Safety Challenges in Transportation in Nigeria – A Relative Risk Approach

This study investigates safety challenges in transportation in Nigeria across the six geopolitical zones of the country comprising South-South, South-East, North-West, North-Central, North-East and South-West geopolitical Zones. Both primary and secondary data were employed, and the Multinomial Logistic Regression Model, with specific adoption of the Relative Risk Ratio approach, is the method of analysis. The main concern is examination of exposed and unexposed commuters in the various locations to determine the degrees of exposure to risks associated with ‘basket’ of modes, state of infrastructures and specific risk factors, which account for the fatalities observed on the different roads under consideration. It is found that the six geopolitical zones have various degrees of risks exposure while North-West, North-Central and South-West zones showed significant risk difference between the exposed and the unexposed groups due to risk factors such as bad roads, road blockage/obstruction, kidnaping, unmaintained vehicles, overloading, over speeding and other forms of reckless use of the roads etc. The study recommends risk avoidance education to commuters as new strategies in vulnerable zones and increased deployment of well-trained community road marshals and other relevant security personnel to monitor situations and provide safety for road users. Also, a working transportation policy must be evolve to mitigate the risk factors highlighted above.

Women’s Literature in African History

African literature refers to (a) African oral literature (also called Orature) and (b) written African literature from West, North, Central, East, and Southern Africa. African oral literature encompasses works from Africa’s ancient and classical narrative traditions and spans oral narratives, proverbs, drama, poetry, chants and songs, riddles, and so on. With the earliest known works located in ancient Egypt, written African literature includes inscriptions on pyramid walls, the short story, the novel, poetry, drama, autobiography, and so forth. Women’s literature in Africa refers to African literatures by and about women. While storytelling styles vary by region and experiences shaped by history and society, the themes are linked by complex worldviews rooted in a common evocation of human experiences that seem unique to the continent. The languages of African literature include Africa’s indigenous languages as well as the languages acquired by different African societies as a result of the continent’s encounters with the East and experiences of Western colonization.

Meropenem-Vaborbactam Activity against Carbapenem-Resistant Enterobacterales Isolates Collected in U.S. Hospitals during 2016 to 2018

The activities of meropenem-vaborbactam and comparators against 152 (1.1%) carbapenem-resistant Enterobacterales (CRE) isolates identified among 13,929 Enterobacterales isolates collected from U.S. hospitals during 2016 to 2018 were evaluated. CRE rates were higher in the Middle Atlantic census division (3.5%) than in the other divisions (range, 0.0% for the West North Central division to 1.4% for the West South Central division).

THE CHANGES OF CLOUD COVER CHARACTERISTICS OVER TERRITORY OF UKRAINE DURING OF THE GLOBAL WARMING

The statistical estimation of changes of the cloud cover characteristics was made by the data of the meteorological observations over Ukraine during 1961-2017. Such characteristics as the quantity of total and lower cloudiness, the frequency of clear and overcast sky, the frequency of main cloud forms were analyzed. Monthly, seasonal and annual observational data were used for computation of the trends, the sliding of thirty years (1961-1990, 1971-2000, 1981-2010, 2001-2017) and the fluctuations between successive decades in regions (west, north, central, east and south). The clear sky frequency for total cloudiness was decreasing with different intensity in all regions. This decreasing was forcing all time on west and east and against the gradually stopping on central and south and forcing in third sliding of thirty years and stopping in fourth on north. The clear sky frequency for lower cloudiness was more complex and indeterminate. The overcast sky frequency for total and lower cloudiness was decreasing all time in all regions with different intensity in space and time. The half-clear sky frequency for total and lower cloudiness was forcing all time in all regions with different intensity in space and time. The quasi-periodicity changes of the cloud cover characteristics for total and lower cloudiness confirm the fluctuations of the changes between the successive decades. These changes agree with the corresponding changes of air pressure on level sea. The decreasing of the frequency of main cloud forms was 55 %, the increasing was 45 %. The increasing of the frequency Cb, Ac, Cc and Ci was all time over all territory

1191. Prevalence and Microbiology of Carbapenem Resistance Among Six Gram-Negative Pathogens in Bloodstream Infections in US Hospitals, 2010–2015

Background Carbapenem resistance (CR) is a growing threat in hospitals in the United States and worldwide. We evaluated the prevalence and geographic distribution of CR among six most common Gram-negative (GN) bloodstream infection (BSI) pathogens in US hospitals. Methods We analyzed microbiology data in a cohort of adults (≥18 years) hospitalized in 181 US hospitals contributing microbiology data to the Premier Healthcare Database (October 2010–September 2015) with blood cultures positive for six most common GN pathogens (S. maltophilia assumed 100% CR). We report CR prevalence by pathogen, hospital ward (ICU vs. floor), and census region. Results Of the 43,095 GN BSIs included, 1,513 (3.5%) were caused by the six most common CR pathogens (Figure 1). CR was more frequently isolated from patients with an ICU stay (4.7%) vs. those without (2.7%). Nearly 75% (n = 1,100) of CR occurred in nonfermenters (S. maltophilia, P. aeruginosa, and A. baumannii). Among individual organisms, the prevalence of CR—outside of S. maltophilia—was highest among A. baumannii, 35.1%, and lowest among E. coli, 0.2% (Figure 2). Geographically, CR prevalence ranged from highest in the Mountain region (7.1%) to lowest in the West North Central (2.3%) (Figure 3). The maximum CR prevalence occurred in A. baumannii from the East North Central (55.7%), and the minimum in E. coli from the West North Central (0.05%) regions. Conclusion Among six most frequently isolated pathogens in BSI, the overall CR prevalence is 3.5%. The wide variations in prevalence based on organism, location in the hospital, and geography emphasize the clinical importance of knowing local pathogen and resistance patterns in order to optimize empiric treatment. Disclosures A. F. Shorr, Astellas: Consultant and Speaker’s Bureau, Consulting fee, Research support and Speaker honorarium. Cidara: Consultant, Consulting fee. Merck & Co.: Consultant and Speaker’s Bureau, Consulting fee, Research support and Speaker honorarium. T. P. Lodise Jr., Motif BioSciences: Board Member, Consulting fee.

Abstract MP75: Geographic Variation in Stroke Rates and Oral Anticoagulation Use among Medicare Beneficiaries with Atrial Fibrillation

Background: Recent studies have shown strong geographic variation in oral anticoagulation (OAC) use in atrial fibrillation (AF); however, it remains unknown how this contributes to the geographic variation in ischemic stroke observed across the US. The objective of the present study was to evaluate the relationship between the geographic variation in the initiation of OAC and the incidence of ischemic stroke in a cohort of Medicare beneficiaries newly diagnosed with AF. Methods: Using 2013-2014 claims data from a 5% random sample of Medicare beneficiaries, we identified patients newly diagnosed with AF in 2013-2014 and categorized them according to their initiation of OAC. Our sample included 21,226 OAC initiators and 20,068 patients who did not initiate OAC therapy. We assigned each patient to one of the 9 US Census Divisions using the zip code, and collected their medical claims with a diagnosis of ischemic stroke. We constructed logistic regression models to estimate the average adjusted probability of OAC initiation and Poisson models to estimate the average adjusted rate of ischemic stroke, in each Census Division. Both estimates were adjusted for demographics, eligibility for Medicaid coverage and for low-income subsidy, enrollment in a Medicare Advantage Part D plan, and a comprehensive list of clinical characteristics. We computed the correlation between the average adjusted probability of OAC initiation and the average adjusted rate of ischemic stroke at the Census Division level. Results: The probability of OAC initiation was lowest in the West South Central (0.47) and highest in the West North Central (0.54) and New England (0.54). The average adjusted rate of ischemic stroke was lowest in the West North Central (0.09) and highest in the South Atlantic (0.14) and South West Central (0.14). The average adjusted probability of OAC initiation at the Census Division level and the average adjusted rate of ischemic stroke were inversely correlated, with R=-0.576, p-value=0.10. This suggests that variation in OAC initiation likely explains at least a third of geographic variation in ischemic stroke [R 2 =(-0.576) 2 =0.332]. Conclusions: Our results suggest that geographic variations in OAC initiation within the U.S. explain, in part, variations in the incidence of ischemic stroke among AF patients. Further mechanistic research using advanced causal mediation models is warranted.

Entrepreneurship and Self-Sustainability in Nigeria

<div><p><em>The need for this study arose from the worrisome state of unemployment in the country and the obvious neglect of the direct effect of entrepreneurship to entrepreneurs. The study therefore, attempts to ascertain the possible relationship between entrepreneurship and self sustainability in Nigeria. The study adopted a survey design and the six Geo-political zones of the country; south-east, south-south, south-west, north central, north east and north west constituted the population for the study from which a purposive sample of ten (10) entrepreneurs from each zone was taken with particular reference to those that have survived the five (5) years of existence and the total was 60. Data so collected was presented in tabular form and analyzed. The Friedman’s Chi-square was instrumental in the test of the hypothesis formulated and the result showed a significant positive relationship between entrepreneurship and self-sustainability in Nigeria. The study therefore, recommended that considering the pivotal role that entrepreneurship plays in enhancing self-sustainability in the economy, all hands must be on desk to encourage and support entrepreneurial activities in order to curb the high level menace of unemployment rate as well as provide a supporting ground for economic sustainability of the country.</em></p></div>