118 research outputs found
Understanding older peoples' chronic disease self-management practices and challenges in the context of grandchildren caregiving: A qualitative study in rural KwaZulu-Natal, South Africa.
No full textWhile chronic diseases are amongst the major health burdens of older South Africans, the responsibilities of caring for grandchildren, by mostly grandmothers, may further affect older people's health and well-being. There is a paucity of information about chronic disease self-management for older people in the context of grandchildren caregiving in sub-Saharan Africa. Guided by the Self-Management Framework, the purpose of this qualitative methods study was to explore the chronic disease self-management practices and challenges of grandparent caregivers in rural KwaZulu-Natal, South Africa. Eighteen repeat in-depth interviews were carried out with six grandparent caregivers aged 56 to 80 years over 12 months. Thematic analysis was conducted based on the Self-Management Framework. Pathways into self-management of chronic illnesses were identified: living with a chronic illness, focusing on illness needs, and activating resources. Self-perceptions of caregiving dictated that grandmothers, as women, have the responsibility of caring for grandchildren when they themselves needed care, lived in poverty, and with chronic illnesses that require self-management. However, despite the hardship, the gendered role of caring for grandchildren brought meaning to the grandmothers' lives and supported self-management due to the reciprocal relationship with grandchildren, although chronic illness self-management was complicated where relationships between grandmothers and grandchildren were estranged. The study findings demonstrate that grandchildren caregiving and self-management of chronic conditions are inextricably linked. Optimal self-management of chronic diseases must be seen within a larger context that simultaneously addresses chronic diseases, while paying attention to the intersection of socio-cultural factors with self-management
Task-sharing for non-communicable disease prevention and control in low- and middle-income countries in the context of health worker shortages: A systematic review.
No full textHealth workers are pivotal for non-communicable disease (NCD) service delivery, yet often are unavailable in low- and middle-income countries (LMICs). There is limited evidence on what NCD-related tasks non-physician health workers (NPHWs) can perform and their effectiveness. This study aims to understand how task-sharing is used to improve NCD prevention and control in LMICs. We also explored barriers, facilitators, and unexpected consequences of task-sharing. Databases searched in two phases and included MEDLINE, EMBASE, CENTRAL, CINAHL, Cochrane, and clinical trial registries, and references of included studies from inception until 31st July 2024. We included randomised control trials (RCTs), cluster RCTs, and associated process evaluation and cost effectiveness studies. The risk of bias was assessed using the Cochrane Risk of Bias Tool v2. PROSPERO: CRD42022315701. The study found 5527 citations, 427 full texts were screened and 149 studies (total population sample>432567) from 31 countries were included. Most studies were on tasks shared with nurses (n=83) and community health workers (n=65). Most studies focussed on cardiovascular disease (n=47), mental health (n=48), diabetes (n=27), cancer (n=20), and respiratory diseases (n=10). Seventeen studies included two or more conditions. Eighty-one percent (n=120) of studies reported at least one positive primary outcome, while 19 studies reported neutral results, one reported a negative result, eight (5.4%) reported mixed positive and neutral results, and one reported neutral and negative findings. Economic analyses indicated that task-sharing reduced total healthcare costs. Task-sharing is an effective intervention for NCDs in LMICs. It is essential to enhance the competencies and training of NPHWs, provide resources to augment their capabilities, and formalise their role in the health system and community. Optimising task-sharing for NCDs requires a holistic approach that strengthens health systems while supporting NPHWs in effectively addressing the diverse needs of their communities. Registration: PROSPERO CRD42022315701
Nanomechanics of membrane tubulation and DNA assembly
No full textWe report an interesting regime of tubule formation in multilamellar membrane vesicles. An optically trapped bead is used to apply a localized subpicoNewton force on a cationic vesicle to form a membrane tubule. The force extension curves reveal a saturation phase, with the tubule length extending up to tens of microns, beyond a threshold force 0.6±0.2 pN. We then use the tubule as a sensor for monitoring the dynamics of charge induced DNA integration on cationic membrane vesicles. Our results may also have applications in the development of nanowires and nanofluidic devices
Direct Measurement of Local Chromatin Fluidity Using Optical Trap Modulation Force Spectroscopy
No full textAbstractChromatin assembly is condensed by histone tail-tail interactions and other nuclear proteins into a highly compact structure. Using an optical trap modulation force spectroscopy, we probe the effect of tail interactions on local chromatin fluidity. Chromatin fibers, purified from mammalian cells, are tethered between a microscope coverslip and a glass micropipette. Mechanical unzipping of tail interactions, using the micropipette, lead to the enhancement of local fluidity. This is measured using an intensity-modulated optically trapped bead positioned as a force sensor on the chromatin fiber. Enzymatic digestion of the histone tail interactions of tethered chromatin fiber also leads to a similar increase in fluidity. Our experiments show that an initial increase in the local fluidity precedes chromatin decompaction, suggesting possible mechanisms by which chromatin-remodeling machines access regulatory sites
Dynamics of Membrane Nanotubulation and DNA Self-Assembly
No full textAbstractA localized point-like force applied perpendicular to a vesicular membrane layer, using an optical tweezer, leads to membrane nanotubulation beyond a threshold force. Below the threshold, the force-extension curve shows an elastic response with a fine structure (serrations). Above the threshold the tubulation process exhibits a new reversible flow phase for the multilamellar membrane, which responds viscoelastically. Furthermore, with an oscillatory force applied during tubulation, broad but well-resolved resonances occur in the flow phase, presumably matching the time scales associated with the vesicle-nanotubule coupled system. These nanotubules, anchored to the optical tweezer also provide, for the first time, a direct probe of the real-time dynamics of DNA self-assembly on membranes. Our studies are a step in the direction of analyzing the dynamics of membrane self-assembly and artificial nanofluidic membrane networks
Unifying Knowledge: Entity Linking in Scholarly Knowledge Graphs
No full textThe poster presents a study of challenges with linking and disambiguating author entities in Scholarly knowledge graphs. Author entities are the central part of scholarly data. The varied representation of author names due to different cultural norms and disambiguation challenges due to common names, makes it a challenging and important problem. We also compare the representation of author labels between two scholarly knowledge graphs DBLP and SemOpenAlex knowledge graphs, to highlight inconsistencies. Entity linking is an important challenge to solve to make knowledge graphs accessible through Knowledge Graph Question Answering. We used of DBLP-QuAD and Scholarly-QALD KGQA datasets for this study
Adherence to diabetes care processes at general practices in the National Capital Region-Delhi, India
No full textAim: To assess the level of adherence to diabetes care processes, and associated clinic and patient factors at general practices in Delhi, India. Methods: We interviewed physicians (n = 23) and patients with diabetes (n = 406), and reviewed patient charts at general practices (government = 5; private = 18). We examined diabetes care processes, specifically measurement of weight, blood pressure (BP), glycated hemoglobin (HbA1c), lipids, electrocardiogram, dilated eye, and a foot examination in the last one year. We analyzed clinic and patient factors associated with a number of care processes achieved using multilevel Poisson regression model. Results: The average number of clinic visits per patient was 8.8/year (standard deviation = 5.7), and physicians had access to patient's previous records in only 19.7% of patients. Dilated eye exam, foot exam, and electrocardiogram were completed in 7.4%, 15.1%, and 29.1% of patients, respectively. An estimated 51.7%, 88.4%, and 28.1% had ≥1 measurement of HbA1c, BP, and lipids, respectively. Private clinics, physician access to patient's previous records, use of nonphysicians, patient education, and the presence of diabetes complication were positively associated with a number of care processes in the multivariable model. Conclusion: Adherence to diabetes care processes was suboptimal. Encouraging implementation of quality improvement strategies like Chronic Care Model elements at general practices may improve diabetes care
Role of Case Histories on Geotechnical Engineering Teaching and Practice
No full textGeotechnical engineering teaching can be made more interesting with the use of modern methods of teaching and learning aids, visits to construction projects, case studies etc. A faculty at an university/technical institute, who is actively involved in geotechnical designs and consultancy works, will have enough case studies, with the examples of which he, will be able to deliver his lectures more effectively and make a good impression upon the students. The universal mantra nowadays is ‘learning should be made more student centric’. At the author\u27s institute, where a post-graduate and doctoral programme in geotechnical engineering are being successfully run for the past two decades, some of his experiences in effectively teaching geotechnical engineering subjects are being explained in the following paragraphs, with the help of a number of case histories on geopractices
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