Factors Contributing to Low Tuberculosis Case Detection in West Akim Municipality of the Eastern Region of Ghana: A Community and Health Facility Based Study

This research has a keen interest into assessing health and community related factors that contribute and influences low TB case detection rate in the West Akim Municipality of the Eastern region of Ghana. Data was collected from a target group of community members and health workers using a well-structured questionnaire. Data from the field was collected using Epi Info 7 and then, exported to Microsoft Excel and finally transferred to SPSS version 24 for the analysis. Some statistical techniques such as descriptive statistics, reliability of scale, t-test of independence, chi-square and analysis of variance was used to obtain results from the data analysis. Community related factors that has been identified as possible contributors to low TB detection rate are as follows, the availability of alternative means of health care (traditional healers, prayer camps, and herbs to manage suspected cases of TB. This turns to keep people away from the health facilities. The long time (2 days) it takes for an individual to get tested and to receive his/her tested results (time of diagnostics). The high levels of experienced stigma associated with psychological distress on suspected people with TB and on friends and relatives living with TB patients. the low knowledge of TB among some reasonable number of community members. The study also identified the possible health related factors influencing low TB case detection rate such as, Low TB trained personals and low TB education during health talks in creating awareness that TB is preventable, curable and treatable and that suspected people with TB (cough for more than two weeks) should seek medical attention. Community health nurses not including TB screening as part of their home visitation program and low level of contact tracing could also contribute to the low case detection rate. The highly inadequate number Gene Xpert machines, DOT centres and laboratories for the diagnostics of TB.  The study also found that, TB stigma even existed among health care providers against suspected patients. This negatively influence the health seeking behavior among suspected patients. This study became necessary to generate information for the Ghana national TB control Programme for appropriate remedial actions to be taken to forestall any catastrophe that may result from undetected and untreated TB cases in the West Akim municipality. Keywords: Gene Xpert machines, DOT Centres, Stigmatization, Psychological Distress, TB screening, Low TB Case Detection. DOI: 10.7176/JHMN/72-11 Publication date:March 31st 202

A Systematic Review Examining the Relationship Between Habit and Physical Activity Behavior in Longitudinal Studies

"Purpose: To explain physical activity behavior, social-cognitive theories were most commonly used in the past. Besides conscious processes, the approach of dual processes additionally incorporates non-conscious regulatory processes into physical activity behavior theories. Habits are one of various non-conscious variables that can influence behavior and thus play an important role in terms of behavior change. The aim of this review was to examine the relationship between habit strength and physical activity behavior in longitudinal studies. Methods: According to the PRISMA guidelines, a systematic search was conducted in three databases. Only peer-reviewed articles using a longitudinal study design were included. Both, habit and physical activity were measured at least once, and habit was related to physical activity behavior. Study quality was evaluated by assessment tools of the NHLBI. Results: Of 3.382 identified publications between 2016 and 2019, fifteen studies with different study designs were included. Most studies supported that positive correlations between habit and physical activity exist. Some positive direct and indirect effects of habit on physical activity were detected and only a minority of studies showed the influence of physical activity on habit strength. Studies differentiating between instigation and execution habit found positive correlations and revealed instigation habit as a stronger predictor of physical activity. The quality of studies was rated as reasonable using assessment tools of the NHLBI. Conclusion: This review revealed a bidirectional relationship between habit and physical activity. Whether habit predicts physical activity or vice versa is still unclear. The observation of habit influencing physical activity may be most appropriate in studies fostering physical activity maintenance while the influence of physical activity on habit may be reasonable in experimental studies with physical activity as intervention content to form a habit. Future investigations should differentiate between habit formation and physical activity maintenance studies depending on the research objective. Long-term study designs addressing the complexity of habitual behavior would be beneficial for establishing cue-behavior associations for the formation of habits. Furthermore, studies should differentiate between instigation and execution habit in order to investigate the influence of both variables on physical activity behavior independently.

THE IMPORTANCE OF PSYCHODYNAMIC APPROACH DURING COVID-19 PANDEMIC

The coronavirus (COVID-19) outbreak was labeled a global pandemic by the WHO in March of 2020. Understanding how crisis influence an individual’s reactions to stressful events (and vice versa) is important in order to create meaningful and effective interventions. Our literature search have revealed lack of the papers related to psychodynamic approach to recent crisis. Psychodynamic places a large emphasis on defense mechanisms and unconscious mind, where upsetting feelings, urges, and thoughts that are too painful for us to directly look at are housed. Even though these painful feelings and thoughts are outside of our awareness, they still influence our behavior in many ways. Optimal application of psychodynamic approach offers the frame for acceptance of psychological stress in a more positive way and benefits psychological growth. We believe that including psychodynamic approach in the national public and mental health emergency system will empower Croatia and the world during (and after) COVID-19 pandemic crisis

PATHOLOGICAL NARCISSISM, NEGATIVE PARENTING STYLES AND INTERPERSONAL FORGIVENESS AMONG PSYCHIATRIC OUTPATIENTS

Background: Pathological narcissism has previously been investigated with regard to negative parenting and interpersonal forgiveness, but inconsistent findings have been obtained in relation to its two phenotypic forms - grandiosity and vulnerability. Moreover, the role of negative parenting in the lack of forgiveness within narcissistic pathology has not been explored thus far. The aim of the current research was to investigate the complex relations among pathological narcissism, negative parenting, and interpersonal forgiveness in psychiatric outpatients. Subjects and methods: A sample of 250 adult psychiatric outpatients (61% female; mean age 39.15 years) were enrolled in this study. The participants filled out the Pathological Narcissism Inventory (PNI), the Tendency to Forgive Scale (TTF), the Measure of Parental Styles (MOPS), and the Depression, Anxiety, Stress Scales (DASS21). Results: Narcissistic grandiosity and narcissistic vulnerability were positively correlated with mothers’ and fathers’ negative parenting, but this association was significantly stronger in the case of narcissistic vulnerability. Only narcissistic vulnerability was related to interpersonal forgiveness. In the mediation analysis, negative parenting was not directly related to interpersonal forgiveness, however, this association became significant after introducing narcissistic vulnerability. Narcissistic vulnerability served as a full mediator of the mothers’ and fathers’ negative parenting - interpersonal forgiveness relationships. Conclusions: Narcissistic vulnerability seems to be more strongly related to negative parenting and interpersonal forgiveness than narcissistic grandiosity, while it also represents one of the underlying mechanisms of the negative parenting - interpersonal forgiveness relationship. The clinical implications of these findings are discussed in relation to pathological narcissism and lack of forgiveness

Prestationsbaserade incitamentssystemets påverkan på agentkostnader

Examensarbetets titel: Prestationsbaserade incitamentssystemets påverkan på agentkostnader Seminariedatum: 2015-01-16 Ämne/kurs: FEKH19, Examensarbete kandidatnivå, 15 högskolepoäng Författare: Sarah Mansour, Ladan Odaway, Fredrik Persson, Darko Puljic. Handledare: Christine Blomquist Fem nyckelord: Prestationsbaserade incitamentssystem, Agentteorin, Psykisk Påverkan, Adverse Learning, Mätproblem. Syfte: Syftet med studien är att ur principalens perspektiv analysera agentkostnader som är förenade med nyttjandet av prestationsbaserade incitamentssystem. Metod: För studien tillämpas en fallstudiedesign med deduktiv ansats. Studiens kvalitativa forskningsstrategi ligger till grund för valt forskningsinstrument i form av semistrukturerade intervjuer. Studiens urval utgjordes av ett bekvämlighets- och snöbollsurval. Vidare har studiens analysverktyg utgjorts av studiens teoretiska ramverk för att söka hypotesstöd i den empiriska datan. Teoretiska perspektiv: Resonemanget kring prestationsbaserade incitamentssystem utifrån agentteorin har föranlett Kohns (1993) artikel "Why Incentive Plans Cannot Work". Med utgångspunkt i Kohns (1993) artikel har tre faktorer identifierats. Dessa benämns som psykisk påverkan, adverse learning och mätproblem. De tre identifierade faktorerna låg sedan till grund för det fenomen vi ämnade analysera. Empiri: Kohn (1993) menar att prestationsbaserade incitamentssystem inverkar negativt på agenters prestation. För att testa detta resonemang har studiens analysföretag utgjorts av tre aktörer inom säljbranschen. Samtliga aktörer nyttjar ett prestationsbaserat incitamentssystem i ett principal-agent förhållande. Resultat: Inget hypotesstödd var funnet i studiens empiriska data. Andra påverkande faktorer, utöver studiens identifierade, påvisades. De påvisade faktorerna utgörs av rekrytering och lojalitet.Title: The performance-based incentive plan's impact on agency costs Seminar date: 2015-01-16 Course: FEKH19, Degree Project Undergraduate level, Business Administration, Undergraduate level, 15 University Credits Points (UPC) or ECTS‐cr) Authors: Sarah Mansour, Ladan Odaway, Fredrik Persson, Darko Puljic. Advisor/s: Christine Blomquist Key words: Performance-based Incentives, Agency theory, Psychological impact, Adverse Learning, Performance measurements. Purpose: The purpose of this study is to analyze agency costs associated with the use of performance-based incentive plans from the perspective of the principal. Methodology: An interview-based case study with a deductive approach was conducted on three companies in the sales industry. The qualitative research strategy underlies chosen research- instrument in the form of semi-structured interviews. The sampling techniques used for this study were a convenience- and snowball sample. The results were analysed using the study's theoretical framework to search for evidence, which serves to either support or counter the hypotheses of the study. Theoretical perspectives: The reasoning behind performance-based incentive plans based on agency theory has led to Kohn’s (1993) article "Why Incentive Plans Cannot Work". Three factors were identified based on Kohn’s (1993) article. The identified factors are referred to as psychological impact, adverse learning and measurement problems. The three identified factors were then the basis for the phenomenon we intended to analyze. Empirical foundation: Kohn (1993) argues that performance-based incentive plans have a negative impact on agents' performance. To test this argument, three players in the sales industry were analyzed. All actors use performance-based incentive plans in a principal-agent relationship. Conclusions: No hypotheses were supported in the study’s empirical data. Other influential factors apart from the study's identified were detected. The influential factors were composed of recruitment and loyalty

Excavation and survey at the Giant’s Grave, Slochd Measach, Nereabolls, a Neolithic chambered cairn on the Isle of Islay, Argyll & Bute

The ‘Giant’s Grave’, formally known as Slochd Measach, Nereabolls, (SM3927) is located on the Isle of Islay in western Scotland and is one of seven confirmed Clyde Cairns on the island. We describe the standing remains and excavations between 2015-18 intended to address the origin, architecture and use of this monument. We found that the cairn was most likely constructed between 3516-336 cal BC in one continuous effort. It was modified and reused on at least four occasions during the Early and Late Bronze Age, and extensively robbed during the Iron Age. This post-Neolithic activity left a small collection of ceramic vessels may have been used for funerary purposes of votive offerings. We compare the architecture of the Giant’s Grave with that of other cairns on Islay and in the wider region

Applications of high-throughput single B-cell sequencing to accelerate rational vaccine design

Understanding the antibody repertoire response to vaccination is critical for the rational design and evaluation of experimental vaccines. Immune receptors comprise two chains encoded by separate mRNA strands and thus conventional NextGen sequencing fails to identify the native pairings encoded by individual lymphocytes. To overcome this limitation, we are applying recent technical advances in high-throughput sequencing of complete antibodies (i.e., paired heavy and light chain sequencing) to generate a quantitative understanding of experimental vaccine performance and to accelerate vaccine design. We apply repertoire-based metrics of vaccine-elicited antibodies to evaluate and select promising candidate immunogens for inducing HIV-1 Envelope-specific VRC01-class antibodies. The VRC01 class of broadly neutralizing antibodies have been observed in multiple individuals and targets the HIV CD4 binding site via a common recognition motif that requires specific features in both heavy and light chains (e.g., VH1-2 heavy chain V-gene and a short, £5 amino acid light chain CDR3). We are using paired heavy and light chain sequencing to quantify the performance of various candidate HIV immunogens for inducing VRC01-class broadly neutralizing HIV antibodies in transgenic mouse models. We are also elucidating the ontogeny of antibodies in vaccinated and naturally infected human subjects and animal models via interrogation of paired heavy and light chain antibody sequences and antibody synthesis/testing of promising clones, including experimental influenza vaccine trials and a Phase I Ebola vaccine trial. These next-generation immunoanalytic approaches are providing detailed molecular feedback regarding experimental vaccine performance to accelerate vaccine design efforts against pathogens of major public health importance

DUX4c, an FSHD candidate gene, interferes with myogenic regulators and abolishes myoblast differentiation

Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant neuromuscular disease. It maps to the D4Z4 repeat array at 4q35, and correlates with a repeat contraction which derepresses transcription of local genes. Which, if any, of these genes is pathogenic to muscle, and through what molecular mechanism is unknown. The present study investigates the function of one candidate gene, DUX4c, encoded by a truncated inverted D4Z4 element located 42 kb proximal to the D4Z4 repeats. Using a gain of function approach we tested DUX4c for toxicity and effects on differentiation in C2C12 myoblasts. DUX4c-expressing myoblasts appear morphologically normal but have reduced expression of myogenic regulators, including MyoD and Myf5. Consistent with this, DUX4c-expressing myoblasts are unable to differentiate into myotubes. Furthermore, overexpression of Myf5 or MyoD rescued myoblast differentiation, suggesting that reductions in expression of these regulators are the relevant DUX4c-induced physiological changes that inhibit differentiation. Our results suggest that upregulation of DUX4c can have a deleterious effect on muscle homeostasis and regeneration, and point to a possible role for DUX4c in the pathology of FSHD