scholarly journals Assessment of neonatal care in clinical training facilities in Kenya

2014 ◽  
Vol 100 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Jalemba Aluvaala ◽  
Rachael Nyamai ◽  
Fred Were ◽  
Aggrey Wasunna ◽  
Rose Kosgei ◽  
...  
Keyword(s):  
Clinical Training ◽  
Professional Training ◽  
Routine Data ◽  
Cross Sectional Study ◽  
Neonatal Care ◽  
Public Hospitals ◽  
Severe Illness ◽  
Median Score ◽  
Cross Sectional ◽  
Care Services

ObjectiveAn audit of neonatal care services provided by clinical training centres was undertaken to identify areas requiring improvement as part of wider efforts to improve newborn survival in Kenya.DesignCross-sectional study using indicators based on prior work in Kenya. Statistical analyses were descriptive with adjustment for clustering of data.SettingNeonatal units of 22 public hospitals.PatientsNeonates aged <7 days.Main outcome measuresQuality of care was assessed in terms of availability of basic resources (principally equipment and drugs) and audit of case records for documentation of patient assessment and treatment at admission.ResultsAll hospitals had oxygen, 19/22 had resuscitation and phototherapy equipment, but some key resources were missing—for example kangaroo care was available in 14/22. Out of 1249 records, 56.9% (95% CI 36.2% to 77.6%) had a standard neonatal admission form. A median score of 0 out of 3 for symptoms of severe illness (IQR 0–3) and a median score of 6 out of 8 for signs of severe illness (IQR 4–7) were documented. Maternal HIV status was documented in 674/1249 (54%, 95% CI 41.9% to 66.1%) cases. Drug doses exceeded recommendations by >20% in prescriptions for penicillin (11.6%, 95% CI 3.4% to 32.8%) and gentamicin (18.5%, 95% CI 13.4% to 25%), respectively.ConclusionsBasic resources are generally available, but there are deficiencies in key areas. Poor documentation limits the use of routine data for quality improvement. Significant opportunities exist for improvement in service delivery and adherence to guidelines in hospitals providing professional training.

scholarly journals Performance evaluation of primary care services for the treatment of tuberculosis

2014 ◽  
Vol 48 (6) ◽  
pp. 1044-1053 ◽  
Author(s):  
Daiane Medeiros da Silva ◽  
Jordana de Almeida Nogueira ◽  
Lenilde Duarte de Sá ◽  
Anneliese Domingues Wysocki ◽  
Lucia Marina Scatena ◽  
...  
Keyword(s):  
Primary Care ◽  
Professional Training ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Professional Qualification ◽  
Process Indicators ◽  
Care Services ◽  
Primary Care Services ◽  
Directly Observed Treatment ◽  
Structural Indicators

Objective Evaluating the performance of primary care services for the treatment of tuberculosis according to the assessment referential of health services (structure/process) in Cabedelo, a port city in the state of Paraíba. Method An evaluation quantitative, cross-sectional study, in which were carried out 117 interviews with health professionals using a structured instrument. The analysis was based on the construction of indicators using a standardized value for the reduced variable (z=1). Results The structural indicators showed regular performance for the following variables: professional training, access to record instruments and coordination with other services. The process indicators related to external actions and information about the disease had unsatisfactory performance. The directly observed treatment and the flows of reference/counter-reference had regular performance. Conclusion The focused professional qualification, the fragmentation of practices and the unsystematic home care constitute obstacles for carrying out actions aimed at providing expanded, continuous and resolute care.



scholarly journals The potential role of local pharmacies to assess asthma control: an Italian cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Caminati ◽  
L. Cegolon ◽  
M. Bacchini ◽  
N. Segala ◽  
A. Dama ◽  
...  
Keyword(s):  
Asthma Control ◽  
Multinomial Logistic Regression ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Disease Assessment ◽  
Community Pharmacies ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Disease Community

Abstract Background Asthma control and monitoring still represents a challenge worldwide. Although the international guidelines suggest the interplay between secondary and primary care services as an effective strategy to control the disease, community pharmacies’ are seldom involved in asthma control assessment. The present cross-sectional study aimed at providing a picture of the relationship between asthma severity and control in community pharmacies within the health district of the city of Verona (Veneto Region, North-Eastern Italy). Methods A call for participation was launched through the Pharmacists’ Association of Verona. Patients referring to the participating pharmacies with an anti-asthmatic drug medical prescription and an asthma exemption code were asked to complete the Asthma Control Test (ACT) and a brief questionnaire collecting information on their age, sex, smoking status, aerobic physical exercise and usual asthma therapy, which also defined asthma severity. A multinomial logistic regression model was fitted to investigate the risk of uncontrolled as well as poorly controlled vs. controlled asthma (base). Results were expressed as relative risk ratios (RRR) with 95% confidence interval (95%CI). Results Fifty-seven community pharmacies accepted to participate and 584 asthmatic patients (54% females; mean-age: 51 ± 19 years) were consecutively recruited from 1st January to 30th June 2018 (6 months). Based upon ACT score 50.5% patients had a controlled asthma, 22.3% a poorly controlled and 27.2% uncontrolled. A variable proportion of patients with uncontrolled asthma were observed for every level of severity, although more frequently with mild persistent form of asthma. Most patients (92%) self-reported regular compliance with therapy. At multinomial regression analysis, patients under regular asthma treatment course (RRR = 0.33; 95%CI: 0.15; 0.77) were less likely to have an ACT< 16 compared to those not taking medications regularly. Conclusions Overall, our findings highlighted an unsatisfactory asthma control in the general population, independently of the severity level of the disease. Community pharmacies could be a useful frontline interface between patients and the health care services, supporting an effective asthma management plan, from disease assessment and monitoring treatment compliance to referral of patients to specialist medical consultancies.

scholarly journals The impact of coronavirus outbreak on breastfeeding guidelines among Brazilian hospitals and maternity services: a cross-sectional study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Walusa Assad Gonçalves-Ferri ◽  
◽  
Fábia Martins Pereira-Cellini ◽  
Kelly Coca ◽  
Davi Casale Aragon ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
World Health ◽  
Breastfeeding Support ◽  
Cross Sectional ◽  
Maternity Services ◽  
Community Needs ◽  
Care Services ◽  
Skin Contact ◽  
Health Organization ◽  
The Impact

Abstract Background The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). Methods This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil’s federal law recommendations. Results The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment’s health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. Conclusions In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic.

scholarly journals Influenza vaccination and the risk of COVID-19 infection and severe illness in older adults in the United States

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kelly Huang ◽  
Shu-Wen Lin ◽  
Wang-Huei Sheng ◽  
Chi-Chuan Wang
Keyword(s):  
Immune Responses ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
The United States ◽  
Cross Sectional Study ◽  
Severe Illness ◽  
Cross Sectional ◽  
Global Pandemic ◽  
Study Population ◽  
Health Database

AbstractThe coronavirus disease of 2019 (COVID-19) has caused a global pandemic and led to nearly three million deaths globally. As of April 2021, there are still many countries that do not have COVID-19 vaccines. Before the COVID-19 vaccines were developed, some evidence suggested that an influenza vaccine may stimulate nonspecific immune responses that reduce the risk of COVID-19 infection or the severity of COVID-19 illness after infection. This study evaluated the association between influenza vaccination and the risk of COVID-19 infection. We conducted a retrospective cross-sectional study with data from July 1, 2019, to June 30, 2020 with the Claims data from Symphony Health database. The study population was adults age 65 years old or older who received influenza vaccination between September 1 and December 31 of 2019. The main outcomes and measures were odds of COVID-19 infection and severe COVID-19 illness after January 15, 2020. We found the adjusted odds ratio (aOR) of COVID-19 infection risk between the influenza-vaccination group and no-influenza-vaccination group was 0.76 (95% confidence interval (CI), 0.75–0.77). Among COVID-19 patients, the aOR of developing severe COVID-19 illness was 0.72 (95% CI, 0.68–0.76) between the influenza-vaccination group and the no-influenza-vaccination group. When the influenza-vaccination group and the other-vaccination group were compared, the aOR of COVID-19 infection was 0.95 (95% CI, 0.93–0.97), and the aOR of developing a severe COVID-19 illness was 0.95 (95% CI, 0.80–1.13). The influenza vaccine may marginally protect people from COVID-19 infection.

scholarly journals Constrains for seeking post-abortion care among adolescents and young women in Guangzhou, China: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yiding Wang ◽  
Jinzhi Liu ◽  
Ribo Xiong ◽  
Yan Liu
Keyword(s):  
Young Women ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Sectional Study ◽  
Cross Sectional ◽  
Services Utilization ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Post Abortion ◽  
Youth Friendly

Abstract Background In China, post-abortion care (PAC) services mainly focus on married couples, such that adolescents and unmarried young womenhave limited access to those services for contraception counseling. The provision of youth-friendly PAC services in public hospitals is a new concept in China. This study examined the magnitude of PAC services utilization as well as factors influencing it’s uptake among adolescents and young women in Guangzhou, China. Methods A cross-sectional study was performed from 1st March 2020 to 30th September 2020 using anonymous self-administered questionnaire among 688 women aged 15–24 years in Tianhe district, Guangzhou. The Multivariate logistic regression was used to determine factors that were significantly associated with the uptake of PAC services. Results The magnitude of PAC services utilization was 35.9% among adolescents and young women in Guangzhou, China. Students were 69.0% significantly less likely to use PAC services compared to women who had no job. Immigrants were 59.0% significantly less likely to use PAC services than their native counterparts. Women who had a feeling of stigma were 70.0% significantly less likely to use PAC services compared to those who did not feel stigmatized. Conclusions The study highlights the need to strengthen youth-friendly PAC services provision, and emphasizes the importance of education about both family planning and abortion services among disadvantaged sub-groups of women in the study setting.

scholarly journals The Prevalence of Necrotizing Enterocolitis and Associated Factors Among Enteral Fed Preterm and Low Birth Weight Neonates Admitted in Selected Public Hospitals in Addis Ababa, Ethiopia: A Cross-sectional Study

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110196
Author(s):  
Sitotaw Molla Mekonnen ◽  
Daniel Mengistu Bekele ◽  
Fikrtemariam Abebe Fenta ◽  
Addisu Dabi Wake
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Gestational Age ◽  
Associated Factors ◽  
Addis Ababa ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Sectional Study ◽  
Cross Sectional

Necrotizing enterocolitis (NEC) remains to be the most critical and frequent gastrointestinal disorder understood in neonatal intensive care units (NICU). The presented study was intended to assess the prevalence of NEC and associated factors among enteral Fed preterm and low birth weight neonates. Institution based retrospective cross-sectional study was conducted on 350 enteral Fed preterm and low birth weight neonates who were admitted at selected public hospitals of Addis Ababa from March 25/2020 to May 10/2020. The data were collected through neonates’ medical record chart review. A total of 350 participants were enrolled in to the study with the response rate of 99.43%. One hundred eighty-four (52.6%) of them were male. The majority 123 (35.1%) of them were (32 + 1 to 34) weeks gestational age. The prevalence of NEC was (25.4%) (n = 89, [95% CI; 21.1, 30.0]). Being ≤28 weeks gestational age (AOR = 3.94, 95% CI [2.67, 9.97]), being (28 + 1 to 32 weeks) gestational age (AOR = 3.65, 95% CI [2.21, 8.31]), birth weight of 1000 to 1499 g (AOR = 2.29, 95% CI [1.22, 4.33]), APGAR score ≤3 (AOR = 2.34, 95% CI [1.32, 4.16]), prolonged labor (AOR = 2.21, 95% CI [1.35, 6.38]), maternal chronic disease particularly hypertension (AOR = 3.2, 95% CI [1.70, 5.90]), chorioamnionitis (AOR = 4.8, 95% CI [3.9, 13]), failure to breath/resuscitated (AOR = 2.1, 95% CI [1.7, 4.4]), CPAP ventilation (AOR = 3.7, 95% CI [1.50, 12.70]), mixed milk (AOR = 3.58, 95% CI [2.16, 9.32]) were factors significantly associated with NEC. Finally, the prevalence of NEC in the study area was high. So that, initiating the programs that could minimize this problem is required to avoid the substantial morbidity and mortality associated with NEC.

scholarly journals Training interns in nutrition and dietetics: a cross-sectional study of the barriers and motivators to being a Registered Dietitian Nutritionist preceptor

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea M. Hutchins ◽  
Donna M. Winham ◽  
Jinette P. Fellows ◽  
Michelle M. Heer
Keyword(s):  
Experiential Learning ◽  
Professional Training ◽  
Online Survey ◽  
Selection Process ◽  
National Level ◽  
Cross Sectional Study ◽  
Registered Dietitian ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Entry Level

Abstract Background As is common across the health professions, training of Registered Dietitian Nutritionists (RDNs) requires experiential learning for interns/students to gain skills and demonstrate entry-level competency. Preceptors are essential to the experiential learning component of health care professional training, providing supervision and mentoring as students and interns gain the skills required for entry-level practice competency. Over the past 27 years, 47–73% of applicants to dietetic internships have received a placement. Practitioners willing to volunteer as preceptors are needed to generate more internship or experiential learning opportunities for the profession to continue to meet workforce demands. Methods The objective of this national-level online cross-sectional survey was to identify perceptions and attitudes associated with the preceptor role and incentives that might encourage precepting by current RDNs. A random sample of RDN and Nutrition and Dietetic Technicians, Registered (NDTR) professionals from the Commission on Dietetic Registration credentialed practitioner database were eligible to participate in the online survey. The main outcome measures included perceptions, attitudes, and preferred incentives to precept compared by preceptor experience categories (current, former, never precepted). Comparisons of perceptions, attitudes, and preferred incentives were made between preceptor experience categories using Chi-square and ANOVA. Results Of 2464 invitations, 308 participants had complete variables for analysis. Top incentives were the opportunity to earn continuing education units (65.9%) and having expenses paid to attend a national conference (49.5%). Significantly more (P < 0.001) “former” and “never” preceptors reported the ability to choose when to take an intern, training on how to teach and communicate with interns, and access to an “on-call” specialist as incentives compared to “current” preceptors. Significantly more (P < 0.01) “never” preceptors reported training on internship expectations and the ability to provide input on intern selection process as incentives compared to “current” or “former” preceptors. Conclusions Incentives to serve as a preceptor differ based on “current”, “former”, or “never” precepted status. Promoting and strategizing solutions to the current imbalance between the greater number of dietetic internship applicants compared to preceptors should be targeted based on preceptor status to retain current preceptors, encourage former preceptors to return and recruit professionals who have never served.

A study on the proportion of hearing impairment among percussionists in Thrissur district of Kerala

2021 ◽  
Vol 9 (3) ◽  
pp. 816
Author(s):  
Jubina Bency A. T. ◽  
Sarangi . ◽  
Sebastian Roy ◽  
Shalu Sara Mathew ◽  
Shamseena A. ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Work Experience ◽  
Health Care Services ◽  
Cross Sectional Study ◽  
Moderate Degree ◽  
Cross Sectional ◽  
Hearing Ability ◽  
Care Services ◽  
Mild Degree

Background: Hearing loss is a cause of global concern. Percussionists are exposed to greater levels of continuous or intermittent noise than others. Little is known about the relationship between percussion activity and hearing impairment. The early detection of the same and subsequent management makes a significant reduction in the burden of health care services. The objective was to study the proportion of hearing impairment in percussionists in the district of Thrissur using an IOS based mobile application.Methods: A cross sectional study was done on percussionists from Thrissur district who has experience of more than five years and has no congenital or traumatic hearing loss. A predesigned semi structured questionnaire was given and hearing tests were done using a mobile application U hear in a sound proof setting to understand the current state of hearing ability amoung the percussionists.Results: A total of 39 subjects were involved in our study of which all were males. Mean age of our study population was 30.44+12.04. most of them were diagnosed with at least mild degree of hearing loss of one of the ear or both the ears. 15.4% of them had mild degree of hearing loss, 64.1% had moderate degree of hearing loss and 20.5% had severe hearing loss.Conclusions: The study shows percussionists are more exposed to sounds of various frequencies for longer duration, they are more prone to hearing loss. The study brought out that age is directly proportional to hearing loss, music induced hearing loss progress at a rate proportion to the work experience. 

Sociodemographic factors associated with postnatal maternal complications in public hospitals in Nairobi City County, Kenya

2021 ◽  
Vol 15 (1) ◽  
pp. 1-7
Author(s):  
Raheli Misiko Mukhwana ◽  
Margaret N Keraka ◽  
Meshack Onyambu
Keyword(s):  
Antenatal Care ◽  
Mode Of Delivery ◽  
Cost Effective ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Factors Associated ◽  
Focused Antenatal Care

Introduction/Aims Focused antenatal care provides individualised counselling, targeted assessment and safe, cost effective, evidence-based intervention. It has been implemented in developing countries as a strategy to improve maternal health. This study aimed to investigate sociodemographic factors associated with maternal complications in selected public county hospitals in Nairobi City County, Kenya. Methods This was a cross-sectional study using a sample of 397 postnatal women who were given a questionnaire, with sections on their sociodemographic and health characteristics. Data analysis was done using the Chi Square test to determine the association between study variables, with P<0.05 considered statistically significant. Results The study found that 30% of respondents reported a maternal complication during their current delivery outcome. Sociodemographic factors significantly associated with maternal complications were age (P=0.002), occupation (P=0.001) and income (P=0.011). The health factors associated with occurrence of maternal complications were number of deliveries (P=0.001) and mode of delivery (P=0.001). Conclusions A number of factors were found to be significantly associated with maternal outcomes, including age and occupation. Further studies to determine why young women do not use focused antenatal care are necessary, as this would help reduce the incidence of birth-associated complications.

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