Occupational Practices and Hazards of Rural Livestock Keepers in Uganda: A Cross-Sectional Study

Objective: In Uganda, 70% of rural poor rely on livestock for subsistence, to meet social obligations, and to insure against disaster. Livestock farming in Africa is in a state of transition from traditional management systems toward intensified modern systems, calling into question the future of traditional systems. To inform this debate, we conducted a survey in Moyo District, Uganda, to describe occupational practices and hazards of agropastoralist livestock keepers.   Methods: Household surveys were administered to heads of household (N=49) from July to September 2016. Cross-sectional data were used to generate descriptive statistics for livestock-associated practices and exposures. Logistic regression was used to estimate odds ratios and Wald-type 95% confidence intervals for risk factors for injury, defined as any animal-related injury in the household in the past year. Risk factors studied were total number of male animals; number of male cattle, sheep/goats, and pigs; proportion male by herd size; herd size; and castration practices.   Results: Adult men perform most livestock-associated tasks, while women, girls, and boys prepare meat, milk cattle, care for poultry, and dispose of waste. While 31 (63%) of households use professional veterinary services and most (n=28, 57.2%) are familiar with zoonoses, 25 (53.2%) do not believe sick animals may look healthy. Over 85.0% (n=41) of respondents routinely wash their hands, while only 31 (64.6%) use soap. Twenty-eight (57.0%) reported using personal protective equipment, while none used gloves or face protection. Most respondents had contact with animal waste “often”, and had contact with urine and blood “sometimes”. Six (12%) reported a needlestick injury while treating an animal, and 22 (45%) reported at least 1 injury from an animal. No significant association was found between the risk factors studied and animal injury, after adjustment for confounders.   Conclusions: Occupational risks for female and young agropastoralists are distinct from those of men. Contact with potentially infectious material is common and current practices – handwashing without soap and low glove use – do little to prevent zoonotic transmission. While agropastoralists are familiar with zoonoses, subclinical infections may be missed. While no significant risk factors were identified for animal injury, both animal and needlestick injuries are common. As livestock agriculture intensifies, these hazards will become more pronounced; drivers of risk behavior and animal injury must be identified to inform interventions to improve the occupational health of rural livestock keepers in Uganda

A Framework to Expand and Advance Probabilistic Risk Assessment to Support Small Modular Reactors

During the early development of nuclear power plants, researchers and engineers focused on many aspects of plant operation, two of which were getting the newly-found technology to work and minimizing the likelihood of perceived accidents through redundancy and diversity. As time, and our experience, has progressed, the realization of plant operational risk/reliability has entered into the design, operation, and regulation of these plants. But, to date, we have only dabbled at the surface of risk and reliability technologies. For the next generation of small modular reactors (SMRs), it is imperative that these technologies evolve into an accepted, encompassing, validated, and integral part of the plant in order to reduce costs and to demonstrate safe operation. Further, while it is presumed that safety margins are substantial for proposed SMR designs, the depiction and demonstration of these margins needs to be better understood in order to optimize the licensing process

Analisis Sifat Patahan (Sealing-leaking) Berdasarkan Data Tekanan, Decline Curve, dan Connectivity Injection pada Lapangan Dima

Lapangan DIMA merupakan salah satu lapangan minyak di Cekungan Sumatera Selatan dan terletak di Provinsi Jambi. Lapangan ini merupakan lapangan tua, oleh karena itu untuk memaksimalkan produksinya saat ini tengah dilakukan proses penginjeksian atau biasa dikenal dengan EOR (Enhanced Oil Recovery). Proses injeksi yang dilakukan berupa injeksi air atau waterflood. Untuk dapat melaksanakan proses EOR tersebut diperlukan perencanaan yang lengkap untuk pengembangan lapangan tersebut, hal ini dinamakan POFD (Plan of Further Development). Dalam POFD, pemilihan pattern injeksi menjadi dasar penting proses ini dan salah satu syaratnya ialah mengetahui potensi sifat patahan sealing (menahan aliran fluida) atau leaking (mengalirkan fluida) yang ada pada lapangan tersebut. Untuk melihat potensi sealing-leaking tersebut penulis menggunakan tiga metode yakni analisis data tekanan, analisis decline curve dan connectivity injection. Analisis data tekanan dilakukan dengan cara melihat perbandingan penurunan tekanan berdasarkan data sumur-sumur pada blok yang saling bersebelahan. Apabila penurunan tekanannya membentuk tren yang sama maka dapat diketahui potensi patahan yang memotong kedua blok tersebut bersifat leaking dan begitupun sebaliknya. Sedangkan, Analisis decline curve dilakukan dengan menggunakan software DSS (Dynamic Surveillance System) untuk membandingkan penurunan decline rate antar blok yang dipisahkan oleh patahan yang ingin diuji. Apabila nilai decline rate pada kedua blok memiliki perbedaan yang tidak terlalu signifikan maka dapat dikatakan bahwa patahan yang memisahkan kedua blok bersifat leaking dan begitupun juga dengan sebaliknya. Metode connectivity injection juga menggunakan software DSS dengan melihat hubungan atau konektivitas antara sumur injeksi dan sumur produksi yang berada diantara patahan yang diuji. Hal ini dilakukan dengan cara melihat adanya Perubahan pada data produksi karena pengaruh proses injeksi. Apabila terdapat konektivitas antara sumur injeksi dan sumur produksi, maka dapat dikatakan bahwa patahan tersebut bersifat leaking. Tetapi jika proses injeksi tidak berpengaruh terhadap data produksi, maka dapat dikatakan patahan tersebut bersifat sealing. Dari hasil analisis data tekanan, analisis decline curve, dan connectivity injection dapat dilihat serta dibandingkan bahwa jika hasil ketiga analisis ini saling mendukung maka dapat diperoleh kesimpulan mengenai sifat patahan yang diuji apakah bersifat sealing atau leaking. Data hasil analisis tersebut digunakan sebagai salah satu justifikasi dalam pembuatan pattern injeksi

The genetic history of the Southern Arc: a bridge between West Asia and Europe

By sequencing 727 ancient individuals from the Southern Arc (Anatolia and its neighbors in Southeastern Europe and West Asia) over 10,000 years, we contextualize its Chalcolithic period and Bronze Age (about 5000 to 1000 BCE), when extensive gene flow entangled it with the Eurasian steppe. Two streams of migration transmitted Caucasus and Anatolian/Levantine ancestry northward, and the Yamnaya pastoralists, formed on the steppe, then spread southward into the Balkans and across the Caucasus into Armenia, where they left numerous patrilineal descendants. Anatolia was transformed by intra–West Asian gene flow, with negligible impact of the later Yamnaya migrations. This contrasts with all other regions where Indo-European languages were spoken, suggesting that the homeland of the Indo-Anatolian language family was in West Asia, with only secondary dispersals of non-Anatolian Indo-Europeans from the steppe

A Framework to Expand and Advance Probabilistic Risk Assessment to Support Small Modular Reactors

During the early development of nuclear power plants, researchers and engineers focused on many aspects of plant operation, two of which were getting the newly-found technology to work and minimizing the likelihood of perceived accidents through redundancy and diversity. As time, and our experience, has progressed, the realization of plant operational risk/reliability has entered into the design, operation, and regulation of these plants. But, to date, we have only dabbled at the surface of risk and reliability technologies. For the next generation of small modular reactors (SMRs), it is imperative that these technologies evolve into an accepted, encompassing, validated, and integral part of the plant in order to reduce costs and to demonstrate safe operation. Further, while it is presumed that safety margins are substantial for proposed SMR designs, the depiction and demonstration of these margins needs to be better understood in order to optimize the licensing process

Acute costs and predictors of higher treatment costs for major paediatric trauma in New South Wales, Australia

Aims: To describe the costs of acute trauma admissions for children aged ≤15 years in trauma centres; to identify predictors of higher treatment costs and quantify differences in actual and state-wide average cost in New South Wales (NSW), Australia. Method: Admitted trauma patient data provided by 12 trauma centres was linked with financial data for 2008-2009. Demographic, injury details and injury severity scores (ISS) were obtained from trauma registries. Individual patient costs, Australian Refined Diagnostic Related Groups (AR-DRG) and state-wide average costs were obtained. Actual costs incurred by each hospital were compared with state-wide AR-DRG average costs. Multivariate multiple linear regression identified predictors of cost. Results: There were 3493 patients with a total cost of AUD$20.2 million. Falls (AUD$6.7 million) and road trauma (AUD$4.4 million) had the highest total expenditure. The reduction in cost between ISS < 9 compared to ISS 9-12 and ISS > 12 was significant (P < 0.0001). The median cost of injury increased with every additional body region injured (P < 0.0001). For each additional day spent in hospital, there was an increased cost of AUD$1898 and patients admitted to an intensive care unit (ICU) cost AUD$7358 more than patients not admitted to ICU. The total costs incurred by trauma centres were AUD$1.4 million above the NSW peer group average cost estimates. Conclusions: The high financial cost of paediatric patient treatment highlights the need to ensure prevention remains a priority in Australia. Hospitals tasked with providing trauma care should be appropriately funded and future funding models should consider trauma severity

Comparative analysis of trends in paediatric trauma outcomes in New South Wales, Australia

Paediatric trauma centres seek to optimise the care of injured children. Trends in state-wide paediatric care and outcomes have not been examined in detail in Australia. This study examines temporal trends in paediatric trauma outcomes and factors influencing survival and length of stay. A retrospective review was conducted using data from the NSW Trauma Registry during 2003-2008 for children aged 15 years and younger who were severely injured (injury severity score >15). To examine trauma outcomes descriptive statistics and multivariable logistic and linear regression were conducted. There were 1138 children severely injured. Two-thirds were male. Road trauma and falls were the most common injury mechanisms and over one-third of incidents occurred in the home. Forty-eight percent of violence-related injuries were experienced by infants aged less than 1 year. For the majority of children definitive care was provided at a paediatric trauma centre, but less than one-third of children were taken directly to a paediatric trauma centre post-injury. Children who received definitive treatment at a paediatric trauma centre had between 3 and 6 times higher odds of having a survival advantage than if treated at an adult trauma centre. The number of severe injury presentations to the 14 major trauma centres in NSW remains constant. It is possible that injury prevention measures are having a limited effect on severe injury in NSW. This research provides stimulus for change in the provision and co-ordination in the delivery of trauma care for injured children. An erratum exists for this article and can be found in: Injury 2014 Volume 44(10) p. 1375 at doi: 10.1016/j.injury.2013.07.0037 page(s

Development of the major trauma case review tool

Background: As many as half of all patients with major traumatic injuries do not receive the recommended care, with variance in preventable mortality reported across the globe. This variance highlights the need for a comprehensive process for monitoring and reviewing patient care, central to which is a consistent peer-review process that includes trauma system safety and human factors. There is no published, evidence-informed standardised tool that considers these factors for use in adult or paediatric trauma case peer-review. The aim of this research was to develop and validate a trauma case review tool to facilitate clinical review of paediatric trauma patient care in extracting information to facilitate monitoring, inform change and enable loop closure. Methods: Development of the trauma case review tool was multi-faceted, beginning with a review of the trauma audit tool literature. Data were extracted from the literature to inform iterative tool development using a consensus approach. Inter-rater agreement was assessed for both the pilot and finalised versions of the tool. Results: The final trauma case review tool contained ten sections, including patient factors (such as pre-existing conditions), presenting problem, a timeline of events, factors contributing to the care delivery problem (including equipment, work environment, staff action, organizational factors), positive aspects of care and the outcome of panel discussion. After refinement, the inter-rater reliability of the human factors and outcome components of the tool improved with an average 86% agreement between raters. Discussion: This research developed an evidence-informed tool for use in paediatric trauma case review that considers both system safety and human factors to facilitate clinical review of trauma patient care. Conclusions: This tool can be used to identify opportunities for improvement