bluuebunny/crossref_metadata_2025 huggingface dataset:
Number needed to screen to prevent progression of liver fibrosis to cirrhosis at primary health centers
Authors: Nagappa Bharathnag , Ramalingam Archana , Rastogi Aayushi , Dubey Shantanu , Thomas Sherin Sarah , Gupta Ekta , Sarin Shiv Kumar
Published: April 2021

Background:

Early diagnosis has been a bottleneck in the care of chronic liver disease patients and can be addressed by Community-based screening for liver fibrosis using non-invasive diagnostic techniques.

Objectives:

The study aimed to determine the prevalence of liver fibrosis and the number needed to screen (NNS) to prevent the progression of fibrosis, among adults visiting urban Primary Health Centres (PHC).

Methods:

A facility-based cross-sectional study was conducted from May 2018 to April 2019 in 72 randomly chosen PHCs using a mobile screening van. A pre-tested questionnaire was used to collect relevant history from adult patients and patient attenders. A venous blood sample was collected for biochemical markers and Transient Elastography was also done to measure Liver stiffness (LSM). LSM ≥6.0 kPa was taken as the cut-off for detecting liver fibrosis. Lifestyle modifications and alcohol cessations were considered as interventions for non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) respectively, to calculate NNS.

Results:

7624 participants were recruited in the study with a mean age of 46 ± 12 years. Around 35.5% of participants had liver fibrosis and 3% had cirrhosis. Nearly 4% had ALD and 30% had NAFLD. NNS for preventing progression of fibrosis for ALD and NAFLD was 12 and 29 respectively. NNS was least among obese, diabetes and hypertensive participants.

Conclusion:

One-third of adults visiting urban PHCs had significant liver fibrosis. Low NNS to prevent the progression of fibrosis to cirrhosis among alcohol users and other high-risk groups, substantiates the need for screening among these groups.
Comparing topical administration of lidocaine alone and in combination with alfentanil in children undergoing bronchoscopy
Authors: Takzare Alireza , Ariana Parastou , Malekianzadeh Bita , Goudarzi Mehrdad , Espahbodi Ebrahim
Published: April 2021

Introduction:

Airway surgery and endoscopy in pediatric patients are always associated with challenges in anesthesia management. Deep anesthesia is required for preventing patient bucking during the procedure but patient breath should be maintained; in this regard, a combination of general and topical anesthesia can be beneficial. There is also evidence of the peripheral effects of opioids. The main objective of this study is to compare using lidocaine topically alone and combined with alfentanil opioids with respect to the central effects of opioids.

Methods:

In this study, 40 ASA class I and II children, aged 1–6 years, who were candidates for flexible diagnostic bronchoscopy were divided into two groups through block randomization using the random number table after obtaining parents' consent in complete health conditions. In this clinical trial, for collecting the data a special data collection form was used at the bedside of patients undergoing bronchoscopy at Pediatric Medical Center in 2017. Data including demographic information (age, weight, gender), duration of anesthesia, blood pressure before and after drug administration, duration of bronchoscopy, and recovery time were recorded in a form.

Findings:

In terms of demographic variables, there were not any significant differences between the two studied groups, indicating that the groups were matched and randomized appropriately. Although there were not any significant differences between the two groups of using lidocaine alone and in combination with alfentanil in other variables, in the recovery time a significant difference was observed between the two groups, with a mean of 13.05 min in the lidocaine group and 18.75 min in the lidocaine combined with alfentanil group.

Conclusion:

Topical administration of opioid with lidocaine through bronchoscopy had no impact on blood pressure, heart rate, anesthesia duration, and the frequency of perioperative complications.
Coverage, utilization, and impact of Ayushman Bharat scheme among the rural field practice area of Saveetha Medical College and Hospital, Chennai
Authors: Sriee G.V Vishnu Priya , Maiya G. Rakesh
Published: April 2021

Introduction:

Ayushman Bharat scheme, otherwise called as Pradhan Mantri Jan Arogya Yojana (PMJAY), is a National Health Protection Scheme introduced on 23 September 2018 by the government of India to aid the economically disadvantaged families.

Aim:

The study was initiated to estimate the coverage, utilization, and impact of Ayushman Bharat scheme in the rural field practice area of Saveetha Medical College and Hospital, Chennai.

Settings and Design:

This is the cross-sectional study conducted in the rural field practice area of Saveetha Medical College and Hospital, Chennai.

Methods and Material:

This cross-sectional study done among 300 households in Mappedu region of Thiruvallur district, Tamil Nadu. Simple random sampling was done to choose the study participants to reach the sample size of 300. Data was collected using semi-structured questionnaire. After the entry of data, the descriptive statistics was presented in frequency tables and graph.

Result:

The study found that out of 300 households only about 42.33% of the households were covered under Ayushman Bharat scheme. Among the households covered under Ayushman Bharat scheme, 47.24% households have availed Ayushman Bharat scheme in the past 1 year and only 10% of those availed the scheme has spent additional amount for health care. Around 39.88% of the households not having Ayushman Bharat scheme has faced financial burden because of health care expenditure.

Conclusion:

Creating awareness, appropriate governance, and working toward quality assurance, prompt referral pathways in both public and private healthcare providers can make Ayushman Bharat scheme effective.
Prevalence and predictors of exclusive breastfeeding in urban slums, Bihar
Authors: Kazmi Shahwar , Akparibo Robert , Ahmed Danish , Faizi Nafis
Published: April 2021

Objective:

Various socio-cultural factors influence infant feeding practices and thus early childhood nutrition and child survival in India. This study aimed to examine the prevalence of exclusive breastfeeding, its promoters and barriers in urban slums of Bihar, India.

Methods:

We conducted a community based cross-sectional survey involving 297 mothers living in slum settlements in Bihar. Data were collected using structured questionnaire on exclusive breastfeeding practices, and the factors that could influence this. Descriptive analysis was done to estimate the prevalence of exclusive breastfeeding and regression model was performed to identify the predictors of exclusive breastfeeding.

Results:

Only 23% of mothers initiate breastfeeding within 1 hour of delivery and 27.6% mothers practise exclusive breastfeeding up to six months. Mother's education was found to be associated with duration of exclusive breastfeeding (OR 11, 95% CI 2-59). Term babies were more likely to be breastfed exclusively for six months than pre-term babies (OR 8.6, 95% CI 1.6-47.6). Antenatal care visits and completing immunization were significantly associated with duration of exclusive breastfeeding (P < 0.001). The majority of mothers acquire exclusive breastfeeding knowledge through television/radio (OR 68, 95% CI 5.5-832.5) and newspaper advertisements (OR 14, 95% CI 2.6-76).

Conclusion:

Prevalence of exclusive breastfeeding up to six months of age and early initiation of breastfeeding remains low in slums of Bihar. Exclusive breastfeeding and early initiation of breastfeeding rates could be improved by educating and counselling mothers during health facility contacts by primary care providers.
Diploma in primary care psychiatry
Authors: Pahuja Erika , Santosh K.T. , Harshitha Nisha , Malathesh Barikar C. , Manjunatha Narayana , Kandasamy Arun , Kumar Channaveerachari Naveen , Math Suresh Bada
Published: April 2021

Background:

Cannabis is one of the most used illicit substances in India but is under-recognized and under-represented in clinical settings of India, especially at primary care. Patients usually do not seek treatment primarily for cannabis use, but it is identified on pro-active questioning by doctors. The aim is to study the clinical profiles of patients with cannabis use disorders (CUD) at primary care and to derive learning points from collaborative consultations to devise an optional module for CUD primarily for primary care doctors (PCDs).

Methods:

File review of general patients with cannabis use, identified by PCDs during collaborative video consultation module of Diploma in Primary Care Psychiatry, was performed, and their profile and management difficulties were assessed.

Result:

Twelve patients with a mean age of 31.25 ± 12.04 years were identified by PCDs over a year. All were males with psychosis being the most common comorbidity. None of the patients presented primarily for cannabis use disorder.

Conclusion:

Identifying cannabis use among patients visiting PCDs becomes all the more important as the use of cannabis is not usually revealed spontaneously unless specifically probed. This warrants establishing guidelines for CUD specifically for use of PCDs for identifying and managing CUD.
Immuno-inflammatory predictors of disease severity in COVID-19
Authors: Panda Suchismita , Nanda Rachita , Tripathy Prasanta Kumar , Mangaraj Manaswini
Published: April 2021

Deregulated immune response and raised inflammation are the cardinal laboratory features in COVID-19 infection reflecting severity of condition. Detection of the markers will help in early diagnosis with timely therapeutic implementation and effective outcome. Observational studies have suggested alteration in these parameters with severity of the condition. This systematic review and meta-analysis was conducted to assess the relevance of the fact. Observational studies from databases were scrutinised and 3669 articles were identified. Further screening, based on the inclusion criteria a total of 19 articles with 3115 participants, were reviewed for meta-analysis using random effects model. Any data in median and interquartile range were converted to mean ± SD. There was a significant rise in total leukocyte count, C-reactive protein, ferritin, IL-6, IL-10, procalcitonin in severe cases but absolute lymphocyte count, CD4+ and CD8+ registered a fall in severe cases in comparison to non-severe group. Immune and inflammatory markers are significantly altered and related to severity of manifestation in COVID-19 infection.
Antimicrobial resistance (AMR) at the community level
Authors: Balachandra Swathi S. , Sawant Prathamesh S. , Huilgol Poorva G. , Vithya T. , Kumar GS , Prasad Ramakrishna
Published: April 2021

Context:

The emergence of antimicrobial resistance (AMR) is a major public health crisis in India and globally. While national guidelines exist, the sources of data which form the basis of these guidelines are limited to a few well-established tertiary care centres. There is inadequate literature on AMR and antibiotic mismatch from India at community level and even less literature on AMR patterns from rural India.

Aims:

The aims of this study were as follows: 1) to describe the patterns of AMR at an urban tertiary care hospital and a rural 100 bedded hospital; 2) to compare and contrast the AMR patterns noted with published ICMR guidelines; 3) to examine the issue of AMR and antibiotic mismatch; and 4) to identify local factors influencing drug-bug mismatch at the local level.

Settings and Design:

The data were obtained from two independently conceived projects (Site 1: Urban tertiary care hospital, Site 2: Rural 100-bedded hospital).

Methods and Materials:

Local antibiograms were made, and the antibiotic resistance patterns were compared between the urban and rural sites and with data published in the 2017 ICMR national guideline for AMR.

Statistical Analysis Used:

Descriptive statistics including means and medians were used.

Results:

Our data reveal: a) a significant mismatch between sensitivity patterns and antibiotics prescribed; b) The national guidelines fail to capture the local picture of AMR, highlighting the need for local data; and c) challenges with data collection/retrieval, access and accuracy of diagnostic tools, administrative issues, and lack of local expertise limit antimicrobial stewardship efforts.

Conclusions:

Our study finds the burden of AMR high in both rural and urban sites, reinforcing that AMR burden cannot be ignored in rural settings. It also highlights that national data obtained from tertiary care settings fail to capture the local picture, highlighting the need for local data. Mechanisms of linking rural practices, primary health centres, and small hospitals with a common microbiology laboratory and shared data platforms will facilitate antibiotic stewardship at the community level.
An innovative procedure
Authors: Şimşek Gürcan , Hasırcı İsmail , Ulutaş Mehmet Eşref , Kartal Adil , Arslan Kemal
Published: April 2021

Sterilisation of the liver hydatid cyst cavities is a significant step in the surgical treatment of these cysts. We previously performed a study addressing the Foley catheter method in sterilisation of the cyst cavities with open surgery. Recently, we have been laparoscopically using Foley catheters for sterilisation of the cyst cavities. We tried laparoscopically in five cases with six cysts. A Foley catheter can be used in the sterilisation of hydatid cysts cavity both in laparoscopic and open interventions. We think that this procedure can reach cysts at all locations of liver and be applied to multiple liver cysts, too. From laparoscopic point of view, the method we presented is innovative procedure. To date, we have not seen any morbidity including recurrence and mortality in cases we applied this procedure.
Readmissions after cholecystectomy in a tertiary UK centre
Authors: Omar Islam , Hafez Ahmed
Published: April 2021

Context:

Although cholecystectomy is a widely performed procedure, post-operative readmissions place a heavy burden on healthcare facilities.

Aims:

This study assesses the incidence, causes and burden of 30-day readmissions after cholecystectomy in a tertiary UK centre.

Settings and Design:

This study was conducted at a university hospital, and the study design involves retrospective cohort study.

Materials and Methods:

Information was obtained from our prospectively maintained database and hospital's computerised records.

Statistical Analysis:

The encounters are expressed in numbers and percentages. The hospital stay, body mass index and age are expressed in mean, standard deviation (SD), min-max and median. Microsoft Excel® was used to calculate the means, SD, min-max and median.

Results:

Out of the 1140 cholecystectomies performed over this time, there were 75 true readmissions and 29 revisits; thus, the actual readmission rate is 6.58%. Non-specific abdominal pain ± deranged liver function test (LFT) is the most common cause of readmissions/ revisits in (38; 36.54%) cases, followed by (18; 17.31%) wound infections and (12; 11.54%) collections/bile leaks/abscess. This cost the centre 93 scans, 30 procedures and 295 days of hospital stay.

Conclusions:

Non-specific abdominal pain ± deranged LFT is the most common cause of readmissions/revisits in the centre. Readmissions after a cholecystectomy are a significant encumbrance.
Could pure agraphia be the only sign of stroke? Lessons from two case reports
Authors: Billeri L , Naro A , Manuli A , Calabrò RS
Published: April 2021

Agraphia is defined as the disruption of the previously intact writing skills due to an acquired brain damage. Stroke remains the most common cause of language impairment; however, writing disorders, including agraphia, are underestimated in patients with stroke. In this regard, we report two patients presenting with pure agraphia as an early symptom of stroke. Both patients complained of at least two difficulties in visualizing letter formation beforehand, the frequent need for verbal cues, misuse of lines and margins, poorly legible signature, and writing and thinking at the same time (e.g., creative thinking and taking notes). They underwent brain magnetic resonance imaging which revealed a small lacunar infarction of the left insula and external capsule (patient 1) and a small hemorrhagic lesion in the posterior limb of the left internal capsule (patient 2). To our knowledge, this is the first report on pure agraphia as the presenting symptom of stroke. We suggest that all patients with acute agraphia, even when presenting as an isolated symptom, should be evaluated for stroke, in order to better facilitate its diagnosis and treatment.
Evaluation of the Ascending Utricular and Descending Saccule Pathway Using Cervical Vestibular Evoked Myogenic Potential and Ocular Vestibular Evoked Myogenic Potential in Diabetic Polyneuropathy
Authors: Akan Onur , Berkiten Güler , Tutar Belgin , Karaketir Semih , Tuna Ömür Biltekin
Published: April 2021

Background:

Chronic hyperglycemia can affect the vestibular system by causing injury in cells and neural structures. In addition to alterations in the microvasculature and connective tissues, changes in inner ear fluid metabolism can also contribute to otolithic damage in patients with diabetes. We aimed to evaluate the effects of neurovascular degeneration occurring in diabetic polyneuropathy (DPN) on the vestibular system.

Methods:

Thirty-five patients with DPN (n = 70 ears) and 34 (n = 68 ears) healthy controls were enrolled. Patients were classified into two subgroups as sensorial axonal PNP and sensory-motor axonal PNP. To assess vestibular functions, cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential (oVEMP) testing were bilaterally performed.

Results:

Bilateral cVEMP and oVEMP P1 latency and N1 latency were significantly prolonged, whereas amplitude values were significantly decreased in patients with DPN compared with the controls (P = 0.001). The cVEMP amplitude asymmetry ratio (AAR) was statistically higher in the DPN group than in controls (P = 0.001); oVEMP AAR was not significant between the patient and control groups (P = 0.095). The cVEMP AAR values were found to be increased in both patient subgroups, and oVEMP AAR was elevated in the sensorineural PNP subgroup. In the DPN group, the nonresponse rate was 48.6% (n = 17) in cVEMP and 51.4% (n = 18) in oVEMP, significantly higher compared with the controls (P < 0.05). In cVEMP, nonresponse rates were found to be lower in both DPN subgroups. In oVEMP, the nonresponse rate was found to be higher in the sensory-motor PNP subgroup when compared with the sensorial PNP subgroup (P = 0.008 and P = 0.003, respectively).

Conclusion:

In diabetes mellitus with multisystemic effects, particularly in patients with polyneuropathy, vestibular testing before the onset of vestibular symptoms may be an early and beneficial diagnostic method for detecting the presence or degree of neurovascular degeneration.
Compact Tree Encodings for Planning as QBF
Authors: Gasquet Olivier , Longin Dominique , Maris FrÂ´edÂ´eric , RÂ´egnier Pierre , Valais MaÂ¨el
Published: April 2021

Considerable improvements in the technology and performance of SAT solvers has made their use possible for the resolution of various problems in artificial intelligence, and among them that of generating plans. Recently, promising Quantified Boolean Formula (QBF) solvers have been developed and we may expect that in a near future they become as efficient as SAT solvers. So, it is interesting to use QBF language that allows us to produce more compact encodings. We present in this article a translation from STRIPS planning problems into quantified propositional formulas. We introduce two new Compact Tree Encodings: CTE-EFA based on Explanatory frame axioms, and CTE-OPEN based on causal links. Then we compare both of them to CTE-NOOP based on No-op Actions proposed in [Cashmore et al. 2012]. In terms of execution time over benchmark problems, CTE-EFA and CTE-OPEN always performed better than CTE-NOOP.
Hybrid Bees Algorithm with Grasshopper Optimization Algorithm for Optimal Deployment of Wireless Sensor Networks
Authors: Deghbouch Hicham , Debbat Fatima
Published: April 2021

This work addresses the deployment problem in Wireless Sensor Networks (WSNs) by hybridizing two metaheuristics, namely the Bees Algorithm (BA) and the Grasshopper Optimization Algorithm (GOA). The BA is an optimization algorithm that demonstrated promising results in solving many engineering problems. However, the local search process of BA lacks efficient exploitation due to the random assignment of search agents inside the neighborhoods, which weakens the algorithmâ€™s accuracy and results in slow convergence especially when solving higher dimension problems. To alleviate this shortcoming, this paper proposes a hybrid algorithm that utilizes the strength of the GOA to enhance the exploitation phase of the BA. To prove the effectiveness of the proposed algorithm, it is applied for WSNs deployment optimization with various deployment settings. Results demonstrate that the proposed hybrid algorithm can optimize the deployment of WSN and outperforms the state-of-the-art algorithms in terms of coverage, overlapping area, average moving distance, and energy consumption.
Effect of an acidifier as replacement for antibiotics on the performance and gut morphology of broilers
Authors: Makanjuola BA , Obi OO , Olorungbohunmi TO , Morakinyo OA , Boladuro BA , Oladele-Bukola MO
Published: April 2021

An experiment was conducted to determine the influence of an acidifier as an alternative to antibiotics on the performance and gut morphology of broiler chickens. One hundred and eighty (180) 7-day old broiler chicks were randomly assigned to 3 dietary treatments of 4 replicates each. Each replicate had 15 birds. The diets fed to the birds were: Treatment 1- diet with neither antibiotic nor acidifier; Treatment 2- diet with antibiotic and Treatment 3- diet with acidifier. The antibiotic used was Enrofloxacin which was administered to the birds on Treatment 2 via their drinking water while the acidifier used was Biotronic SE (a combination of propionic and formic acids) which was added to the diet of birds on Treatment 3 at the rate of 4kg/tonne of feed. The experiment lasted 42 days. No significant differences were observed in the feed intake, final weight and weight gain of the birds on the different diets. Significant differences were however observed in the villus height in the duodenum and ileum of the birds. The crypt depth values in the different segments of the small intestines of the birds were not significantly affected by the different treatments.Key words: Organic acids, Biotronic SE, Enrofloxacin, Crypt, villus.
Market structure and performance of value chain actors in hides and skins processing and marketing in Nigeria
Authors: Yusuf O , Abdurrahman S
Published: April 2021

The study was designed to investigate the Structure and Performance of value chain actors in hides and skins processing and marketing in Nigeria. Specifically, the study described the structure of hides and skins processing and marketing, estimated the marketing margin and marketing efficiency. One hundred and six respondents were selected from Kano, Anambra and Lagos states for the study. The result of the market structure revealed that there was no barrier to entry and exit of the business of hides and skins processing and marketing. Registration was compulsory for tanners and hides and skins wholesalers while it was optional for ‘pomo’ wholesalers, leather wholesalers and butchers. Though, the registration fee for skins wholesalers was very small (about ₦500), Result of the market performance of hides and skins processing and marketing revealed that the marketing margin for leather final consumer was 48% while that of ‘pomo’ final consumers was about 44%. Marketing efficiency of tanners was about 176% while that of ‘pomo’ wholesalers was 188%. There was high performance in hides and skins processing and marketing in Nigeria. Based on the findings, it was recommended that public or private market information service rendering agencies should be involved in the area of hides and skins processing and marketing in providing reliable and timely information.Keywords: Structure, performance, value chain actors, hides and skins, Nigeria.
Live weight estimation of male donkeys from measurements of heart girth, umbilical girth and body length in northwest Nigeria
Authors: Hassan MR , Abdu SB , Amodu JT , Muniratu AA , Adamu HY , Kabir M , Junaidu LA , Ibrahim TA , Tamburawa MS , Abubakar SA
Published: April 2021

This study examines the use of morphological parameters to predict live weight of male working donkeys in three locations of northwest Nigeria. The study employed the use of measuring tape to measure some morphological parameters from 127 male working donkeys selected at random from three locations namely: Giwa (Kaduna state), Kofar Dan ‘agundi (Kano state) and Zandam (Jigawa state). Data obtained was analyzed using descriptive statistics, analysis of variance and regression analysis. Results indicated that length of neck of donkeys was 40% higher (P<0.05) in Giwa than Kofar Dan’agundi. However, donkeys in Zandam had 5% and 6% higher (P<0.05) length of ear and body length, respectively compared to those in Giwa. Predicted live weight of donkeys was 34% higher (P<0.05) using allometric model II (144 kg) than model I (95 kg), regardless of the location. Heart girth and body length of donkeys were the best predictors of live weight (P<0.001; R2 = 0.99, se = 0.01 and R2 = 0.72, se = 0.10), respectively. Predicted live weight relates positively with body length of donkeys in the study areas (R2 = 0.73). It was therefore concluded that equations developed to estimate live weight of donkeys using morphological parameters could be used in Nigeria with high degree of certainty. Considering the fact that weight is sexually dimorphic, similar research should be conducted on female donkeys to have a wider understanding of Nigerian donkeys for sustainable development.Key words: Donkey, heart girth, live weight, morphology, Nigerian
Adoption of improved rice varieties by farmers in Bende local government area of Abia state
Authors: Ijioma JC , Osundu CK
Published: April 2021

The study investigated the adoption of improved rice varieties by farmers in Bende Local Government Area, Abia State, Nigeria. A multi-stage random sampling technique was used to select a total of 120 rice farmers. Descriptive statistics and tobit regression model were employed to analyze the data. Results showed that cumulatively 73.3% of the farmers fell within the age range of 20-50 years, most (86.7%) of the rice farmers were literate. More than half (57.5%) of the rice farmers are females. Result further indicated that 43.3% had household sizes of 5-8 persons. A fair proportion (33.3%) had been in rice production for 11-15 years, while majority (73.3%) belongs to farmers’ associations. Fairly good (51.6%) were aware of the improved rice varieties and used it, while a substantial number (93.3%) number of the farmers cultivated swamp rice. MAS 240 variety (mean=3.13), Faro 7 variety (mean=2.95), Faro II variety (mean=2.75), Faro 8 variety (mean=2.70.) and Faro 48 variety (mean=2.68) were highly adopted by farmers in the area. The Chi square value of 7.290 was significant at 1.0% probability level and indicates goodness of fit of the model used. Coefficient of age (-0.023), and gender (-1.967) were negative and significant at 10.0% and 1.0% level of probability respectively. The coefficient of education level (0.041), farm size (0.940), farming experience (0.206) and membership of farmers’ association (0.168) were significant at 5.0% and were positively related to adoption of improved rice varieties. Farmers encountered various problems of paucity of funds (35.8%), scarcity of inputs (22.5%), and dearth of information (20.89). Based on these findings it was recommended that rice farmers should form cooperative societies to enable them raise funds for buying agricultural equipment to boost rice production. More young male farmers should be sensitized and motivated by the state government to take up rice production since female farmers dominate rice production in the area. Extension agencies should increase the level of information dissemination and teaching to the rice farmers’ clientele.Key words: Adoption, Improved Varieties, Rice
Urbanization, housing and environmental quality indicators
Authors: Oladele A
Published: April 2021

The migration of human populations from rural to urban settlements known as urbanization in its most basic sense suggests an improvement in various facets of life. Urbanization ideally should also imply an enhancement of housing quality and other components of human settlements such as power supply, portable water, good roads, proper refuse and sewage disposal facilities, maintenance of ecological balance and a reduction in environmental pollution. Globally, the urbanization process has occurred in a disorganized and nearly uncontrollable manner. The spontaneity in growth of urban settlements has affected negatively several components of the urban fabric such that these components (previously mentioned) are either severely inadequate or non-existent in majority of instances where urbanization has taken place. Arguably, the success of any urbanization process can be measured by the quality of the environments produced and the housing stock found within such environments. This paper seeks to identify and evaluate the components of urban settlements that can be used as indices for establishing quality of our housing, environments and urban clusters particularly for the Nigerian context. The research methodology is a reconnaissance survey, field observation and comparison of four main areas within Ido Local Government Area of Ibadan, Oyo State, namely Apete, Elebu, Elenusonso and Ologuneru.Key words: Urbanization, Environmental quality indicators.
Exploring fertility decisions among pregnant HIVpositive women on antiretroviral therapy at a health centre in Balaka, Malawi: A descriptive qualitative
Authors: Biseck T , Kumwenda S , Kalulu K , Chidziwisano K , Kalumbi L
Published: April 2021

Background The proportions of women of reproductive age living with the human immunodeficiency virus (HIV) vary between different regions of the world, with significantly higher proportions in sub-Saharan Africa. Family planning is one of the major issues that couples and families affected with HIV must confront. We aimed to assess the cultural and social factors associated with childbearing and family planning knowledge, decisionmaking, and practices among HIV-positive pregnant women attending antenatal clinic at a health centre in Balaka, Malawi.Methods This was a qualitative descriptive study carried out at Kalembo Health Centre in Balaka. A purposive sampling technique was used to select pregnant women enroled in the antiretroviral therapy (ART) programme. A sample size of thirty-five women was decided upon after data saturation. Qualitative inquiry was used during data collection. Data were analysed using systematic text condensation, while numbers and percentages were generated using Microsoft Excel.Results Out of 35 participants, 20 were aged between 25 and 34 years, and 18 had been married at least three times. All 35 women wished to have their own biological child. Factors, reported by participants, that promote childbearing included: the desire to please their husbands, fear of losing their husbands to others if they did not bear children, the knowledge that ART would help prevent their children from acquiring the virus, the desire to prove to others that they can also bear children, and a lack of family planning leading to unplanned pregnancies.Conclusions The factors that lead to pregnancies among women on ART in Balaka ranged from assured safety of the child from HIV, lack of contraception, to other factors related to their partners. The authors recognize and support the freedom for women to become pregnant and bear children, and, in the context of HIV infection, fertility and reproductive services should include a comprehensive approach towards addressing issues of HIV and AIDS and childbearing among infected women.
Maximizing HIV partner notification opportunities for index patients and their sexual partners in Malawi
Authors: Kamanga G , Brown L , Jawati P , Chiwanda D , Nyirenda N
Published: April 2021

Introduction HIV testing and counselling (HTC) is important to effect positive sexual behaviour change and is an entry point to treatment, care, and psychosocial support. One of the most practical initiatives to increase HTC is to encourage sexual partners of HIV-infected persons to test for HIV. However, partner notification strategies must be feasible in the healthcare setting and acceptable to the population.Methods We conducted a qualitative study during the pilot phase of an HIV partner notification trial to complement its assessment of feasibility and acceptability of methods of partner notification. We performed in-depth interviews with 16 consecutive HIV-positive index participants who consented and their 12 identifiable sexual partners. We also conducted two focus group discussions with healthcare workers to supplement the patient perspectives. In the main study, newly diagnosed HIV cases (index cases) were randomized to one of three methods of partner notification: passive, contract, and provider referral. Clients in the passive referral group were responsible for notifying their sexual partners themselves. Individuals in the contract referral group were given seven days to notify their partners, after which a healthcare provider contacted partners who had not reported for counselling and testing. In the provider group, a healthcare provider notified partners directly.Results Although most index participants and partners expressed a preference for passive notification, they also highlighted benefits for provider-assisted notification and the universal right for all HIV-exposed persons to know their HIV exposure and benefit from HIV testing and access antiretroviral treatment. Several participants mentioned couples counselling as a way to diffuse tension and get accurate information. All mentioned benefits to HIV testing, including the opportunity to change behaviour.Conclusions Provider-assisted partner notification is not preferred, but it is acceptableand may complement the passive method of notification. Couples counselling should also be encouraged.
In memoriam: Mr Jimmy James (1940–2019). His contribution to the training of surgeons in Malawi and the College of Surgeons of East Central and Southern Africa (COSECSA) region
Authors: Mulwafu Wakisa
Published: April 2021

John “Jimmy” James MB ChB FRCS Ed passed on the 4th December 2019, the day we had our COSECSA annual general meeting in Kampala, Uganda. He died after a short battle with metastatic prostate cancer.
The Malawi Orthopaedic Association/AO Alliance guidelines and standards for open fracture management in Malawi: a national consensus statement
Authors: Schade Alexander
Published: April 2021

BackgroundOpen fractures are common injuries in Malawi that pose a large burden on the healthcare system and result in long-term disability.AimEstablishing a multiprofessional agreement on the management of open fractures in Malawi from a consensus meeting. MethodsAO Alliance convened a consensus meeting to build an agreement on the management of open fractures in Malawi. Eighteen members from different professions and various regions of Malawi participated in a 1-day consensus meeting on 7 September 2019. Prior to the meeting the British Orthopaedic Audit Standards for Trauma (BOAST) for open fractures, as well as relevant systematic reviews and seminal literature were circulated. Panel members gave presentations on open fracture management, followed by an open discussion meeting. At the 1-day consensus meeting panel members developed statements for each standard and guideline. Panel members then voted to accept or reject the statements.ResultsSubstantial agreement (no rejections) was reached for all 17 guidelines and the associated terminology was agreed on. These guidelines were then presented to the members of the Malawi Orthopaedic Association (MOA) at their annual general meeting on 28 September 2019 and all participants agreed to adopt them.ConclusionsThese MOA/AO Alliance guidelines aim to set a standard for open fracture management that can be regularly measured and audited in Malawi to improve care for these patients.
Availability, Accessibility and Proper Use of Personal Protective Equipment in Wards at Queen Elizabeth Central Hospital (QECH) Blantyre, Malawi: An Observational Study
Authors: Madziatera Davie
Published: April 2021

BackgroundThe purpose of this study was to evaluate the availability, accessibility and proper use of personal protective equipment (PPE) in the wards at Queen Elizabeth Central Hospital (QECH).Methods: We conducted an observational study with a cross-section design. Convenience sampling method was used for selection of healthcare workers (HCWs) in wards. HCWs filled a checklist on accessibility of PPEs and they were observed on proper use of PPE while conducting clinical procedures. Nurse ward in-charge was asked to fill out a checklist on availability of PPE in their ward.Results PPE was available in 75.8% of wards, not available in 12.5%. Goggles were absent in 70.8% of wards. PPEs were 71.4% accessible and 28.6% inaccessible to healthcare workers in the wards. The most inaccessible PPEs were goggles (83.2%) and footwear (73.7%) while facemasks, sterile and non-sterile gloves and aprons were readily accessible. Non sterile gloves were 100% available and accessible. Only 13.5% of the HCWs had good compliance with PPE standard procedures. The average PPE compliance score of those who had been trained was 6 % greater than those who were not trained. ConclusionThis study identified areas of improvement in healthcare system delivery regarding standard precautions with emphasis on PPE. Improvements in training during professional college education and in-service refresher training could improve compliance with appropriate use of PPE for relatively low cost. Management support could improve availability and accessibility of PPE in the wards at QECH, with active supervision to improve adherence levels to personal protective equipment usage. The study can also help in the development of policies and guidelines regarding PPE usage by showing that most HCWs need to be trained in proper PPE usage.
Baseline, Cross-sectional Survey of Knowledge, Attitudes, and Practices Related to Efficient Use of Government Resources in the Health Sector in Malawi
Authors: Msoma Aulive
Published: April 2021

BackgroundMisuse of government resources is a challenge within the health sector that can be addressed by increasing public demand for accountability, reporting suspected misuse of resources, and other client-driven changes. This study was led by the USAID/Health Communication for Life Project to inform the design of social accountability communication messages and interventions. The study also established baseline data on Malawians’ knowledge, attitudes, and practices related to efficient use of government resources in the health sector.MethodsThis baseline, formative research study used a non-experimental, cross sectional survey design. Sampling for the mobile survey was conducted using the random digit dialing technique. Data were collected via mobile phone using interactive voice response technology. Our sample included 1,425 respondents, 67% of whom were male and 33% were female. Respondents were mostly 35 years old or younger, with more than half of female respondents reporting their age as 18–24 years. Results Our findings indicate that Malawians believe misuse of government resources is pervasive in Malawi. Seventy percent of men and nearly 60% of women reported having noticed, found, or seen drugs believed to be from a government health facility being sold elsewhere. Few respondents who had observed or experienced misuse of government health sector resources reported the incident. When asked the likelihood that they would report a request for a bribe, gift, or favor in exchange for health services in the future, 68% of respondents said they would report it.ConclusionsSocial and behavior change communication could serve a key role in motivating those who are aware of misuse of public sector health resources to report the issues they observe and providing them with the information needed to follow through. Further research is needed to understand the best approaches to mitigate underlying factors that drive misuse of resources and underreporting.
INDIAN IT FIRMS CREATING MANAGEMENT CODES FOR FOREIGN EXCHANGE RISK
Authors: Shankar Nitin , Beena Fatima
Published: April 2021

Purpose: India has been a preferred I.T. service sourcing nation globally and has been registering high growth. India has a significant pie of the global sourcing market, accounting for nearly 55 % share. It covers significant global through its more than one thousand centres spread across continents. With a year-on-year growth of 6.1%, India’s I.T. and ITES industry will increase to the U.S. $ 350 million by 2025. The extensive expanse of geographical coverage also translates into foreign exchange risk; hence foreign exchange risk management becomes an important strategy. The current study attempts to assess the impact of foreign exchange risk management on the Indian sector over 2007-2017; the period includes the 2008 financial crisis taken up in the current study.

Design/Methodology/ Approach: We analyzed the Indian I.T. companies listed on the BSE Ltd on their exposure, approach, and management towards foreign exchange risk. We investigated their annual reports from 2007 -2017 to understand their exposure and the adopted external foreign exchange risk management techniques. We further assessed the impact of these foreign exchange risk management techniques on the firm’s value.

Findings: The impact of foreign exchange risk management was significant on small-cap I.T. companies for the study period. Though for the during the 2008 crisis term, it was found to be insignificant.

Practical/Implications: Foreign exchange risk management is crucial for Indian I.T. companies indulging in cross-border trade. The current study incorporates external methods of managing foreign exchange risk management; hence even if the impact were found to be insignificant for Mid Cap and some Large-cap companies, they would be practicing internal hedging methods, which puts a strong case tapping trillion-dollar business through a fully functional competitive International Financial Centre.

Originality/Value: Our paper contributes to the literature on Foreign exchange risk management by Indian I.T. companies, which contributes handsomely to India’s GDP and Foreign exchange reserve.

JEL Classification Codes: F31, G32.
An Adaptive Weighted Image Denoising Method Based on Morphology
Authors: Wang Jinjuan , Duan Shan , Zhou Qun
Published: April 2021

In its generation, transmission and record, image signal is often interfered by various noises, which have severally affected the visual effects of images; therefore, it is a very important pre-processing step to take proper approaches to reduce noises. Conventional denoising methods have also blurred image edge information while removing noises, which can be overcome by the method based on mathematical morphology. While eliminating different noises from images, it can not only keep clear object edges, but also preserve as many image details as possible and it also has excellent capacities in noise resistance and edge preservation. With image denoising and mathematical morphology as the research subject, this paper analyzes the generation and characteristics of common image noises, studies the basic theories of mathematical morphology and its applications in image processing, discusses the method to select structural elements in mathematical morphology and proposes a filtering algorithm which combines image denoising and mathematical morphology. This method conducts morphological filtering and denoising on noised image with filter cascade and its performance is verified with stimulation testing. The experiment results prove that the approach to build the morphological filter into cascaded filter through series and parallel connection can to a certain extent, affect the effect of common filter while being applied to different image processing.
An Image Multi-scale Feature Recognition Method Based on Image Saliency
Authors: Yang Chengzhi
Published: April 2021

Image recognition refers to the technology which processes, analyzes and understands images with computer so as to recognize various targets and objects of different patterns. To effectively combine image recognition and intelligent algorithm can enhance the efficiency of image feature analysis, improve the detection accuracy and guarantee real-time detection. In image feature recognition, the following problems exist: the description of accurate object features, object blockage, complex and changeable scenes. Whether these problems can be effectively solved has great significance in improving the stability and robustness of object recognition algorithm. This paper takes image salience as the fundamental framework, and makes in-depth study of the problems of effective object appearance description, multi-feature fusion and multi-feature adaptive combination. Then it proposes an image multi-scale feature recognition method based on image salience and it can better locate the saliency object in the image, and more evenly highlight the salient object and significantly suppress background noises. The experiment results prove that salient region detection algorithm can better stress the entire salient image.
ISSUES OF TRANSFER OF TRAINING FROM THE TRAINING HOUSES TO THE LINE DEPARTMENT: A CASE OF GOVERNMENT SECTOR DEPARTMENT IN PAKISTAN
Authors:   Bahria University, Karachi., Cheema Farooq-E-Azam
Published: April 2021

Purpose:Purpose of this case study and its analysis is to highlight the issue of transfer inherent with the classroom training especially in the government sector departments. Of-the-job training is an expensive investment disparate with its returns. The issue is growingly attracting the attention of the HRD writers and the practitioners. Methodology/Sampling:The study is based on comprehensive literature reviewed critically and the diverse factors affecting transfer of training from the training houses to the line departments. The good practices from the literature were juxtaposed with the actual practices of the Directorate of Human Resource Development Pakistan Customs and Sales Tax and the line departments that directorate was serving. Findings:In theory and practice both, measures relating to transfer of training from the training houses to the line departments is aimed at improving the organizations’ individual employee’s productivity and organizational performance in the result. It focuses on diverse elements and subsystems of the organization involved in the transfer of training including the training house management, the trainees, line managers and the top management of the client organizations. Involvement of the people in the process of organizational development is hall mark of this process.