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Objective To explore the gaps in the safe handling, administration, preparation and disposal of chemotherapy agents in low and middle-income countries.Design Two surveys comprising a needs assessment survey and an American Cancer Society (ACS) ChemoSafe Facility Assessment.Setting 2019 African Research Group for Oncology Symposium in South-West Nigeria (needs assessment) and the 2021 virtual engagement (ChemoSafe Assessment).Participants Health professionals (n=50 of 98) from multiple institutions across Nigeria (needs assessment survey) and a designated task force of health professionals (n=10) from one teaching hospital in Southwest Nigeria(ChemoSafe Facility Assessment).Results In 2019, 75% of survey respondents (n=50) reported a lack of training resources for safe handling of chemotherapy. Additionally, 61% felt dissatisfaction with assessment practices for preparing and administering chemotherapy. ChemoSafe is a programme developed by the ACS to assess the ability of a facility to handle hazardous drugs. The 2021 ACS ChemoSafe survey administered at one teaching hospital indicated several areas for improvement to promote concordance with international standards for safe handling. Thirty-three (19.5%) items received a ‘Yes’ response (ie, met compliance with international standards).Conclusion There is a need for the implementation of training resources for handling, administering and disposing of chemotherapy at sites across Nigeria. Strategies to identify and prioritise areas of need must be implemented in the context of available resources.

Introduction Ideology underscores how we make sense of history and reality. It is the underlying theory that governs every organized movement, institution, and government. In Politics, ideology superintends the constructs, subversions, moderations, and resistance of power. In Literature, ideology plays even a deluxe role as it is the vehicle that drives political and cultural purposes. A close consideration of the African creative canvass reveals that her imaginative writings are burdened with the ideology of socio-cultural redemption. Although replete with a recasting of themes that stress the subversions and resistance of political and religious power, especially in the continent’s post-colonial space, there is not much thematic commitment among creative writers to the ideology that constructs and moderates power. Using the New Historicism as the theoretical basis, this paper proposes that to understand the logic that has bedeviled post-colonial African governance, there is need to revisit power structures that characterize the continent’s pre-colonial history. It is in this burden that this paper shall attempt to examine the dialectics of political ideology, power relations and the prophetic in Baṣọrun Gáà ̀. The paper also argues that the private anxieties of the playwright, as presented in the play, 160 Lere Adeyemi are prophetic in nature and that Baṣọrun Gáà is weakened by the burdens of ̀ his strength, in other words, blinded by sight.

Background Few population-based studies have been conducted to determine the burden of neurological diseases in sub-Saharan Africa. A better understanding of the magnitude and impact of these disorders is pivotal to effective planning and provision of neurological services.Methods A cross-sectional survey of 2392 adults in Odeda Local Government Area, Ogun State, Southwest Nigeria was conducted between May and June 2015. Trained non-medical interviewers administered a screening instrument designed to measure the prevalence of neurological diseases and disability, while positive responders were subsequently examined by neurologists. Diagnoses were made clinically according to well-established criteria.Results The mean age of respondents was 37.2±16.1 years. A total of 842 cases of neurological diseases/disability were diagnosed in 815 individuals (26 individuals with more than one disorder). The all-cause neurological morbidity rate was 352 per 1000, while the crude prevalence rates of common neurological disorders were 304.3 per 1000 for primary headaches, 16.3 per 1000 for tropical ataxic neuropathy, 7.11 per 1000 for stroke, 5.85 per 1000 for essential tremor and 4.18 per 1000 for Parkinson’s disease. Neurological years lost due to disability was 2806.18 per 100 000.Conclusion This study provides evidence of a high neurological disease burden within the communities surveyed, which may be representative of Southwest Nigeria. In comparison with findings from previous studies within the same region, this report suggests a persistence of toxiconutritional disorders and postinfectious neurological sequelae on one hand and increased prevalence of non-communicable neurological disorders such as stroke and Parkinson’s disease.

Between modernism and postmodernism, critics have continued to appraise literary texts in the light of their contributions to and implications for the society. Opinions have continued to vary on the most suitable theory for coming to terms with prevalent conditions in contemporary society. Modernism precedes postmodernism and there is the rationalisation that it is thus more suitable for the contemporary African society. However, opposition to this view cannot be waved aside in view of evident effects of postmodernist ideal on the society. Hence, this paper attempts to further investigate the relevance of postmodernism to the African society in its struggle against socio-political aberrations. The three texts selected for this study have the potential of revealing a historical trend of struggle through early colonialism in West Africa to armed struggle in East Africa and late anti-apartheid struggle in South Africa. The study reveals that, historically, attempts by Africans to carry on spirited united struggle have usually been undermined by disunity and sabotage. This has again authenticated the skepticism about the tenets of postmodernism being able to effectively aid successful struggle against social-political aberrations on the African continent. Perhaps a blend of modernism and postmodernism would serve better.

Of all the species of Dioscorea, D. alata possesses higher multiplication ratio and better storability, and requires less capital and labour to produce than the most common specie, D. rotundata. Exploitation of the industrial potential of D. alata by diversifying its utilisation through the development of novel products will expand its utilisation. This study therefore investigated the potential of developing instant poundo yam flour from D. alata. Instant poundo yam flour was prepared from D. alata by peeling, dicing and immersing yam tubers in sodium metabisulphite solution (800 ppm for 20 min). The tubers were thereafter blanched at 70 oC for either 5 or 10 min, dried in a cabinet dryer at 60 oC for 72 hr, milled and sieved (600 μm) to obtain two experimental samples of poundo yam flours. The proximate composition of the flours was determined using standard methods. Sensory evaluation was conducted to determine the sensory attributes [colour, flavour, taste, textural quality (strecthability, adhesiveness, cohesiveness, smoothness) and general acceptability] of the flours. The two instant poundo yam samples were further compared with a commercial poundo yam in terms of the sensory attributes. There was no significant difference (p≤ 0.05) in the proximate composition of the two experimental instant poundo yam samples but their textural quality differed significantly (p ≤ 0.05). Instant poundo yam blanched for 10 min recorded higher sensory scores than the one blanched for 5 min and compared fairly well with the reference sample. An acceptable instant poundo yam has been developed from D. alata. Keywords: D. alata, instant poundo yam, proximate composition, sensory attributes J. Appl. Sci. Environ. Manage. Sept, 2012, Vol. 16 (3) 287 - 290

Abnormal liver tests are one of the most common challenges in the primary care setting. Primary care practitioners order these tests for numerous reasons, including investigating abdominal signs and symptoms or suspected alcohol-use disorder, or to determine medication adverse effects. Evaluation should be guided by both the clinical presentation and the pattern of injury. In this article, we will focus on the epidemiology, pathophysiology, clinical presentation, diagnostic work-up, and management of elevated liver enzymes, with an emphasis on the most common causes of abnormal liver testing., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Rural communities in the United States have a shortage of primary care physicians. Women physicians are more likely than male physicians to choose primary care specialties but less likely to locate in rural areas. With an increasing proportion of women physicians, it is important to understand community characteristics that encourage their recruitment and retention. This qualitative study explored community characteristics that influenced successful rural practice. We conducted telephone interviews with 25 women family physicians in rural practice in the United States in 2012. Interviews continued until saturation of themes was reached. Data were analyzed using immersion and crystallization. Community themes associated with successful rural practice included: fit with the community; spouse/partner fit with the community; relationships with individuals; and relationships with the community. Family ties, training experience within the community, social networks, and investment in the community were positive factors, while political/cultural differences were negative. Community integration arose from compatibility between the physicians' goals and community characteristics, opportunities for a spouse/partner, friendships, and a feeling of community purpose. This information can be used by rural communities to recruit and retain physicians, and by physicians, medical students, and those who advise them to promote successful rural practice.

Introduction: Despite significant health care reform in the past 10 years, health disparities persist in marginalized and low-resource communities. Although there are a lot of reasons for health disparities, many of which are not related to health care, changes in health policy can lead to improved health equity. Redefining health policy as an important aspect of medical education could popularize the teaching and application of health policy competencies within academic health centers., Methods: The Kern model was applied to develop a workshop to educate medical students on basic health policy concepts and opportunities for them to apply a health policy framework to facilitate organizational change. Specifically, the workshop helped trainees to define common concepts in health policy, to understand a framework for developing policy initiatives, and to identify areas of overlap between health policy and academic medicine. Instructional methods included a PowerPoint presentation, vignette-based small-group discussion, and career reflection., Results: The workshop was implemented at three national conferences with a total of 144 participants. Comparing pre- and postworkshop survey responses, participants felt health policy work was compatible with an academic medicine career. Over 95% of respondents agreed or strongly agreed that each objective had been met., Discussion: By viewing health policy through the lens of academia, trainees were able to develop a new appreciation for how health policy activities can contribute to peer-reviewed publications, teaching, and leadership opportunities. Participants were better situated to integrate health policy skills in their academic or nonacademic careers., Competing Interests: None to report.

Introduction: The USA needs more rural physicians. Although women represent half of all US trained medical students, the rural physician workforce has remained predominantly male. Insight is needed into what makes rural practice attractive for women and which practice characteristics allow women physicians to practice successfully in rural areas. This study's purpose was to examine aspects of the practice environment that impact women physicians' professional satisfaction and commitment to rural medicine., Methods: Twenty-five women family physicians practicing in rural areas of the USA were interviewed by phone using a semi-structured format. Transcribed interviews were analyzed using an immersion and crystallization approach. Emergent themes were identified, coded, and discussed until team consensus was attained. Interviews continued until saturation of themes was reached., Results: Three themes emerged from the data, in relationship to practice and employment attributes that contribute to US women physicians' professional satisfaction and willingness to remain in a rural setting: professional relationships, practice characteristics, and support during times of transition. Participants placed high importance on professional relationships, both within and outside of their rural practice. Rural women physicians enjoyed practicing an expanded scope of care, valued loan repayment opportunities, and appreciated supportive practice partners. Importantly, women physicians who found themselves struggling to maintain rural careers often had experienced difficulty during times of practice transition, including maternity leaves., Conclusions: Understanding practice attributes valued by successful rural women family physicians in the USA will help rural health systems, practices, and physicians-in-training to develop and evaluate opportunities that will best contribute to successful rural practice. Supporting women physicians during periods of practice transition may improve retention.

Hispanics represent the fastest growing ethnic segment of the lesbian, gay, bisexual, and transgender (LGBT) community in the United States and are disproportionately burdened by LGBT-related health issues and limited political support from Hispanic medical organizations. Recently, the Latino Medical Student Association, the National Hispanic Medical Association, and the Hispanic Serving Health Professions Schools, representing over 60,000 Hispanic students and providers and 35 institutions, collaborated to support a resolution opposing discrimination based on sexual orientation or gender identity and recognizing the obstacles encountered by LGBTQ Hispanics. The resolution provides an important framework for organizational members and leaders to address LGBT health issues and serve to support a more positive sociopolitical climate for the Hispanic LGBT community nationally and internationally.

Individuals infected by the human immuno deficiency are more prone to suffering certain bacterial infections in the course of their clinical evolution. The agents involved in these infections are: Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, Salmonella spp and Campylobacter spp, which occasion an increase in morbidity and mortality. With a lower frequency, but with an equal morbidity and mortality, infections have been found caused by Rhodococcus equi, Nocardia spp and Bartonella spp. Even though all of them account for a selective impairment of immunodeficiency in one way or another, their incidence varies. Other factors such as degree of immuno suppression, habits, social and geographic living environment could be important. In general, there is a lack of chemoprophylactic strategies for their prevention. Early diagnosis and correct treatment could have important advantages for the quality of life and survival of these patients

Portions of the latissimus dorsi (LD) muscle are frequently employed as free muscle or myocutaneous grafts. The functional consequences for both the graft and the remaining donor tissue must depend in part on the neural organization of the muscle. Previous anatomical and clinical reports have suggested that the LD is organized into independently innervated segments, but experimental documentation has been lacking. This study investigated the neural organization of the LD in pigs using (1) synchronous electromyography (EMG) of several sites within the LD and motion analysis of the shoulder and forelimb, and (2) dissection and stimulation of the primary branches of the thoracodorsal nerve, followed by histochemical analysis, to delineate the areas innervated by each. The findings indicated that while there is minor overlap between adjacent segments, the LD can be considered as consisting of three semi-independent compartments. Further, the teres major is linked to the LD functionally as well as anatomically, so that the two muscles can be considered as a four-part complex.

The use of the latissimus dorsi muscle for cardiomyoplasty requires accurate assessment of the outcome of methods used to convert fast fibers to slow fibers. A knowledge of the normal distribution pattern of slow fibers within the latissimus dorsi is necessary for this endeavor. Fresh latissimus dorsi and teres major muscle tissues from seven pigs, one rabbit, two sheep, one monkey, and four dogs were studied with myosin adenosine triphosphatase staining. Fiber counts were made visually. With the exception of the rabbit, the distribution patterns were similar for all species: (1) intersegmentally--the number of slow fibers decreased steadily from the teres major to the anterior edge of the lateral segment; (2) intrasegmentally--slow fibers were more frequent in the deep layer than the superficial layer; and (3) intrasegmentally--the slow fibers tended to cluster in rosette formations around the neurovascular bundles. These patterns of distribution indicate the need for careful location of biopsies to ensure valid comparison of the amount of slow fibers in tissue before and after treatment.

Gross and histologic studies of human and canine latissimus dorsi muscle were carried out to identify anatomic and histochemical properties that may be relevant to its use as a resource muscle, particularly for heart reconstruction. In both human and canine latissimus dorsi, three distinct muscle segments were observed, differing in direction of fibers, fiber characteristics, thickness, and blood supply. The entire canine latissimus dorsi could also be separated into superficial and deep layers, whereas only the anterolateral segment of human latissimus dorsi was separated further by the neurovascular bundle. Histochemical studies suggested significant differences between the ratios of fast to slow fibers in the superior and anterolateral segments of human muscle. Variation in size, weight, and shape within and between subjects demonstrates a need for careful evaluation of the potential resource muscle.