bluuebunny/crossref_metadata_2025 huggingface dataset:
A Method for Aggregating Ranked Services for Personal Preference Based Selection
Authors: Fletcher Kenneth K
Published: September 2020

Typically, users' service requests, which are similar with varying preferences on non-functional attributes, may result in ranked lists of services that partially meet their needs due to conflicting non-functional attributes. The resultant multiple ranked lists of services that partially satisfies the user's request makes it challenging for the user to choose an optimal service, based on his/her preference. This work proposes a method that aggregates multiple ranked lists of services into a single aggregated ranked list, where top ranked services are selected for the user. Two algorithms are proposed; 1) Rank Aggregation for Complete Lists (RACoL), that aggregates complete ranked lists and 2) Rank Aggregation for Incomplete Lists (RAIL) to aggregate incomplete ranked lists. Examples using real-world airline services to evaluate both algorithms show that the results from both proposed algorithms closely represent the sets of ranked lists better than using alternative approaches. Experiments were also carried out to validate their performance.
Cross-Border E-Commerce Payments
Authors: Begum Noor Nahar , Hassan Md Masudul
Published: September 2020

The rapid expansion of the internet provides the world great achievements both in social and economic life. E-commerce has become one of the serenest ways of doing business and has a persuasive impact on the economy. It is the set of transactions that have been conducted through internet connections and computer networks. This chapter aims to look at the cross-border e-commerce payments. Specially, the chapter has focused on the trends in e-commerce payments, methods of online payments, effects of cross-border e-commerce, factors affecting cross-border e-commerce payments, friction of cross-border e-commerce system, drivers and impediments of cross-border e-commerce, growth of cross-border e-commerce in emerging markets. Moreover, this chapter shows how information has become the blood of e-commerce. It has extensive effects on the economy, society, and indeed national security.
Cross-Border E-Commerce and Small Medium Enterprises (SMEs)
Authors: Anshari Muhammad , Almunawar Mohammad Nabil , Lim Syamimi Ariff
Published: September 2020

The emergence of cross-border e-commerce (CBE) has its relevance in this digital age and thus brings about the discussion regarding the challenges and potentials of CBE on the local business especially small medium enterprises (SMEs). The wide availability of technology has made CBE possible across geographical, political, and cultural borders. It is a new driving force to promote the upgrading of industrial structure. The method used throughout the research is independent reviews from various studies and articles. Despite the dynamic development of CBE, communication in other languages, the form of payment, currency, legal, and tax conditions, as well as the delivery of products remain barriers to the CBE. The findings of the study show that there are four major drivers affecting CBE performance. These are economics, politics and policies, socio-cultural, and technology.
Understanding the Relationship Between the Dark Triad of Personality Traits and Neutralization Techniques Toward Cybersecurity Behaviour
Authors: Padayachee Keshnee
Published: September 2020

This study considers the framework of neutralization techniques, which responds to the attitude/rationalization leg of the fraud triangle with respect to the dark triad of personality traits' predictability toward compliant cybersecurity behaviour. Logically, organizations focus on reducing the insider's motivation and opportunities for malfeasance. However, it may be prudent to consider the rationalization for insider crime, which is arguably the most obscure element. This study is a unique contribution as it considers both the roles of neutralization techniques and the dark triad of personality traits with respect to insider threats and compliance intention. Furthermore, the specific categories of neutralization techniques will be considered as antecedents towards insider maleficence.
Proposed Framework of Smart Transportation in Pakistan
Authors: Awan Jawad Hussain , Memon Shahzad , Shah Azhar Ali , Pathan Kamran Taj
Published: September 2020

This paper proposes a framework for a smart transportation system of Pakistan and discusses modern approaches as solutions to emerging threats and vulnerabilities of STS. In addition, STS changes the life of people and decreases the number of accidents, deaths, and traffic incidents. STS is saving the time of users and makes the urban city even smarter. The aim of STS is to accomplish more efficiency of traffic by decreasing traffic issues. It also provides the information about route traffic toward destination, local expediency, passing, vehicle dynamic or requested information, availability of seats to users, which decreases journey time of commuters and improves their security and ease. This paper discusses STS, its application and working mechanism, and the main parameters of the proposed framework of STS of Pakistan such as road condition monitoring, traffic management, municipal involvement, link data for society, accidental measures, and security, which are necessary while designing or implementing such systems.
Consumer E-Loyalty for E-Grocery Shopping in a Metro City of India
Authors: Khan Sablu , Khan Adil
Published: September 2020

This study focuses on the e-loyalty of the grocery consumers. Understanding online behavior in developing countries is an emerging issue in these days. The purpose of this research is to examine the effects of antecedents of flow on attitude and perceived ease of use in the context of online grocery purchase behavior in a developing country perspective. Further, the study also examines the role of attitude and perceived ease of use in building e-loyalty. The present study analyzes the data of 250 respondents collected through an online survey. The data were analyzed employing exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structural equational modeling (SEM). The results show that the flow variables (concentration and enjoyment) have a positive but differential effect on attitude towards online grocery purchase. However, both concentration and enjoyment were equally important in influencing the perceived ease of use. The study also found that attitude positively influences the e-loyalty, and perceived ease of use influences both attitude and e-loyalty.
Exploring Supportive and Deterrent Factors on Online Shopping in a Developing Country
Authors: Pusatli Tolga , Akman Ibrahim
Published: September 2020

This study explores the influence of the reasons of individuals' supportive and deterrent behaviors against commercial usage of online media in the emerging market of Turkey. The supportive and deterrent factors are grouped in empirical categories as discouragement and encouragement, respectively. The impact of these factors on actual behavior were assessed via intermediary empirical category including the variables inefficiency, efficiency, intention, and subjective norm. A survey was conducted using a sample of 251 observations obtained from the visitors of three large/busy malls using purposive sampling. The multiple least-square regression was utilized to test the nature of the relationships between variables. Results indicated a significant discouraging impact of warranty, finance, habits, security on inefficiency perceptions, an encouraging impact of geography and convenience on efficiency perceptions. Significant behavioral impact of perceptions regarding inefficiency, efficiency, subjective norms, and intention on actual usage of online shopping was also observed.
Integrating Digital Innovation Capabilities Towards Value Creation
Authors: Edu Sampson Abeeku , Agoyi Mary , Agozie Divine Quazie
Published: September 2020

Towards the view of value creation through digital applications integration and their complementary characteristics, this study proposes a framework using the resource-based view and the capability view to explore the integration of digital capabilities to support value creation in an organization. The paper adopted a systematic review by exploring literature on digital innovations applications such as big data analytics, cloud computing, and internet of things (IoTs). The conceptual model developed suggested that deploying digital innovation capabilities promotes organizations to benefit in the area the of managerial decision making, enhancing information technology infrastructure alignments, operational activities, and overall firm performance. This article further extends the discussions toward the need to integrate digital innovation capabilities such as IoTs, big data analytics, and cloud computing and the range of relationships existing among these innovations to support value creation for firms towards technology deployment in IS literature.
The Role of Twitter in Opening New Domains of Discourse in the Public Sphere
Authors: Al-Jenaibi Badreya Nasser
Published: September 2020

The use of Twitter to coordinate political dialogue and crisis communication has been a vital key to its legitimization. In the past few years, the users of Twitter were increased in the GCC. Also, the use of social media has received a lot of ‘buzz' due to the events that unfurled in the uprisings in Tunisia and Egypt during the Arab Spring. Although not as dramatic as overthrowing a regime, the use of social media has been revolutionary in most areas of the Middle East, especially in the most conservative societies that have been relatively closed to the flow of information. Saudi Arabia and the UAE, for example, now have the largest-growing Twitter community of all the nations in the Arabian Gulf. Known for its tight rein on public discourse and the flow of information, even elements of the current regime are opening doors to a new public discourse, due in large part to the influence of social media. This paper explores the social media phenomenon that has had such an impact on the relatively closed societies of the Arab world, examining how it has changed the nature of the public sphere. The researcher used content analysis of four GCC journalists' accounts for four months. The paper concludes that the use of Twitter is shifting the Arab public's discourse and opinions in the region because those opinions are being heard instead of censored. Social media is having a major impact on the conservative Saudi, Qatar, and UAE societies.
Examining Consumer Loyalty, Internet of Things (IoT), and Theme Restaurants in the Delhi Region
Authors: Ahuja Pooja , Tiwari Pankaj
Published: September 2020

The research is conducted keeping in view the new trend of theme restaurants in India. Theme restaurants are not very famous in India. But people look for more than food in a restaurant. They want to have good experience along with food. So, ambience, crowd, and other aspects come into the scenario. The theme industry is not dominated by any major players, but there are some players like Pind Baluchi, Haveli that are doing good. Theme restaurants target different age groups. They are considered to be expensive. Customer loyalty is the new marketing now. Loyal customers not only help in generating profits but also spread positive reviews about the product or service. It helps in generating new customers and creates publicity without any promotional efforts. There are four types of loyalty: true loyalty, spurious loyalty, latent loyalty, and no loyalty. It is based on behavioral and attitudinal aspects of customers. Out of four types of loyalty, the type of loyalty for theme restaurants in Delhi/NCR is determined in this study. This can be helpful for existing players as well as for new entrants. They can understand the current scenario or level of loyalty in theme restaurant business. The study has determined the factors that can impact customer loyalty in theme restaurants in Delhi/NCR. If any new entrant comes, they can design their offerings based on the factors. This in turn can help them in bringing customer loyalty. For existing players, they can revise their services and offerings based on the determined factors.
Sentiment Analysis of Tweets Using Naïve Bayes, KNN, and Decision Tree
Authors: Zerrouki Kadda , Hamou Reda Mohamed , Rahmoun Abdellatif
Published: September 2020

Making use of social media for analyzing the perceptions of the masses over a product, event, or a person has gained momentum in recent times. Out of a wide array of social networks, the authors chose Twitter for their analysis as the opinions expressed there are concise and bear a distinctive polarity. Sentiment analysis is an approach to analyze data and retrieve sentiment that it embodies. The paper elaborately discusses three supervised machine learning algorithms—naïve bayes, k-nearest neighbor (KNN), and decision tree—and compares their overall accuracy, precision, as well as recall values, f-measure, number of tweets correctly classified, number of tweets incorrectly classified, and execution time.
2D- and 3D-QSAR and Molecular Docking of 2-Hydroxyisoquinoline-1,3-Diones as Inhibitors of HIV Reverse Transcriptase
Authors: Aanouz Ilham , El Khatabi Khalil , Assia BelHassan  , Lakhlifi Tahar , Elidrissi Mostafa , Bouachrine Mohammed
Published: September 2020

The main objective of this study is to develop 2D- and 3D-QSAR statistical models for a series consisting of 28 molecules. The authors started with a 2D study based on principal component analysis (PCA), multiple linear regression (RLM), and nonlinear regression (RNLM). The models were developed using 28 molecules with a pIC50 between 5.70 and 6.70. Then they applied 3D-QSAR analysis based on the partial least squares (PLS) method. For 3D-QSAR, they used the molecular field comparative analysis (CoMFA) and comparative molecular similarity index (CoMSIA) methods. For this analysis, they have worked on a training set of 24 compounds, which then give acceptable and reliable values of Q2 (0.791 and 0.538, respectively) and R2 (0.974 and 0.98, respectively). To determine the quantitative 3D-QSAR, the interpretations were based on the contour maps which are produced by the CoMFA and CoMSIA models. In addition, molecular docking is also one of the most important methods for confirming the binding interactions of predicted molecules with their receptors.
The Influences of Knowledge Management and Customer Relationship Management to Improve Hotels Performance
Authors: Brahami Menaouer , Adjaine Mammar , Semaoune Khalissa , Matta Nada
Published: September 2020

The motivations for a company to adopt Knowledge Management (KM) and Customer Relationship Management (CRM) systems can be very varied, which brings an additional complexity to the adoption decision. It is important to understand the main drivers of KM and CRM adoption so that companies can better target their performance indicators. However, the influence of KM on organization performance in hotel industry has received less attention. In addition, the relationship between CRM technology and hotel performance is still ambiguous. In the right context, this paper tends to bring attention to the influences of KM and CRM to improve hotels performance. It presents and discusses the main findings of a study undertaken among a sample of large hotels Algerian, identifying and discussing the main motivations for KM and CRM systems utilization and adoption in order to improve hotels performance. A survey of 80 hotels executives was conducted on hotels operating in the Algeria west territory. In short, the results of this study may help these businesses to effectively use KM and CRM, so as to improve hotels performance and subsequently create a sustainable competitive advantage.
A Comparative Study of Trust in Mobile Banking
Authors: Lonkani Ravi , Changchit Chuleeporn , Klaus Tim , Sampet Jomjai
Published: September 2020

With the rapid growth of mobile phone usage, mobile services have influenced many industries including banking. Mobile banking has become a popular service as it offers a convenient channel for customers to perform banking transactions. Nevertheless, not all customers feel safe performing financial transactions online. Trust has become a crucial element on whether customers choose to use mobile banking. As a comparative study, this research examines factors and bank customers' characteristics that influence trust in mobile banking between U.S. and Thai mobile banking customers. Three hundred and eight USA consumers and two hundred and fifty-two Thai consumers participated in this study. The results found multiple significant factors influencing trust and usage of mobile banking. This study expands on previous trust and mobile banking usage research and provides practical implications for cross-cultural strategies in mobile banking.
Epidemiology of Boys' Club Lacrosse Injuries During the 2018 Summer Lacrosse Season
Authors: McGinnis Ian William , Mair K. Ellis F. , Mansell Jamie , Collins Christy
Published: September 2020

Context

In the past 10 years, participation in boys' youth and high school lacrosse has increased by 33%. Among many club teams and tournaments, athletes may not have access to medical coverage. Additionally, these athletes face a higher volume of play than in traditional scholastic sport settings.

Objective

To describe the injury characteristics of boys' nonscholastic youth and high school club lacrosse athletes over the course of a summer season.

Design

Descriptive epidemiology study.

Patients or Other Participants

Boys' nonscholastic youth and high school lacrosse athletes, aged 8 to 18 years, who competed in tournaments.

Main Outcome Measure(s)

Athletic trainers at tournaments were given standardized injury report forms to document patient encounters. These reports were then entered into the Datalys Injury Surveillance Tool.

Results

Over the summer tournament season, 233 injuries were reported in 109 342 athlete-exposures (AEs) for an injury rate of 2.13 per 1000 AEs (95% confidence interval = 1.87, 2.42). The most frequently injured body parts were the head and/or face (n = 51, 22%), arm and/or elbow (n = 34, 15%), and hand and/or wrist (n = 29, 12%). The most common diagnoses were contusions (n = 63, 27%), concussions (n = 44, 19%), fractures (n = 39, 17%), and sprains (n = 35, 15%). The most often injured position was midfielder (n = 65, 41%), followed by defense (n = 48, 30%), attack (n = 36, 23%), and goalkeeper (n = 9, 6%). The concussion rate was 0.4 per 1000 AEs (95% confidence interval = 0.28, 0.52).

Conclusions

The injury rate experienced by boys' nonscholastic club lacrosse athletes was similar to the rates of their high school counterparts as well as school-sponsored football and wrestling athletes. Because of the risk of injury, athletic training services should be available for youth and high school club lacrosse tournaments.
Patient Care Documentation in the Secondary School Setting: Unique Challenges and Needs
Authors: Kasamatsu Tricia M. , Nottingham Sara L. , Eberman Lindsey E. , Neil Elizabeth R. , Welch Bacon Cailee E.
Published: September 2020

Context

Athletic trainers (ATs) recognize patient care documentation as an important part of clinical practice. However, ATs using 1 electronic medical record (EMR) platform reported low accountability and lack of time as barriers to documentation. Whether ATs using paper, other EMRs, or a combined paper-electronic system exhibit similar behaviors or experience similar challenges is unclear.

Objective

To explore ATs' documentation behaviors and perceived challenges while using various systems to document patient care in the secondary school setting.

Design

Qualitative study.

Setting

Individual telephone interviews.

Patients or Other Participants

Twenty ATs (12 women, 8 men; age = 38 ± 14 years; clinical experience = 15 ± 13 years; from National Athletic Trainers' Association Districts 2, 3, 6, 7, 8, 9, and 10) were recruited via purposeful and snowball-sampling techniques.

Data Collection and Analysis

Two investigators conducted semistructured interviews, which were audio recorded and transcribed verbatim. Following the consensual qualitative research tradition, 3 researchers independently coded transcripts in 4 rounds using a codebook to confirm codes, themes, and data saturation. Multiple researchers, member checking, and peer reviewing were the methods used to triangulate data and enhance trustworthiness.

Results

The secondary school setting was central to 3 themes. The ATs identified challenges to documentation, including lack of time due to high patient volume and multiple providers or locations where care was provided. Oftentimes, these challenges affected their documentation behaviors, including the process of and criteria for whether to document or not, content documented, and location and timing of documentation. To enhance patient care documentation, ATs described the need for more professional development, including resources or specific guidelines and viewing how documentation has been used to improve clinical practice.

Conclusions

Challenges particular to the secondary school setting affected ATs' documentation behaviors, regardless of the system used to document care. Targeted professional development is needed to promote best practices in patient care documentation.
A Social-Marketing Intervention and Concussion-Reporting Beliefs
Authors: Warmath Dee , Winterstein Andrew P.
Published: September 2020

Context

Concussion-symptom education remains the primary approach used by athletic trainers to address underreporting of possible sport-related concussions. Social marketing represents an untapped approach to promote concussion reporting by communicating the benefits or consequences of reporting or not reporting, respectively.

Objective

To apply expectancy value theory and identify how marketing the possible consequences of concealing concussion symptoms influenced young adults' concussion-reporting beliefs to increase the likelihood of reporting.

Design

Randomized controlled clinical trial.

Setting

Laboratory.

Patients or Other Participants

A total of 468 competitive collegiate club sport athletes at a large US university who engaged in 1 of 46 sports with various levels of concussion risk.

Intervention(s)

Participants were randomly assigned by team to 1 of 3 conditions. The treatment condition was a social-marketing program focused on the possible consequences of the reporting decision. The control condition was traditional concussion-symptom education based on the National Collegiate Athletic Association's publication, “Concussion: A Fact Sheet for Student-Athletes.” An additional condition mirrored the traditional symptom education but included a less clinical delivery.

Main Outcome Measure(s)

Positive and negative beliefs regarding concussion reporting were assessed. We applied expectancy value theory, which posits that changing beliefs in the short term will produce greater reporting intentions in the long term.

Results

Club sport athletes exposed to consequence-based social marketing showed higher levels of positive reporting beliefs and lower levels of negative reporting beliefs than athletes exposed to traditional or revised symptom education. We observed no differences between the traditional and revised symptom-education programs. Exposure to consequence-based marketing decreased negative beliefs about reporting (B = −0.165, P = .01) and increased positive beliefs about reporting (B = 0.165, P = .01).

Conclusions

Social marketing offers athletic trainers another strategic tool for motivating athletes to report concussion symptoms by translating scientific findings into marketable statements and then communicating the benefits of reporting or the negative consequences of concealing concussion symptoms.
A new health care profession in rural district hospitals: a case study of the introduction of Clinical Associates in Shongwe hospital
Authors: Bac M , Hamm J M A , Van Bodegraven P C , Pater B , Louw J M
Published: September 2020

Background: One of the reasons to develop training courses for medical mid-level workers in South Africa is a shortage of doctors. The introduction of this new profession has led to task sharing and redefining of professional boundaries. The primary aim of this study is to evaluate the introduction of new healthcare professionals in a rural hospital district.

Methods: This multi-method qualitative research study used a semi-structured questionnaire to assess the effectiveness of Clinical Associates. A review of documents from 2012 to 2015 was done including a longitudinal study of the development of the Bachelor in Clinical Medical Practice (BCMP) programme at Shongwe hospital.

Results: Three Clinical Associates in 2011 and six Clinical Associates in 2014 completed questionnaires. Student satisfaction increased as measured with the Med IQ tool. At the end of 2013 Shongwe Clinical Learning Centre (CLC) had improved from last position out of 17 CLCs in 2011 to position number eight in 2014. Casualty was run by Clinical Associates and during observations it became clear that Clinical Associates were able to take responsibility for outpatient departments (OPDs), the emergency unit and some wards with supervision by a doctor.

Conclusion: The introduction of the BCMP programme and the establishment of a Clinical Learning Centre in Shongwe hospital have led to improved patient care and a more conducive environment for teaching and learning. With the availability of more Clinical Associates vacant medical officer posts can be converted to employ Clinical Associates to serve patients without an increase in the cost of total human resources.

(Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)

S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1248144
Illegible handwriting and other prescription errors on prescriptions at National District Hospital, Bloemfontein
Authors: Brits H , Botha A , Niksch L , Terblanché R , Venter K , Joubert G
Published: September 2020

Background: It is generally accepted that doctors have illegible handwriting. The writer usually knows what is written, but other parties often have problems with reading and interpreting.

Aim: The aim of the study was to determine whether illegible doctors’ handwriting and other factors that can lead to dispensing errors occur on prescriptions at National District Hospital.

Method: In part one the prescriptions of 20 doctors were read by five doctors, nurses and pharmacists to detect who could read it most accurately. In part two, these doctors were asked to write a prescription with an IntelliPen®.

Results: From the 300 measurements, 88% of the doctors read the prescriptions correctly, compared with 82% of the nurses and 75% of the pharmacists. A potential fatal error was lorazepam injection 4 mg, which was read as 40 mg (lethal dose) by 20% of healthcare workers (HCWs). With the IntelliPen® only 39% of the prescriptions were readable. Only 65% of prescribers could be identified from their handwriting or the name stamp used.

Conclusion: Pharmacists read the prescriptions worst and they are the people who must dispense the prescriptions. Some of the reading mistakes were critical and could be lethal. Many of the prescriptions did not meet the legal requirement for prescriptions.

(Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)

S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1254932
Mastering your fellowship (Online)
Authors: Naidoo Mergan , Mabuza Langalibalele Honey , Ross Andrew
Published: September 2020

The series, “Mastering your Fellowship”, provides examples of the question format encountered in the written Final Part A of the FCFP (SA) examination. The series is aimed at helping family medicine registrars prepare for this examination. Model answers are available online.
Common cutaneous dermatophyte infections of the skin and nails
Authors: Marais André , Osuch Elzbieta
Published: September 2020

Superficial fungal infections occur in approximately 20% of the population. Dermatophyte infections are mainly caused by organisms from the Trichophyton, Epidermophyton, and Microsporum genera, and should not be confused with infections caused by Candida sp. since management may differ. The diagnosis of cutaneous dermatophyte infections are confirmed with potassium hydroxide (KOH) preparations as clinical diagnosis is not always accurate, and may result in inappropriate treatment. Most dermatophyte infections are successfully managed with topical antifungal preparations; however, systemic therapy provides an increased cure rate and reduces re-occurrence. This review focuses on the most common dermatophyte infections seen by South African health-care providers and briefly describes the available treatment options, which may differ from agents used elsewhere in the world.
Colds and flu – an overview of the management
Authors: Ismail Halima , Schellack Natalie
Published: September 2020

The common cold and flu are two very different viruses that share very similar symptoms. The common cold is a self-limiting upper respiratory tract infection and it is caused by the rhinovirus, coronavirus or the adenovirus. It usually resolves within 7-10 days. The flu is caused by the influenza virus and usually presents with headaches, myalgia, fever and body aches. There is no place for antibiotic usage in colds and flu and there is no clinical evidence which suggests that using antibiotics alters the course of the disease or prevents secondary infection. Treatment is mainly symptomatic and includes many over the counter medicines, antivirals and herbal treatment.
Review of once-monthly oral ibandronate and the use thereof
Authors: De Villiers T , Davey M , Cassim B , De Lange W
Published: September 2020

An advisory board meeting of key opinion leaders was held in 2015 to discuss the clinical data on oral ibandronate in the treatment of postmenopausal osteoporosis.

Boniva 150 mg (ibandronate) oral once-monthly is indicated for the treatment of osteoporosis in postmenopausal women, in order to reduce the risk of vertebral fractures.1
Factors associated with failed spinal anaesthesia for Caesarean sections in Mthatha general hospital, Eastern Cape, South Africa
Authors: Alabi Adeyinka Abiodun , Adeniyi Oladele Vincent , Adeleke Olukayode Ademola , Pilla Pamela , Haffajee Mohamed Rashid
Published: September 2020

Background: The use of spinal anaesthesia has increased in the last three decades, given that it is the recommended anaesthetic of choice for better foetal and maternal outcomes in Caesarean section. Failed spinal anaesthesia (FSA) exposes patients to unfavourable experience of pain and the potential complications of general anaesthesia that are being avoided in the first instance. This study determines the incidence and the predictors of failed spinal anaesthesia in pregnant women presenting for Caesarean section at Mthatha General Hospital, Eastern Cape.

Methods: This descriptive cross-sectional study included 197 pregnant women scheduled for Caesarean section under spinal anaesthesia at Mthatha General Hospital from May 1 to August 30, 2013. A standard proforma was utilised for data collection on items of demographic, surgical and anaesthetic records of each parturient. The main outcome measure was the incidence of failed spinal anaesthesia (defined as partial or incomplete spinal block requiring conversion to general anaesthesia).

Results: The incidence of failed spinal anaesthesia was 11.7%, which was slightly higher in emergency Caesarean sections. In univariate analysis, previous anaesthesia, obesity, dry tap of cerebrospinal fluid (CSF), bloody CSF and duration of work experience less than one year were significantly associated with FSA in the cohort.

Conclusion: The study found a high incidence of failed spinal anaesthesia during Caesarean section in this setting. Upskilling of doctors in spinal anaesthesia is urgently needed in the study setting.

(Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)

S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1292696
Knowledge of Zika virus disease among reproductive-age women attending a general outpatient clinic in Northern Nigeria
Authors: Michael G C , Aliyu I , Grema B A , Ashimi A O
Published: September 2020

Background: Nigeria is not insulated from the global threat of Zika virus disease (ZVD) because of international travel and the presence of Zika-virus-carrying mosquitoes in the country. A paucity of studies exists concerning knowledge of ZVD among atrisk populations. Thus, the necessity for assessment of knowledge of ZVD among reproductive-age women in general outpatient setting.

Materials and methods: A cross-sectional study was conducted on 377 reproductive-age women attending a Nigerian tertiary hospital’s general outpatient clinic. Their knowledge of ZVD was assessed using a structured questionnaire. A chi-square test was used to assess the relationship between participants’ sociodemographics and ZVD knowledge.

Results: The participants’ median age was 27.0 ± 7.19 years. Though 68.97% of participants were aware of ZVD, only 23.85% of those had good knowledge of ZVD. Their median knowledge score was 57.14%. Participants’ age (< 27 years) (p = 0.00399), tribe (Hausa) (p = 0.0174) and monogamous family type (p = 0.0108) were associated with good knowledge of ZVD. Only 5% knew that ZVD is transmitted through both mosquito bites and a sexual route. Some 80% were unaware that everybody was at risk of ZVD but 80.77% knew it could cause microcephaly. Insecticide-treated nets (80.77%), environmental sanitation (78.08%) and indoor insecticide spraying (58.85%) were preventive measures reported by most participants; a minority reported mosquito repellents (28.46%), wearing of protective clothing (36.15%), and traditional medicines (20.00%) as preventive measures. They lacked knowledge of prevention of sexual transmission.

Conclusion: Participants’ knowledge of ZVD was inadequate despite the high awareness rate. Stakeholders may need to address existing knowledge gaps through effective public enlightenment.

(Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)

S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1313484
Mastering your fellowship (Online)
Authors: Von Pressentin Klaus B , Naidoo Mergan , Ross Andrew , Ras Tasleem
Published: September 2020

The series, “Mastering your Fellowship”, provides examples of the question format encountered in the written examination, Part A of the FCFP (SA) examination. The series is aimed at helping family medicine registrars prepare for this examination. Model answers are available online.
Death and dying: elderly persons’ experiences of grief over the loss of family members
Authors: Lekalakala-Mokgele Eucebious
Published: September 2020

Background: Death is one of life’s few certainties and a universal experience for all individuals. When death occurs there is usually an impact on the family and friends of the deceased, the magnitude of which often depends on whether death was expected or unexpected. The grieving experiences of the elderly are rarely discussed. The purpose of this study was to describe experiences of grief and reactions to the death of family members amongst the elderly.Methods: A qualitative phenomenological approach was used to obtain data from elderly women in Ga-Rankuwa, Gauteng, to gain insight into the experiences of grief in this age group. Purposive sampling was used to conduct in-depth interviews with 10 elderly women whose family members had died. The data were analysed using a thematic approach.Results: The findings show that the elderly were exposed to multiple deaths of family members. The participants helplessly experienced with sorrow the death of family members, had experienced death anxiety, and relinquished control to God in terms of deaths.Conclusions: The response to death of the elderly affirms that it cannot be assumed that multiple death experiences establish their readiness or ability to handle these experiences and to grieve successfully. It can be concluded that the grieving process of the elderly is not different from any other age group and that they will also require the type of support and assistance considered for younger persons in times of grieving.
Association of Insulin, Metformin, and Statin with Mortality in Breast Cancer Patients
Authors: Choi Mihong , Han Jiyeon , Yang Bo Ram , Jang Myoung-jin , Kim Miso , Lee Dae-Won , Kim Tae-Yong , Im Seock-Ah , Lee Han-Byoel , Moon Hyeong-Gon , Han Wonshik , Noh Dong-Young , Lee Kyung-Hun
Published: September 2020

Purpose This study investigated the association of insulin, metformin, and statin use with survival and whether the association was modified by the hormone receptor status of the tumor in patients with breast cancer.Materials and Methods We studied 7,452 patients who had undergone surgery for breast cancer at Seoul National University Hospital from 2008 to 2015 using the nationwide claims database. Exposure was defined as a recorded prescription of each drug within 12 months before the diagnosis of breast cancer.Results Patients with prior insulin or statin use were more likely to be older than 50 years at diagnosis and had a higher comorbidity index than those without it (p < 0.01 for both). The hazard ratio (HR) for death with insulin use was 5.7 (p < 0.01), and the effect was attenuated with both insulin and metformin exposure with an HR of 1.2 (p=0.60). In the subgroup analyses, a heightened risk of death with insulin was further prominent with an HR of 17.9 (p < 0.01) and was offset by co-administration of metformin with an HR of 1.3 (p=0.67) in patients with estrogen receptor (ER)–negative breast cancer. Statin use was associated with increased overall mortality only in patients with ER-positive breast cancer with HR for death of 1.5 (p=0.05).Conclusion Insulin or statin use before the diagnosis of breast cancer was associated with an increase in all-cause mortality. Subsequent analyses suggested that metformin or statin use may have been protective in patients with ER-negative disease, which warrants further studies.
Are risk factors for non-communicable diseases in adolescents a problem in senior high schools in Accra?
Authors: Bandoh Delia , Sunkwa-Mills Gifty , Kenu Ernest
Published: September 2020

Background: We assessed risk factors of noncommunicable diseases (NCDs) among adolescents in a senior high schoolDesign: We conducted a cross-sectional study in 2016Setting: Senior High School in AccraParticipants: Adolescents in senior high schoolInterventions: Adolescents were interviewed with a structured questionnaire designed using the WHO STEPS framework. Data on tobacco use, alcohol consumption, physical activity and physical measurements of respondents were taken.Main outcome measures: risk factors of noncommunicable diseases among adolescentsResults: A total of 360 adolescents in the school were assessed. Mean age was (17±1.21) years with minimum age being 13 and maximum 19 years. Females were 51% (184/360). About 75% (271/360) reported low physical activity, 15% (55/360) were overweight or obese (95%CI: 0.0317-0.078), 7.0% (25/360) consumed alcohol (95%CI: 0.054-0.111) and 2.5% (9/360) smoked tobacco (95%CI: 0.013- 0.048). Majority of the respondents (346/360) were exposed or at risk of developing at least one risk factor. However, no one was found to be at risk of all five risk factors assessed. Females were three times more likely to be overweight or obese compared to their male counterparts (OR:3,95%CI:1.581-5.624)Conclusion: We found that majority of the children had low physical activity and more than 90% of the respondents had at least one NCD risk factor.Keywords: noncommunicable diseases, risk factors, physical activity, tobacco use, consumption of alcoholFunding: This work was funded by the authors
Barriers to early infant diagnosis of HIV in the Wa Municipality and Lawra District of Upper West Region, Ghana
Authors: Nuoh Robert , Nyarko Kofi , Noora Charles , Addo-Lartey Adolphina , Nortey Priscillia , Nuolabong Culbert , Lartey Margaret , Kenu Ernest
Published: September 2020

Objective: We identified socio-demographic, health system and psycho-social barriers to Early Infant Diagnosis (EID) of HIV in the Upper West Region of Ghana.Design: An unmatched case control study of 96 cases and 96 controls was conducted in the ART centers in Lawra district and Wa Municipality between December 2014 and April 2015.Setting: A public health facilityParticipants: We defined a case as an HIV positive mother with an exposed infant who received EID service between January 2011 and December 2014. A control was defined as HIV Positive Mother with an exposed infant who did not receive EID services between January 2011 and December 2014.Main outcome: EID by dry blood spot Deoxyribonucleic acid Polymerase chain reaction.Results: A total of 192 mother-infant pairs were assessed. The mean age of infants at testing for cases was 17.3±14.9 weeks. Mother-to-child-transmission-rate was 2.3%. Factors associated with EID testing included: mother being formallyemployed (cOR=2.0: 95%CI:1.1-3.8), maternal formal education (cOR=2.0, 95%CI: 1.1-3.6) and maternal independent source of income (cOR 2.2, 95%CI 1.2-4.1). After adjusting for confounders, maternal independent incomebsource was associated with EID testing (aOR 2.2, 95%CI 1.2-4.1). Median turn-around time of EID result was 11 weeks (IQR 4-27weeks).Conclusion: Women need to be empowered to gain an independent source of income. This can help maximize the benefits of e-MTCT and increase EID in the Upper West Region of Ghana.Keywords: Barriers; HIV; early infant diagnosis; DNA-PCR; GhanaFunding: This work was funded by the authors
Sexual experiences of adolescents and young adults living with HIV attending a specialized clinic in Accra, Ghana
Authors: Kenu Ernest , Bandoh Delia , Adu Rita , Akwa Adwoa , Sam Mariam , Lartey Margaret
Published: September 2020

Background: We assessed sexual experiences among adolescent and young adults living with HIV (AYALHIV) attending the adolescent HIV care clinic in Korle Bu Teaching Hospital (KBTH)Design: Cross-sectional study conducted in 2015.Setting: HIV clinic at KBTHParticipants: AYALHIV who attended the adolescent HIV care clinicInterventions: AYALHIV were interviewed with a structured questionnaire to obtain data on their socio-demographic characteristics and sexual experiences. The data was analyzed with STATA version 13.Main outcome measures: sexual experiences of adolescents and young people living with HIVResults: Of 101 participants, 60.4% (61/101) were males. The mean age of respondents was (18±3.2) years with an average age at sexual debut (16.2±4.2) years. A third of the respondents (34/101) had had sex before and out of them 76.5% (26/34) were males. Seventeen percent (4/23) had multiple sexual partners and 38.1% (8/21) of sexually active use condom at last sexual intercourse. Eighty-six percent (87/101) of respondents knew their HIV status, 66.7% (58/87) of them were males. There was a significant association (p<0.05) between being male and knowledge of HIV positive status. Knowledge of a respondents’ HIV positive status was found to be positively associated with ever using condom.Conclusion: Sexual experience prevalence is high among AYALHIV. More males were sexually active, not using condom and had multiple sexual partners. Safer sexual practices such as consistent use of condoms, need to be intensifiedespecially during counselling sessions. This could contribute to the reduction in prevalence of HIV among the adolescents in the country.Keywords: adolescents; young people; HIV; sex education; sexual experienceFunding: This work was funded by the authors
Evaluation of viral haemorrhagic fever surveillance system with focus on Ebola virus disease, Bawku municipality- Upper East Region, Ghana, 2011- 2015
Authors: Broni Francis , Larbi Joseph , Afari Edwin , Nyarko Kofi , Ameme Donne , Kenu Ernest
Published: September 2020

Background: We evaluated the Viral haemorrhagic fever (VHF) surveillance system from 2011 to 2015 in the Bawku Municipality, Upper East region, Ghana to determine whether the goals of the surveillance system are being met and to assess the performance of the system attributes.Design: Descriptive secondary data analysis.Setting: Bawku MunicipalityData Source: Review VHF surveillance records, interviewed community-based surveillance volunteers (CBSVs) and reviewed vital events registers. We also assessed the system attributes by reviewing records and interviewing key stakeholders involved in VHF surveillance system with focus on Ebola using checklist and semi structured questionnaire developed based on the Centers for Disease Control and Prevention (CDC) guidelines.Main outcome measure: System attributes of the VHF surveillance systemResults: Population under surveillance was 105,849. The system required detail information about suspected cases. However, it had a simple and clear standard case definitions, and was well integrated with the IDSR. There is a regular and timely flow of information. The system captured 155 suspected cases nationwide from 2011 to 2015 and all tested negative. Of these, Upper East Region reported 10 suspected cases including 4 suspected cases from Bawku Municipality.Conclusion: The VHF surveillance system achieved its objectives. However, poor data quality, inadequately trained surveillance officers, and inadequate financial support are threats to the effectiveness of the system.Keywords: Viral haemorrhagic fever, surveillance system evaluation, attributes, Bawku Municipality, GhanaFunding: This work was supported by Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana
Vulture updates No 11 - October 2019 - Around the World of Vultures & VSG activities
Authors: Murn Campbell
Published: September 2020

No Abstract.
Effect of Personalized Learning on Mathematics Performance among Secondary Schools in Awendo Sub-County, Kenya
Authors: Ogwari Peter , Mendoza-Role Elizabeth , Amimo Catherine
Published: September 2020

This study explored the effect of Personalized Learning (PL) on mathematics performance, based on the Social Constructivism Theory of Learning. Purposive sampling was used to select one school with 40 form one students taught by one teacher. Data collection techniques used included video recording and photos, observation schedules, questionnaires and achievement examination. Data was analyzed using descriptive statistics (mean, standard deviation) and Mann-Whitney U Test. Findings revealed that both the experimental and control group, with 20 students per group, had same level of achievement before PL was implemented. The Posttest showed that the experimental class had a higher performance index than the control at 74.15% against 68.95%. With a p value of 0.957 > 0.05, the difference between the posttest scores of the experimental group and the control group was considered not significant. The p-value of 0.594 > 0.05 also indicated that posttest scores of the male and female students in the experimental group is not significant. The implementation was generally good for Student Ownership and Reflection (M=3.21; SD= 0.49), areas of Targeted Instruction (M=2.92; SD= 0.69), Flexible Content Tools and Learning Environment (M= 2.86; SD= 0.64520. However, inconsistency was observed mostly in the implementation of PL which focused on group work, student’s interests, needs, skill level and one on one support. The study recommends that Mathematics teachers should be inducted in PL particularly in the use of Flexible Content Tools and Learning Environment that factors in student’s interests, needs, skill level and support.