scholarly journals Association between ambulance prehospital time and maternal and perinatal outcomes in Sierra Leone: a countrywide study

2021 ◽  
Vol 6 (11) ◽  
pp. e007315
Author(s):  
Marta Caviglia ◽  
Giovanni Putoto ◽  
Andrea Conti ◽  
Francesca Tognon ◽  
Amara Jambai ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Perinatal Mortality ◽  
Rural Areas ◽  
Binary Data ◽  
National Level ◽  
Capital City ◽  
Risk Of Death ◽  
Essential Surgery ◽  
Obstetric Emergencies ◽  
Prehospital Time

IntroductionSierra Leone, one of the countries with the highest maternal and perinatal mortality in the world, launched its first National Emergency Medical Service (NEMS) in 2018. We carried out a countrywide assessment to analyse NEMS operational times for obstetric emergencies in respect the access to timely essential surgery within 2 hours. Moreover, we evaluated the relationship between operational times and maternal and perinatal mortality.MethodsWe collected prehospital data of 6387 obstetric emergencies referrals from primary health units to hospital facilities between June 2019 and May 2020 and we estimated the proportion of referrals with a prehospital time (PT) within 2 hours. The association between PT and mortality was investigated using Poisson regression models for binary data.ResultsAt the national level, the proportion of emergency obstetric referrals with a PT within 2 hours was 58.5% (95% CI 56.9% to 60.1%) during the rainy season and 61.4% (95% CI 59.5% to 63.2%) during the dry season. Results were substantially different between districts, with the capital city of Freetown reporting more than 90% of referrals within the benchmark and some rural districts less than 40%. Risk of maternal death at 60, 120 and 180 min of PT was 1.8%, 3.8% and 4.3%, respectively. Corresponding figures for perinatal mortality were 16%, 18% and 25%.ConclusionNEMS operational times for obstetric emergencies in Sierra Leone vary greatly and referral transports in rural areas struggle to reach essential surgery within 2 hours. Maternal and perinatal risk of death increased concurrently with operational times, even beyond the 2-hour target, therefore, any reduction of the time to reach the hospital, may translate into improved patient outcomes.

Terrorism in Colombia

2003 ◽  
Vol 18 (2) ◽  
pp. 80-87 ◽  
Author(s):  
Gabriel Darío Paredes Zapata
Keyword(s):  
Rural Areas ◽  
Poor Country ◽  
National Level ◽  
Armed Forces ◽  
Capital City ◽  
Internally Displaced ◽  
Self Defense ◽  
Terrorist Groups ◽  
Drug Manufacturing ◽  
Criminal Groups

AbstractColombia is a poor country that has been plagued by ongoing violence for more than 120 years. During the 1940s, subversive terrorist groups emerged in rural areas of the country when criminal groups came under the influence of Communism, and were later transformed into contemporary groups, such as the Ejercito de Liberacion Nacional (ELN) or National Liberation Army and Fuerzas Armadas Revolucionares de Colombia (FARC) or Revolutionary Armed Forces of Colombia). Paramilitary terrorist groups emerged in response to subversive groups and were later transformed into contemporary groups, such as the Autodefensas Unidas de Colombia (AUC) or United Self-Defense Forces of Colombia.Terrorism has placed an enormous burden on modern Colombia. From 1995 to 2002, 9,435 people were killed by terrorism-related events, of which 5,864 were killed by subversive terrorist activities and 3,571 were killed by paramilitary terrorist activities. In 2002, at least nineteen attacks produced 10 or more casualties, of which 18 were bombings. In 2002, terrorists killed at least 12 mayors, 71 legislators, and internally displaced 300,000 persons from their homes. Since terrorist groups in Colombia are typically supported by drug manufacturing and trafficking, it has been difficult at times to distinguish violence due to terrorism from violence due to illicit drug trafficking. Terrorism has also had a major adverse effect on the economy, with restricted travel, loss of economic resources, and lack of economic investment. In addition to political, military, and commercial targets, terrorists have specifically targeted healthcare infrastructure and personnel.At the national and local levels, much emergency planning and preparedness has taken place for terrorism-related events. The Centro Regulador de Urgencias (CRU) or Emergency Regulation Center in Bogota plays a major role in coordinating local prehospital and hospital emergency response in the capital city and the national level where necessary.

Mau-Mau Rebels’ Doctor in Mount Kenya East Forest (1952–1960): Retrieving the Revolutionary History of Milton Munene Gachau

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Julius M. Gathogo
Keyword(s):  
National Level ◽  
Medical Doctor ◽  
Capital City ◽  
Revolutionary Movement ◽  
Armed Struggle ◽  
War Of Independence ◽  
Mau Mau ◽  
History Of ◽  
Revolutionary History ◽  
Second World

The Kenya Land and Freedom Army (KLFA), otherwise known as Mau-Mau revolutionary movement was formed after returnees of the Second World War (1939–1945) ignited the African populace to militarily fight for land and freedom (wiyathi nai thaka). John Walton’s theory of reluctant rebels informs this article theoretically, as it is indeed the political elites who inspired this armed struggle. To do this, they held several meetings in the capital city of Nairobi, drew the war structures from the national level to the sub-location level, especially in the central region of Kenya, and tasked locals with filling in the leadership vacuums that were created. In view of this, the article seeks to unveil the revolutionary history of the Mau-Mau medical Doctor, also known as Major Judge Munene Gachau (born in 1935), whose contribution in the Kenyan war of independence (1952–1960) remains unique. This uniqueness can be attested to by considering various factors. First, he is one of the few surviving leaders who joined the guerrilla forest war while he was relatively young. Normally, the Mau-Mau War Council did not encourage people below the age of 25 to join the rebels in the forest of Mt. Kenya, Aberdare Mountains and/or other places. Nor did they encourage adults past the age of 35 to join as combatants in the forest fight. Second, he is the only known Mau-Mau rebel in Kirinyaga county of Kenya to have gone back to school after the war had ended, traveled abroad, and studied up to a Masters degree level. Third, Munene Gachau belongs in the category that joined the rebels while still relatively educated and eventually got promoted to the rank of Major, upon being confirmed as the Mau-Mau Doctor.

scholarly journals Quantifying Air Pollutant Variations during COVID-19 Lockdown in a Capital City in Northwest China

Atmosphere ◽  
2021 ◽  
Vol 12 (6) ◽  
pp. 788
Author(s):  
Rong Feng ◽  
Hongmei Xu ◽  
Zexuan Wang ◽  
Yunxuan Gu ◽  
Zhe Liu ◽  
...  
Keyword(s):  
Air Pollution ◽  
Air Quality ◽  
Rural Areas ◽  
Vehicle Emissions ◽  
Motor Vehicle ◽  
Northwest China ◽  
Air Pollutant ◽  
Capital City ◽  
Air Pollution Control ◽  
Motor Vehicle Emissions

In the context of the outbreak of coronavirus disease 2019 (COVID-19), strict lockdown policies were implemented to control nonessential human activities in Xi’an, northwest China, which greatly limited the spread of the pandemic and affected air quality. Compared with pre-lockdown, the air quality index and concentrations of PM2.5, PM10, SO2, and CO during the lockdown reduced, but the reductions were not very significant. NO2 levels exhibited the largest decrease (52%) during lockdown, owing to the remarkable decreased motor vehicle emissions. The highest K+ and lowest Ca2+ concentrations in PM2.5 samples could be attributed to the increase in household biomass fuel consumption in suburbs and rural areas around Xi’an and the decrease in human physical activities in Xi’an (e.g., human travel, vehicle emissions, construction activities), respectively, during the lockdown period. Secondary chemical reactions in the atmosphere increased in the lockdown period, as evidenced by the increased O3 level (increased by 160%) and OC/EC ratios in PM2.5 (increased by 26%), compared with pre-lockdown levels. The results, based on a natural experiment in this study, can be used as a reference for studying the formation and source of air pollution in Xi’an and provide evidence for establishing future long-term air pollution control policies.

Designing, Implementing, and Managing a National Emergency Medical Service in Sierra Leone

2020 ◽  
pp. 1-6
Author(s):  
Luca Ragazzoni ◽  
Marta Caviglia ◽  
Paolo Rosi ◽  
Riccardo Buson ◽  
Sara Pini ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Medical Service ◽  
Sierra Leone ◽  
Low Income ◽  
Medical Service ◽  
Joint Venture ◽  
National Level ◽  
Emergency Medical ◽  
National Emergency ◽  
Operation Center

Abstract Sierra Leone is one of the least developed low-income countries (LICs), slowly recovering from the effects of a devastating civil war and an Ebola outbreak. The health care system is characterized by chronic shortage of skilled human resources, equipment, and essential medicines. The referral system is weak and vulnerable, with 75% of the country having insufficient access to essential health care. Consequently, Sierra Leone has the highest maternal and child mortality rates in the world. This manuscript describes the implementation of a National Emergency Medical Service (NEMS), a project aiming to create the first prehospital emergency medical system in the country. In 2017, a joint venture of Doctors with Africa (CUAMM), Veneto Region, and Research Center in Emergency and Disaster Medicine (CRIMEDIM) was developed to support the Ministry of Health and Sanitation (MOHS) in designing and managing the NEMS system, one of the very few structured, fully equipped, and free-of-charge prehospital service in the African continent. The NEMS design was the result of an in-depth research phase that included a preliminary assessment, literature review, and consultations with key stakeholders and managers of similar systems in other African countries. From May 27, 2019, after a timeframe of six months in which all the districts have been progressively trained and made operational, the NEMS became operative at national level. By the end of March 2020, the NEMS operation center (OC) and the 81 ambulances dispatched on the ground handled a total number of 36,814 emergency calls, 35,493 missions, and 31,036 referrals.

scholarly journals Comparison of Cancer Patients to Non-Cancer Patients among COVID-19 Inpatients at a National Level

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1436
Author(s):  
Alain Bernard ◽  
Jonathan Cottenet ◽  
Philippe Bonniaud ◽  
Lionel Piroth ◽  
Patrick Arveux ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Mortality Risk ◽  
Hospital Admissions ◽  
National Level ◽  
Administrative Database ◽  
Hospital Death ◽  
Solid Cancer ◽  
Hematological Cancer ◽  
Risk Of Death

(1) Background: Several smaller studies have shown that COVID-19 patients with cancer are at a significantly higher risk of death. Our objective was to compare patients hospitalized for COVID-19 with cancer to those without cancer using national data and to study the effect of cancer on the risk of hospital death and intensive care unit (ICU) admission. (2) Methods: All patients hospitalized in France for COVID-19 in March–April 2020 were included from the French national administrative database, which contains discharge summaries for all hospital admissions in France. Cancer patients were identified within this population. The effect of cancer was estimated with logistic regression, adjusting for age, sex and comorbidities. (3) Results: Among the 89,530 COVID-19 patients, we identified 6201 cancer patients (6.9%). These patients were older and were more likely to be men and to have complications (acute respiratory and kidney failure, venous thrombosis, atrial fibrillation) than those without cancer. In patients with hematological cancer, admission to ICU was significantly more frequent (24.8%) than patients without cancer (16.4%) (p < 0.01). Solid cancer patients without metastasis had a significantly higher mortality risk than patients without cancer (aOR = 1.4 [1.3–1.5]), and the difference was even more marked for metastatic solid cancer patients (aOR = 3.6 [3.2–4.0]). Compared to patients with colorectal cancer, patients with lung cancer, digestive cancer (excluding colorectal cancer) and hematological cancer had a higher mortality risk (aOR = 2.0 [1.6–2.6], 1.6 [1.3–2.1] and 1.4 [1.1–1.8], respectively). (4) Conclusions: This study shows that, in France, patients with COVID-19 and cancer have a two-fold risk of death when compared to COVID-19 patients without cancer. We suggest the need to reorganize facilities to prevent the contamination of patients being treated for cancer, similar to what is already being done in some countries.

scholarly journals Green and Blue Space Availability and Self-Rated Health among Seniors in China: Evidence from a National Survey

2021 ◽  
Vol 18 (2) ◽  
pp. 545
Author(s):  
Chensong Lin ◽  
Longfeng Wu
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Empirical Studies ◽  
National Level ◽  
The Elderly ◽  
Coverage Ratio ◽  
Self Rated Health ◽  
Health Promoting ◽  
Major River ◽  
Urban And Rural Areas

Many empirical studies have shown evidence of multiple health benefits provided by green and blue spaces. Despite the importance of these spaces, investigations are scarce in details for blue spaces rather than green. Moreover, most research has focused on developed regions. A limited number of studies on blue spaces can be found in China with a focus on the city level. Outcomes have been mixed due to varying research scales, methodologies, and definitions. This study relies on a national-level social survey to explore how the self-rated health (SRH) of senior individuals is associated with local green and blue space availability in urban and rural areas. Results indicate that the coverage ratio of overall green spaces and waterbodies around a resident’s home have marginal effects on SRH status in both urban and rural areas. In urban areas, living close to a park can is marginally beneficial for older people’s health. Regarding different types of blue spaces, the presence of a major river (within 0.3–0.5 km) or coastline (within 1 km and 1–5 km) in the vicinity of home negatively affects SRH among the elderly in urban areas. Close proximity to lakes and other types of waterbodies with a water surface larger than 6.25 ha did not significantly influence SRH. These findings not only evaluate general health impacts of green/blue space development on senior populations across the county but inform decision makers concerning the health-promoting qualities and features of different green/blue spaces to better accommodate an aging population in the era of urbanization.

scholarly journals Baseline risk factor prevalence among adolescents aged 15–17 years old: findings from National Non-communicable Disease Monitoring Survey (NNMS) of India

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044066
Author(s):  
Prashant Mathur ◽  
Vaitheeswaran Kulothungan ◽  
Sravya Leburu ◽  
Anand Krishnan ◽  
Himanshu Kumar Chaturvedi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Rural Areas ◽  
Communicable Disease ◽  
National Level ◽  
Developed Countries ◽  
Overweight And Obesity ◽  
Baseline Risk ◽  
Attitudes And Practices ◽  
Non Communicable Disease

ObjectiveTo generate national estimates of key non-communicable disease (NCD) risk factors for adolescents (15–17 years) identified in the National NCD Monitoring Framework and, study the knowledge, attitudes and practices towards NCD risk behaviours among school-going adolescents.Design and settingA community-based, national, cross-sectional survey conducted during 2017–2018. The survey was coordinated by the Indian Council of Medical Research—National Centre for Disease Informatics and Research with 10 reputed implementing research institutes/organisations across India in urban and rural areas.ParticipantsA multistage sampling design was adopted covering ages between 15 and 69 years—adolescents (15–17 years) and adults (18–69 years). The sample included 12 000 households drawn from 600 primary sampling units. All available adolescents (15–17 years) from the selected households were included in the survey.Main outcome measuresKey NCD risk factors for adolescents (15–17 years)—current tobacco and alcohol use, dietary behaviours, insufficient physical activity, overweight and obesity.ResultsOverall, 1402 households and 1531 adolescents completed the survey. Prevalence of current daily use of tobacco was 3.1% (95% CI: 2.0% to 4.7%), 25.2% (95% CI: 22.2% to 28.5%) adolescents showed insufficient levels of physical activity, 6.2% (95% CI: 4.9% to 7.9%) were overweight and 1.8% (95% CI: 1.0% to 2.9%) were obese. Two-thirds reported being imparted health education on NCD risk factors in their schools/colleges.ConclusionThe survey provides baseline data on NCD-related key risk factors among 15–17 years in India. These national-level data fill information gaps for this age group and help assess India’s progress towards NCD targets set for 2025 comprehensively. Though the prevalence of select risk factors is much lower than in many developed countries, this study offers national evidence for revisiting and framing appropriate policies, strategies for prevention and control of NCDs in younger age groups.

Influence of community satisfaction with individual happiness: comparative study in semi-urban and rural areas of Tikapur, Nepal

2017 ◽  
Vol 25 (3) ◽  
pp. 22-32 ◽  
Author(s):  
Myung-Bae Park ◽  
Chun-Bae Kim ◽  
Chhabi Ranabhat ◽  
Chang-Soo Kim ◽  
Sei-Jin Chang ◽  
...  
Keyword(s):  
Rural Areas ◽  
Physical Environment ◽  
Urban Areas ◽  
Positive Relationship ◽  
National Level ◽  
Medical Services ◽  
Community Satisfaction ◽  
Critical Factors ◽  
Urban And Rural Areas

Happiness is a subjective indicator of overall living conditions and quality of life. Recently, community- and national-level investigations connecting happiness and community satisfaction were conducted. This study investigated the effects of community satisfaction on happiness in Nepal. A factor analysis was employed to examine 24 items that are used to measure community satisfaction, and a multiple regression analysis was conducted to investigate the effects of these factors on happiness. In semi-urban areas, sanitation showed a positive relationship with happiness. In rural areas, edu-medical services were negatively related to happiness, while agriculture was positively related. Gender and perceived health were closely associated with happiness in rural areas. Both happiness and satisfaction are subjective concepts, and are perceived differently depending on the socio-physical environment and personal needs. Sanitation, agriculture (food) and edu-medical services were critical factors that affected happiness; however, the results of this study cannot be generalized to high-income countries.

Polyculture de tilapia et Clarias en etang dans la commune de Pobè, sud-est du Benin.

2020 ◽  
Author(s):  
Kochikpa Ondodje
Keyword(s):  
Rural Areas ◽  
Eating Habits ◽  
National Level ◽  
Wholesale Price ◽  
Point Of View ◽  
Fish Farms ◽  
Technical Standards ◽  
Pipe System ◽  
The Many ◽  
Modern Breeding

Abstract The SARL "Pobè Fish Farm" located in the South-East of Benin specializes in the production and sale of tilapia and Clarias. The farm has twenty two ponds of 200 m2 (10 m × 20 m) supplied with water by a pipe system from a natural and permanent stream. The water supply is via a concrete channel which did not allow the water to be renewed once the pond is full. Work has been carried out to allow a larger inflow of water and communication between the ponds. The operation of the farm is modeled on the types of agro-fish farms existing in Asia and encountered in Vietnam in particular; it aims to put theoretical knowledge into practice and on the other hand to contribute to the development of a sector still little known in Benin, despite the many hydroagricultural potentials with which this country is endowed. The species bred at national level are rustic and adapted to the environment and whose genetic performance has not been improved. In fact, only modern breeding following very precise technical standards can allow obtaining interesting results from the point of view of agronomic yield and financial profitability. Indeed, these fish from our ponds are very popular with the populations (the average wholesale price is 1000 FCFA/kg) and are already an integral part of eating habits both in rural areas and in cities.

scholarly journals Regional differences between rural areas of Serbia in population aging and agricultural activities: Case studies of the Indjija and Knjazevac municipalities

Spatium ◽  
2010 ◽  
pp. 29-37 ◽  
Author(s):  
Marijana Pantic ◽  
Jelena Zivanovic-Miljkovic
Keyword(s):  
Case Studies ◽  
Rural Areas ◽  
Regional Differences ◽  
Statistical Data ◽  
Population Aging ◽  
National Level ◽  
Agricultural Activities ◽  
Economic Activities ◽  
Qualitative Approaches ◽  
Source Of Information

As one of the signs of demographic change, population aging influences various spatial categories: economic activities, social features, land-use, perspectives for future development and more. Even though the process is indicative on a national level, there are significant differences among geographically and functionally distinctive regions. Based on considerable regional differences in the development of Serbia, this paper analyses the key problems of rural areas related to the interdependences of population aging and agricultural activities. Research on aging processes, changes in agricultural activities and their features is based here on the examples of two case studies. The Indjija and Knjazevac Municipalities have been chosen to represent geographically different regions - lowland and mountainous. This study uses both quantitative and qualitative approaches in order to achieve a better understanding of the situation. Statistical data were used to illustrate processes of aging and agriculture where data from two census years indicate a trend of changes. Interviews conducted with representatives of local government, entrepreneurs and local citizens from the villages are the source of information for quantitative analysis. Population aging and agriculture are examined separately, followed by an illustration of their interdependences.

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