1,378 research outputs found
EHMTI-0314. A window to the past: the association between inflated pain scores and a history of abuse in women with chronic migraine
Comparative analysis of municipal solid waste (MSW) composition in three local government areas in Rivers State, Nigeria
Rivers State is one of the major oil producing States in Nigeria. Its capital, Port Harcourt and sub-urban areas have witnessed an increased influx of migrants in recent time. Consequently, the consumption of goods and services has also increased leading to generation of unprecedented quantities of municipal solid waste. Previous efforts by relevant authorities to contain this increase in waste generation have proved abortive due largely to among other reasons, inappropriate and unsustainable municipal solid waste (MSW) management systems. The first step in a sustainable MSW management is to understand the types, composition and variation that exist in the waste generated in time and space. Previous reports have been concentrated on the characteristics of waste in Port Harcourt. This present work evaluated solid waste composition in three LGAs in Rivers State with a view of an integrated approach in MSW management in the State. Waste characteristics varied with the different locations studied. Generation rate was 0.45, 0.98 and 1.16 kg/capita/day for Emougha, Obio/Akpor and Port Harcourt, respectively. Most prominent categories were organic waste, paper and nylon. Mean percentage composition was 65, 65.5 and 59% for organic waste, 13, 11 and 6% for paper and 12, 16 and 14% for nylon in Port Harcourt, Obio/Akpor and Emougha LGAs, respectively. It is believed that given the characteristics of these waste streams, a sustainable management strategy could have several benefits including resources recovery and energy generation.Key words: Municipal solid waste (MSW), characterization, Rivers State, integrated MSW management
Estimating Entropy of Liquids from Atom-Atom Radial Distribution Functions: Silica, Beryllium Fluoride and Water
Molecular dynamics simulations of water, liquid beryllium fluoride and silica
melt are used to study the accuracy with which the entropy of ionic and
molecular liquids can be estimated from atom-atom radial distribution function
data. All three systems are known to display similar liquid-state thermodynamic
and kinetic anomalies due to a region of anomalous excess entropy behaviour
where entropy rises on isothermal compression. The pair correlation entropy is
demonstrated to be sufficiently accurate that the density-temperature regime of
anomalous behaviour as well as the strength of the entropy anomaly can be
predicted reliably for both ionic melts as well as different rigid-body pair
potentials for water. Errors in the total thermodynamic entropy for ionic melts
due to the pair correlation approximation are of the order of 10% or less for
most state points but can be significantly larger in the anomalous regime at
very low temperatures. In the case of water, as expected given the rigid-body
constraints for a molecular liquids, the pair correlation approximation causes
significantly larger errors, between 20 and 30%, for most state points.
Comparison of the excess entropy, Se, of ionic melts with the pair correlation
entropy, S2, shows that the temperature dependence of Se is well described by T
??2=5 scaling across both the normal and anomalous regimes, unlike in the case
of S2. As a function of density, the Se(rho) curves shows only a single maximum
while the S2(rho) curves show both a maximum and a minimum. These differences
in the behaviour of S2 and Se are due to the fact that the residual
multiparticle entropy, delta(S) = Se - S2, shows a strong negative correlation
with tetrahedral order in the anomalous regime.Comment: 30 pages, 8 figure
Donβt turn your back on the symptoms of psychosis : a proof-of-principle, quasi-experimental public health trial to reduce the duration of untreated psychosis in Birmingham, UK
Background: Reducing the duration of untreated psychosis (DUP) is an aspiration of international guidelines for first episode psychosis; however, public health initiatives have met with mixed results. Systematic reviews suggest that greater focus on the sources of delay within care pathways, (which will vary between healthcare settings) is needed to achieve sustainable reductions in DUP (BJP 198: 256-263; 2011).
Methods/Design: A quasi-experimental trial, comparing a targeted intervention area with a βdetection as usualβ area in the same city. A proof-ofβprinciple trial, no a priori assumptions are made regarding effect size; key outcome will be an estimate of the potential effect size for a definitive trial. DUP and number of new cases will be collected over an 18-month period in target and control areas and compared; historical data on DUP collected in both areas over the previous three years, will serve as a benchmark. The intervention will focus on reducing two significant DUP component delays within the overall care pathway: delays within the mental health service and help-seeking delay.
Discussion: This pragmatic trial will be the first to target known delays within the care pathway for those with a first episode of psychosis. If successful, this will provide a generalizable methodology that can be implemented in a variety of healthcare contexts with differing sources of delay.
Trial registration: http://www.controlled-trials.com/ISRCTN45058713
Keywords: Public mental health campaign, First-episode psychosis, Early detection, Duration of untreated psychosis, Youth mental healt
The case for home monitoring in hypertension
Although the assessment of cardiovascular risk in individual patients takes into account a range of risk factors, the diagnosis and management of hypertension (high blood pressure) is largely determined by a single numerical value, albeit that often several readings are taken over time. Given the critical impact of a decision to embark on lifelong drug therapy, the importance of ensuring that a blood pressure (BP) record is both accurate and representative is clear. However, there is good evidence that the variability of BP is such that even if measurement is of the highest quality, it can be difficult to say with confidence whether a patient is above or below a treatment threshold. This commentary argues that current BP measurement is inadequate to make the clinical decisions that are necessary and that multiple readings are required to deliver an acceptable degree of accuracy for safe decision-making. This is impractical in a doctor's surgery, and the only realistic long-term strategy is to involve the patient in measuring his or her own BP in their own environment. Evidence is presented that such a strategy is better able to predict risk, is cost-effective for diagnosing hypertension, can improve BP control and is thus better able to protect individuals in the future
Inequitable Gains and Losses from Conservation in a Global Biodiversity Hotspot
A billion rural people live near tropical forests. Urban populations need them for water, energy and timber. Global society benefits from climate regulation and knowledge embodied in tropical biodiversity. Ecosystem service valuations can incentivise conservation, but determining costs and benefits across multiple stakeholders and interacting services is complex and rarely attempted. We report on a 10-year study, unprecedented in detail and scope, to determine the monetary value implications of conserving forests and woodlands in Tanzaniaβs Eastern Arc Mountains. Across plausible ranges of carbon price, agricultural yield and discount rate, conservation delivers net global benefits (+US10.1B), while local-rural communities bear substantial net costs (-US72M); logging, fuelwood and management costs encourage depletion (-US$148M). Substantial global investment in disaggregating and mitigating local costs (e.g., through boosting smallholder yields) is essential to equitably balance conservation and development objectives
Allergic Rhinitis and its Associated Co-Morbidities at Bugando Medical Centre in Northwestern Tanzania; A Prospective Review of 190 Cases.
Allergic rhinitis is one of the commonest atopic diseases which contribute to significant morbidity world wide while its epidemiology in Tanzania remains sparse. There was paucity of information regarding allergic rhinitis in our setting; therefore it was important to conduct this study to describe our experience on allergic rhinitis, associated co-morbidities and treatment outcome in patients attending Bugando Medical Centre. This was descriptive cross-sectional study involving all patients with a clinical diagnosis of allergic rhinitis at Bugando Medical Centre over a three-month period between June 2011 and August 2011. Data was collected using a pre-tested coded questionnaire and analyzed using SPSS statistical computer software version 17.0. A total of 190 patients were studied giving the prevalence of allergic rhinitis 14.7%. The median age of the patients was 8.5 years. The male to female ratio was 1:1. Adenoid hypertrophy, tonsillitis, hypertrophy of inferior turbinate, nasal polyps, otitis media and sinusitis were the most common co-morbidities affecting 92.6% of cases and were the major reason for attending hospital services. Sleep disturbance was common in children with adenoids hypertrophy (Ο2β=β28.691, Pβ=β0.000). Allergic conjunctivitis was found in 51.9%. The most common identified triggers were dust, strong perfume odors and cold weather (Pβ<β0.05). Strong perfume odors affect female than males (Ο2β=β4.583, Pβ=β0.032). In this study family history of allergic rhinitis was not a significant risk factor (P =0.423). The majority of patients (68.8%) were treated surgically for allergic rhinitis co morbidities. Post operative complication and mortality rates were 2.9% and 1.6% respectively. The overall median duration of hospital stay of in-patients was 3 days (2 - 28 days). Most patients (98.4%) had satisfactory results at discharge. The study shows that allergic rhinitis is common in our settings representing 14.7% of all otorhinolaryngology and commonly affecting children and adolescent. Sufferers seek medical services due to co-morbidities of which combination of surgical and medical treatment was needed. High index of suspicions in diagnosing allergic rhinitis and early treatment is recommended
The ITGAV rs3738919 variant and susceptibility to rheumatoid arthritis in four Caucasian sample sets
INTRODUCTION: Angiogenesis is an important process in the development of destructive synovial pannus in rheumatoid arthritis (RA). The ITGAV +gene encodes a cell cycle-associated antigen, integrin alphanubeta 3, which plays a role in RA angiogenesis. Previously, two independent studies identified an association between the major allele of the ITGAV single-nucleotide polymorphism (SNP) rs3738919 and RA. We therefore tested this association in an independent study using New Zealand (NZ) and Oxford (UK) RA case control samples. METHODS: We compared genotype frequencies in 740 NZ Caucasian RA patients and 553 controls genotyped for rs3738919, using a polymerase chain reaction-restriction fragment length polymorphism assay. A TaqMan genotyping SNP assay was used to type 713 Caucasian RA patients and 515 control samples from Oxford for the rs3738919 variant. Association of rs3738919 with RA was tested in these two sample sets using the chi-square goodness-of-fit test. The Mantel-Haenszel test was used to perform a meta-analysis, combining the genetic results from four independent Caucasian case control cohorts, consisting of 3,527 cases and 4,126 controls. Haplotype analysis was also performed using SNPs rs3911238, rs10174098 and rs3738919 in the Wellcome Trust Case Control Consortium, NZ and Oxford case control samples. RESULTS: We found no evidence for association between ITGAV and RA in either the NZ or Oxford sample set (odds ratio [OR] = 0.88, P(allelic) = 0.11 and OR = 1.18, P(allelic) = 0.07, respectively). Inclusion of these data in a meta-analysis (random effects) of four independent cohorts (3,527 cases and 4,126 controls) weakens support for the hypothesis that rs3738919 plays a role in the development of RA (OR(combined) = 0.92, 95% confidence interval 0.80 to 1.07; P = 0.29). No consistent haplotype associations were evident. CONCLUSIONS: Association of ITGAV SNP rs7378919 with RA was not replicated in NZ or Oxford case control sample sets. Meta-analysis of these and previously published data lends limited support for a role for the ITGAV in RA in Caucasians of European ancestry
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