5,178 research outputs found

    Architects’ View on Design Consideration that Can Reduce Maintenance Cost

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    Buildings are designed with the intent of lasting for a certain period of time. Building maintenance in different building typology is described as multi-faceted activities which involve planning, directing, controlling and organizing resources for the sustenance of the building’s physical, functional and operational performance. The research focused on ways cost of maintaining a building was done, effectively or efficiently with the influence of the design approach used. Literatures of works pertaining to building maintenance were reviewed to identify the various impacts, influences that a building design would have on the cost of maintaining any building type. Maintenance departments of educational institutions were surveyed and data analyzed. The study revealed that maintenance culture of buildings could either be positive or negative, based on the quality of design approach used. The study recommends a proper review of building codes and regulations by organizations intending to erect building structures with a view of designers to specified standards and prevent excess maintenance cost in the future

    Dual use of VA and Non-VA Hospitals by Veterans with Multiple Hospitalizations

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    Background: Veterans who are hospitalized in both VA and non-VA hospitals within a short timespan may be at risk for fragmented or conflicting care. To determine the characteristics of these “dual users,” we analyzed administrative hospital discharge data for VA-enrolled veterans of any age in seven states, including any VA or non-VA hospitalizations they had in 2004 – 2007. Method: For VA enrollees in Arizona, Iowa, Louisiana, Florida, South Carolina, Pennsylvania, or New York in 2007, we merged 2004 – 2007 discharge data for all VA hospitalizations and all non-VA hospitalizations listed in state health department or hospital association databases. For patients hospitalized in 2007, we compared those younger or older than 65 years who had one or multiple hospitalizations during the year, split into users of VA hospitals, non-VA hospitals, or both (“ dual users ”), on demographics, priority for VA care, travel times, principal diagnoses, co-morbidities, lengths of stay, and prior (2004 – 2006) hospitalizations, using chi-square analysis or ANOVA. Multiply hospitalized patients were compared with multinomial logistic regressions to predict non-VA and dual use. Payers for non-VA hospitalizations also were compared across groups. Results: Of unique inpatients in 2007, 38% of those 65 or older were hospitalized more than once during the year, as were 32% of younger patients; 3 and 8%, respectively, were dual users. Dual users averaged the most index-year (3.7) and prior (1.5) hospitalizations, split evenly between VA and non-VA. They also had higher rates of admission for circulatory diseases, symptoms/signs/ill-defined conditions, and injury and poisoning, and more admissions for multiple diagnostic categories; among younger patients they had the highest rate of mental disorders admissions. Higher income, non-rural residence, greater time to VA care, lower VA priority, prior non-VA hospitalization, no prior VA hospitalization, and several medical categories predicted greater non-VA use. Among younger patients, however, mental disorders predicted more dual use but less exclusively non-VA use. Dual users’ non-VA admissions were more likely than others’ to be covered by payers other than Medicare or commercial insurance. Conclusions: Younger dual users require more medical and psychiatric treatment, and rely more on government funding sources. Effective care coordination for these inpatients might improve outcomes while reducing taxpayer burden

    Kilohertz Quasi-Periodic Oscillation Peak Separation is not Constant in the Atoll Source 4U 1608-52

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    We present new Rossi X-ray Timing Explorer observations of the low-mass X-ray binary 4U 1608-52 during the decay of its 1998 outburst. We detect by a direct FFT method the existence of a second kilohertz quasi-periodic oscillation (kHz QPO) in its power density spectrum, previously only seen by means of the sensitivity-enhancing `shift and add' technique. This result confirms that 4U 1608-52 is a twin kHz QPO source. The frequency separation between these two QPO decreased significantly, from 325.5 +/- 3.4 Hz to 225.3 +/- 12.0 Hz, as the frequency of the lower kHz QPO increased from 470 Hz to 865 Hz, in contradiction with a simple beat-frequency interpretation. This change in the peak separation of the kHz QPOs is closely similar to that previously seen in Sco X-1, but takes place at a ten times lower average luminosity. We discuss this result within the framework of models that have been proposed for kHz QPO. Beat frequency models where the peak separation is identified with the neutron star spin rate, as well as the explanations previously proposed to account for the similar behavior of the QPOs in Sco X-1, are strongly challenged by this result.Comment: To appear in ApJL. AAS LaTex v4.0 (6 pages plus 3 postscript figures

    Thrombotic disorders (part 1)

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    Thromboembolic conditions are the leading cause of mortality, estimated to account for 1 in 4 deaths worldwide in 2010. Over time, the incidence and mortality rates of these conditions have improved in developed countries, but are increasing in developing countries. The haemostatic system comprises 6 main components, i.e. (i) platelets; (ii) vascular endothelium; (iii) coagulation proteins; (iv) natural anticoagulants; (v) the fibrinolytic system; and (vi) natural antifibrinolytic factors. A delicate balance exists between procoagulant and anticoagulant factors within the vascular system. Numerous acquired or inherited conditions may tip the balance either way, i.e. towards a prothrombotic or prohaemorrhagic state. In this issue of CME, the first of a 2-part series on thrombophilic disorders, the subject of discussion is on inherited varieties that the general practitioner is likely to encounter. This review is primarily based on venous thrombosis

    Girls’ and women’s education within Unesco and the World Bank, 1945–2000

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    By 2000, girls’ and women’s education was a priority for international development organisations. While studies have examined the impact of recent campaigns and programmes, there has been less exploration of ideas about girls’ and women’s education within development thought in the immediate post?colonial period, and the political mechanisms through which this came to be a global concern. Through a study of policy documents, this paper investigates how the education of girls and women came to be prioritised within the two principle UN agencies involved with education since 1945, the World Bank and Unesco. A shift in priorities is evident, from ensuring formal rights and improving the status of women, to expanding the productive capacities of women, fertility control and poverty reduction. While the ascendance of human capital theory provided a space for a new perception of the role of women’s education in development, in other policy arenas women’s education was central to exploring more substantive, rights?based notions of gender equality. Ultimately, the goal of improving girls’ and women’s education fitted into diverse development agendas, paving the way for it to become a global development priority

    Assessment of Poor Housing in informal settlement, Ogun State, South Western, Nigeria

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    This paper examines the influence of poverty on housing in informal settlement. Housing ownership has become a paramount thing in Nigeria, due to high cost of rent. This has resulted in informal settlement and sustaining those buildings has become hectic as a result of poverty. This research work was carried out in order to highlight and examine the influence of poor housing on the health and behaviour of the residents in the study area. Data for the study were generated from both primary and secondary school sources, and were equally analyzed through Descriptive statistics. The sampling population was 250 respondents who are representative of the house heads. Findings from the study revealed that the area chosen for the study exhibit slum condition that has denied impact on the socio-economic lifestyles and the health of the residents, as well as the general outlook of the environment. The study then concludes that people should design and build their houses based on their income rather than hoping for a better future. The study also recommends public campaign, to educate the dwellers on the need for good building condition as well to know the danger of abusing their environmen

    Assessing carbon dioxide removal through global and regional ocean alkalinization under high and low emission pathways

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    Atmospheric carbon dioxide (CO2) levels continue to rise, increasing the risk of severe impacts on the Earth system, and on the ecosystem services that it provides. Artificial ocean alkalinization (AOA) is capable of reducing atmospheric CO2 concentrations and surface warming and addressing ocean acidification. Here, we simulate global and regional responses to alkalinity (ALK) addition (0.25 PmolALK yr−1) over the period 2020–2100 using the CSIRO-Mk3L-COAL Earth System Model, under high (Representative Concentration Pathway 8.5; RCP8.5) and low (RCP2.6) emissions. While regionally there are large changes in alkalinity associated with locations of AOA, globally we see only a very weak dependence on where and when AOA is applied. On a global scale, while we see that under RCP2.6 the carbon uptake associated with AOA is only ∌ 60 % of the total, under RCP8.5 the relative changes in temperature are larger, as are the changes in pH (140 %) and aragonite saturation state (170 %). The simulations reveal AOA is more effective under lower emissions, therefore the higher the emissions the more AOA is required to achieve the same reduction in global warming and ocean acidification. Finally, our simulated AOA for 2020–2100 in the RCP2.6 scenario is capable of offsetting warming and ameliorating ocean acidification increases at the global scale, but with highly variable regional responses

    Pitfalls and Projections of Secondary School Education in Nigeria

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    Education plays an important role in the development and globalization of any nation. It is the bedrock of social change and can often be described as an accelerator of social and economic progress. Secondary school education in Nigeria is the bridge between primary education and tertiary education. However, with as much importance as it carries, secondary school education in Nigeria is faced with a myriad of problems ranging from insufficient government funding to poor maintenance of infrastructure. This paper is aimed at highlighting some of the current problems stifling the development of secondary school education in Nigeria by addressing issues such as poor government funding, unavailability of infrastructure, poor maintenance of provided infrastructure, under qualified teachers, and poor supervision of schools. The study adopted exploratory research methodology through literature and documentary survey. This paper concludes that in order to achieve major improvements in secondary school education, the need to reevaluate the priorities of the country in favor of education must be addressed. Also, issues of government funding must be re-addressed, governments should ensure that schools are properly and effectively supervised and inspected and extra effort needs to be put into ensuring adequately qualified teachers are recruited and remunerated accordingly, all in an effort to achieve meaningful development in secondary school education in Nigeria

    Short-term genome stability of serial Clostridium difficile ribotype 027 isolates in an experimental gut model and recurrent human disease

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    Copyright: © 2013 Eyre et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are creditedClostridium difficile whole genome sequencing has the potential to identify related isolates, even among otherwise indistinguishable strains, but interpretation depends on understanding genomic variation within isolates and individuals.Serial isolates from two scenarios were whole genome sequenced. Firstly, 62 isolates from 29 timepoints from three in vitro gut models, inoculated with a NAP1/027 strain. Secondly, 122 isolates from 44 patients (2–8 samples/patient) with mostly recurrent/on-going symptomatic NAP-1/027 C. difficile infection. Reference-based mapping was used to identify single nucleotide variants (SNVs).Across three gut model inductions, two with antibiotic treatment, total 137 days, only two new SNVs became established. Pre-existing minority SNVs became dominant in two models. Several SNVs were detected, only present in the minority of colonies at one/two timepoints. The median (inter-quartile range) [range] time between patients’ first and last samples was 60 (29.5–118.5) [0–561] days. Within-patient C. difficile evolution was 0.45 SNVs/called genome/year (95%CI 0.00–1.28) and within-host diversity was 0.28 SNVs/called genome (0.05–0.53). 26/28 gut model and patient SNVs were non-synonymous, affecting a range of gene targets.The consistency of whole genome sequencing data from gut model C. difficile isolates, and the high stability of genomic sequences in isolates from patients, supports the use of whole genome sequencing in detailed transmission investigations.Peer reviewe
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