Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening

<p>Abstract</p> <p>Background</p> <p>Cervical cancer is the most common female cancer in Uganda. Over 80% of women diagnosed or referred with cervical cancer in Mulago national referral and teaching hospital have advanced disease. Plans are underway for systematic screening programmes based on visual inspection, as Pap smear screening is not feasible for this low resource country. Effectiveness of population screening programmes requires high uptake and for cervical cancer, minimal loss to follow up. Uganda has poor indicators of reproductive health (RH) services uptake; 10% postnatal care attendance, 23% contraceptive prevalence, and 38% skilled attendance at delivery. For antenatal attendance, attendance to one visit is 90%, but less than 50% for completion of care, i.e. three or more visits.</p> <p>Methods</p> <p>We conducted a qualitative study using eight focus group discussions with a total of 82 participants (16 men, 46 women and 20 health workers). We aimed to better understand factors that influence usage of available reproductive health care services and how they would relate to cervical cancer screening, as well as identify feasible interventions to improve cervical cancer screening uptake.</p> <p>Results</p> <p>Barriers identified after framework analysis included ignorance about cervical cancer, cultural constructs/beliefs about the illness, economic factors, domestic gender power relations, alternative authoritative sources of reproductive health knowledge, and unfriendly health care services. We discuss how these findings may inform future planned screening programmes in the Ugandan context.</p> <p>Conclusion</p> <p>Knowledge about cervical cancer among Ugandan women is very low. For an effective cervical cancer-screening programme, awareness about cervical cancer needs to be increased. Health planners need to note the power of the various authoritative sources of reproductive health knowledge such as paternal aunts (<it>Sengas</it>) and involve them in the awareness campaign. Cultural and economic issues dictate the perceived reluctance by men to participate in women's reproductive health issues; men in this community are, however, potential willing partners if appropriately informed. Health planners should address the loss of confidence in current health care units, as well as consider use of other cervical cancer screening delivery systems such as mobile clinics/camps.</p

Breakdown into nanoscale of graphene oxide: Confined hot spot atomic reduction and fragmentation

Nano-graphene oxide (nano-GO) is a new class of carbon based materials being proposed for biomedical applications due to its small size, intrinsic optical properties, large specific surface area, and easy to functionalize. To fully exploit nano-GO properties, a reproducible method for its production is of utmost importance. Herein we report, the study of the sequential fracture of GO sheets onto nano-GO with controllable lateral width, by a simple, and reproducible method based on a mechanism that we describe as a confined hot spot atomic fragmentation/reduction of GO promoted by ultrasonication. The chemical and structural changes on GO structure during the breakage were monitored by XPS, FTIR, Raman and HRTEM. We found that GO sheets starts breaking from the defects region and in a second phase through the disruption of carbon bonds while still maintaining crystalline carbon domains. The breaking of GO is accompanied by its own reduction, essentially by the elimination of carboxylic and carbonyl functional groups. Photoluminescence and photothermal studies using this nano-GO are also presented highlighting the potential of this nanomaterial as a unique imaging/therapy platform

Stimulus responsive graphene scaffolds for tissue engineering

Tissue engineering (TE) is an emerging area that aims to repair damaged tissues and organs by combining different scaffold materials with living cells. Recently, scientists started to engineer a new generation of nanocomposite scaffolds able to mimic biochemical and biophysical mechanisms to modulate the cellular responses promoting the restoration of tissue structure or function. Due to its unique electrical, topographical and chemical properties, graphene is a material that holds a great potential for TE, being already considered as one of the best candidates for accelerating and guiding stem cell differentiations. Although this is a promising field there are still some challenges to overcome, such as the efficient control of the differentiation of the stem cells, especially in graphene-based microenvironments. Hence, this chapter will review the existing research related to the ability of graphene and its derivatives (graphene oxide and reduced graphene oxide) to induce stem cell differentiation into diverse lineages when under the influence of electrical, mechanical, optical and topographic stimulations