareness of schizophrenia have been suggested as potentially important factors relating to untreated psychosis. Method: Participants were asked to rate to what extent they believe vignettes describing classic symptoms (positive and negative) of schizophrenia indicate mental illness. They were also asked if the individuals depicted in the vignettes required help or treatment and asked to suggest what kind of help or treatment. Results: Only three positive symptoms (i.e., Hallucinatory behaviour, Unusual thought content and Suspiciousness) of schizophrenia were reasonably well perceived (above 70%) as indicating mental illness more than the other positive or negative symptoms. Even when the participants recognised that the symptoms indicated mental illness, not everyone recommended professional help. Conclusion: There may be a need to improve public awareness of schizophrenia and psychosis symptoms, particularly regarding an awareness of the importance of early intervention for psychosis

Trauma history and depression predict incomplete adherence to antiretroviral therapies in a low income country.

As antiretroviral therapy (ART) for HIV becomes increasingly available in low and middle income countries (LMICs), understanding reasons for lack of adherence is critical to stemming the tide of infections and improving health. Understanding the effect of psychosocial experiences and mental health symptomatology on ART adherence can help maximize the benefit of expanded ART programs by indicating types of services, which could be offered in combination with HIV care. The Coping with HIV/AIDS in Tanzania (CHAT) study is a longitudinal cohort study in the Kilimanjaro Region that included randomly selected HIV-infected (HIV+) participants from two local hospital-based HIV clinics and four free-standing voluntary HIV counselling and testing sites. Baseline data were collected in 2008 and 2009; this paper used data from 36 month follow-up interviews (N = 468). Regression analyses were used to predict factors associated with incomplete self-reported adherence to ART. INCOMPLETE ART ADHERENCE WAS SIGNIFICANTLY MORE LIKELY TO BE REPORTED AMONGST PARTICIPANTS WHO EXPERIENCED A GREATER NUMBER OF CHILDHOOD TRAUMATIC EVENTS: sexual abuse prior to puberty and the death in childhood of an immediate family member not from suicide or homicide were significantly more likely in the non-adherent group and other negative childhood events trended toward being more likely. Those with incomplete adherence had higher depressive symptom severity and post-traumatic stress disorder (PTSD). In multivariable analyses, childhood trauma, depression, and financial sacrifice remained associated with incomplete adherence.\ud This is the first study to examine the effect of childhood trauma, depression and PTSD on HIV medication adherence in a low income country facing a significant burden of HIV. Allocating spending on HIV/AIDS toward integrating mental health services with HIV care is essential to the creation of systems that enhance medication adherence and maximize the potential of expanded antiretroviral access to improve health and reduce new infections

How community ART delivery may improve HIV treatment outcomes: Qualitative inquiry into mechanisms of effect in a randomized trial of community-based ART initiation, monitoring and re-supply (DO ART) in South Africa and Uganda

INTRODUCTION: UNAIDS fast track targets for ending the AIDS epidemic by 2030 call for viral suppression in 95% of people using antiretroviral therapy (ART) to treat HIV infection. Difficulties in linking to care following a positive HIV test have impeded progress towards meeting treatment targets. Community-based HIV services may reduce linkage barriers and have been associated with high retention and favourable clinical outcomes. We use qualitative data from The Delivery Optimization of Antiretroviral Therapy (DO ART) Study, a three-arm randomized trial of community ART initiation, monitoring and re-supply conducted in western Uganda and KwaZulu-Natal South Africa, to identify mechanisms through which community ART delivery may improve treatment outcomes, defined as viral suppression in people living with HIV (PLHIV). METHODS: We conducted open-ended interviews with a purposeful sample of 150 DO ART participants across study arms and study sites, from October 2016 to November 2019. Interviews covered experiences of: (1) HIV testing; (2) initiating and refilling ART; and (3) participating in the DO ART Study. A combined inductive content analytic and thematic approach was used to characterize mechanisms through which community delivery of ART may have contributed to viral suppression in the DO ART trial. RESULTS: The analysis yielded four potential mechanisms drawn from qualitative data representing the perspectives and priorities of DO ART participants. Empowering participants to schedule, re-schedule and select the locations of community-based visits via easy phone contact with clinical staff is characterized as flexibility. Integration refers to combining the components of clinic-based visits into single interaction with a healthcare provider. Providers" willingness to talk at length with participants during visits, addressing non-HIV as well as HIV-related concerns, is termed "a slower pace". Finally, increased efficiency denotes the time savings and increased income-generating opportunities for participants brought about by delivering services in the community. CONCLUSIONS: Understanding the mechanisms through which HIV service delivery innovations produce an effect is key to transferability and potential scale-up. The perspectives and priorities of PLHIV can indicate actionable changes for HIV care programs that may increase engagement in care and improve treatment outcomes

Histone deacetylases as new therapy targets for platinum-resistant epithelial ovarian cancer

Introduction: In developed countries, ovarian cancer is the fourth most common cancer in women. Due to the nonspecific symptomatology associated with the disease many patients with ovarian cancer are diagnosed late, which leads to significantly poorer prognosis. Apart from surgery and radiotherapy, a substantial number of ovarian cancer patients will undergo chemotherapy and platinum based agents are the mainstream first-line therapy for this disease. Despite the initial efficacy of these therapies, many women relapse; therefore, strategies for second-line therapies are required. Regulation of DNA transcription is crucial for tumour progression, metastasis and chemoresistance which offers potential for novel drug targets. Methods: We have reviewed the existing literature on the role of histone deacetylases, nuclear enzymes regulating gene transcription. Results and conclusion: Analysis of available data suggests that a signifant proportion of drug resistance stems from abberant gene expression, therefore HDAC inhibitors are amongst the most promising therapeutic targets for cancer treatment. Together with genetic testing, they may have a potential to serve as base for patient-adapted therapies

Micronutrient Deficits Are Still Public Health Issues among Women and Young Children in Vietnam

Background: The 2000 Vietnamese National Nutrition Survey showed that the population’s dietary intake had improved since 1987. However, inequalities were found in food consumption between socioeconomic groups. As no national data exist on the prevalence of micronutrient deficiencies, a survey was conducted in 2010 to assess the micronutrient status of randomly selected 1526 women of reproductive age and 586 children aged 6–75 mo. Principal Findings: In women, according to international thresholds, prevalence of zinc deficiency (ZnD, 67.262.6%) and vitamin B12 deficiency (11.761.7%) represented public health problems, whereas prevalence of anemia (11.661.0%) and iron deficiency (ID, 13.761.1%) were considered low, and folate (,3%) and vitamin A (VAD,,2%) deficiencies were considered negligible. However, many women had marginal folate (25.1%) and vitamin A status (13.6%). Moreover, overweight (BMI$23 kg/m 2 for Asian population) or underweight occurred in 20 % of women respectively highlighting the double burden of malnutrition. In children, a similar pattern was observed for ZnD (51.963.5%), anemia (9.161.4%) and ID (12.961.5%) whereas prevalence of marginal vitamin A status was also high (47.362.2%). There was a significant effect of age on anemia and ID prevalence, with the youngest age group (6–17 mo) having the highest risk for anemia, ID, ZnD and marginal vitamin A status as compared to other groups. Moreover, the poorest groups of population had a higher risk for zinc, anemia and ID

Quetiapine in the treatment of schizophrenia and related disorders

Quetiapine was developed in 1985 by scientists at AstraZeneca (formerly Zeneca) Pharmaceuticals. It received official US Food and Drug Administration approval in September 1997 and approval in Germany in 2000. Since then, quetiapine has been used in the treatment of severe mental illness in approximately 70 countries including Canada, most Western European countries, and Japan. Quetiapine is a dibenzothiazepine derivative with a relatively broad receptor binding profile. It has major affinity to cerebral serotonergic (5HT2A), histaminergic (H1), and dopaminergic D1 and D2 receptors, moderate affinity to α1- und α2-adrenergic receptors, and minor affinity to muscarinergic M1 receptors; it demonstrates a substantial selectivity for the limbic system. This receptor occupancy profile with relatively higher affinity for the 5HT2A receptor compared with the D2 receptor is in part responsible for the antipsychotic characteristics and low incidence of extrapyramidal side-effects of quetiapine. The efficacy of quetiapine in reducing positive and negative symptoms of schizophrenia has been proven in several clinical trials with placebo-controlled comparators. Quetiapine has also demonstrated robust efficacy for treatment of cognitive, anxious-depressive, and aggressive symptoms in schizophrenia. Long-term trials show sustained tolerability for a broad spectrum of symptoms. Quetiapine has also proven efficacy and tolerability in the treatment of moderate to severe manic episodes, and in the treatment of juveniles with oppositional-defiant or conduct disorders, and in the geriatric dementia population. Recent data indicate that quetiapine may also be effective in the treatment of bipolar depressive symptoms without increasing the risk of triggering manic episodes, and in borderline personality disorder. In comparison with other antipsychotics, quetiapine has a favorable side-effect profile. In clinical trials only small insignificant prolongations of the QT interval were observed. Weight-gain liabilities and new-onset metabolic side-effects occupy a middle-ground among newer antipsychotics. As a result of its good efficacy and tolerability profile quetiapine has become well established in the treatment of schizophrenia and manic episodes