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The management and treatment of Medical Waste (MW) are of great concern owing to its potential hazard to human health and the environment, particularly in developing countries. In Bhutan, although guidelines exist on the prevention and management of wastes, the implementation is still hampered by technological, economic, social difficulties and inadequate training of staff responsible for handling these waste. The study aimed at assessing the awareness and practice of medical waste management among health care providers and support staff at the National Referral Hospital and its compliance with the existing National guidelines and policies.

An observational cross-sectional study was conducted from March to April 2019. Three research instruments were developed and used; (i) Demographic questionnaire, (ii) Awareness questions, and (iii) the Observational checklist. The data was coded and double entered into Epi data version 3.1 and SPSS version 18 was used for analysis. Descriptive statistics were used to ps required with regular training for healthcare workers and support staff. Furthermore, strengthening the waste management system at National Referral Hospital would provide beneficial impact in enhancing safety measures of patients.

The awareness and practice of medical waste management among healthcare workers is often limited with inadequate sensitization and lack of proper implementation of the existing National guidelines at the study site. Therefore, timely and effective monitoring is required with regular training for healthcare workers and support staff. Furthermore, strengthening the waste management system at National Referral Hospital would provide beneficial impact in enhancing safety measures of patients.The loss of biodiversity-caused mainly by habitat destruction-is one of the environmental problems with major repercussions on ecosystem functioning. Nevertheless, our understanding of the functional consequences of habitat changes on the communities and ecosystems remains limited to a small number of case studies. We evaluated the change in taxonomic and functional diversity of copro-necrophagous beetles (Scarabaeinae) and their relationship with the varying environmental factors present in four habitats with different degrees of disturbance. Furthermore, we evaluated how changes in taxonomic and functional diversity affect the rates of excrement removal. The collections were carried out at four locations in the state of Santa Catarina, Southern Brazil, on natural systems with different degrees of disturbances (forests in advanced and initial succession) and agroecosystems (silviculture and pastures dedicated to livestock). We collected a total of 1266 dung beetles distributed in 35 species and classified into 11 functional groups. The taxonomic and functional diversity analyses showed that habitats that still maintain an arboreal stratum do not present differences between them, in contrast to habitats dedicated to livestock where there was a significant loss of species and functional groups. The distance between the trees, as well as the air and soil temperatures were determining factors in the selection of species and functional groups. Some of these environmental factors explain the differences in functional traits, represented as varying abundances of the species found. The rates of manure removal from the ecosystem were positively correlated to taxonomic and functional richness as well as biomass of beetles. Thus, we can conclude that habitats with tree strata have the capacity to preserve a larger proportion of the regional set of species as well as the important ones, while preserving the taxonomic and functional diversity and the ecosystem functions, such as the excrement removal rate.

The global tobacco epidemic contributes to more than 8 million deaths annually. However, most tobacco control interventions have been driven by an emphasis on smoked tobacco. Globally and more so in Nigeria, less attention has been paid to the similarly harmful smokeless tobacco (SLT) whose use appeals to a different demography. We examined the prevalence, patterns of use and correlates of SLT in Nigerian adults to guide targeted control efforts.

We conducted a secondary analysis of the 2012 Global Adult Tobacco Survey (GATS) data. We obtained data on 9,765 non-institutionalised adults aged 15 years and older. Variables included current SLT use, sociodemographic characteristics and perceived harm of SLT use. selleck inhibitor We used Chi-square test to examine associations and binary logistic regression to assess predictors of current SLT use. All analyses were conducted with sample-weighted data.

The prevalence of current SLT use was 1.9% of all adults. About 1.4% were daily users. The main types were snuff by nose (1.6 unacceptably high proportion remain unaware. We recommended targeted interventions to increase awareness of the harmful effects of SLT use especially among residents of the South-East, those in rural areas, males, and individuals with no formal education. We also recommended a follow-up survey.

Studies have evaluated the application of perfusion MR for predicting survival in patients with astrocytic brain tumors, but few of them statistically adjust their results to reflect the impact of the variability of treatment administered in the patients. Our aim was to analyze the association between the perfusion values and overall survival time, with adjustment for various clinical factors, including initial treatments and follow-up treatments.

This study consisted of 51 patients with astrocytic brain tumors who underwent perfusion-weighted MRI with MultiHance® at a dose of 0.1 mmol/kg prior to initial surgery. We measured the mean rCBV, the 5% & 10% maximum rCBV, and the variation of rCBV in the tumors. Comparisons were made between patients with and without 2-year survival using two-sample t-test or Wilcoxon rank-sum test for the continuous data, or chi-square and Fisher exact tests for categorical data. The multivariate cox-proportional hazard regression was fit to evaluate the association between rCBV and overall survival time, with adjustment for clinical factors.

Patients who survived less than 2 years after diagnosis had a higher mean and maximum rCBV and a larger variation of rCBV. After adjusting for clinical factors including therapeutic measures, we found no significant association of overall survival time within 2 years with any of these rCBV values.

Although patients who survived less than 2 years had a higher mean and maximum rCBV and a larger variation of rCBV, rCBV itself may not be used independently for predicting 2-year survival of patients with astrocytic brain tumors.

Although patients who survived less than 2 years had a higher mean and maximum rCBV and a larger variation of rCBV, rCBV itself may not be used independently for predicting 2-year survival of patients with astrocytic brain tumors.