Water Source and Water Demand Needs Assessments for Bonwire

This work assessed the water supply source and water demand of Bonwire, a town in the Ashanti Region of Ghana. The work was done to solve an identified water threat in Bonwire. The assessment was done via the identification and discharge quantification of water sources; the physicochemical and biological assessments of the source(s); estimation of water needs and a comparison of the supply and demand in Bonwire, and to recommend this assessment to the local government and Donor Agencies. The methodology for the work was site reconnaissance and desk studies, water discharge measurement via area-velocity method, field sampling and laboratory testing. The ions were analysed by ICP-AES and IC. The current water demand was estimated as 274 m3d-1.The  two sources of water identified for Bonwire were four (4) rivers and groundwater from two (2) boreholes. The discharge measurements and borehole yields indicated that the total discharge for Bonwire is 14,239 m3d-1 of which rivers contribute about 99%.  Inspite of the large river discharges, the physicochemical properties finger the river waters as unpotable, because the rivers are contaminated with contaminants (nitrates, sulphates, coliform) and hardness. The groundwater source which is the only potable source has a daily discharge of 86 m3d-1, which is in a deficit of 188 m3d-1 for the current water demand. It was concluded that there was a water threat in Bonwire. It was therefore recommended that contamination of the rivers should be controlled; a hydrogeological assessment for additional borehole drilling should be conducted, and  the possibility of treating the rivers for supplying water to Bonwire and the Municipality should be considered. Keywords: Water Supply, Water Demand, Water Threat, Contaminants, Coliform, Water Hardness, Hydrogeological Assessment

Application of the Consolidated Framework for Implementation Research to examine nurses’ perception of the task shifting strategy for hypertension control trial in Ghana

Background: The burden of hypertension in many low-and middle-income countries is alarming and requires effective evidence-based preventative strategies that is carefully appraised and accepted by key stakeholders to ensure successful implementation and sustainability. We assessed nurses’ perceptions of a recently completed Task Shifting Strategy for Hypertension control (TASSH) trial in Ghana, and facilitators and challenges to TASSH implementation. Methods: Focus group sessions and in-depth interviews were conducted with 27 community health nurses from participating health centers and district hospitals involved in the TASSH trial implemented in the Ashanti Region, Ghana, West Africa from 2012 to 2017. TASSH evaluated the comparative effectiveness of the WHO-PEN program versus provision of health insurance for blood pressure reduction in hypertensive adults. Qualitative data were analyzed using open and axial coding techniques with emerging themes mapped onto the Consolidated Framework for Implementation Research (CFIR). Results: Three themes emerged following deductive analysis using CFIR, including: (1) Patient health goal setting- relative priority and positive feedback from nurses, which motivated patients to make healthy behavior changes as a result of their health being a priority; (2) Leadership engagement (i.e., medical directors) which influenced the extent to which nurses were able to successfully implement TASSH in their various facilities, with most directors being very supportive; and (3) Availability of resources making it possible to implement the TASSH protocol, with limited space and personnel time to carry out TASSH duties, limited blood pressure (BP) monitoring equipment, and transportation, listed as barriers to effective implementation. Conclusion: Assessing stakeholders’ perception of the TASSH implementation process guided by CFIR is crucial as it provides a platform for the nurses to thoroughly evaluate the task shifting program, while considering the local context in which the program is implemented. The feedback from the nurses informed barriers and facilitators to implementation of TASSH within the current healthcare system, and suggested system level changes needed prior to scale-up of TASSH to other regions in Ghana with potential for long-term sustainment of the task shifting intervention

Determinantes dos honorários de auditoria para Portugal e Espanha

A liberalização dos serviços de auditoria em Portugal , com a eliminação em 2005, da tabela que fixava honorários mínimos baseados em padrões de dimensão da empresa auditada desperta o interesse em percecionar quais são os fatores que originam a determinação dos honorários de auditoria. Em Espanha, o conjunto de escândalos fina nceiros de que tem sido alvo tem colocado os honorários de auditoria no foco principal. A análise inclui uma amostra de 40 empresas cotadas em Portugal e 113 empresas cotadas em Espanha p ara o ano de 2013 utilizando a regressão dos mínimos quadrados (OSL). Os resultados indicam que em Espanha, os honorários são fixados principalmente em função da dimensão, complexidade e risco de auditoria, sendo que quanto maior a dimensão, a complexidade e o risco da empresa auditada, maiores os honorários de auditoria. E m Portugal, a dimensão da empresa auditada foi considerado o único fator que contribui para a determinação dos honorários em Portugal. Os resultados obtidos permitem - nos assim concluir que a determinação dos honorários de auditoria em Portugal é muito dife rente da dos honorários das empresas cotadas em Espanh

An assessment of indoor radon level in a suburb of Ghana

Abstract Radiation and radioactive isotopes form part of our natural environment. Elevated levels of these radioactive isotopes in the environment can pose a threat to our health. A greater proportion of the natural radiation is from the radioactive gas radon. Although it cannot be detected by human senses, radon and its progenies are of health concern as it can cause lung cancer when inhaled over a period of time. This study sought to provide baseline indoor radon data, the life time risk of lung cancer and its interpretation within a suburb of Ghana. Solid State Nuclear Track Detector (LR-115 type II) was deployed in 82 homes within a suburb for a period of three months (September 2017- January 2018). Indoor radon concentration (IRC) for the suburb was within the range of 4.1�176.3 Bq m?3. With mean 57 ± 39 Bq m?3. The mean radon exposure to the dwellers was recorded as 0.12 ± 0.08 WLMy?1 resulting in 0.7 ± 0.5 mSvy?1 effective dose to the lung with an excess lifetime cancer risk of 0.39 ± 0.26%. There was a positive correlation between indoor radon concentration and the building type and the association was significant with a P value of 0.047.</jats:p

Impaired Cognitive Function and Altered Hippocampal Synaptic Plasticity in Mice Lacking Dermatan Sulfotransferase Chst14/D4st1

Chondroitin sulfate (CS) and dermatan sulfate (DS) proteoglycans (PGs) are major extracellular matrix (ECM) components of the central nervous system (CNS). A large body of evidence has shown that CSPGs/DSPGs play critical roles in neuronal growth, axon guidance, and plasticity in the developing and mature CNS. It has been proposed that these PGs exert their function through specific interaction of CS/DS chains with its binding partners in a manner that depends on the sulfation patterns of CS/DS. It has been reported that dermatan 4-O-sulfotransferase-1 (Chst14/D4st1) specific for DS, but not chondroitin 4-O-sulfotransferase-1 (Chst11/C4st1) specific for CS, regulates proliferation and neurogenesis of neural stem cells (NSCs), indicating that CS and DS play distinct roles in the self-renewal and differentiation of NSCs. However, it remains unknown whether specific sulfation profiles of DS has any effect on CNS plasticity. In the present study, Chst14/D4st1-deficient (Chst14−/−) mice was employed to investigate the involvement of DS in synaptic plasticity. First, behavior study using Morris Water Maze (MWM) showed that the spatial learning and memory of Chst14−/− mice was impaired when compared to their wild type (WT) littermates. Corroborating the behavior result, long-term potentiation (LTP) at the hippocampal CA3-CA1 connection was reduced in Chst14−/− mice compared to the WT mice. Finally, the protein levels of N-Methyl-D-aspartate (NMDA) receptor, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor, postsynaptic density 95 (PSD95), growth associated protein 43 (GAP-43), synaptophysin (SYN) and N-ethylmaleimide sensitive factor (NSF) which are important in synaptic plasticity were examined and Chst14/D4st1 deficiency was shown to significantly reduce the expression of these proteins in the hippocampus. Further studies revealed that Akt/mammalian target rapamycin (mTOR) pathway proteins, including protein kinase B (p-Akt), p-mTOR and p-S6, were significantly lower in Chst14−/− mice, which might contribute to the decreased protein expression. Together, this study reveals that specific sulfation of DS is critical in synaptic plasticity of the hippocampus and learning and memory, which might be associated with the changes in the expression of glutamate receptors and other synaptic proteins though Akt/mTOR pathway

Lifestyle information and access to a commercial weight management group to promote maternal postnatal weight management and positive lifestyle behaviour: the SWAN feasibility RCT

Background Increasing numbers of UK women have overweight or obese body mass index scores when they become pregnant, or gain excessive weight in pregnancy, increasing their risk of adverse outcomes. Failure to manage postnatal weight is linked to smoking, non-healthy dietary choices, lack of regular exercise and poorer longer-term health. Women living in areas of higher social deprivation are more likely to experience weight management problems postnatally. Objectives The objectives were to assess the feasibility of conducting a definitive randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of lifestyle information and access to a commercial weight management group focusing on self-monitoring, goal-setting and motivation to achieve dietary change commencing 8–16 weeks postnatally to achieve and maintain weight management and positive lifestyle behaviour. Design The design was a randomised two-arm feasibility trial with a nested mixed-methods process evaluation. Setting The setting was a single centre in an inner city setting in the south of England. Participants Participants were women with body mass index scores of > 25 kg/m2 at antenatal ‘booking’ and women with normal body mass index scores (18.0–24.9 kg/m2) at antenatal booking who developed excessive gestational weight gain as assessed at 36 weeks’ gestation. Main outcome measures Recruitment, retention, acceptability of trial processes and identification of relevant economic data were the feasibility objectives. The proposed primary outcome was difference between groups in weight at 12 months postnatally, expressed as percentage weight change and weight loss from antenatal booking. Other proposed outcomes included assessment of diet, physical activity, smoking, alcohol consumption, body image, maternal esteem, mental health, infant feeding and NHS costs. Results Most objectives were achieved. A total of 193 women were recruited, 98 allocated to the intervention arm and 95 to the control arm. High follow-up rates (> 80%) were achieved to 12 months. There was an 8.8% difference in weight loss at 12 months between women allocated to the intervention arm and women allocated to the control arm (13.0% vs. 4.2%, respectively; p = 0.062); 47% of women in the intervention arm attended at least one weight management session, with low risk of contamination between arms. The greatest benefit was among women who attended ≥ 10 sessions. Barriers to attending sessions included capability, opportunity and motivation issues. Data collection tools were appropriate to support economic evaluation in a definitive trial, and economic modelling is feasible to quantify resource impacts and outcomes not directly measurable within a trial. Limitations The trial recruited from only one site. It was not possible to recruit women with normal body mass index scores who developed excessive pregnancy weight gain. Conclusions It was feasible to recruit and retain women with overweight or obese body mass index scores at antenatal booking to a trial comparing postnatal weight management plus standard care with standard care only and collect relevant data to assess outcomes. Approaches to recruit women with normal body mass index scores who gain excessive gestational weight need to be considered. Commercial weight management groups could support women’s weight management as assessed at 12 months postnatally, with probable greater benefit from attending ≥ 10 sessions. Process evaluation findings highlighted the importance of providing more information about the intervention on trial allocation, extended duration of time to commence sessions following birth and extended number of sessions offered to enhance uptake and retention. Results support the conduct of a future randomised controlled trial

Variation in optineurin (OPTN) allele frequencies between and within populations

PURPOSE: To evaluate the extent to which mutations in the optineurin (OPTN) glaucoma gene play a role in glaucoma in different populations. METHODS: Case-controlled study of OPTN sequence variants in individuals with or without glaucoma in populations of different ancestral origins and evaluate previous OPTN reports. We analyzed 314 subjects with African, Asian, Caucasian and Hispanic ancestries included 229 cases of primary open-angle glaucoma, 51 cases of juvenile-onset open-angle glaucoma, 33 cases of normal tension glaucoma, and 371 controls. Polymerase chain reaction-amplified OPTN coding exons were resequenced and case frequencies were compared to frequencies in controls matched for ancestry. RESULTS: The E50K sequence variant was identified in one individual from Chile with normal tension glaucoma, and the 691_692insAG variant was found in one Ashkenazi Jewish individual from Russia. The R545Q variant was found in two Asian individuals with primary open-angle glaucoma; one of Filipino ancestry and one of Korean ancestry. In addition to presenting OPTN allele frequencies for Caucasian and Asian populations that have been the subject of previous reports, we also present information for populations of Hispanic and black African ancestries. CONCLUSIONS: Our study contributes additional evidence to support the previously reported association of the OPTN E50K mutation with glaucoma. After finding an additional 691_692insAG OPTN variant, we can still only conclude that this variant is rare. Combined analysis of our data with data from more than a dozen other studies indicates no association of R545Q with glaucoma in most populations. Those same studies disagree in their conclusions regarding the role of M98K in glaucoma. Our analysis of the combined data provides statistically significant evidence of association of M98K with normal tension glaucoma in Asian populations, but not in Caucasian populations; however, the validity of this conclusion is questionable because of large differences in allele frequencies between and within populations. It is currently not possible to tell how much of the underlying cause of the allele frequency difference is attributable to demographic, technical, or ascertainment differences among the studies