Demonstration project on epilepsy in Brazil - Outcome assessment

Purpose: To assess the outcome of patients with epilepsy treated at primary care health units under the framework of the demonstration project on epilepsy in Brazil, part of the WHO/ILAE/IBE Global Campaign Against Epilepsy. Method. We assessed the outcome of patients treated at four primary health units. The staff of the health units underwent information training in epilepsy. The outcome assessment was based on: 1) reduction of seizure frequency, 2) subjective perception from the patient's and the physician's point of view, 3) reduction of absenteeism, 4) social integration (school and work), and 5) sense of independence. Results: A total of 181 patients (93 women - 51%) with a mean age of 38 (range from 2 to 86) years were studied. The mean follow-up was 26 months (range from 1 to 38 months, 11 patients had follow-up of less than 12 months). Seizure frequency was assessed based on a score system, ranging from 0 (no seizure in the previous 24 months) to 7 (> 10 seizure/day). The baseline median seizure-frequency score was 3 (one to three seizures per month). At the end of the study the median seizure-frequency score was 1 (one to three seizures per year). The patients' and relatives' opinions were that in the majority (59%) the health status had improved a lot, some (19%) had improved a little, 20% experienced no change and in 2% the health status was worse. With regard to absenteeism, social integration and sense of independence, there were some modest improvements only. Discussion: The development of a model of epilepsy treatment at primary health level based on the existing health system, with strategic measures centred on the health care providers and the community, has proved to be effective providing important reductions in seizure frequency, as well as in general well being. This model can be applied nationwide, as the key elements already exist provided that strategic measures are put forward in accordance with local health providers and managers

Demonstration project on epilepsy in Brazil - Situation assessment

Purpose: To provide a situation assessment of services for people with epilepsy in the context of primary health care, as part of the Demonstration Project on Epilepsy in Brazil, part of the WHO/ILAE/IBE Global Campaign 'Epilepsy out of the shadows'. Methods: We performed a door-to-door epidemiological survey in three areas to assess the prevalence of epilepsy and its treatment gap. We surveyed a sample of 598 primary health care workers from different regions of Brazil to assess their perceptions of the management of people with epilepsy in the primary care setting. Results: The lifetime prevalence of epilepsy was 9.2/1,000 people [95% Cl 8.4-10.0] and the estimated prevalence of active epilepsy was 5.4/1,000 people. Thirty-eight percent of patients with active epilepsy were on inadequate treatment, including 19% who were taking no medication. The survey of health workers showed that they estimated that 60% of patients under their care were seizure-free. They estimated that 55% of patients were on monotherapy and that 59% had been referred to neurologists. The estimated mean percentage of patients who were working or studying was 56%. Most of the physicians (73%) did not feel confident in managing people with epilepsy. Discussion: The epidemiological survey in the areas of the Demonstration Project showed that the prevalence of epilepsy is similar to that in other resource-poor countries, and that the treatment gap is high. One factor contributing to the treatment gap is inadequacy of health care delivery. The situation could readily be improved in Brazil, as the primary health care system has the key elements required for epilepsy management. To make this effective and efficient requires: i) an established referral network, ii) continuous provision of AEDs, iii) close monitoring of epilepsy management via the notification system (Sistema de lnformacao da Atencao Basica - SIAB) and iv) continuous education of health professionals. The educational program should be broad spectrum and include not only medical management, but also psycho-social aspects of epilepsy

Two-Loop Renormalization Group Analysis of the Burgers-Kardar-Parisi-Zhang Equation

A systematic analysis of the Burgers--Kardar--Parisi--Zhang equation in $d+1$ dimensions by dynamic renormalization group theory is described. The fixed points and exponents are calculated to two--loop order. We use the dimensional regularization scheme, carefully keeping the full $d$ dependence originating from the angular parts of the loop integrals. For dimensions less than $d_c=2$ we find a strong--coupling fixed point, which diverges at $d=2$, indicating that there is non--perturbative strong--coupling behavior for all $d \geq 2$. At $d=1$ our method yields the identical fixed point as in the one--loop approximation, and the two--loop contributions to the scaling functions are non--singular. For $d>2$ dimensions, there is no finite strong--coupling fixed point. In the framework of a $2+\epsilon$ expansion, we find the dynamic exponent corresponding to the unstable fixed point, which describes the non--equilibrium roughening transition, to be $z = 2 + {\cal O} (\epsilon^3)$, in agreement with a recent scaling argument by Doty and Kosterlitz. Similarly, our result for the correlation length exponent at the transition is $1/\nu = \epsilon + {\cal O} (\epsilon^3)$. For the smooth phase, some aspects of the crossover from Gaussian to critical behavior are discussed.Comment: 24 pages, written in LaTeX, 8 figures appended as postscript, EF/UCT--94/3, to be published in Phys. Rev. E

Kinetic modelling of competition and depletion of shared miRNAs by competing endogenous RNAs

Non-conding RNAs play a key role in the post-transcriptional regulation of mRNA translation and turnover in eukaryotes. miRNAs, in particular, interact with their target RNAs through protein-mediated, sequence-specific binding, giving rise to extended and highly heterogeneous miRNA-RNA interaction networks. Within such networks, competition to bind miRNAs can generate an effective positive coupling between their targets. Competing endogenous RNAs (ceRNAs) can in turn regulate each other through miRNA-mediated crosstalk. Albeit potentially weak, ceRNA interactions can occur both dynamically, affecting e.g. the regulatory clock, and at stationarity, in which case ceRNA networks as a whole can be implicated in the composition of the cell's proteome. Many features of ceRNA interactions, including the conditions under which they become significant, can be unraveled by mathematical and in silico models. We review the understanding of the ceRNA effect obtained within such frameworks, focusing on the methods employed to quantify it, its role in the processing of gene expression noise, and how network topology can determine its reach.Comment: review article, 29 pages, 7 figure

Chronic psychosocial and financial burden accelerates 5-year telomere shortening: findings from the Coronary Artery Risk Development in Young Adults Study.

Leukocyte telomere length, a marker of immune system function, is sensitive to exposures such as psychosocial stressors and health-maintaining behaviors. Past research has determined that stress experienced in adulthood is associated with shorter telomere length, but is limited to mostly cross-sectional reports. We test whether repeated reports of chronic psychosocial and financial burden is associated with telomere length change over a 5-year period (years 15 and 20) from 969 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study, a longitudinal, population-based cohort, ages 18-30 at time of recruitment in 1985. We further examine whether multisystem resiliency, comprised of social connections, health-maintaining behaviors, and psychological resources, mitigates the effects of repeated burden on telomere attrition over 5 years. Our results indicate that adults with high chronic burden do not show decreased telomere length over the 5-year period. However, these effects do vary by level of resiliency, as regression results revealed a significant interaction between chronic burden and multisystem resiliency. For individuals with high repeated chronic burden and low multisystem resiliency (1 SD below the mean), there was a significant 5-year shortening in telomere length, whereas no significant relationships between chronic burden and attrition were evident for those at moderate and higher levels of resiliency. These effects apply similarly across the three components of resiliency. Results imply that interventions should focus on establishing strong social connections, psychological resources, and health-maintaining behaviors when attempting to ameliorate stress-related decline in telomere length among at-risk individuals

Economic Analysis of Beekeeping in Chibok Local Government Area of Borno State, Nigeria

The study was carried out to analyze the economics of beekeeping in Chibok Local Government Area of Borno State, Nigeria. Data were obtained using structured questionnaire. Three (3) wards (extension blocks) were purposely selected out of the eleven (11) wards to reflect areas where beekeeping is predominantly found. A total of 100 respondents were randomly and proportionately selected from the three (3) wards and used for the study. Descriptive statistics, budgetary technique and multiple regression were used as analytical tools. The result indicates that majority (90%) were male, most of them (56%) had between 20 – 40 colonies, 44% had primary education and 40% had between 16 – 20 years beekeeping experience in the study area. The results of multiple regression analysis indicate that the coefficients of age, number of colony owned and gender were positive and significant at 5% and 10%, respectively. Costs and returns analysis indicates that gross revenue, total cost and net farm income were N14,234.17, N5,260.65 and N8,973.74 per colony, respectively. Inadequate credit, theft, bush burning, absconding of bees and inadequate improved technologies were some of the major problems militating against beekeeping in the study area. It was recommended that extension agents in the state should be property trained and provided with all the necessary technological packages required to teach and guide farmers on improved beekeeping to reduce cost of production, farmers engaged in beekeeping should form cooperative groups that will enable them obtain credit from government and financial institutions and non-governmental organisations in collaboration with farmers cooperative groups should provide improved beekeeping technologies at subsidized rate to the farmers.Keywords: Beekeeping, Economic analysis, Borno StateNigerian Journal of Basic and Applied Science (2011), 19(2): 285-29

Effect of “Irkoy Gomni” Micro-credit scheme on Resource- Use in cattle fattening in Tillabery Region of Niger Republic

This study was carried out to ascertain whether credit obtained for cattle fattening has had any meaningful contribution to the resources used by the beneficiary farmers in Kollo LGA of Tillabery Region Niger Republic. One hundred loan beneficiary cattle fattening farmers were randomly selected out of a sampling frame of 732 beneficiaries with not less than 5 borrowing circles. One hundred non-beneficiary cattle fatteners who were immediate neighbours of the sampled beneficiaries were also randomly selected from an established sampling frame obtained from the village heads to make a total sample size of 200, comprising of 100 beneficiaries and 100 non beneficiaries. Data were analyzed using descriptive statistics, chi-square and multiple regressions. The results showed that cattle fattening was the most preferred economic activity for both the beneficiaries (94%) and their non beneficiary counterparts (91%). The chisquare value (5.192) showed no significant difference in preferences of the economic activities between the two sets of farmers. Credit delivered to the beneficiaries enabled them use higher quantities of feed (P<0.01) and labour resources (P<0.1) than their non-beneficiary counterparts. Similarly, credit delivered has brought about significant increase (P<0.01) in revenue accrued to the fattening business of the beneficiary farmers. Based on the results, it is recommended that the scope of the credit be expanded to cover more farmers in the area. &#160

Determination of the level of resource-use efficiency in Quality Protein Maize (QPM) production in Kaduna State, Nigeria

The study aimed at determining the level of resource use efficiency in Quality Protein Maize (QPM) production in Kaduna State. Multi stage sampling technique was used to sample 170 respondents from four L.G.As. where QPM is mostly produced. Data were collected through questionnaire administration during the 2009 cropping season. Data analysis was done using multiple regression and estimation of resource-use efficiency ratio. The results showed that fertilizers, family and hired labour were over utilized while land and seeds were under utilized in the production process. This implied that, in order to scale-up output, levels of fertilizers, family and hired labour ought to be reduced while land and seeds ought to be increased

Profitability Analysis of Rice Processing and Marketing in Kano State, Nigeria

The study determined the profitability of rice processing and marketing in Kano State. The objective of the study was to assess the profitability levels of rice processing and marketing, evaluate the value added to the commodity at each stage in the study area and determine the most efficient services produce. Primary data were collected from 120 randomly selected respondents comprising parboilers, millers, retailers and wholesalers using interview schedule. The findings indicated that Net Milling Income of millers was N3,378,855.08 per respondent per year; the value added was N5,736,658.82 and service efficiency was 243.3. This result, therefore, showed that the Net Milling Income, value added and service efficiency for millers were higher, followed by wholesalers (N2,239,086.63, N2,239,086.63 and 3.5 respectively) and retailers (N422,230.77, N422,230.77 and 5.65 respectively), with the parboilers having the least. The millers had a Net Present Value of N10, 555,709 at 22% and an Internal Rate of Return of 140 which shows that the business of milling can payback money loaned from bank at even 140% interest rate. Based on the findings, it was recommended that the parboilers should be paid for their services separately from costs of input for parboiling and the traders should enhance the existing co-operatives societies and encourage bulk purchase and transportation of the milled rice. This will reduce the high cost of milled rice as well as reduce the cost of transportation.Keywords: Rice, Processing, Marketing, ProfitabilityNigerian Journal of Basic and Applied Science (2011), 19(2): 293-29

Application of Park's power components to the differential protection of three-phase transformers

This paper presents a new scheme for power transformers differential protection, in which the concept of the Park's instantaneous differential powers is introduced. The proposed method is able to detect winding insulation failures and to distinguish them from magnetizing inrush current transients. Experimental and simulation results are presented and discussed