Diagnostic challenges and psychosocial impacts of hypersomnia in a Nigerian adolescent: A case report

Hypersomnia, a disorder of sleep characterized by excessive quantity of sleep and excessive daytime sleepiness (EDS), could adversely affect health outcomes in childhood. To highlight diagnostic challenges and the impact of childhood hypersomnia in a resource limited setting, a 14year old Nigerian who presented with a seven year history of hypersomnia was studied. Screening for sleep disorder using BEARS sleep algorithm and assessment for EDS using the Epworth Sleepiness Scale were both positivefor EDS. The assessment of sleep hygiene using the Adolescent Sleep Hygiene Scale was normal and the use of Raven’s Progressive Matrices to assess intelligence was also normal. There was no contributory pastmedical history or demonstrable etiology. Magnetic Resonance Imaging (MRI) of the brain, Electro Encephalogram (EEG), assay of serum electrolytes were all normal while screening test for trypanosomiasis was negative. Poor level of awareness, high cost of evaluation and limited facilities for diagnosis of sleep disorder were the major diagnostic challenges. Depression, poor academic performance, suicidal ideation andstigmatization were all associated with hypersomnia in the patient.Keywords: Hypersomnia, adolescence, depression, sleep disorders, diagnostic challenges

In Vivo Anti-Trypanosomal Activity of Ethanolic Leaf Extract of Carissa Spinarum (Wild Karanda) in Mice Infected with Trypanosoma Brucei Brucei Spp.

Carissa Spinarum plant has been implicated as a medicinal plant for joints, muscle, chest pains by the massai people of Kenya, also as an antiviral supplement for HIV treatment in Tanzania. Acute toxicity of the ethanolic leaf extract and minimum inhibition concentration (MIC) using four (4) microorganism (proteus, e.coli, staphylococcus aureus spp & enterobacter spp) was evaluated in mice using Lorke’s method & serial dilution method respectively. The ethanolic leaf extract was evaluated for in vivo anti-trypanosomal activity against federa strain of Trypanosoma brucei brucei in albino mice. Four days suppressive, curative effect against established infection and prophylactic models of anti-trypanosomal studies were carried out. The median lethal dose of the extract was determined to be ? 100mg ? kg body weight. The extract (12.5, 25, 50mg / kg) exerted some dose dependent suppressive effects at the different levels of infections tested, with no significant curative effects recorded. However, further antitrypanosomal property can be explored for the management of trypanosomiasis. Keywords: Carissa spinarum, antitrypanosomal, albino mice, trypanosome brucei brucei speci

What motivates employers to establish preventive arrangements? An examination of the case of supply chains

This paper examines existing evidence as to the factors that prompt organisations to utilise supply chains to influence how health and safety is managed within them, with a view to shedding light on how far it serves to confirm or challenge the view that in general employers are unlikely to voluntarily pursue preventive management initiatives in the absence of external regulatory pressures. The analysis reveals a range of initiatives undertaken to utilise supply chains to support improvements in health and safety management, both at the level of individual organisations and via trade and industry bodies. It also, however, indicates that while supply chains can be used to improve how health and safety is managed within them, only in relatively narrowly defined circumstances will market-based business motivations alone serve to encourage the utilisation of this potential. It is further concluded that if policy-makers wish to see supply chains used more widely to improve standards of health and safety standards, then they need to do more than merely encourage voluntary action in this regard

Private finance for the delivery of school projects in England

This paper analyses the use of the private finance initiative (PFI) approach to deliver school projects in England. The findings are based on case-study research in the Building Schools for the Future scheme (BSF), the largest single capital investment in SO years to rebuild and renew all of England's secondary schools. Up to half of the school infrastructure is to be procured by PFI contracts. A major concern has been the high cost associated with PFI procurement and any subsequent changes to scope. Furthermore, in some cases PFI-funded schools have been closed soon after completion; at great cost to the public sector. The aim of this research was therefore to understand the underlying reasons for these problems. The main conclusion is that the difficulties in BSF arise from not sorting out strategic issues and instituting appropriate organisational frameworks before engaging the private sector. The result of this is a lack of clarity about the long-term needs and end user aspirations. A brief outline of current programme management methods is given and it is suggested that this might be integral to the successful delivery of schools using private finance. A clear strategic vision that cascades into projects via programmes will ensure that the school infrastructure is appropriate for the anticipated strategic benefits and is aligned to the overall service delivery ambitions

Automated construction of variable density navigable networks in a 3D indoor environment for emergency response

Widespread human-induced or natural threats on buildings and their users have made preparedness and quick response as crucial issues for saving human lives. Available information about an emergency scene, e.g. the building structure, material and trapped people helps for decision-making and organizing rescue operations. The ability to evaluate potential scenarios for human evacuation, and then identifying the paths of egress during an emergency is critical for rescue and emergency services. Good quality models supporting real, or near-real, time decision-making and allowing the implementation of automated methods are highly desirable. In this paper, we propose a new automated method for deriving a navigable network in a 3D indoor environment, including a full 3D topological model which may be used not only for standard navigation but also for finding alternative egress routes and simulating phenomena associated with disasters such as fire spread and heat transfer

The changing landscape of IS project failure: an examination of the key factors

YesInformation systems (IS) project failure has been a recurring problem for decades. The purpose of this paper is twofold: first, to examine the key factors that influence project failure and an analysis of the major areas that can have a significant impact on success; and second, to explore some of the key aspects that have an impact on project management performance from the practitioner perspective and discusses the problems faced by organizations in the closer integration of change and project management. Design/methodology/approach: This study critically reviews the IS failure literature developing a synthesized view of the key issues and common reasons for projects to fail. The approach taken in this study is one that focuses on a number of key questions that pull together the relevant themes in this genre of research whilst highlighting many of the implications for practitioners and organizations alike. Findings: Key questions remain on the underlying causes of instances of poor project management as an IS failure factor. The literature has omitted to develop a deeper analysis of the associations between failure factors and the potential causal relationships between these factors. The realization of project benefits relies on the success of both change and project management yet the formal integration of these two disciplines is constrained by separate standards bodies and an immature body of research. Research limitations/implications: This study is limited by its theoretical nature lacking an empirical element to provide a deeper analysis of IS failure factors and their interrelationships. This specific area is a recommendation for future research, where causal relationships between failure factors could be developed via a mathematic-based method such as interpretive structural modeling. Practical implications: With failure rates of IS projects still unacceptably high after decades of attempts to significantly change outcomes, a deeper analysis of this topic is required. The research gaps and recommendations for practitioners highlighted in this study have the potential to provide valuable contributions to this topic of research. Originality/value: The intent of this study is to present a new perspective of this genre of IS research that develops the main arguments and gaps in the literature from the practitioner viewpoint