Prevalence and Risk Factors of Work Related Stress in the Medical Emergency Services in Douala, Cameroon
Background: Healthcare workers are exposed to work related stress in the course of their activities. We conducted this study to determine the prevalence of work-related stress and search for its associated factors among healthcare workers assigned to the emergency medical services of public hospitals in Douala. Methods: The cross-sectional and analytical study was carried out from March 27th to June 30th, 2017 in 8 public hospitals in Douala. The sampling method was non-random, consisting of consecutive recruitment of volunteer healthcare staff working in the emergency departments of public hospitals who provided the framework for the study. The level of stress was measured using the French version of KARASEK’s psychometric scale. The analysis was performed with SPSS 20.0 software. The study was authorized and obtained an clearance was granted. Results: The sample consists of 51 men (33.55%) and 101 women (66.44%). The average age is 34.6 ± 5.4 years. Nurses (54.6%) and healthcare staff aged 30 to 39 years (61.2%) predominates in the sample. Day / night shift work is the main form of work done by ¾ staff (75.6%). The prevalence of stress is 78.9% and the associated risk factors are the following: belonging to a 4th category hospital (p = 0.008), medical professions (p = 0.001), nurses (p = 0.0002), work experience of less than 10 years (p = 0.04) and exclusive night shifts (p = 0.02). Conclusion: Continuous improvement of the working conditions must be implemented inside the various facilities to mitigate the consequences of work related stress among the healthcare workers.
Instructors Responsiveness to Peer Led Team Learning pedagogical Initiative and Its Contributing Factors in Higher Education Institutions
This manuscript was intended to investigate instructors’ responsiveness to cooperative learning or PLTL change initiative and its contributing factors such as instructors’ attitude, work culture, leadership styles, and instructional delivery models. The study employed mixed method research design. 91 instructors were participated to fill in 5 point Likert and rating scale item questionnaires. An interview with key informants were conducted. The three HEIs instructors’ responsiveness to PLTL overall mean 2.8254 rested in disagree scale which implies instructors’ responsiveness to cooperative learning or PLTL was below average expectation. Thus, cooperative learning/PLTL pedagogical model application by the three HEIs did not achieve desired learning goals on learners . Transformational and servant leadership styles as well as communal culture showed more prediction and relationship with instructors responsiveness to cooperative learning and PLTL. Positive interdependence, individual and group accountability, interaction, and group process principles of cooperative learning were not implemented in the right way and did not result in desired learning goal. Pre, during and post instruction task categories were poorly implemented. Hence, instructors’ responsiveness to PLTL needs attention of instructors and institutional leaders for its improvement. Adjustments on instructors’ attitude, institutional leadership and culture styles with other situational factors may enhance PLTL practice and performance.
Indian Ragas for treating health problems
Music is a universal language. It influences all levels of human existence. It is a medium for communication, which can be both a pleasant and healing experience. Modern science and medicine are now rediscovering the healing powers of music. And various ragas in Hindustani & Karnataka treating persons with special needs in mental and physical health, rehabilitation and special education is gaining ground. It is a great ancient holistic medical science of India. The whole subject of music medical therapy is now getting attention from all across the world. In this paper we are presenting how a different raga affects the human body.
Exposure and transmission risk of blood and body fluids among health care personnel at first level referral public hospitals in Meme division, Cameroon
Occupational exposure to blood and body fluids is a serious concern for health care personnel (HCP), and posed a serious risk for the transmission of infectious pathogens. The aim of this study was to investigate occupational exposures of HCP at first level hospitals in Meme Division, Cameroon. We sampled 190 HCP working in 3 first level referral hospitals in Meme division in Cameroon using a structured questionnaire with a participation rate of 94.06 %. Descriptive statistics and multivariate analysis using logistic regression were performed. Of the 190 HCP who participated in the study, 77 (40.53 %) indicated having at least an encounter with exposure with blood and body fluids within the past 12 months. The physicians (78.57%) and the nurses (40.54%) were the most exposed categories of HCP. Working for long hours, lack of continuous training on infection prevention, 7-10 years working experience, dissatisfaction with current jobs, recapping needles after used were significantly associated with exposure and transmission risk to blood and body fluids among HCP. There was a high level of exposure to blood and body fluids among HCP at the first level referral hospitals in Meme division in Cameroon. Programs targeting the implementation of surveillance systems for training, registering, reporting, provision of basic personal protective equipment and management of occupational exposures in health care settings should be prioritised.
Synthesis of Bicyclic Adduct through Regioselective Baeyer-Villager oxidation
Baeyer-Villager oxidation reaction has become accepted as a right approach in the ring expansions for the preparation of both bicyclic and tricyclic lacotnes; however, successful application of the regioselective Bayer-Villager oxidation protocol to the synthesis of particularly congested scaffolds remains distinctly tricky. Herein the Baeyer–Villiger oxidation of Bicyclo[3.2.0]hept-3-ene-6-one is studied with oxygen insertion leading to the functionalized oxabicyclic adduct with complete regioselectivity.
T Prolymphocytic Leukemia, a rare disease, case presentation with typical pathological findings and review of management
Background: Prolymphocytic leukemia (PLL) is a rare disease, accounting for < 2% of lymphoid leukemias [1].There are 2 quite different entities with distinct pathologic features and different therapeutic strategies, T-cell and B-cell [2]. T-PLL is more common [3]. Although termed ‘prolymphocytic,’ T-PLL is characterized by the proliferation of post-thymic T-lymphocytes. It is estimated that physicians will see a case of T-PLL every five to ten years [4]. Over the last 15 years, 3 cases of T-PLL were diagnosed in our center. We present here the latest case, with typical pathological findings. Case Report: A 63-year-old British gentleman, previously healthy with good performance, presented with fatigue for 6 – 8 weeks with puffiness of face and eyelids and weight loss of 5 kilograms. Physical exam showed periorbital edema and conjunctival injection (Figure 1), cervical lymphadenopathy, and hepatosplenomegaly. Initial complete blood count (CBC): white blood cells (WBCs) 331.9 x109/L (4.0 – 10.0), with 94% lymphocytes, hemoglobin (Hb) 119 gm/L (130 – 170), platelets (Plts) 128 x109/L (150 – 400). Lactate dehydrogenase 10.4 µkat/L (2.1 – 3.7), uric acid 537 µmol/L (210 – 420). Abdomen ultrasound showed markedly enlarged spleen (20.3 cm). The peripheral blood smear showed profound leukocytosis with 94% abnormal lymphoid cells. The cells were small to medium in size with high nucleo-cytoplasmic ratio, moderately condensed chromatin and almost all with prominent nucleolus. Substantial number of the cells show irregular nuclear contour with short indentation. The cytoplasm was basophilic agranular and many cells show irregular cytoplasmic protrusions (Figure 2). Flow cytometry on peripheral blood revealed one homogenous abnormal population positive for cluster of differentiation 45 (CD45) and express the pan T-cell markers (CD3, CD2, CD5 and CD7). All were positive for CD4, T-cell receptor (TCR) alpha/beta, CD43 and BCl2 with partial expression of CD38. These cells were negative for CD56, CD57,...
Assessment of Hygiene Practices among Students at the University of Cape Coast, Ghana
Background: Proper hand hygiene practices have been shown to prevent the spread of communicable diseases. Although diarrhoeal diseases continue to be recorded among university students, there is paucity of studies focusing on hygiene behavior among university students in Ghana. This study assessed hand washing behavior, knowledge and practices among students of the University of Cape Coast, Ghana. Methods: A cross sectional study was conducted among 422 students from 4th January 2018 to 21st January 2018. A pretested, structured questionnaire was used to collect all relevant data. Frequencies and percentages were used for categorical data. Chi square and one –way ANOVA were used to determine associations between some selected variables. P values,
Use of Benzodiazepines and Hypnotic Medications in Psychiatry Older Adult Outpatients
Benzodiazepines have anxiolytic, hypnotic, anticonvulsant, and muscle-relaxing properties, therefore, a widely prescribed treatment for anxiety and insomnia. They bind to gamma-aminobutyric acid type A (GABAA) receptors, which are responsible for most of the inhibitory neurotransmission in the central nervous system and these receptors are a major target of alcohol, barbiturates, muscle relaxants, and other medications with sedative effects, resulting in tolerance and dependence [1]. Benzodiazepines are categorized into short (15 to 30 minutes), intermediate (30 to 60 minutes), and long-acting agents (one hour or longer). Benzodiazepines are frequently prescribed for elderly patients living in the community and for those in hospitals and institutions. Prolonged use of benzodiazepines is particularly likely in old age for the treatment not only of insomnia and anxiety, but also of a wide range of nonspecific symptoms. Long term users are likely to have multiple concomitant physical and psychological health problems [2]. Benzodiazepines produce dependence, reduce attention, memory, and motor ability. They can cause disinhibition or aggressive behavior, facilitate the appearance of delirium, and increase accident and mortality rates in people older than 60 [3]. According to Maudsley guidelines, benzodiazepines use in elderly are poorly supported for their link to cognitive decline, increase risk of falls and hip fractures [4]. And, if indicated, short acting agents should be avoided. Long acting agents should be started in low doses and patients need to be followed and reassessed regularly. Zolpidem or melatonin are indicated for insomnia, clonazepam and diazepam for agitation and pregabalin for generalized anxiety disorder [5].
Effects of Freshwater Environmental Changes on Spread of Schistosoma haematobium in Guinea Bissau: a Retrospective Analysis
Schistosoma haematobium (blood fluke) is a digenetic trematode, which, as all digenetic trematode, has a complex life cycle including one parasite stage in a mollusk (freshwater snail – intermediate host) and one in a vertebrate – definitive host (1). In the vertebrate host the parasite reaches sexual maturity and releases eggs, which are expelled through urine; each egg develops into a miracidium larva, the first free-living stage of the development, which infects the intermediate host. In this, the miracidium undergoes metamorphosis to become a cercaria stage. The cercaria leaves the snail and actively searches, thanks to chemical and physical signals (2) the vertebrate definitive host, being the usual portal of entry the skin. After penetration, the cercariae are known as schistosomulae. These migrate and develop into mature adult schistosome worms, in and around the vesical plexus, and occasionally in the rectal region, the mesenteric portal system and ectopic sites (3). In (4) we have a good article, of general character, on digenetic trematode as parasites, the diversity of trematodes that infect humans, and the economic impact of digenetic flukes. Considering the dependence of blood flukes on freshwater our objective is to show the effects of freshwater environmental changes on the spread of Schistosoma haematobium in Guinea Bissau. Freshwater without flow or with little flow is the favorable habitat for free life stages (miracidium and cercaria) of S. haematobium, as well as, of their snail (Gastropoda) intermediate hosts. Thus, in areas where schistosomiasis caused by S. haematobium is endemic, a change of water flow to without flow or little flow constitutes a potential risk of appearance of new foci of transmission of schistosomiasis. This type of situation of decrease of flow in freshwater collections has occurred in several zones along the Geba river in Guinea Bissau, and this was a consequence…
Nitrogen Release Dynamics of Erythrina abyssinian and Erythrina brucei litters as Influenced by Polyphenol, Lignin and Nitrogen Contents
Litter mineralization is a crucial process in providing nutrients through decomposition to plants, which also depends in the chemical composition of the litter and soil properties as well. Decomposition rate of Erythrina abyssinian and Erythrina brucei in Luvisol was investigated in relation to their nutrient release dynamics such as NH4+ and NO3- in relation to their initial concentrations of lignin, ADF, cellulose and total polyphenol content and their ratios. The dynamic was followed in an incubation pot experiment, CRD design in replication. Erythrina abyssinian has an average of 4.05%, 9.7% and 2.04% TN, lignin and total polyphenol content respectively. Erythrina brucei has also an average of 3.05 %, 12.63 % and 1.05 % content of TN, lignin and total polyphenol respectively. The samples of Erythrina abyssinian and Erythrina brucei were ground and incorporated with Luvisol in pots. Each treatment and control were sampled and analyzed on weekly basses to determine the amount of ammonium and nitrate released. The lignin and total polyphenol was significantly positively correlated with the release of NH4+, while the NO3- showed significant negative correlations with the release of ammonium. From the experiment it was observed that the Erythrina abyssinian with lower content of lignin and high in TN has released the nutrients faster where as Erythrina brucei with high lignin and low total polyphenol content released slowly. In general, these leguminous trees released NH4+and NO3- easily because of their high total nitrogen content and low lignin, ADF, cellulose and total polyphenol content. They attained their half-life within 2–3 weeks. Therefore, Erythrina abyssinica and Erythrina brucei bears fast mineralization as a result they can be used for fast-term correction of crop nutrient demand. However, more detailed researches are needed to synchronize and verify laboratory results with field measurements of their effect on crop production and synchronization of…
