Flood Risk Management and its Compliance in Loko Community Adamawa State, Nigeria

Flood risk management functions to reduce socio-economic and human resources associated with disasters. This study investigates flood risk administration for the socio-demographic progress of the Loko Community in the Song local government area in Adamawa State, Nigeria. The study’s objective was to evaluate the compliance levels to flood risk management practices, challenges and interventions adopted to address the concerns. The study utilized a case study research design while targeting a population of 4,200 inhabitants comprising, 800 households, 20 NEMA staff and 40 ADSEMA staff. The findings indicated that floods significantly affects the socio-economic condition and livelihoods of the people. Moreover, the study found that institutional, cultural, and demographic factors limited compliance to FRM practices, necessitating the adoption of appropriate interventions. Therefore, it is necessary because homes far from flood-prone areas will mitigate the adverse flood effects. Similarly, the Ministry of Agriculture and Cooperatives through the Extension Services should incentivize the communities through funding to increase the area cultivated on the upland to enhance the food security at the household level. There should be increased support programmes for the affected, and viable farmers prioritized for the support programmes. The study concludes that there is a need to develop better and appropriate measures to prepare and mitigate the effects of floods. Socio-economic problems such as poverty, livelihood profile, cultural views, the position of weaker social groups, and the rights of minorities and ethnic groups must be addressed urgently.

Clozapine and COVID-19: A Case Report and Clinical Considerations

Background: The emergence of coronavirus SARS-CoV-2, and the subsequent global epidemic of COVID-19, brought with it innumerable new clinical experiences across all medical specialties, and psychiatry is no exception. Individuals with serious mental illness, in particular schizophrenia and related disorders, may be especially susceptible to coronavirus infection given the overlapping risk factors of vulnerable sociodemographic status, increased challenges with quarantining requirements, and limited compliance with “respiratory etiquette.” The case presented here describes a patient with schizophrenia who was being managed on clozapine and who developed symptomatic COVID-19 infection. Special care was taken to ensure that potential interactions between clozapine and the associated COVID-19 treatments were safe for the patient’s mental and physical wellbeing. Case Presentation: A 71-year-old schizophrenic Caucasian male is being managed with clozapine. While hospitalized, the patient was screened positive for COVID-19 and was admitted to the ICU due to his declining respiratory status. He was treated with both remdesivir and prednisone. He was able to fully recover from his COVID-19 infection. Conclusion: The authors review the clinical characteristics of the case, highlighting both the overlapping synergistic effects and antagonistic influences of clozapine therapy in combination with COVID-19 and its associated treatments. A review of the literature offers an opportunity to examine various frameworks for individualized clinical decision-making while making the case for greater epidemiologic research into the optimal management of individuals with a psychotic disorder who are diagnosed with COVID-19 infection.

Occupational Disruption during the COVID-19 Pandemic: The Lived Experience of Community-Dwelling Older Adults

This qualitative descriptive study presents the experience of an abrupt disruption of daily activities among community-dwelling older adults during the early months of the COVID-19 pandemic. Sixteen older adults (age: 71 ± 6.4) were interviewed in April–June, 2020. Five themes were identified: (1) Understanding and applying COVID-19 guidelines: guidelines were clear and participants adhered closely to them, motivated mainly by fear; ageing-specific guidelines are needed. (2) Daily life during lockdown: the abrupt occupational disruption was managed by transitioning to virtual activities, and/or performing more activities at home. New daily activities were generally more sedentary and less meaningful. (3) Social context: family assistance aroused mixed feelings, as it compromised independence; limited compliance at the community level created stress. (4) Mood and affect: mood often fluctuated, and participants employed various coping strategies. (5) Aging: participants became more aware of their age and were concerned about negative health implications of adherence to COVID-19 guidelines.

The Social, Economic, and Environmental Impacts of Ridesourcing Services: A Literature Review

The proliferation of ridesourcing services has raised both hopes and concerns about their role in cities. The impacts of ridesourcing services are complex and multi-faceted. Through reviewing the literature, this study aims to identify the social, economic, and environmental impacts of these services and highlight opportunities and challenges that lay ahead of them for resolving issues related to urban transportation. According to the results, ridesourcing services offer safe modes of transport that provide convenient mobility options, improve transit availability in disadvantaged and remote areas, and respond to taxi demand fluctuations. They can create new job opportunities by employing new human resources that have not been used before, provide flexible working hours for drivers, and are more efficient than taxi cabs. These services provide other opportunities to extend or complement public transit, reduce car ownership and congestion, and minimize parking supply. However, they are criticized for unfair competition with traditional taxis, limited compliance with social legislation, and lack of affordability. They are not available in all places and exclude some vulnerable and socially disadvantaged groups. Labor rights are not secure in this industry, and driver income is not stable. Finally, there is also evidence showing that, in some cases, they contribute to the growth of VMT, energy use, greenhouse gas emissions, and congestion in cities.

The Dialectic of Transnational Integration and National Disintegration as Challenge for Multilevel Governance

A large number of studies have detected that within the EU multilevel governance there is a transformation toward a hybrid knowledge co-production that overcomes traditional categories such as locality or embeddedness. There, a sort of sustainable decision-making knowledge is co-developed and theoretically supposed to be applied top-down on the national level of EU member states. However, in practice such processes of unification are always associated with a risk of limited compliance with specific national situations and with a specific national “world of relevancies”. Despite the rise in popularity of these top-down initiatives within international policy levels, there is a lack of studies that empirically analyze how national policy systems respond to these global standardization approaches. Therefore, the central aim of this study is twofold: Based on an exemplary case of an international information system co-produced by an expert group of the European Commission, it first reconstructs whether and how transnational information is integrated on the national policy level. Second, it elucidates factors limiting an application. The results show that this international knowledge system was used for basal purposes and was mainly challenged by non-compliance with national specificities and the existence of alternative knowledge sources.

Compliance of Goat Farming under Extensive Grazing with the Organic Standards and Its Contribution to Sustainability in Puebla, Mexico

In order to determine whether organic production may be a viable option for goat farmers of the lower Mixteca region of Puebla, Mexico, in order to increase sustainability of their farms, we evaluated the extent to which these goat farms fulfill organic standards. Additionally, we revised their level of sustainability by calculating an Organic Livestock Conversion Index (OLCI) using 10 indicators and 36 variables. Information was obtained through two means: direct observation and a questionnaire applied to 119 goat farmers of six municipalities of the region. These goat farms principally consist of creole goats that graze in extensive communal rangelands and grasslands in non-arable lands with xerophytic vegetation, and their principal product is meat of adult goats. The goat farms had a moderate level of OLCI (48.0–53.6%) as well as a moderate level of sustainability (46.0–58%) for the goat farms included in this study). Five indicators showed limited compliance of the goat farms, with organic standards. Five showed a high level of compliance. The greater the OLCI value, the greater the sustainability of the goat farms. Increasing the level of compliance of the goat farms of the lower Mixteca region of Puebla, with the organic standards, which would in turn increase their level of sustainability, would require improving technical, social, environmental, and economic aspects of these farms, as well as co-responsibility in promoting sustainable organic goat farming by the different social actors involved (farmers, researchers, technical advisors, and policymakers).

Monitoring of the Мain Рarameters of Еnvironmental Safety Industrial Production

A critical analysis of the existing approaches to monitoring the main parameters of the environmental safety of industrial production is presented, a number of shortcomings are revealed associated with the limited compliance methods for assessing the compliance of environmental indicators with current standards, or the degree of information transparency of companies; the lack of consideration of the impact of dividend and investment policies of companies on the environmental safety of industrial production; lack of comparability of environmental performance in public reports. The scientific novelty of the proposed monitoring lies in the use of a systematic approach to the formation of the main parameters of environmental safety and the expansion of monitoring directions by including trends in the relationship between economic and environmental indicators calculated from the data of public reports of companies. The study was carried out on the example of the metallurgical industry in Russia, which made it possible to assess the representativeness of environmental reports and trends in the environmental safety of the industry.

Piloting a Quality Improvement Intervention for Urinary Catheter Removal to Reduce Catheter-Associated Urinary Tract Infection in a Medical Intensive Care Unit

Background: Catheter-associated urinary tract infections (CAUTIs) are among the most prevalent healthcare-associated infections (HAIs) globally, contributing to increased morbidity, prolonged hospital stays, and increased healthcare costs. Interventions that support prompt removal of the urinary catheter are evidence-based actions to effectively reduce CAUTI rates.1Objective: At the National Hospital of Tropical Disease (NHTD), catheter removal interventions in the intensive care unit (ICU) were implemented using quality improvement (QI) methodology to reduce CAUTI incidence and urinary catheter device utilization. Methods: Training was performed for ICU clinical staff with knowledge checks before and after the program. A bedside visual reminder of CAUTI risk and checklist to assess catheter need were implemented. Weekly compliance of provided visual reminders and checklists were measured using a simple audit tool. Device utilization ratios (DURs, ratios of device days to patient days), and CAUTI incidence rates (per 1,000 device days) were collected at baseline (July–September 2018) and quarterly thereafter until June 2019. Statistical significance was determined by an independent t test. Results: In the first quarter (October–December 2018), the CAUTI incidence rate decreased from 8.9 to 1.3 per 1,000 device days (P = .036). The ICU staff trained in CAUTI prevention, mean knowledge scores before and after training increased from 68% to 87%. The DUR decreased slightly from 0.59 to 0.55 after the first-quarter training then steadily increased in the following quarter (0.60; January–March 2019) and after the intervention (0.54; April–June 2019). CAUTI incidence rates also increased but were still lower than at baseline: 4.8 and 6.3 per 1,000 days of device use. Compliance of reminders was 51% during the first quarter, increased slightly in the second quarter 62%, then decreased to 40% during the last quarter. The nurses’ adherence to the daily checklist remained stable (>75%). Conclusions: This CAUTI prevention project was the first use of quality improvement methodology to implement change at NHTD. A trend decrease in CAUTI was observed, though a greater decrease occurred at the beginning of the intervention. Limited compliance of daily reminders is likely reflected in no statistically significant decrease in DUR. Possibly, this quality improvement project raised awareness among clinicians to improve general CAUTI prevention practices in the ICU without decreasing DUR. Given limited compliance with reminder and checklists, the intervention will be revised during the next PDSA cycle to improve adherence.1Meddings J, Rogers MA, Krein SL, Fakih MG, Olmsted RN, Saint S. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual Saf 2014;23:277–289.Funding: NoneDisclosures: None

Sustained virologic suppression with abacavir, emtricitabine, and crushed dolutegravir and tenofovir alafenamide in a patient with HIV and eosinophilic esophagitis

We report the use of crushed dolutegravir (DTG) and tenofovir alafenamide (TAF) tablets in a 27-year-old man with progressive dysphagia due to eosinophilic esophagitis, which severely limited compliance, leading to viral resistance. Based on his drug resistance history, allergies, and inability to swallow tablets intact, he was transitioned to DTG 50 mg (crushed), TAF 25 mg (crushed), liquid abacavir (20 mg/ml) 30 ml, and liquid emtricitabine (10 mg/ml) 24 ml orally daily. After receiving this regimen for five months, the patient’s HIV viral load decreased from 9910 to 59 copies/ml and after ten total months became suppressed at <20 copies/ml. Our case report suggests administration of crushed DTG and TAF tablets may be a viable option for patients with dysphagia and limited treatment options.

Reforming the Role of the African Commission on Human and Peoples’ Rights in Advancing Democratic Principles and Human Rights in African Countries: An Examination Using the Lens of Swaziland/ eSwatini

This article explores the role of the African Commission on Human and Peoples’ Rights and the role it plays regarding human rights in individual country situations in Africa. It specifically examines the extent to which it has been able to advance a human rights agenda in countries with long-standing human rights problems. The article uses Swaziland/ eSwatini as a lens to examine the matter, because of the longstanding problems that exist in that country. This is done to indicate how the institution works over time on a country’s human rights problems. The article examines a range of institutional structural matters to establish how these issues affect the role of the Commission in its work. The article examines the way in which the Commission uses its various tools, including its communications, the state reporting processes, fact-finding visits, and resolutions, to determine whether those tools are being used effectively. The article examines how the Commission’s processes issues also affect it work. Issues examined negatively affecting the Commission are examined, including problems with the status of its resolutions and communications, limited compliance with its outcomes, and inadequate state cooperation. Reforms necessary to enhance to role and functions of the Commission are surveyed to determine how the institution could become more effective. The African Union’s (AU|) Kagame Report on AU reform is briefly reviewed to examine the limited view and focus of AU reform processes and why AU reform ought to focus on enhancing human rights compliance. The article makes various suggestions on necessary institutional reforms but also as far as the African Commission’s procedures and methods of work to allow it to have a far more effective role in the promotion and protection of human rights on the continent. It is noted that political will by the AU and African states is the largest obstacle to giving the Commission the necessary independence, support and assistance that it needs to play the role in Africa that it should.