176 research outputs found
Semi-autonomous vehicles as a cognitive assistive device for older adults
Losing the capacity to drive due to age-related cognitive decline can have a detrimental impact on the daily life functioning of older adults living alone and in remote areas. Semi-autonomous vehicles (SAVs) could have the potential to preserve driving independence of this population with high health needs. This paper explores if SAVs could be used as a cognitive assistive device for older aging drivers with cognitive challenges. We illustrate the impact of age-related changes of cognitive functions on driving capacity. Furthermore, following an overview on the current state of SAVs, we propose a model for connecting cognitive health needs of older drivers to SAVs. The model demonstrates the connections between cognitive changes experienced by aging drivers, their impact on actual driving, car sensors' features, and vehicle automation. Finally, we present challenges that should be considered when using the constantly changing smart vehicle technology, adapting it to aging drivers and vice versa. This paper sheds light on age-related cognitive characteristics that should be considered when developing future SAVs manufacturing policies which may potentially help decrease the impact of cognitive change on older adult drivers
Fasting of Ramadan in peoples with diabetes in Benghazi, Libya: an exploratory study
Background: The epidemiology of diabetes and Ramadan fasting was reported from many Muslim countries, but not from Libya. Methodology: We interviewed 493 consecutive diabetic patients at Benghazi Diabetes and Endocrine Center for the potential complications of fasting during Ramadan. Results: We found 70% of diabetic patients completed the 30 days of Ramadan fasting. Hypo- and hyperglycemia was the most commonly reported complications especially during the first two weeks of Ramadan month. Conclusion: It seems majority of diabetic patients in Libya manage to fast during Ramadan month. Patient education and early planned adjustment of diabetic medication is needed to decrease the frequency of diabetic complication during Ramadan month
Weak surveillance and policy attention to cancer in global health: the example of Mozambique
Cancer is an emerging public health problem in sub-Saharan
Africa due to population growth, ageing and westernisation of
lifestyles. The increasing burden of cancer calls for urgent
policy attention to develop cancer prevention and control
programmes. Cancer surveillance is an essential prerequisite.
Only one in five low-income and middle-income countries have the
necessary data to drive policy and reduce the cancer burden. In
this piece, we use data from Mozambique over a 50-year period to
illustrate cancer epidemiological trends in low-income and
middle-income countries to hypothesise potential circumstances
and factors that could explain changes in cancer burden and to
discuss surveillance weaknesses and potential improvements. Like
many low-income and middle-income countries, Mozambique faces
the dual challenge of a still high morbidity and mortality due
to infectious diseases in rural areas and increased incidence of
cancers associated with westernisation of lifestyles in urban
areas, as well as a rise of cancers related to the HIV epidemic.
An increase in cancer burden and changes in the cancer profile
should be expected in coming years. The Mozambican healthcare
and health-information systems, like in many other low-income
and middle-income countries, are not prepared to face this
epidemiological transition, which deserves increasing policy
attention
Trends in Cancer Incidence in Maputo, Mozambique, 1991-2008
BACKGROUND: Very limited information is available regarding the
incidence of cancer in sub-Saharan Africa. We analyzed changes
in cancer patterns from 1991 to 2008 in Maputo (Mozambique).
METHODS: We calculated the rates of incidence of different
cancer sites by sex in the 5-year age-group of the population of
Maputo city as well as age-standardized rates (ASRs) and average
annual percentage changes (AAPC). RESULTS: Over the 18-year
study period a total of 12,674 cases of cancer (56.9% females)
were registered with an overall increase in the risk of cancer
in both sexes. In males, the most common cancers were those of
the prostate, Kaposi sarcoma (KS) and the liver. Prostate cancer
showed the most dramatic increase over the whole study period
(AAPC +11.3%; 95% CI: 9.7-13.0), with an ASR of 61.7 per 105 in
2003-2008. In females, the most frequent cancers were of the
uterine cervix, the breast and KS, with the former increasing
along the whole study period (AAPC + 4.7%; 95% CI: 3.4-6) with
an ASR of 62.0 per 105 in 2003-2008 as well as breast cancer
(AAPC +6.5%; 95%CI: 4.3-8.7). CONCLUSIONS: Overall, the risk of
cancer rose in both sexes during the study period, particularly
among cancers associated with westernization of lifestyles
(prostate, breast), combined with increasingly rising incidences
or limited changes in cancers associated with infection and
poverty (uterine cervix, liver). Moreover, the burden of
AIDS-associated cancers has shown a marked increase
An ordinary differential equation for velocity distribution and dip-phenomenon in open channel flows
An ordinary differential equation for velocity distribution in open channel
flows is presented based on an analysis of the Reynolds-Averaged Navier-Stokes
equations and a log-wake modified eddy viscosity distribution. This proposed
equation allows to predict the velocity-dip-phenomenon, i.e. the maximum
velocity below the free surface. Two different degrees of approximations are
presented, a semi-analytical solution of the proposed ordinary differential
equation, i.e. the full dip-modified-log-wake law and a simple
dip-modified-log-wake law. Velocity profiles of the two laws and the numerical
solution of the ordinary differential equation are compared with experimental
data. This study shows that the dip correction is not efficient for a small
Coles' parameter, accurate predictions require larger values. The simple
dip-modified-log-wake law shows reasonable agreement and seems to be an
interesting tool of intermediate accuracy. The full dip-modified-log-wake law,
with a parameter for dip-correction obtained from an estimation of dip
positions, provides accurate velocity profiles
An autopsy study of maternal mortality in Mozambique: the contribution of infectious diseases
Background Maternal mortality is a major health problem concentrated in resource-poor regions. Accurate data on its causes using rigorous methods is lacking, but is essential to guide policy-makers and health professionals to reduce this intolerable burden. The aim of this study was to accurately describe the causes of maternal death in order to contribute to its reduction, in one of the regions of the world with the highest maternal mortality ratios. Methods and Findings We conducted a prospective study between October 2002 and December 2004 on the causes of maternal death in a tertiary-level referral hospital in Maputo, Mozambique, using complete autopsies with histological examination. HIV detection was done by virologic and serologic tests, and malaria was diagnosed by histological and parasitological examination. During 26 mo there were 179 maternal deaths, of which 139 (77.6%) had a complete autopsy and formed the basis of this analysis. Of those with test results, 65 women (52.8%) were HIV-positive. Obstetric complications accounted for 38.2% of deaths; haemorrhage was the most frequent cause (16.6%). Nonobstetric conditions accounted for 56.1% of deaths; HIV/AIDS, pyogenic bronchopneumonia, severe malaria, and pyogenic meningitis were the most common causes (12.9%, 12.2%, 10.1% and 7.2% respectively). Mycobacterial infection was found in 12 (8.6%) maternal deaths. Conclusions In this tertiary hospital in Mozambique, infectious diseases accounted for at least half of all maternal deaths, even though effective treatment is available for the four leading causes, HIV/AIDS, pyogenic bronchopneumonia, severe malaria, and pyogenic meningitis. These observations highlight the need to implement effective and available prevention tools, such as intermittent preventive treatment and insecticide-treated bed-nets for malaria, antiretroviral drugs for HIV/AIDS, or vaccines and effective antibiotics for pneumococcal and meningococcal diseases. Deaths due to obstetric causes represent a failure of health-care systems and require urgent improvement
Development of a post-mortem procedure to reduce the uncertainty regarding causes of death in developing countries
A major failure of our global society in the 21st century is that many people in developing countries are not only born and live without any official record of their existence a flagrant deprivation of an essential human right but also die without having been seen by medically qualified personnel. The resultant uncertainty about the real burden of specific causes of death is being increasingly recognised by international health and funding agencies as a crucial limitation in the prioritisation of effective public health programmes and assessment of their effect
Carriage prevalence of Salmonella enterica serotype Typhi in gallbladders of adult autopsy cases from Mozambique
INTRODUCTION: Typhoid fever is an important public health
problem in many low-income countries where asymptomatic carriers
play an important role in its dissemination. The bacterium
causing typhoid fever can live in the gallstones of asymptomatic
persons after the infection. These carriers are reservoirs of S.
Typhi, are highly contagious, and spread the disease through the
secretion of bacteria in feces and urine. The aim of this study
was to determine the carrier rate in an area of Mozambique.
METHODOLOGY: The presence of S. Typhi was analyzed in
gallbladder samples obtained from 99 adult corpses (in-hospital
deaths) from Mozambique by gold-standard culture and polymerase
chain reaction (PCR). RESULTS: Only one sample was positive with
the culture. However, nine additional samples were positive by
PCR and confirmed by DNA sequencing. Thus, the prevalence of S.
Typhi was 10.1% (10/99). CONCLUSIONS: We report a high
prevalence of S. Typhi in gallbladders among adult autopsy cases
from Mozambique
Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach
BACKGROUND AND AIMS: Complete diagnostic autopsies (CDA) remain the gold standard in the determination of cause of death (CoD). However, performing CDAs in developing countries is challenging due to limited facilities and human resources, and poor acceptability. We aimed to develop and test a simplified minimally invasive autopsy (MIA) procedure involving organ-directed sampling with microbiology and pathology analyses implementable by trained technicians in low- income settings. METHODS: A standardized scheme for the MIA has been developed and tested in a series of 30 autopsies performed at the Maputo Central Hospital, Mozambique. The procedure involves the collection of 20 mL of blood and cerebrospinal fluid (CSF) and puncture of liver, lungs, heart, spleen, kidneys, bone marrow and brain in all cases plus uterus in women of childbearing age, using biopsy needles. RESULTS: The sampling success ranged from 67% for the kidney to 100% for blood, CSF, lung, liver and brain. The amount of tissue obtained in the procedure varied from less than 10 mm2 for the lung, spleen and kidney, to over 35 mm2 for the liver and brain. A CoD was identified in the histological and/or the microbiological analysis in 83% of the MIAs. CONCLUSIONS: A simplified MIA technique allows obtaining adequate material from body fluids and major organs leading to accurate diagnoses. This procedure could improve the determination of CoD in developing countrie
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