Patient Satisfaction in a Statewide Cervical Cancer Screening Program

A cross-sectional study of patients participating in the Nevada State Health Division’s Women Health Connection Program (WHC) was conducted to assess patient satisfaction for cervical cancer screening. In this study, 528 WHC program patients provided information regarding their satisfaction with the treatment services they received, accessibility issues, breast and cervical cancer health education and information, and overall program satisfaction. A large majority of patients reported high levels of satisfaction with the program services and clinic personnel. Significant positive correlations were found when comparing satisfaction with services received at the clinic to treatment received by physicians, nurses, and admissions personnel, how well information provided to patients eased their concerns, and when results were discussed with patients. Wait time for admission and to see a physician were negatively correlated to satisfaction. Those who reported that they would not use services again indicated lower levels of satisfaction with the information received and treatment from caregivers and admissions personnel when compared to those who would use the program again

Evaluation of waist-to-height ratio to predict 5 year cardiometabolic risk in sub-Saharan African adults

Simple, low-cost central obesity measures may help identify individuals with increased cardiometabolic disease risk, although it is unclear which measures perform best in African adults. We aimed to: 1) cross-sectionally compare the accuracy of existing waist-to-height ratio (WHtR) and waist circumference (WC) thresholds to identify individuals with hypertension, pre-diabetes, or dyslipidaemia; 2) identify optimal WC and WHtR thresholds to detect CVD risk in this African population; and 3) assess which measure best predicts 5-year CVD riskPeer reviewedFinal Accepted Versio

The relationship between female adiposity and physical attractiveness amongst adults in rural Ranaka village, Botswana

Objective: The aim was to assess the relationship between female adiposity and physical attractiveness among men and women in Botswana. Design: A cross-sectional study was undertaken. Setting: Ranaka rural village, Botswana. Subjects: Randomly selected adults (n = 113, men = 48 and women = 65), 18–50 years old were recruited. Outcome measures: Scores to indicate the attractiveness of 21 images of female bodies that represented different percentage body fat (%BF) according to participants’ age, gender and body mass index (BMI) were recorded. Results: The perceptions of physical attractiveness of female body size were similar among men and women, regardless of significant differences between the BMI of men and women. Younger (18–30 years) and older participants (31–50 years) separately, as well as underweight/normal weight versus overweight/obese groups all gave higher attractiveness scores for images with a lower %BF. All groups gave the highest score for the same image (%BF of 19% and waist:hip ratio (WHR) of 0.72), and the lowest score for an image with %BF of 49% and WHR of 0.81. There was a significant negative correlation between attractiveness score and %BF of the images for all groups, but no significant correlation between the attractiveness scores for the images and WHR. There was a consistent outlier in the graphs between attractiveness score and %BF with a % BF of 32% and a WHR of 0.61, with a relatively high score of 7.4 out of 9 for all groups. Conclusions: Participant groups according to gender, age or BMI gave similar attractiveness scores for leaner female body images

Statistical properties of coronal hole rotation rates: Are they linked to the solar interior?

The present paper discusses results of a statistical study of the characteristics of coronal hole (CH) rotation in order to find connections to the internal rotation of the Sun. The goal is to measure CH rotation rates and study their distribution over latitude and their area sizes. In addition, the CH rotation rates are compared with the solar photospheric and inner layer rotational profiles. We study coronal holes observed within $\pm 60$ latitude and longitude degrees from the solar disc centre during the time span from the 1 January 2013 to 20 April 2015, which includes the extended peak of solar cycle 24.We used data created by the Spatial Possibilistic Clustering Algorithm (SPoCA), which provides the exact location and characterisation of solar coronal holes using SDO=AIA 193 {\AA} channel images. The CH rotation rates are measured with four-hour cadence data to track variable positions of the CH geometric centre. North-south asymmetry was found in the distribution of coronal holes: about 60 percent were observed in the northern hemisphere and 40 percent were observed in the southern hemisphere. The smallest and largest CHs were present only at high latitudes. The average sidereal rotation rate for 540 examined CHs is $13:86 (\pm 0:05)$ degrees/d. Conclusions. The latitudinal characteristics of CH rotation do not match any known photospheric rotation profile. The CH angular velocities exceed the photospheric angular velocities at latitudes higher than 35-40 degrees. According to our results, the CH rotation profile perfectly coincides with tachocline and the lower layers of convection zone at around 0.71 $R_{\odot}$; this indicates that CHs may be linked to the solar global magnetic field, which originates in the tachocline region.Comment: 8 pages, 8 figures, Accepted for publication in A&

Guillain-Barre Syndrome: A Case Report

Guillain-Barre syndrome (GBS) is a complicated degenerative neurological disorder which can be acute or chronic in nature. It is an acquired condition which is characterized by progressive, symmetrical, proximal and distal tingling and weakness. Muscle stretch reflexes are decreased to absent and loss of sensation is common. Etiology remains unclear but pathophysiology includes demyelination of spinal nerve roots. Death is rare. Early diagnosis and prompt referral should occur in severe cases due to the incidence of potential ventilation   failure and cardiovascular instability in some patients. The case of a 26-year-old male presenting to a physician is described. The importance of a correct diagnosis by the physician and the subsequent management is reviewed. Key words: Guillain-Barre syndrome, extremity weakness, peripheral nerves, traum

A Drug–Drug Interaction Study to Investigate the Effect of Nintedanib on the Pharmacokinetics of Microgynon (Ethinylestradiol and Levonorgestrel) in Female Patients with Systemic Sclerosis-Associated Interstitial Lung Disease

Nintedanib; Drug Interactions; Systemic SclerosisNintedanib; Interacciones medicamentosas; Esclerosis sistémicaNintedanib; Interaccions farmacològiques; Esclerosi sistèmicaBackground and Objectives Nintedanib is a tyrosine kinase inhibitor approved for the treatment of systemic sclerosis-associated interstitial lung disease (SSc-ILD), idiopathic pulmonary fibrosis, and other chronic fibrosing ILDs with a progressive phenotype. As nintedanib may cause foetal harm, patients taking nintedanib should avoid pregnancy. The objective of this study was to investigate the effect of nintedanib co-administration on the pharmacokinetics of Microgynon (ethinylestradiol and levonorgestrel) in female patients with SSc-ILD. Methods This was an open-label, two-period, fixed-sequence, drug–drug interaction study. Female patients with SSc and ≥ 10% extent of fibrotic ILD on a high-resolution computed tomography scan were eligible to participate. In Period 1, patients received one Microgynon tablet (ethinylestradiol 30 μg and levonorgestrel 150 μg) ≥ 3 days before the first administration of nintedanib in Period 2. In Period 2, patients received one Microgynon tablet following intake of nintedanib 150 mg twice daily for ≥ 10 consecutive days. The primary pharmacokinetic endpoints were the areas under the plasma concentration–time curve of ethinylestradiol and levonorgestrel over the time interval from 0 to the last quantifiable data point (AUC0–tz) and the maximum measured concentrations of ethinylestradiol and levonorgestrel in plasma (Cmax). The secondary pharmacokinetic endpoint was the area under the plasma concentration–time curve of ethinylestradiol and levonorgestrel over the time interval from 0 extrapolated to infinity (AUC0–∞). The relative exposures of ethinylestradiol and levonorgestrel when administered alone and in combination with nintedanib were assessed using an ANOVA model. Results Seventeen patients were treated. Pharmacokinetic data from 15 patients were analysed. Plasma concentration–time profiles of ethinylestradiol and levonorgestrel were similar following administration of Microgynon before and after administration of nintedanib for ≥ 10 consecutive days. Adjusted geometric mean (gMean) ratios [90% confidence intervals (CIs)] for AUC0‒tz (101.4% [92.8, 110.7]) and AUC0‒∞ (101.2% [94.0, 109.1]) indicated that there was no difference in total ethinylestradiol exposure when Microgynon was administered before or after administration of nintedanib. The adjusted gMean ratio for Cmax of ethinylestradiol (116.7% [90% CI 107.6, 126.5]) indicated an increase in peak exposure in the presence of nintedanib. Adjusted gMean ratios [90% CIs] for AUC0-tz (96.4% [91.5, 101.6]) and Cmax (100.9% [89.9, 113.2]) indicated that there was no difference in total or peak levonorgestrel exposure when Microgynon was administered before or after administration of nintedanib. The adjusted gMean ratio for AUC0‒∞ of levonorgestrel indicated a decrease in total exposure in the presence of nintedanib (88.1% [90% CI 80.0, 97.0]). Conclusion Pharmacokinetic data indicate that there is no relevant effect of nintedanib on plasma exposure to ethinylestradiol and levonorgestrel in female patients with SSc-ILD

AN EVALUATION OF EFFECTIVENESS OF ECONOMIC AND FINANCIAL CRIME COMMISSION (EFCC) IN CHECKMATING PUBLIC SECTOR ACCOUNTANTS OPERATION IN NIGERIA

Abstract The study aimed at evaluating the effectiveness of the EFCC in checkmating the accountants in rendering accountability in the public sector

Investigating emotion regulation and social information processing as mechanisms linking adverse childhood experiences with psychosocial functioning in young swiss adults: the FACE epidemiological accelerated cohort study.

BACKGROUND Adverse childhood experiences increase the risk for psychological disorders and lower psychosocial functioning across the lifespan. However, less is known about the processes through which ACE are linked to multiple negative outcomes. The aim of the FACE epidemiological study is to investigate emotion regulation (emotional reactivity, perseverative thinking and self-efficacy for managing emotions) and social information processing (rejection sensitivity, interpretation biases and social understanding) as potential mechanisms linking adverse childhood experiences and psychosocial functioning in a large population sample of young adults. It is embedded in a larger project that also includes an ecological momentary assessment of emotion regulation and social information processing and informs the development and evaluation of an online self-help intervention for young adults with a history of ACE. METHODS The study plans to recruit 5000 young adults aged 18 to 21 from the German-speaking Swiss population. Addresses are provided by Swiss Federal Statistical Office and participants are invited by mail to complete a self-report online survey. If the targeted sample size will not be reached, a second additional sample will be recruited via educational facilities such as universities or teacher training colleges or military training schools. Three follow-ups are planned after 1 year, 2 years and 3 years, resulting in ages 18-24 being covered. The main exposure variable is self-reported adverse childhood experiences before the age of 18, measured at the baseline. Primary outcomes are psychosocial functioning across the study period. Secondary outcomes are social information processing, emotion regulation and health care service use. Statistical analyses include a range of latent variable models to identify patterns of adverse childhood experiences and patterns and trajectories of psychosocial adaptation. DISCUSSION The results will contribute to the understanding of the underlying mechanisms that link ACE with psychosocial functioning which is crucial for an improved insight into risk and resilience processes and for tailoring interventions. Furthermore, the identification of factors that facilitate or hinder service use among young adults with ACE informs healthcare policies and the provision of appropriate healthcare services. TRIAL REGISTRATION NUMBER NCT05122988. The study was reviewed and authorized by the ethical committee of Northwestern and Central Switzerland (BASEC number 2021-01204)