Adiposity in British secondary school children: a population based study

Summary:Adiposity is defined as the property of containing fat. Excessive adiposity is a cause of both morbidity and mortality in adults. Important consequences include increased risks of type 2 diabetes, coronary heart disease and stroke, (particularly through the increased risks of high blood pressure, dyslipidaemia and insulin resistance associated with adiposity), osteoarthritis, gall bladder disease and some cancers (particularly endometrial, breast, and colon). There is concern, both in the UK and in other settings, that levels of adiposity have risen during the past 20-30 years or so, both in adults and in children and adolescents, in whom relative increases in risk have been particularly large.Key adiposity indicators include markers of general adiposity, of which body mass index weight (kg)/height2 (m2) is the most commonly used and markers of central adiposity, of which waist circumference is the most commonly used; central adiposity is particularly related to increased risks of cardiovascular disease and type 2 diabetes. High levels of body mass index, and, increasingly waist circumference, have been used to define overweight and obesity, although the definition of cut-offs for abnormality is difficult, especially in children and adolescents.In British adults, there are marked geographic, social and ethnic variations in the occurrence of adiposity. Higher levels of adiposity have been reported in Northern England and Wales when compared to Southern England, in lower social class groups compared to higher ones and among South Asians compared to White Europeans. However, there is limited information on the extent of geographic, social and ethnic variation in adiposity in children. Although raised adiposity in an individual fundamentally reflects an imbalance between energy intake and expenditure, many potential determinants of adiposity have been identified. These include not only recent and previous dietary factors and physical activity, but also early life exposures and parental influences.In a population-based study of British 13-16 year-olds, this Thesis sets out to address four overall aims;- (i) to examine patterns of adiposity, including the interrelationships of different adiposity markers; (ii) to explore geographic, social and ethnic differences in adiposity and relate them to patterns observed in adults; (iii) to examine the association of three individual factors – current physical activity pattern, infant feeding and parental BMI – with adiposity; (iv) to examine the associations between adiposity markers, blood pressure and insulin resistance, particularly to determine which adiposity measures are most strongly related to these factors in adolescence

PATHOGENIC BACTERIA IN LAKE VICTORIA SHORE WATER AT KASENYI LANDING SITE IN ENTEBBE MUNICIPALITY, UGANDA: A CROSS-SECTIONAL PILOT SURVEY ON OCCURRENCE PROFILES AND ASSOCIATED FACTORS.

Background: Goal six (6) of the 2030 agenda and sustainable development goals highlights the need to "ensure availability and sustainable management of water and sanitation for all." Over the years; Lake Victoria, which supports nearly one-third of the total East African population has been facing pollution-related effects and thus risking water-borne infections from pathogenic bacteria for example; Citrobacter freundii, Klebsiella pneumoniae, Staphylococcus species, Enterococcus species, etc.; with some of the associated factors including wastewater treatment, agricultural activities, soil surface runoffs, bathing, rubbish dumping among others. Methods: A two-month cross-sectional pilot survey was done in which thirty-one (n=31) Lake Victoria surface water samples were collected at the Kasenyi landing site and bacteriologically examined through culturing water samples. Additionally; a one-time field observation accompanied by eleven (n=11) short interviews with key respondents was undertaken to identify the factors potentially associated with the bacterial contamination of the Lake Victoria shore surface water. Data were analyzed using Microsoft Excel 2013. Results: Citrobacter freundii accounted for the highest occurrence at 58% (46/79) while Klebsiella pneumoniae was the least occurring at 3% (2/79). “Soil surface run-off” emerged as the most occurring factor related to possible bacterial contamination of the shore surface waters (73%; 8/11). One-time field observation revealed the presence of “bathing practices, rubbish dumping, and soil surface runoff.” Conclusion:  Citrobacter freundii was the most occurring bacterial pathogen; soil surface run-off emerged as the most occurring factor; there is a low chance of encountering Klebsiella pneumoniae and a high chance of encountering Citrobacter freundii, Staphylococcus species, and Enterococcus species. Recommendation: Establishment of control mechanisms (i.e. physical barriers) for soil run-off into the lake shore

Assessment of the impact of climate change on road maintenance

Climate affects road deterioration, vehicle operating costs, road safety and the environment. Current and past pavement design guides and engineering models assume a static climate whose variability can be determined from past data. This fixed climate assumptions is often used in road management decision support models such as the Highway Development and Management system (HDM-4) to simulate future behaviour of road sections and consequently inform long-term road maintenance strategies and policies. Contrary to the assumption of a static climate in road management approaches, observations over the last 40 or 50 years show increasing trend in global warming. This raises the possibility that the severity and frequency of pavement defects may be altered leading to premature pavement deterioration and increased costs of managing and using roads. As a consequence, current road management strategies and policies may not offer sufficient resilience to increased frequency of future extreme climate events. A study was undertaken at the University of Birmingham to develop improved deterioration model for asphalt rut depth prediction. The approach used entailed the application of Bayesian Monte Carlo analysis. The output of the study will be used to improve existing road management systems such as HDM-4 and to consequently facilitate the investigation of strategies for adapting to future changes in climate

Multi-Year Program under Budget Constraints Using Multi-Criteria Analysis

Road investment appraisal requires joint consideration of multiple criteria which are related to engineering, economic, social and environmental impacts. The investment consideration could be based on the economic analysis but however for some factors, such as environmental, social, and political, are difficult to quantify in monetary term. The multi-criteria analysis is the alternative tool which caters the requirements of the issues above. The research, which is based on 102 class D and class E paved road sections in Kenya, is about to optimize road network investment under budget constraints by applying a multi-criteria analysis (MCA) method and compare it with the conventional economic analysis. The MCA is developed from hierarchy structure which is considered as the analytical framework. The framework is based on selected criteria and weights which are assigned from Kenya road policy. The HDM-4 software is applied as decision-making tool to obtain the best investment alternatives and road work programs from both MCA and economic analysis. The road work programs will be the results from the analysis using both MCA and economic analysis within HDM-4 software to see the difference and compare the results between both programs. The results from MCA show 51 road sections need periodic work, which is overlay or resealing. Meanwhile, 51 others need rehabilitation or reconstruction. The five years road work program which based on economic analysis result shows that it costs almost Kenyan Shilling (KES) 130 billion to maintain the class D and E paved road in Kenya. Meanwhile, the MCA only requires KES 59.5 billion for 5 years program. These results show huge margin between two analyses and somehow MCA result provides more efficient work program compared to economic analysis

Study on pavement damage caused by axle overloading and associated costs in kenya

Road transport remains the predominant mode of transportation in most developing countries for both freight and passenger traffic. To this end, most developing countries have invested heavily in improving the condition of their road network since the turn of the millennia. However, it is emerging that these gains are coming under increasing threat as a result of overloading vehicle axles. This study focuses on vehicle loading trends in Kenya. The study involved performing pavement life-cycle cost analysis using the Highway Development & Management (HDM-4) tool based on the concept of Equivalent Standard Axle Load Factor (ESALF). HDM-4 was used to determine annual road condition trends, road user costs, and yearly road works costs for two-axle loading scenarios; (i) using ESALF determined from the legal axle load limits, and (ii) those determined from independent field axle load surveys. The study revealed that axle overloading is still prevalent in Kenya, and that Kenya is losing about US$ 43 million per year to pavement damage as a result of overloading while collecting less than 10% of that amount in axle overloading fines. The study further quantified the average increase in road user cost per vehicle-km and additional maintenance costs due to axle overloading.Papers presented at the 40th International Southern African Transport Conference on 04 -08 July 202

OCCURRENCE OF HUMAN PATHOGENIC BACTERIA IN LAKE VICTORIA SHORE WATER AND Oreochromis niloticus AT KASENYI LANDING SITE, WAKISO DISTRICT IN UGANDA

Background: As of 2008; human pathogenic bacteria were being identified in lake water and fish and by 2017; it was still a persistent problem in the aquatic environment up to date. Sources attributed to their presence in lake water and fish include; surface run-off from land, sewage discharge, sewage over flow, run-off of domestic and wildlife animal waste, direct waste deposition by grazing animals among others. Mitigation for aquatic ecosystems degradation over the years has been attempted through field and / or laboratory-based bacteriological monitoring of lake surface water quality. Methods: A cross-sectional laboratory-based survey was undertaken at Kasenyi landing site. Thirty-one (n=31) Lake Victoria shore water samples and thirty (n=30) Oreochromis niloticus samples were collected and bacteriologically examined for Staphylococcus species, Enterococcus species, and Enterobacteria. Data was analyzed using Microsoft Excel 2013 software to compute the chi-square and p-values.  Results: Citrobacter freundii was the most occurring human bacterial contaminant in water at 71% (22/31) while Klebsiella pneumoniae was the least occurring human bacterial contaminant at 6% (2/31). In the Orechromis niloticus organ samples; the most occurring was Enterococcus species at 77.5% (93/120) while the least occurring was Citrobacter freundii at 39% (47/120). There was no statistically significant relationship between the occurrence of bacteria in the Lake Victoria shore water and in the Oreochromis niloticus organs. Conclusion: Citrobacter freundii had the highest occurrence in the Lake Victoria shore water while Enterococcus species had the highest occurrence in all the four Oreochromis niloticus organs. A chance-based relationship between the occurrence of bacteria in the Lake Victoria shore water and in the specific Oreochromis niloticus organs was established. Recommendation: A larger sample size research to evidence the potential sources of human pathogenic bacteria into the Lake Victoria shore water and the fish at Kasenyi landing site

Multicriteria evaluation on accessibility-based transportation equity in road network design problem

This paper investigates the performance of accessibility-based equity measurements in transportation and proposes a multiobjective optimization model to simulate the trade-offs between equity maximization and cost minimization of network construction. The equity is defined as the spatial distribution of accessibilities across zone areas. Six representative indicators were formulated, including GINI coefficient, Theil index, mean log deviation, relative mean deviation, coefficient of variation, and Atkinson index, and incorporated into an equity maximization model to evaluate the performance sensitivity. A bilevel multiobjective optimization model was proposed to obtain the Pareto-optimal solutions for link capacity enhancement in a stochastic road network design problem. A numerical analysis using the Sioux Falls data was implemented. Results verified that the equity indicators are quite sensitive to the pattern of network scenarios in the sense that the level of equity varies according to the amount of overall capacity enhancement as well as the assignment of improved link segments. The suggested multiobjective model that enables representing the Pareto-optimal solutions can provide multiple options in the decision making of road network design.</p

Antibiotic-Resistant Profiles of Bacteria Isolated from Cesarean and Surgical Patients from Kasese District Hospitals Western Uganda

Surgical site infections (SSIs) are challenging to treat and often associated with much higher extended stays, morbidity, and mortality, higher treatment costs, especially when the causative agent is multidrug resistance (MDR). This study was designed to determine the prevalence of nosocomial infections and susceptibility profiles of bacteria isolated from Cesarean section (C-section) and surgical patients from Kasese District Hospitals in Western Uganda. A descriptive cross-sectional study was conducted from January to September 2016 involving 303 patients with SSIs in obstetrics &amp; gynecology; and general surgery wards in three health facilities. Clinical-demographic characteristics of patients were obtained using structured questionnaires before surgery. Bacterial analysis of the air and floor of the theatre room was done using the standard culture method. Of the 303 patients enrolled with SSIs (median age 34 years), 71.6% were female, and 28.4% were males. Only 14.5% developed SSIs, with predominant isolates being Staphylococcus aureus&nbsp;33.33% and Escherichia coli 24%. The majority of recruited participants underwent a C-section of 58% and the least amputations of 0.3%. Duration of operation or surgery, p-value 0.002 (95% CI 1.599-7.667) was significantly associated with SSIs. Gram-negative bacteria were found resistant (50-100%) to ampicillin, gentamycin, and ciprofloxacin, the commonly used post-operative drugs of choice. Hospital-acquired infections were common with emerging antibiotic-resistant strains isolated in most SSIs at Kasese hospitals. The development of resistance to commonly used antibiotics such as ampicillin, gentamycin, and ciprofloxacin than previously reported calls for laboratory-guided SSIs therapy and strengthening infection control policies

Rolling resistance contribution to a road pavement life cycle carbon footprint analysis

Purpose Although the impact of road pavement surface condition on rolling resistance has been included in the life cycle assessment (LCA) framework of several studies in the last years, there is still a high level of uncertainty concerning the methodological assumptions and the parameters that can affect the results. In order to adopt pavement carbon footprint/LCA as a decision-making tool, it is necessary to explore the impact of the chosen methods and assumptions on the LCA results. Methods This paper provides a review of the main models describing the impact of the pavement surface properties on vehicle fuel consumption and analyses the influence of the methodological assumptions related to the rolling resistance on the LCA results. It compares the CO2 emissions, calculated with two different rolling resistance models existing in literature, and performs a sensitivity test on some specific input variables (pavement deterioration rate, traffic growth, and emission factors/fuel efficiency improvement). Results and discussion The model used to calculate the impact of the pavement surface condition on fuel consumption significantly affects the LCA results. The pavement deterioration rate influences the calculation in both models, while traffic growth and fuel efficiency improvement have a limited impact on the vehicle CO2 emissions resulting from the pavement condition contribution to rolling resistance. Conclusions and recommendations Existing models linking pavement condition to rolling resistance and hence vehicle emissions are not broadly applicable to the use phase of road pavement LCA and further research is necessary before a widely-used methodology can be defined. The methods of modelling and the methodological assumptions need to be transparent in the analysis of the impact of the pavement surface condition on fuel consumption, in order to be interpreted by decision makers and implemented in an LCA framework. This will be necessary before product category rules (PCR) for pavement LCA can be extended to include the use phase

Rural road management in Botswana

This paper discusses the management of rural roads in Chobe in Botswana, which are mainly tertiary and access roads. These roads are low-volume roads and mostly gravelled. It was observed that the maintenance management of these roads was based on engineering judgement through visual inspection all over the country, without having any economic or technical analysis. Therefore, a comprehensive pavement management system for rural roads' maintenance is needed in Chobe and also in all the council areas of Botswana, which would consist of data collection, database, use of the Highway Development and Management Model to undertake efficient decision making project preparation, funding, implementation and feedback. A partial implementation of pavement management system in Chobe has been highlighted in this paper. The present analysis reveals that total demand for the road network in Chobe was 41·29 million pula, the backlog was 34·86 million pula and the first-year backlog demand was 20·63 million pula. Furthermore, the analysis found the long-term periodic maintenance strategy for the network at 6·43 million pula when there is no backlog. This huge backlog indicates that roads are not being maintained appropriately. The paper also estimates current road asset value in Chobe at 55·48 million pula. Finally, the paper recommends several solutions for the efficient preservation of road assets in Botswana