Evaluation of Provider Recommendation of Colorectal Cancer Screening in a Primary Care Setting

Objectives: The overall objective of this practice inquiry project was to evaluate whether providers in a primary care clinic in Louisville, KY were following the United States Preventive Services Task Force (USPSTF) screening guidelines regarding colorectal cancer for patients aged 50 -75. The study examined the types of screening recommended, and whether completion of screening was documented in the medical record. Finally in this study, provider recommendation for Colorectal Cancer Screening (CRC) was evaluated to determine if types of screening recommended, and documentation varied based on the ethnicity of the patients. Methods: This was a descriptive study using a retrospective chart review of patient medical records (n= 200) in a primary care office located in Louisville, Kentucky. Charts were reviewed and data collected for male and female patients ages 50-75, who were seen in the primary care office between January 1, 2015 and December 31, 2015. Data was also collected and charts examined on whether CRC screening was recommended, the type of screening that was recommended, whether recommendation was based on ethnicity, and whether completion of screening was documented. Results: There was no statistically significant difference in gender by CRC screening recommendation. According to the data, females were as likely to be recommended for CRC screening as their male counterparts. There was no statistically significant relationship between ethnicity and the recommendation of CRC screening. The data did reveal however, that the providers overwhelmingly chose to recommend one type of screening (colonoscopy) over the other types of screening, (e.g., Fecal Occult Blood, Fecal immunochemical test, Cologuard, Flexible sigmoidoscopy). This might be due to the high predictive value of colonoscopy compared to the other types of CRC screening processes. Also the data revealed that, while there was no statistically significant difference by age (p=.52), those recommended for CRC screening were slightly older. (Mean=59.1) as compared to those not recommended 56.6 for screening. This is older than what USPSTF recommends. Conclusion: In this clinic, providers were as likely to recommend CRC screening for women as for men. In addition, the CRC screening did not differ based on race or ethnicity. Notwithstanding, it was apparent that younger patients were not screening for CRC at the same rate compared to the older patients. There is need for provider improvement in recommendation of CRC screening for the patients starting at age 50, in line with the USPSTF guidelines. This is critical as new research has found colon cancer rates rising among individuals under 50

Agricultural Credit Guarantee in Nigeria and the Uncertainties of the Macroeconomic Environment

Efforts to revitalize agricultural credit delivery became a reality in 1977 with the establishing of the Agricultural Credit Guarantee Scheme Fund. This study assesses the Agricultural Credit Guarantee Scheme (ACGS) under the Nigerian macroeconomic environment. It assesses the real value of loans guaranteed overtime; analyzes agricultural output in agriculture credit guarantee scheme, analyses the effect of changes in interest rate and other variables on the volume of loans guaranteed. Data obtained were analyzed using both descriptive and inferential statistics. This study suggests that the macroeconomic environment has not been friendly with ACGS operations. Credit guarantee contributes positively to increased agricultural output, but the number and value of loans guarantee as well as the performance of loans and agricultural sector output would be greatly enhance by policies that make interest rates, inflation, stock market capitalization, nominal exchange rates and other variables of the macroeconomic environment agricultural sector friendly and supportive.  Keywords: Credit Guarantee, Agricultural Sector, Macroeconomic environment, Nigeria. JEL Classifications: H81 DOI: https://doi.org/10.32479/ijefi.910

High-resolution linkage map and chromosome-scale genome assembly for cassava (Manihot esculenta Crantz) from 10 populations

Cassava (Manihot esculenta Crantz) is a major staple crop in Africa, Asia, and South America, and its starchy roots provide nourishment for 800 million people worldwide. Although native to South America, cassava was brought to Africa 400–500 years ago and is now widely cultivated across sub-Saharan Africa, but it is subject to biotic and abiotic stresses. To assist in the rapid identification of markers for pathogen resistance and crop traits, and to accelerate breeding programs, we generated a framework map for M. esculenta Crantz from reduced representation sequencing [genotyping-by-sequencing (GBS)]. The composite 2412-cM map integrates 10 biparental maps (comprising 3480 meioses) and organizes 22,403 genetic markers on 18 chromosomes, in agreement with the observed karyotype. We used the map to anchor 71.9% of the draft genome assembly and 90.7% of the predicted protein-coding genes. The chromosome-anchored genome sequence will be useful for breeding improvement by assisting in the rapid identification of markers linked to important traits, and in providing a framework for genomic selectionenhanced breeding of this important crop.Bill and Melinda Gates Foundation (BMGF) Grant OPPGD1493. University of Arizona. CGIAR Research Program on Roots, Tubers, and Bananas. Next Generation Cassava Breeding grant OPP1048542 from BMGF and the United Kingdom Department for International Development. BMGF grant OPPGD1016 to IITA. National Institutes of Health S10 Instrumentation Grants S10RR029668 and S10RR027303.http://www.g3journal.orghb201