Mepilex Border Sacrum and Heel Dressings for the Prevention of Pressure Ulcers: A NICE Medical Technology Guidance.

Mepilex Border Sacrum and Heel dressings are self-adherent, multilayer foam dressings designed for use on the heel and sacrum aiming to prevent pressure ulcers. The dressings are used in addition to standard care protocols for pressure ulcer prevention. The National Institute for Health and Care Excellence (NICE) selected Mepilex Border Sacrum and Heel dressings for evaluation. The External Assessment Centre (EAC) critiqued the company's submission. Thirteen studies (four randomised controlled trials and nine nonrandomised comparative studies) were included. The majority of studies compared Mepilex Border Sacrum dressings (plus standard care) with standard care alone. Comparative evidence for Mepilex Border Heel dressings was limited. A meta-analysis indicated a non-statistically significant difference in favour of Mepilex Border Sacrum dressings for pressure ulcer incidence [RR 0.51 (95% CI 0.22-1.18)]. The company produced a de novo cost model, which was critiqued by the EAC. After the EAC updated input parameters, cost savings of £19 per patient compared with standard care alone for pressure ulcer prevention were estimated with Mepilex Border dressings predicted to be cost saving in 57% of iterations. The Medical Technologies Advisory Committee reviewed the evidence and judged that, although Mepilex Border Heel and Sacrum dressings have potential to prevent pressure ulcers in people who are considered to be at risk in acute care settings, further evidence is required to address uncertainties around the claimed benefits of the dressings and the incidence of pressure ulcers in an NHS acute-care setting. After a public consultation, NICE published this as Medical Technology Guidance 40.

Assessment of water quality of rivers that serve as water sources for drinking and domestic functions in rural and pre-urban communities in Edo North, Nigeria.

Surface waters are important to humans because they are a significant water supply source. They are, however, under serious environmental stress and are being threatened as a consequence of developmental activities. The present study describes the physicochemical properties and water quality indices of five different rivers used for drinking and other domestic activities in rural and pre-urban communities in Edo North, Nigeria. The physicochemical variable ranges include pH [wet season (6.47 ± 0.30-6.89 ± 0.11), dry season (6.61 ± 0.14-7.84 ± 0.24)], electrical conductivity (EC) [wet season (3.33 ± 0.57-12.33 ± 2.51 µS/cm), dry season (5.33 ± 0.57-21.33 ± 2.08 µS/cm)], water temperature [wet season (24.23 ± 0.98-25.40 ± 1.15 °C), dry season (26.20 ± 0.55-27.10 ± 0.75 °C)], TDS [wet season (417.00 ± 15.87-433.33 ± 18.50 mg/L), dry season (319.33 ± 16.50-372.66 ± 22.30 mg/L)], turbidity [wet season (1.01 ± 0.11-2.08 ± 0.99 NTU), dry season (3.11 ± 0.01-5.41 ± 0.24 NTU)], and DO [wet season (2.65 ± 0.37-3.99 ± 0.01 mg/L), dry season (2.12 ± 0.11-2.44 ± 0.01 mg/L)]. For the wet and dry seasons, the water quality indices were 120.225 and 585.015 for River Osolo, 119.849 and 445.751 for River Foreign, 200.474 and 587.833 for Ijoh River, 105.261 and 512.498 for Ole River, and 150.114 and 489.992 for Ole Extension River, respectively. The pH was negatively correlated with DO (r = -0.648), and EC was negatively correlated with DO (r = -0.635). Most of the evaluated parameters were within recommended water safety guidelines. However, the water quality index shows that the water quality was very poor and/or unsuitable for drinking and other domestic uses, especially during the dry season. It is suggested that river water be treated prior to its use for drinking and other domestic purposes.

Biotreatment of effluent from 'Adire' textile factories in Ibadan, Nigeria.

In this present study, bacteria were isolated from wastewater and polluted soil collected from two cottage textile factories in Ibadan. These bacteria isolates were used for the biotreatment of textile mill effluent. The physicochemical parameters of the textile mill effluent before treatment were carried out and percentage decolourisation of the effluent was analysed using ultraviolet-visible spectroscopy (UV-vis technique). The degradation products of the textile mill effluent characterised by Fourier transform infrared spectroscopy (FTIR). The pH values of the effluent were within the permissible limit of Federal Environmental Protection Agency (FEPA) and National Environmental Standards and Regulations Enforcement Agency (NESREA), while temperature and electric conductivity of the effluents were below the permissible limit of FEPA and NESREA. The BOD, COD, TSS, TDS and chloride of the textile mill effluent from the two cottage textile factories were above the permissible limits of FEPA and NESREA. Twelve bacteria isolates were screened, effective in decolourising commercial dyes and used to decolourise the textile mill effluent. The bacteria isolates were characterised and identified as Bacillus sp., Micrococcus sp., Erwinia sp., Acinetobacter sp. and Nocardia sp. The decolourisation of textile effluent was observed through the changes of spectra of UV-visible spectrophotometer. The following bacteria revealed different percentage proportion of decolouration profile:- Bacillus sp., had the highest percentage decolourisation of 57.7%, whereas Micrococcus sp. and Acinetobacter sp. had percentage decolourisation of 32.8 and 26.3%, respectively. The degradation profile of textile effluent was revealed through FTIR spectral analysis. The changes in the position of major peaks revealed from the textile effluent through FTIR spectral analysis, appearances of new peaks and the disappearances of existing peaks signify the degradation of the wastewater. Thus, some native microorganisms from the textile effluent could be enhanced to effectively degrade effluent from such environments.

Management of conflicts arising from disclosure of HIV status among married women in southwest Nigeria.

This study examined if disclosure to their spouses by married women living with HIV/AIDS resulted in conflicts. Fifty-seven women completed a questionnaire on conflict indicators. While 93% disclosed their status within 6 months of diagnosis, 12.3% did so through a third party. More than thirty-six percent (36.8%) confirmed that disclosure led to conflict. Although 19.3% had their conflicts resolved through a third party, 10% suffered separation. Marital status and fear of stigma significantly influence time to disclose (p <.01 and p <.05), while type of marriage strongly influences whether status will be disclosed (p <.01). Programs for women with HIV should consider conflicts that may arise from disclosure.

Chemometric analysis of ecological toxicants in petrochemical and industrial environments.

The application of chemometrics in the assessment of toxicants, such as heavy metals (HMs) and polycyclic aromatic hydrocarbons (PAHs) potentially derived from petrochemical activities in the microenvironment, is vital in providing safeguards for human health of children and adults residing around petrochemical industrial regions. Several multivariate statistical methods are used in geosciences and environmental protection studies to classify, identify and group prevalent pollutants with regard to exhibited trends. Chemometrics can be applied for toxicant source identification, estimation of contaminants contributions to the toxicity of sites of interest, the assessment of the integral risk index of an area and provision of mitigating measures that limit or eliminate the contaminants identified. In this study, the principal component analysis (PCA) was used for dimensionality reduction of both organic and inorganic substances data in the environment, which are potentially hazardous. The high molecular weight (HMW) PAHs correlated positively with stronger impact on the model than the lower molecular weight (LMW) PAHs, the total petroleum hydrocarbons (TPHs), PAHs and BTEX correlate positively in the F1 vs F2 plot indicating similar source contributions of these pollutants in the environmental material. Cu, Cr, Cd, Fe, Zn and Pb all show positive correlation in the same space indicating similar source of contamination. Analytical processes involving environmental assessment data obtained in the Niger Delta area of Nigeria, confirmed the usefulness of chemometrics for comprehensive ecological evaluation.

Exploring the cultural context of HIV stigma on antiretroviral therapy adherence among people living with HIV/AIDS in southwest Nigeria.

This study explored the cultural context of HIV stigma on antiretroviral therapy adherence among people living with HIV/AIDS (PLWHA) in southwest Nigeria. Using purposive sampling, participants were recruited through a community-based organization. Consenting PLWHA participated in in-depth interviews and focus group discussions that were audio-taped. Using Deacon's conceptual framework of stigma, four opinion guides facilitated the interviews and discussions. Interviews and discussions were conducted in three languages, and lasted from 45 min to 2 h. A total of 35 women and men participated in the study. Participants ranged in age from 22 to 58 years, with an average of 4 years since clinical diagnosis of HIV/AIDS. All participants were receiving ART, and self-reported high adherence level. Using thematic analysis, three themes emerged: life before ART, life after ART, and strategies used in ART adherence. In describing their lives before ART, participants reported experiencing self, anticipated and enacted stigmas due to their sickly appearance from HIV-related complications. After initiating ART, participants talked about friends and families "returning to them" and "apologizing for abandoning" them once they started "looking well." In response to anticipated stigma, many reported sticking to their medications. Drawing from the cultural milieu as part of their strategies, participants discussed the use of plastic bags for medications and àkònpó, as ways of diverting attention from their use of many medications. Implications for ART program policies and stigma interventions were discussed, along with limitation of a short-term ART study on stigma since long-term use of ART can contribute to stigma by way of lipoatrophy as PLWHA age.