State of Watermain Infrastructure: A Canadian Case Study using Historic Pipe Break Datasets

Author(s):  
Brett Snider ◽  
Edward McBean

Over the last two decades, a variety of reports have suggested that watermains in Canada are deteriorating, and break rates are increasing. However, these reports are often limited as the years of break records being utilized are brief; this paper revisits those assessments using over forty-five years of break records and shows that three of the five utilities investigated are experiencing significant decreases in break rates over the past 10 years while the two other utilities are maintaining consistent break rates. These results indicate that these utilities are effectively managing their watermain infrastructure, and suggest watermain infrastructure throughout Canada may be performing better than suggested by cross-sectional survey results. Analyses indicate that on average, 22% of the watermains analysed have exceeded the 0.125 brk/km/yr break rate threshold and may be considered for pipe replacement / rehabilitation. In particular 50% of cast iron pipes installed post-WWII have exceeded a break rate threshold of 0.125 brks/km/yr, suggesting large pipe replacement/rehabilitation of this pipe cohort is required.

Author(s):  
Yoshito Nishimura ◽  
Tomoko Miyoshi ◽  
Hideharu Hagiya ◽  
Yoshinori Kosaki ◽  
Fumio Otsuka

The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between the COVID-19 pandemic and the prevalence of burnout in healthcare professionals in Japan. Healthcare workers in a single Japanese national university hospital participated in the survey, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks and the Maslach Burnout Inventory. Of those, 25.4% fully answered the survey; 33.3% were doctors and 63.6% were nurses, and 36.3% engaged in care of COVID-19 patients in the past 2 weeks. Compared to those belonging to General Medicine, those in Emergency Intensive Care Unit were at higher risk of burnout (odds ratio (OR), 6.7; 95% CI, 1.1–42.1; p = 0.031). Of those who engaged in care of COVID-19 patients, 50% reported burnout while 6.1% did not (OR 8.5, 95% CI; 1.3–54.1; p = 0.014). The burnout of healthcare workers is a significant concern amid the pandemic, which needs to be addressed for sustainable healthcare delivery.


2017 ◽  
Vol 7 (4) ◽  
pp. 87
Author(s):  
James K. Sirite ◽  
Henry Ongori ◽  
Darius Bosire

The purpose of this study was to identify the challenges faced in quality service delivery to Turkana Central Sub-county citizens of Turkana County. The study used cross-sectional survey design. The sample size selected for the study was 261.  Data was collected using questionnaires and interview guides. Data was analyzed by descriptive statistics and presented in tables and figures for ease interpretation. The major findings of the study show that devolved governance faces some challenges. For instance the devolved governance is faced with corruption, lack of transparency and accountability and inadequate funds. This adversely   affects quality service delivery to its citizens. The findings of the study would inspire policy makers at the county and national government level to come up with appropriate strategies to mitigate the challenges identified in order to improve the quality of services offered by the county governments.


2006 ◽  
Vol 4 (1) ◽  
pp. 58-63
Author(s):  
Lisa Smith ◽  
James F. McKenzie

This study examined the task of health educators working in a clinical setting to better understand their roles. The study was designed as a descriptive, cross-sectional survey using a convenience sample of health educators who worked in clinical settings in Indiana and who had a college degree in health education. Forty health educators were contacted and 62% of the subjects participated in the survey. Results indicated most jobs were similar in nature and the health education curriculum studied helped them in the roles they were serving. However, many educators felt there were other content areas of study that would have been helpful to prepare them for working in the clinical setting. A majority of the respondents reported that having Certified Health Education Specialist (CHES) certification was helpful and necessary in their positions.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S292-S292
Author(s):  
Rie Suzuki ◽  
Jennifer Blackwood ◽  
Shailee Shah ◽  
Sabah Ganai ◽  
Kimberly Warden

Abstract The built environment is commonly cited as a facilitator to local walking. Although health promotion programs targeting physical activity are available, few studies have investigated the associations of the perceived neighborhoods with the incidence of falls in the minority communities. Hence, the purpose of this preliminary study was to understand whether the perceived built environment influenced the fall experiences in older adults living in the underserved community. The preliminary cross-sectional survey was conducted at the regional health clinic in Flint, MI. Descriptive statistics and analysis of variance (ANOVA) were performed using SAS v8.4. The eligibility criteria included over 65 years old and Flint residents. Of 132 participants, the mean age was 69.75 (SD=5.00). The majority were female (68%), African Americans (80%), single, divorced or widowed (80%), and > GED (84%). The ANOVAs supported that “had fallen in the past year” was associated with “stores are within easy walking distance,” “easy to walk to a transit stop” and “there is a dirt strip that separates the streets from the sidewalks.” The fall experience was more likely to associate with the sedentary lifestyle and the comorbidities such as diabetes, fatigues, muscle spasms, and chronic pain. To summarize, the built environment increased the incidence of falls in the past year. Those who had fallen had poor health conditions. Further studies are needed for older adults to engage in physical activity. It is essential to develop the age-friendly support systems and accommodations to local walking in this community.


2020 ◽  
pp. 019459982095115
Author(s):  
Andrew J. Steehler ◽  
Brian Pettitt-Schieber ◽  
Matthew B. Studer ◽  
Geetha Mahendran ◽  
Barbara J. Pettitt ◽  
...  

Objective To develop and evaluate a virtual otolaryngology medical student elective created during the COVID-19 crisis with the intention of teaching the basic tenets of otolaryngology and increasing exposure to the specialty. Study Design Cross-sectional survey. Setting Emory University School of Medicine. Methods A 1-week virtual otolaryngology curriculum was offered to third- and fourth-year medical students that centered on the American Academy of Otolaryngology–Head and Neck Surgery Foundation’s handbook Primary Care in Otolaryngology (fourth edition). The course covered a variety of topics and was conducted remotely via online video conferencing software. We applied multiple teaching modalities and surveyed students regarding the effectiveness of the course. Mixed methods analysis was employed to analyze the course data. Results Twelve students participated; 67% reported their baseline precourse understanding of otolaryngology in the “poor-fair” range. After the course, 92% of students reported increased understanding, with 42% and 58% reporting “good” and “very good” understanding, respectively. Following completion of the course, posttest scores on summative assessments were significantly higher than pretest scores ( P < .001). Ninety-two percent of students reported either “increased” or “greatly increased” interest in otolaryngology postcourse. Qualitative survey results revealed students’ appreciation of course organization, formative assessments, and case-based learning. Conclusions An otolaryngology elective administered through a virtual format can be effective at providing an educational experience and garnering interest in the field. Positive exposure to otolaryngology can increase medical students’ interest in pursuing the specialty and expand their general knowledge of consultation, diagnosis, and management in otolaryngology.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Tidenek Mulugeta Tujo ◽  
Tadesse Gudeta Gurmu

Background. The increased morbidity and mortality rates in children under five in developing countries are mostly attributed to poor availability and failure of prescribing lifesaving medicines. This study was aimed at evaluating the availability and utilization of the WHO-recommended priority lifesaving medicines for children under five in public health facilities. Method. A cross-sectional survey complemented with a qualitative method was conducted in 14 health centers and four hospitals in the Jimma Zone, Ethiopia. In the facilities, we assessed the availability within the last half year and on the day of the visit. Utilization of the medicines was assessed through a review of patient records of the last one year. Twelve in-depth interviews were carried out to collect the qualitative data, and the analysis was executed using thematic analysis. Results. For treatment of pneumonia, amoxicillin dispersible tablets and gentamycin injection were available in 94.4% of the facilities. For treatment of malaria, artemether/lumefantrine was available in 61.1% of the facilities. For pain management, paracetamol tablets were available in 94.4% of the facilities. AZT+3TC+NEV for HIV/AIDS management was available in all facilities. At least one essential medicine was out of stock in the past six months with the average duration of 33.6 days in health centers and 28.25 days in hospitals. Oral rehydration salt and zinc (84.7%) and AZT+3TC+NEV (100%) had better utilization. However, for almost all cases, other nonpriority medicines were highly prescribed. Lack of administrative commitment, supply of near expiry products, complexity of diseases, and lack of customized child formulations were among the challenges of availability and utilization of those medicines. Conclusions. The overall availability of lifesaving medicines on the day of the visit was fairly good but with poor utilization in almost all facilities. Some products were not available for considerable length of time in the past six months.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039792
Author(s):  
Anna Gottschlich ◽  
Sophia Mus ◽  
Jose Carlos Monzon ◽  
James F Thrasher ◽  
Joaquin Barnoya

ObjectivesHeated tobacco products (HTPs) are increasingly marketed worldwide, yet limited research on HTPs has been conducted in low and middle-income countries (LMICs) or among adolescents. Guatemala is one of the few LMICs where HTPs are available. This study examined prevalence and correlates of HTP awareness, susceptibility and use among adolescents in Guatemala.Design, setting and participantsA cross-sectional survey on HTP awareness, susceptibility and use was conducted among 2870 students between the ages of 13 and 17 in private schools in Guatemala City, Guatemala.Primary and secondary outcome measuresThe primary outcome was susceptibility to future use of HTP among school-aged current and never smokers in Guatemala. We also explored awareness and use of HTPs. Multivariate binomial regression models were used to explore associations between these outcomes and both sociodemographic factors and established smoking correlates.ResultsOf all students (n=2870), about half were aware of HTPs (52.4%) and susceptible to future or continued use (52.4%). Whereas 8.4% of students had tried HTPs in the lifetime (but not in the last month), only 2.9% used HTPs in the past month. Independent correlates of HTP susceptibility and ever-use included: use of other tobacco products (current smoking: adjusted OR (AOR)=10.53 and 6.63, respectively; current e-cigarette use: AOR=21.87 and 10.40, respectively), moderate alcohol consumption (AOR=1.49 and 1.19, respectively), marijuana use in the past 30 days (AOR=3.49 and 2.29, respectively) and having friends who use HTPs (AOR=1.83 and 7.28, respectively).ConclusionsAmong this sample of adolescents in Guatemala City, where tobacco control is weak, the prevalence of HTP use was low but susceptibility to future use was high. Tobacco prevention and intervention strategies for cigarettes and e-cigarettes should now also include HTPs, which tend to be used by similar adolescent populations (ie, those who use other substances or are exposed to tobacco through family and friends).


Author(s):  
Jiayao Xu ◽  
Xiaomin Wang ◽  
Kai Sing Sun ◽  
Leesa Lin ◽  
Xudong Zhou

Abstract Background Self-medication with antibiotics (SMA) is one of the most dangerous inappropriate antibiotic use behaviors. This study aims to investigate the impact of parental SMA for children before a consultation on their doctor’s subsequent antibiotic prescribing behavior, including intravenous (IV) antibiotic use in the clinical setting of China. Methods A cross-sectional survey was conducted between June 2017 and April 2018 in three provinces of China. A total of 9526 parents with children aged 0–13 years were investigated. Data from 1275 parents who had self-medicated their children and then visited a doctor in the past month were extracted and analyzed. Results One-third (410) of the studied children had parental SMA before the consultation and 83.9% of them were subsequently prescribed antibiotics by doctors. Children with parental SMA were more likely to be prescribed antibiotics (aOR = 7.79, 95% CI [5.74–10.58]), including IV antibiotics (aOR = 3.05, 95% CI [2.27–4.11]), and both oral and IV antibiotics (aOR = 3.42, 95% CI [2.42–4.84]), than children without parental SMA. Parents with SMA behaviors were more likely to request antibiotics (aOR = 4.05, 95% CI [2.59–6.31]) including IV antibiotics (aOR = 2.58, 95% CI [1.40–4.76]), and be fulfilled by doctors (aOR = 3.22, 95% CI [1.20–8.63]). Conclusions Tailored health education for parents is required in both community and clinical settings to discourage parental SMA for children. The doctors should not prescribe unnecessary antibiotics to reinforce parents’ SMA behaviors. We recommend expanding the current IV antibiotics ban in outpatient settings of China to cover outpatient pediatrics.


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