Elements of person-centred diagnostic imaging care in low-and middle-income countries: A systematic review.

INTRODUCTION: Diagnostic imaging professionals are trained to deliver safe and high-quality person-centred radiographic diagnostic imaging care. The term person-centred care has been described as a confused concept without a unified definition. This systematic review identified the elements that have been used to measure person-centred care in diagnostic imaging in low- and middle-income countries (LMICs). METHODS: A systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Embase, MEDLINE and Cochrane library were searched. Bias was assessed using the Critical Appraisal Skill Programme and Mixed Method Appraisal Tool. A narrative synthesis guided by the Picker Principles of person-centred care was undertaken. RESULTS: Of the 4482 articles identified, 26 articles were included. The studies were from 12 LMICs. Synthesis of the literature generated six themes, namely access to high quality and safe diagnostic imaging care, effective communication and shared diagnostic imaging decision making, suitable diagnostic imaging environment for physical comfort, respectful and compassionate diagnostic radiographers, effective coordination of diagnostic imaging care process, and family and friends' involvement in diagnostic imaging care. CONCLUSION: Medical imaging facilities in most LMICs continue to struggle with issues of access, safety, quality, and responsiveness to the needs of patients. The need for innovative person-centred diagnostic imaging care interventions in LMICs has become urgent. IMPLICATIONS FOR PRACTICE: If diagnostic imaging services in LMICs are to move beyond the current models of limited person-centred access to care, a greater focus on systems thinking is required. It is imperative to involve all stakeholders, not only patients and radiographers, but also policymakers whose works impact on equitable access to diagnostic imaging services.

POTENTIAL EXPOSURE LEVELS FROM BROADCAST TRANSMITTERS IN GHANA.

The protection of man and his environment from undue exposure from radio frequency electromagnetic field requires identification of the location where exposures are likely to be higher than safe levels established by international safety standards. A wideband measurement with a spectrum analyzer and a log-periodic antenna in conjunction with the three-point spatial average method was used. The results ranged from 16.21 to 2907.00 mVm-1 and complied with a maximum of 1.08% of the ICNIRP reference level. Private frequency modulation (FM) sources were identified as the major source of exposure to the public with a mean value of 337.70 ± 133.70 mVm-1 against 122.30 ± 36.47 mVm-1 for the public FM transmitters. Even though the result was lower than a workplace assessment, it was, however, higher than similar works conducted in Africa and Palestine. Finally, four sensitive locations were identified for further research work.

Monitoring of pesticide residues of five notable vegetables at Agbogbloshie market in Accra, Ghana.

The study monitored the concentrations of pesticide residues in vegetables arriving at Agbogbloshie, a central market in the Accra Metropolis from different parts of Ghana and beyond. A total of 810 samples of 5 different vegetables from Central, Volta, Greater Accra, Ashanti, Eastern Regions, and neighboring country (Togo) were collected from January 2009 through to December 2011. In all, 18 % of the samples had no detectable residues, 62 % were below the maximum residue limits (MRLs), and 20 % also exceeded the EU (MRLs) adopted values. Overall, lettuce contained the highest number of residues above their MRLs besides cucumber and cabbage. The pesticide residues were mainly organophosphates and synthetic pyrethroids. The results demonstrate the need for continuous monitoring of pesticide residues in vegetables arriving at the various major markets in Ghana.

Awareness and Perceptions of and Attitudes towards Caesarean Delivery among Antenatal.

BACKGROUND: Caesarean section (CS) rates have been increasing steadily globally. The safety of the procedure has resulted in some women requesting it in the absence of any medical indication, particularly in the developed countries. OBJECTIVES: To determine the awareness and perceptions of and attitudes towards caesarean delivery among antenatal clinic (ANC) attendants in a Ghanaian teaching hospital. DESIGN: Descriptive cross-sectional study. SETTING: The ANC of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. METHODS: A 13-point structured questionnaire containing items on demographic characteristics and assessment of knowledge of, perceptions and attitudes towards caesarean delivery was administered to women attending the hospital's antenatal clinic from 1(st) December to 31(st) December, 2006. RESULTS: Of 317 women interviewed 304 (96%) had heard of the operation; however only 43 (13.5%) could mention specific indications for it. Vaginal delivery was preferred by 296 (93.3%) while 11 (3.5%) preferred planned caesarean delivery; the remaining 10 (3.2%) were undecided. Although 164 (51.7%) perceived it as being dangerous to the mother and baby, 287 (90.5%) were willing to undergo the operation when indicated; 19 (6%) would refuse the operation even when indicated. Almost all the women, 311 (98.1%), wanted caesarean section to be part of client education at the antenatal clinic and 314 (99.1%) wanted to be informed about the specific indication before surgery. CONCLUSION: There is a high level of awareness of caesarean delivery among ANC attendants at the Komfo Anokye Teaching Hospital. Client education is necessary to address some concerns on safety of and indications for the operation.

Mercury in different environmental compartments of the Pra River Basin, Ghana.

Artisanal gold mining (AGM) with metallic mercury has a long history in Ghana. It is believed to be over 2,000 years old. Today, AGM has escalated in a new dimension consuming about half of the country where gold lode deposits exist along riverbanks or rivers are alluvial-gold rich. The Pra River in southwestern Ghana is a site of on going application of metallic mercury in prospecting gold, and this paper examines mercury (Hg) contamination in the different environmental compartments in its watershed. Samples of water, sediment, soil and biota (i.e., human hair and fish) were collected from locations along the course of the river during the rainy and dry seasons of 2002 and 2003, respectively. Besides the obvious Hg point sources along the Pra and its tributaries, the obtained results show that Hg levels and speciation in the studied aquatic system are controlled by precipitation, which drives the hydrology and differences in flow regimes versus seasons. The seasonal difference in Hg speciation suggests that methyl mercury (MeHg) found in the aqueous phase and riverine sediments is likely of terrestrial origin where its production is favored during the rainy season by high soil water and organic matter content. The use of the enrichment factor (EF) for the assessment of sediment quality indicated moderate to severe contamination of surface sediments in the rainy season, while in the dry season, the EF index indicates nearly no pollution of surface sediments. Accordingly, most of the Hg introduced into this river system is likely transported to depositional downstream terminal basins (e.g. the river delta and the Gulf of Guinea). With regard to biota, Hg measured in hair in the dry period was higher than data obtained on samples collected during the wet period. This could be explained at least in part by the shift in diet as a result of abundance of fish in the local markets and the concurrent increase and more active fishing during the dry season. Mercury data obtained on a very limited number of fish samples collected during the dry period only are also presented.

Preparation of heterocycle-masked beta-enamino acids.

The preparation of masked N-substituted beta-enamino acid derivatives 3a-n by reaction of 2-alkyl-oxa(thia)zolines 2a,b with imidoylbenzotriazoles 1a-g in the presence of LDA was described.