Health worker transfer processes within the public health sector in Ghana : a study of three districts in the Eastern Region

The lack of appropriate policies and procedures to ensure transparent transfer practices is an important source of dissatisfaction among health workers in low- and middle-income countries. In order to alter and improve current practices, a more in-depth and context-specific understanding is needed. This study aims to (1) identify rationales behind transfer decisions in Ghana and (2) examine how transfers are managed in practice versus in policies.; The study took place in 2014 in three districts in Eastern Ghana. The study population included (1) national, regional, and district health administrators with decision-making authority in terms of transfer decisions and (2) health workers who had transferred between 2011 and 2014. Data was collected through semi-structured and structured face-to-face interviews focusing on rationales behind transfer decisions, health administrators' role in managing transfers, and health workers' experience of transfers. A data triangulation approach was applied to compare identified practices with national policies and procedures.; A total of 44 health workers and 21 administrators participated in the study. Transfers initiated by health workers were mostly based on family conditions and preferences to move away from rural areas, while transfers initiated by administrators were based on service requirements, productivity, and performance. The management of transfers was not guided by clear and explicit procedures and thus often depended on the discretion of decision-makers. Moreover, health workers frequently reported not being involved in transfer decision-making processes. We found existing staff perceptions of a non-transparent system.; Our findings suggest a need to foster incentives to attract and retain health workers in rural areas. Moreover, health worker-centered procedures and systems that effectively guide and monitor transfer practices must be developed to ensure that transfers are carried out in a timely, fair, and transparent way

Approximating Sievert Integrals to Monte Carlo Methods to calculate dose rate distributions around P192PIr brachytherapy source

Radiation dose rates along the transverse axis of a miniature P192PIr source were calculated using Sievert Integral (considered simple and inaccurate), and by the sophisticated and accurate Monte Carlo method. Using data obt-ained by the Monte Carlo method as benchmark and applying least squares regression curve fitting, a mathemat-ical relationship was established to parameterise errors inherent in the Sievert Integral outputs. The dose rate anisotropy distributions around the source were determined to evaluate the anisotropy corrections required to modify the Sievert Integral method to improve the accuracy in dose calculations. With the accuracy of Monte Carlo method incorporated in the Sievert Integral method, the model equation could be applied successfully in clinical practice to safe time

Calculation of the Transit Dose in HDR Brachytherapy Based on Monte Carlo Simulations

The Monte Carlo method, which is the gold standard for accurate dose calculations in radiotherapy, was used to obtain the transit doses around a high dose rate (HDR) brachytherapy implant with thirteen dwell points. The midpoints of each of the inter-dwell separations, of step size 0.25 cm, were representative of the positions of the dynamic brachytherapy source, so the average dose rates were calculated when the geometrical centre of the moving source was at each of these points. The dose rates were then transformed into transit doses and our output compared to outputs from other methods. There were especially high discrepancies between our results and the Sievert Integral results, ranging from –32 to –21% for the examples considered. The discrepancies could be much higher for implants of longer lengths where contributions from points near the longitudinal axis of the source become more important. These translate into errors of more than 4 % in the prescribed dose and could have significant impact on complication free tumour control. The Monte Carlo method is therefore recommended for the evaluation of transit doses around brachytherapy implants. Other methods which do not exhibit the same level of accuracy as the Monte Carlo method must be used with great caution. Journal of the Ghana Science Association Vol. 10 (2) 2008: pp. 134-13

Assessment of cancer incidence and mortality risks associated with effective dose of computed tomography examinations

Advances in diagnostic medical imaging in the past few decades using procedures such as computed tomography (CT), have significantly enhanced health care delivery. The effective doses and associated cancer incidence and mortality risks were estimated for adult patients undergoing the five most common types of CT examinations, namely, head, neck, chest, abdomen and pelvis, at Sweden Ghana Medical Centre (SGMC) in Accra, Ghana. The two methods employed in the study were patients’ data collection and phantom measurements to verify the patien-ts’ data. The effective doses were estimated using the dose length product (DLP) from the control console of the CT machine and the anatomic region specific conversion factors. The lifetime attributable risks of cancer inciden-ce and cancer mortality for each patient for a particular examination were both determined from the effective dose, age and sex of each patient using the standard Biological Effects of Ionizing Radiation (BEIR) VII criteria. The effective doses were all within the range of 1 - 10 mSv recommended for CT examinations. The average risk for all the examinations was observed to be very low, i.e. 1 in 10001 to 1 in 10 000. The average lifetime attributable risk (LAR) of cancer incidence was 0.049 % (1 in 2041), while for risk of cancer mortality, the average was 0.030 % (1 in 3333).Keywords: Computed tomography, Effective dose, Dose length product, Life attributable risk, Cancer incidence, Cancer mortalit

Natural radioactivity concentrations in beach sands from some tourist resorts., Research Journal of Environment and Earth Sciences

Abstract: Beaches along the coastlines in Ghana are important holiday destinations for tourists from many countries around the world. The radiological quality of sand from these beaches is very important to assess exposure of the public who use the beaches for recreational purposes and other activities. This study investigates the levels and hazards associated with the U-Th series and 40 K in beach sands from some renowned tourist resorts in the Greater Accra region of Ghana. Samples of beach sand from eleven beaches were analyzed using direct gamma-ray spectrometry. The total absorbed dose rate and the annual effective doses were calculated. The radiation hazards and risks associated with the use of the beach sand as construction material were also determined. The results show specific activities in the range 11.0-31.8 Bq/kg for 238 U, 0.5-1. U activity ratios calculated for the beaches is in the range of 0.032-0.053 with an average of 0.045±0.007 and that of the other radionuclides are close to unity, indicating only natural radionuclides were detected in the samples investigated. The results are within the values found in literature and show that the natural radionuclides in samples of the beach sand do not pose any significant risk to tourists and other holiday makers. Sand from the beaches is also safe for use as construction material, indicating the relevance in terms of the radiological quality of the beaches from both human and environmental health view points

Radiation Processing And Characterization Of Chitin And Chitosan Extracted From Crab Shells

The extraction and characterization of Chitin and Chitosan from crab shells (Callinectes sp.) obtained locally in Ghana is presented. The shells were finely milled and soaked in 10 % dilute hydrochloric acid (HCl) for 48 hr followed by de-proteinization using 2M sodium hydroxide (NaOH) solution for 24 hr to obtain Chitin. The Chitin was refluxed at 100 oC in 50 % NaOH for 7 hr to yield Chitosan. The Chitin and Chitosan were characterized by determining the de-acetylation, viscosity and average molecular weights. The degree of de-acetylation was determined to be 89.7 %. The viscosity of Chitosan in dilute acetic acid was measured and the average molecular weight estimated. The average molecular weight of dry gamma irradiated (up to 100kGy) Chitosan samples decreased with increasing dose. The results have been discussed in terms of radiation induced degradation of solids. Journal of the Ghana Science Association Vol. 9 (2) 2007: pp. 18-2