Physical accessibility and utilization of health services in Yemen.

BACKGROUND: Assessment of physical access to health services is extremely important for planning. Complex methods that incorporate data inputs from road networks and transport systems are used to assess physical access to healthcare in industrialised countries. However, such data inputs hardly exist in many developing countries. Straight-line distances between the service provider and resident population are easily obtained but their relationship with driving distance and travel time is unclear. This study aimed to investigate the relationship between different measures of physical access, including straight-line distances, road distances and travel time and the impact of these measures on the vaccination of children in Yemen. METHODS: Coordinates of houses and health facilities were determined by GPS machine in Urban and rural areas in Taiz province, Yemen. Road distances were measured by an odometer of a vehicle driven from participants' houses to the nearest health centre. Driving time was measured using a stop-watch. Data on children's vaccination were collected by personal interview and verified by inspecting vaccination cards. RESULTS: There was a strong correlation between straight-line distances, driving distances and driving time (straight line distances vs. driving distance r = 0.92, p < 0.001, straight line distances vs. driving time r = 0.75; p < 0.001, driving distance vs. driving time r = 0.83, p < 0.001). Each measure of physical accessibility showed strong association with vaccination of children after adjusting for socio-economic status. CONCLUSION: Straight-line distances, driving distances and driving time are strongly linked and associated with vaccination uptake. Straight-line distances can be used to assess physical access to health services where data inputs on road networks and transport are lacking. Impact of physical access is clear in Yemen, highlighting the need for efforts to target vaccination and other preventive healthcare measures to children who live away from health facilities

Systematic review of the safety of medication use in inpatient, outpatient and primary care settings in the Gulf Cooperation Council countries

Background Errors in medication use are a patient safety concern globally, with different regions reporting differing error rates, causes of errors and proposed solutions. The objectives of this review were to identify, summarise, review and evaluate published studies on medication errors, drug related problems and adverse drug events in the Gulf Cooperation Council (GCC) countries. Methods A systematic review was carried out using six databases, searching for literature published between January 1990 and August 2016. Research articles focussing on medication errors, drug related problems or adverse drug events within different healthcare settings in the GCC were included. Results Of 2094 records screened, 54 studies met our inclusion criteria. Kuwait was the only GCC country with no studies included. Prescribing errors were reported to be as high as 91% of a sample of primary care prescriptions analysed in one study. Of drug-related admissions evaluated in the emergency department the most common reason was patient non-compliance. In the inpatient care setting, a study of review of patient charts and medication orders identified prescribing errors in 7% of medication orders, another reported prescribing errors present in 56% of medication orders. The majority of drug related problems identified in inpatient paediatric wards were judged to be preventable. Adverse drug events were reported to occur in 8.5–16.9 per 100 admissions with up to 30% judged preventable, with occurrence being highest in the intensive care unit. Dosing errors were common in inpatient, outpatient and primary care settings. Omission of the administered dose as well as omission of prescribed medication at medication reconciliation were common. Studies of pharmacists’ interventions in clinical practice reported a varying level of acceptance, ranging from 53% to 98% of pharmacists’ recommendations. Conclusions Studies of medication errors, drug related problems and adverse drug events are increasing in the GCC. However, variation in methods, definitions and denominators preclude calculation of an overall error rate. Research with more robust methodologies and longer follow up periods is now required.Peer reviewe

Frequency-dependent spontaneous emission rate from CdSe and CdTe nanocrystals: influence of dark states

We studied the rate of spontaneous emission from colloidal CdSe and CdTe nanocrystals at room temperature. The decay rate, obtained from luminescence decay curves, increases with the emission frequency in a supra-linear way. This dependence is explained by the thermal occupation of dark exciton states at room temperature, giving rise to a strong attenuation of the rate of emission. The supra-linear dependence is in agreement with the results of tight-binding calculations.Comment: 11 page

Innovative concept of an educational physical simulation tool for teaching energy consumption in buildings for enhancing public engagement

Buildings consume significant amount of energy for heating or air-conditioning in most countries. Therefore, educating the public and young generations to enhance their engagement and encourage them to reduce carbon emission and energy consumption in their daily life is becoming essential worldwide to drive continuous improvement towards more sustainable future. This paper presents an innovative educational tool to simulate energy performance and its use in educating university students and teaching school children about the subject. The paper outlines the developed educational tool and presents its benefits via two detailed case studies, with wide and diverse level of knowledge and learning outcomes. The educational technology includes a small-scale multi-layered model of buildings where insulation layers can be added to or removed from the building's envelop to influence energy performance. Qualitative and quantitative research has been conducted . The results show that the technology is capable of engaging the young generation and to help them to understand the thermal performance and energy efficiency of buildings

Boron isotope ratio (delta B-11) measurements in water framework directive monitoring programs: comparison between double focusing sector field ICP and thermal ionization mass spectrometry

International audienceThe aim of our research was to compare delta B-11 measurements performed with thermal ionization mass spectrometry (TIMS) and sector field-inductively coupled plasma-mass spectrometry (SF-ICP-MS) and evaluate the feasibility of implementing stable isotope methods in European water framework directive (WFD) monitoring programs. The comparison was based on delta B-11 measurements of 192 ground-and surface water samples and 15 leachates of nitrate pollution source materials (organic and mineral fertilisers). The precision of delta B-11 measurements attainable with SF-ICP-MS, 2 sigma= +/- 2.6 parts per thousand; (n = 192), is as expected lower than the precision achieved by TIMS, 2 sigma= +/- 0.3 parts per thousand (n=183). However the ease of use, rapidity and availability of SF-ICP-MS on one hand and the observed variability in delta B-11 in ground-and surface water on the other (from -3.4 to +37 parts per thousand), demonstrates that using SF-ICP-MS as an isotopic screening method would promote the use of isotopic methodology for WFD monitoring. Based on the results of the different case studies it is shown that retrieving precise information on the identification of pollution sources from delta B-11 values requires reaching the best analytical precision and accuracy possible. Hence, the superior precision of TIMS advantages tracing of nitrate pollution sources. However for some cases, e. g. trying to decipher contributions between sources with really distinct delta B-11 signatures (e.g. manure and sewage effluent), SF-ICP-MS results lead to the same conclusions and can therefore be used as a first approachable screening method for the determination of delta B-11 in WFD monitoring programs

Evaluation of alternative solvents in common amide coupling reactions : replacement of dichloromethane and N,N-dimethylformamide

A range of alternative solvents have been evaluated within amidation reactions employing common coupling reagents with a view to identifying suitable replacements for dichloromethane and N,N-dimethylformamid