Rehabilitation of Onitsha-Enugu Dual Carriageway in Anambra State, Nigeria: Lessons Learned

The rehabilitation of Onitsha-Enugu dual carriageway in Anambra State, Nigeria, which started in 2009 was marred by inadequate rehabilitation design and gross shortfall in earthwork quantities. The project was awarded at a cost less than 60% of what was actually needed to execute it at the time of award. Delays in the approval of the supplementary bills for the project introduced another (time dependent) variation, i.e. increase in the cost of materials and labour. The fact of the matter   was that rehabilitation design and preparation of the bill of engineering measurement and evaluation were done six years before the contract was awarded. Appraisal of the design specifications shows that the adopted pavement cross section was adequate. The design however, considered a greater percentage of the carriageway to be in good condition, whereas pavement evaluation carried out at the commencement of the project showed that many sections of the carriageway had failed completely. In this study, both the technical deficiencies of the rehabilitation design and the managerial problems militating against timely execution of this road rehabilitation project were identified. Various alternative proposals to execute the contract within and outside the original project cost limit were discussed and recommendations were made based on lessons learned

A comparison of two methods of pre-labour cervical ripening following intrauterine fetal death

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Measurement batch differences and between-batch conversion of Alzheimer's disease cerebrospinal fluid biomarker values

Introduction: Batch differences in cerebrospinal fluid (CSF) biomarker measurement can introduce bias into analyses for Alzheimer's disease studies. We evaluated and adjusted for batch differences using statistical methods. Methods: A total of 792 CSF samples from 528 participants were assayed in three batches for 12 biomarkers and 3 biomarker ratios. Batch differences were assessed using Bland-Altman plot, paired t test, Pitman-Morgan test, and linear regression. Generalized linear models were applied to convert CSF values between batches. Results: We found statistically significant batch differences for all biomarkers and ratios, except that neurofilament light was comparable between batches 1 and 2. The conversion models generally had high R2 except for converting P-tau between batches 1 and 3. Discussion: Between-batch conversion allows harmonized CSF values to be used in the same analysis. Such method may be applied to adjust for other sources of variability in measuring CSF or other types of biomarkers

Методология синтеза архитектуры программно-технического комплекса автоматизированной системы мониторинга обстановки

Предложен подход к проектированию архитектуры программно-технического комплекса автоматизированной системы мониторинга обстановки в реальном времени, основанный на классификации решаемых функциональных задач на основе методов кластерного анализа и выбранного множества признаков подобия. Разработанный подход позволяет из множества функций системы выделить подобные (по определенным признакам) и объединить их в архитектурные компоненты (унифицированные функциональные модули).Запропоновано підхід до проектування архітектури центру обробки інформації автоматизованої системи моніторингу середовища в реальному часі, що заснований на класифікації функціональних задач на підставі методів кластерного аналізу і обраної множини ознак схожості. Розроблений підхід дозволяє вибрати із множини функцій системи схожі (за певними ознаками) і поєднати їх в архітектурні компоненти (уніфіковані функціональні модулі).The approach to designing architecture of the information processing complex of the automated real time conditions monitoring system based on classification of functional tasks on the basis of methods of cluster analysis and the chosen set of similarity attributes is offered. The developed approach allows to allocate from a set of functions the systems similar (on certain attributes) and to unite them in architectural components (unified functional modules)

Perceptions and utilization of the anti-malarials artemether-lumefantrine and dihydroartemisinin-piperaquine in young children in the Chikhwawa District of Malawi: a mixed methods study

Background Adherence to anti-malarial dosing schedules is essential to ensure effective treatment. Measuring adherence is challenging due to recall issues and the participants’ awareness of the desired behaviour influencing their actions or responses. This study used qualitative methods, which allow for rapport building, to explore issues around anti-malarial utilization in young children, and used the results to guide the development of a context specific questionnaire on perceptions and adherence to artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DHA-PPQ). Methods Qualitative data collection included 12 focus group discussions which explored community perceptions of anti-malarials and experiences of administering medications to children. Critical incidence interviews were conducted with 22 caregivers to explore experiences of administering the dispersible or original formulation of AL to young children during recent febrile episodes. A structured questionnaire was used to gather data on experience of recent treatment and adherence to anti-malarials during follow-up visits with 218 caregivers whose child was recently treated with either dispersible AL or DHA-PPQ. Discussion/Conclusion Caregivers experience great difficulty in administering medication to children. While the sweet taste of dispersible AL may have reduced conflict between the child and caregiver, sub-optimal dosing due to medication loss remained a problem and overall adherence was greater among those receiving DHA-PPQ, which requires fewer doses. Some caregivers were found to deliberately alter the dosing schedule according to whether they perceived the medication to be too weak or strong. They also developed theories for poor treatment outcomes, such as attributing this to lack of compatibility between the medication and the child. Health education messages should be strengthened to ensure a combination of clear pictorial and verbal instructions are used during dispensing, and consequences of under and over-dosing are explained alongside appropriate responses to possible adverse events. Further optimizing of anti-malarial adherence among children requires the development of anti-malarials with pharmacological properties that allow user-friendly administration and simplified dosing schedules

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Appraisal of in-service trainee teachers' competency on applications of principles of test items writing

Most procedures used to obtain information about student learning are subsumed under assessment. This study appraised in-service trainee teachers' competency on applications of principles of test items writing. One Study Centre was purposively drawn from the National Teachers' Institute for the study. A sample of 33 students was further purposively drawn from the population. The instrument designed to assess teachers' competency in applications of principles of test items writing competency (Clay, 2001) was adopted for data collection. Data was analysed with use of descriptive statistics, correlation and analysis of variance. The result showed participants' areas of weakness and strength in the applications of principles of test item writing competency. Observed general lack of competency in their applications of principles of test items writing skills point to capacity building needs in learning outcomes assessment particularly in the use of such principles in items writing to enhance their professional skills as teachers

Resident Doctors Perceptions Of The Postgraduate Examinations In Obstetrics And Gynaecology

The National Postgraduate Medical College was established by Decree 67 in September 1979 with the main objective of conducting professional postgraduate examinations for candidates in specialized branches of Medicine and Dentistry and to make awards thereto. A total of 46 specialists graduated from the Faculty of Obstetrics and Gynaecology over a period of 5years (1999 and 2004), which is a grossly inadequate number when one considers the high maternal mortality rate and shortage of specialists. The aim of this study was to ascertain the perception of resident doctors of the examination and make suggestions as to how their training and performance at the examinations can be enhanced. A total of 159 residents in Obstetrics and Gynaecology who attended the September 2006 update course organized by the College were interviewed with a structured questionnaire. Majority of the residents 84(53%) were between the ages of 31 and 35years with 79% being males. Seventy percent (70%) were married and 54% were 6-10 years post MBBS Seventy percent felt poor preparation of candidates was responsible for examination failure while 21% blamed this on biased examiners, 53% wanted the format for the examination to be changed with 24% of these opting for objective structured clinical examination method (OSCE). In conclusion, the study established that poor preparation, examiners bias and inadequate consultant involvement in residency training were significant causes of poor performance. Keywords: Perception, resident doctors, postgraduate examsAnnals of Biomedical Sciences Vol. 6 (2) 2007: pp. 22-2