Ocular Morbidity—A Critical Analysis to Improve Outpatient Services in an Eye Department in a Sub-Saharan Megacity

The aim of this study was to analyse outpatient services in an ophthalmic clinic of a church-run hospital providing secondary level care in an African megacity, paying special attention to the poorest users of the services. The range of examination was reviewed from 500 patient records of all ages consecutively chosen on random days attending the outpatient department for the first time in order to optimize workflow and to analyse the offered treatment modalities. Mean age was 41.9 ± 21.9 years, and 53.6% of the patients were female. Of the patients, 74.8% presented with visual impairment. The most frequent findings were refractive errors (35.8%), presbyopia (21.2%), allergic conjunctivitis (14.0%), cataract (13.2%) and glaucoma (6.4%). Patient management consisted of optical treatment (49.6%), surgery (11.4%) and medical treatment (39.0%). These results show the importance of the demand in refractive services and the need to train specific service providers. Knowing the frequencies of common conditions enables more appropriate diagnostic and treatment strategies, e.g., the importance of refractive errors, and should lead to improvements in training, staffing, therapeutics and patient outcomes. This approach can be applied to many other outpatient services and should be evaluated in light of the city’s impoverished health outreach and educational situation.

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Treatment Options for Depression: Women and Primary Service Providers

Australian Journal of Primary Health ◽

10.1071/py99018 ◽

1999 ◽

Vol 5 (2) ◽

pp. 38 ◽

Cited By ~ 3

Author(s):

Bernadette Hood ◽

Ronnie Egan ◽

Heather Gridley ◽

Christine Brew

Keyword(s):

Pharmacological Treatment ◽

Professional Training ◽

Qualitative Methodology ◽

Service Providers ◽

Treatment Options ◽

Treatment Strategies ◽

Psychosocial Interventions ◽

Research Literature ◽

Treatment Modalities ◽

Primary Service

A substantive quantitative research literature base exists exploring aspects of treatment for depression. Major themes to emerge from this literature include the use of general practitioners (GPs) in preference to psychiatrists for treatment and the negative public attitudes toward the use of pharmacological treatment strategies for depression. The study reported in this paper utilises a qualitative methodology to explore the experiences and attitudes of women currently being treated for depression. Specifically the paper focusses on the women's attitudes toward psychological versus medical treatment options for the disorder. Attitudes toward treatment modalities of medical and non-medical primary service providers are also investigated. Several significant findings emerged from the study. Women interviewed expressed a sense of personal responsibility for both the occurrence and management of depression.Consequent to this belief psychosocial interventions were critical to 'getting well'. Medication was viewed positively by all women, not as a treatment for depression, rather as a means of relieving the extreme symptoms of the illness, therefore providing space for psychosocial interventions. Medical and non-medical service providers expressed an acceptance of the need for integrating psychological and pharmacological treatment strategies though all providers acknowledged their lack of skills in incorporating treatments outside of their professional training. The study provides insight into the belief structures which influence participants' behaviours, presenting a less polarised view of attitudes toward psychological and pharmacological interventions than suggested by the current quantitative literature.

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Cyberpolitik

ADALAH ◽

10.15408/adalah.v4i2.17927 ◽

2020 ◽

Vol 4 (2) ◽

Author(s):

Munadhil Abdul Muqsith

Keyword(s):

Political Communication ◽

Total Population ◽

Service Providers ◽

Mailing List ◽

The Internet ◽

Internet Service Providers ◽

Internet Service ◽

Internet Users ◽

Internet Media ◽

First Time

Abstract:The internet developed for the first time in Indonesia in the early 1990s. Starting from the pagayuban network, it is now expanding without boundaries anywhere. A survey conducted by the Indonesian Internet Service Providers Association (APJII) said that the number of internet users in Indonesia in 2012 reached 63 million people or 24.23 percent of the country's total population. Next year, that figure is predicted to increase by close to 30 percent to 82 million users and continue to grow to 107 million in 2014 and 139 million or 50 percent of the total population in 2015. million people. This matter also results in political communication with the internet media, or is often said to be cyber politics. Cyber politics in Indonesia has faced growth in recent years. There are many facilities that support the growth of cyber politics, such as Facebook, Twitter, mailing list, YouTube, and others.Keywords: Cyberpolitik, Internet Abstrak:Internet berkembang pertama kali di Indonesia pada awal tahun 1990-an. Diawali dari pagayuban network kini berkembang luas tanpa batas dimanapun juga. Suatu survei yang diselenggarakan Asosiasi Penyelenggara Jasa Internet Indonesia (APJII) mengatakan kalau jumlah pengguna internet di Indonesia tahun 2012 menggapai 63 juta orang ataupun 24,23 persen dari total populasi negeri ini. Tahun depan, angka itu diprediksi naik dekat 30 persen jadi 82 juta pengguna serta terus berkembang jadi 107 juta pada 2014 serta 139 juta ataupun 50 persen total populasi pada 2015. juta orang. Perihal ini pula berakibat pada komunikasi politik dengan media internet, ataupun kerap diucap dengan cyber politic. Cyber politic di Indonesia hadapi pertumbuhan sebagian tahun terakhir. Banyaknya fasilitas yang menunjang pertumbuhan cyber politic semacam terdapatnya facebook, Twitter, mailing list, youtobe, serta lain-lain.Kata Kunci: Cyberpolitik, Internet

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New Trends and Developments in Patients with Severe Aortic Stenosis – Towards Optimal Treatment?

European Cardiology Review ◽

10.15420/ecr.2009.5.2.81 ◽

2009 ◽

Vol 5 (2) ◽

pp. 81 ◽

Cited By ~ 2

Author(s):

Martijn WA van Geldorp ◽

Johanna JM Takkenberg ◽

Ad JJC Bogers ◽

A Pieter Kappetein ◽

◽

...

Keyword(s):

Aortic Stenosis ◽

Severe Aortic Stenosis ◽

Surgical Techniques ◽

Treatment Strategies ◽

Tissue Doppler ◽

Doppler Imaging ◽

Treatment Modalities ◽

Diagnostic Tools ◽

Number Of Patients ◽

Transcatheter Valve

Over the next few decades the number of patients diagnosed with aortic stenosis is expected to rise as the population ages and the use of several diagnostic tools expands. This will result in a growing need for both medical and surgical treatment and stimulate the development of new diagnostic and surgical techniques. This article briefly describes the prevalence, pathogenesis and clinical presentation of patients with aortic stenosis and focuses on developments in diagnostic tools, treatment strategies and treatment modalities: the use of echocardiography, tissue Doppler imaging, stress testing and biomarkers is discussed, as well as timing of surgery and the role microsimulation can play in prosthesis selection. Furthermore, newly developed transcatheter valve implantation techniques and their possible role in treating ‘inoperable’ or ‘elderly’ patients are discussed.

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Chemical Constituents and Antibacterial Activity of Cissus Aralioides.

Letters in Organic Chemistry ◽

10.2174/1570178617999200609130127 ◽

2020 ◽

Vol 17 ◽

Author(s):

Balogun Olaoye Solomon ◽

Ajayi Olukayode Solomon ◽

Owolabi Temitayo Abidemi ◽

Oladimeji Abdulkarbir Oladele ◽

Liu Zhiqiang

Keyword(s):

Plant Extract ◽

Chemical Constituents ◽

Ethyl Acetate Fraction ◽

Antibacterial Activities ◽

Sub Saharan Africa ◽

Chromatographic Purification ◽

Whole Plant ◽

Sub Saharan ◽

First Time

: Cissus aralioides is a medicinal plant used in sub-Saharan Africa for treatment of infectious diseases; however the chemical constituents of the plant have not been investigated. Thus, in this study, attempt was made at identifying predominant phytochemical constituents of the plant through chromatographic purification and silylation of the plant extract, and subsequent characterization using spectroscopic and GC-MS techniques. The minimum inhibitory concentration (MICs) for the antibacterial activities of the plant extract, chromatographic fractions and isolated compounds were also examined. Chromatographic purification of the ethyl acetate fraction from the whole plant afforded three compounds: β-sitosterol (1), stigmasterol (2) and friedelin (3). The phytosterols (1 and 2) were obtained together as a mixture. The GC-MS analysis of silylated extract indicated alcohols, fatty acids and sugars as predominant classes, with composition of 24.62, 36.90 and 26.52% respectively. Results of MICs indicated that friedelin and other chromatographic fractions had values (0.0626-1.0 mg/mL) comparable with the standard antibiotics used. Characterization of natural products from C. aralioides is being reported for the first time in this study.

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Molecular Subtypes and Precision Oncology in Intrahepatic Cholangiocarcinoma

Journal of Clinical Medicine ◽

10.3390/jcm10132803 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2803

Author(s):

Carolin Czauderna ◽

Martha M. Kirstein ◽

Hauke C. Tews ◽

Arndt Vogel ◽

Jens U. Marquardt

Keyword(s):

Clinical Care ◽

Treatment Options ◽

Treatment Strategies ◽

Specific Treatment ◽

Growth Factor Receptor ◽

Treatment Modalities ◽

Precision Oncology ◽

Recurrence Rates ◽

Isocitrate Dehydrogenase 1 ◽

Liver Cancers

Cholangiocarcinomas (CCAs) are the second-most common primary liver cancers. CCAs represent a group of highly heterogeneous tumors classified based on anatomical localization into intra- (iCCA) and extrahepatic CCA (eCCA). In contrast to eCCA, the incidence of iCCA is increasing worldwide. Curative treatment strategies for all CCAs involve oncological resection followed by adjuvant chemotherapy in early stages, whereas chemotherapy is administered at advanced stages of disease. Due to late diagnosis, high recurrence rates, and limited treatment options, the prognosis of patients remains poor. Comprehensive molecular characterization has further revealed considerable heterogeneity and distinct prognostic and therapeutic traits for iCCA and eCCA, indicating that specific treatment modalities are required for different subclasses. Several druggable alterations and oncogenic drivers such as fibroblast growth factor receptor 2 gene fusions and hotspot mutations in isocitrate dehydrogenase 1 and 2 mutations have been identified. Specific inhibitors have demonstrated striking antitumor activity in affected subgroups of patients in phase II and III clinical trials. Thus, improved understanding of the molecular complexity has paved the way for precision oncological approaches. Here, we outline current advances in targeted treatments and immunotherapeutic approaches. In addition, we delineate future perspectives for different molecular subclasses that will improve the clinical care of iCCA patients.

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Labellum and gynostemium micromorphology in Polystachya (Orchidaceae)

Plant Systematics and Evolution ◽

10.1007/s00606-020-01724-1 ◽

2020 ◽

Vol 307 (1) ◽

Author(s):

Mytnik Joanna ◽

Davies L. Kevin ◽

Narajczyk Magdalena ◽

Łuszczek Dorota ◽

Kubiak Joanna ◽

...

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Sub Saharan Africa ◽

Capitate Trichomes ◽

Sub Saharan ◽

First Time ◽

Scanning Electron

AbstractPolystachya is a large, pantropical orchid genus of 200 species, most of which occur as epiphytes in sub-saharan Africa. The three-lobed labellum of most Polystachya species possesses a fleshy callus and various types of trichomes and papillae. In this paper, we present the results of micromorphological studies on the labellum of 20 species, representing eight of the 13 sections in the genus, using scanning electron microscopy (SEM). Our results show the scale of infrageneric diversity of trichomes and papillae relative to the sampled sections. They also demonstrate the taxonomic value of labellar micromorphology at the sectional level. The study revealed seven types of papillae and five types of trichomes (uni- and multi-cellular) in Polystachya, some of which, are described here for the first time. Clavate trichomes are the most common and are present in 60% of the species studied. Moniliform trichomes mainly occur in sect. Polystachya and are strongly characteristic of the section. Pseudopollen is formed by fragmentation of moniliform trichomes or the detachment of other trichomes as bicellular units. We provide, for the first time, evidence for the detachment of the terminal cells of capitate trichomes.

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Schistosoma mansoni eggs induce Wnt/β-catenin signaling and activate the protooncogene c-Jun in human and hamster colon

Scientific Reports ◽

10.1038/s41598-020-79450-4 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Jakob Weglage ◽

Friederike Wolters ◽

Laura Hehr ◽

Jakob Lichtenberger ◽

Celina Wulz ◽

...

Keyword(s):

Signaling Pathways ◽

Colorectal Carcinogenesis ◽

Sub Saharan Africa ◽

Interleukin 4 ◽

Health Burden ◽

Sub Saharan ◽

Considerable Morbidity ◽

First Time

AbstractSchistosomiasis (bilharzia) is a neglected tropical disease caused by parasitic flatworms of the genus Schistosoma, with considerable morbidity in parts of the Middle East, South America, Southeast Asia, in sub-Saharan Africa, and particularly also in Europe. The WHO describes an increasing global health burden with more than 290 million people threatened by the disease and a potential to spread into regions with temperate climates like Corsica, France. The aim of our study was to investigate the influence of S. mansoni infection on colorectal carcinogenic signaling pathways in vivo and in vitro. S. mansoni infection, soluble egg antigens (SEA) and the Interleukin-4-inducing principle from S. mansoni eggs induce Wnt/β-catenin signaling and the protooncogene c-Jun as well as downstream factor Cyclin D1 and markers for DNA-damage, such as Parp1 and γH2a.x in enterocytes. The presence of these characteristic hallmarks of colorectal carcinogenesis was confirmed in colon biopsies from S. mansoni-infected patients demonstrating the clinical relevance of our findings. For the first time it was shown that S. mansoni SEA may be involved in the induction of colorectal carcinoma-associated signaling pathways.

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Assessing Future Water Demand and Associated Energy Input with Plausible Scenarios for Water Service Providers (WSPs) in Sub-Saharan Africa

Energies ◽

10.3390/en14082169 ◽

2021 ◽

Vol 14 (8) ◽

pp. 2169

Author(s):

Pauline Macharia ◽

Nzula Kitaka ◽

Paul Yillia ◽

Norbert Kreuzinger

Keyword(s):

Water Supply ◽

Water Demand ◽

Energy Input ◽

Service Providers ◽

Sub Saharan Africa ◽

Water Losses ◽

Water Service ◽

Current State ◽

Per Capita ◽

Sub Saharan

This study examined the current state of water demand and associated energy input for water supply against a projected increase in water demand in sub-Saharan Africa. Three plausible scenarios, namely, Current State Extends (CSE), Current State Improves (CSI) and Current State Deteriorates (CSD) were developed and applied using nine quantifiable indicators for water demand projections and the associated impact on energy input for water supply for five Water Service Providers (WSPs) in Kenya to demonstrate the feasibility of the approach based on real data in sub-Saharan Africa. Currently, the daily per capita water-use in the service area of four of the five WSPs was below minimum daily requirement of 50 L/p/d. Further, non-revenue water losses were up to three times higher than the regulated benchmark (range 26–63%). Calculations showed a leakage reduction potential of up to 70% and energy savings of up to 12 MWh/a. The projected water demand is expected to increase by at least twelve times the current demand to achieve universal coverage and an average daily per capita consumption of 120 L/p/d for the urban population by 2030. Consequently, the energy input could increase almost twelve-folds with the CSI scenario or up to fifty-folds with the CSE scenario for WSPs where desalination or additional groundwater abstraction is proposed. The approach used can be applied for other WSPs which are experiencing a similar evolution of their water supply and demand drivers in sub-Saharan Africa. WSPs in the sub-region should explore aggressive strategies to jointly address persistent water losses and associated energy input. This would reduce the current water supply-demand gap and minimize the energy input that will be associated with exploring additional water sources that are typically energy intensive.

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FATCA violation underlies latest US tax and securities fraud charges

Journal of Investment Compliance ◽

10.1108/joic-01-2015-0008 ◽

2015 ◽

Vol 16 (1) ◽

pp. 74-76

Author(s):

Miriam Fisher ◽

Brian McManus

Keyword(s):

Law Enforcement ◽

Service Providers ◽

Task Force ◽

Tax Compliance ◽

Financial Fraud ◽

Securities Fraud ◽

Content Type ◽

The Impact ◽

First Time ◽

Practical Implications

Purpose – To explain the details and implications of a September 9, 2014 federal indictment, US v. Robert Bandfield, the first time a Foreign Account Tax Compliance Act (FATCA) violation has been charged as an “overt act” in furtherance of a tax conspiracy and securities fraud. Design/methodology/approach – Provides background, including the enactment of FATCA and the details of the indictment; describes an undercover investigation conducted by President Obama’s Financial Fraud Enforcement Task Force; and discusses the warnings this indictment sends to the global financial community. Findings – The indictment confirms the coordinated and aggressive tactics US law enforcement is now employing to investigate and prosecute offshore financial fraud. Practical implications – Banks and financial service providers need to be aware of the impact of enhanced US regulatory obligations and implement appropriate compliance measures. These institutions must also remain sensitive to risks presented by unscrupulous customers. Finally, they must be ready to manage appropriately information-gathering and investigatory inquiries originating with US authorities. Originality/value – Practical guidance from experienced tax controversy lawyers.

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Cancer immunoediting: A game theoretical approach

In Silico Biology ◽

10.3233/isb-200475 ◽

2020 ◽

pp. 1-12

Author(s):

Fatemeh Tavakoli ◽

Javad Salimi Sartakhti ◽

Mohammad Hossein Manshaei ◽

David Basanta

Keyword(s):

Immune System ◽

Cancer Cells ◽

Evolutionary Game ◽

Equilibrium Phase ◽

Tumor Development ◽

Treatment Strategies ◽

Cancer Immunoediting ◽

Proposed Model ◽

Game Theoretical Approach ◽

First Time

The role of the immune system in tumor development increasingly includes the idea of cancer immunoediting. It comprises three phases: elimination, equilibrium, and escape. In the first phase, elimination, transformed cells are recognized and destroyed by immune system. The rare tumor cells that are not destroyed in this phase may then enter the equilibrium phase, where their growth is prevented by immunity mechanisms. The escape phase represents the final phase of this process, where cancer cells begin to grow unconstrained by the immune system. In this study, we describe and analyze an evolutionary game theoretical model of proliferating, quiescent, and immune cells interactions for the first time. The proposed model is evaluated with constant and dynamic approaches. Population dynamics and interactions between the immune system and cancer cells are investigated. Stability of equilibria or critical points are analyzed by applying algebraic analysis. This model allows us to understand the process of cancer development and might help us design better treatment strategies to account for immunoediting.

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