1,721,019 research outputs found
Facilitators and barriers to extending prescribing authority to pharmacists in Nigeria: a mixed methods study
Get PDFBackground and aim: In Nigeria, only medical doctors, dentists and some nurses in primary care facilities have the legal right to prescribe medicines. Patients’ access to prescriptions can be seriously affected by the shortage of prescribers and waiting times in hospitals. This research was carried out to investigate the facilitators and barriers to extending pharmacists’ clinical roles to include prescribing in Nigeria.
Methods: The research employed an exploratory sequential mixed methods design consisting of three studies: The first involved semi-structured interviews with 32 UK pharmacy staff to investigate the changes in the structure of pharmacy practice in order to identify lessons for the Nigerian context. The second was semi-structured interviews with 49 Nigerian stakeholders including policymakers, pharmacists, doctors and patient group representatives to explore their views on pharmacist prescribing in Nigeria. The third was a cross-sectional survey involving 775 Nigerian pharmacists.
Results: The UK study suggests that changes in the traditional structure of pharmacy including a shift in the focus of pharmacy training to a patient orientated one, specialisation in practice, the development of a clinical career route, enhanced working relationship with doctors and the utilisation of pharmacy technicians could benefit the development of pharmacists’ clinical roles including prescribing. The two Nigerian studies showed a strong support for pharmacist prescribing especially by pharmacists and patient group representatives. The facilitators to pharmacist prescribing identified included pharmacists’ expert medicine knowledge, the positive attitude of pharmacists towards extended clinical roles, a positive relationship between doctors and pharmacists in some teaching hospitals and the potential benefits associated with pharmacist prescribing including increasing patients’ access to medicines. Barriers identified included lack of government support, medical opposition, pharmacists’ lack of confidence to do clinical roles, inadequate pharmacists’ skills in diagnosis and shortage of pharmacists.
Conclusion: This research concludes that a change in the traditional structure of pharmacy would be necessary for the development of pharmacist prescribing in Nigeria. The key areas for change are enumerated in the recommendations of this thesis
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
The public health sector supply of modern contraceptives in rural Nigeria: an analysis of selection, forecasting and inventory control
Get PDFPublic health facilities in rural Nigeria have been experiencing a long period of stock-outs and unavailability of modern contraceptives. This work was carried out to review the public health sector supply of modern contraceptives in rural Nigeria in order to make recommendations on how to improve the supply of modern contraceptives in this area. The study reviewed secondary data from country documents and literature obtained from Pubmed, Popline, and Global Health databases; as well as websites of USAID/DELIVER Project, Measure DHS and Federal Ministry of Health. The study revealed that a wide range of contraceptives are included in the essential drug list to be used in secondary facilities, while only a few ones are selected to be used in primary facilities which serve the majority of rural population. Forecasting is done using issue data from the central warehouse because facilities are not generating reliable consumption data. Inventory control is poor in rural facilities, and these facilities do not follow the established inventory control guidelines. The study therefore demonstrates that the current essential drug list should be reviewed in order to include injectables for use in primary facilities, strengthen the current forecasting, data reporting and inventory control system
Epidemiology of harmful use of alcohol in Nigeria: a systematic review and meta-analysis
No full textBackground: Nigeria, the most populous country in Africa, has reported relatively high levels of alcohol misuse, yet limited resources to guide effective population-wide response. There is a need to integrate existing empirical information in order to increase the power and precision of estimating epidemiological evidence necessary for informing policies and developing prevention programs. Objectives: We aimed to estimate nationwide and zonal prevalence of harmful use of alcohol in Nigeria to inform public health policy and planning. Methods: Epidemiologic reports on alcohol use in Nigeria from 1990 through 2018 were systematically searched and abstracted. We employed random-effects meta-analysis and meta-regression model to determine the number of harmful alcohol users. Results: 35 studies (n = 37,576 Nigerians) were identified. Pooled crude prevalence of harmful use of alcohol was 34.3% (95% CI: 28.6–40.1); twice as high among men (43.9%, 31.1–56.8) compared to women (23.9%, 16.4–31.4). Harmful alcohol use was higher in rural settings (40.1%, 24.2–56.1) compared to urban settings (31.2%, 22.9–39.6). The number of harmful alcohol users aged ≥15 years increased from 24 to 34 million from 1995 to 2015. However, actual age-adjusted prevalence of harmful use of alcohol in Nigeria decreased from 38.5% to 32.6% over the twenty-year period. Conclusions: While the prevalence of the total population that drinks harmfully appears to be dropping, absolute number of individuals that would be classified as harmful drinkers is increasing. This finding highlights the complexity of identifying and advocating for substance abuse policies in rapidly changing demographic settings common in Africa, Asia, and other developing countries.</p
Medical injection and access to sterile injection equipment in low- and middle-income countries: a meta-analysis of Demographic and Health Surveys (2010-2017).
No full textBACKGROUND:Unsafe injection practices contribute to increased risks of blood-borne infections, including human immunodeficiency virus, hepatitis B and hepatitis C viruses. The aim of this study was to estimate the prevalence of medical injections as well as assess the level of access to sterile injection equipment by demographic factors in low- and middle-income countries (LMICs). METHODS:We carried out a meta-analysis of nationally representative Demographic and Health Surveys (DHSs) conducted between 2010 and 2017 in 39 LMICs. Random effects meta-analysis was used in estimating pooled and disaggregated prevalence. All analyses were conducted using Stata version 14 and Microsoft Excel 2016. RESULTS:The pooled 12-month prevalence estimate of medical injection was 32.4% (95% confidence interval 29.3-35.6). Pakistan, Rwanda and Myanmar had the highest prevalence of medical injection: 59.1%, 56.4% and 53.0%, respectively. Regionally, the prevalence of medical injection ranged from 13.5% in west Asia to 42.7% in south and southeast Asia. The pooled prevalence of access to sterile injection equipment was 96.5%, with Pakistan, Comoros and Afghanistan having comparatively less prevalence: 86.0%, 90.3% and 90.9%, respectively. CONCLUSIONS:Overuse of medical injection and potentially unsafe injection practices remain a considerable challenge in LMICs. To stem the tides of these challenges, national governments of LMICs need to initiate appropriate interventions, including education of stakeholders, and equity in access to quality healthcare services
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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