Awareness and Coverage of the National Health Insurance Scheme among Formal Sector Workers in Ilorin, Nigeria

A prepayment scheme for health through the National Health Insurance Scheme (NHIS) was commenced in Nigeria about ten years ago. Nigeria operates a federal system of government. Sub- national levels possess a high degree of autonomy in a number of sectors including health. It is important to assess the level of coverage of the scheme among the formal sector workers in Nigeria as a proxy to gauge the extent of coverage of the scheme and derive suitable lessons that could be used in its expansion. This is a cross-sectional, descriptive survey carried out among formal sector workers in Ilorin Kwara State, Nigeria. A stratified sampling technique was used to select study participants. A self-administered questionnaire was used to collect data from respondents. Data was analysed with the SPSS. Ethical approval to conduct the study was obtained from the Bowen University Teaching Hospital Research Ethics Committee. A total of 370 people participated in the study. Majority, (78.9%) of the respondents were aware of the NHIS, however only 13.5 % paid for health care services through the NHIS. Logistic regression analysis shows that respondents with post-secondary education (OR = 9.032, CI = 2.562 – 31.847, p = 0.001) and in federal civil service (OR = 2.679, CI = 1.036 – 6.929, p = 0.042) were over nine and three times more likely to be aware of the scheme than others. Coverage of the scheme among the respondents was unimpressive. A lot still need to be done to fast-track the expansion of the scheme among this sector of the population.

A Transformative Olympic Village: The Washington 2024 Post-Games Legacy

This thesis explores the Modern Olympic Games to strategically design an Olympic Village for Washington D.C. that plans not just to house athletes, but to provide a vision for the post-Games city. Through discovery of the spirit and meaning behind one of the world’s biggest events and analysis of various post-Games Villages, the proposed Olympic Village will innovate the future of Washington D.C.’s Southeast region. Study of existing mixed-use architecture, urban planning, and adaptation will help formulate an Olympic Village design. It is the intention that the Olympic Village, much like its athletes, will emulate the Olympic motto “Citius, Altius, Fortius,” meaning “Faster, Higher, Stronger.” The objective is to establish a village that allows for a faster turnaround in post-Olympic design, utilizes higher standards, and uses stronger applications to building a more sustainable city.

The Influence of Pre-Migration Factors and Post-Migration Climate of the Receiving Community on the Psychological Distress of Latino Immigrants

Over forty million foreign-born residents currently live in the United States. Latinos make up the largest population of immigrants living in the U.S. Previous research suggests that Latino immigrants often experience pre-migration stressors, such as traumatic experiences, political upheaval, and unplanned migration. These stressors may have a negative impact on immigrants’ post-migration mental health. Research also suggests that the post-migration climate of the receiving community may inform the connection between pre-migration experiences and post-migration mental health. The current study examined the relationship between Latino immigrants’ reasons for migration, migration planning, and pre-migration experience of political and/or interpersonal violence, and post-migration symptoms of psychological distress. In addition to examining the effect of these pre-migration factors, the current study also examined the community “climate” experienced by Latino immigrants post-migration by assessing the influence of three post-migration factors: 1) community support and engagement, 2) discrimination, and 3) employment. The study was a secondary analysis of data collected for the National Latino and Asian American Study, which focused on the mental health and service utilization of Latinos and Asian Americans. Participants included 1,629 Latino immigrants from across the United States. Results indicated that pre-migration experience of political and/or interpersonal trauma, post-migration experience of discrimination, and female sex were positively associated with psychological distress. Post-migration employment was negatively associated with psychological distress. In addition, discrimination modified the association between unplanned migration and psychological distress; the relationship between unplanned migration and psychological distress decreased for participants who reported more discrimination. Furthermore, employment modified the association between political and/or interpersonal trauma and psychological distress; the connection between trauma and psychological distress increased among those who reported having less employment. Recommendations for further research were presented. Policy and clinical practice implications were discussed, particularly given the current climate of high anti-immigrant sentiment and hostility in the U.S.

The antecedents of post-initial adoption behavior in a S-D logic context

Repercussions of innovation adoption and diffusion studies have long been imperative to the success of novel introductions. However, perceptions and deductions of current innovation understandings have been changing over time. The paradigm shift from the goods-dominant (G-D) logic to the service-dominant (S-D) logic potentially makes the distinction between product (goods) innovation and service innovation redundant as the S-D logic lens views all innovations as service innovations (Vargo and Lusch, 2004; 2008; Lusch and Nambisan, 2015). From this perspective, product innovations are in essence service innovations, as goods serve as mere distribution mechanisms to deliver service. Nonetheless, the transition to such a broadened and transcending view of service innovation necessitates concurrently a change in the underlying models used to investigate innovation and its subsequent adoption. The present research addresses this gap by engendering a novel model for the most crucial period of service diffusion within the S-D logic context – the post-initial adoption phase, which demarcates an individual’s behavior after the initial adoption decision of a service. As a wellfounded understanding of service diffusion and the complementary innovation adoption still lingers in its infancy, the current study develops a model based on interdisciplinary domains mapping. Here fore, knowledge of the relatively established viral source domain is mapped to the comparatively undetermined target domain of service innovation adoption. To assess the model and test the importance of the explanatory variables, survey data from 750 respondents of a bank in Northern Germany is scrutinized by means of Structural Equation Modeling (SEM). The findings reveal that the continuance intention of a customer, actual usage of the service and the customer influencer value all constitute important postinitial adoption behavior that have meaningful implications for a successful service adoption. Second, the four constructs customer influencer value, organizational commitment, perceived usefulness and service customization are evidenced to have a differential impact on a iv customer’s post-initial adoption behavior. Third, this study indicates that post-initial adoption behavior further underlies the influence of a user’s age and besides that is also provoked by the internal and external environments of service adoption. Finally, this research amalgamates the broad view of service innovation by Nambisan and Lusch (2015) with the findings ensuing this enquiry’s model to arrive at a framework that it both, generalizable and practically applicable. Implications for academia and practitioners are captured along with avenues for future research.

Design of evacuation plans for densely urbanised city centres

The high population density and tightly packed nature of some city centres make emergency planning for these urban spaces especially important, given the potential for human loss in case of disaster. Historic and recent events have made emergency service planners particularly conscious of the need for preparing evacuation plans in advance. This paper discusses a methodological approach for assisting decision-makers in designing urban evacuation plans. The approach aims at quickly and safely moving the population away from the danger zone into shelters. The plans include determining the number and location of rescue facilities, as well as the paths that people should take from their building to their assigned shelter in case of an occurrence requiring evacuation. The approach is thus of the location–allocation–routing type, through the existing streets network, and takes into account the trade-offs among different aspects of evacuation actions that inevitably come up during the planning stage. All the steps of the procedure are discussed and systematised, along with computational and practical implementation issues, in the context of a case study – the design of evacuation plans for the historical centre of an old European city.

Are adolescents/young people and their families getting the best service when being cared for by young adolescent student nurses?

The purpose of this presentation is to highlight issues that exist for student nurses who embark on a career in children's nursing at a very young age and subsequently find themselves in a situation where they are expected to deliver high quality care to young people and their families. An introductory sentence indicating the purpose of the presentation: Currently in the UK under the Making a Différence Curriculum (DOH 1999) students can enrol on a single registration programme for Children's Nursing as young as 17.5 years. Children are admitted to hospital onto the children's wards between the ages of 0-16 years (occasionally older). Using Viner's (2003) définition of adolescence as being that period between the ages of ten and twenty-five years when biopsychosocial maturation leads to functional independence in adult iife demonstrates the possibility that both the patients and the nursing students could be undergoing very similar transitional experiences. Historically, in the 1940-50's children were admitted to childrens wards between the ages of 2-12 years. Nurse education at that time tended to be undertaken for first or second level registration in the first instance, followed by post-registration training for specialist areas. Subsequently, the phenomenon of adolescent paediatric nursing students being required to care for adolescents and their families on the children's wards did not exist some 60 years ago. A brief description of the highiights of the présentation: This présentation will focus on adolescent transitions with particular reference to issues that could arise when young students are required to care for young people and their families, particularly when there is a diagnosis of self harm or substance abuse. A summary of findings and/or other relevant information: Preliminary findings have indicated that very young student nurses find caring for adolescents to be particularly challenging. Health issues pertinent to young people appear to présent particular challenges for the students which raises questions in respect of the quality of care that the young people and their families may receive. A conclusion and implications: The following need to be further explored: i) Support within the clinical areas and adequate de-briefing strategies, ii) The efficacy of single registration to children's nursing, iii) Young people and their family's perception of the quality of care they receive from very young students.

Use of Fiber Reinforced Polymer Composite Cable for Post-tensioning Application

Corrosion of steel tendons is a major problem for post-tensioned concrete, especially because corrosion of the steel strands is often hard to detect inside grouted ducts. Non-metallic tendons can serve as an alternative material to steel for post-tensioning applications. Carbon fiber reinforced polymer (CFRP), given its higher strength and elastic modulus, as well as excellent durability and fatigue strength, is the most practical option for post-tensioning applications. The primary objective of this research project was to assess the feasibility of the use of innovative carbon fiber reinforced polymer (CFRP) tendons and to develop guidelines for CFRP in post-tensioned bridge applications, including segmental bridges and pier caps. An experimental investigation and a numerical simulation were conducted to compare the performance of a scaled segmental bridge model, post-tensioned with two types of carbon fiber strands and steel strands. The model was tested at different prestress levels and at different loading configurations. While the study confirms feasibility of both types of carbon fiber strands for segmental bridge applications, and their similar serviceability behavior, strands with higher elastic modulus could improve structural performance and minimize displacements beyond service loads. As the second component of the project, a side-by-side comparison of two types of carbon fiber strands against steel strands was conducted in a scaled pier cap model. Two different strand arrangements were used for post-tensioning, with eight and six strands, respectively representing an over-design and a slight under-design relative to the factored demand. The model was tested under service and factored loads. The investigation confirmed the feasibility of using carbon fiber strands in unbonded post-tensioning of pier caps. Considering both serviceability and overload conditions, the general performance of the pier cap model was deemed acceptable using either type of carbon fiber strands and quite comparable to that of steel strands. In another component of this research, creep stress tests were conducted with carbon fiber composite cable (CFCC). The anchorages for all the specimens were prepared using a commercially available expansive grout. Specimens withstood 95% of the guaranteed capacity provided by the manufacturer for a period of five months, without any sign of rupture.

Evaluating Methods of Calculating the Fixed Fee on Professional Service Contracts

The South Carolina Department of Transportation routinely retains Professional Consulting Engineering firms to provide engineering design and related professional services for the preparation of construction plans or design-build Request for Proposal bid packages for a wide variety of Federal-aid Highway Program roadway and bridge construction projects throughout South Carolina.The purpose of this project is to examine the current process of determining a "Fair and Reasonable" fixed fee for professional service contracts and to evaluate possible alternative methods including practices in other states that may improve the process, particularly in light of the considerable variation in audited overhead rates among consulting firms. In reviewing such alternative methods particular attention will be given to evaluating the potential impact of the method as an incentive to consulting firms to effectively manage their overhead costs.

An Efficient Protocol For The Generation Of Monocyte Derived Dendritic Cells Using Serum-free Media For Clinical Applications In Post Remission Aml Patients.

Protocols for the generation of dendritic cells (DCs) using serum as a supplementation of culture media leads to reactions due to animal proteins and disease transmissions. Several types of serum-free media (SFM), based on good manufacture practices (GMP), have recently been used and seem to be a viable option. The aim of this study was to evaluate the results of the differentiation, maturation, and function of DCs from Acute Myeloid Leukemia patients (AML), generated in SFM and medium supplemented with autologous serum (AS). DCs were analyzed by phenotype characteristics, viability, and functionality. The results showed the possibility of generating viable DCs in all the conditions tested. In patients, the X-VIVO 15 medium was more efficient than the other media tested in the generation of DCs producing IL-12p70 (p=0.05). Moreover, the presence of AS led to a significant increase of IL-10 by DCs as compared with CellGro (p=0.05) and X-Vivo15 (p=0.05) media, both in patients and donors. We concluded that SFM was efficient in the production of DCs for immunotherapy in AML patients. However, the use of AS appears to interfere with the functional capacity of the generated DCs.

Temporomandibular Dysfunction Post-craniotomy: Evaluation Between Pre- And Post-operative Status.

To identify risk factors associated with post-operative temporomandibular joint dysfunction after craniotomy. The study sample included 24 patients, mean age of 37.3 ± 10 years; eligible for surgery for refractory epilepsy, evaluated according to RDC/TMD before and after surgery. The primary predictor was the time after the surgery. The primary outcome variable was maximal mouth opening. Other outcome variables were: disc displacement, bruxism, TMJ sound, TMJ pain, and pain associated to mandibular movements. Data analyses were performed using bivariate and multiple regression methods. The maximal mouth opening was significantly reduced after surgery in all patients (p = 0.03). In the multiple regression model, time of evaluation and pre-operative bruxism were significantly (p < .05) associated with an increased risk for TMD post-surgery. A significant correlation between surgery follow-up time and maximal opening mouth was found. Pre-operative bruxism was associated with increased risk for temporomandibular joint dysfunction after craniotomy.

[principles Of Universality, Comprehensiveness And Equity In A Hearing Health Care Service].

This article analyzed whether the practices of hearing health care were consistent with the principles of universality, comprehensiveness and equity from the standpoint of professionals. It involved qualitative research conducted at a Medium Complexity Hearing Health Care Center. A social worker, three speech therapists, a physician and a psychologist constituted the study subjects. Interviews were conducted as well as observation registered in a field diary. The thematic analysis technique was used in the analysis of the material. The analysis of interviews resulted in the construction of the following themes: Universality and access to hearing health, Comprehensive Hearing Health Care and Hearing Health and Equity. The study identified issues that interfere with the quality of service and run counter to the principles of Brazilian Unified Health System. The conclusion reached was that a relatively simple investment in training and professional qualification can bring about significant changes in order to promote a more universal, comprehensive and equitable health service.

Metals And (metallo)proteins Identification In Vitreous Humor Focusing On Post-mortem Biochemistry.

This work describes the evaluation of metals and (metallo)proteins in vitreous humor samples and their correlations with some biological aspects in different post-mortem intervals (1-7 days), taking into account both decomposing and non-decomposing bodies. After qualitative evaluation of the samples involving 26 elements, representative metal ions (Fe, Mg and Mo) are determined by inductively coupled plasma mass spectrometry after using mini-vial decomposition system for sample preparation. A significant trend for Fe is found with post-mortem time for decomposing bodies because of a significant increase of iron concentration when comparing samples from bodies presenting 3 and 7 days post-mortem interval. An important clue to elucidate the role of metals is the coupling of liquid chromatography with inductively coupled plasma mass spectrometry for identification of metals linked to proteins, as well as mass spectrometry for the identification of those proteins involved in the post-mortem interval.

Taurine Supplementation Reduces Blood Pressure And Prevents Endothelial Dysfunction And Oxidative Stress In Post-weaning Protein-restricted Rats.

Taurine is a sulfur-containing amino acid that exerts protective effects on vascular function and structure in several models of cardiovascular diseases through its antioxidant and anti-inflammatory properties. Early protein malnutrition reprograms the cardiovascular system and is linked to hypertension in adulthood. This study assessed the effects of taurine supplementation in vascular alterations induced by protein restriction in post-weaning rats. Weaned male Wistar rats were fed normal- (12%, NP) or low-protein (6%, LP) diets for 90 days. Half of the NP and LP rats concomitantly received 2.5% taurine supplementation in the drinking water (NPT and LPT, respectively). LP rats showed elevated systolic, diastolic and mean arterial blood pressure versus NP rats; taurine supplementation partially prevented this increase. There was a reduced relaxation response to acetylcholine in isolated thoracic aortic rings from the LP group that was reversed by superoxide dismutase (SOD) or apocynin incubation. Protein expression of p47phox NADPH oxidase subunit was enhanced, whereas extracellular (EC)-SOD and endothelial nitric oxide synthase phosphorylation at Ser 1177 (p-eNOS) were reduced in aortas from LP rats. Furthermore, ROS production was enhanced while acetylcholine-induced NO release was reduced in aortas from the LP group. Taurine supplementation improved the relaxation response to acetylcholine and eNOS-derived NO production, increased EC-SOD and p-eNOS protein expression, as well as reduced ROS generation and p47phox expression in the aortas from LPT rats. LP rats showed an increased aortic wall/lumen ratio and taurine prevented this remodeling through a reduction in wall media thickness. Our data indicate a protective role of taurine supplementation on the high blood pressure, endothelial dysfunction and vascular remodeling induced by post-weaning protein restriction. The beneficial vascular effect of taurine was associated with restoration of vascular redox homeostasis and improvement of NO bioavailability.

Effects Of Programmed Physical Activity On Body Composition In Post-pubertal Schoolchildren.

To assess body composition modifications in post-pubertal schoolchildren after practice of a physical activity program during one school year. The sample consisted of 386 students aged between 15 and 17 years and divided into two groups: the study group (SG) comprised 195 students and the control group (CG), 191. The SG was submitted to a physical activity program and the CG attended conventional physical education classes. Body composition was assessed using body mass index (BMI), percentage of body fat (%BF), fat mass (FM), and lean mass (LM). A positive effect of the physical activity program on body composition in the SG (p<0.001) was observed, as well as on the interaction time x group in all the variables analyzed in both genders. A reduction in %BF (mean of differences = -5.58%) and waist circumference (-2.33cm), as well as an increase in LM (+2.05kg) were observed in the SG for both genders, whereas the opposite was observed in the CG. The practice of programmed physical activity promotes significant reduction of body fat in post-pubertal schoolchildren.

Post Hoc Analysis Of The Patricia Randomized Trial Of The Efficacy Of Human Papillomavirus Type 16 (hpv-16)/hpv-18 As04-adjuvanted Vaccine Against Incident And Persistent Infection With Nonvaccine Oncogenic Hpv Types Using An Alternative Multiplex Type-specific Pcr Assay For Hpv Dna.

The efficacy of the human papillomavirus type 16 (HPV-16)/HPV-18 AS04-adjuvanted vaccine against cervical infections with HPV in the Papilloma Trial against Cancer in Young Adults (PATRICIA) was evaluated using a combination of the broad-spectrum L1-based SPF10 PCR-DNA enzyme immunoassay (DEIA)/line probe assay (LiPA25) system with type-specific PCRs for HPV-16 and -18. Broad-spectrum PCR assays may underestimate the presence of HPV genotypes present at relatively low concentrations in multiple infections, due to competition between genotypes. Therefore, samples were retrospectively reanalyzed using a testing algorithm incorporating the SPF10 PCR-DEIA/LiPA25 plus a novel E6-based multiplex type-specific PCR and reverse hybridization assay (MPTS12 RHA), which permits detection of a panel of nine oncogenic HPV genotypes (types 16, 18, 31, 33, 35, 45, 52, 58, and 59). For the vaccine against HPV types 16 and 18, there was no major impact on estimates of vaccine efficacy (VE) for incident or 6-month or 12-month persistent infections when the MPTS12 RHA was included in the testing algorithm versus estimates with the protocol-specified algorithm. However, the alternative testing algorithm showed greater sensitivity than the protocol-specified algorithm for detection of some nonvaccine oncogenic HPV types. More cases were gained in the control group than in the vaccine group, leading to higher point estimates of VE for 6-month and 12-month persistent infections for the nonvaccine oncogenic types included in the MPTS12 RHA assay (types 31, 33, 35, 45, 52, 58, and 59). This post hoc analysis indicates that the per-protocol testing algorithm used in PATRICIA underestimated the VE against some nonvaccine oncogenic HPV types and that the choice of the HPV DNA testing methodology is important for the evaluation of VE in clinical trials. (This study has been registered at ClinicalTrials.gov under registration no. NCT00122681.).