Acceptance of Partner’s Presence during Labour by Midwives, Clients and Partners in selected Health Facilities in Osogbo, Nigeria

This study examined the acceptance of partners’ presence during labour by midwives, clients and partners in selected health facilities in Osogbo, Nigeria. Well-structured questionnaire was used to collect data from a total of 120 respondents consisting of midwives, clients and partners from the health facilities. Data collected and analyzed using descriptive and inferential statistics. The Statistics Package for Social Sciences (SPSS version 20) was employed for data analysis. All analyses were done at p≤0.05. The study reveals that there is no significant difference in the acceptance of partners’ presence during labour by the three categories of respondents. The study concludes that partners’ presence be embraced as an intentional policy in health care, Midwifery training and practices in labour management in Nigeria. The study recommends that Government should initiate policies to facilitate partners’ presence during labour and organize programmes on partners’ presence during labour which will be made a standardized practice in all hospitals and this should be communicated and taught to staff immediately they are employed into the health care institutions.

Artificial Intelligence in Kidney Transplantation: A Scoping Review (Preprint)

BACKGROUND Artificial Intelligence technologies and big data have been increasingly used to enhance kidney transplant experts’ ability to make critical decisions and manage the care plan for their patients. OBJECTIVE To explore the use of AI technologies in the field of kidney transplantation as reported in the literature. METHODS Embase, CINAHL, PubMed and Google Scholar were used in the search. Backward reference list checking of included studies was also conducted. Study selection and data extraction was done independently by three reviewers. Data extracted was synthesized in a narrative approach. RESULTS Of 505 citations retrieved from the databases, 33 unique studies are included in this review. Artificial intelligence (AI) technologies in the included studies were used to help with diagnosis (n= 16), used as a prediction tool (n=15) and, also for supporting appropriate prescription for kidney transplant patients (n = 2). The population who benefited from the technique included patients who underwent kidney transplantation procedure (n = 24) and those who are potential candidate (n=6). The most prominent AI branch used in kidney transplantation care was machine learning with Random Forest (n=11) being the most used AI model, followed by Linear Regression (n=6). CONCLUSIONS Conclusion: AI is extensively being used in the field of kidney transplant. However, there is a gap in research on the limitation and obstacles associated with implementing AI technologies in kidney transplant. There is a need for more research to identify educational needs and standardized practice for clinicians who wish to apply AI technologies in critical transplantation-related decisions.

Premedication for Nonemergent Intubation in the NICU: A Call for Standardized Practice

This paper discusses neonatal endotracheal intubation and the need for standardization in practice regarding the use of premedication. Intubation is common in the NICU because of resuscitation, surfactant administration, congenital anomalies, apnea, and sedation for procedures or surgery. Intubation is both painful and stressful. Unmedicated intubation is associated with several adverse outcomes including repeat and prolonged attempts, airway trauma, bradycardia, severe desaturation, and need for resuscitation. Most providers believe intubation is painful and that premedication should be provided; however, there is still resistance to provide premedication and inconsistency in doing so. Reasons for not providing premedication include concerns about medication side effects such as chest wall rigidity or prolonged respiratory depression inhibiting immediate extubation after surfactant administration. Premedication should include an opioid analgesic for pain, a benzodiazepine for an adjuvant sedation, a vagolytic to decrease bradycardia, and the optional use of a muscle relaxant for paralysis.

Tracheostomy tube change during the COVID-19 pandemic: timing and safety considerations

Background The recent outbreak of SARS-CoV-2 has become pandemic since it began in late 2019. Tracheostomy is considered an aerosol-generating procedure which increases potential viral exposure to the health care staff. Main body Since many patients diagnosed with SARS-CoV-2 underwent tracheostomy, the need for a standardized practice for tracheostomy tube change and care is mandatory. Articles listed in PubMed and guidelines from the otolaryngology societies were reviewed, and the state-of-the-art practice related to the topic is highlighted. Conclusions Tracheostomy care in COVID-19 patients requires significant decision-making and preparation to carry out the task in a safe way and eliminate the risk of viral transmission.

The Unexamined Diversity: Disability Policies and Practices in US Graduate Medical Education Programs

ABSTRACT Background Graduate medical education (GME) institutions must ensure equal access for trainees with disabilities through appropriate and reasonable accommodations and policies. To date, no comprehensive review of the availability and inclusiveness of GME policies for residents with disabilities exists. Objective We examined institutions' compliance with Accreditation Council for Graduate Medical Education (ACGME) requirements and alignment with Association of American Medical Colleges (AAMC) policy considerations. Methods Between June and August 2019, we conducted a directed content analysis of GME institutional policies using the AAMC report on disability considerations and the ACGME institutional requirements as a framework. Results Of the 47 GME handbooks available for review, 32 (68%) included a disability policy. Forty-one of the 47 (87%) handbooks maintained a nondiscrimination statement that included disability. Twelve of the 32 (38%) handbooks included a specific disability policy and language that encouraged disclosure, and 17 (53%) included a statement about the confidential documentation used to determine reasonable accommodations. Nineteen of the 32 (59%) maintained a clear procedure for disclosing disabilities and requesting accommodations. Conclusions While disability policies are present in many of the largest GME institutions, it is not yet a standardized practice. For institutions maintaining a disability policy, many lack key elements identified as best practices in the AAMC considerations.

Cistercians and Saints in Scotland: Cults and the Monastic Context

While Cistercian liturgical practices generally maintained a high degree of uniformity, that deviations from standardized practice consistently occurred in the celebration of saints is evidenced by the highly individualized composition of kalendars and litanies. Some of these variances emerged through special permissions while others were unsanctioned additions. This article utilizes the surviving evidence for Cistercian abbeys in Scotland to explore the unique blend of saints commemorated at particular houses, demonstrating that monastic observance reflects local devotion to cults within varying regional contexts. It is suggested that this ‘responsiveness’ to lay religiosity goes beyond the institutional appropriation of local culture, and should be viewed within the context of patterns of monastic recruitment from particular localities. Thus, the types of pressures felt from external lay populations, often cited as the key factor in shaping Cistercian interaction with saints’ cults, were just as likely to come from within the monastery itself.