scholarly journals The growing use of the WHO Safe Childbirth Checklist: Lessons learned at the Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon

2019 ◽  
Author(s):  
Julius Sama DOHBIT ◽  
Namanou Ines Emma WOKS ◽  
Carlin Héméry KOUDJINE ◽  
Willy TAFEN ◽  
Pascal FOUMANE ◽  
...  
Keyword(s):  
Good Practice ◽  
Lessons Learned ◽  
Qualitative Assessment ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Pediatric Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Safe Childbirth Checklist ◽  
Safe Childbirth

Abstract Background: Safe childbirth remains a daunting challenge, particularly in low-resource settings where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 782 per 100,000 live births in 2011 is significantly high. Adherence to good practice standards by birth attendants is key to improving pregnancy outcomes. The WHO Safe Childbirth checklist was designed as a tool to improve the quality of care provided to women giving birth. This checklist was implemented at the Yaounde Gyneco-Obsteric and Pediatric Hospital. Quantitative and qualitative assessment of its utilization is essential to secure a change in attitudes and practice and engender improvement in maternal health. Objective: Evaluate the change in attitudes and practice of nurses and compare outcomes in cases where it was and was not used, 6 months after introduction of the safe childbirth checklist in a maternity setting. Methods: A cross sectional and retrospective study was conducted over a 6 month period (January – June 2018). Predesigned questionnaires were used to collect qualitative data on the checklist from personnel of the maternity and another data collection form used to extract information from patient records. Data analysis was done using SPSS version 23.0. Chi square test was used to compare categorical variables, while the student test was used to compare continuous variables. Results: Of the 1001 files retrieved from the archives, 25 were excluded. The checklist was used in 828/976 (84.8%) files. We observed an increasing trend in the usage rate, with a peak at 93.9% recorded during the last 2 months. Pages 2 and 3 were least completed, in <10% of cases during the first 5 months. Fewer cases of pre-eclampsia and eclampsia were associated with the use of the checklist, compared to patients in whom the checklist was not used (2·1% Vs 5·4%, p = 0·017). Fifty percent of the staff reported that the checklist increased workload while 37.5% mentioned laziness and absence of checklists in some files as a hindrance to its proper use. Conclusion: The use of the safe childbirth checklist improved progressively with a simultaneous reduction in obstetrical and neonatal complications overtime.

scholarly journals The growing use of the WHO Safe Childbirth Checklist: Lessons learned at the Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon

2019 ◽  
Author(s):  
Julius Sama DOHBIT ◽  
Namanou Ines Emma Woks ◽  
Carlin Héméry KOUDJINE ◽  
Willy TAFEN ◽  
Pascal FOUMANE ◽  
...  
Keyword(s):  
Good Practice ◽  
Lessons Learned ◽  
Qualitative Assessment ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Pediatric Hospital ◽  
Cross Sectional ◽  
Gynecology And Obstetrics ◽  
Safe Childbirth Checklist ◽  
Safe Childbirth

Abstract Background: Safe childbirth remains a daunting challenge, particularly in low-resource settings where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 782 per 100,000 live births in 2011 is significantly high. Adherence to good practice standards by birth attendants is key to improving pregnancy outcomes. The WHO Safe Childbirth checklist was designed as a tool to improve the quality of care provided to women giving birth. This checklist was implemented at the Yaounde Gyneco-Obsteric and Pediatric Hospital. Quantitative and qualitative assessment of its utilization is essential to secure a change in attitudes and practice and determine improvement in maternal health. Objective: Evaluate a change in attitudes and practice and determine improvement in outcomes 6 months after initiation of the safe childbirth checklist use. Methods: A cross sectional and retrospective study was conducted over a 6 month period (January – June 2018). Predesigned questionnaires were used to collect qualitative data from personnel of the Gynecology and Obstetrics unit and quantitative data from patient delivery records. Data analysis was done using SPSS version 23.0. Chi square test was used to compare categorical variables, while the student test was used to compare continuous variables. P -values below 5% were considered statistically significant. Results: Of the 1001 files retrieved from the archives, 25 were excluded. The checklist was used in 828/976 (84.8%) files. We observed an increasing trend in the usage rate, with a peak at 93.9% during the last 2 months. Pages 2 and 3 were least completed, in <10% of cases during the first 5 months. A significant reduction in the onset of pre-eclampsia and eclampsia was noted with the use of the checklist (2·1% Vs 5·4%, p = 0·017). The proportion of neonatal deaths recorded amongst cases with a used checklist was smaller compared to cases without checklists (0·2% Vs 0·7%, p = 0·380). Fifty percent of the staff reported that the checklist increased workload while 37.5% mentioned laziness and absence of checklists in some files as a hindrance to its proper use. Conclusion: The use of the checklist improved progressively with a simultaneous reduction in obstetrical and neonatal complications.

scholarly journals The growing use of the WHO Safe Childbirth Checklist: Lessons learned at the Yaounde Gyneco-Obstetric and Pediatric Hospital, Cameroon

2019 ◽  
Author(s):  
Julius Sama DOHBIT ◽  
Namanou Ines Emma WOKS ◽  
Carlin Héméry KOUDJINE ◽  
Willy TAFEN ◽  
Pascal FOUMANE ◽  
...  
Keyword(s):  
Good Practice ◽  
Lessons Learned ◽  
Qualitative Assessment ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Pediatric Hospital ◽  
Cross Sectional ◽  
Gynecology And Obstetrics ◽  
Safe Childbirth Checklist ◽  
Safe Childbirth

Abstract Background: Safe childbirth remains a daunting challenge, particularly in low-resource settings where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 782 per 100,000 live births in 2011 is significantly high. Adherence to good practice standards by birth attendants is key to improving pregnancy outcomes. The WHO Safe Childbirth checklist was designed as a tool to improve the quality of care provided to women giving birth. This checklist was implemented at the Yaounde Gyneco-Obsteric and Pediatric Hospital. Quantitative and qualitative assessment of its utilization is essential to secure a change in attitudes and practice and engender improvement in maternal health. Objective: Evaluate the change in attitudes and practice of nurses and compare outcomes in cases where it was and was not used, 6 months after introduction of the safe childbirth checklist in a maternity setting. Methods: A cross sectional and retrospective study was conducted over a 6 month period (January – June 2018). Predesigned questionnaires were used to collect qualitative data from personnel of the Gynecology and Obstetrics unit who used the safe childbirth checklist and quantitative data from patient delivery records. Data analysis was done using SPSS version 23.0. Chi square test was used to compare categorical variables, while the student test was used to compare continuous variables. Results: Of the 1001 files retrieved from the archives, 25 were excluded. The checklist was used in 828/976 (84.8%) files. We observed an increasing trend in the usage rate, with a peak at 93.9% recorded during the last 2 months. Pages 2 and 3 were least completed, in <10% of cases during the first 5 months. A significant reduction in the onset of pre-eclampsia and eclampsia was noted with the use of the checklist (2·1% Vs 5·4%, p = 0·017). Fifty percent of the staff reported that the checklist increased workload while 37.5% mentioned laziness and absence of checklists in some files as a hindrance to its proper use. Conclusion: The use of the safe childbirth checklist improved progressively with a simultaneous reduction in obstetrical and neonatal complications overtime. Keywords: Checklist, childbirth, Obstetrical complications

Ethnicity, age, and education influence perceptions of vegetable healthiness and macronutrient content

2021 ◽  
pp. 026010602110511
Author(s):  
McKenna Aram ◽  
Rachel Smallman ◽  
Sherecce A. Fields ◽  
Arianna Larez ◽  
Namino Glantz ◽  
...  
Keyword(s):  
Online Survey ◽  
Categorical Variables ◽  
Continuous Variables ◽  
College Degree ◽  
Nutritional Content ◽  
White Potato ◽  
Chi Square ◽  
Cross Sectional ◽  
Macronutrient Content ◽  
Diabetes Status

Objective: To assess perceptions of nutritional content and health value of popular vegetables. Design: Cross-sectional online survey. Participants: A total of 760 adults participated in the study. Main Outcome Measures: Likert scale ratings of healthy, calories, carbohydrates, protein, and fiber, for (i) avocado, (ii) romaine lettuce, (iii) white potato, (iv) white onion, and (v) red tomato. Analysis: ANOVAs for continuous variables and Chi-square for categorical variables. Outcomes for nutritional content were compared using separate one-way ANOVAs with ethnicity (Hispanic/Latino vs. non-Hispanic); education (college degree/no college degree); age (18–34, 35–50, 51–70, 70 + ); and diabetes status (with or without diabetes) as the grouping variables. Results: Significant ethnicity effects were found for avocado, lettuce, potato, onion, and tomato. Education level effects were found for avocado, lettuce, potato, and tomato. Age level effects were found for avocado, lettuce, potato, and tomato. Conclusions and Implications: Participant perceptions of the macronutrient content of common vegetables and fruits largely coincided with the US Department of Agriculture values. However, stratifying by ethnicity, age, and education revealed significant differences in both macronutrient perceptions and perceived healthiness. There were no consistent, significant results for interactions of ethnicity by education, nor ethnicity by age. These results suggest that dietary interventions may need to be adjusted based on participant sociodemographic characteristics linked to the perceptions of nutritional value and healthiness.

Association between parents’ physical activity and mode of commuting with their offsprings

2020 ◽  
Author(s):  
FERNANDO RODRIGUEZ ◽  
Francisco Javier Huertas-Delgado ◽  
Yaira Barranco-Ruiz ◽  
María Jesús Aranda-Balboa ◽  
Palma Chillón
Keyword(s):  
Physical Activity ◽  
Vigorous Physical Activity ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Ripple Effect ◽  
Inverse Association ◽  
Continuous Variables ◽  
Chi Square ◽  
Cross Sectional

Abstract Background. Some studies have reported a positive association between parents and their offspring’s physical activity (PA), but few have examined the difference in these associations concerning both genders. The objective of this study was to establish the association between moderate-vigorous physical activity (MVPA) and mode of commuting (MC) of the parents with their offspring’s MC, by gender and age group. Methods. This cross-sectional study included 686 parents (mothers: 52.8%) and their offsprings (33.8% girls). Each participant completed a questionnaire on PA and MC. Chi-square test, Odds Ratio for categorical variables and lineal regressions for continuous variables were used to examine the associations between the parents and their offspring. Results. An inverse association was found between fathers-children in the weekend MVPA in children and between mothers-adolescents in out-of-school and weekend MVPA in adolescents, specifically, an inverse association was found in MVPA between mothers-girls and 2) the different parents’ MC to work were positively associated with the MC to school in children and adolescents except for the association AC parents-adolescents and specifically, the AC was mainly associated between mothers and girls and boys. Conclusion. This study emphasizes the importance of involving parents in school-based interventions to create a positive ripple effect in PA-related behaviours.

scholarly journals A Cross-sectional Analysis of Radiographic Ankle Osteoarthritis Frequency and Associated Factors: The Johnston County Osteoarthritis Project

2017 ◽  
Vol 44 (4) ◽  
pp. 499-504 ◽  
Author(s):  
Shahmeer Lateef ◽  
Yvonne M. Golightly ◽  
Jordan B. Renner ◽  
Joanne M. Jordan ◽  
Amanda E. Nelson
Keyword(s):  
Weight Bearing ◽  
Ankle Injury ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Older Individuals ◽  
Ankle Osteoarthritis ◽  
Chi Square ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
History Of

Objective.Because there are no epidemiologic data regarding the frequency of ankle osteoarthritis (OA) in a general population, we sought to analyze this disabling condition in a large, well-characterized, community-based cohort of older individuals.Methods.Cross-sectional data, including ankle radiographs, were from the most recent data collection (2013–2015) of the Johnston County OA Project. Radiographic ankle OA (rAOA) was defined as a Kellgren-Lawrence arthritis grading scale of ≥ 2 on weight-bearing lateral and mortise radiographs. The presence of pain, aching, or stiffness in the ankles as well as history of ankle injury (limiting ability to walk for at least 2 days) were assessed. Chi-square statistics (categorical variables) and Student t tests (continuous variables) were used to compare all participant characteristics by rAOA status. Joint-based logistic regression models with generalized estimating equations were used to examine associations of rAOA and covariates of interest [age, body mass index (BMI), sex, race, ankle symptoms, and injury history].Results.Of 864 participants with available data, 68% were women, 34% were African American, with a mean age of 72 years and BMI of 31 kg/m2. Nearly 7% of this sample had rAOA. Increasing age, high BMI, history of ankle injury, and presence of ankle symptoms were all independently associated with greater odds of having rAOA; no significant differences were seen by sex or race.Conclusion.The frequency of rAOA was higher than estimates generally quoted in the literature. While injury was an important contributor, other factors such as age, BMI, and symptoms were also significantly associated with rAOA.

scholarly journals Diagnostic Dilemmas: A Multi-Institutional Retrospective Analysis of Adrenal Incidentaloma Pathology Based on Radiographic Size

2021 ◽  
Author(s):  
David Zekan ◽  
Robert Scott King ◽  
Ali Hajiran ◽  
Apexa Patel ◽  
Samuel Deem ◽  
...  
Keyword(s):  
Ct Scan ◽  
Imaging Modality ◽  
Univariate Analysis ◽  
Adrenal Incidentaloma ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Adrenal Cortical Adenoma ◽  
Simple Logistic

Abstract Introduction/Background Adrenal incidentalomas (AIs) are masses >1 cm found incidentally during radiographic imaging. They are present in up to 4.4% of patients undergoing CT scan, and incidence is increasing with usage and sensitivity of cross-sectional imaging. Most result in diagnosis of adrenal cortical adenoma, questioning guidelines recommending removal of all AIs with negative functional workup. This retrospective study analyzes histological outcome based on size of non-functional adrenal masses. Material and Methods 10 years of data was analyzed from two academic institutions. Exclusion criteria included patients with positive functional workups, those who underwent adrenalectomy during nephrectomy, <18 years, and incomplete records. AI radiologic and histologic size, histologic outcome, laterality, imaging modality, gender, and age were collected. T-test was used for comparison of continuous variables, and the two-sided Fisher’s exact or chi-square test were used to determine differences for categorical variables. Univariate analysis of each independent variable was performed using simple logistic regression. Results 73 adrenalectomies met the above inclusion criteria. 60 were detected on CT scan, 12 on MRI, and one on ultrasound. Eight of 73 cases resulted in malignant pathology, 3 of which were adrenocortical carcinoma (ACC). Each ACC measured >6 cm, with mean radiologic and pathologic sizes of 11.2 cm and 11.3 cm. Both radiologic and pathologic size were significant predictors of malignancy (p=0.008 and 0.011). Conclusions Our results question the generally-accepted 4 cm cutoff for excision of metabolically-silent AIs. They suggest a 6 cm threshold would suffice to avoid removal of benign lesions while maintaining sensitivity for ACC.

Androgen Receptor Overexpression in Patients With Prostate Cancer in Kampala, Uganda

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S86-S87 ◽  
Author(s):  
James Yahaya ◽  
Florence Ajok ◽  
Michael Odida ◽  
Henry Wabinga
Keyword(s):  
Androgen Receptor ◽  
Prostate Specific Antigen ◽  
Gleason Score ◽  
Specific Antigen ◽  
Staining Intensity ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Independent Expert

Abstract Objectives This study was aimed at determining the status of androgen receptor overexpression in patients with PCa and also correlating overexpression with Gleason score, patient age, and prostate-specific antigen (PSA). Methods This was a cross-sectional analytical laboratory-based study using retrospectively retrieved formalin-fixed, paraffin-embedded (FFPE) tissue blocks of 93 PCa patients who were diagnosed histologically between January and December 2018. Immunostaining was done using AR antibody. Cases with ≥10% positive cells having staining intensity of +1 and above were considered positive. Confirmation of the histological diagnosis and interpretation of the IHC-stained slides were done by two independent expert pathologists in a blinded manner. The association between AR overexpression and categorical variables was tested using the chi-square test, while continuous variables were tested using the t test with a 95% confidence interval (CI). A P < 0.05 was taken as statistically significant. Results AR overexpression was found in 54.8% (51/93) of the cases in this study. Majority of patients, 73.1% (68/93), had a Gleason score of 8 to 10, whereas a Gleason score of 6 to 7 was found in 26.9% (25/93). The mean Gleason score for the cases was 8.47 ± 1.52. Patients with a low Gleason score (≤7) had a higher proportion of AR overexpression than those with a high Gleason score (>8) and the difference was statistically significant (P = .013). Conclusion The clinical relevance of this study was that AR overexpression is associated with a Gleason score but not with age and prostate-specific antigen (PSA). AR overexpression was an independent predictor of PCa prognosis.

scholarly journals Morbidade neonatal dos recém-nascidos pré-termo tardios comparados aos de termo precoce

2017 ◽  
Vol 27 (1) ◽  
pp. 25876 ◽  
Author(s):  
Nuno Lourenço ◽  
Marco Fernandes ◽  
Clara Gomes ◽  
Cristina Resende
Keyword(s):  
Multiple Pregnancy ◽  
Neonatal Morbidity ◽  
Maternity Hospital ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Term Infants ◽  
Cross Sectional ◽  
Breastfeeding Rate

Aims: To evaluate and compare neonatal morbidity between late-preterm infants (LPTI) and early term infants (ETI).Methods: Retrospective cross-sectional study, including live births at a regional referral maternity hospital in Portugal, in the years 2014 and 2015, with gestational age between 340/7 and 386/7 weeks. LPTI (340/7-366/7 weeks) were considered as cases and ETI (370/7-386/7 weeks) were considered controls. Neonates with congenital malformations, lack of prenatal care and hospitalization for social/maternal reasons were excluded. We evaluated and compared neonatal morbidity between the two groups, using Student's t-test for comparison between means (continuous variables) and Chi-square or Fisher's test for comparison between categorical variables. Odds ratio (OR) was calculated and adjusted (aOR) to birth weight, maternal disease, type of birth and multiple pregnancy. A value of p <0,05 was considered of statistical significance.Results: A total of 1,745 neonates were evaluated: 324 cases (LPTI) and 1,421 controls (ETI). LPTI was associated with a higher frequency of maternal hypertension and gestational diabetes and higher rates of twinning and cesarean section. LPTI also had a higher risk for resuscitation (OR = 2.0 - 95%CI 1.3-3.0); hypoglycemia (aOR = 4.9 - 95%CI 2.9-8.2); hyperbilirubinemia (aOR = 4.8 - 95%CI 3.7-6.2), transient tachypnea (aOR = 6.4 - 95%CI 4.0-10.3); eating difficulties (aOR = 6.6 - 95%CI 4.8-8.9); sepsis (aOR = 4.4 - 95%CI 4.8-8.9); hospital stay ≥5 days (aOR = 8.6 - 95%CI 6.6-11.3); and lower exclusive breastfeeding rate (aOR = 0.2 - 95%CI 0.15-0.3).Conclusions: In comparison to ETI, LPTI presented a higher risk of morbidity. This study reinforces the need for appropriate clinical follow-up of LPTI in the neonatal period.

scholarly journals Factors affecting the time lag to the second eye cataract surgery in a hospital-based population

2014 ◽  
Vol 6 (1) ◽  
pp. 31-38
Author(s):  
Charu Malik ◽  
Manjit S Bhatia ◽  
Upreet Dhaliwal
Keyword(s):  
Cataract Surgery ◽  
Time Lag ◽  
Cross Sectional Study ◽  
Analysis Of Covariance ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Group 2 ◽  
One Year

Introduction: Cataract can be treated successfully, yet patients delay surgery. Surgery in one eye may not promote surgery in the second. Objectives: To determine the time lag to the second eye cataract surgery and identify the factors that affect it. Materials and methods: This study was conducted at an ophthalmology out-patient department of a teaching hospital and was an observational, cross-sectional study. Consecutive patients of over 45 years who had had cataract surgery in one eye and had visually significant senile cataract in the other were categorized into those that requested sequential surgery (Group 1) and those that refused (Group 2). The relevant history and vision were recorded. A questionnaire was used to seek possible responsible factors that determined the refusal for the second surgery. Statistical analysis: Categorical variables were compared between groups using the chi-square test and continuous variables using the Student t-test. Factors significantly affecting the time lag were subjected to the analysis of covariance. Rresults: Of the 250 patients of the study, only 104 (41.6 %) requested the second eye surgery, less than one-fifth within one year. Thirteen patients from Group 2 presented with complications of hypermaturity in the second eye. The average time lag was 2.39 ± 2.19 years. It was significantly more in Group 2 patients (p = 0.024) who also reported more barriers (2.75 ± 1.23 versus 1.58 ± 1.10; p = 0.005). The factors that increased the time lag were older age (p = 0.028), extra-capsular surgery (p < 0.001), and being able to manage after the first surgery (p = 0.011) in Group1, and eye-camp (p = 0.021) or extra-capsular surgery (p < 0.001) in Group 2 patients. Conclusions: One-fifth of the patients reported back for sequential surgery within one year. Patients who refused surgery had more barriers; most were related to the first surgery and should be anticipated by compassionate ophthalmic professionals after surgery in the first eye. DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10761   Nepal J Ophthalmol 2014; 6 (2): 31-38

scholarly journals Frequency of types of parturition and their relationship with maternal characteristics: a cross-sectional analysis

2020 ◽  
Vol 8 (6) ◽  
pp. 2051
Author(s):  
Farah Khan ◽  
Saira Jamshed ◽  
Zakia Bano ◽  
Amna Begum ◽  
Madiha Ariff ◽  
...  
Keyword(s):  
Social Sciences ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Maternal Characteristics ◽  
Pregnant Females ◽  
Study Results ◽  
Chi Square Test ◽  
Inferential Analysis

Background: The pathways that are involved for the duration of pregnancy and type of parturition are extremely complex, involving maternal as well as fetal systems. The objective of this study was to determine the frequency of types of parturition and their relationship with maternal characteristics among pregnant female patients.Methods: A cross-sectional survey using a non-probability convenient sampling technique was conducted among 195 healthy pregnant females at Obstetrics and Gynaecological Department of Hamdard Hospital, Karachi, from 1st March 2019 to 31st August 2019. After taking written informed consent from the participants, the relevant data were gathered with the help of a structured questionnaire designed specifically for the study. Statistical package for social sciences was used for data entry while the chi-square test was applied for inferential analysis. The duration of the study was six months. Data were entered and analyzed using Statistical Package for Social Sciences version 20.0. Descriptive analysis was performed by generating means and standard deviations for continuous variables while frequencies and percentages for categorical variables. A Chi-square test was applied to perform the inferential analysis while the significance level was set at 0.05.Results: A total of 195 pregnant females were included in the study, whose mean age was 29.29±5.22 years. The study results showed that BMI before pregnancy (p=0.021), rest is taken during pregnancy (p=0.034) and gravida status (p=0.047) were all significantly associated with the type of parturition among the study participants, but spacing in pregnancies and parity were not.Conclusions: Maternal characteristics were found to be significantly associated with the type of parturition among pregnant females. For gynecologists the maternal characteristics identified in this study may serve as a useful indicator of the type of parturition expected in their patients.

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