The Effectiveness if the Intervention Programming the Framework of Professional General Practice to Educate Social Workers Working in the Elderly Patients Field Treated for Alzheimer 'sand Their Families

There are changes associated with aging, including deficiencies in mental capacity and lack of emotional balance and diseases of aging like Alzheimer which is lackof mental capacity and functional brain disorder Patient social care has a direct impact on the worsening condition of the patient; where studies indicated that patient care delays the worsening of their health status.Social work isgenerally regardedas one of the professionsthat cares for and looks after elderly and their families in cases of wellness and illness.Social worker plays an important role in helping patient family to deal with problems arising from the disease as well as guiding the family to join psychological and social support groups in order to help them toovercome their problems.The general practice in social work could have effective results whensocial workers dealwith Alzheimer's patient’s families.Social work is considered one of the recent trends. It is an applied trend dealing with all patterns and by applyingthis trendon social workers working in elderly fieldcould achieve two objectives.The first objective istrainingsocial workers to use this trend with all clientsgenerally and the objective is training them to apply itonthe patient families particularly.Hence, problem of the study is identified as: effectiveness testing of general practice utilization in social work for raising the awareness of social workers working in the field ofelderlypatientstreatedforAlzheimer'sand patient social caremethod. Keywords: Professional intervention - Alzheimer – effectiveness – awareness - general practice.

Vitamin D Status and TB Treatment Outcomes in Adult Patients in Tanzania: A Cohort Study.

Vitamin D is an immunomodulator and can alter response to tuberculosis (TB) treatment, though randomised trials have been inconclusive to date. We present one of the first comprehensive analysis of the associations between vitamin D status and TB treatment, T-cell counts and nutritional outcomes by HIV status. Cohort study. Outpatient clinics in Tanzania. 25-hydroxyvitamin D levels were assessed in a cohort of 677 patients with TB (344 HIV infected) initiating anti-TB treatment at enrolment in a multivitamin supplementation (excluding vitamin D) trial (Clinicaltrials.gov identifier: NCT00197704). Information on treatment outcomes such as failure and relapse, HIV disease progression, T-cell counts and anthropometry was collected routinely, with a median follow-up of 52 and 30 months for HIV-uninfected and HIV-infected patients, respectively. Cox and binomial regression, and generalised estimating equations were used to assess the association of vitamin D status with these outcomes. Mean 25-hydroxyvitamin D concentrations at enrolment were 69.8 (±21.5) nmol/L (27.9 (±8.6) ng/mL). Vitamin D insufficiency (<75 nmol/L) was associated with a 66% higher risk of relapse (95% CI 4% to 164%; 133% higher risk in HIV-uninfected patients). Each unit higher 25-hydroxyvitamin D levels at baseline were associated with a decrease of 3 (p=0.004) CD8 and 3 (p=0.01) CD3 T-cells/µL during follow-up in patients with HIV infection. Vitamin D insufficiency was also associated with a greater decrease of body mass index (BMI; -0.21 kg/m(2); 95% CI -0.39 to -0.02), during the first 8 months of follow-up. No association was observed for vitamin D status with mortality or HIV disease progression. Adequate vitamin D status is associated with a lower risk of relapse and with improved nutritional indicators such as BMI in patients with TB, with or without HIV infection. Further research is needed to determine the optimal dose of vitamin D and effectiveness of daily vitamin D supplementation among patients with TB

Impact of wastewater effluent on the diatom assemblages structure of a brackish small stream: Oued Hassar (Morocco)

AbstractThe impact of the wastewater input of Médiouna agglomeration (southeastern area of Casablanca) on the diatom flora and water quality of Oued Hassar stream (Morocco) was studied from July 1997 to August 1998. This wastewater effluent, which was highly loaded with ammonia, orthophosphates and organic matters, had disturbed the diatom assemblages structure and water quality of this stream.The study of the epilithic algal assemblages revealed the presence of 130 taxa of diatoms, 21 of which, according to the available literature, were recorded for the first time in the Moroccan inland waters. Almost all the latter taxa are mesohalobic or oligohalobic-indifferent. Nitzschia inconspicua Grun. was the most abundant species (47.7%) and grows particularly at the source of the stream. Navicula subminuscula Manguin, Nitzschia capitellata Hust. and Nitzschia desertorum Hust. have their dominance in the highly polluted zones, especially downstream the wastewater input

Performance and emission evaluations of a prototype stepped-piston engine using carburetor and direct fuel-injection systems

Two-stroke engines have been used for sometimes in automotive and stationary applications since early 20th century. The advantages of two-stroke engines are obvious, i.e., lighter, simpler and less expensive to manufacture. Technically, two-stroke engines have the potential to pack almost twice the power into the same space because there are twice as many power strokes per revolution. The combination of lightweight and twice the power gives two-stroke engines a great power-to-weight ratio compared to many four stroke engine designs. However due to the short-circuiting process of the fuel before combustion, this has resulted in deterioration in overall performances especially poor combustion efficiency and high white smoke emission problem. Coupled with the improvement in the four-stroke engine technology, the former has overcome the latter in being the choice for mobile platform applications. Due to high fuel cost and the need to explore the use of other fuel sources, notably gaseous fuels, a number of enthusiasts and engine developers have revisited the two-stroke engine design. Fuels such as hydrogen and methane are said to be ideal for use with the incorporation of the some new features (Goldsborough and Blaringan, 2003). An engine design and development program was initiated at Universiti Teknologi Malaysia (UTM) in year 2003 to develop local R&D capabilities in small power-train engineering. The exercise evolved around the development of an air-cooled single cylinder of stepped-piston engine concept. The term “stepped piston” refers to the conventional piston having compounded with a larger diameter section at the rear section of its geometry. The changes to the original design were made as the research group feels that there are rooms for improvements. In addition to this, the modifications will infuse other innovative scope of work from design to product testing activities (Hooper, 1985).This program, eventually leads to the incorporation of features, is expected to enhance performance of the prototype and subsequently exhaust emission. This is in anticipation of producing a working prototype for multiple applications namely stationary and automotive. The gasoline stepped-piston engine is a relatively new design concept for small mobile power plants. It is an engine, operating on a two-stroke cycle but is infused with four-stroke engine features. It has a build-in supercharger mechanism (by virtue of the extended flange) that improves the scavenging process thus improve combustion efficiency. Due to these operating characteristics, the engine has all the attributes of a low emission, high-efficiency power plant that eliminates many of the major weaknesses associated with the Otto four-stroke engine and with modern two-stroke engines

L’enclouage centromedullaire dans les fractures bifocales de la jambe: à propos de 16 cas

Afin d'évaluer la gravité de cette lésion inhabituelle, nous avons mené une étude rétrospective intéressant les fractures bifocales fermées du tibia et nous avons étudié la place de l'enclouage centromédullaire ainsi que les différents moyens thérapeutiques. Seize patients avec fractures bifocales de jambe type 42C2 de l'AO ont été traités dans notre unité de traumatologie Orthopédie A du CHU Hassan II Fès. Il s'agissait de sujets jeunes, victimes de traumatisme de moyen à haute énergie. Cinq patients étaient polytraumatisés et deux poly fracturés. L'enclouage centromédullaire verrouillé avec alésage était utilisé dans six cas et sans alésage dans dix cas. Nous avons déplorés après enclouage deux cas de syndromes de loge. Le délai de consolidation moyen était de douze mois. Deux cas de pseudarthroses ont été repris avec succès par un enclouage avec sur alésage. La fracture bifocale de jambe pose de nombreux défis au chirurgien en raison de l'approvisionnement vasculaire précaire du segment intermédiaire et de la grave détérioration des tissus mous environnants. Elles doivent être individualisées de l'ensemble des fractures de jambe tant par leur contexte de survenue que par les difficultés de fixation et la lenteur de leur consolidation

Risk Factors for Preterm Birth among HIV-Infected Tanzanian Women: A Prospective Study

Premature delivery, a significant cause of child mortality and morbidity worldwide, is particularly prevalent in the developing world. As HIV is highly prevalent in much of sub-Saharan Africa, it is important to determine risk factors for prematurity among HIV-positive pregnancies. The aims of this study were to identify risk factors of preterm (<37 weeks) and very preterm (<34 weeks) birth among a cohort of 927 HIV positive women living in Dar es Salaam, Tanzania, who enrolled in the Tanzania Vitamin and HIV Infection Trial between 1995 and 1997. Multivariable relative risk regression models were used to determine the association of potential maternal risk factors with premature and very premature delivery. High rates of preterm (24%) and very preterm birth (9%) were found. Risk factors (adjusted RR (95% CI)) for preterm birth were mother <20 years (1.46 (1.10, 1.95)), maternal illiteracy (1.54 (1.10, 2.16)), malaria (1.42 (1.11, 1.81)), Entamoeba coli (1.49 (1.04, 2.15)), no or low pregnancy weight gain, and HIV disease stage ≥2 (1.41 (1.12, 1.50)). Interventions to reduce pregnancies in women under 20, prevent and treat malaria, reduce Entamoeba coli infection, and promote weight gain in pregnant women may have a protective effect on prematurity

Biomarkers of systemic inflammation and growth in early infancy are associated with stunting in young Tanzanian children

Stunting can afflict up to one-third of children in resource-constrained countries. We hypothesized that low-grade systemic inflammation (defined as elevations in serum C-reactive protein or alpha-1-acid glycoprotein) in infancy suppresses the growth hormone–insulin-like growth factor (IGF) axis and is associated with subsequent stunting. Blood samples of 590 children from periurban Dar es Salaam, Tanzania, were obtained at 6 weeks and 6 months of age as part of a randomized controlled trial. Primary outcomes were stunting, underweight, and wasting (defined as length-for-age, weight-for-age and weight-for-length z-scores < −2) between randomization and endline (18 months after randomization). Cox proportional hazards models were constructed to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of time to first stunting, underweight, and wasting as outcomes, with measures of systemic inflammation, insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) as exposures, adjusting for numerous demographic and clinical variables. The incidences of subsequent stunting, underweight, and wasting were 26%, 20%, and 18%, respectively. In multivariate analyses, systemic inflammation at 6 weeks of age was significantly associated with stunting (HR: 2.14, 95% CI: 1.23, 3.72; p = 0.002). Children with higher levels of IGF-1 at 6 weeks were less likely to become stunted (HR: 0.58, 95% CI: 0.37, 0.93; p for trend = 0.019); a similar trend was noted in children with higher levels of IGF-1 at 6 months of age (HR: 0.50, 95% CI: 0.22, 1.12; p for trend = 0.07). Systemic inflammation occurs as early as 6 weeks of age and is associated with the risk of future stunting among Tanzanian children.This research was funded by the National Institutes of Health (R01 HD048969, 2P30 DK040561, K24 DK104676-Dr. Duggan) and the Bill and Melinda Gates Foundation (OPP1066203-Dr. Duggan). (R01 HD048969 - National Institutes of Health; 2P30 DK040561 - National Institutes of Health; K24 DK104676 - National Institutes of Health; OPP1066203 - Bill and Melinda Gates Foundation)Accepted manuscrip

Supplementation With Multivitamins and Vitamin A and Incidence of Malaria Among HIV-Infected Tanzanian Women

Introduction: HIV and malaria infections occur in the same individuals, particularly in sub-Saharan Africa. We examined whether daily multivitamin supplementation (vitamins B complex, C, and E) or vitamin A supplementation altered malaria incidence in HIV-infected women of reproductive age. Methods: HIV-infected pregnant Tanzanian women recruited into the study were randomly assigned to daily multivitamins (B complex, C, and E), vitamin A alone, both multivitamins and vitamin A, or placebo. Women received malaria prophylaxis during pregnancy and were followed monthly during the prenatal and postpartum periods. Malaria was defined in 2 ways: presumptive diagnosis based on a physician's or nurse's clinical judgment, which in many cases led to laboratory investigations, and periodic examination of blood smears for malaria parasites. Results: Multivitamin supplementation compared with no multivitamins significantly lowered women's risk of presumptively diagnosed clinical malaria (relative risk: 0.78, 95% confidence interval: 0.67 to 0.92), although multivitamins increased their risk of any malaria parasitemia (relative risk: 1.24, 95% confidence interval: 1.02 to 1.50). Vitamin A supplementation did not change malaria incidence during the study. Conclusions: Multivitamin supplements have been previously shown to reduce HIV disease progression among HIV-infected women, and consistent with that, these supplements protected against development of symptomatic malaria. The clinical significance of increased risk of malaria parasitemia among supplemented women deserves further research, however. Preventive measures for malaria are warranted as part of an integrated approach to the care of HIV-infected individuals exposed to malaria

Adoption of an intelligent irrigation scheduling technique and its effect on water use efficiency for tomato crops in arid regions

Abstract The intelligent irrigation technique is a valuable tool for scheduling irrigation and quantifying water required by plants. This study was carried out during two successive seasons spanning 2010 and 2011. The main objectives were to investigate the effectiveness of the intelligent irrigation system (IIS) on water use efficiency (WUE), irrigation water use efficiency (IWUE) and to assess its potential for monitoring the water status and irrigation schedule of a tomato crop cultivated under severely arid climate conditions. The intelligent irrigation system was implemented and tested under a drip irrigation system for the irrigation of tomato crops (Lycopersicon esculentum Mill, GS-12). The results obtained with this system were consequently compared with the control system (ICS), which utilized an automatic weather station. The results reveal that plant growth parameters and water conservation were significantly affected by IIS irrigation. The water use efficiency under IIS was generally higher (7.33 kg m -3 ) compared to that under ICS (5.33 kg m -3 ), resulting in maximal water use efficiency for both growing seasons (average 6.44 kg m -3 ). The application of IIS technology therefore provides significant advantages in terms of both crop yield and WUE. In addition, IIS conserves 26% of the total irrigation water compared to the control treatment, and simultaneously generates higher total yields. These results show that this technique could be a flexible, practical tool for improving scheduled irrigation. Hence, this technology can therefore be recommended for efficient automated irrigation systems because it produces higher yield and conserves large amounts of irrigation water. The intelligent irrigation technique may provide a valuable tool for scheduling irrigation in tomato farming and may be extendable for use in other similar agricultural crops

Prediction of Compressive Strength of Reinforced Concrete Structural Elements by Using Combined Non-Destructive Tests

This research is devoted to investigate relationship between both Ultrasonic Pulse Velocity and Rebound Number (Hammer Test) with cube compressive strength and also to study the effect of steel reinforcement on these relationships. A study was carried out on 32 scale model reinforced concrete elements. Non destructive testing campaign (mainly ultrasonic and rebound hammer tests) made on the same elements. About 72 concrete cubes (15 X 15 X15) were taken from the concrete mixes to check the compressive strength.. Data analyzed.Include the possible correlations between non destructive testing (NDT) and compressive strength (DT) Statistical approach is used for this purpose. A new relationships obtained from correlations results is given