The role of organizational factors in the provision of comprehensive women's health in the veterans health administration

Background: Increasing numbers of women veterans (WV) present an organizational challenge to a healthcare system that primarily serves men. WV use reproductive services traditionally not provided by the Veterans Health Administration (VHA). Objective: Examine the association of organizational factors and adoption of comprehensive women’s health (WH) care in the VHA. Study Design: Cross-sectional secondary analysis of the 2007 VHA Survey of Women’s Veterans Health Programs and Practices. Methods: Dependent measures were (a) model of women’s health care: separate women’s health clinic (WHC), designated women’s health provider within primary care (DWHP), both (WHC/DWHP), or neither and (b) availability of five basic WH services: cervical cancer screening and evaluation and management of: vaginitis, menstrual disorders, contraception and menopause. Exposure variables were organizational factors drawn from an adaptation of the Greenhalgh model of diffusion of innovations including structural factors, measures of absorptive capacity and system readiness for innovation. Results: Compared to sites with DWHP or neither, WHC and WHC/DWHP were more likely at facilities with: a gynecology clinic, an academic affiliation, a WH representative on high impact committee, and a greater number of WV. Academic affiliation and high impact committee remained significant in multivariable analysis. All five basic WH services were more likely to be offered at sites with WHC or WHC/DWHP, remaining significant after adjusting for organizational factors. Conclusion: Facilities that adopt WHC are associated with greater absorptive capacity (academic affiliation and WH representation on high-impact committees) and are more likely to deliver basic WH services. Separate WHCs may promote more comprehensive care for WV

Long-term outpatient therapy: perspectives from acquired brain injury survivors, their caregivers and the therapy team: a KwaZulu-Natal study.

Master’s Degree. University of KwaZulu-Natal, Durban.ABSTRACT Introduction: Acquired brain injuries often result in persistent residual impairments which negatively impact the individual for years after the injury, contributing to difficulty in the acquired brain injury survivor reintegrating into the community. A non-government organisation in KwaZulu-Natal provides long-term outpatient therapy to this population, with involvement from their caregivers, and the therapy team. This study aims to gain more insight into the stakeholders’ experiences of this type of the therapy, and whether there is a need for it. Aim: To explore the experiences and perceptions of acquired brain injury survivors, their caregivers and the therapy team involved in this long-term therapy programme. Methods: An exploratory, qualitative research design was used. The study was conducted at the non-government organisation providing long-term outpatient therapy for the acquired brain injury survivors in the province of KwaZulu-Natal, and the sample was recruited from participants attending this facility, using purposive sampling. Face-toface and telephonic interviews were conducted with participants who met the inclusion criteria, with a total of 11 participants recruited. Data was then analysed using thematic analysis. Results: Three main themes emerged, namely: the impact of an acquired brain injury indicating the need for long-term therapy; the benefits of long-term therapy for acquired brain injury survivors; and the challenges of long term therapy for acquired brain injury survivors. The acquired brain injury survivors still had residual deficits which impacted on their ability to engage in occupations, and as a result required continued intervention. Furthermore, participation in groups and long-term therapy reduced the participants’ feeling of social isolation and contributed toward the acquired brain injury survivors’ perceptions of being engaged in meaningful occupations. However, some changes to the programme were suggested. Conclusion: Acquired brain injury is a complex condition which can result in residual impairments, and which requires care on a long-term basis. The provision of long-term therapy for this population appears to have numerous benefits, and some challenges that need to be addressed. The provision of this service assists in bridging the gap between hospitalisation and community reintegration for the acquired brain injury survivors. Keywords: Acquired brain injury, ABI survivor, long-term therapy/rehabilitation, caregiver, therapy team.Abstract available in the PDF

Effect Of Fenugreek And Curry Leaves Powder On Dyslipidemia- A Randomized Controlled Pilot Study

Background: Dyslipidemias, a disorder of lipid metabolism, is widely established as an independent major and modifiable risk factor of cardiovascular disease (CVD). The conditions are common worldwide and a leading cause of death in India, and has even riven the age bar swaying in young people too. The significant effect of an increase in dyslipidemias depends on diabetes and hypertension. Nutraceuticals, derived from food sources serve as an alternative therapy for the management of dyslipidemia. India is home to multitudinous medicinal plants, of which many remain underutilized. Murraya Koenigii (curry leaf) and Trigonella foenum-graecum (fenugreek leaves) are well-proven as good sources of nutraceutical and functional foods. Objectives: To study the effect of fenugreek and curry leaves powder on dyslipidemia and also the dietary habits of dyslipidemic subjects. Materials and Methods: 31 subjects aged between 40-70 years were recruited based on inclusion and exclusion criteria, and grouped into group 1(hypertensive with dyslipidemia), group 2 (diabetic with dyslipidemia), and group 3 (only dyslipidemia) supplemented with the mixture of fenugreek and curry leaf powder for 3 months. Results: Reduction in total cholesterol and triglyceride levels were observed in group 2 (DM+DLP) and group 1 (HTN+DLP) i.e 221.2±29 and 193±72.4 respectively. The HDL levels increased in all three groups. Reduced VLDL and FBS levels were observed in all three groups. Conclusion: Our findings showed that fenugreek and curry leaf powder supplementation, as a phenolic-rich herb can be effective in the reduction of some lipid profiles in dyslipidemic patients suggesting their potential neutraceutical role in treating CVD

Coherent Receiver for Turbo Coded Single-User Massive MIMO-OFDM with Retransmissions

Single-user massive multiple-input multiple-output (MIMO) systems have a large number of antennas at the transmitter and receiver. This results in a large overall throughput (bit-rate), of the order of tens of gigabits per second, which is the main objective of the recent fifth-generation (5G) wireless standard. It is feasible to have a large number of antennas in mm-wave frequencies, due to the small size of the antennas. This chapter deals with the coherent detection of orthogonal frequency division multiplexed (OFDM) signals transmitted through frequency-selective Rayleigh fading MIMO wireless channels. Low complexity, discrete-time algorithms are developed for channel estimation, carrier and timing synchronization, and finally turbo decoding of the data at the receiver. Computer simulation results are presented to validate the theory

The effect of irrigating solutions on the hydration of tricalcium silicate cements: an in vitro study

Background: Calcium silicate cements are hydraulic cements, routinely used for perforation repairs. During such repairs, these cements are invariably exposed to irrigating solutions. Aim: This study aimed to understand the effect of irrigating solutions on the hydration of calcium silicate cements.  Materials and Methods: Sixty extracted teeth were taken and horizontal sections of 2mm were obtained. These samples were randomly divided into two groups viz. Biodentine and BioMTA Plus groups later these cements were condensed into the canal spaces and allowed to set until their setting time. These samples were further subdivided and allowed to encounter three irrigating solutions viz. Normal saline, 17% EDTA, and 2% Chlorhexidine for 5 minutes. These were allowed to mature in an incubator for seven days and subjected to Scanning Electron Microscopy and Energy Dispersive X-ray analysis. Results: The SEM analysis of the Biodentine/control group displayed a petal-like appearance, with a Ca/Si ratio of 2. Whereas, the Biodentine/Normal saline, Biodentine/17% EDTA and Biodentine/2% Chlorhexidine group displayed crumbled paper-like appearance. The Ca/Si ratios for the Biodentine/Normal saline, Biodentine/17% EDTA and Biodentine/2% Chlorhexidine were 2.72, 1.6, and 4.21, respectively. In the BioMTA Plus group, all the SEM analyses displayed round crystalline structures in all groups. The Ca/Si ratio of BioMTA Plus/Control, BioMTA Plus/17% EDTA and BioMTA Plus/2% Chlorhexidine were 25.5, 17.42, 24.1, and 39.4, respectively. Conclusion: The study concluded that the irrigating solutions did not affect the hydration mechanism of Biodentine and BioMTA Plus despite the variations in the Ca/Si ratios and surface morphology

On the Probability of Erasure for MIMO-OFDM

Detecting the presence of a valid signal is an important task of a telecommunication receiver. When the receiver is unable to detect the presence ofa valid signal, due to noise and fading, it is referred to as an erasure. Thiswork deals with the probability of erasure computation for orthogonalfrequency division multiplexed (OFDM) signals used by multiple inputmultiple output (MIMO) systems. The theoretical results are validated bycomputer simulations. OFDM is widely used in present day wireless communication systems due to its ability to mitigate intersymbol interference(ISI) caused by frequency selective fading channels. MIMO systems offerthe advantage of spatial multiplexing, resulting in increased bit-rate, whichis the main requirement of the recent wireless standards like 5G and beyond

A novel Plasmodium falciparum rhoptry associated adhesin mediates erythrocyte invasion through the sialic-acid dependent pathway

Erythrocyte invasion by Plasmodium falciparum merozoites is central to blood-stage infection and malaria pathogenesis. This intricate process is coordinated by multiple parasite adhesins that bind erythrocyte receptors and mediate invasion through several alternate pathways. P. falciparum expresses 2700 genes during the blood-stages, of which the identity and function of many remains unknown. Here, we have identified and characterized a novel P. falciparum rhoptry associated adhesin (PfRA) that mediates erythrocyte invasion through the sialic-acid dependent pathway. PfRA appears to play a significant functional role as it is conserved across different Plasmodium species. It is localized in the rhoptries and further translocated to the merozoite surface. Both native and recombinant PfRA specifically bound erythrocytes in a sialic-acid dependent, chymotrypsin and trypsin resistant manner, which was abrogated by PfRA antibodies confirming a role in erythrocyte invasion. PfRA antibodies inhibited erythrocyte invasion and in combination with antibodies against other parasite ligands produced an additive inhibitory effect, thus validating its important role in erythrocyte invasion. We have thus identified a novel P. falciparum adhesin that binds with a sialic acid containing erythrocyte receptor. Our observations substantiate the strategy to block P. falciparum erythrocyte invasion by simultaneously targeting multiple conserved merozoite antigens involved in alternate invasion pathways

Central Composite Designed Formulation, Characterization and In-Vitro Cytotoxic effect of Erlotinib Loaded Chitosan Nanoparticulate System

© 2019 Elsevier B.V. The most common cause of deaths due to cancers nowadays is lung cancer. The objective of this study was to prepare erlotinib loaded chitosan nanoparticles for their anticancer potential. To study the effect of formulation variables on prepared nanoparticles using central composite design. Erlotinib loaded chitosan nanoparticles were prepared by ionic gelation method using probe sonication technique. It was found that batch NP-7 has a maximum loading capacity and entrapment efficiency with a particle size (138.5 nm) which is ideal for targeting solid tumors. Analysis of variance was applied to the particle size, entrapment efficiency and percent cumulative drug release to study the fitting and the significance of the model. The batch NP-7 showed 91.57% and 39.78% drug release after 24 h in 0.1 N hydrochloric acid and Phosphate Buffer (PB) pH 6.8, respectively. The IC50 value of NP-7 evaluated on A549 Lung cancer cells was found to be 6.36 μM. The XRD of NP-7 displayed the existence of erlotinib in the amorphous pattern. The optimized batch released erlotinib slowly in comparison to the marketed tablet formulation. Erlotinib loaded chitosan nanoparticles were prepared successfully using sonication technique with suitable particle size, entrapment efficiency and drug release. The formulated nanoparticles can be utilized for the treatment of lung cancer