ABSTRACT
BACKGROUND: Children with sickle cell anemia (SCA) are at high risk for stroke. Protocols for stroke prevention including blood transfusions, screening for abnormal non-imaging transcranial Doppler (TCD) measurements, and hydroxyurea therapy are difficult to implement in low-resource environments like Nigeria. This study aimed to examine the contextual factors around TCD screening in a community hospital in Nigeria using qualitative interviews and focus groups. METHODS: We conducted a descriptive qualitative study in a community hospital in Kaduna, Nigeria, using focus groups and interviews. Interview guides and analysis were informed by the Consolidated Framework for Implementation Research (CFIR) framework and the Theory of Planned Behavior. Transcripts were coded and analyzed using an iterative deductive (CFIR)/Inductive (transcribed quotes) qualitative methodology. RESULTS: We conducted two focus groups and five interviews with health care workers (nurses and doctors) and hospital administrators, respectively. Themes identified key elements of the inner setting (clinic characteristics, resource availability, implementation climate, and tension for change), characteristics of individuals (normative, control, and behavioral beliefs), and the implementation process (engage, implement, and adopt), as well as factors that were influenced by external context, caregiver needs, team function, and intervention characteristics. Task shifting, which is already being used, was viewed by providers and administrators as a necessary strategy to implement TCD screening in a clinic environment that is overstressed and under-resourced, a community stressed by poverty, and a nation with an underperforming health system. CONCLUSION: Task shifting provides a viable option to improve health care by making more efficient use of already available human resources while rapidly expanding the human resource pool and building capacity for TCD screening of children with SCD that is more sustainable. TRIAL REGISTRATION: NCT05434000.
ABSTRACT
Background: Children with sickle cell anemia (SCA) are at high risk for stroke. Protocols for stroke prevention including blood transfusions, screening for abnormal non-imaging transcranial Doppler (TCD) measurements, and hydroxyurea therapy are difficult to implement in low-resource environments like Nigeria. This study aimed to examine the contextual factors around TCD screening in a community hospital in Nigeria using qualitative interviews and focus groups. Methods: We conducted focus groups with health care providers and interviews with administrative leadership of the community hospital. Interview guides and analysis were informed by the Consolidated Framework for Implementation Research (CFIR) framework. Transcripts were coded and analyzed using an iterative deductive (CFIR)/Inductive (transcribed quotes) qualitative methodology. Results: We conducted two focus groups and five interviews with health care workers (nurses and doctors) and hospital administrators, respectively. Themes identified key elements of the inner setting (clinic characteristics, resource availability, implementation climate, and tension for change), characteristics of individuals (normative, control, and behavioral beliefs), and the implementation process (engage, implement, and adopt), as well as factors that were influenced by external context, caregiver needs, team function, and intervention characteristics. Task shifting, which is already being used, was viewed by providers and administrators as a necessary strategy to implement TCD screening in a clinic environment that is overstressed and under-resourced, a community stressed by poverty, and a nation with an underperforming health system. Conclusion: Task shifting provides a viable option to improve health care by making more efficient use of already available human resources while rapidly expanding the human resource pool and building capacity that is more sustainable. Trial registration: NCT05434000.
ABSTRACT
Tomato is beneficial to human health because it contains valuable vitamins such as vitamins A, C and several minerals. However, to meet up with the demands of the ever increasing population, there is need to improve tomato production. This research, thus, investigated the impact of rice-husk biochar on the agronomic performances of tomato plant and microbial biomass of carbon, nitrogen and phosphorus in different tomato growth stages. The rice husk biochar pyrolyzed at 350 °C was amended with soil at four different application rates: 0, 2.5, 5.0 and 7.5 t/ha. Physicochemical property of soil was conducted using Mid Infrared Reflectance Spectroscopy method. Impact of biochar on Microbial Biomass Carbon, Microbial Biomass Nitrogen and Microbial Biomass Phosphorous was conducted using fumigation extraction method and monitored at three functional stages. Biochar application appreciably increase the soil physicochemical properties such as pH, Ca, Na, H+, S, P, B, C, Zn and cation exchangeable capacity in comparison with the control. Biochar amended soil significantly enhanced tomato height, stem girth, leaf area, flowers, fruit yields and weight. Although, B3 recorded the lowest leaf area, it possessed the highest number of fruits and fruit weight of 3 and 40%, respectively. The ratio of Microbial biomass C:N:P for biochar amended soil at 7.5 t/ha (B3) was 302.30:18.81:11.75 µg/g, compared to control, which was 242.12:18.30:11.49 µg/g. This study revealed that biochar amendments significantly (p < 0.05) increased the yields and microbial biomass of tomato plants. Conclusively, the application of rice-husk biochar (7.5 t/ha) to soil is considered as a suitable approach to improve tomato growth and yield.
