Patterns of chronic illness among older patients attending a university hospital in Nigeria

Background: The rising burden of chronic diseases has attracted the attention of public health researchers and policymakers worldwide. Objectives: To assess the demographic, morbidity and outcome patterns of chronic illness among the older patients at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Design: Retrospective study Setting: Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Participants: Seven hundred and eighty-eight (788) adults (60 years and over) hospitalized between 2010 and 2014 in the hospital. Interventions: None Results: The age of the selected study population ranged from 60 to 99 years with a mean of 76.08(±10.42). More than half (53.0%) were between 60–69 years, with a subsequent decline. Male patients accounted for 64.0%, but females were more frequent among patients 80 years and older. The most common health conditions were heart diseases (22.5%), neoplasm (13.2%), cerebrovascular accident (12.4%), and gastrointestinal diseases (14.5%). The records showed that 14.9% were referred to other institution for various reasons (including further management, lack of space, industrial action by workers, discharged against medical advice or dead). Conclusion: Heart diseases were the major chronic illnesses among the older adults followed by neoplasm conditions, while musculoskeletal conditions were the least. It also found that there was a poor outcome of conditions amongolder adults in this setting. Therefore, efforts should be made towards the prevention and reduction of chronic illnesses, as well as improving the outcome of care. Keywords: chronic diseases, older adults, health care, retrospective, demographic Funding: Doctoral Fellowship from Consortium for Advanced Research Training in Afric

Effects of mothers' socio-economic status on the management of febrile conditions in their under five children in a resource limited setting

BACKGROUND: Public health research is shifting focus to the role of socioeconomic indicators in the promotion of health. As such an understanding of the roles that socio-economic factors play in improving health and health-seeking behaviour is important for public health policy. This is because the share of resources devoted to different policy options should depend on their relative effectiveness. OBJECTIVE: To measure the effect of socio-economic status (age, education, occupation, income, religion and family structure) of mothers on the management of febrile conditions in under-fives children METHOD: Two hundred mothers who brought their febrile under-five children to a health facility were interviewed on the treatment they gave to their children before reporting at health facility. Data collected were entered and analyzed using the SPSS software. Binary logistic regression was adopted for the quantitative analysis of the effect of socio-economic variables on the mothers' actions prior to utilizing the health facility. RESULTS: Results showed that while mothers' age was negatively correlated (-0.13), occupation was positively correlated (0.17) with under-fives mothers' action. Education, religion, income and family structure were however insignificant at 5% level CONCLUSION: This poses a lot of challenges to policy makers in the developing nations where women's education and earning capacity is low. There is therefore a need to increase the number of women benefiting from micro credit. This will ensure that more women are engaged in a form of occupation that is profitable and can sustain the economic and health needs of the family

PERFORMANCE EVALUATION OF ENERGY-SAVING BULBS IN SELECTED NIGERIAN LOCATIONS WITH ARTIFICIAL NEURAL NETWORK MODELLING

The performance evaluation of energy-saving bulbs in the Nigerian market is crucial in assisting energy auditing, which is beneficial to producers and consumers of electricity. Specifically, the high-power bills issued monthly by Electricity Distribution Company in most parts of Nigeria have made Nigerians in our various domestic homes embrace the latest lighting technology that consumes less energy.In this study, lighting system data were obtained from twenty-four households from different geographical zones in Nigeria. The performance evaluation of compact fluorescent light(CFL) bulbs was investigated and the observation was predicted with artificial neural networks (ANN) to enhance informed policy formulation and decision-makingResults showed that CFL bulbs givehigh-quality light that is cost-effective and environmentally friendly. ANN predicted the observation with high accuracie

SENSITIVITY ANALYSIS OF HYBRIDIZED WIND/PV ENERGY SYSTEM FOR POWERING TELECOMMUNICATION MAST IN LAGOS SOUTH-WEST NIGERIA

Power delivery micro-grid of hybridized wind and solar system installations keep growing worldwide. There is a great economic advantage in the use of cleaner renewable energy for power generation in the telecommunication industries, especially in remote areas. This studyanalyses the effect of three wind speed fluctuationsor levels on a hybridizedwind energy system’s electricity production for a typical three (3) BTS telecommunication mast using Hybrid Optimization Model for Energy Resources (HOMER)PRO software in Lagos south-western Nigeria as a case study. The economic implication of energy at the different wind speed levels investigated was also derived. From the obtained results, a wind speed of 4, 4.22, and 5 m/s gave an annual electric production of 39,950, 39,050, and 39,250 kWh and energy cost of 195, 192, and ₦175, respectively. This result is useful for the techno-economic operation of hybridized wind/solar system powered by three (3) BTS telecommunication masts

MODELLING AND OPTIMIZATION OF COEFFICIENT OF PERFORMANCE OF LOWER TEMPERATURE CYCLE OF TWO-STEP REFRIGERATION SYSTEMS

The coefficient of performance (COP) of a single-stage refrigeration system is low, thus there is a need for two-step refrigeration systems when there is a desire to have an evaporator temperature that is below -25 oC. The COP of the lower temperature cycle of the two-step refrigeration systems is a function of the COP of the refrigeration systems.This research aimed at optimizing COP of the lower temperature cycle of two-step refrigeration systems using eco-friendly refrigerants.Thermodynamic analysis of these refrigeration systems was performed by varying seven operating parameters. R-134a was used in the high-temperature cycle (HTC) and R-23 was used in the low-temperature cycle (LTC). The coefficient of performance of the lower temperature cycle (COP.REF[LTC]) of the refrigeration systems was optimized using Half Factorial Design of Design-Expert 12.0.1. The influence of the condensing temperature (TC,HTC),evaporating temperature (TE,HTC), cascade temperature difference (∆TCAS,DIFF), evaporating temperature (TE,LTC), superheating temperature (TSUP,LTC), sub-cooling temperature (TSUB,LTC), and refrigerant mass Flow rate (ṁHTC)was investigated on the values of COP.REF[LTC] of the refrigeration systems. The highest value of COP.REF[LTC] (18.1) was obtained under optimum conditions of the 30 TC,HTCoC , -40 TE,HTCoC, 0 ∆TCAS,DIFFoC, -50 TE,LTCoC, 0 TSUP,LTCoC, 20 TSUB,LTCoC and 0.01 ṁHTC kg/s.The study revealed that all the factors having interaction with TC[HTC] and TE[HTC] have a great influence on the value of COP.REF[LTC

A Simulation Study of Functional Electrical Stimulation for An Upper Limb Rehabilitation Robot using Iterative Learning Control (ILC) and Linear models

A proportional iterative learning control (P-ILC) for linear models of an existing hybrid stroke rehabilitation scheme is implemented for elbow extension/flexion during a rehabilitative task. Owing to transient error growth problem of P-ILC, a learning derivative constraint controller was included to ensure that the controlled system does not exceed a predefined velocity limit at every trial. To achieve this, linear transfer function models of the robot end-effector interaction with a stroke subject (plant) and muscle response to stimulation controllers were developed. A straight-line point-point trajectory of 0 - 0.3 m range served as the reference task space trajectory for the plant, feedforward, and feedback stimulation controllers. At each trial, a SAT-based bounded error derivative ILC algorithm served as the learning constraint controller. Three control configurations were developed and simulated. The system performance was evaluated using the root means square error (RMSE) and normalized RMSE. At different ILC gains over 16 iterations, a displacement error of 0.0060 m was obtained when control configurations were combined.Comment: 15 pages, 16 Figure

Genomic Diversity of a Globally Used, Live Attenuated Mycoplasma Vaccine

: The Mycoplasma synoviae live attenuated vaccine strain MS-H (Vaxsafe MS; Bioproperties Pty., Ltd., Australia) is commonly used around the world to prevent chronic infections caused by M. synoviae in birds and to minimize economic losses in the poultry industry. MS-H is a temperature-sensitive strain that is generated via the chemical mutagenesis of a virulent M. synoviae isolate, 86079/7NS. 32 single nucleotide polymorphisms have been found in the genome of MS-H compared to that of 86079/7NS, including 25 in predicted coding sequences (CDSs). There is limited information on the stability of these mutations in MS-H in vitro during the propagation of the vaccine manufacturing process or in vivo after the vaccination of chickens. Here, we performed a comparative analysis of MS-H genomes after in vitro and in vivo passages under different circumstances. Studying the dynamics of the MS-H population can provide insights into the factors that potentially affect the health of vaccinated birds. The genomes of 11 in vitro laboratory passages and 138 MS-H bird reisolates contained a total of 254 sequence variations. Of these, 39 variations associated with CDSs were detected in more than one genome (range = 2 to 62, median = 2.5), suggesting that these sequences are particularly prone to mutations. From the 25 CDSs containing previously characterized variations between MS-H and 86079/7NS, 7 were identified in the MS-H reisolates and progenies examined here. In conclusion, the MS-H genome contains individual regions that are prone to mutations that enable the restoration of the genotype or the phenotype of wild-type 86079/7NS in those regions. However, accumulated mutations in these regions are rare. IMPORTANCE Preventative measures, such as vaccination, are commonly used for the control of mycoplasmal infections in poultry. A live attenuated vaccine strain (Vaxsafe MS; MS-H; Bioproperties Pty. Ltd., Australia) is used for the prevention of disease caused by M. synoviae in many countries. However, information on the stability of previously characterized mutations in the MS-H genome is limited. In this study, we performed a comparative analysis of the whole-genome sequences of MS-H seeds used for vaccine manufacturing, commercial batches of the vaccine, cultures minimally passaged under small-scale laboratory and large-scale manufacturing conditions, MS-H reisolated from specific-pathogen-free (SPF) chickens that were vaccinated under controlled conditions, and MS-H reisolated from vaccinated commercial poultry flocks around the world. This study provides a comprehensive assessment of genome stability in MS-H after in vitro and in vivo passages under different circumstances and suggests that most of the mutations in the attenuated MS-H vaccine strain are stable

Safety of the surgeon: ‘Double-gloving’ during surgical procedures

Background. In the face of increasing HIV/AIDS prevalence in subSaharan Africa, we evaluate the effectiveness of ‘double-gloving’ during surgery as a means of protecting the surgeon operating on patients with a known or unknown HIV status.Methods. A prospective study was conducted to determine the rate of glove puncture and intraoperative injury in categories of patients with known positive, known negative or unknown HIV status.Results. The surgeon and the first assistant double-gloved in all the 1 050 procedures performed between 2009 and 2013, and a total of 8 400 surgical gloves were used. Sixty-nine patients (6.6%) were HIV-positive, 29 patients (2.8%) were HIV-negative, and the HIV status was unknown for the remaining 952 patients (90.7%). The overall glove puncture rate in the study was 14.5%. The glove puncture rate was 0%, 31% and 15% for HIV-positive, HIV-negative and HIV status unknown, respectively, and this difference was statistically significant. The mean operating time in the group with glove punctures was 148 min (95% confidence interval (CI) 135 - 161), while mean operating time in the group without glove puncture was 88 min (95% CI 84 - 92). Conclusion. Double-gloving offers protection against intraoperative injury. Knowing the HIV status of the patient offers additional protection to the operating surgeon. While we recommend routine double-gloving for surgeons working in HIV-prevalent patient populations, we also advocate for the routine screening for HIV in all surgical patients

Making Nurses and Nursing Care Visible in Nigeria. A Review of Standardized Nursing Care Plan from the Nurse Len

A standardized nursing care plan (SNCP) is a published universal action plan that specifies nursing care, and it has evolved into the standard in nursing practice for the betterment of healthcare globally. However, this nursing care plan’s use can vary depending on the institutions thus limiting the use among developing hospitals in developing countries such as Nigeria. The scoping review sought to analyze, consolidate, and summarize data from the body of research on the use of standardized nursing care plans by Nigerian nurses. Searching for and combining research published between 2015 and 2019 involved using a scoping review technique based on Arksey and O’Malley. Google Scholar, PubMed, CINAHL, and MEDLARS Online, also known as the Medical Literature Analysis and Retrieval System Online, were among the databases that were searched. The number of items that might be included was 38. Standardized nursing languages in the form of NANDA-I were the mostly utilized nursing languages in many hospitals in the country, meanwhile, activities in nursing intervention classification were used by a few. However, nursing outcome classification was stated as nursing evaluation in many hospitals. Also, three categories of identified factors to SNCPs use were I. not having the right format of SNCP on the wards. II. Nursing and Midwifery Council of Nigeria not mandating its use. III. Hospitals not having a policy for the nurses to mandate its use. Addressing the core barriers and making the right format of SNCP available will promote its use in all hospitals in the country. The authors recommend that the Nursing and Midwifery Council of Nigeria should mandate its full adoption in documenting patient care in the hospitals

Mevalonate pathway analysis of Saccharomyces cerevisiae during bioisoprene synthesis

Isoprene, synthesized through two complementary biosynthetic routes known as the mevalonate (MVA) pathway and the deoxy-xylulose phosphate pathway, is a valuable monomer that is used for rubber and several other chemical industries. Despite the recent interest in the industrial and biomedical applications of isoprene and its derivatives, the complexity of controlling its chemical synthesis due to the formation of greenhouse gases is a significant problem. To overcome the productivity and yield challenges, in addition to generating environmental and economic benefits, this study aimed to focus on the direct fermentation of cellulosic materials into bioisoprene. In this study, bioisoprene was synthesized via a biotransformation process through enzymatic hydrolysis of cassava peel using Aspergillus niger 11JK and Saccharomyces cerevisiae 19KB strain. The mevalonate (MVA) pathway (synthetic route) exploited during bioisoprene production by S. cerevisiae 19KB strain was investigated using the hydrolyzed cassava peel broth. The obtained crude extract was analyzed for bioisoprene yield and enzymatic activities using Gas chromatography. Furthermore, results of the size exclusion chromatography revealed the presence of polysaccharide hydrolyzing enzymes (e.g., amylase and cellulase), and mevalonate pathway enzymes, including isoprene synthase, mevalonate-5-diphosphate decarboxylase, and isopentyl phosphate kinase, in addition to isoprene, mevalonic acid (MVA), and its isomer dimethylallyl diphosphate (DMAPP). Based on the results obtained in this study, bioisoprene synthesis via direct fermentation of cheap and abundant carbon sources such as cassava peel using the S. cerevisiae 19KB strain will overcome the high production costs and low yield challenges of bioisoprene, thus generating significant environmental and economic benefits