Are estimates of socioeconomic inequalities in chronic disease artefactually narrowed by self-reported measures of prevalence in low-income and middle-income countries? Findings from the WHO-SAGE survey

Background: The use of self-reported measures of chronic disease may substantially underestimate prevalence in low-income and middle-income country settings, especially in groups with lower socioeconomic status (SES). We sought to determine whether socioeconomic inequalities in the prevalence of non-communicable chronic diseases (NCDs) differ if estimated by using symptom-based or criterion-based measures compared with self-reported physician diagnoses. Methods: Using population-representative data sets of the WHO Study of Global Ageing and Adult Health (SAGE), 2007–2010 (n=42 464), we calculated wealth-related and education-related concentration indices of self-reported diagnoses and symptom-based measures of angina, hypertension, asthma/chronic lung disease, visual impairment and depression in three ‘low-income and lower middle-income countries’—China, Ghana and India—and three ‘upper-middle-income countries’—Mexico, Russia and South Africa. Results: SES gradients in NCD prevalence tended to be positive for self-reported diagnoses compared with symptom-based/criterion-based measures. In China, Ghana and India, SES gradients were positive for hypertension, angina, visual impairment and depression when using self-reported diagnoses, but were attenuated or became negative when using symptom-based/criterion-based measures. In Mexico, Russia and South Africa, this distinction was not observed consistently. For example, concentration index of self-reported versus symptom-based angina were: in China: 0.07 vs −0.11, Ghana: 0.04 vs −0.21, India: 0.02 vs −0.16, Mexico: 0.19 vs −0.22, Russia: −0.01 vs −0.02 and South Africa: 0.37 vs 0.02. Conclusions: Socioeconomic inequalities in NCD prevalence tend to be artefactually positive when using self-report compared with symptom-based or criterion-based diagnostic criteria, with greater bias occurring in low-income countries. Using standardised, symptom-based measures would provide more valid estimates of NCD inequalities

Measuring Fatigue of Soldiers in Wireless Body Area Sensor Networks

Wireless Body Area Sensor Networks (WBASNs) consist of on-body or in-body sensors placed on human body for health monitoring. Energy conservation of these sensors, while guaranteeing a required level of performance, is a challenging task. Energy efficient routing schemes are designed for the longevity of network lifetime. In this paper, we propose a routing protocol for measuring fatigue of a soldier. Three sensors are attached to soldier's body that monitor specific parameters. Our proposed protocol is an event driven protocol and takes three scenarios for measuring the fatigue of a soldier. We evaluate our proposed work in terms of network lifetime, throughput, remaining energy of sensors and fatigue of a soldier.Comment: IEEE 8th International Conference on Broadband and Wireless Computing, Communication and Applications (BWCCA'13), Compiegne, Franc

Crop-based irrigation operations in the North West Frontier Province of Pakistan. Vol.II: Research approach and interpretation. Final Report

Irrigation management / Crop-based irrigation / Research / Irrigation canals / Water demand / Performance evaluation / Agricultural production / Pakistan / North West Frontier Province

Incidence and medical management of bisphosphonate-associated atypical femoral fractures in a major trauma centre: a retrospective observational study

BACKGROUND: Atypical femoral fractures (AFFs) are rare events associated with increased duration of bisphosphonate exposure. Recommended management of AFFs include cessation of bisphosphonates and imaging of the contralateral femur. The aims of this study were to identify the local incidence of AFFs in bisphosphonate users and to audit the medical management of AFFs against published recommendations. METHODS: A retrospective analysis of the admissions database for a major trauma centre identified all femoral fractures (3150) in a five-year period (July 2009 to June 2014). Electronic health records and radiographs were reviewed using the 2013 American Society for Bone and Mineral Research (ASBMR) diagnostic criteria for AFF to establish the number of cases. To estimate incidence, the total number of bisphosphonate users was derived from primary care prescription and secondary care day-case records. Medical management of cases with AFF on bisphosphonates was audited against guidance from ASBMR and Medicines & Healthcare Products Regulatory Agency. RESULTS: 10 out of 3150 femoral fractures met criteria for AFF; 7 of these patients had a history of exposure to bisphosphonates (6 oral, 1 intravenous). There were 19.1 AFFs per 100,000 years of bisphosphonate use in our region. Bisphosphonates were stopped and the contralateral femur imaged in only 2 of the 7 patients treated with bisphosphonates. CONCLUSION: Our local incidence is in line with published figures; however, this is the first published evidence suggesting that medical management and identification of AFF may be suboptimal. Managing these patients remains challenging due to their rarity and possible lack of awareness

Pre-discovery and Follow-up Observations of the Nearby SN 2009nr: Implications for Prompt Type Ia SNe

We present photometric and spectroscopic observations of the Type Ia supernova SN 2009nr in UGC 8255 (z=0.0122). Following the discovery announcement at what turned out to be ten days after peak, we detected it at V ~15.7 mag in data collected by the All Sky Automated Survey (ASAS) North telescope 2 weeks prior to the peak, and then followed it up with telescopes ranging in aperture from 10-cm to 6.5-m. Using early photometric data available only from ASAS, we find that the SN is similar to the over-luminous Type Ia SN 1991T, with a peak at Mv=-19.6 mag, and a slow decline rate of Dm_15(B)=0.95 mag. The early post-maximum spectra closely resemble those of SN 1991T, while the late time spectra are more similar to those of normal Type Ia SNe. Interestingly, SN 2009nr has a projected distance of 13.0 kpc (~4.3 disk scale lengths) from the nucleus of the small star-forming host galaxy UGC 8255. This indicates that the progenitor of SN 2009nr is not associated with a young stellar population, calling into question the conventional association of luminous SNe Ia with the "prompt" component directly correlated with current star formation. The pre-discovery observation of SN 2009nr using ASAS demonstrates the science utility of high cadence all sky surveys conducted using small telescopes for the discovery of nearby (d=<50 Mpc) supernovae.Comment: 11 pages, 11 figures, 4 tables. Accepted for publication in ApJ on 11/02/201

A Novel Energy-Driven Architecture for Wireless Sensor Networks

This paper proposes a novel Energy-Driven Architecture (EDA) as a durable architecture and considers almost all principal energy constituents of wireless sensor networks applications. By creating a single overall model, a tolerable formulation is then offered to communicate the total energy use of a wireless sensor network application regarding the energy constituents. The formulation provides a tangible illustration for analyzing the performance of a wireless sensor network application, optimizing its constituent's operations, as well as creating more energy saving applications. The simulations are employed to show the feasibility of our model and also energy formulation