Outcome of childhood malignancies at the University of Port Harcourt Teaching Hospital: a call for implementation of palliative care

Background: Cancers in children are yet to be recognised as an important cause of childhood morbidity and mortality in developing countries where more than 70% of the world annual cases occur. Despite the limited resources and whatever the projected outcome, children with cancer need treatment, be it curative or palliative.Objectives: To determine outcome of cancers in children at the UPTH; identify factors that influence outcome, highlight the need for palliative care.Method: A retrospective study of cases of childhood malignancies admitted into Paediatric Oncology unit of UPTH over a two year period. Clinical profile of patients and outcome were analyzed using SPSS version 20.0.Results: Sixty cases were analysed: 35(58.3%) males, 25(41.7%) females giving a M:F ratio of 1.4:1. Under-fives constituted 55%. Twenty-seven (45%) patients presented within 4 weeks of onset of symptoms. Median duration of symptoms before presentation was 8 weeks while 36 (60%) had metastatic disease at diagnosis. Twenty patients (33.3%) defaulted with or without specific treatment. Mortality was recorded in 26(43.4%) of cases.Conclusion: There were more cases of cancer amongst under-fives with male preponderance. Late presentation, financial constraints and high default rate were contributory factors to poor outcome in most cases. Lack of palliative care left many families to face their sufferings.Keywords: Outcome, childhood malignancies, implementation, palliative car

Hubble Space Telescope weak lensing study of the z=0.83 cluster MS 1054-03

We have measured the weak gravitational lensing signal of MS 1054-03, a rich and X-ray luminous cluster of galaxies at a redshift of z=0.83, using a two-colour mosaic of deep WFPC2 images. The small corrections for the size of the PSF and the high number density of background galaxies obtained in these observations result in an accurate and well calibrated measurement of the lensing induced distortion. The strength of the lensing signal depends on the redshift distribution of the background galaxies. We used photometric redshift distributions from the Northern and Southern Hubble Deep Fields to relate the lensing signal to the mass. The predicted variations of the signal as a function of apparent source magnitude and colour agrees well with the observed lensing signal. We determine a mass of (1.2+-0.2)x10^15 Msun within an aperture of radius 1 Mpc. Under the assumption of an isothermal mass distribution, the corresponding velocity dispersion is 1311^{+83}_{-89} km/s. For the mass-to-light ratio we find 269+-37 Msun/Lsun. The errors in the mass and mass-to-light ratio include the contribution from the random intrinsic ellipticities of the source galaxies, but not the (systematic) error due to the uncertainty in the redshift distribution. However, the estimates for the mass and mass-to-light ratio of MS 1054-03 agree well with other estimators, suggesting that the mass calibration works well. The reconstruction of the projected mass surface density shows a complex mass distribution, consistent with the light distribution. The results indicate that MS 1054-03 is a young system. The timescale for relaxation is estimated to be at least 1 Gyr. Averaging the tangential shear around the cluster galaxies, we find that the velocity dispersion of an Lstar galaxy is 203+-33 km/s.Comment: 21 pages, Latex, with 27 figures (3 figures bitmapped), ApJ, in press. Version (with non-bitmapped figures) available at http://www.astro.rug.nl/~hoekstra/papers.htm

Public-Sector Project Abandonment Decision: A Test of the Ricardian Equivalence Theory on the Failed Lagos Metroline in Nigeria

This chapter examines the implications of projects abandonment with test of the Ricardian Equivalence on the failed Lagos metro line project in Nigeria as case study. The main variables used are Rail and Pipeline Output, Budget Deficit, Interest Rate, Corruption Index, Savings and some others. The study results on the Ricardian Equivalence hypothesis on deficit financing of projects using Vector autoregression model from 1980-2012 indicate that no causal influence holds in Nigeria. Results show that poor planning, corruption, political factors, poor support infrastructures, poor quality of local resources, etc. were attributable. The results of the Impulse Response tests reveal that Rail and Pipeline output and a few others responded positively to shocks in the short run (years 1-2), and negatively to others. The result affirms that Government should privatize the railway system, legislate against project abandonment and ensure that projects are adequately planned, funded, insured and insulated against corruptio

Constraints on Omega_m and sigma_8 from weak lensing in RCS fields

We have analysed 53 square degrees of imaging data from the Red-Sequence Cluster Survey (RCS), and measured the excess correlations in the shapes of galaxies on scales out to ~1.5 degrees. We separate the signal into an ``E''- (lensing) and ``B''-mode (systematics), which allows us to study residual systematics. On scales larger than 10 arcminutes, we find no ``B''-mode. On smaller scales we find a small, but significant ``B''-mode. This signal is also present when we select a sample of bright galaxies. These galaxies are rather insensitive to observational distortions, and we therefore conclude that the oberved ``B''-mode is likely to be caused by intrinsic alignments. We therefore limit the cosmic shear analysis to galaxies with 22<R_C<24. We derive joint constraints on Omega_m and sigma_8, by marginalizing over Gamma, Omega_Lambda and the source redshift distribution, using different priors. We obtain a conservative constraint of $\sigma_8=0.45^{+0.09}_{-0.12} \Omega_m^{-0.55}$ (95% confidence). A better constraint is derived when we use Gaussian priors redshift distribution. For this choice of priors, we find $\sigma_8=(0.46^{+0.05}_{-0.07})\Omega_m^{-0.52}$ (95% confidence). Using our setof Gaussian priors, we find that we can place a lower bound on Gamma: Gamma>0.1+0.16\Omega_m$ (95% confidence). Comparison of the RCS results with three other recent cosmic shear measurements shows excellent agreement. The current weak lensing results are also in good agreement with CMB measurements, when we allow the reionization optical depth tau and the spectral index n_s to vary. We present a simple demonstration of how the weak lensing results can be used as a prior in the parameter estimation from CMB measurements to derive constraints on the reionization optical depth tau. (abridged)Comment: 9 pages, 6 figures, Accepted for publication in the Astrophysical Journa

Constraints on the Dark Matter Particle Mass from the Number of Milky Way Satellites

We have conducted N-body simulations of the growth of Milky Way-sized halos in cold and warm dark matter cosmologies. The number of dark matter satellites in our simulated Milky Ways decreases with decreasing mass of the dark matter particle. Assuming that the number of dark matter satellites exceeds or equals the number of observed satellites of the Milky Way we derive lower limits on the dark matter particle mass. We find with 95% confidence m_s > 13.3 keV for a sterile neutrino produced by the Dodelson and Widrow mechanism, m_s > 8.9 keV for the Shi and Fuller mechanism, m_s > 3.0 keV for the Higgs decay mechanism, and m_{WDM} > 2.3 keV for a thermal dark matter particle. The recent discovery of many new dark matter dominated satellites of the Milky Way in the Sloan Digital Sky Survey allows us to set lower limits comparable to constraints from the complementary methods of Lyman-alpha forest modeling and X-ray observations of the unresolved cosmic X-ray background and of dark matter halos from dwarf galaxy to cluster scales. Future surveys like LSST, DES, PanSTARRS, and SkyMapper have the potential to discover many more satellites and further improve constraints on the dark matter particle mass.Comment: 17 pages, 13 figures, replaced with final version published in Physical Review

Assessment of Workers’ Level of Exposure to Work-Related Musculoskeletal Discomfort in Dewatered Cassava Mash Sieving Process

This study was undertaken to assess the level of exposure of processors to work-related musculoskeletal disorder when using the locally developed traditional sieve in the sieving process. Quick ergonomic checklist (QEC) &nbsp;involving the researcher’s and the processors’ assessment using the risk assessment checklist, was used in this assessment and data was obtained from a sample of one hundred and eight (108) processors randomly selected from three senatorial districts of Rivers State. Thirty-six processors from each zone comprising of 14 males and 22 females, were selected., and assessed on the bases of their back, shoulder/arm, wrist/hand and neck posture and frequency of movement during traditional sieving process. The result of the assessment showed that the highest risk of discomfort occurred at the region of the wrist/hand, followed by back, shoulder/arm, and neck. The posture used in the sieving process exposed the processors, not only to the discomfort of pain but also put them at high risk of musculoskeletal disorder at indicated by &nbsp;a high level of percentage exposure of 66% QEC rating. The result indicated a need for immediate attention and change to an improved method that will reduce the discomfort on the body parts assessed. identified parts

The impact of active stakeholder involvement on recruitment, retention and engagement of schools, children and their families in the cluster randomised controlled trial of the Healthy Lifestyles Programme (HeLP): a school-based intervention to prevent obesity

This is the final version of the article. Available from BioMed Central via the DOI in this record.BACKGROUND: Recruitment and retention of participants is crucial for statistical power and internal and external validity and participant engagement is essential for behaviour change. However, many school-based interventions focus on programme content rather than the building of supportive relationships with all participants and tend to employ specific standalone strategies, such as incentives, to improve retention. We believe that actively involving stakeholders in both intervention and trial design improves recruitment and retention and increases the chances of creating an effective intervention. METHODS: The Healthy Lifestyles Programme, HeLP (an obesity prevention programme for children 9-10 years old) was developed using intervention mapping and involved extensive stakeholder involvement in both the design of the trial and the intervention to ensure that: (i) delivery methods were suitably engaging, (ii) deliverers had the necessary skills and qualities to build relationships and (iii) the intervention dovetailed with the National Curriculum. HeLP was a year-long intervention consisting of 4 multi-component phases using a range of delivery methods. We recruited 1324 children from 32 schools from the South West of England to a cluster-randomised controlled trial to determine the effectiveness of HeLP in preventing obesity. The primary outcome was change in body mass index standard deviation score (BMI SDS) at 24 months post randomisation. Secondary outcomes included additional anthropometric and behavioural (physical activity and diet) measures at 18 and 24 months. RESULTS: Anthropometric and behavioural measures were taken in 99%, 96% and 94% of children at baseline, 18 and 24 months, respectively, with no differential follow up between the control and intervention groups at each time point. All children participated in the programme and 92% of children and 77% of parents across the socio-economic spectrum were considered to have actively engaged with HeLP. CONCLUSIONS: We attribute our excellent retention and engagement results to the high level of stakeholder involvement in both trial and intervention design, the building of relationships using appropriate personnel and creative delivery methods that are accessible to children and their families across the social spectrum. TRIAL REGISTRATION: International Standard Randomised Controlled Trials Register, ISRCTN15811706 . Registered on 1 May 2012.The UK National Institute for Health Research (NIHR) Public Health Research Programme (10/3010/01) funded all research activities for the HeLP RCT. The costs of the intervention were funded by the Peninsula College of Medicine and Dentistry