Exploring the Social and Environmental Determinants of Child Health in Ilorin, Nigeria

Death of children under the age of five years is a major challenge to health profile in Africa and the realization of the Millennium Development Goals (MDGs). The Sub-Saharan Africa has been shown to have performedpoorly in the effort to realize the goals due partly to the soaring infant and childhood mortality. This study examines the factors-social and environmental- that affect child health in the Sub-Saharan Africa using theexample of Ilorin in Nigeria. The study adopts a multi-stage sampling procedure to select 300 nursing mothers from the twenty wards of Ilorin metropolis while structured questionnaires was used to obtain information on the socio-economic characteristics of mothers as well as the residential quality in their households. Thus, ten variables were selected; covering residential quality, socio-economic status, access to health care and healthcare options mothers often adopt when illness occur in their children. These variables were expected to offer varying degrees of explanation to the observed pattern of child health in Ilorin metropolis. The surrogateadopted for child health in the study was occurrence of childhood diarrhea during the six weeks preceding the survey. A multiple regression analysis was used to determine the relative contributions of the selected variablesto the observed pattern of child health. The result shows that the variables in the residential quality domain offer the highest explanation for the occurrence of childhood diarrhea while all other variables also possessedpositive relationships. This finding corroborates earlier studies and draws implications for public health in cities of Africa. It particularly advocates for a deliberate intervention by urban administrators in the urban renewal processes that are ongoing in the inner parts of the traditional African cities with a view to providing basic home and environmental services in the old houses in these areas that are being renovated. The study  believes that the MDGs are achievable if micro-level interventions were given priority over and above the macro- scale solutions that may fall short of local realities.Keywords: Under-five mortality, diarrhea, residential quality, MDGs, child health, Nigeri

Investigating the Potential of High-Density Polyethylene and Nano Clay Asphalt-Modified Binders to Enhance the Rutting Resistance of Asphalt Mixture

This study investigates the potential of two bitumen modifiers, high-density polyethylene (HDPE) and nano clay (NC), to enhance the rutting resistance of asphalt mixture. Four HDPE asphalt binders were prepared by mixing the HDPE at percentages of 2%, 4%, 6%, and 8% with the virgin binder, while four NC asphalt binders were produced by mixing the NC at percentages of 1%, 2%, 3%, and 4%. The consistency and flow of virgin binder, HDPE binders, and NC binders were evaluated by penetration, softening point, and viscosity tests. The results show a gradual increment in the binder stiffness by increasing the percentage of both modifiers. The static creep test was conducted at a temperature of 40 °C to evaluate the rutting resistance. The results confirm that both modifiers can greatly improve the rutting resistance of the asphalt mixture, where 8% HDPE and 3% NC modifications reduce the strains provoked in the asphalt mixture under loading by about 50%. According to the correlation analysis, the mixture rutting performance is highly attributed to the binder stiffness, where the lower the penetration value of the asphalt binder, the lower the strains in the asphalt mixture and the higher the stiffness modulus of the asphalt mixture

Elevated Aspartate and Alanine Aminotransferase Levels and Natural Death among Patients with Methamphetamine Dependence

Background: Methamphetamine is one of the fastest growing illicit drugs worldwide, causing multiple organ damage and excessive natural deaths. The authors aimed to identify potential laboratory indices and clinical characteristics associated with natural death through a two-phase study. Methods: Methamphetamine-dependent patients (n = 1,254) admitted to a psychiatric center in Taiwan between 1990 and 2007 were linked with a national mortality database for causes of death. Forty-eight subjects died of natural causes, and were defined as the case subjects. A time-efficient sex-and age-matched nested case-control study derived from the cohort was conducted first to explore the potential factors associated with natural death through a time-consuming standardized review of medical records. Then the identified potential factors were evaluated in the whole cohort to validate the findings. Results: In phase I, several potential factors associated with natural death were identified, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), comorbid alcohol use disorder, and the prescription of antipsychotic drugs. In phase II, these factors were confirmed in the whole cohort using survival analysis. For the characteristics at the latest hospital admission, Cox proportional hazards models showed that the adjusted hazard ratios for natural death were 6.75 (p<0.001) in the group with markedly elevated AST (>80 U/L) and 2.66 (p<0.05) in the group with mildly elevated AST (40-80 U/L), with reference to the control group (>40 U/L). As for ALT, the adjusted hazard ratios were 5.41 (p<0.001), and 1.44 (p>0.05). Comorbid alcohol use disorder was associated with an increased risk of natural death, whereas administration of antipsychotic drugs was not associated with lowered risk. Conclusions: This study highlights the necessity of intensive follow-up for those with elevated AST and ALT levels and comorbid alcohol use disorder for preventing excessive natural deaths