Assessment of patients' medical fitness to drive by primary care physicians: A cross-sectional study

Objectives: Motor vehicle collisions (MVCs) are a significant health burden in Saudi Arabia. The literature has consistently indicated that chronic medical conditions, such as diabetes, heart disease, stroke, obstructive sleep apnea, and neurodevelopmental disorders, increase the risk of MVCs. Therefore, assessment of driver fitness by primary care physicians (PCPs) remains a major health intervention that might reduce MVCs. We studied the practices of PCPs in assessing medical fitness to drive in at-risk patients.

Methods: We conducted a cross-sectional study of all 88 government-funded primary care centers in the city of Riyadh, Saudi Arabia. We administered a self-reported questionnaire to PCPs that inquired about their driving risk assessment for specific medical conditions.

Results: Among all PCPs and centers, 189 PCPs (63%) from 74 centers (84%) participated in our survey. The mean age of the PCPs was 40 ± 10 years, and 108 (57%) were men. The average clinical experience of the group was 13 ± 9 years. Fewer than half of PCPs considered diabetes mellitus (45%) and obstructive sleep apnea (46%) as potential risks for MVCs. Approximately 45% of PCPs did not notify any authority or relatives of potential driving issues that they noticed in their patients. Only 15% of the participants believed that PCPs were responsible for alerting authorities about their fitness to drive.

Conclusions: PCPs did not adequately assess their patients' driving history and eligibility. Efforts are needed to improve awareness among PCPs regarding the effects of chronic medical conditions on driving.     

Cadmium and Lead Levels in Fish (Tilapia Nilotica) Tissues as Biological Indicator for Lake Water Pollution

Cadmium and lead were determined in different tissues (muscle,gill, stomach, intestine, liver, vertebral column and scales) of Tilapia nilotica from the High Dam Lake, Aswan (Egypt) to assess the lake water pollution with those toxic metals. Fish samples were chosen from different ages and weights to be analyzed along with samples of the aquatic plant(Najas armeta), sediment and lake water.The results showed that cadmium and lead concentrations were higher in fish scales and vertebral column than in the other parts of the fish. Cadmium and lead levels in High Dam lake water and fish (Tilapia nilotica) were a result of the pollution which uptakes from aquatic plants, sediments andgasoline containing lead that leaks from fishery boats. Tilapia nilotica fish was used as a good bio-assay indicator for the lake pollution with cadmium and lead. The fish musclesin this study were in the safety baseline levels for man consumption.     

Fruit Stones from Industrial Waste for the Removal of Lead Ions from Polluted Water

Lead, one of the earliest metals recognized and used by humans, has a long history of beneficial use. However, it is now recognized as toxic and as posing a widespread threat to humans and wildlife. Treatment of lead from polluted water and wastewater has received a great deal of attention. Adsorption is one of the most common technologies for the treatment of lead-polluted water. This technique was evaluated here, with the goal of identifying innovative, low-cost adsorbent. This study presents experiments undertaken to determine the suitable conditions for the use of peach and apricot stones, produced from food industries as solid waste, as adsorbents for the removal of lead from aqueous solution. Chemical stability of adsorbents, effect of pH, adsorbents dose, adsorption time and equilibrium concentration were studied. The results reveal that adsorption of lead ions onto peach stone was stronger than onto apricot stone up to 3.36% at 3 h adsorption time. Suitable equilibrium time for the adsorption was 3–5 h (% Pb adsorption 93% for apricot and 97.64% for peach). The effective adsorption range for pH in the range was 7–8. Application of Langmuir and Freundlich isotherm models show high adsorption maximum and binding energies for using these adsorbents for the removal of lead ions from contaminated water and wastewater.     

Trace elements in camel tissues from a semi-arid region

Trace and minor element concentrations differ in animal tissues as the result of the surrounding environment (feeding plants, soil contaminated with food and drinking water) and animal absorption of these elements. Concentrations of Ag, Au, Ca, Co, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, and Zn were determined from different tissues of camel (inter-costal, scapula, sirloin, flank, front knuckle and front limb) from the semi-arid areas of the Aswan desert (Wadi El-Allaqi) and from Aswan city, Egypt. The study included an assessment of these same elements in the desert and city plants used as food by the camels and in soils from the study areas. The results reveal that camel tissues from the desert areas exhibited higher concentrations of Na, Mg, K, Au, Ag, Cu, Co and Zn than in those of the city camels. These higher levels of element are because of the high concentrations of the same elements in the desert plants and soil of the desert area. This, in turn, depends upon the geological formation differences between the desert area and the city area. Camel tissues appear to concentrate high levels of Mn, Ni, Co and Mg in the scapula while flank portions concentrate high levels of Mg and K. The levels of elements in the camel tissues under study were within the recommended safety baseline levels for camel health and human use, as well as within the appropriate limits in the desert and city plants for camel use.     

Soil seed bank and seedling populations of Hordeum murinum and Cardaria draba in saffron fields

Geostatistical techniques were used to characterize the spatial relationship between Hordeum murinum and Cardaria draba seedling and soil seed bank over the entire growing season of 2004–2005 in three saffron (Crocus sativus) fields, located in Southern Khorasan (33°N latitude, 57°E longitude), Iran. The maps of H. murinum seed bank density corresponded moderately to those seedling density in a and strongly to those in b and c fields. The emergence percentage of C. draba was higher than for H. murinum in all fields. Semivariograms showed spatial autocorrelation in seed bank and seedling populations of H. murinum and C. draba in all fields. Grey-scale field maps of C. draba seed banks corresponded visually to maps of seedling populations and could have been used to target control efforts, but visual correspondence between H. murinum seed bank and seedling maps was poor.     

Animal Hair as Biological Indicator for Heavy Metal Pollution in Urban and Rural Areas

Animal hair is a good biomonitoring tool for heavy metals assessment and reflects the content of heavy metals in the forage and soil. Heavy metals Fe, Mn, Co and Ni as well as toxic metals Cd and Pb were determined in goat, sheep and camel hair, forage and soil collected from four different environmental urban and rural regions. These regions are Aswan city farms, Allaqi desert pasture, Kalabsha farms and Halaiub desert pasture at far south of Egypt. The results reveal that sheep hair contains the highest levels of Fe and Mn (879 and 55 μg/g, respectively), camel hair contains the highest Pb, whereas for goat Cd and Ni were the highest. Heavy metal concentrations in the studied hair reflect the presence of these metals in the surrounding forage and soil and vary from one area to another, and give knowledge of pollution in the area. Correlation statistics analysis and cluster analysis show a good and significant value between metals in hair and plants.     

Assessment of metals in soil extracts and their uptake and movement within Tamarix nilotica at Lake Nasser banks,Egypt

This study aims to determine heavy-metal levels in soil from the banks of Lake Nasser, the ability of Tamarix nilotica to accumulate such metals from soil and hence its potential for phytoextraction. Soil and Tamarix samples were collected from the banks of four bights around Lake Nasser and analysed for Fe, Mn, Ca, Mg, Cr, Cu, Ni, Zn, Cd and Pb by atomic absorption spectrometry, whereas Na and K were measured by atomic emission spectrophotometry. Three different methods of extraction were used for the soil samples. Lead, copper and zinc were equally distributed between the exchangeable phase and Fe/Mn oxide-bound form, while other measured metals were mainly present in the Fe/Mn oxide fraction. With the exception of iron, all metals studied showed total concentrations within the geochemical background values. T. nilotica exhibited elevated concentrations of Na (36.2–48.5?mg?g^?1) and K (2.74–4.33?mg?g^?1) in stems, and relatively high concentrations of Pb, Cd and Co (0.39–1.03?µg?g^?1, 0.24–1.3?µg?g^?1 and 1.94–5.3?µg?g^?1, respectively) are found in plant leaves. Bioaccumulation factors of Na and K (9.3 and 12.63, respectively) were high in T. nilotica stems. While the bioaccumulation of Pb, Cd, Co and Ni (2870.1, 2035.4, 10.5 and 5313.2, respectively) was high in plant leaves, Fe, Mn, Ca and Mg were accumulated relatively equally in plant stems and leaves. T. nilotica was found to secrete high amounts of Na, Ca and K, in addition to small amounts of all accumulated metals except Cd and Cu. These secreted metals appeared as salt crystals (67.5% Na; 25.8% Ca; 5% Mg; 1.5% K and 0.16% trace and minor elements) on the plant surface. The concentrations of all the metals studied in T. nilotica were higher than in the salt crystals. Statistical analysis of the database suggests bioaccumulation of these metals from soil to T. nilotica. This reflects the importance of using T. nilotica as a model in the phytoremediation process as an established environmental clean-up technology.     

Sea level extremes in the U.S.-Affiliated Pacific Islands—a coastal hazard scenario to aid in decision analyses

The objective of this study is to provide a perspective on the extremes of sea-level variability and predictability for the U.S.-Affiliated Pacific Islands (USAPI) on seasonal time-scales. Based on the Generalized Extreme Value (GEV) model, the L-moments method has been used to estimate the model parameters. The bootstrap method has been used to define the exceedance probability level of upper and lower bounds of the return periods at the 90% confidence interval. On the basis of these return calculations and expected extremes of high sea level, the seasonal maxima of sea level and the varying likelihood of extreme events have been estimated. For analyzing the predictability of the extremes of sea-level, a canonical correlation analysis (CCA) statistical model has been developed. Findings reveal that there is seasonal climatology of extreme events in the vicinity of USAPI that are variable on temporal and spatial scales. Some of the islands (Yap and Saipan) display considerably higher seasonal extremes than the others for 20 to 100 year return periods because of typhoon-related storm surges. These surges are likely to cause huge tidal large sea-level inundations and increased erosion to low-lying atolls/islands and result in considerable damage to roads, harbors, unstable sandy beaches, and other major infrastructures. Finally, the need for evaluating the extreme events and associated typhoons from a regional perspective has been stressed for coastal hazard management decision analyses in the USAPI.     

Evaluation of dilute hydrochloric acid and acid ammonium oxalate as extractants for some heavy metals from Nile River sediments

The suitability of a 0.5 M HCl solution for extraction of Fe, Mn, Cd, Co, Cu, Pb, and Zn from Nile River sediments was evaluated by comparing its effectiveness with that of conventional acid ammonium oxalate (Tamm's solution) and aqua regia extraction solutions. The present study has shown that although the extraction data indicate that both 0.5 M HCl and acid ammonium oxalate solutions are able to extract heavy metals simultaneously from the adsorbed, organic, and precipitated phases of Nile sediments, the 0.5 M HCl solution is preferred. It provides a rapid, reliable, and inexpensive method of measuring environmentally mobile metal concentrations in the aquatic sediments. From an analytical chemistry point of view, the 0.5 M HCl extracts do not clog the atomizer of the spectrophotometer. Extraction with dilute HCl solution obviates the need to use chemicals, some of which are toxic or not available readily as a high-purity grade. A standard extraction method should be relatively simple, to conduct a routine analysis of large numbers of sediment samples, yet at the same time it should provide sufficient information for assessment of the environmental impact of particulate metals. Therefore, extraction with 0.5 M HCl solution is very suitable for heavy-metal pollution monitoring in the Nile River     

Consensus Seasonal Flood Forecasts and Warning Response System (FFWRS): An Alternate for Nonstructural Flood Management in Bangladesh

Despite advances in short-range flood forecasting and information dissemination systems in Bangladesh, the present system is less than satisfactory. This is because of short lead-time products, outdated dissemination networks, and lack of direct feedback from the end-user. One viable solution is to produce long-lead seasonal forecasts—the demand for which is significantly increasing in Bangladesh—and disseminate these products through the appropriate channels. As observed in other regions, the success of seasonal forecasts, in contrast to short-term forecast, depends on consensus among the participating institutions. The Flood Forecasting and Warning Response System (henceforth, FFWRS) has been found to be an important component in a comprehensive and participatory approach to seasonal flood management. A general consensus in producing seasonal forecasts can thus be achieved by enhancing the existing FFWRS. Therefore, the primary objective of this paper is to revisit and modify the framework of an ideal warning response system for issuance of consensus seasonal flood forecasts in Bangladesh. The five-stage FFWRS—i) Flood forecasting, ii) Forecast interpretation and message formulation, iii) Warning preparation and dissemination, iv) Responses, and v) Review and analysis—has been modified. To apply the concept of consensus forecast, a framework similar to that of the Southern African Regional Climate Outlook Forum (SARCOF) has been discussed. Finally, the need for a climate Outlook Fora has been emphasized for a comprehensive and participatory approach to seasonal flood hazard management in Bangladesh.