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.     

Stakeholder trust: How do I get it?

A damaged corporate environmental reputation can cost your company business—and may take years to overcome. Building stakeholder trust should be central to every firm's corporate strategy in today's environmentally conscious world. © 2000 John Wiley & Sons, Inc.     

Screening of phthalic acid esters in raw materials,premixes and feed additives

Phthalates are animal carcinogens and may cause death or tissue deformities. Samples of feedstuffs collected in 2005 and 2006 from industrial feed manufacturers in the Czech Republic were analysed for contamination with phthalic acid esters (PAEs), specifically di-2-ethylhexyl phthalate (DEHP) and di-n-butyl phthalate (DBP). Samples of feed additives, premixes and raw materials were collected (year 2005, n = 26). For soybean oil, the total volume of phthalates measured (DBP + DEHP) reached a level of 131.42 mg kg⁻¹; for rapeseed oil, fish meal and animal fats, the levels measured were 15.00, 7.96 and 58.87 mg kg⁻¹, respectively. The lowest level of DBP + DEHP was found in corn (2.03 mg kg⁻¹). Since phthalates were detected, samples of feed additives (n = 28) and raw materials (n = 28) were collected again in 2006. The highest levels of DBP + DEHP were found in raw materials containing fat. Phthalate levels in rapeseed oil samples ranged from 1.38 to 32.40 mg kg⁻¹ DBP + DEHP. For feed additives, contamination levels in vitamins and amino acids ranged from 0.06 to 3.15 and 1.76 to 4.52 mg kg⁻¹ DBP + DEHP, respectively. Here, we show that the levels of PAEs found in cereals such as wheat, barley and corn may be regarded as being alarmingly high, because cereals make up the largest proportion of compound feed of farm animals.     

Landscape context and scale differentially impact coffee leaf rust, coffee berry borer, and coffee root-knot nematodes

Crop pest and disease incidences at plot scale vary as a result of landscape effects. Two main effects can be distinguished. First, landscape context provides habitats of variable quality for pests, pathogens, and beneficial and vector organisms. Second, the movements of these organisms are dependent on the connectivity status of the landscape. Most of the studies focus on indirect effects of landscape context on pest abundance through their predators and parasitoids, and only a few on direct effects on pests and pathogens. Here we studied three coffee pests and pathogens, with limited or no pressure from host-specific natural enemies, and with widely varying life histories, to test their relationships with landscape context: a fungus, Hemileia vastatrix, causal agent of coffee leaf rust; an insect, the coffee berry borer, Hypothenemus hampei (Coleoptera: Curculionidae); and root-knot nematodes, Meloidogyne spp. Their incidence was assessed in 29 coffee plots from Turrialba, Costa Rica. In addition, we characterized the landscape context around these coffee plots in 12 nested circular sectors ranging from 50 to 1500 m in radius. We then performed correlation analysis between proportions of different land uses at different scales and coffee pest and disease incidences. We obtained significant positive correlations, peaking at the 150 m radius, between coffee berry borer abundance and proportion of coffee in the landscape. We also found significant positive correlations between coffee leaf rust incidence and proportion of pasture, peaking at the 200 m radius. Even after accounting for plot level predictors of coffee leaf rust and coffee berry borer through covariance analysis, the significance of landscape structure was maintained. We hypothesized that connected coffee plots favored coffee berry borer movements and improved its survival. We also hypothesized that wind turbulence, produced by low-wind-resistance land uses such as pasture, favored removal of coffee leaf rust spore clusters from host surfaces, resulting in increased epidemics. In contrast, root-knot nematode population density was not correlated to landscape context, possibly because nematodes are almost immobile in the soil. We propose fragmenting coffee plots with forest corridors to control coffee berry borer movements between coffee plots without favoring coffee leaf rust dispersal.     

Synthesis of 2,5‐diaryl‐2,4‐pentadienenitriles and their spectral,fluorescence and mutagenic properties

The condensation of substituted cinnamaldehydes and arylacetonitriles using sodium ethoxide in ethanol at room temperature afforded 2,5‐diaryl‐2,4‐pentadienenitriles in good yield. The structure of the reaction products was established on the basis of their infrared, nuclear magnetic resonance and elemental analysis data. Two representative compounds were studied for their mutagenic activity. One of them showed a weak mutagenicity while the second showed a high mutagenic activity in TA97a Salmonella strain. Both were negative in TA100. Some of these pentadienenitriles showed fluorescence in solutions.     

Non-timber forest products and village livelihoods in Rajasthan,India: adaptation in a changing environment

This paper presents the results of research conducted between 2009 and 2014 in the village of Khanda Sharol in the state of Rajasthan, India. Our research objective was to determine how the livelihoods of village residents have been affected by the intensification of forest use, and the resulting loss of domestic access to traditionally used forest resources. Results indicate that changes in forest cover have resulted in a loss of livelihood options for village residents. Yet rather than being victimized by environmental change processes, this paper shows how villagers have responded by partnering with public and private actors to develop a community protected forest area that is now helping villagers to meet their livelihood needs. These findings suggest that sustainable livelihoods in rural regions of India require committed and scaled approaches involving local, public, and private actors.     

Localized hyper saline waters in Arabian Gulf from desalination activity��an example from South Kuwait

Desalination is the only means of reliable water supply in most of the Arabian Gulf States including Kuwait, Saudi Arabia, Bahrain, Qatar, and United Arab Emirates. Huge desalination capacities are installed on the western margin of the Arabian Gulf contributing to increased salinity off the coast. This paper presents long term salinity observation made near outfall of Az Zour Power and Desalination Plant in South Kuwait. The salinity values peak at around 50 ppt at observation station located in open gulf around 5 km from the outfall of the power and desalination plant. The observation highlights the stress on the local marine environment continued incremental salinity can impair the marine biodiversity in the area. The study suggests that a stringent post construction and operational offshore water quality assessment can help in early detection of potentially complex environmental issues.     

Denitrification potential of the Northern Arabian Gulf—an experimental study

The study aims to establish denitrification potential of the Northern Arabian Gulf (NAG), as nitrogen critically affects the ocean productivity, obliterates acidity, oxidative capacity and radiative transfer capability of atmosphere. The experimental study was conducted by taking cores from intertidal zones from two different sites in North and South, referred as sites N and S; representing two distinct environmental milieu. The experiment was conducted in controlled laboratory conditions simulating the tidal cycles. Multiple cores were taken and loaded with seawater with different N concentrations, the redox potential was established for each condition. Redox potential was significantly lower at 10?cm depth compared to the surface in all cores (P?<?0.001). The redox potential at surface and at 10?cm depth was significantly lower at site S compared to site N (P?<?0.001; F?=?714.2), suggesting anaerobic sediments at site S. Effects of nitrate spiked seawater on denitrification under nonflooded and flooded conditions at the two sites were also studied. Three-way ANOVA analysis indicated that site, nitrate concentration, and flooding had significant main and interactive effects on the rate of denitrification. The results suggest that under ambient nitrate concentrations (0.03?mg NO₃-N?l^?1), 6.3?±?2.1?g NO₃-N?ha?day can be denitrified by inter-tidal zone sediments. At a nitrate concentration of 1?mg NO₃-N?l^?1, 92?±?16?g NO₃-N?ha?day may be denitrified whilst at a very high nitrate load of 10?mg NO₃-N?l^?1, the sediments may attain a rate of denitrification close to 404?±?78?g NO₃-N?ha?day.     

The effects of temperature on decomposition and allelopathic phytotoxicity of boneseed litter

Decomposition of plant litter is a fundamental process in ecosystem function, carbon and nutrient cycling and, by extension, climate change. This study aimed to investigate the role of temperature on the decomposition of water soluble phenolics(WSP), carbon and soil nutrients in conjunction with the phytotoxicity dynamics of Chrysanthemoides monilifera subsp. monilifera(boneseed) litter. Treatments consisted of three factors including decomposition materials(litter alone, litter with soil and soil alone), decomposition periods and temperatures(5–15, 15–25and 25–35°C(night/day)). Leachates were collected on 0, 5, 10, 20, 40 and 60 th days to analyse physico-chemical parameters and phytotoxicity. Water soluble phenolics and dissolved organic carbon(DOC) increased with increasing temperature while nutrients like SO-24 and NO-13 decreased. Speed of germination, hypocotyl and radical length and weight of Lactuca sativa exposed to leachates were decreased with increasing decomposition temperature. All treatment components had significant effects on these parameters. There had a strong correlation between DOC and WSP, and WSP content of the leachates with radical length of test species. This study identified complex interactivity among temperature, WSP, DOC and soil nutrient dynamics of litter occupied soil and that these factors work together to influence phytotoxicity.     

Impediments to River Rehabilitation

Rehabilitation of river ecosystems is generally initiated when a river is no longer able to provide benefits to humans and other living beings. The major purposes of river rehabilitation projects are improving water quality, conserving nature, rehabilitating fisheries and riparian habitats, flood mitigation, and creating recreational opportunities. For a river rehabilitation project to be successful, it must have specific and clearly explained objectives, although these objectives will vary for each project depending upon factors such as economics, public demand, ecosystem benefits, and the like. In this article, we provide a critical analysis of the purposes that drive river rehabilitation projects and we identify and discuss impediments that can cause a project to deviate from its intended goals. We also discuss major constraints on rehabilitation efforts that can result in failed projects.