Managing Urban Crimes with Geoinformatics: A Case Study of Benin City, Nigeria

In recent time, the increase in rural-urban migration has continued to have both positive and negative impact on the receiving urban environment. Social vices such as terrorism, urban crimes, prostitution, drug cartel and urban slums are on the increase and as a result, most infrastructural facilities are been overused resulting to urban blight. In most developing countries like Nigeria, the impact of corruption and act of criminality has equally added to this menace and effort by security organisations to restore urban sanity has yielded little or no result due largely to the use of mundane policing methods. Using Geoinformatics methodologies (ArcGIS and ILWIS software), results of buffering; network, proximity, and crime service area analyses on crime hotspots in Benin City reveals that some areas are more vulnerable than others. Base on statistical analysis of administered questionnaire, the study shows that perceived higher income (33%), employment opportunities (24%), basic infrastructures (15%), quality of life (10%), change of environment (9%) and other reasons  put together (9%) are mainly responsible for migration and consequent urban growth. The location of police stations vis-à-vis police-public relations was observed to be very poor. The study also revealed that the major crimes in the city are armed robbery (29%), burglary (22%), rape (19%), pick pocket (15%), murder/assassination (4%) and other petty crimes put together (11%). Combating crime requires intelligent ICT system and a pragmatic intelligent synergy between the public and well-prepared police force. Reducing indiscriminate rural-urban migration through rural infrastructure and police welfare/logistics improvements are recommended. Keywords: Crime, Geographic Information Systems (GIS), Geoinformatics, Remote Sensing, Urban Environment

Sleep Disorders, Obesity, Hypertension, and Cardiovascular Risk

In this paper we describe a concept-wise multi-preference semantics for description logic which has its root in the preferential approach for modeling defeasible reasoning in knowledge representation. We argue that this proposal, beside satisfying some desired properties, such as KLM postulates, and avoiding the drowning problem, also defines a plausible notion of semantics. We motivate the plausibility of the concept-wise multi-preference semantics by developing a logical semantics of self-organising maps, which have been proposed as possible candidates to explain the psychological mechanisms underlying category generalisation, in terms of multi-preference interpretations

Management of Hypertension in High-Risk Ethnic Minority with Heart Failure

Hypertension (HTN) is the most common co-morbidity in the world, and its sequelae, heart failure (HF) is one of most common causes of mortality and morbidity in the world. Current understanding of pathophysiology and management of HTN in HF is mainly based on studies, which have mainly included whites. Among racial groups, African-American adults have the highest rates (44%) of hypertension in the world and are more resistant to treatment. There is an emerging consensus on the significance of racial disparities in the pathophysiology and treatment options of hypertension and heart failure. However, African Americans had been underrepresented in all the trials until the initiation of the A-HEFT trial. Since the recognition of obstructive sleep apnea (OSA) as an important medical condition, large clinical trials have shown benefits of OSA treatment among patients with HTN and HF. This paper focuses on the pathophysiology, causes of secondary hypertension, and treatment of hypertension among African-American patients with heart failure. There is increasing need for randomized clinical trials testing innovative treatment options for African-American patients

An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective

<p>Abstract</p> <p>Background</p> <p>Sub-Saharan African (SSA) countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially cardiovascular disease (CVD). This double burden of communicable and chronic non-communicable diseases has long-term public health impact as it undermines healthcare systems.</p> <p>Purpose</p> <p>The purpose of this paper is to explore the socio-cultural context of CVD risk prevention and treatment in sub-Saharan Africa. We discuss risk factors specific to the SSA context, including poverty, urbanization, developing healthcare systems, traditional healing, lifestyle and socio-cultural factors.</p> <p>Methodology</p> <p>We conducted a search on African Journals On-Line, Medline, PubMed, and PsycINFO databases using combinations of the key country/geographic terms, disease and risk factor specific terms such as "diabetes and Congo" and "hypertension and Nigeria". Research articles on clinical trials were excluded from this overview. Contrarily, articles that reported prevalence and incidence data on CVD risk and/or articles that report on CVD risk-related beliefs and behaviors were included. Both qualitative and quantitative articles were included.</p> <p>Results</p> <p>The epidemic of CVD in SSA is driven by multiple factors working collectively. Lifestyle factors such as diet, exercise and smoking contribute to the increasing rates of CVD in SSA. Some lifestyle factors are considered gendered in that some are salient for women and others for men. For instance, obesity is a predominant risk factor for women compared to men, but smoking still remains mostly a risk factor for men. Additionally, structural and system level issues such as lack of infrastructure for healthcare, urbanization, poverty and lack of government programs also drive this epidemic and hampers proper prevention, surveillance and treatment efforts.</p> <p>Conclusion</p> <p>Using an African-centered cultural framework, the PEN3 model, we explore future directions and efforts to address the epidemic of CVD risk in SSA.</p

Resistant Hypertension and Obstructive Sleep Apnea in the Primary-Care Setting

We ascertained the prevalence of resistant hypertension (RH) among blacks and determined whether RH patients are at greater risk for obstructive sleep apnea (OSA) than hypertensives. Method. Data emanated from Metabolic Syndrome Outcome Study (MetSO), a study investigating metabolic syndrome among blacks in the primary-care setting. Sample of 200 patients (mean age = 63 ± 13 years; female = 61%) with a diagnosis of hypertension provided subjective and clinical data. RH was defined using the JNC 7and European Society guidelines. We assessed OSA risk using the Apnea Risk Evaluation System ARES), defining high risk as a total ARES score ≥6. Results. Overall, 26% met criteria for RH and 40% were at high OSA risk. Logistic regression analysis, adjusting for effects of age, gender, and medical co morbidities, showed that patients with RH were nearly 2.5 times more likely to be at high OSA risk, relative to those with hypertension (OR = 2.46, 95% CI: 1.03–5.88, P < .05). Conclusion. Our findings show that the prevalence of RH among blacks fell within the range of RH for the general hypertensive population (3–29%). However, patients with RH were at significantly greater risk of OSA compared to patients with hypertension

Stroke in Ashanti region of Ghana

Objective: To determine the morbidity and mortality in adult in-patients with stroke admitted to the KomfoAnokye Teaching Hospital (KATH).Methods: A retrospective study of in-patients with stroke admitted to the KATH, from January 2006 todecember 2007 was undertaken. Data from admission and discharge registers were analysed to determinestroke morbidity and mortality.Results: Stroke constituted 9.1% of total medical adult admissions and 13.2% of all medical adult deathswithin the period under review. The mean age of stroke patients was 63.7 (95% ci=62.8, 64.57) years. Males were younger than females. The overall male to female ratio was 1:0.96, and the age-adjusted risk of death from stroke was slightly lower for females than males (relative risk= 0.88; 95% ci=0.79, 1.02, p=0.08). The stroke case fatality rate was 5.7% at 24 hours, 32.7% at 7 days, and 43.2% at 28 days.Conclusion: Stroke constitutes a significant cause of morbidity and mortality in Ghana. Major efforts are needed in the prevention and treatment of stroke. Population-based health education programs and appropriate public health policy need to be developed. This will require a multidisciplinary approach of key players with a strong political commitment. There is also a clear need for further studies on this topic including, for example, an assessment of care and quality of life after discharge from hospital. The outcomes of these studies will provide important information for the prevention efforts.Keywords: Stroke, Cerebrovascular disease, CVD, Komfo Anokye Teaching Hospital, Ghan

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