31 research outputs found
Elucidation of the Role of DNA-Damage Response Genes in the Tumor Microenvironment and Molecular Characterization of a “Tropical” Chronic Lymphocytic Leukemia Cohort
No full textIn most human cancers such as diffuse large B cell lymphoma (DLBCL) and chronic lymphocytic leukemia (CLL), major genes of the DNA damage response (DDR) complex such as TP53, suffers inactivating mutations and dysregulation that impairs DNA repair processes and apoptotic machinery relevant for treatment. Despite the successes with Chemoimmunotherapy (CIT), many B-cells malignancies remain a major clinical challenge as therapy resistance account for 90% of cancer related fatalities. The tumor microenvironment (TME) is particularly culpable. Protumorigenic TME promotes complex crosstalk of tumor and stroma cells to facilitate tumor survival, proliferation, immune escape and metastasis.
This study elucidated the role of DDR in TME interactions and characterized molecular signature of Ghanaian CLL cohort.
Using shRNA to downregulate DDR genes in an ABC-subtype of DLBCL cell line we demonstrate that, functional TP53 and ATX (SMG-1) genes are critical for ADCP of DLBCL cells and that loss of TP53 and ATX in DLBCL induce resistance towards CIT by inhibition of macrophage effector functions through changes in formation/secretion of cellular secretome.
Additionally, phagocytosis is significantly enhanced in ABC-DLBCL expressing high levels of PD-L1 and CD47 antigens when treated in vitro with CIT/anti-CD47, anti-PD-L1 or anti-PD1 combination. Particularly, CD47/Sirp-α blockade circumvent impaired ADCP due to TP53, ATX, KD providing a rational for incorporation of checkpoint inhibitors into current R-CHOP regimen for the management of TP53, ATX mutated, resistant/refractory ABC-DLBCL.
Characterization of tropical African CLL showed females predominant incidence (51.1% vs 48.9%), lower median age of incidence (59yrs with 42.2% < 55yrs) compared to Western CLL which shows predominant males incidence (2:1) with a higher median age (71yrs, with 5-11% < 55yrs). Measurement of informative molecular markers showed 80% good prognosis by ZAP-70 and CD38 but 88.4% presentation at late clinical stage of disease, higher monotypic sIgM than dual IgM+/IgD+ (54.5% vs 34.1%) compared to predominant dual IgM+/IgD+ expression among European patients. These differences in CLL biology and clinical outcome may reflect interplay of genetic and environmental factors among racial groups in different geographical settings
A spatiotemporal perspective on empowerment in projects
No full textThe complex and dynamic nature of project environments presents both opportunities and challenges for the empowerment of individuals and teams. Yet, empowerment is a complex concept in its own right, taking on multiple forms across people, is contextually embedded and shifts over time. As research on empowerment in projects continues to grow, pertinent questions are emerging aimed at promoting the growth of empowerment theory and its applicability in practice. For example, how do organizations empower employees at different levels and still be able to achieve goal congruence across the organization?; how does empowerment manifest itself across project phases?; and how does empowerment manifest across co-located or geographically/physically spaced individuals on the same or different projects/teams across the same organization? The multiplicity and dynamism of empowerment in projects across three aspects - space, time and levels, and their intersections are examined within the context of the complex, dynamic and uncertain operational realities of projects. It is argued that such a spatiotemporal agenda is better understood through the lens of chaos and complexity theory, a perspective that reveals the way in which empowerment is intertwined with other managerial interventions and business strategies for the successful delivery of projects
PATIENT-CENTERED CARE; THE PHYSICIAN'S PERSPECTIVE AND ITS IMPACT ON QUALITY HEALTHCARE DELIVERY
No full textAbstract: Despite the recent research interest in examining the impact of patient-centered care (PCC) on quality healthcare delivery, various studies fall short in explaining physicians’ perceptions of PCC and its effects on their quality healthcare delivery. Hence, this study aims to examine physicians’ perception of PCC and its impact on quality healthcare delivery in Ghana. A survey data from 366 physicians in major hospitals in the Eastern and Ashanti regions of Ghana were sampled and further analyzed using hierarchical linear regression analysis. The findings of this study show that, out of the five components of PCC examined, physical comfort and patient preference influence physicians’ reliability, responsiveness, empathy, and assurance. Again, information and education significantly influenced physicians’ assurance. These results suggest that some aspects of PCC (physical comfort, patient preference, and information and education) influence physicians to deliver quality healthcare. These findings inform health institutions on the need to prioritize patient-centered care as it has been seen to contribute effectively to quality healthcare delivery. Hence, the need to reorient physicians' minds on the concept of PCC and its importance to the health sector.
Keywords: Patient-Centered Care, Quality healthcare delivery, Ghana, Physicians.
Title: PATIENT-CENTERED CARE; THE PHYSICIAN’S PERSPECTIVE AND ITS IMPACT ON QUALITY HEALTHCARE DELIVERY
Author: Francisca Arboh, Esther Agyeiwaa Owusu, Stephen Addai-Dansoh, Samuel Atingabilli, Ewuradjoa Quansah, Baaba Boadziwa Sackey, Adwoa Asantewaa Acquah Tyse, Selorm Yao-Say Solomon Adade, Nana Ama Anokyewaa Darko, Akpene Yawa Amaglo
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
Vol. 10, Issue 1, April 2022 - September 2022
Page No: 343-355
Research Publish Journals
Website: www.researchpublish.com
Published Date: 23-September-2022
DOI: https://doi.org/10.5281/zenodo.7107570
Paper Download Link (Source)
https://www.researchpublish.com/papers/patient-centered-care-the-physicians-perspective-and-its-impact-on-quality-healthcare-deliveryInternational Journal of Healthcare Sciences, ISSN 2348-5728 (Online), Research Publish Journals, Website: www.researchpublish.co
Is there discrimination against the agricultural sector in the credit rationing behavior of commercial banks in Ghana?
No full text
Purpose
The purpose of this paper is to examine if credit rationing persists even in the era of financial liberalization, the extent to which individual, firm and loan characteristics influence the rationing behavior of commercial banks and whether the agricultural sector is discriminated against in the commercial bank credit market.
Design/methodology/approach
The study employed a probit model with marginal effects and a generalized Blinder-Oaxaca decomposition estimation on a randomly selected data of 1,239 entrepreneurs from eight commercial banks’ credit records about their individual, firm and loan characteristics.
Findings
The study revealed that credit rationing persists and that applying for a relatively longer payment period, providing collateral and guarantor, being illiterate, being relatively older and being in the agricultural sector increases the likelihood of being credit rationed, while having some relationship with the bank, having non-mandatory savings and applying from a bank with relatively high interest rates reduce the likelihood of being credit rationed. The study also revealed a credit gap of 17.77 percent and a positive discrimination against borrowers in the agricultural sector as the gap was largely being influenced by unexplained factors.
Research limitations/implications
The research was intended to cover a large number of commercial banks in Ghana. However, most of the banks were unwilling to provide such information about their borrowers; hence, the research was limited to only eight commercial banks who provided the author with the information needed for the study.
Practical implications
The study concludes that policies that enhance human capital, women, and older access to credit and agricultural-oriented financial services and others, will go a long way to reduce rationing and increase access to credit, especially to the agricultural sector.
Social implications
The research proposes the use of group lending as a form of collateral and monitoring to ease risks and default, and hence supports sustainable funding to increase access and outreach.
Originality/value
The paper looks at the comprehensive way about the various factors determining credit rationing in that it considers not only the individual, economic/firm and loan characteristics but also the extent to which discrimination toward the agricultural sector exists in the commercial banks credit market.
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Blood storage effect of G6PD on RBC quality
No full textBackground: The most prevalent metabolic condition of red blood cells, glucose-6-phosphate dehydrogenase (G6PD) deficiency, affects around 35 million people globally. The highest prevalence is seen in tropical and subtropical areas of the eastern hemisphere, where it can affect up to 35 % of the population. G6PD deficiency, the most prevalent enzyme deficit, is not currently tested for in blood products. G6PD deficiency is a genetic factor that influences the quality of stored red blood cells impacting their ability to respond to oxidative stress. This hospital-based cross-sectional study aimed at assessing the prevalence of G6PD deficiency in donor blood and the impact of the enzyme deficiency on red cell indices during storage. Method: A total of 57 blood bags were screened for G6PD deficiency. Red cell indices and blood film comments were investigated on Day 0, Day 7 and Day 14 of storage. Results: Eight out of 57 (14 %) had the G6PD full defect and 86 % (49/57) had no defect. Over the course of 14 days storage, the hemoglobin and red blood cell count significantly decreased in G6PD-deficient blood units with a corresponding significant increase in mean corpuscular volume and red cell distribution width-standard deviation compared to baseline and normal G6PD activity. The blood film comment showed 85.7 % normocytic normochromic, 2.0 % microcytic hypochromic and 12.2 % macrocytic hyperchromic from G6PD-non-deficient donors whereas G6PD-deficient donors had 75 % normocytic normochromic with 12.5 % microcytic hypochromic and 12.5 % macrocytic hypochromic after 2 wk in storage. Conclusion: Red blood cell count and hemoglobin reduce significantly in G6PD-deficient donor units during storage with an associated increased mean corpuscular volume indicating progressive loss of the cellular membrane homeostatic mechanism that could potentially result in further hemolysis during long term storage
Gender-affirming genital surgery in the Nordic countries : Narrative review of current practices and challenges
No full textGenital gender-affirming surgery is a crucial yet often overlooked component of gender-affirming care for transgender individuals. Genital gender-affirming surgery is a rapidly evolving field, and it is not uncommon for surgeons - sometimes without prior experience in gender-affirming care - to encounter transgender individuals in clinical practice; hence, it is essential that all healthcare providers possess a foundational understanding of gender-affirming procedures and individual's needs.Research has shown that genital gender-affirming surgery significantly improves the quality of life for transgender individuals by aligning their physical characteristics with their gender identity. It can offer substantial satisfaction, both aesthetically and functionally. For transwomen, genital gender-affirming surgery enables them to wear underwear aligned with their gender identity, facilitates sexual function and the potential for vaginal intercourse. For transmen, it provides a more masculine appearance in the groin area, allows for penetrative intercourse with a reconstructed penis (neophallus), and in some cases enables urination while standing when combined with urethral lengthening.Today, a wide range of surgical options exists for both transwomen and transmen. Thorough preoperative counseling is essential when selecting the most appropriate reconstructive method. Advances in plastic, reconstructive, and microsurgery continue to expand these options, offering greater personalization and improved outcomes. While genital gender-affirming surgery is complex and often irreversible, individuals are generally highly satisfied with the results, particularly when they have realistic expectations prior to surgery.The aim of this narrative review is to provide an overview of genital gender-affirming surgery from a Nordic perspective. In the Nordic countries, gender-affirming care is highly centralized and integrated into publicly funded healthcare systems. The care programs across these countries share many similarities and are largely comparable in structure and approach.Peer reviewe
Evaluation of the measles surveillance system of the Ga West Municipality, Ghana, 2017
No full textIntroduction: Over 140,000 people globally died from measles in 2018; most of which occurred in developing countries. In Ghana, measles is one of the diseases earmarked for elimination in the Integrated Disease Surveillance and Response (IDSR) strategy. The measles surveillance system seeks to monitor trends, detect outbreaks and report in a timely manner. In order to improve upon the performance of the Ga West Municipal Measles surveillance system, it was evaluated with the aim of determining its effectiveness. Methods: We used CDC updated guidelines for surveillance system evaluation to assess system attributes. Measles surveillance data from 2012 – 2016 were abstracted from the DHIMS. Case investigation forms, weekly and monthly IDSR reporting forms were reviewed to validate abstracted data. Key surveillance officers were interviewed on system operations. Data was analyzed descriptively to generate frequencies and relative frequencies. Results: The system operated with a reasonable number of disease variables and case definition was simple to apply. The system was found to be integrated with the national IDSR. Government facilities across all seven sub-districts, owned and contributed data to the system. Of the 48 suspected case-patients, 39 (81.0%) were investigated; none of which was positive giving a Predictive value positive (PVP) of 0%. Majority of facilities (though privately owned) did not contribute data to the system. All tested samples were received at the laboratory within the stipulated three (3) days. The system was stable with available case base forms. Over 56% (22/39) of the samples tested had no vaccination records. Data is used to guide routine and supplementary immunization activities. Conclusion: Ga west Municipal measles surveillance system is simple, flexible and generally acceptable. It is sensitive, timely, stable but with low representativeness. It is therefore effective. Municipal health officials have been sensitized on private sector participation and need for quality and timely data
Evaluation of the measles surveillance system of the Ga West Municipality, Ghana, 2017
No full textIntroduction: Over 140,000 people globally died from measles in 2018; most of which occurred in developing countries. In Ghana, measles is one of the diseases earmarked for elimination in the Integrated Disease Surveillance and Response (IDSR) strategy. The measles surveillance system seeks to monitor trends, detect outbreaks and report in a timely manner. In order to improve upon the performance of the Ga West Municipal Measles surveillance system, it was evaluated with the aim of determining its effectiveness.
Methods: We used CDC updated guidelines for surveillance system evaluation to assess system attributes. Measles surveillance data from 2012 – 2016 were abstracted from the DHIMS. Case investigation forms, weekly and monthly IDSR reporting forms were reviewed to validate abstracted data. Key surveillance officers were interviewed on system operations. Data was analyzed descriptively to generate frequencies and relative frequencies.
Results: The system operated with a reasonable number of disease variables and case definition was simple to apply. The system was found to be integrated with the national IDSR. Government facilities across all seven sub-districts, owned and contributed data to the system. Of the 48 suspected case-patients, 39 (81.0%) were investigated; none of which was positive giving a Predictive value positive (PVP) of 0%. Majority of facilities (though privately owned) did not contribute data to the system. All tested samples were received at the laboratory within the stipulated three (3) days. The system was stable with available case base forms. Over 56% (22/39) of the samples tested had no vaccination records. Data is used to guide routine and supplementary immunization activities.
Conclusion: Ga west Municipal measles surveillance system is simple, flexible and generally acceptable. It is sensitive, timely, stable but with low representativeness. It is therefore effective. Municipal health officials have been sensitized on private sector participation and need for quality and timely data
Geospatial clustering of meningitis: an early warning system (hotspot) for potential meningitis outbreak in upper east region of Ghana
No full textObjective: We mapped and generated hot spots for potential meningitis outbreak from existing data in Upper East region, Ghana.Design: This was a cross-sectional study conducted in 2017Data Source: Meningitis data in the Upper East Region from January 2007, to December 2016.Main outcome measure: We used spatial tools in Quantum Geographic Information System (QGIS) and Geoda to draw choropleth map of meningitis incidence, case fatality and hotspot for potential meningitis outbreak
Results: A total of 2312 meningitis cases (suspected and confirmed) were recorded from 2016-2017 with median incidence of 15.0cases/100,000 population (min 6.3, max 47.8). Median age of cases was 15 years (IQR: 6-31 years). Most (44.2%) of those affected were 10 years and below. Females (51.2%) constituted the highest proportion. Median incidence from 2007-2011 was 20cases/100,000 population (Min 11.3, Max 39.9) whilst from 2012-2016 was 11.1cases/100,000 populations (Min 6.3, Max 47.8). A total of 28 significant hotspot sub-districts clusters (p=0.024) were identified with 7 High-high risk areas as potential meningitis outbreak spots.Conclusion: The occurrence of meningitis is not random, spatial cluster with high –high-risk exist in some sub-districts. Overall meningitis incidence and fatality rate have declined in the region with district variations. Districts with high meningitis incidence and fatality rates should be targeted for intervention.Keywords: meningitis outbreak, geospatial clustering, Upper East Region, meningitis incidence, GhanaFunding: Author EA was supported by the West Africa Health Organization (Ref.: Prog/A17IEpidemSurveillN°57212014/mcrt)
