Evolution of Programs to Improve Transfers between Hospitals and Nursing Homes at the Community Level

This study described the evolution of programs to improve the efficiency of patient movement between hospitals and nursing homes in the metropolitan area of Syracuse, New York. These programs were needed in order to improve coordination among providers in the absence of networks that included both acute and long term care providers. The mechanisms included the exchange of data and monitoring the movement of Difficult to Place patients from hospitals to nursing homes. Between 2006 and 2014, the annual number of Difficult to Place patients increased from 983 to 1836. During this period, annual hospital medical/surgical discharges increased by 7.5 percent, severity of illness increased by 13.7 percent, and the population aged 65 years and over increased by 9.8 percent. Most of the Difficult to Place patients were admitted by the four largest facilities in the community, which accounted for 60 percent of the nursing home beds. The initiatives also included Subacute and Complex Care Programs that provided financial incentives for admission of certain types of patients, such as intravenous therapy and extensive wound care. The programs described how these programs were implemented using minimal financial resources and without adding positions to the participating provider organizations.

Effects of Biostimulation-Bioaugmentation on Coastal Microbial Community in an in situ Mesocosm System

Globally,various types of pollution affect coastal waters as a result of human activities.Bioaugmentation and biostimulation are effective methods for treating water pollution.However,few studies have explored the response of coastal prokaryotic and eukaryotic communities to bioaugmentation and biostimulation.Here,a 28-day outdoor mesocosm experiment with two treatments(bioaugmentation-A and combined treatment of bioaugmentation and biostimulation-AS)and a control(untreated-C)were carried out.The experiment was conducted in Meishan Bay to explore the composition,dynamics,and co-occurrence patterns of prokaryotic and eukaryotic communities in response to the A and AS using 16S rRNA and 18S rRNA gene amplicon sequencing.After treatment,Gammaproteobacteria and Epsilonproteobacteria were significantly increased in group AS compared to group C,while Flavobacteriia and Saprospirae were significantly reduced.Dinoflagellata was significantly reduced in AS compared to C,while Chrysophyta was significantly reduced in both AS and A.Compared to C,the principal response curve analyses of the prokaryotic and eukaryotic communities both showed an increasing trend followed by a decreasing trend for AS.Furthermore,the trends of prokaryotic and eukaryotic communities in group A were similar to those in group AS compared with group C,but AS changed them more than A did.According to the species weight table on principal response curves,a significant increase was observed in beneficial bacteria in prokaryotic communities,such as Rhodobacterales and Oceanospirillales,along with a decrease in autotrophs in eukaryotic communities,such as Chrysophyta and Diatom.Topological properties of network analysis reveal that A and AS complicate the interactions between the prokaryotic and eukaryotic communities.Overall,these findings expand our understanding of the response pattern of the bioaugmentation and biostimulation on coastal prokaryotic and eukaryotic communities.

Rate of Inappropriate Imaging Utilization by the Emergency Department in Community Hospitals

Objective: To retrospectively analyse the use of imaging studies in the Emergency Department of community hospitals using evidence based guidelines and clinical judgement. Methods: Medical records of 661 patients who visited the Emergency Department (ED) in 2015 and underwent imaging studies were reviewed. The Canadian Association of Radiologists, American College of Radiologists and Choosing Wisely Canada guidelines were used to determine the appropriateness of imaging studies. The use of prior patient imaging, the rate at which studies were repeated and the respective impacts on patient management of the imaging studies were also examined. Results: Of the 1056 imaging studies reviewed, 228 (22%) were found to be clinical situations where no imaging study was indicated while 168 (16%) were considered a suboptimal choice of imaging study or modality. When no study was recommended, a positive impact on the diagnosis was noted in 105 (46%) cases and on patient management 83 (36%) times. Notably, 219 (21%) patients had a relevant examination performed in the last 30 days, and 147 (14%) reports noted that the results of the prior study also concurred with the imaging study evaluated. Conclusion: In this study, 228 (22%) radiographs and CT studies, excluding MVC related imaging and extremity imaging, were not indicated based on appropriateness criteria and consequently had a limited impact on patient management. This supports the need for increased clinical decision support for ED physicians, regional health information exchanges and consideration of Computerized Physician Order Entry in the ED with embedded appropriateness criteria at the point of ordering.

FORGET: Pilot of an Innovative and Simple History Based Screening Tool for Dementia Community Clinics and Acute Medical Hospitals

The aim of this study is to pilot FORGET as screening tool for dementia in community OP clinic and acute medical hospital assessments. Sample size included 30 each of memory clinic and acute medical hospital patients. Assessments included FORGET and MMSE. Psychometric test parameters were calculated for FORGET (Cut-off >1 in OP clinic and >3 in acute medical hospital). Of 30 referrals to memory clinic, 25 had dementia. A score >1 on FORGET had sensitivity 80%, specificity 80%, PPV 95.24%, NPV 44.44%, OR 16.00 (p = 0.02) for diagnosis of dementia. Of 30 acute hospital referrals, 20 had dementia. A score >3 on FORGET had sensitivity 95%, specificity 90%, PPV 95% and NPV 90%, OR 171 (p = 0.0005). FORGET at a score of >1 in community and >3 in acute medical hospital is a useful screening tool for dementia.

Macroinvertebrate Community Index (MCI) and Quantitative Macroinvertebrate Community Index (QMCI) Analysis: A Comparative Study between Le Afe and Mulivaifagatoloa Rivers, Upolu Island, Samoa

The diversity of Samoa’s freshwater macroinvertebrates remains largely unexplored, with past studies focusing on specific species without comprehensive cataloguing. This research evaluated the health of Upolu Island’s rural rivers through macroinvertebrate analysis, particularly in the Le Afe and Mulivaifagatoloa Rivers. Collaborating with Samoa’s Water Resources Division in the Ministry of Natural Resources and Environment (MNRE), three sites along each river were sampled, representing a gradient from pristine to anthropogenically impacted areas. A total of 2953 macroinvertebrates were collected and classified into five categories using established identification keys. The Macroinvertebrate Community Index (MCI) and Quantitative Macroinvertebrate Community Index (QMCI) were applied for analysis. The results showed no clear pattern of pollutant-sensitive species prevalence or decline in less disturbed rivers. High MCI scores with low QMCI values indicated numerous low-scoring species, while the opposite suggested a richness of high-scoring taxa. Although MCI and QMCI are tools for monitoring freshwater health, this study lays the groundwork for future research to categorize Samoan macroinvertebrates and assign tolerance scores based on their presence in varying river conditions. .

Nontraditional energy-assisted mechanical machining of difficult-to-cut materials and components in aerospace community:a comparative analysis

The aerospace community widely uses difficult-to-cut materials,such as titanium alloys,high-temperature alloys,metal/ceramic/polymer matrix composites,hard and brittle materials,and geometrically complex components,such as thin-walled structures,microchannels,and complex surfaces.Mechanical machining is the main material removal process for the vast majority of aerospace components.However,many problems exist,including severe and rapid tool wear,low machining efficiency,and poor surface integrity.Nontraditional energy-assisted mechanical machining is a hybrid process that uses nontraditional energies(vibration,laser,electricity,etc)to improve the machinability of local materials and decrease the burden of mechanical machining.This provides a feasible and promising method to improve the material removal rate and surface quality,reduce process forces,and prolong tool life.However,systematic reviews of this technology are lacking with respect to the current research status and development direction.This paper reviews the recent progress in the nontraditional energy-assisted mechanical machining of difficult-to-cut materials and components in the aerospace community.In addition,this paper focuses on the processing principles,material responses under nontraditional energy,resultant forces and temperatures,material removal mechanisms,and applications of these processes,including vibration-,laser-,electric-,magnetic-,chemical-,advanced coolant-,and hybrid nontraditional energy-assisted mechanical machining.Finally,a comprehensive summary of the principles,advantages,and limitations of each hybrid process is provided,and future perspectives on forward design,device development,and sustainability of nontraditional energy-assisted mechanical machining processes are discussed.

Insights into microbiota community dynamics and flavor development mechanism during golden pomfret(Trachinotus ovatus)fermentation based on single-molecule real-time sequencing and molecular networking analysis

Popular fermented golden pomfret(Trachinotus ovatus)is prepared via spontaneous fermentation;however,the mechanisms underlying the regulation of its flavor development remain unclear.This study shows the roles of the complex microbiota and the dynamic changes in microbial community and flavor compounds during fish fermentation.Single-molecule real-time sequencing and molecular networking analysis revealed the correlations among different microbial genera and the relationships between microbial taxa and volatile compounds.Mechanisms underlying flavor development were also elucidated via KEGG based functional annotations.Clostridium,Shewanella,and Staphylococcus were the dominant microbial genera.Forty-nine volatile compounds were detected in the fermented fish samples,with thirteen identified as characteristic volatile compounds(ROAV>1).Volatile profiles resulted from the interactions among the microorganisms and derived enzymes,with the main metabolic pathways being amino acid biosynthesis/metabolism,carbon metabolism,and glycolysis/gluconeogenesis.This study demonstrated the approaches for distinguishing key microbiota associated with volatile compounds and monitoring the industrial production of high-quality fermented fish products.

Manure substitution improves maize yield by promoting soil fertility and mediating the microbial community in lime concretion black soil

Synthetic nitrogen(N)fertilizer has made a great contribution to the improvement of soil fertility and productivity,but excessive application of synthetic N fertilizer may cause agroecosystem risks,such as soil acidification,groundwater contamination and biodiversity reduction.Meanwhile,organic substitution has received increasing attention for its ecologically and environmentally friendly and productivity benefits.However,the linkages between manure substitution,crop yield and the underlying microbial mechanisms remain uncertain.To bridge this gap,a three-year field experiment was conducted with five fertilization regimes:i)Control,non-fertilization;CF,conventional synthetic fertilizer application;CF_(1/2)M_(1/2),1/2 N input via synthetic fertilizer and 1/2 N input via manure;CF_(1/4)M_(3/4),1/4 N input synthetic fertilizer and 3/4 N input via manure;M,manure application.All fertilization treatments were designed to have equal N input.Our results showed that all manure substituted treatments achieved high soil fertility indexes(SFI)and productivities by increasing the soil organic carbon(SOC),total N(TN)and available phosphorus(AP)concentrations,and by altering the bacterial community diversity and composition compared with CF.SOC,AP,and the soil C:N ratio were mainly responsible for microbial community variations.The co-occurrence network revealed that SOC and AP had strong positive associations with Rhodospirillales and Burkholderiales,while TN and C:N ratio had positive and negative associations with Micromonosporaceae,respectively.These specific taxa are implicated in soil macroelement turnover.Random Forest analysis predicted that both biotic(bacterial composition and Micromonosporaceae)and abiotic(AP,SOC,SFI,and TN)factors had significant effects on crop yield.The present work strengthens our understanding of the effects of manure substitution on crop yield and provides theoretical support for optimizing fertilization strategies.

Zooplankton community response to eddy during dinoflagellate Noctiluca scintillans blooms off Pakistan,northern Arabian Sea

Eddies are major elements of ocean dynamics that affect ocean production.Understanding their effects on plankton distribution may help understand the dynamics of harmful phytoplankton blooms.Previous studies on the effects of eddies in the northern Arabian Sea have primarily focused on the zooplankton community,and few have observed zooplankton dynamics during winter blooms of Noctiluca scintillans.We investigated zooplankton community structure and the related environmental variability during a N.scintillans bloom that was affected by an eddy in February 2018.The sampling stations were deployed at eddy core and eddy edge distinguished in salinity,temperature,and velocity.Results show that N.scintillans bloomed at the eddy core with high-velocity currents induced by warm eddies that moved from eddy core to eddy edge.As a result,blooms significantly changed the zooplankton community structure.Non-bloom stations had higher zooplankton diversity than bloom stations.Zooplankton at non-bloom stations were dominated by either tunicates or copepods,such as Thalia democratica and Pleuromamma gracilis.In addition to the influence of N.scintillans blooms,the velocity of eddy currents was a crucial factor on the similarities in the zooplankton community composition between eddy edge and eddy core.Moreover,the lower abiotic factors in bloom area contribute to the structuring of the zooplankton community during N.scintillans blooms.

Construction of Urban Mixed-age Community: Opportunities, Challenges and Countermeasures: A Case Study of“Fangjia Hutong”in Beijing

In the context of China’s economic development and population aging,the innovation and exploration of the old-age care model has emerged as a new community transformation and development direction.Given the differing needs and characteristics of individuals across the lifespan,it is evident that a design approach that incorporates mixed-age integration and mutual-help communities is a viable strategy for enhancing intergenerational exchanges.This entails the creation of a diverse and open community that is conducive to habitation for individuals of all ages,encompassing the full spectrum of needs,from those of young children to the elderly.Such a community must be designed and constructed with the population in mind,from the initial planning and design stages to the operational phase.This encompasses a comprehensive range of services,including food,clothing,housing,transportation,and medical care and recreation.

Development of Self-Rated Nursing Record Frequency for Delirium Care of Nurses in Acute Care Hospitals (NRDC-Acute)

Background: Nursing records play an important role in multidisciplinary collaborations in delirium care. This study aims to develop a self-rated nursing record frequency scale for delirium care among nurses in acute care hospitals (NRDC-Acute). Methods: A draft of the scale was developed after a literature review and meeting with researchers with experience in delirium care, and a master’s or doctoral degree in nursing. We identified 25 items on a 5-point Likert scale. Subsequently, an anonymous self-administered questionnaire survey was administered to 520 nurses from 41 acute care hospitals in Japan, and the reliability and validity of the scale were examined. Results: There were 232 (44.6%) respondents and 218 (41.9%) valid responses. The mean duration of clinical experience was 15.2 years (SD = 8.8). Exploratory factor analysis extracted 4 factors and 13 items for this scale. The model fit indices were GFI = 0.991, AGFI = 0.986, and SRMR = 0.046. The Cronbach’s alpha coefficient for the entire scale was .888. The four factors were named “Record of Pharmacological Delirium Care on Pro Re Nata (PRN)”, “Record of Non-Pharmacological Delirium Care”, “Record of Pharmacological Delirium Care on Regular Medication”, and “Record of Collaboration for Delirium Care”. Conclusion: The scale was relatively reliable and valid. Nurses in acute care hospitals can use this scale to identify and address issues related to the documentation of nursing records for delirium care.

Effects of water tables and nitrogen application on soil bacterial community diversity, network structure, and function in an alpine wetland, China

Nitrogen deposition and water tables are important factors to control soil microbial community structure.However,the specific effects and mechanisms of nitrogen deposition and water tables coupling on bacterial diversity,abundance,and community structure in arid alpine wetlands remain unclear.The nitrogen deposition(0,10,and 20 kg N/(hm^(2)•a))experiments were conducted in the Bayinbulak alpine wetland with different water tables(perennial flooding,seasonal waterlogging,and perennial drying).The 16S rRNA(ribosomal ribonucleic acid)gene sequencing technology was employed to analyze the changes in bacterial community diversity,network structure,and function in the soil.Results indicated that bacterial diversity was the highest under seasonal waterlogging condition.However,nitrogen deposition only affected the bacterial Chao1 and beta diversity indices under seasonal waterlogging condition.The abundance of bacterial communities under different water tables showed significant differences at the phylum and genus levels.The dominant phylum,Proteobacteria,was sensitive to soil moisture and its abundance decreased with decreasing water tables.Although nitrogen deposition led to changes in bacterial abundance,such changes were small compared with the effects of water tables.Nitrogen deposition with 10 kg N/(hm^(2)•a)decreased bacterial edge number,average path length,and robustness.However,perennial flooding and drying conditions could simply resist environmental changes caused by 20 kg N/(hm^(2)•a)nitrogen deposition and their network structure remain unchanged.The sulfur cycle function was dominant under perennial flooding condition,and carbon and nitrogen cycle functions were dominant under seasonal waterlogging and perennial drying conditions.Nitrogen application increased the potential function of part of nitrogen cycle and decreased the potential function of sulfur cycle in bacterial community.In summary,composition of bacterial community in the arid alpine wetland was determined by water tables,and diversity of bacterial community was inhibited by a lower water table.Effect of nitrogen deposition on bacterial community structure and function depended on water tables.

Response of Bacterial Community and Enzyme Activity of Greenhouse Tomato under Different Irrigation Systems

The micro-sprinkler irrigation mulched(MSM)has been suggested as a novel water-saving approach in con-trolled environment agriculture.However,the effects of microbial community structure and enzyme activity in the rhizosphere soil on crop growth under MSM remain unclear.This study conducted a randomized experimen-tal design using greenhouse tomatoes to investigate changes in bacterial community structure and enzyme activity in rhizosphere soil under different irrigation frequencies(F)and amounts(I)of MSM.Thefindings revealed that with the increase of F or I,The total count of soil bacteria in tomatoesfirst rose and then fell in terms of Opera-tional Taxonomic Units(OTUs)classification.Compared to other F,the most abundance of nitrogen and phos-phorus metabolism genes and enzyme activities were observed with a 5-day F.Moreover,the diversity of soil bacterial community structure initially rose before eventually declining with the increase of the I.Applying 1.00 Epan(cumulative evaporation of a 20 cm standard pan)under MSM helped boost the abundance of nitrogen and phosphorus metabolism functional genes in soil bacteria,ensuring higher enzyme activities related to nitro-gen,carbon,and phosphorus metabolism in the rhizosphere soil of tomatoes.Tomatoes’yield initially rose before eventually declining with the increase in F or I,whereas I had a more significant effect on yield.A 1.00%increase in I yielded a minimum of 39.24%increase in tomato yield.The study showed a positive correlation between soil bacterial community,soil enzyme activity,and greenhouse tomato yield under MSM.Considering the results comprehensively,the combined irrigation mode of F of 5 d and I of 1.00 Epan was recommended for greenhouse tomatoes under MSM.This conclusion provides theoretical support for water-saving practices and yield improve-ment in facility agriculture,especially tomato cultivation.

The microbial community,nutrient supply and crop yields differ along a potassium fertilizer gradient under wheat-maize double-cropping systems

Soil microorganisms play critical roles in ecosystem function.However,the relative impact of the potassium(K)fertilizer gradient on the microbial community in wheat-maize double-cropping systems remains unclear.In this long-term field experiment(2008-2019),we researched bacterial and fungal diversity,composition,and community assemblage in the soil along a K fertilizer gradient in the wheat season(K0,no K fertilizer;K1,45 kg ha^(-1) K_(2)O;K_(2),90 kg ha^(-1)K_(2)O;K3,135 kg ha^(-1)K_(2)O)and in the maize season(K0,no K fertilizer;K_(1),150 kg ha^(-1) K_(2)O;K_(2),300 kg ha^(-1)K_(2)O;K_(3),450 kg ha^(-1)K_(2)O)using bacterial 16S rRNA and fungal internally transcribed spacer(ITS)data.We observed that environmental variables,such as mean annual soil temperature(MAT)and precipitation,available K,ammonium,nitrate,and organic matter,impacted the soil bacterial and fungal communities,and their impacts varied with fertilizer treatments and crop species.Furthermore,the relative abundance of bacteria involved in soil nutrient transformation(phylum Actinobacteria and class Alphaproteobacteria)in the wheat season was significantly increased compared to the maize season,and the optimal K fertilizer dosage(K2 treatment)boosted the relative bacterial abundance of soil nutrient transformation(genus Lactobacillus)and soil denitrification(phylum Proteobacteria)bacteria in the wheat season.The abundance of the soil bacterial community promoting root growth and nutrient absorption(genus Herbaspirillum)in the maize season was improved compared to the wheat season,and the K2 treatment enhanced the bacterial abundance of soil nutrient transformation(genus MND1)and soil nitrogen cycling(genus Nitrospira)genera in the maize season.The results indicated that the bacterial and fungal communities in the double-cropping system exhibited variable sensitivities and assembly mechanisms along a K fertilizer gradient,and microhabitats explained the largest amount of the variation in crop yields,and improved wheat?maize yields by 11.2-22.6 and 9.2-23.8%with K addition,respectively.These modes are shaped contemporaneously by the different meteorological factors and soil nutrient changes in the K fertilizer gradients.

Effects of potassium lactate on sensory attributes,bacterial community succession and biogenic amines formation in Rugao ham

To deepen the understanding in the effect of potassium lactate on the sensory quality and safety of Rugao ham,sensory attributes,physicochemical parameters,total volatile basic nitrogen(TVBN),microorganism community and biogenic amines of Rugao ham manufactured with different potassium lactate levels(0%,0.5%,1%,2%)were investigated;the relationship between microbial community and the formation of TVBN and biogenic amines was further evaluated.With the increase of potassium lactate from 0%to 2%,the increased sensory scores and the decreased total aerobic bacterial count and TVBN were observed;the abundance of Staphylococcus increased,while the content of Halomonas decreased.LDA effect size(LEf Se)and correlations analysis showed that Staphylococcus equorum and Lactobacillus fermentum could be the key species to improve sensory scores and decrease biogenic amines and TVBN.Metabolic pathway analysis further showed that amino acids metabolism and nitrogen metabolism were mainly involved in decreasing TVBN and biogenic amines in the treatment of 2%potassium lactate.

PLFA Analysis of Soil Microbial Community Structure in Different Forest Types

Soil soluble organic matter is an important component in the study of carbon and nitrogen cycling in terrestrial ecosystems. Soil microorganisms, as soil decomposers, participate in soil biogeochemical processes and play an important role in maintaining the balance of soil ecosystems. As a typical subtropical regional unit, Queensland, Australia, is a relatively concentrated distribution area of forests in Australia. It is very sensitive to climate change and plays an important role in Australian climate and even global climate change. Its unique natural environment and ecosystem occupy a special position in the world. However, the knowledge of available carbon and nitrogen pool and microbial activity in forest soil is still very limited. Pinus elliottii, Araucaria cunninghamii and Agathis australis are the three most important forest types in southern Queensland, Australia. In our research, the function and structural diversity of soil microbial communities of these three forest types were studied using biochemical and molecular biological methods, and the effective carbon and nitrogen pools of soil of different forest types and related microbial processes were discussed, which has important theoretical guiding significance for further research on the structure and function of soil ecosystem. The number of PLFAs in the soil of P. elliottii was 45, the number of PLFAs in the soil of Araucaria cunninghamii and Agathis australis was 39 and 35, respectively. The number and content of PLFAs monomer in P. elliottii were higher than those in the other two kinds of forest soil.

Advancing climate resilience through a geo-design framework: strengthening urban and community forestry for sustainable environmental design

Urban and community forestry is a specialized discipline focused on the meticulous management of trees and forests within urban,suburban,and town environments.This field often entails extensive civic involvement and collaborative partnerships with institutions.Its overarching objectives span a spectrum from preserving water quality,habitat,and biodiversity to mitigating the Urban Heat Island(UHI)effect.The UHI phenomenon,characterized by notably higher temperatures in urban areas compared to rural counterparts due to heat absorption by urban infrastructure and limited urban forest coverage,serves as a focal point in this study.The study focuses on developing a methodological framework that integrates Geographically Weighted Regression(GWR),Random Forest(RF),and Suitability Analysis to assess the Urban Heat Island(UHI)effect across different urban zones,aiming to identify areas with varying levels of UHI impact.The framework is designed to assist urban planners and designers in understanding the spatial distribution of UHI and identifying areas where urban forestry initiatives can be strategically implemented to mitigate its effect.Conducted in various London areas,the research provides a comprehensive analysis of the intricate relationship between urban and community forestry and UHI.By mapping the spatial variability of UHI,the framework offers a novel approach to enhancing urban environmental design and advancing urban forestry studies.The study’s findings are expected to provide valuable insights for urban planners and policymakers,aiding in creating healthier and more livable urban environments through informed decision-making in urban forestry management.

Changes in Inpatient Hospital Utilization at the Community Level

This study demonstrated that numbers of hospital inpatient discharges have declined in the metropolitan area of Syracuse, New York. The largest impact has been in adult medicine and adult surgery, the hospital services with the highest utilization rates. Reductions in inpatient care have also affected services with lower utilization, such as pediatrics, obstetrics, and mental health. The study indicated that, between January - June 2019 and 2024, adult medicine discharges declined by 11.9 percent and adult surgery discharges declined by 24.6 percent. A large proportion of the reductions involved orthopedic surgery. They indicated that more than 50 percent of the joint replacements in the Syracuse hospitals have been moved to outpatient services. These patients included those with low severity of illness. The study suggested that reductions in hospital discharges could contribute to the efficiency of care. Fewer inpatient admissions could reduce the need for staffing and other resources. Information from the Syracuse hospitals has suggested that these reductions may continue.

The Burden of Undiagnosed Hypertension and Associated Risk Factors among Adults in a Rural Community in Imo Sate, South-East Nigeria

Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor for undiagnosed hypertension.

Feasibility Study of Assist-Linked Brief Intervention for Substance Use Disorders in a Rural Community of Plateau State, Nigeria

Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.