Pattern of Cardiovascular Diseases Among Elderly Patients Admitted in Medical Wards at Muhimbili National Hospital Dar es salaam Tanzania

Cardiovascular disease is the most frequent cause of death in persons over the age 50 years and most importantly it is responsible for considerable morbidity and large burden of disability in the community. Cardiovascular diseases are an increasing cause of admissions among elderly in Africa, yet little research is available on pattern and magnitude of the problem. To determine the pattern of cardiovascular disease in elderly patients admitted in medical wards at Muhimbili National Hospital Dar es Salaam Tanzania. This was a descriptive cross sectional study that was carried our between September 2008 and September 2009. Social demographic information; medical history physical examination; electrocardiographic and echocardiography examination; biochemical and haematological parameters were collected from study patients One hundred eighty five elderly patients admitted at MNH, medical department, were enrolled into the study, all were of African black race. Majority, 116 (62.7%), were male. Their mean age was 66.1 (SD, 9.3; range, 50-87) years. The mean body mass index\ud (BMI) was 23.9 (SD, 3.9; range, 16.6-40.1) kg/m2. Hypertension was the most frequent condition encountered affecting both males (67.2%)and females (68.1%). Congestive heart failure was second common condition affecting 37% elderly patients. According to the echocardiogram findings, among 185 elderly patients 68.6% were diagnosed to have cardiovascular disease. There were no significant sex differences in the prevalence of cardiac disease (p>005). The commonest echocardiographic diagnosis were left ventricular hypertrophy (LVH) secondary to hypertension found in 45%, diastolic dysfunction found in 31% and systolic dysfunction 25%.The least common types were septal defect, pulmonary hypertension and calcified mitral valve found in one percent each. The commonest clinical presentations were palpitations, dyspnoea, orthopnoea, pedal oedema and right upper quadrant abdominal pain. Obese patients presenting with cardiovascular abnormalities were 9 (7.1%). Anaemia was the leading co- morbidity affecting 90.3% of the patients Hypertension, congestive heart failure and left ventricular hypertrophy were the commonest cardiovascular diseases among elderly patients at MNH. Coexistence of anaemia, stroke, renal impairment and diabetes was also frequent. Elderly patients should be screened for cardiovascular diseases especially hypertension whenever they are admitted to the hospital even if the reasons for admission are not cardiovascular problems.\u

What Workers Say: Employee Voice in the Anglo-American Workplace

[Excerpt] This book is about employee voice in the workplaces of the highly developed Anglo-American economies: the United States, Canada, the United Kingdom, Ireland, Australia, and New Zealand. These are among the most economically successful countries in the world. Despite being located in three different geographic areas, the Anglo-American countries have a common language and legal tradition, have close economic and political ties, and are linked by flows of people, goods, and capital. Many of the same firms operate in each country. The unions in each pay more attention to their counterparts within the group than to unions in other countries. The Anglo-American brand of capitalism – market oriented and open to competition, with modest welfare sates and income transfer systems – differentiates the countries from countries in the “social dialogue” model of the European Union (although the United Kingdom and Ireland are part of the Union) and from the highly unionized labor system in Scandinavia

A Geometric Theory for Hypergraph Matching

We develop a theory for the existence of perfect matchings in hypergraphs under quite general conditions. Informally speaking, the obstructions to perfect matchings are geometric, and are of two distinct types: 'space barriers' from convex geometry, and 'divisibility barriers' from arithmetic lattice-based constructions. To formulate precise results, we introduce the setting of simplicial complexes with minimum degree sequences, which is a generalisation of the usual minimum degree condition. We determine the essentially best possible minimum degree sequence for finding an almost perfect matching. Furthermore, our main result establishes the stability property: under the same degree assumption, if there is no perfect matching then there must be a space or divisibility barrier. This allows the use of the stability method in proving exact results. Besides recovering previous results, we apply our theory to the solution of two open problems on hypergraph packings: the minimum degree threshold for packing tetrahedra in 3-graphs, and Fischer's conjecture on a multipartite form of the Hajnal-Szemer\'edi Theorem. Here we prove the exact result for tetrahedra and the asymptotic result for Fischer's conjecture; since the exact result for the latter is technical we defer it to a subsequent paper.Comment: Accepted for publication in Memoirs of the American Mathematical Society. 101 pages. v2: minor changes including some additional diagrams and passages of expository tex

Flow Invariance on Stratified Domains

This paper studies conditions for invariance of dynamical systems on stratified do- mains as originally introduced by Bressan and Hong. We establish Hamiltonian conditions for both weak and strong invariance of trajectories on systems with non-Lipschitz data. This is done via the identification of a new multifunction, the essential velocity multifunction. Properties of this multifunction are investigated and used to establish the relevant invariance criteria

Using wage council data to identify the effect of recessions on the impact of the minimum wage

Up until now the National Minimum Wage (NMW) introduced in April 1999 appears to have been a policy success. So far there has been little evidence of a negative effect on employment. However, to date, the NMW has largely been operating in a period of prolonged economic expansion. Since the spring of 2008 the UK economy has experienced a downturn of significant proportions. In this report we examine the impact of the UK minimum wages in force during the 1980s and 1990s recessions when a system of Wages Councils was in operation. Wages Councils set (different) minimum rates of pay in a range of low-paying industries. However there were still a large number of low-wage industries not covered by the legislation. This project analyses the impact of the two previous recessions on employment and wages in Wages Council sectors relative to other similar but uncovered low-wage industries using data from the New Earnings Survey and Workforce in Employment Survey form the panel. The findings are informative about the likely consequences of the NMW in the current recession. We can find no significant detrimental impact on employment from the Wages Councils. We do find some evidence of negative hours effects from the Wages Councils, although we cannot find any further detrimental impacts through the recessions of the 1980s or 1990s. In addition, our individual level results are consistent with higher turnover in the Wages Councils sectors. We do find some evidence of a slowdown in turnover through the recessions, and some evidence that hiring increased in the 1990s recession in these low wage sectors. None of the results here indicate that the National Minimum Wage will have any more detrimental impacts on employment through the recent Credit Crunch recession. However, one must be mindful of the fact that recessions can be very different. Our individual results suggest this. So the recent recession that the UK has experienced may play out differently across different sectors than have recessions of the past

Factors Influencing Voting Results of Local Transportation Funding Initiatives with a Substantial Transit Component: Case Studies of Ballot Measures in Eleven Communities, MTI Report 01-17

This publication is a follow-up study to MTI publication 00-01, Why Campaigns for Local Transportation Funding Initiatives Succeed or Fail: An Analysis of Four Communities and National Data. The earlier publication was case studies of four local ballot tax measures for transportation packages. The current study, Factors Influencing Voting Results of Local Transportation Funding Initiatives with a Substantial Rail Transit Component: Case Studies of Ballot Measures in Eleven communities, uses the same case study methodology as the prior study, and is expanded to 11 communities from the past four years. Some of the important conclusions identified by the study are as follows: 1) The combination of an energetic and credible opposition and a questionable reputation of the transit agency or transit system make it extremely difficult for a ballot measure to be successful; 2) When a community has no prior rail transit system, a comprehensive rail-only package is unlikely to be successful; 3)Without $1 million or more to spend on a combination of direct mail and television advertising it is difficult for proponents to be successful; 4) Developing a consensus transportation package depends on the specific details of the package and it is very difficult to generalize about the needed details; and 5) Under certain circumstances, voters do not appear to place significant importance on the existence or length of the expiration date of the tax used to fund the transportation package