An overview of diabetes and its complications

Diabetes mellitus is a metabolic disorder in which the body’s capacity to utilise glucose, fat and protein is disturbed due to impairment in insulin secretion and/or insulin resistance leading to chronic hyperglycaemia. Therefore, having an understanding of the underlying pathophysiology and the acute and/or long-term complications of diabetes will enable the development of strategies for ameliorating the condition. Individuals may be classified as having pre-diabetes or diabetes based on their fasting blood glucose and/or postprandial blood glucose. In this regard, individuals with impaired fasting glycaemia (IFG) have fasting plasma glucose >6.1 mmol/L to 7.8 mmol/L to <11.1 mmol/L following a 2 hour oral glucose tolerance test and both IFG and IGT define the extent of glucose dysregulation between the range of normoglycaemia and type 2 diabetes. The diagnostic criteria for patients with diabetes are fasting plasma glucose ≥7.0 mmol/L and oral glucose tolerance Test (OGTT) ≥11.1 mmols/L.1 While normal fasting glucose depends on the ability to sustain the production of basal insulin and promotion of insulin sensitivity at the level of the liver, IFG results from abnormalities of these metabolic functions and are often characterised by raised hepatic glucose output and defect in early insulin secretion.2 However, during OGTT, the normal body’s response is usually in the form of increased insulin secretion, decreased hepatic glucose production and enhanced glucose uptake in the liver and the muscle. Therefore, IGT is often associated with peripheral insulin resistance, mostly in the skeletal muscle. In addition to IFG and IGT, other risk factors for type 2 diabetes include genetics/family history, environmental factors such as type of diet and physical activity, obesity, age and body fat distribution

Diabetic retinopathy screening: A systematic review on patients’ non-attendance

Diabetic Retinopathy is a microvascular complication of diabetes, that can go undetected and unnoticed until irreversible damage and even blindness has occurred. Effective screening for diabetic retinopathy has been proven to reduce the risk of sight loss. The National Health Service (NHS) which provides healthcare for all UK citizens, implemented systematic retinal screening for diabetic retinopathy in England in 2003, with the aim of identifying and treating all patients with sight threatening retinopathy. Crucial to this is patients partaking in the programme. Therefore, increasing screening uptake has been a major focus of the programme. This review explores the views of people living with diabetes who do not attend retinal screening, their characteristics, concerns, experiences of retinal screening and their understanding of the risks of diabetic retinopathy. All studies that satisfied the study inclusion criteria on ‘patients’ non-attendance at retinal screening’, between 2003 to 2017 were included after extensive database search. A total of 16 studies were included in the review. Findings showed that socio-economic deprivation was a major risk factor for non-attendance, about 11.5–13.4% of the screened population had sight threatening retinopathy (STDR), repeated nonattendance was linked to sight threatening diabetic retinopathy, and that certain factors, could be barriers or incentives for screening uptake. Some of those factors are modifiable whilst others are not

Prison Preparedness and Legal Obligations To Protect Prisoners During Natural Disasters

Since at least 2004, the intensity of hurricanes and the damage they have caused in America has increased significantly. After the turbulent hurricane season of 2017, citizens should recognize the elevated risks to safety that occur when individuals stay put, especially during high-intensity hurricanes (Category 3 and higher). States of emergency and evacuation orders have been declared recently in many states and cities that anticipated extreme hurricane conditions. However, even with increased calls for evacuations, warnings from public officials, and around the clock media coverage, a significant portion of the population has continued to be overlooked during times of natural disasters. This neglected group of citizens “left out of sight and out of our hearts” during natural disasters are the incarcerated men and women in correctional facilities across the country

The impact of changes in health and social care on enteral feeding in the community

This paper examines the impact of the changes to health and social care on enteral feeding in the community, outlines implications for practice and offers recommendations to ameliorate the challenges. It is now clear that there have been significant changes especially in the last 10 years in health and social care provisions in the UK with an overarching effect on enteral nutrition in the community. Advances in technology, increasing demand and treatment costs, the need for improvement in quality, economic challenges, market forces, political influences and more choices for patients are some of the factors driving the change. Government’s vision of a modern system of health and social care is based on initiatives such as clinically led commissioning, establishment of Monitor, shifting care from acute hospitals to community settings, integrating health and social care provisions, Quality, Innovation, Productivity and Prevention (QIPP) program and the concept of “Big Society”. These strategies which are encapsulated in various guidelines, policies and legislation, including the health and social care Act, 2012 are clarified. The future challenges and opportunities brought on by these changes for healthcare professionals and patients who access enteral nutrition in the community are discussed and recommendations to improve practice are outlined

Hydrogeochemical and Biophysical Characterization of Groundwater in Eastern Nigeria: A Case Study of Onitsha and Environs

Hydro-geological studies revealed that Onitsha and environs tapped their groundwater from the middle aquifer (&gt; 40 m &lt; 90 m)which belongs to the Ameki group; hence, water samples from ten (10) wells in areas of high population density namely Okpoko, Fegge, main market, GRA phase 1, Inland town, Nkpor, Obosi, Awada and Mgbemena on 6049’30”E and 608’830”N were collected for biological and physiochemical analysis in order to determine its quality for consumption by comparing with established standard of World Health Organization. The samples were analyzed using standard methods. The Coliform counts result showed a range of 1 to 30MPN/100MI while heavy metal value shows that Fe &gt; Zn &gt; Mn &gt; Ba &gt; Cu. The results for the major cations analyzed shows a mean value of  Na+ (3.32 mg l-1), K+ (0.8mg l-1) Ca2+ (8.62 mg l-1), Mg2+ (2.57mg l-1), Temperature, pH, Total Dissolved Solid (TDS) and Electrical Conductivity (EC) where measured in situ,  major anions where also analyzed and the results shows that the mean value for HCO3- (61mg l-1), PO43- (61.5 mg l-l), NO3- (21.6 mg l-1) , SO42- (99 mg l-1), while Cl- (450 mg l-1), Correlation at P &lt; 0.05 using micro soft excel 2007shows that metals assessed were from similar source. The ultimate result when compared with World Health Organization shows that the groundwater of the middle aquiferous horizon in Onitsha and environ in Eastern Nigeria is polluted in some areas covered in this research and not fit for consumption except when treated appropriately.http://dx.doi.org/10.4314/njt.v34i4.2

Litho-stratigraphic and hydrogeological evaluation of groundwater system in parts of Benin Metropolis, Benin City Nigeria: The key to groundwater sustainability

Previous studies revealed that soil properties play a significant role in aquifer contamination. Consequently, it is necessary to understand the nature and  properties of soil in carrying out groundwater evaluation. This study evaluates the subsurface geology and groundwater flow direction in Okpagha, Iguomo, Ikhueniro and Okhuahe suburbs in Benin City, Nigeria. Six boreholes were drilled by means of manual (rotary) method in different parts of the study area and each borehole was logged in order to  understand the lithology, depth to water table, static water level as well as flow direction. The results obtained show that aquifer within the study areas were confined, semi confined to unconfined and was dominated by sands with minor clay and lignite  interbed. It was observed that aquifer becomes shallower towards eastern portion of the study areas with increase in sand and decrease in clay  materials. It was also observed that groundwater flow map revealed a flow direction of North-West to South-East from North West to South East. The decrease in the depth of aquifer and increase in sand material could be explained by the  closeness to sea level. This phenomenon can enhance the infiltration of contaminants into aquifer thereby contaminating the groundwater bodies. It is therefore necessary to constantly monitor the groundwater quality in this suburbs in order to be aware of the quality of water resources being consumed because poor water quality can impact public health negatively. Furthermore, the authors advise that boreholes should be drilled in the direction of groundwater flow for maximum yieldKeywords: Groundwater, lithology, borehole, aquifer, water quality and contaminant

Waste Management as a Practical Approach to Sustainable Development: A Case Study of the University of Benin,Faculty of Physical Sciences

The wastes generated in the Faculty of Physical Sciences shopping complex and offices on daily basis for a  period of one week continuous sampling have been determined. The summation of the wastes generated amounted to 355.38kg; the volume was arrived at following the daily scientific survey by gathering all wastes matrix generated in a particular day followed by manual sorting and weighing of the various fractions. Out of the total volume of the wastes generated, food wastes accounted for the total of 129.39 kg/week amounting to 37%, paper and cardboard accounted for 105.73 kg/week taking 30% of the total. Plastic, glass and metals accounted for 92.91kg /week, 15.93kg/week, and 9.42kg/week i.e. (26%, 4% and 3%) of the total waste matrix respectively. Correlation at P &lt; 0.5 two tailed  shows a positive correlation indicating that wastes generated were from a similar source, The results were presented in graphs. The ultimate results show that  over 100% of the wastes generated in the complex are recyclable and will increase the institution income and create employment opportunities if properly managed while in the same process enhance sustainable development.Keywords: Waste, Generation, Recycle, Management and sustainable developmen

Modelling and simulation of intermediate temperature solid oxide fuel cells and their integration in hybrid gas turbine plants

PhD ThesisSolid oxide fuel cells (SOFCs) are gaining prominence as power sources amongst other types of fuel cells due to their high electric energy efficiencies, their ability to integrate with other energy cycles in a hybrid system, fuel choice flexibility and low pollutant emissions. Operation of an SOFC involves complex coupling of the electrochemical reactions, chemical reactions and transport phenomena simultaneously in the cell’s main components consisting of gas channels, porous electrodes and the dense ceramic electrolyte. Consequently, mathematical modelling of these processes becomes an essential research tool aiming to provide detailed insight, while reducing cost, time and the effort associated with experimentation. The main aim of this thesis is to develop mathematical models in the cell and at system level to better understand the complex operation of SOFCs and its associated cycle under practical conditions with the aim of enhancing the power output and efficiency of the cell. At the cell level, a two dimensional along the channel micro-scale isothermal model of a SOFC is developed and validated against experimental data and other simulated result from literature. The steady state behaviour of the cell was determined by numerical solution of the combined transport, continuity and kinetic equations. The model is capable of predicting the cell performance including polarisation behaviour and power output. The model is used to study the effect of the support structure, geometric parameters and the effect of operating conditions on cell performance. Several parametric studies, such as the effect of operating conditions and geometric parameters on cell performance with a view to optimising the cell. Also, at the cell level, a two dimensional along the channel model was developed which integrates a heat transfer model and direct internal reforming kinetics into the earlier developed isothermal model. This non-isothermal model was also validated against experimental data. The developed model not only predicts the performance of the SOFC at different design and operating conditions, it also provides an insight on the different phenomena and the distributions of current density, temperature and gas pressures within the cell. Microstructural parametric studies of the reaction layer were also carried out.Solid oxide fuel cells (SOFCs) are gaining prominence as power sources amongst other types of fuel cells due to their high electric energy efficiencies, their ability to integrate with other energy cycles in a hybrid system, fuel choice flexibility and low pollutant emissions. Operation of an SOFC involves complex coupling of the electrochemical reactions, chemical reactions and transport phenomena simultaneously in the cell’s main components consisting of gas channels, porous electrodes and the dense ceramic electrolyte. Consequently, mathematical modelling of these processes becomes an essential research tool aiming to provide detailed insight, while reducing cost, time and the effort associated with experimentation. The main aim of this thesis is to develop mathematical models in the cell and at system level to better understand the complex operation of SOFCs and its associated cycle under practical conditions with the aim of enhancing the power output and efficiency of the cell. At the cell level, a two dimensional along the channel micro-scale isothermal model of a SOFC is developed and validated against experimental data and other simulated result from literature. The steady state behaviour of the cell was determined by numerical solution of the combined transport, continuity and kinetic equations. The model is capable of predicting the cell performance including polarisation behaviour and power output. The model is used to study the effect of the support structure, geometric parameters and the effect of operating conditions on cell performance. Several parametric studies, such as the effect of operating conditions and geometric parameters on cell performance with a view to optimising the cell. Also, at the cell level, a two dimensional along the channel model was developed which integrates a heat transfer model and direct internal reforming kinetics into the earlier developed isothermal model. This non-isothermal model was also validated against experimental data. The developed model not only predicts the performance of the SOFC at different design and operating conditions, it also provides an insight on the different phenomena and the distributions of current density, temperature and gas pressures within the cell. Microstructural parametric studies of the reaction layer were also carried out.Solid oxide fuel cells (SOFCs) are gaining prominence as power sources amongst other types of fuel cells due to their high electric energy efficiencies, their ability to integrate with other energy cycles in a hybrid system, fuel choice flexibility and low pollutant emissions. Operation of an SOFC involves complex coupling of the electrochemical reactions, chemical reactions and transport phenomena simultaneously in the cell’s main components consisting of gas channels, porous electrodes and the dense ceramic electrolyte. Consequently, mathematical modelling of these processes becomes an essential research tool aiming to provide detailed insight, while reducing cost, time and the effort associated with experimentation. The main aim of this thesis is to develop mathematical models in the cell and at system level to better understand the complex operation of SOFCs and its associated cycle under practical conditions with the aim of enhancing the power output and efficiency of the cell. At the cell level, a two dimensional along the channel micro-scale isothermal model of a SOFC is developed and validated against experimental data and other simulated result from literature. The steady state behaviour of the cell was determined by numerical solution of the combined transport, continuity and kinetic equations. The model is capable of predicting the cell performance including polarisation behaviour and power output. The model is used to study the effect of the support structure, geometric parameters and the effect of operating conditions on cell performance. Several parametric studies, such as the effect of operating conditions and geometric parameters on cell performance with a view to optimising the cell. Also, at the cell level, a two dimensional along the channel model was developed which integrates a heat transfer model and direct internal reforming kinetics into the earlier developed isothermal model. This non-isothermal model was also validated against experimental data. The developed model not only predicts the performance of the SOFC at different design and operating conditions, it also provides an insight on the different phenomena and the distributions of current density, temperature and gas pressures within the cell. Microstructural parametric studies of the reaction layer were also carried out.At the system level, the SOFC was integrated in a hybrid gas turbine plant. The integrated cycle was modelled using energy and exergy thermodynamic analysis. The analysis was done using the non-isothermal models developed for SOFC at the cell level and through the development of thermodynamic models for the other components such as the compressors, turbines, mixers, recuperators and combustors in the hybrid system. Performance comparison of two different hybrid configurations was carried out. Electrical efficiency, fuel utilisation efficiency, and exergy destruction were used in assessing the system performance. The results from the developed models shows that the anode supported SOFCs gives the best cell performance amongst other support structures when operated at intermediate temperatures and that the cathode ohmic overpotential is the single largest contributor to the cell potential loss. Also, the inclusion of the heat transfer model and internal reforming kinetics significantly improves the cell predictions. The study on the effect of integrating the SOFC in a hybrid system showed an overall improvement with respect to electrical efficienc

Comparative study of Leachate Characterization: Implication for Sustainable Environmental Management

Understanding the sources of environmental stressors, the role of geology, climate and technology would provide a guide to solving the problems posed by such stressor. The study examine the sources of wastes in Ikhueniro open dumpsite located in Benin city, Nigeria and characterize the leachate emanating from it. This will assist in adequate design of managerial scheme to tackle the menace posed by it while putting into consideration the role of geology, climate and technology. The key objectives are to carry out field study, characterize wastes in the dumpsite and collect raw leachate emanating from the wastes heap in order to determine its chemistry with established scientific techniques. The results obtained show a pH value of 7.7, BOD5/COD of 0.66mg/L and ammonia value of 64mg/L shows that the dumpsite is in a young stage which is \u3e 0.5mg/L. The value of 3500mg/L of COD indicate that leachate in current study cannot be discharged into the environment unless treated. By comparison with previous studies, it was observed that climate, geology and technology are key factors influencing the prevalence of leachate in an environment. It is recommended that dumpsites should be well designed to collect raw leachate from source and treat before discharging into environment. It is further recommended that improving solid waste management through grassroots education and public awareness of the consequences of environmental mismanagement through media houses and social forums as well as funding of research geared towards specific wastes management should be adopted