A critical appraisal of the social entrepreneurship paradigm in an international setting : a proposed conceptual framework

Evaluation of factors affecting adherence to asthma controller therapy in chest clinics in a sub-Saharan African setting: a cross-sectional study

Background: Adherence to controller therapy in asthma is a major concern during the management of the disease. Objective: To determine the adherence rate and identify the predictors of low adherence to asthma controller therapy. Methods: A cross-sectional study including asthma patients was conducted from November 1, 2012 to May 31, 2013 in 4 chest clinics in Cameroon. The adherence to asthma treatment was rated using Morisky Medication Adherence Scale. A multivariate logistic regression analysis was performed for the identification of factors associated with adherence to asthma treatment. Results: Among the 201 asthma patients included, 133 (66.2%) were female. The mean age of participants was 41.2 years. Sixty-one (30.3%) of the patients did not visit the chest physician during the last year prior to the study. Asthma was well controlled in 118 patients (58.7%). The prevalence of low adherence rate to asthma controller therapy was 44.8% and the absence of any chest specialist visit within the last 12 months was the only factor associated with the low adherence rate to asthma treatment (OR 5.57 ; 95% CI 2.84–10.93). Conclusion: The adherence rate to asthma controller therapy in Cameroon is low and it could be improved if scheduled visits are respected by patients.

Is facility based neonatal care in low resource setting keeping pace? A glance at Uganda’s National Referral Hospital.

Objectives: To identify reasons for neonatal admission and death with the aim of determining areas needing improvement. Method: A retrospective chart review was conducted on records for neonates admitted to Mulago National Referral Hospital Special Care Baby Unit (SCBU) from 1st November 2013 to 31st January 2014. Final diagnosis was generated after analyzing sequence of clinical course by 2 paediatricians. Results: A total of 1192 neonates were admitted. Majority 83.3% were in-born. Main reasons for admissions were prematurity (37.7%) and low APGAR (27.9%).Overall mortality was 22.1% (Out-born 33.6%; in born 19.8%). Half (52%) of these deaths occurred in the first 24 hours of admission. Major contributors to mortality were prematurity with hypothermia and respiratory distress (33.7%) followed by birth asphyxia with HIE grade III (24.6%) and presumed sepsis (8.7%). Majority of stable at risk neonates 318/330 (i.e. low APGAR or prematurity without comorbidity) survived. Factors independently associated with death included gestational age <30 weeks (p 0.002), birth weight <1500g (p 0.007) and a 5 minute APGAR score of < 7 (p 0.001). Neither place of birth nor delayed and after hour admissions were independently associated with mortality. Conclusion and recommendations: Mortality rate in SCBU is high. Prematurity and its complications were major contributors to mortality. The management of hypothermia and respiratory distress needs scaling up. A step down unit for monitoring stable at risk neonates is needed in order to decongest SCBU.

Matkakohteesta historian kaupungiksi – Historian ja matkakirjoittamisen suhde historioitsija John Andrewsin grand tour -oppaan Letters to a Young Gentleman, on His Setting out for France (1784) Pariisi-osuuksissa

Työni kohteena on ollut historiankirjoittaja John Andrewsin (n.1736–1809) grand tour -opas Letters to a Young Gentleman, on His Setting out for France (1784). Tutkielmassa olen tarkastellut sitä, millaiseen suhteeseen historia ja matkakirjoittaminen ovat teoksen Pariisi-osuuksissa asettuneet. Ilmiötä olen lähestynyt hyödyntämällä niin kutsuttua reframingin käsitettä, jolla historiantutkimuksessa on jäsennetty ajatusten kehystymistä eri konteksteissa – siis niille annettujen merkitysten muuttumista. Tämä käsite on mahdollistanut sellaisen tarkastelun, jossa huomio on kohdistunut historian oppaassa saamiin käyttöihin sekä sen merkitysten muotoutumiseen. Andrewsin oppaasta voi erottaa kaksi pistettä, joissa historia ja matkakirjoittaminen ovat kietoutuneet toisiinsa. Pisteistä ensimmäinen on kytkeytynyt nähtävyyksien kohtaamiseen, kun taas niistä jälkimmäinen on liittynyt Pariisin kulttuurisen aseman määrittelemiseen. Andrewsille historia onkin näyttäytynyt eräänlaisena välineenä, joka on paitsi ohjannut myös perustellut nähtävyyksien tarkastelemista. Samalla historia on jäsentänyt kaupungin suhdetta Ranskaan, Eurooppaan ja kristikuntaan – sekä muihin kansoihin ja eri kirkkokuntiin. Nämä pisteet eivät kuitenkaan ole jääneet irrallisiksi, sillä molemmissa yhteyksissä uskonnolliset erot ovat saaneet merkittävän sijan. Yhtäältä historia on tukenut näihin eroihin perustuneita vertailuasetelmia; toisaalta erot ovat muokanneet Andrewsin suhdetta nähtävyyksiin sekä niiden historiallisuuteen. Reframingin käsitteeseen perustuva erittely on osoittanut sen, että Andrewsin oppaassa historia ei ole ollut vain matkakirjoittamisen aihepiiri. Tekstissä historia onkin saanut myös toisenlaisia käyttöjä, minkä voi liittää matkakirjallisuuden konventioihin sekä aikakauden grand tour -keskusteluihin. Kyse on siitä, että Andrewsin matkakirjoittamista ovat ohjanneet lajityypin genrepiirteet sekä teoksen oletettu yleisö – siis grand tourille aikovat nuorukaiset. Nämä keskustelut ja konventiot ovat tarjonneet Andrewsille eräänlaisen kehyksen, joka on säädellyt hänen tekemiään valintoja. Samalla se on jäsentänyt historian oppaassa saamia merkityksiä.

Functions of code-switching in multilingual student community

Dissertação de Mestrado, Ciências da Linguagem, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2013

Evaluation of antibiotic prescription for upper respiratory tract infections in the community pharmacy setting

This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License. http://creativecommons.org/licenses/by/4.0/

The Role of EFL Teachers in the ESL Setting

Se describen las acciones que los profesionales de la enseñanza del inglés como lengua extranjera deben llevar a cabo al trasladarse a un contexto en el que se aprende el idioma como segunda lengua. Se subraya la función de esos profesionales como defensores y tutores de estudiantes con diversidad cultural y lingüística. Asimismo, se señalan los importantes aspectos portener en cuenta para cumplir con esa función.A description is provided of the challenges that English as a Foreign Language teaching professionals face when being relocated to an English as a Second Language setting. Language teaching professionals' role as advocates and educational parents to Culturally and Linguistically Diverse (CLD) students is highlighted. The most important aspects to take into account to fulfill such a role are also presented.

Pharmacists’ knowledge and perception of topical antibacterial drug dispensing in community pharmacy setting in Kedah, Malaysia

Purpose: To assess Pharmacists’ Perceptions and Experiences of Topical Antibacterial Drug Dispensing in Community Pharmacy Setting in Kedah State, Malaysia in order to minimize drug resistance issues. Methods: A cross-sectional study involving a pre-validated questionnaire was conducted in community pharmacies within Kedah State, Malaysia. Descriptive statistics and Spearman’s correlation coefficient were used for data analysis. The collected were analysed using statistical package for social sciences (SPSS) version 18.0. Results: The result shows that, 53.4 % of CPs in Kedah State perceived that topical antibacterial is not necessary for every topical bacterial infection. Fusidic acid was the most frequently dispensed topical antibacterial drug while superficial wound was reported to be the most frequently encountered topical bacterial infection. CPs (12.60 %) encountered antibacterial resistance cases but none reported them. The drug that had resistance issue was neomycin. Conclusion: CPs in Kedah State, Malaysia generally have the right perceptions on the dispensing of topical antibacterial drugs. However, their knowledge on the rational use of topical antibacterial drugs and vigilance on antibacterial resistance issue need improvement.

Complications associated with malnutrition in elective surgical patients in a Malaysian setting

Purpose: To identify the level of malnutrition and complications observed in Malaysia. Methods: A prospective, observational study was conducted with the objectives of identifying the degree of malnutrition, complications and the need for nutritional support in elective surgical patients. Collection of data was performed in local tertiary hospitals using a Patient Generated Subjective Global Assessment (PG - SGA) nutritional screening tool and medical records. Results: A total of 50 patients electively admitted for surgery were included. The results demonstrated that there was a significant increase in malnourished patients post-surgery compared to pre-surgery (p = 0.0001). Most interesting was the significant number of complications observed post-surgery compared to pre-surgery (p = 0.035) which was associated to the poor level of nutrition. The most common type of complications noted post-surgery were nosocomial infection, wound infection and readmission. Conclusion: Malnutrition is prevalent pre- and post-operatively in Malaysia. Therefore, focus on the outcome of these malnourished patients should be performed to reduce complications associated with poor nutrition.