Strengthening Visceral Leishmaniasis Diagnosis Capacity to Improve Access to Care in Kenya: The Example of Marsabit County

BackgroundVisceral leishmaniasis (VL), also known as kala-azar, is a neglected tropical disease (NTD) that is fatal if not treated early. The WHO targets the elimination of VL as a public health problem in its 2030 NTD road map. However, improving access to VL diagnosis and treatment remains a major challenge in many VL-endemic countries. Kenya is endemic for VL and is among the top 6 high-disease burden countries in the world.MethodsFIND, through its activities in improving the diagnosis of VL and supporting the elimination of the disease in Kenya, has worked with various county ministries of health (MOH) and central MOH over the last couple of years. FIND’s activities in Marsabit county started in 2018. In this work, we present the implementation of activities and the impacts in Marsabit county. We reviewed the data for 2017 and 2019 outbreaks (before and after the implementation of FIND’s activities) and assessed the importance of improving access and community sensitization to VL diagnosis. We assessed the contribution of each facility to the total distance traveled from a perspective of location optimization.ResultsThere was a sharp increase in the number of people tested in the 2017 outbreak compared to the 2019 outbreak. In 2017, 437 people were tested compared to 2,338 in 2019. The county reported 234 and 688 VL cases in 2017 and 2019, respectively. The data revealed a shift in the demographic structures of cases toward the younger population (mean age in 2017 was 17.6 years and 15.3 years in 2019), with more female cases reported in 2019 compared to 2017. In 2017, 44.4% were 10 years of age or under. In 2019, the proportion 10 years or below was 52.2%. The addition of two new diagnosis facilities in 2018 resulted in a decrease in the distance traveled by confirmed VL cases from 28.1 km in 2017 to 10.8 km in 2019. Assessing the impact of facility placement indicated the most optimal facilities to provide VL diagnostic services and minimize the distance traveled by patients. Adding new facilities reduces the travel distance until a point where the addition of a new facility provides no additional impact.ConclusionThe results from this study indicate the need to carefully consider the placement of health facilities in improving access to VL diagnosis and treatment and could serve as an investment case in deciding when to stop adding new facilities in a particular setting. Extending the activities in Kenya to other VL-endemic countries in East Africa will contribute significantly toward the elimination of the disease, addressing the needs of marginalized populations and leaving no one behind.

A striking growth of CO2 emissions from global cement industry driven by new facilities in emerging countries

Global industrialization and urbanization processes enabled a diverse cement production boom over the past three decades, as cement is the most important building construction material. Consequently, the cement industry is the second-largest industrial CO2 emitter (~25% of global industrial CO2 emissions) globally. In this study, the Global Cement Emission Database, which encompasses anthropogenic CO2 emissions of individual production units worldwide for 1990-2019, was developed. A recently developed unit-level China Cement Emission Database is then applied to override China’s data and the combination of two database is used to reveal the unit characteristics of CO2 emissions and ages for global cement plants, assess large disparities in national and regional CO2 emissions, growth rates and developmental stages from 1990-2019, and identify key emerging countries of carbon emissions and commitment. This study finds that globally, CO2 emissions from the cement industry have increased from 0.86 Gt in 1990 to 2.46 Gt in 2019 (increasing by 186%). More importantly, the large CO2 emissions and the striking growth rates from those emerging countries, including most of developing countries in Asia and the Middle East and Africa, are clearly identified. For example, the Middle East and Africa, including mostly developing or underdeveloped countries, only represented 0.07 Gt CO2 in 1990 (8.4% of the total), in contrast to 0.26 Gt (10.4% of the total) CO2 in 2019, which is a 4.5% average growth rate during 1990-2019. Further, the intensive expansion of large and new facilities since 2005 in Asia and the Middle East and Africa has resulted in heavy commitment (90.1% of global commitment in 2019), and mitigation threats in the future considering their increasing emissions (national annual growth rate can be up to >80%) and growing infrastructure construction (~50% of clinker capacity operating ≤10 years). Our results highlight the cement industry’s development and young infrastructure in emerging economies; thus, future increasing cement demand and corresponding carbon commitment would pose great challenges to future decarbonization and climate change mitigation.

Design and Fabrication of Elevators Using AVR Microcontroller

Men, along with the progress in his civilization and daily life, felt the need more and more every day that in addition to all the facilities and tools he had created for himself to move horizontally, he needed a tool to move himself and his tools and loads in the horizontal direction. Is. Images have been recorded in history that show that he invented methods for vertical movement in the distant past. Initially, this was done by levers and animals. An elevator is a permanent public vehicle that moves between predefined levels. The elevator is the only means of transportation used by all age groups and is the most common means of vertical movement in the world. The elevator is installed inside an environment that consists of three parts: 1. Engine room 2. Elevator well 3. Well. The gearbox motor acts as the heart of the elevator and the control panel acts as the core of the elevator. The aim of this research is to simulate and build the circuit and the building of the elevator so that it can be equipped with new facilities and sensors by using reprogramming if necessary to make its operation safer and provide more comfort for the passengers. Here we have programmed the AVR microcontroller using codevisionAVR software and performed the simulation using Proteus software.

Architecture and Recreation as a Political Tool—Seaside Architectural Heritage of the Worker Holiday Fund (WHF) in the Era of the Polish People’s Republic (1949–1989)

The Worker Holiday Fund (WHF) was set up just after the Second World War as a state-dependent organization that arranged recreation for Polish workers under the socialist doctrine. The communist authorities turned organized recreation into a tool of indoctrination and propaganda. This research aims to characterize the seaside tourism architecture in the Polish People’s Republic (1949–1989) against the background of nationalized and organized tourism being used as a political tool, to typify the architecture and to verify the influence of politics on the development of holiday architecture in Poland. The research methodology is based on historical and interpretative studies (iconology, iconography and historiography) and field studies. The research helped distinguish four basic groups of holiday facilities: one form of adapted facilities (former villas and boarding houses) and three forms of new facilities (sanatorium-type, pavilion-type and lightweight temporary facilities, such as bungalows and cabins). The study found that each type of holiday facility was characterized by certain political significance and social impact. Gradual destruction was the fate of a significant part of WHF facilities, which, in the public awareness, are commonly associated with the past era of the Polish People’s Republic (PRL) as an “unwanted heritage”.

Low-Energy Coulomb Excitation for the Shell Model

Low-energy Coulomb excitation is capable of providing unique information on static electromagnetic moments of short-lived excited nuclear states, including non-yrast states. The process selectively populates low-lying collective states and is, therefore, ideally suited to study phenomena such as shape coexistence and the development of exotic deformation (triaxial or octupole shapes). Historically, these experiments were restricted to stable isotopes. However, the advent of new facilities providing intense beams of short-lived radioactive species has opened the possibility to apply this powerful technique to a much wider range of nuclei. The paper discusses the observables that can be measured in a Coulomb-excitation experiment and their relation to the nuclear structure parameters with an emphasis on the nuclear shape. Recent examples of Coulomb-excitation studies that provided outcomes relevant for the Shell Model are also presented.

Study of the operation features of CHP cooling tower in conditions of forced air supply

In our country, at thermal and nuclear power plants, tower cooling towers built in 1960-1975 are still in operation. At the same time, the construction of new facilities and the modernization of existing installations requires a high-quality mathematical study of technical solutions. As part of the work, it is proposed to simulate the operation of a tower cooling tower, subject to additional forced air supply. Using the equations of heat and material balance for the cooling tower, a mathematical model of the operation of the cooling tower was developed in Microsoft Excel. The modelling of the operation of the cooling tower in the design conditions of the city of Yoshkar-Ola, as well as when installing additional fans of various capacities, has been carried out.

Physical parameters for the estimation of the return coefficient in the sewer of the La Chivera watershed

Estimating the amount of flow carried by the sanitary sewer system in a locality is essential for the design of new facilities. Having a record of the flow rates allows the adequate hydraulic design of a drainage system. The objective of this work is to determine the physical parameters for the estimation of the return coefficient that allows estimating the flow rates for the sanitary sewer of the La Chivera watershed, San José de Cúcuta, Colombia. In this sense, dry weather monitoring of the wastewater in the study area was carried out. The data collected in the field were used to construct the hourly flow variation curve or inflow hydrograph in the drainage system. The average hourly flow parameters were estimated with a value of 205.7 m3/h, a value recorded at the 11th hour of the day. Similarly, the average daily flow was determined with a value of 180.3 m3/h, while the maximum peak factor was 1.14. Finally, through the physical parameters of the sanitary sewer, the return coefficient was determined, which is 0.72, a value that represents the conditions of the study area.

Equity of geographical access to public health facilities in Nepal

IntroductionGeographical accessibility is important against health equity, particularly for less developed countries as Nepal. It is important to identify the disparities in geographical accessibility to the three levels of public health facilities across Nepal, which has not been available.MethodsBased on the up-to-date dataset of Nepal formal public health facilities in 2021, we measured the geographical accessibility by calculating the travel time to the nearest public health facility of three levels (ie, primary, secondary and tertiary) across Nepal at 1×1 km2 resolution under two travel modes: walking and motorised. Gini and Theil L index were used to assess the inequality. Potential locations of new facilities were identified for best improvement of geographical efficiency or equality.ResultsBoth geographical accessibility and its equality were better under the motorised mode compared with the walking mode. If motorised transportation is available to everyone, the population coverage within 5 min to any public health facilities would be improved by 62.13%. The population-weighted average travel time was 17.91 min, 39.88 min and 69.23 min and the Gini coefficients 0.03, 0.18 and 0.42 to the nearest primary, secondary and tertiary facilities, respectively, under motorised mode. For primary facilities, low accessibility was found in the northern mountain belt; for secondary facilities, the accessibility decreased with increased distance from the district centres; and for tertiary facilities, low accessibility was found in most areas except the developed areas like zonal centres. The potential locations of new facilities differed for the three levels of facilities. Besides, the majority of inequalities of geographical accessibility were from within-province.ConclusionThe high-resolution geographical accessibility maps and the assessment of inequality provide valuable information for health resource allocation and health-related planning in Nepal.

The diagnostic audit of the management system complies with the requirements of GOST R ISO 9001-2015 of the fish processing industry

Для повышения конкурентоспособности рыбохозяйственного комплекса в настоящее время в России происходят модернизация уже существующих предприятий отрасли и создание новых объектов с высококвалифицированным персоналом. Улучшить результаты деятельности таких предприятий позволит применение системы менеджмента качества - ГОСТ Р ИСО 9001-2015. Ведь именно качество продукции определяет не только конкурентоспособность организации, но и дает возможность выбиться в лидеры. Проанализирована результативность действующей системы управления, ее способность добиваться нужных целей в компании; определен уровень соответствия требованиям стандарта ГОСТ Р ИСО 9001-2015 и выполнению правил СМК, установленных в документации самой организации; проведена оценка качества выполняемых работ путем контроля соответствия результатов работ и требований, установленных в документации; оценена готовность системы менеджмента организации к сертификации; выявлены несоответствия и предложены корректирующие действия. To increase the competitiveness of the fishery complex, currently existing enterprises of the industry are being modernized in Russia and new facilities with highly qualified personnel are being created. The performance of such enterprises will be improved by the use of a quality management system - GOST R ISO 9001-2015. After all, it is the quality of products that determines not only the competitiveness of the organization, but also makes it possible to break out into the leaders. Analyzed the effectiveness of the current management system, its ability to achieve the desired goals in the company; the level of compliance with the requirements of the GOST R ISO 9001-2015 standard and the implementation of the QMS rules established in the documentation of the organization itself was determined; the quality of the work performed was assessed by monitoring the compliance of the work results and the requirements established in the documentation; assessed the readiness of the organization's management system for certification; nonconformities are identified and corrective actions are proposed.

REVITALIZATION OF THE AREA OF FORT III GRAF KIRCHBACH AS AN ELEMENT OF RESPONSIBLE URBANIZATION OF THE CITY OF POZNAŃ

The paper aim is to examine urban and spatial possibilities of the Poznań Fort III area in the context of the implementation of the city's spacial policy. Urbanisation based on executing new facilities and investments results in the creation of diverse urban landscape. This contrast concerns not only the visual perception, but also also uneven use of different parts of the city. The aim of the study is to present a strategy for the revitalisation of the Fort Graf Kirchbach in the accordance with the principles of responsible urbanisation.