Perspectives of Librarians on Quality Assurance Measures for Admission of Students in Distance Education Programme in Nigeria

The quality assurance measures for admission of students into Distance Education (DE) programs in Nigeria were evaluated in this study. The study employed a descriptive survey design, with a total population of Librarians and learners in distance learning centers in Southeast in Nigeria, of which 206 librarians were used in the study. The librarians and learners were chosen using a multi-stage sampling technique. The data gathering instrument was a questionnaire. Three professionals independently validated the instrument. The questionnaire\u27s reliability index was 0.97. The data was analyzed using the mean, standard deviation, and analysis of variance. The findings revealed that quality is highly assured for students admitted to DE programs (X = 2.87, SD = 0.49). In South East Nigeria, significant variations in the mean assessments of students and librarians on how quality is ensured in the admission of students to DE programs were discovered. It was suggested that prospective students be provided greater opportunities to enroll in distant education programs in order to minimize illiteracy among the population

Closing the Revolving Door: Enhanced Orientation and Mentoring of New Nurses to Decrease Turnover in Long Term Care

Background: New nurse turnover is a global issue and in the United States the cost to onboard a bedside registered nurse averages $40,038.This money is lost if the nurse decides to leave the job. Losses attributed to nurse turnover can cost a hospital$3.6 million to $6.5 million annually, and the problem is getting worse. Many studies have found that mentorship is effective in new nurse retention. Objectives: To implement mentorship and preceptorship at a long-term care facility to see if it will improve the high turnover of new nurses there. Methods: The project is a quality improvement (QI) project, pre- and post-survey design, that followed the “Plan-Do-Study-Act” (PDSA) framework. The Intention to stay or leave survey measured the intention to stay or leave their position at the beginning and end of the mentorship program. The intervention was a 3-month designed preceptorship/mentorship program. Result: Positive results were noted, showing that close mentoring, support, and guidance helped retain new nurses. For the question on intent to stay for 12 months there were 2 agree or strongly agree pre-intervention and 4 agree or strongly agree post-intervention showing improvement in the primary concern, similar positive results were found in the other 6 questions as well. Conclusion: Structured preceptorship/mentorship for at least three months is beneficial to retaining new nurses. It is imperative for healthcare facilities to push the idea of providing the support and guidance needed for new nurses to feel valued, appreciated, and confident in their skills

The potential cost and benefits of raltegravir in simplified second-line therapy among HIV Infected Patients in Nigeria and South Africa

BACKGROUND: There is an urgent need to improve the evidence base for provision of second-line antiretroviral therapy (ART) following first-line virological failure. This is particularly the case in Sub-Saharan Africa where 70% of all people living with HIV/AIDS (PHA) reside. The aim of this study was to simulate the potential risks and benefits of treatment simplification in second-line therapy compared to the current standard of care (SOC) in a lower-middle income and an upper-middle income country in Sub-Saharan Africa. METHODS: We developed a microsimulation model to compare outcomes associated with reducing treatment discontinuations between current SOC for second-line therapy in South Africa and Nigeria and an alternative regimen: ritonavir-boosted lopinavir (LPV/r) combined with raltegravir (RAL). We used published studies and collaborating sites to estimate efficacy, adverse effect and cost. Model outcomes were reported as incremental cost effectiveness ratios (ICERs) in 2011 USD per quality adjusted life year ($/QALY) gained. RESULTS: Reducing treatment discontinuations with LPV/r+RAL resulted in an additional 0.4 discounted QALYs and increased the undiscounted life expectancy by 0.8 years per person compared to the current SOC. The average incremental cost was$6,525 per treated patient in Nigeria and $4,409 per treated patient in South Africa. The cost-effectiveness ratios were$16,302/QALY gained and $11,085/QALY gained for Nigeria and South Africa, respectively. Our results were sensitive to the probability of ART discontinuation and the unit cost for RAL. CONCLUSIONS: The combination of raltegravir and ritonavir-boosted lopinavir was projected to be cost-effective in South Africa. However, at its current price, it is unlikely to be cost-effective in Nigeria.Karen Schneider, Chidi Nwizu, Richard Kaplan, Jonathan Anderson, David P. Wilson, Sean Emery, David A. Cooper, Mark A. Boy

Thermal damage and excision time of micro and super pulsed diode lasers: A comparative ex vivo analysis

Abstract Objectives The primary aim of this ex vivo study was to evaluate thermal damage and cutting efficiency of micro and super pulsed diode lasers. The secondary aim was to suggest a guideline to perform simple surgical excisions adequate for histopathological evaluation. Material and Methods Ten groups of 10 specimens of pig tongues were excised using a blade (G1), a micro pulsed (G2–G9), and a super pulsed diode (G10) lasers. Different output power, pulse duration, pulse interval, and duty cycle were tested. Quantitative measures of thermal damage and excision times were recorded. Statistical analysis was performed at a significance level of 5%. Results The control group (G1) presented no thermal damage. Within the laser groups (G2–G10), no statistically significant differences in depth of thermal damage (µm) were noted. G3 showed significantly less area of thermal damage (mm2) when compared with G7 and G9 (p < .05). The median excision time of the control group and super pulsed diode laser group were significantly lower (p < .001) than the micro pulsed diode laser groups. Conclusions The cutting efficiency of the super pulsed diode laser is comparable to traditional blade, and with appropriate parameters, these lasers can produce predictable surgical outcomes with less collateral damage

Social action : a quarterly review of social trends

Background Uncertainty exists about the best treatment for people with HIV-1 who have virological failure with first-line combination antiretroviral therapy of a non-nucleoside analogue (NNRTI) plus two nucleoside or nucleotide analogue reverse transcriptase inhibitors (NtRTI). We compared a second-line regimen combining two new classes of drug with a WHO-recommended regimen.Methods We did this 96-week, phase 3b/4, randomised, open-label non-inferiority trial at 37 sites worldwide. Adults with HIV-1 who had confirmed virological failure (plasma viral load >500 copies per mL) after 24 weeks or more of first-line treatment were randomly assigned (1:1) to receive ritonavir-boosted lopinavir plus two or three NtRTIs (control group) or ritonavir-boosted lopinavir plus raltegravir (raltegravir group). The randomisation sequence was computer generated with block randomisation (block size four). Neither participants nor investigators were masked to allocation. The primary endpoint was the proportion of participants with plasma viral load less than 200 copies per mL at 48 weeks in the modified intention-to-treat population, with a non-inferiority margin of 12%. This study is registered with ClinicalTrials.gov, number NCT00931463.Findings We enrolled 558 patients, of whom 541 (271 in the control group, 270 in the raltegravir group) were included in the primary analysis. At 48 weeks, 219 (81%) patients in the control group compared with 223 (83%) in the raltegravir group met the primary endpoint (difference 1.8%, 95% CI -4.7 to 8.3), fulfilling the criterion for non-inferiority. 993 adverse events occurred in 271 participants in the control group versus 895 in 270 participants in the raltegravir group, the most common being gastrointestinal.Interpretation The raltegravir regimen was no less efficacious than the standard of care and was safe and well tolerated. This simple NtRTI-free treatment strategy might extend the successful public health approach to management of HIV by providing simple, easy to administer, effective, safe, and tolerable second-line combination antiretroviral therapy

Lessons learned from the development of a hidradenitis suppurativa xenograft mouse model

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease originating from the pilosebaceous unit, in which patients develop painful abscesses, sinus tracts, nodules and scarring, typically in intertriginous areas. Major gaps in our understanding of HS exist, and these may be partially due to the lack of an animal model for experimental studies. We developed an HS xenograft mouse model using human HS lesions grafted onto immunocompromised mice. Although the model had its limitations, several informative lessons were learned, which may contribute to future attempts at an HS animal model