Evaluating the effectiveness of agricultural adaptation to climate change in preindustrial society

The effectiveness of agricultural adaptation determines the vulnerability of this sector to climate change, particularly during the preindustrial era. However, this effectiveness has rarely been quantitatively evaluated, specifically at a large spatial and long-term scale. The present study covers this case of preindustrial society in AD 1500–1800. Given the absence of technological innovations in this time frame, agricultural production was chiefly augmented by cultivating more land (land input) and increasing labor input per land unit (labor input). Accordingly, these two methods are quantitatively examined. Statistical results show that within the study scale, land input is a more effective approach of mitigating climatic impact than labor input. Nonetheless, these observations collectively improve Boserup's theory from the perspective of a large spatial and long-term scale.postprin

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Characteristics and Determinants of Patients Discontinuation of Breast Cancer Follow-Up Care at the Radiation Oncology Department, University College Hospital, Ibadan, Nigeria

Objectives. The aim of this study is to describe the characteristics and predictors of discontinuation during follow-up care among breast cancer patients at the Radiation Oncology Department, University College Hospital (UCH), Ibadan, Nigeria. Methodology. This is a retrospective cross-sectional study of 504 patients with histological diagnosis of breast cancer referred for radiotherapy to the breast or chest wall. Data extraction form was used to obtain information on sociodemographic and disease related variables and time to discontinuation of care. Discontinuation rates and its predictors were estimated using Kaplan-Meier, Log rank test, and Cox’s regression method of analyses. Results. Five hundred and four breast cancer patients were studied. The mean age was 47.7years, 58.2% presented late with advanced stage disease, and 40% and 39% had metastasis and anaemia, respectively. Seventy-seven percent of patients discontinued follow-up care before completion of ten-year period. The 5-year and 10-year discontinuation rates were 69.8% and 92.6%, respectively. The median discontinuation time was 44 months. Discontinuers were more likely to be older than the age of 45years HR=1.415; 95% CI= 1.044 - 1.917, have metastasis HR=1.793; 95% CI=1.396 - 2.302, be anaemic HR=1.404; 95% CI = 1.120 - 1.760), and have late-stage disease HR=1.310; 95% CI = 1.407-1.639). Conclusion. Breast cancer care discontinuation is associated with late presentation and advanced stage of disease. Therefore a system of community follow-up care and public awareness about breast cancer symptoms is recommended to reduce late presentation and discontinuity of care

Assessment of the attitude of nuclear medicine staff towards patient care at a nuclear medicine centre in Nigeria

Introduction: The mutual relationship between health care providers and their clients (patients) is very important in achieving the desired result in seeking health care services by the patients. The crucial qualities in the patientpersonnel relationship are effective communication, care, empathy, respect and trust. These are major components of attitude of personnel towards patients but there is a strong widespread negative attitude of health care providers towards patients. While it had also been shown that the level of knowledge of healthcare providers (healthcare workers) significantly determines their attitudes towards their clients, the attitude of medical professionals towards patient care has largely been ignored in studies so we decided to assess the attitude of medical personnel in nuclear medicine. Methods: A self applied structured questionnaire was designed to collect data from the research population of patients who came to access nuclear medicine services in the department. Data were collected using the research instrument and were analyzed with Statistical Package for Social Sciences (SPSS) version 20 (SPSS, Inc. Chicago Ill) using descriptive statistics, Pearson correlation coefficient and regression analysis respectively. Results: Majority of respondents rated the attitude of Nuclear Medicine staff in this department as positive. The result also showed that the attitude of health care providers (or health care professionals) correlates positively with clients’ satisfaction. Conclusion: We conclude that majority of the Patients were satisfied with the attitude of Nuclear Medicine Staff towards Patients Care and hence, were satisfied with the health services provide