Healthcare risk waste and waste legislation in South Africa

Published ArticleHealthcare risk waste is highly regulated in several countries by well-developed legislative frameworks; however, there is a lack of development and adherence to directives and laws in developing countries such as South Africa. Although legislation is in place, it does not always address medical waste in detail to assist with issues such as segregation, categorisation, collection, transport, treatment and final disposal practices. Incineration is still the most common means of treatment, which has shifted the focus of the Department of Environmental Affairs, the department responsible for overseeing waste disposal, to air quality monitoring. The objective of this paper is to highlight issues related to HCRW management, and to suggest a way forward, rather than to provide an in-depth analysis of the problem

Characterization of elastic scattering near a Feshbach resonance in rubidium 87

The s-wave scattering length for elastic collisions between 87Rb atoms in the state |f,m_f>=|1,1> is measured in the vicinity of a Feshbach resonance near 1007 G. Experimentally, the scattering length is determined from the mean-field driven expansion of a Bose-Einstein condensate in a homogeneous magnetic field. The scattering length is measured as a function of the magnetic field and agrees with the theoretical expectation. The position and the width of the resonance are determined to be 1007.40 G and 0.20 G, respectively.Comment: 4 pages, 2 figures minor revisions: added Ref.6, included error bar

Mental models of high reliability systems

Reliable performance in complex systems is determined in part by the ade quacy with which mental models of the system capture accurately the dimen sions of system coupling and system complexity. Failure to register coupling and complexity leads the observer to intervene into an imagined technology that does not exist and to convert opportunities for error into actual errors. To decrease the frequency with which this conversion occurs, people can make their models more complex or the systems they monitor less complex. Neither type of change is as daunting as it may appear, and this is illustrated by an analysis of the mental model and system design associated with the invasion of Grenada.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68652/2/10.1177_108602668900300203.pd

Very high precision bound state spectroscopy near a 85^{85}Rb Feshbach resonance

We precisely measured the binding energy of a molecular state near the Feshbach resonance in a $^{85}$Rb Bose-Einstein condensate (BEC). Rapid magnetic field pulses induced coherent atom-molecule oscillations in the BEC. We measured the oscillation frequency as a function of B-field and fit the data to a coupled-channels model. Our analysis constrained the Feshbach resonance position [155.041(18) G], width [10.71(2) G], and background scattering length [-443(3) a$_0$] and yielded new values for $v_{DS}$, $v_{DT}$, and $C_6$. These results improved our estimate for the stability condition of an attractive BEC. We also found evidence for a mean-field shift to the binding energy.Comment: 5 pages, 2 figures, submitted to PR

Influence of provider factors and race on uptake of breast cancer gene expression profiling

BACKGROUND: Gene expression profiling (GEP) has been rapidly adopted for early breast cancer and can aid in chemotherapy decision making. Study results regarding racial disparities in testing are conflicting, and may reflect different care settings. To the authors' knowledge, data regarding the influence of provider factors on testing are scarce. METHODS: The authors used a statewide, multipayer, insurance claims database linked to cancer registry records to examine the impact of race and provider characteristics on GEP uptake in a cohort of patients newly diagnosed with breast cancer between 2005 and 2012. Incidence proportion models were used to examine the adjusted likelihood of testing. Models were stratified by lymph node status (N0 vs N1). RESULTS: Among 11,958 eligible patients, 23% of black and 26% of non-Hispanic white patients received GEP. Among patients with N0 disease, black individuals were 16% less likely to receive testing after adjustment for clinical factors and the provider's specialty and volume of patients with breast cancer (95% confidence interval, 0.77-0.93). Adjustment for provider characteristics did not attenuate the effect of race on testing. Patients of middle-volume providers were more likely to be tested compared with those with either high-volume or low-volume providers, whereas patients seeing a medical oncologist were more likely to be tested compared with those whose only providers were from surgical specialties. CONCLUSIONS: Provider volume and specialty were found to be significant predictors of GEP use, but did not explain racial disparities in testing. Further research concerning the key contributors to lagging test use among black women is needed to optimize the equitable use of GEPs and support personalized treatment decision making for all patients

The 5:2 diet does not increase adult hippocampal neurogenesis or enhance spatial memory in mice

New neurones are generated throughout life in the mammalian brain in a process known as adult hippocampal neurogenesis (AHN). Since this phenomenon grants a high degree of neuroplasticity influencing learning and memory, identifying factors that regulate AHN may be important for ameliorating age‐related cognitive decline. Calorie restriction (CR) has been shown to enhance AHN and improve memory, mediated by the stomach hormone, ghrelin. Intermittent fasting (IF), a dietary strategy offering more flexibility than conventional CR, has also been shown to promote aspects of AHN. The 5:2 diet is a popular form of IF; however, its effects on AHN are not well characterised. To address this, we quantified AHN in adolescent and adult wild‐type and ghrelin‐receptor‐deficient mice following 6 weeks on a 5:2 diet. We report an age‐related decline in neurogenic processes. However, the 5:2 diet does not increase AHN nor enhance memory performance, suggesting that this specific form of IF is ineffective in promoting brain plasticity to support learning

Key climate change stressors of marine ecosystems along the path of the east african coastal current

For the countries bordering the tropical Western Indian Ocean (TWIO), living marine resources are vital for food security. However, this region has largely escaped the attention of studies investigating potential impacts of future climate change on the marine environment. Understanding how marine ecosystems in coastal East Africa may respond to various climatic stressors is vital for the development of conservation and other ocean management policies that can help to adapt to climate change impacts on natural and associated human systems. Here, we use a high-resolution (1/4°) ocean model, run under a high emission scenario (RCP 8.5) until the end of the 21st century, to identify key regionally important climate change stressors over the East African Coastal Current (EACC) that flows along the coasts of Kenya and Tanzania. We also discuss these stressors in the context of projections from lower resolution CMIP5 models. Our results indicate that the main drivers of dynamics and the associated ecosystem response in the TWIO are different between the two monsoon seasons. Our high resolution model projects weakening of the Northeast monsoon (December–February) winds and slight strengthening of the Southeast monsoon (May–September) winds throughout the course of the 21st century, consistent with CMIP5 models. The projected shallower mixed layers and weaker upwelling during the Northeast Monsoon considerably reduce the availability of surface nutrients and primary production. Meanwhile, primary production during the Southeast monsoon is projected to be relatively stable until the end of the century. In parallel, a widespread warming of up to 5 °C is projected year-round with extreme events such as marine heatwaves becoming more intense and prolonged, with the first year-long event projected to occur as early as the 2030s. This extreme warming will have significant consequences for both marine ecosystems and the coastal populations dependent on these marine resources. These region-specific stressors highlight the importance of dynamic ocean features such as the upwelling systems associated with key ocean currents. This indicates the need to develop and implement a regional system that monitors the anomalous behaviour of such regionally important features. Additionally, this study draws attention to the importance of investment in decadal prediction methods, including high resolution modelling, that can provide information at time and space scales that are more directly relevant to regional management and policy making

Academic advocacy in public health: Disciplinary ‘duty’ or political ‘propaganda’?

The role of ‘advocacy’ within public health attracts considerable debate but is rarely the subject of empirical research. This paper reviews the available literature and presents data from qualitative research (interviews and focus groups conducted in the UK in 2011–2013) involving 147 professionals (working in academia, the public sector, the third sector and policy settings) concerned with public health in the UK. It seeks to address the following questions: (i) What is public health advocacy and how does it relate to research?; (ii) What role (if any) do professionals concerned with public health feel researchers ought to play in advocacy?; and (iii) For those researchers who do engage in advocacy, what are the risks and challenges and to what extent can these be managed/mitigated? In answering these questions, we argue that two deeply contrasting conceptualisations of ‘advocacy’ exist within public health, the most dominant of which (‘representational’) centres on strategies for ‘selling’ public health goals to decision-makers and the wider public. This contrasts with an alternative (less widely employed) conceptualisation of advocacy as ‘facilitational’. This approach focuses on working with communities whose voices are often unheard/ignored in policy to enable their views to contribute to debates. We argue that these divergent ways of thinking about advocacy speak to a more fundamental challenge regarding the role of the public in research, policy and practice and the activities that connect these various strands of public health research

Pulsar-wind nebulae and magnetar outflows: observations at radio, X-ray, and gamma-ray wavelengths

We review observations of several classes of neutron-star-powered outflows: pulsar-wind nebulae (PWNe) inside shell supernova remnants (SNRs), PWNe interacting directly with interstellar medium (ISM), and magnetar-powered outflows. We describe radio, X-ray, and gamma-ray observations of PWNe, focusing first on integrated spectral-energy distributions (SEDs) and global spectral properties. High-resolution X-ray imaging of PWNe shows a bewildering array of morphologies, with jets, trails, and other structures. Several of the 23 so far identified magnetars show evidence for continuous or sporadic emission of material, sometimes associated with giant flares, and a few possible "magnetar-wind nebulae" have been recently identified.Comment: 61 pages, 44 figures (reduced in quality for size reasons). Published in Space Science Reviews, "Jets and Winds in Pulsar Wind Nebulae, Gamma-ray Bursts and Blazars: Physics of Extreme Energy Release