Miracle-dz/UniFAR-FTUs huggingface dataset:
Involving migrants in the development of guidelines for communication in cross-cultural general practice consultations: a participatory learning and action research project

Objective The aim of this research was to involve migrants and other key stakeholders in a participatory dialogue to develop a guideline for enhancing communication in cross-cultural general practice consultations. In this paper, we focus on findings about the use of formal versus informal interpreters because dialogues about these issues emerged as central to the identification of recommendations for best practice. Design This qualitative case study involved a Participatory Learning and Action (PLA) research methodology. Participants The sample comprised 80 stakeholders: 51 from migrant communities; 15 general practitioners (GPs) and general practice staff; 7 established migrants as peer researchers; 5 formal, trained interpreters; and 2 service planners from the national health authority. Setting Galway, Ireland. Results There was 100% consensus across stakeholder groups that while informal interpreters have uses for migrants and general practice staff, they are not considered acceptable as best practice. There was also 100% consensus that formal interpreters who are trained and working as per a professional code of practice are acceptable as best practice. Conclusions Policymakers and service planners need to work in partnership with service providers and migrants to progress the implementation of professional, trained interpreters as a routine way of working in general practice.
Barriers and enablers to childhood cataract services in India

There is little epidemiological information about cataract in children globally and thus a lack of evidence to guide policy related to childhood cataract. Early presentation for cataract surgery in children is an important first step for effective treatment. The overall aim of this research was to determine the age at childhood cataract surgery in India and to understand the barriers and enablers to accessing childhood cataract services in the region. A mixed methods approach was used. Quantitative data were obtained via a questionnaire in nine different eye hospitals in eight states in India. Qualitative data were collected from the perspectives of parents and carers and primary eye care providers using in-depth interviews and focus group discussions respectively and Theoretical Domains Framework (TDF) of behaviour change was used for analysis. A systematic review was conducted to estimate global prevalence of childhood cataract. This was estimated to be 1.14 /10000 overall, and 0.46 /10000 in low and lower middle income economies. The mean age at surgery for congenital cataract in India was 4 years and for developmental cataract it was 8 years, but these numbers varied significantly between the regions in the country. Delays to surgery occurred at recognition, when accessing the hospital and delayed surgery at the hospital. The barriers and enablers identified from the perspectives of the parents and carers suggest a need for behavioural change intervention to enhance health seeking behaviour in the communities. The findings suggest gaps in knowledge and awareness among the primary care team which should be further investigated and addressed. Based on these research findings several recommendations were identified and a preliminary recommended intervention strategy was developed to achieve behaviour changes with the aim of increasing early uptake of childhood cataract services in India.
A cross-sectional study on the risk factors for cardiovascular disease and risk profiling of adults in central India

Context: Cardiovascular disease (CVD) tops the list of the causes of noncommunicable disease mortality, followed by cancers, respiratory diseases, and diabetes. More than 75% of CVD deaths occur in low- and middle-income countries. Thus, estimation of the future CVD risk in this population becomes an important step. Aims: The aim is to study the prevalence of risk factors for CVD and to study the 10-year risk for fatal or nonfatal cardiovascular events. Subjects and Methods: A cross-sectional study was conducted at an urban health training center of a tertiary care hospital in Central India. Adults >30 years of age attending the outpatient department were recruited. Patients on long-term steroids, critically ill patients, and pregnant females were excluded from the study. Predesigned and pretested questionnaire was used to collect the data. For individuals above 40 years of age, the 10-year risk for cardiovascular events was estimated using the World Health Organization/International Society of Hypertension risk prediction charts. Results: A total of 243 participants (mean age 51.4 ± 12.2 years; female:male ratio 1.38:1) were included in the study. The prevalence of tobacco chewing (33.3%) and smoking (10.8%) was significantly higher among males compared with females (P < 0.001). The prevalence of hypertension, family history of CVD, overweight, and obesity was higher among females but did not attain statistical significance. The estimated 10-year risk of a cardiovascular event was <10%, 10%–< 20%, 20%–< 30%, 30%–<40%, and >40% in 72%, 17%, 7%, 2%, and 2% study participants, respectively. Conclusions: We found significantly higher prevalence of males consuming tobacco and smoking as compared to females. About 28% of the eligible study participants had a predicted 10-year cardiovascular risk of 10% or more in our study. This high proportion of elevated cardiovascular risk is a cause of concern and necessitates aggressive preventive efforts.
PREVALENCE, PATHOLOGY AND MOLECULAR DIAGNOSIS OF POX IN DOMESTIC BIRDS

OF THE THESIS Title of the thesis : PREVALENCE, PATHOLOGY AND MOLECULAR DIAGNOSIS OF POX IN DOMESTIC BIRDS Research pertaining to the degree programme : DOCTOR OF PHILOSOPHY in VETERINARY PATHOLOGY Name of the Scholar : DR. NAYANJYOTI PATHAK Roll number : No. 2012-VDK -24 Name and designation of the Major Adviser : Dr. G.K. Baruah Professor & Head Department of Pathology College of Veterinary Science Assam Agricultural University Khanapara, Guwahati-781 022 Department where research work was conducted : Department of Pathology College of Veterinary Science Assam Agricultural University Khanapara, Guwahati-781 022 Name of the University : Assam Agricultural University Total number of pages : 124 Total number of Tables : 24 Total number of Figures : 35 Year of Submission : July, 2016
What makes a nursing home homely? A Scottish based study, using Q methodology of the perceptions of staff, residents and significant others

Background A ‘homely’ nursing or care home is of international interest and comes from a wide variety of academic disciplines and from policy makers and charities. However, ‘homeliness’ is a dynamic and complex concept and one worthy of further investigation. Aims (a) To explore what is meant by ‘homely’ in the care home environment, (b) to explore whether a ‘homely’ care home is a priority in the expressed views of residents, staff and visitors, and (c) to explore features contributing to the creation of homeliness in the care home environment. Method A mixed methodology was used – a narrative literature review, an environmental assessment using the Sheffield care environment assessment matrix (SCEAM) tool and Q methodology. Participants (n = 16) included staff, residents and their relatives from care homes in the west of Scotland. Results The literature review generated eight themes: home as space; home as place, design features, homeliness, the outdoors, home and identity, dementia design and specific rooms. The SCEAM revealed that homely environments supported personalisation, safety and health, privacy, community, comfort and awareness, choice and staff accommodation. The Q method revealed three factors: standards driven, making the most of it and a sense of belonging. Conclusion The results showed that staff and relatives placed priority on features included in national standards of care, while residents placed more importance on a feeling of belonging.
Evaluation of Anterior Cruciate Ligament Partial Tear Injury Management

Background: Cruciate ligament is divided into two ligaments (Anterior Cruciate Ligament & Posterior Cruciate Ligament) and is attached to the femur and tibia. The rate Anterior Cruciate Ligament partial tear is high among athletes and it is relatively high in comparison to other knee injuries. Anterior Cruciate Ligament partial tear commonly associated with hem-arthrosis of the knee and can evolve into complete tear. Various approaches have been suggested to treat Anterior Cruciate Ligament partial tear. However, deciding which approach to follow is still controversial. Objective: In this study we aimed at reviewing the current available literatures reporting on the management of partial tears of the ACL. Methods: PubMed database was used for articles selection, and the following keys used in the mesh ("Anterior Cruciate Ligament /partial tear"[Mesh] OR "Anterior Cruciate Ligament /management"[Mesh] OR "Anterior Cruciate Ligament /outcomes"[Mesh]). 10 studies were enrolled according to our inclusion, and exclusion criteria. Conclusion: The initial treatment after an ACL injury is rest, ice and usually crutches. Immobilization is important while the patient remains symptomatic. A course of conservative treatment by physiotherapy can be successful in patients not participating in strenuous physical activity. In patients with a high functional demand, even after a conservative program, surgical treatment is often required. Keeping ACL remnants when reconstructing the ACL is recommended. It might be beneficial on knee function because it preserves numerous mechanoreceptors that favor knee proprioception. In prepubescent children with several years of growth ahead, physical-sparing technique like Micheli technique is recommended. Less invasive techniques such as Thermal modification of knee’s connective tissues can be suggested in order to reduce the dilemma and difficulty of the operation for the surgeon.
A Video Game with Foot Switch for Walking and Balance Ability Improvement in Children with Cerebral Palsy

Background: Ankle dorsiflexion exercises are important for gait and balance abilities, and these walking abilities can be facilitated by repetition Objectives: Video games for rehabilitation have been used to make home training accessible, with a mouse modified to a foot switch for children with CP. Design: A randomized controlled trial. Participants: The intervention group (n=24) received 15 weeks, of approximately 3.5 hours/week VG training using a pressure-activated electronic foot switch, in addition to routine after-school programs. The control group (n=24) received routine after-school activities only. Main Outcome Measures: A force platform to measure Center of Pressure sway (sway path, area, rate), and two function test scores, Pediatric Balance Scale score and One-Meter Test of Walking score, were used to measure the standing balance and walking performance. Results: In the analysis of covariance, there were significant improvements in the intervention group than those in the control group in Center of Pressure sway performance, and functional test. Conclusions: Using this modified foot switch with video games may improve exercise compliance and enhance recovery of balance and walking performance.
"I Should Be Pregnant So Many Times By Now": Risk Perception, Numeracy, and Young Women's Contraceptive Use

vii Chapter 1: Introduction . 1 : Reciprocal Relationships between Estimated Pregnancy Risk and Young Women’s Contraceptive Use . 8 : Side Effect Concerns and Young Women’s Contraceptive Use . 31 : Numeracy and Young Women’s Contraceptive Use . 50 : Conclusion. 75 Appendices . 81 Bibliography . 95
A systematic review of the effect of mobile health on cardiac rehabilitation among coronary heart disease patients

Abstract Objective Mobile health (mHealth) provides an innovative and effective approach to promote prevention and management of coronary heart disease. However, the magnitude of its effects is unclear. The aim of this systematic review was to examine the impact of mHealth-based cardiac rehabilitation outcomes among coronary heart disease patients. Methods Medline, CINAHL, Embase, PubMed, Google Scholar, NICE, and Cochrane library were searched for randomized controlled trials published between January 2002 and March 2017 which compared mHealth with conventional cardiac rehabilitation programs among coronary heart disease patients. Results Eight articles were included in this review. The impact of mHealth interventions on physical activity, medicine adherence, smoking cessation, level of anxiety, and quality of life was inconsistent among the articles. Conclusions Further research is needed to conclusively determine the impact of mHealth interventions on cardiac rehabilitation outcomes. The limitations of the included studies (e.g., inadequate sample size, failure to address the core components of cardiac rehabilitation programs, and lack of theory-based design) should be taken into account when designing future studies.
Feasibility of using point prevalence surveys to assess antimicrobial utilisation in public hospitals in South Africa: a pilot study and implications

ABSTRACT Objectives: There is currently a lack of data regarding antimicrobial use among public hospitals in South Africa. This is a concern given their growing use and increasing antimicrobial resistance rates in South Africa. Consequently, the objectives of this study were to firstly determine the appropriateness of point prevalence survey (PPS) data collection instruments for performing antimicrobial utilization studies among public sector hospitals in South Africa; secondly, to determine current antimicrobial utilization in a public sector hospital, and thirdly evaluate the prescribing of antimicrobials with those contained within the national Essential Medicines List and Standard Treatment Guidelines (EML/STGs). The findings will be used to guide future activities in South Africa. Methods: A PPS was conducted in Dr George Mukhari Academic Hospital. For each in-patient ward, all patients’ files were completely surveyed on a single day. The number of patients who were on antimicrobials served as the numerator and the denominator comprised the total number of patients in the ward. Results: 39 wards and 512 patient files were surveyed. The overall prevalence of antimicrobial use was 37.7%, highest in the ICUs. Beta lactamase inhibitors and antimicrobials for tuberculosis were the most prevalent antimicrobials. More than two thirds (83%) of antimicrobial treatment was modified following culture sensitivity test results when requested, and 98% of antimicrobials prescribed were contained within the current EML/STGs. In 10.8% of occasions, antimicrobials appear to have been prescribed other than for treatment, i.e. no systemic infection. There were concerns though with the lack of IV to oral switching. Conclusion: The PPS method offers a standardized tool that can be used to identify targets for quality improvement. However, there were concerns with the time taken to conduct PPS studies, which is an issue in resource limited settings. This is being addressed alongside concerns with the lack of IV to oral switching.
Correlation Between DTI Findings and Volume of Corpus Callosum in Children with AUTISM.

BACKGROUND Autism Spectrum Disorder (ASD) is a complex developmental disorder in which neurological basis is largely unknown. The Corpus Callosum (CC) is the main commissure that connects the cerebral hemispheres. Previous evidence suggests the involvement of the CC in the pathophysiology of autism. AIM The aim of our study is to assess whether there were any changes in Corpus Callosum (CC) area and volume and to reveal the relationship between Diffusion Tensor Imaging (DTI) features in genu and splenium of corpus callosum in children with ASD. METHODS Eighteen patient and 15 controls were recruited. The volumetric sagittal TI images were used to provide measurements of midsagittal corpus callosum surface area while FA, MD, RD, and ADC values were extracted from genu and splenium of corpus callosum after which the correlation in the area and volume in ASD children was examined. RESULTS CC area and volume in children with ASD were decreased than controls. FA values obtained from the genu and splenum of CC were significantly lower and RD values were significantly higher. A positive correlation was observed between the FA of the genu and splenium and area and volume of the CC. There was a negative correlation between ADC, MD and RD of CC and area and volume measurements. CONCLUSION The conclusions in the interrelations of morphometric and DTI data may demonstrate a likelihood of damages in the axons and cortical neurons. The results showed that there existed microstructural damages from the DTI findings. Furthermore, the decrease in FA could be a representation of the reduction in the myelination in nerve pathways, impaired integrity, reduced axonal density, and organization. Indeed, the changes in volumetric and microstructural of CC could be useful in evaluating underlying pathophysiology in children with autism.
Regulation of clathrin-coated vesicle nucleation

Clathrin-mediated endocytosis is a selective pathway for the entry of transmembrane proteins into the cell through the generation of a short-lived vesicular intermediate. Cells and tissues depend on this process for obtaining nutrients, modulation of signaling and cell migration. The clathrin-coated structure intermediate is assembled on the plasma membrane from a cohort of 20-30 distinct proteins that aid in cargo selection, scaffolding, membrane bending and scission of the vesicle. Exactly how these complex assemblies are nucleated at the plasma membrane remains unclear although the lipid phosphatidylinositol-4,5-bisphosphate (PtdIns(4,5)P2) plays an important role by anchoring many of the endocytic components. The work in this thesis helps to clarify the nucleation phase by describing the molecular details of the interaction between a PtdIns(4,5)P2-generating lipid kinase PIPKIgamma and the heterotetrameric clathrin adaptor AP-2. By engaging a subdomain on the AP-2 beta2 subunit appendage, the kinase is strategically positioned at assembly sites to generate PtdIns(4,5)P2 and drive coat assembly forward. Clathrin binds to the same subdomain on the beta2 appendage but with a higher apparent affinity. I therefore invoke a model in which PtdIns(4,5)P2 production for nucleation is negatively regulated by PIPKIgamma displacement from AP-2 by clathrin at later stages of assembly. I also demonstrate that a cargo-sorting alternate adaptor that binds to the other subsite on the AP-2 beta2 appendage is not subject to displacement by clathrin during clathrin-coated vesicle budding, ensuring non-competitive cargo incorporation into the vesicle. Finally, the PtdIns(4,5)P2-binding EFC domain proteins FCHO1 and FCHO2 have been proposed to act as dedicated nucleators of clathrin-coated structures on the plasma membrane. I demonstrate in multiple cell lines that these proteins are not invariantly required for placement of clathrin-coated assemblies on the plasma membrane despite being early arriving components themselves. FCHO1/2 are involved in the regulation of the size and number of these assemblies in some cellular contexts. My data support the model of PtdIns(4,5)P2 regulated, not protein regulated, nucleation of clathrin-coated structures; however multiple parallel pathways may contribute to initiation of endocytic buds.
Optimal lane guidance for improving traffic efficiency on homogeneous freeway sections

Participation of vehicles in traffic is largely self-interested. This holds also for lateral movements, wherein rational drivers try to make lane changes that maximize their own individual utility, such as keeping a desired speed, lane or route. However, the sum effect of all individual lane changes may not necessarily be optimal for the overall traffic efficiency [Ahn and Cassidy, 2007, Duret et al., 2012]. Intelligent vehicle technologies can be used to design more safe and efficient systems, for individual vehicles but also for the overall system. Specifically, with lane keeping and lane change assistance systems already in the market, modelling and control of lateral behaviour under different driving situations, such as free lane changing, merging and overtaking, has regained attention in traffic research. From a modelling perspective, the research focus in literature is on microscopic models for lane change decision-making [Hidas, 2002, Kesting et al., 2007], their integration with car-following models [Schakel et al., 2012, Toledo et al., 2007], and on modelling the effects of lateral movements on the dynamics of the subject and surrounding vehicles [Laval and Leclercq, 2008, Schakel et al., 2012]. From a control perspective, different approaches are being developed, some at the operational-level: for planning and tracking reference trajectory for a lane change manoeuvre [You et al., 2015], at the tactical-level: for optimizing lane selection or when and where a lane is performed [Talebpour et al., 2015, Wang et al., 2015], and others at the strategic-level: for optimizing lane distribution for a higher system objective [Roncoli et al., 2016, 2017]. In this work, we are interested in (strategic) lane guidance systems that aim to improve network performance. There are very few studies that aim to do so, mostly because existing lane change models are not suitable for estimating/predicting effects of individual lane changes on overall traffic. Recent work of Roncoli et al. [2016] addresses this gap by developing a macroscopic model for multi-lane traffic with aggregated lateral flows, and a strategy for optimizing traffic distribution over the lanes at freeway bottlenecks. The control mechanism used in their work relates to preventing loss of speed from increasing lane densities. In contrast, we develop a microscopic framework for controlling individual lane change decisions for maximizing traffic throughput on homogeneous freeway sections. The novelty of our control approach is that it takes into account the desired speeds of individual vehicles. Thus, the resulting lane distribution may not necessarily homogenize flow distribution over the lanes but instead distributes vehicles such that the blocking effect from slower vehicles (with relatively lower desired speeds) is minimized. The approach in its current formulation is not applicable to all demand levels, and therefore, the traffic conditions under which it is applicable are also discussed in Section 4.