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Identifying Training Needs in Pain Management—A Survey of Staff at a Tertiary Cancer Care Centre

Pain Studies and Treatment 2022年第2期10卷 9-20页

作者： Nazima Dharsee Mary Haule Genoveve Mlawa theodora lwanga Ocean Road Cancer Institute Dar es Salaam Tanzania Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania

Pain is one of the most common and distressing symptoms experienced by cancer patients and can cause significant physical and psychological complications for patients and their families. Adequate pain management requires an understanding of pain, its assessment, and the use of analgesics according to the WHO analgesic ladder;information that is often lacking in routine medical education. Understanding the level of knowledge, attitudes and practices of clinicians who treat cancer pain can help us prepare relevant educational programs to address this need. A cross-sectional descriptive study was conducted among randomly selected eligible clinical staff using self-administered questionnaires that contained close-ended and open-ended questions testing factual knowledge on pain, attitudes towards pain management, and practices related to pain management and opioid use. Results were analyzed using SPSS Version 28. Of 66 participants of this study, 78% were female and 65% were nurses. Only 10% had received any additional training in pain management. Knowledge on pain was found to be adequate in some areas, but deficient in others such as “types of pain” and “adjuvant drugs” (35% and 26% respectively). A significant proportion of responses (73%) showed incorrect attitudes towards pain and opioid use. Recommended practices such as prescribing laxatives with opioids were prevalent (72%), however using a tool to assess pain or the WHO ladder to prescribe analgesics was not as common. The results of this study show that despite being a key component of clinical care, pain management is not adequately understood by many clinicians. Gaps in knowledge, and incorrect attitudes could contribute to inadequate pain management for patients. This study provides valuable information for an educational workshop planned on pain management.

关键词： Pain Knowledge Training

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Management of dog bites by frontline service providers in primary healthcare facilities in the Greater Accra Region of Ghana,2014-2015

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Infectious Diseases of Poverty 2018年第1期7卷 189-198页

作者： Ernest Kenu Vincent Ganu Charles lwanga Noora Richard Adanu Margaret Lartey Department of Medicine School of Medicine and DentistryCollege of Health SciencesUniversity of GhanaKorle BuAccraGhana Department of Epidemiology and Disease Control School of Public HealthCollege of Health SciencesUniversity of GhanaLegonAccraGhana Department of Medicine and Therapeutics Korle Bu Teaching HospitalAccraGhana Sunyani Regional Hospital Ghana Health ServiceSunyaniGhana Department of Population Family and Reproductive Health School of Public HealthCollege of Health SciencesUniversity of GhanaLegonAccraGhana.

Background:Dog bites are common in developing countries including Ghana,with the victims often being *** some breeds of dogs have been identified as being more aggressive than others,all dog bites carry a risk of *** and initial assessment of the risk for tetanus and rabies infection with appropriate interventions such as wound management and subsequent selection of prophylactic antibiotics are essential in the management of dog *** study examined the management of patients with dog bites by frontline service providers at primary healthcare facilities in the Greater Accra Region,***:We conducted a cross-sectional study in 66 public health facilities in the Greater Accra Region from July 2014 to April *** to four frontline service providers were randomly selected to participate from each facility.A structured questionnaire was administered to all consenting *** variables were presented as means and standard *** frontline service providers’knowledge was assessed as a discrete variable and values obtained presented as percentages and *** chi-square test of proportions was used to determine any significant associations between the various categories of the frontline service providers and their knowledge about the management of ***:Regarding the frontline service providers’knowledge about rabies,57.8%(134/232)were correct in that the rabies virus is the causative agent of rabies,39.2%(91/232)attributed it to a dog bite,2.6%(6/232)did not know the cause,and one person(0.4%)attributed it to the herpes *** 15.5%(36/232)knew the incubation period in dogs and the period required to observe for signs of a rabies *** respect to the administration of rabies immunoglobulin,42.2%(98/232)of the frontline service providers did not know how to administer *** the facilities visited,76%(50/66)did not have the rabies vaccines and 44%(102/232)of frontline service p

关键词： Dog bites Rabies Frontline service providers Healthcare facilities Greater Accra Region Ghana

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缅甸坡鹿(Cervus eldi thamin)雌性群等级序位的初步研究

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兽类学报 1990年第2期10卷 97-103页

作者：徐宏发 Kanta Kumari J.S.lwanga 华东师范大学生物学系马来西亚野生动物基金会美国佛罗里达州立大学

本文对11只雌性缅甸坡鹿合群后等级序位建立过程进行了观察,用全部事件取样法(Alloccurrence sampling)对坡鹿的14种社会行为进行了记录,在观察期内记录到1145个社会行为中有962次(84％)是侵犯行为,183次(16％)友好行为。根据侵犯指数... 详细信息

本文对11只雌性缅甸坡鹿合群后等级序位建立过程进行了观察,用全部事件取样法(Alloccurrence sampling)对坡鹿的14种社会行为进行了记录,在观察期内记录到1145个社会行为中有962次(84％)是侵犯行为,183次(16％)友好行为。根据侵犯指数和优势指数排列了各个体的优势等级序位,经用兰道氏(Landau's)指数测定,坡鹿群的优势等级序位是很强的线性等级序位。坡鹿在合群后,通过激烈的争斗建立群内的优势等级序位;然后以较温和的威胁姿态来维持已建立的等级序位。新的入侵者进入已建立等级序位的鹿群会触发起重新争夺序位的激烈争斗。

关键词：坡鹿缅甸坡鹿雌性社群等级序位

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Achieving timely percutaneous reperfusion for rural ST-elevation myocardial infarction patients by direct transport to an urban PCI-hospital

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Journal of Geriatric Cardiology 2016年第10期13卷 840-845页

作者： Charles-lwanga K Bennin Saif Ibrahim Farah Al-Saffar Lyndon C Box Joel A Strom Valley Cardiology Fayetteville North Carolina USA Division of Cardiology Department of Medicine University of Florida College of Medieine Jacksonville Jaeksonville Florida USA Division of Cardiovascular Diseases Mayo Clinic Seottsdale Arizona USA West Valley Medical Group Caldwell Idaho USA Florida Polytechnic University Lakeland Florida USA

Backgrounds ST-elevation myocardial infarction （STEMI） guidelines recommend reperfusion by primary percutaneous coronary in- tervention （PCI） ≤ 90 min from time of first medical contact （FMC）. This strategy is challenging in rural areas lacking a nearby PCI-capable hospital. Recommended reperfusion times can be achieved for STEMI patients presenting in rural areas without a nearby PCI-capable hospital by ground transportation to a central PCI-capable hospital by use of protocol-driven emergency medical service （EMS） STEMI field triage protocol. Methods Sixty STEMI patients directly transported by EMS from three rural counties （Nassau, Camden and Charlton Counties） within a 50-mile radius of University of Florida Health-Jacksonville （UFHJ） from 01/01/2009 to 12/31/2013 were identified from its PCI registry. The STEMI field triage protocol incorporated three elements：（1） a cooperative agreement between each of the rural emergency medical service （EMS） agency and UFHJ; （2） performance of a pre-hospital ECG to facilitate STEMI identification and laboratory activation; and （3） direct transfer by ground transportation to the UFHJ cardiac catheterization laboratory. FMC-to-device （FMC2D）, door-to-device （D2D）, and transit times, the day of week, time of day, and EMS shift times were recorded, and odds ratio （OR） of achieving FMC2D times was calculated. Results FMC2D times were shorter for in-state STEMIs （81 ± 17 vs. 87± 19 min）, but D2D times were similar （37 ± 18 vs. 39 ± 21 min）. FMC2D 〈 90 min were achieved in 82.7% in-state STEMIs compared to 52.2% for out-of-state STEMIs （OR = 4.4, 95% CI： 1.24-15.57; P = 0.018）. FMC2D times were homogenous after adjusting for weekday vs. weekend, EMS shift times. Nine patients did not meet FMC2D ≤ 90 min. Six were within 10 min of target; all patient achieved FMC2D 〈 120 min. Conclusions Guideline-compliant FMC2D ≤90 min is achievable for rural STEMI patients within a 50 mile radius of a PCI-capable hospital by use of protocol-driv

关键词： Myocardial infarction Percutaneous coronary intervention Systems of care

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The Distributional Impacts of Fiscal Consolidation in Uganda

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International Relations and Diplomacy 2020年第10期8卷 438-459页

作者： Corti Paul Lakuma Joseph Mawejje Musa Mayanja lwanga Ezra Munyambonera Makerere University KampalaUganda World Bank Group KampalaUganda Uganda Bankers Association KampalaUganda

While Uganda is considered to be at low risk of debt distress,the stagnant tax effort and large planned capital expenditures might significantly alter this *** paper employs the Dynamic Stochastic General Equilibrium(DSGE)model to examine tax design issues that arise in addressing debt *** results suggest that Uganda may improve it debt position by permanently increasing tax rates by 5%***,an increase of consumption tax rates(Value Added Tax(VAT)and Excise)by this magnitude to meet debt reduction is found to be relatively more distortionary affecting consumption,especially for the poor households,in both the short and long run leading to large temporary reductions in the Gross Domestic Product(GDP).

关键词： Equity Inequality Debt Taxes Fiscal Consolidation Public Finance DSGE Macro-Fiscal Policy

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Effects of Sand-Harvesting on River Water Quality and Riparian Soil Physico-Chemical Properties

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Open Journal of Ecology 2022年第8期12卷 570-583页

作者： Aquila Isere lwanga Harrison Mugatsia Tsingalia Humphrey Agevi Zablon Weku Shilenje Department of Biological Sciences Masinde Muliro University of Science and Technology Kakamega Kenya Department of Water Environment Natural Resources and Climate Change County Government of Kakamega Kakamega Kenya Department of Biological Sciences Jaramogi Oginga Odinga University of Science and Technology Bondo Kenya Department of Atmospheric Physics Charles University Prague Czech Republic

The widespread distribution of river sand-harvesting activities continues to degrade river water quality and the surrounding riverine environments. This study determined practical effects of sand-harvesting on two rivers in Kakamega County Kenya. Water samples were tested for turbidity and total suspended solids (TSS). For riparian soils, nitrogen (N), phosphorus (P), pH, organic carbon (OC), moisture content and textural class were determined on composite samples obtained from the field. Two control sites not affected by sand-harvesting were also used for comparison. Results indicate TSS concentrations increased during the rainy season when sand-harvesting was occurring, with significant differences between the control and sand-harvesting sample groups. Between seasons—dry and wet—in natural circumstances, the riparian soil moisture and phosphorus contents increased significantly. The study shows that river sand-harvesting degrades the aesthetic value of riparian areas, and makes rivers prone to bank erosion, and silt. This increases river water turbidity. The study concludes that sand-harvesting does not directly affect the riparian soil moisture content, total N, P, pH, OC or textural class, but reduces productivity of riparian land and puts the riverine ecosystems at risk.

关键词： River Ecosystem Conservation Riparian Area Kakamega River Lusumu River Shiastala

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5分钟重组Windows自制“再生光碟”

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电脑爱好者 2000年第22期 44-45页

作者： lwanga

想必经常使用电脑的朋友都有这样的经历或苦恼,自己辛苦组装好的电脑在使用一段时间后,由于病毒、软件安装失败、硬件不兼容等原因需要重新安装系统。可就算你对系统安装驾轻就熟,重装一遍Windows少说也要20～30分钟,如果把硬件驱动程... 详细信息

想必经常使用电脑的朋友都有这样的经历或苦恼,自己辛苦组装好的电脑在使用一段时间后,由于病毒、软件安装失败、硬件不兼容等原因需要重新安装系统。可就算你对系统安装驾轻就熟,重装一遍Windows少说也要20～30分钟,如果把硬件驱动程序与其他软件的安装也算在内,则起码要耗上个把小时。这时品牌机所附送的Recovery CD的种种优点一一浮现在眼前,因此萌发了自制“再生光碟”的念头。这种光碟的原理非常简单,它是以整个硬盘或分

关键词：映像盘符 Windows 硬盘硬磁盘磁盘文件光盘软盘第一个

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Grain Yield and Protein Content of Brazilian Cowpea Genotypes under Diverse Ugandan Environments

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American Journal of Plant Sciences 2015年第13期6卷 2074-2084页

作者： Gabriel Ddamulira Carlos Antonio Fernandes Santos Peter Obuo Mildred Alanyo Charles Kasozi lwanga National Crops Resource Research Institute Kampala Uganda Embrapa Semi-Arid Petrolina Brazil National Semi-Arid Resource Research Institute Serere Uganda

Twenty nine cowpea genotypes, including four Ugandan genotypes, were evaluated for grain yield, protein stability and adaptability under diverse environments in a randomized complete block design with three replications. The analysis showed that cowpea grain yield and protein content were significantly (P < 0.01) affected by genotypes (G), environments (E), and interaction (G x E). Genotypes C2T and C2I had the highest grain yield and protein content respectively, but both were only adapted to specific environments. Genotypes C1J, C1V, C2A, C2O, and C2R were adapted to three environments with high yield which was stable. Similarly, genotypes BRS Pujante, C1J, C2Q and CIT also expressed high protein levels with high stability and wide adaptability. The study further revealed that Namulonge 2014B, Serere 2014A, Serere 2014B and Serere were the most favorable environments for obtaining high yield and protein respectively, because at these four environments, mean yield and protein were higher than the overall mean. All Brazilian genotypes had high protein levels compared to Ugandan genotypes indicating the potential of Brazilian genotypes in improving cowpea seed protein content in Uganda.

关键词： Stability Adaptability AMMI GxE Interaction

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