24 research outputs found

    Understanding the causes of breast cancer treatment delays at a teaching hospital in Ghana

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    Poor outcomes for breast cancer in Ghana have been attributed to late presentation of symptoms at biomedical facilities. This study explored factors accounting for delays in initiation of breast cancer treatment at the Korle-Bu Teaching Hospital in Accra. Focus group discussions were conducted with 20 women with breast cancer. A theory-driven thematic analysis identified three multilevel factors influencing treatment seeking delays: (1) patient (e.g. misinterpretation of symptoms, fear), (2) healthcare provider (e.g. negative attitudes) and (3) health systems (e.g. shortage of medicines). Addressing treatment delays will require multilevel interventions, including culturally congruent education, psychosocial counselling/support and strengthening health systems

    A systematic review of the safety of lisdexamfetamine dimesylate

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    BACKGROUND: Here we review the safety and tolerability profile of lisdexamfetamine dimesylate (LDX), the first long-acting prodrug stimulant for the treatment of attention-deficit/hyperactivity disorder (ADHD). METHODS: A PubMed search was conducted for English-language articles published up to 16 September 2013 using the following search terms: (lisdexamfetamine OR lisdexamphetamine OR SPD489 OR Vyvanse OR Venvanse OR NRP104 NOT review [publication type]). RESULTS: In short-term, parallel-group, placebo-controlled, phase III trials, treatment-emergent adverse events (TEAEs) in children, adolescents, and adults receiving LDX were typical for those reported for stimulants in general. Decreased appetite was reported by 25-39 % of patients and insomnia by 11-19 %. The most frequently reported TEAEs in long-term studies were similar to those reported in the short-term trials. Most TEAEs were mild or moderate in severity. Literature relating to four specific safety concerns associated with stimulant medications was evaluated in detail in patients receiving LDX. Gains in weight, height, and body mass index were smaller in children and adolescents receiving LDX than in placebo controls or untreated norms. Insomnia was a frequently reported TEAE in patients with ADHD of all ages receiving LDX, although the available data indicated no overall worsening of sleep quality in adults. Post-marketing survey data suggest that the rate of non-medical use of LDX was lower than that for short-acting stimulants and lower than or equivalent to long-acting stimulant formulations. Small mean increases were seen in blood pressure and pulse rate in patients receiving LDX. CONCLUSIONS: The safety and tolerability profile of LDX in individuals with ADHD is similar to that of other stimulants

    Intensive care unit course of infants and children after cranial vault reconstruction for craniosynostosis

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    <p>Abstract</p> <p>Background</p> <p>Craniosynostosis (CSS) results from the premature closure of one or more cranial sutures, leading to deformed calvaria at birth. It is a common finding in children with an incidence of one in 2000 births. Surgery is required in order to release the synostotic constraint and promote normal calvaria growth. Cranial vault remodeling is the surgical approach to CSS repair at our institution and it involves excision of the frontal, parietal, and occipital bones. The purpose of this article is to describe the post-operative course of infants and children admitted to our PICU after undergoing cranial vault remodeling for primary CSS.</p> <p>Findings</p> <p>Complete data was available for analyses in only 82 patients, 44 males (M) and 38 females (F); M: F ratio was 1:1.2. Patients (pts) age in months (mo) ranged from 2 mo to 132 mo, mean 18.2 ±-24.9 mo and weights (wt) ranged from 4.7 kg to 31.4 kg, mean 10.24 ± 5.5 Kg.. Duration of surgery (DOS) ranged from 70 minutes to 573 minutes mean 331.6 ± 89.0 minutes. No significant correlation exist between duration of surgery, suture category, patient's age or use of blood products (P > 0.05). IOP blood loss was higher in older pts (P < 0.05) and it correlates with body temperature in the PICU (P < .0001). Post-op use of FFP correlated with intra-operative PRBC transfusion (P < 0.0001). More PRBC was transfused within 12 hrs-24 hrs in PICU compared to other time periods (P < 0.05). LOS in PICU was < 3 days in 68% and > 3 days in 32%. Pts with fever had prolonged LOS (P < 0. 05); re-intubation rate was 2.4% and MVD were 1.83 days. Repeat operation for poor cosmetic results occurred in 9.7% of pts.</p> <p>Conclusions</p> <p>Post-op morbidities from increased use of blood products can be minimized if cranial vault remodeling is done at a younger age in patients with primary CSS. PICU length of stay is determined in part by post-op pyrexia and it can be reduced if extensive evaluations of post-op fever are avoided.</p

    The Transformation from Traditional Nonprofit Organizations to Social Enterprises: An Institutional Entrepreneurship Perspective

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    The development of commercial revenue streams allows traditional nonprofit organizations to increase financial certainty in response to the reduction of traditional funding sources and increased competition. In order to capture commercial revenue-generating opportunities, traditional nonprofit organizations need to deliberately transform themselves into social enterprises. Through the theoretical lens of institutional entrepreneurship, we explore the institutional work that supports this transformation by analyzing field interviews with 64 institutional entrepreneurs from UK-based social enterprises. We find that the route to incorporate commercial processes and convert traditional nonprofit organizations into social enterprises requires six distinct kinds of institutional work at three different domains; these are—“engaging commercial revenue strategies”, “creating a professionalized organizational form”, and “legitimating a socio-commercial business model”. In elaborating on social entrepreneurship research and practice, we offer a comprehensive framework delineating the key practices contributing to the transformation from traditional nonprofit organizations to social enterprises. This extends our understanding of the ex-ante strategy of incorporating commercial processes within social organizations. Furthermore, the identification of these practices also offers an important tool for scholars in this field to examine the connection (or disconnection) of each practice with different ethical concerns of social entrepreneurship in greater depth.British Academ

    Short communication - HEMATOLOGICAL VALUES IN JUVIENILE PERIODONTITIS PATIENTS IN IBADAN, NIGERIA

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    In this study, clinical and hematological examinations of forty adolescent patients in the group (15-22) years with established clinical features of chronic periodontitis but without any diagnosable medical disease were done. The patients were divided into two Groups (A &B). Group A were diagnosed as having juvenile periodontitis (JP) while group B had the plaque-induced chronic periodontitis i.e. non- JP and were used as control. We then compared the following hematological features between these two groups and the expected normal values here in the tropics; White Blood Cell (\VBC)-total and differential, Packed Cell Volume (PCV) and the blood film appearance. According to the general blood examination of both groups, almost all the numerical values were within the normal range as compared to the documental normal value in Nigeria. It was therefore concluded that low lymphocyte responsiveness, lymphocyte dysfunction and a deficiency of neutrophil chemotaxis as earlier reported may be involved in the pathogenesis of JP rather than the numerical value of these cells. The relationship of periodontal disease to other neutrophil functions such as phargocytosis and bactericidal activity requires further investigation

    Hodgkin's disease after treatment for Burkitt's lymphoma: case report

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    (East African Medical Journal: 2001 78(6): 334-336

    A basic investigation for inherited metabolic diseases: indication for genomic approach

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    The inherited metabolic diseases (IMDs) or Inborn errors of metabolism (IEM) are mostly determined by single abnormal autosomal recessive genes; which though rare as a group account for a sizeable proportion of disorders in very large populations. There is neither a screening policy as in many advanced countries nor have the diseases been investigated in the concomitant institution for the handicapped in Nigeria. Sixty-one (61) subjects (40M, 20F); Mean age 18.38 + 1.3 (SD) years who were residents of the Oluyole Cheshire School and the School for the Handicapped both in the Eleyele area of Ibadan, were selected for the study. Thirty-five (35) apparently healthy (no manifest genetic disorder) individuals, mean age 19.00 + 1.30 (SD) years were selected as controls. The mean weight of the handicapped was 40.9 + 1.1kg while the controls was 47.63 + 1.17 (SD) kg. Mid morning urine samples were collected from all subjects and controls. Aversion for venepuncture by both subjects and their care providers prevented some blood assays. All subjects were subjected to Benedicts reaction, the Ferric Chloride (FeC13) test, clinstix, and the ninhydrin reactions. Thirty-two (32) out of a population of 45 (71.1%) at the Oluyole Chesire Home and 29 out of a population 42 (69.1%) at the School for the handicapped participated in the study. The handicapped subjects had significantly lower weight than controls (
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