Reference values for glucose tolerance test in the urban Zimbabwean pregnant woman

A clinical study carried out in urban Zimbabwe on how to derive normal glucose values for the normal woman at different gestations of pregnancy.The oral glucose tolerance test is widely used as a screening test for impaired glucose tolerance. Criteria for abnormal results in pregnancy have been documented from different countries and in Zimbabwe, the North American values as proposed by O’Sulluvan and Mahan1 have been adopted. These standards were derived from populations on Western diets; also the glucose load was 100 g, the gestations were unselected and no allowance had been made for altered glucose tolerance with advancing gestation. The standards may also be inappropriate because of the differences in the nutritional status and the dietary habits of the two population groups. Others that have used a glucose load of 50 g have obtained significantly lower values than O’Sullivan and Mahan.2,3 Although in 1979 the WHO expert committee on diabetes4 recommended a standard glucose load of 75 g, many units, including ours, continue to use the 50 g load. The aim of this study was, therefore, to derive normal glucose values for the normal urban Zimbabwean woman at different gestations of pregnancy

More on Strikes by Public Employees

We have two brief observations on the paper by Messrs. Burton and Krider. First, we suggest that society is not limited to a choice between their strike and no-strike alternatives. Our earlier article argued that the typical municipal political structure is vulnerable to strikes by wvell entrenched public employee unions, and that, given this existing political structure, the no-strike model is preferable to the strike model. We stated, however, that changes in the political structure which reduce the vulnerability of municipal employers to strikes by public employees can be made and that we intended (and we still do intend) to explore these possibilities in a future article. There is, therefore, a third model—one which permits some strikes in conjunction with various changes in municipal political structures. Second, we wish to define what seems to be the principal area of our disagreement with Messrs. Burton and Krider. All agree that the services performed by some public employees are in one way or another essential and that this essentiality is in some sense related to society\u27s ability to tolerate strikes. However, which employees under the Burton-Krider strike model are to have union activities limited depends very much on one\u27s view of essentiality. It is now clear that our vision is different from theirs

Prevalence of sulfonamide resistance genes in bacterial isolates from manured agricultural soils and pig slurry in the United Kingdom

Prevalence of three sulfonamide resistance genes, sul1, sul2 and sul3 and sulfachloropyridazine (SCP) resistance was determined in bacteria isolated from UK manured agricultural clay soils and slurry samples, over a two year period. Slurry from tylosin-fed pigs amended with SCP and oxytetracycline (OTC) was used for manuring. Sul gene positive isolates were further screened for the presence of class 1 and 2 integrons. Phenotypic resistance to SCP was significantly higher in pig slurry and post application soil than in pre-application soil. Of 5isolates, 23 % carried sul1, 18 % sul2 and 9 % sul3 only. Two percent of isolates contained all three sul genes. Class 1 and class 2 integrons were identified in 5 % and 11.7 % of sul positive isolates. In previous reports, sul1 was linked to class 1 integrons, but in this study only 8 % of sul1 positive isolates carried the intI1 gene. Sulfonamide resistant pathogens were identified in slurry amended soil and soil leachate, including Shigella flexneri, Aerococcus spp. and Acinetobacter baumanni, suggesting a potential environmental reservoir. Sulfonamide resistance in Psychrobacter, Enterococcus and Bacillus spp. is reported for the first time, and this study also provides the first description of the genotype sul1, sul2 and sul3 outside the Enterobacteriacae, and in the soil environment

Built-operate-transfer (BOT) model for public universities in Ghana for accelerating infrastructural development

Abstract: At independence, many countries look to reform education to accelerate economic and social development. Ghana is no exception, and after independence government saw in education the keys to social and economic development. Quality and availability of school infrastructure is one of the numerous problems confronting Ghana's education delivery. The purpose of this research is to find out infrastructure delivered by the private sector in our state Universities. The main objectives of this study were to assess the effectiveness of public private partnership in infrastructure development at the state public universities in Ghana, and also find out the number of infrastructure undertaken by the private sector; and to find out which of the PPP model is appropriate for the development of infrastructure in the state public universities. Data will be collected using the Delphi and field questionnaire survey. The Structural Equation Modeling (SEM) and Nvivo will be used to analyze data from the field questionnaire survey and Delphi respectively. This is a preliminary survey study on an ongoing Ph.D. study

Delineation of hippocampal subregions using T1-weighted magnetic resonance images at 3 Tesla

Although several novel approaches for hippocampal subregion delineation have been developed, they need to be applied prospectively and may be limited by long scan times, the use of high field (\u3e3T) imaging systems, and limited reliability metrics. Moreover, the majority of MR imaging data collected to date has employed a T1-weighted acquisition, creating a critical need for an approach that provides reliable hippocampal subregion segmentation using such a contrast. We present a highly reliable approach for the identification of six subregions comprising the hippocampal formation from MR images including the subiculum, dentate gyrus/cornu Ammonis 4 (DG/CA4), entorhinal cortex, fimbria, and anterior and posterior segments of cornu Ammonis 1-3 (CA1-3). MR images were obtained in the coronal plane using a standard 3D spoiled gradient sequence acquired on a GE 3T scanner through the whole head in approximately 10 min. The average ICC for inter-rater reliability across right and left volumetric regions-of-interest was 0.85 (range 0.71-0.98, median 0.86) and the average ICC for intra-rater reliability was 0.92 (range 0.66-0.99, median 0.97). The mean Dice index for inter-rater reliability across right and left hemisphere subregions was 0.75 (range 0.70-0.81, median 0.75) and the mean Dice index for intra-rater reliability was 0.85 (range 0.82-0.90, median 0.85). An investigation of hippocampal asymmetry revealed significantly greater right compared to left hemisphere volumes in the anterior segment of CA1-3 and in the subiculum

Review of critical success factors for the implementation of total quality management in the construction industry

Abstract: Total Quality Management (TQM) is a philosophy that involves every organization in the industry in the effort to improve performance. The concept is an integrative management principle for continuously improving the quality of products and processes to achieve customer satisfaction. To achieve this concept required a clear establishment of Critical Success Factors (CSFs). However, lack of clear establishment of CSFs for the implementation of TQM in the construction industry has led to failure of the system. In the pursuit of performance excellence in the construction industry and with an increasing awareness of construction quality, construction firms have no option than to implement TQM with clear CSFs

Bony ingrowth potential of 3D-printed porous titanium alloy: a direct comparison of interbody cage materials in an in vivo ovine lumbar fusion model.

Background contextThere is significant variability in the materials commonly used for interbody cages in spine surgery. It is theorized that three-dimensional (3D)-printed interbody cages using porous titanium material can provide more consistent bone ingrowth and biological fixation.PurposeThe purpose of this study was to provide an evidence-based approach to decision-making regarding interbody materials for spinal fusion.Study designA comparative animal study was performed.MethodsA skeletally mature ovine lumbar fusion model was used for this study. Interbody fusions were performed at L2-L3 and L4-L5 in 27 mature sheep using three different interbody cages (ie, polyetheretherketone [PEEK], plasma sprayed porous titanium-coated PEEK [PSP], and 3D-printed porous titanium alloy cage [PTA]). Non-destructive kinematic testing was performed in the three primary directions of motion. The specimens were then analyzed using micro-computed tomography (µ-CT); quantitative measures of the bony fusion were performed. Histomorphometric analyses were also performed in the sagittal plane through the interbody device. Outcome parameters were compared between cage designs and time points.ResultsFlexion-extension range of motion (ROM) was statistically reduced for the PTA group compared with the PEEK cages at 16 weeks (p-value=.02). Only the PTA cages demonstrated a statistically significant decrease in ROM and increase in stiffness across all three loading directions between the 8-week and 16-week sacrifice time points (p-value≤.01). Micro-CT data demonstrated significantly greater total bone volume within the graft window for the PTA cages at both 8 weeks and 16 weeks compared with the PEEK cages (p-value<.01).ConclusionsA direct comparison of interbody implants demonstrates significant and measurable differences in biomechanical, µ-CT, and histologic performance in an ovine model. The 3D-printed porous titanium interbody cage resulted in statistically significant reductions in ROM, increases in the bone ingrowth profile, as well as average construct stiffness compared with PEEK and PSP