The Simple Triage Scoring System (STSS) successfully predicts mortality and critical care resource utilization in H1N1 pandemic flu: a retrospective analysis

Introduction: Triage protocols are only initiated when it is apparent that resource deficits will occur across a broad geographical area despite efforts to expand or acquire additional capacity. Prior to the pandemic the UK Department of Health (DOH) recommended the use of a staged triage plan incorporating Sepsis-related Organ Failure Assessment (SOFA) developed by the Ontario Ministry of Health to assist in the triage of critical care admissions and discharges during an influenza outbreak in the UK. There are data to suggest that had it been used in the recent H1N1 pandemic it may have led to inappropriate limitation of therapy if surge capacity had been overwhelmed.Methods: We retrospectively reviewed the performance of the Simple Triage Scoring System (STSS) as an indicator of the utilization of hospital resources in adult patients with confirmed H1N1 admitted to a university teaching hospital. Our aim was to compare it against the staged initial SOFA score process with regards to mortality, need for intensive care admission and requirement for mechanical ventilation and assess its validity.Results: Over an 8 month period, 62 patients with confirmed H1N1 were admitted. Forty (65%) had documented comorbidities and 27 (44%) had pneumonic changes on their admission CXR. Nineteen (31%) were admitted to the intensive care unit where 5 (26%) required mechanical ventilation (MV). There were 3 deaths. The STSS group categorization demonstrated a better discriminating accuracy in predicting critical care resource usage with a receiver operating characteristic area under the curve (95% confidence interval) for ICU admission of 0.88 (0.78-0.98) and need for MV of 0.91 (0.83-0.99). This compared to the staged SOFA score of 0.77 (0.65-0.89) and 0.87 (0.72-1.00) respectively. Low mortality rates limited analysis on survival predictions.Conclusions: The STSS accurately risk stratified patients in this cohort according to their risk of death and predicted the likelihood of admission to critical care and the requirement for MV. Its single point in time, accuracy and easily collected component variables commend it as an alternative reproducible system to facilitate the triage and treatment of patients in any future influenza pandemic.</p

Impact Analysis of Ban of Commercial Motorcycle on Commuters in the University of Ibadan Campus

In Nigeria, commercial motorcycle operations (CMO) can be traced back to the period 1970-1980. Their emergence is primarily a result of public transport failure and economic downturn in that period. Up until recently, CMO have been a major means of intra-city public transport. Now, its operations have been prohibited or limited in many urban centers and campuses due to its connection to crime and high risk of accidents. Many studies have attempted to research the impacts of its ban on urban commuters' traffic behavior, with total neglect for campuses. Hence, this study attempts to assess the impacts of ban of CMO on commuters in the University of Ibadan Campus, within a year, its activities was proscribed. The study adopted survey research design. Primary and secondary data were sourced. Both random and purposive sampling techniques was used in selecting 300 students from a total students population of 35000 and 50 staff from a total staff population 3,684. A set of pre-tested questionnaire was administered on 350 commuters comprising mainly of students and staff selected randomly from the total student and staff population. Information gathered includes socio-economic characteristics of university commuters (students and staff), social economic impacts of ban of commercial motorcycles and its impacts on students’ activities on campus. Data obtained were analyzed using both descriptive (tables, frequency counts and percentage.) and inferential (T-test and Chi Square) statistics. Two hypotheses were formulated and tested. Paired sample t-test statistics was used to analyze the difference between cost of trips before ban of commercial motorcycles operations in the university and after the ban. The results of the analysis revealed that cost of trips increased significantly by N15.28 (p=0.045). Chi square test was used to test significance difference in university commuters’ modal mode of transport before and after the ban. The chi square results gives a chi square value 74.235 which is significant (p=.000).  Thus, the study confirmed that the ban of commercial motorcycles operations in the university have significant negative impacts on university commuters, especially students. The study therefore, suggest an inclusive transportation policy for university community, one that focus development on infrastructure, improvement in transport infrastructure and effective management of university commuters’ demand. Keywords: Impact Analysis; Ban of Commercial Motorcycle operations; University of Ibadan; campus planning; commuter. DOI: 10.7176/DCS/10-6-07 Publication date:June 30th 202

Exploring the waveform characteristics of tidal breathing carbon dioxide, measured using the N-Tidal C device in different breathing conditions (The General Breathing Record Study): protocol for an observational, longitudinal study

Background: In an increasingly comorbid population, there are significant challenges to diagnosing the cause of breathlessness, and once diagnosed, considerable difficulty in detecting deterioration early enough to provide effective intervention. The burden of the breathless patient on the health care economy is substantial, with asthma, chronic heart failure, and pneumonia affecting over 6 million people in the United Kingdom alone. Furthermore, these patients often have more than one contributory factor to their breathlessness symptoms, with conditions such as dysfunctional breathing pattern disorders—an under-recognized component. Current methods of diagnosing and monitoring breathless conditions can be extensive and difficult to perform. As a consequence, home monitoring is poorly complied with. In contrast, capnography (the measurement of tidal breath carbon dioxide) is performed during normal breathing. There is a need for a simple, easy-to-use, personal device that can aid in the diagnosis and monitoring of respiratory and cardiac causes of breathlessness.Objective: The aim of this study was to explore the use of a new, handheld capnometer (called the N-Tidal C) in different conditions that cause breathlessness. We will study whether the tidal breath carbon dioxide (TBCO2) waveform, as measured by the N-Tidal C, has different characteristics in a range of respiratory and cardiac conditions.Methods: We will perform a longitudinal, observational study of the TBCO2 waveform (capnogram) as measured by the N-Tidal C capnometer. Participants with a confirmed diagnosis of asthma, breathing pattern disorders, chronic heart failure, motor neurone disease, pneumonia, as well as volunteers with no history of lung disease will be asked to provide twice daily, 75-second TBCO2 collection via the N-Tidal C device for 6 months duration. The collated capnograms will be correlated with the underlying diagnosis and disease state (stable or exacerbation) to determine if there are different TBCO2 characteristics that can distinguish different respiratory and cardiac causes of breathlessness.Results: This study’s recruitment is ongoing. It is anticipated that the results will be available in late 2018.Conclusions: The General Breathing Record Study will provide an evaluation of the use of capnography as a diagnostic and home-monitoring tool for various diseases

Modelling Immunological Effects on Fractional Order of Cholera Dynamics with Behavioral Response via Numerical simulation

Cholera, spread by the bacterium Vibrio cholerae, is still a major health problem in places with unsanitary conditions. The way it spreads relies on the host’s immunity, certain environmental aspects and how clean people keep themselves and their properties.  The model in this study applies Caputo fractional-order derivatives to capture the immunity of people, their hygiene, memory in diseases and various ways of controlling them.  It includes the study of how people respond and interact with their environment and disease-related factors in a mathematical way. We perform solid analyses on the model, confirming the existence, uniqueness, positivity and boundedness of its solutions. A basic reproduction number is calculated to find out if the disease will continue to exist in a population. Analyzing what makes a disease-free state or an endemic equilibrium stable tells us how to best control the disease. Using the Laplace-Adomian Decomposition Method for solving the nonlinear fractional system results in simulations that match actual cholera behavior.  Findings point out that a decline in immunity and better hygiene help reduce how cholera spreads. The framework supports an understanding of cholera spread and is also useful for examining other diseases that are highly complex

Unpacking the Complexities of Re-Enrollment in Secondary Schools: A Dual Perspective from Parents and Teenage Mothers in Osun State, Nigeria

Teenage pregnancy is a multifaceted issue that intersects with various social, cultural, and economic factors. The issue of teenage pregnancy raises important questions about the well-being and future prospects of young girls and most importantly, efforts at reschooling them. This study adopted a qualitative method using interview method to explore both teenage mothers’ and their parents willing to reenroll their daughters in school. The population for this study consisted pregnant girls awaiting child bearing, young-mothers and teenage mothers who had dropped out of school or still attending school. Eight teenage mothers that dropped out of school and two parents were reached and interviewed. The results revealed that teenage mothers admitted that they missed school, and interested in continuing their education. Parents were worried about their daughters dropping out of school and were willing to help them complete their secondary school education, while identifying financial difficulties as a major challenge.

Analysis of school bullying menace incorporating family education: a mathematical modeling approach

School bullying is a severe social problem that has an unfavorable impact on students development and behavior. Based on family education and students memory of having been bullied or witnessed bullying, this work established a mathematical model for analyzing school bullying dynamics. By employing the Caputo fractional derivative, the model incorporates students' memory in the interactional patterns of bullying, which provides for improved emulation of the impacts of previous episodes on future behaviors. An Adams-Bashforth method numerical scheme is presented, offering a robust approach for scenario simulations under the Caputo fractional operator. Scenario simulations shows the impact of family education on the prevalence and dynamics of school bullying. It is noticed that the behavior of students who lack and with family education and not involving bullying under different values of fractional order. The trajectory changes with the fractional order, suggesting that the system's sensitivity to initial conditions or recent changes decreases as fractional order reduce from the normal dynamics (integer order). Essentially, a lower fractional order makes the system less reactive to short-term fluctuations and more stable

Survey datasets on organisational climate and job satisfaction among academic staff in some selected private universities in Southwest Nigeria

This study attempts to establish the relationships that exist between the different variables of organizational climate and job satisfaction among academic staff in some selected private Universities in South- West Nigeria,to ascertain related factors in organizational climate that can caused is satisfaction among academics;and to determine if there is asignificant difference in the way senior academics and junior academics perceive the existing organizational climate. A total of 384 copies of questionnaires were administered to selected five (5)private Universities in the South-West Zone of Nigeria but a total of 293 questionnaireswerereturnedfullyandappropriately filled.Thestudy made useofappropriatestatisticssuchasmeasurementmodel(Con- firmatoryFactorAnalysis)andMultipleRegressiontoobtainresult

Monitoring of seepages around dams using geophysical methods: a brief review

The slow escape of a liquid or gas through a porous material or small openings is called seepage. It is a process of seeping in soil engineering whereby water in soils move. Seepages often pose a grave problem in building foundations and also a common problem in earth dams (Dams are structures built to retain water/fluild) due to abnormal or excessive leakage. Seepage through or around dams have been responsible for most dam failures. Dam failures are usually catastrophic with many fatalities and causing the destruction of infrastructure and properties. Therefore, monitoring of seepage through and around dams becomes a necessity in other to maintain dam’s stability. The main field of application of this investigation is subjected to site characterization and foundation quality assurance. This paper reviews the geophysical techniques which have been considered for the monitoring and control of seepages around dam