Implementation of A Perinatal Problem Identification Program (PPIP) In Zambia: A Feasibility Study

Background: Zambia is among the African countries with a high perinatal mortality rate. Though programs teaching medical practitioners about advanced neonatal resuscitation have reduced deaths and improved survival, more information is needed to further decrease morbidity and mortality in newborns. The objectives of this study was to implement a Perinatal Problem Identification Program (PPIP) to improve collection of information on early and late neonatal mortalities. Methods: The Perinatal Problem Identification Program was implemented in the Neonatal intensive Care unit of the Women and Newborn Hospital in Lusaka Zambia. The program started on 1 May 2019 and ended on 31 December 2019. Data entry was conducted and analysis was undertaken using the PPIP computer based software program. The PPIP software calculated neonatal deaths and their causes.Results: The Neonatal intensive care unit at women and newborn hospital recorded a total of 2640 deaths in 7 months from May 1st 2019 to 31st December 2019.The highest cause of death was prematurity with its complications at 126 (54%) in the sampled 238 recorded deaths. Followed by infection at 46 (19%) and hypoxia at 44 (18%). These deaths ranged from birth weights of less than 1000 grams to more than 2500 grams.Conclusion: The results reveal that it is possible to implement PPIP in Zambia and its use eases the audit review process, which combined with audit review meetings can improve the quality of care of neonates in the neonatal intensive care unit.

1686 Are We Addressing the Syndesmosis in All Ankle Fractures – 2nd Cycle Audit at an MTC

Aim Assess compliance with BOAST guidelines – “Surgery should aim to achieve reduction and stabilisation of the ankle mortise. The syndesmosis should then be assessed and stabilised if unstable.” Method 103 Ankle ORIF procedures done for closed malleolar fractures in skeletally mature induviduals over a 12-month period used for first audit. Review of Op notes and intra-operative images was done looking for evidence of assessment of syndesmotic stability. Results were presented to the department and specific guidance on assessment of syndesmosis distributed. 84 Ankle ORIF procedures performed in next 12-month period used to re-audit. Results In the first audit, 34% cases had inadequate documentation regarding the stability of syndesmosis. This is similar to finding of 32% in a previous audit in 2018. Re-audit after presentation and review of guidelines, showed improved compliance with only 14.3% cases having no documentation of syndesmosis status. Conclusions Distribution of evidence supporting assessment of syndesmosis and making all grades of surgeons aware of the relevant guideline led to an improved compliance of more than 85%. There always remains the vulnerability to miss syndesmotic injuries and potentially adversely affect patient outcomes, if not explicitly assessed on table after bony fixation. All surgeons and rotating trainees need to be aware of this requirement.

Business Combination Process And Its Audit Review Of Financial Statements

Enterprises are known to be important subjects of accounting, which is the main link in the economy of any individual society, respectively, as a means of management. Through enterprises, tangible and intangible goods are created, various works are performed, services are provided and they are delivered to consumers. Increasing the number of enterprises, merging them, enlarging them, developing joint activities is one of the important factors in increasing the country's GDP, employment and income, improving living standards and welfare. This article reveals the basic rules of accounting and financial reporting in the context of reorganization of enterprises on the basis of existing laws and regulations, including national standards. The essence, features and procedures of reorganization of the main branches of the economy of the republic, respectively, the main subjects of accounting are revealed. The article also outlines the general requirements for accounting and financial reporting in the context of reorganization of enterprises.

Inservice road safety audit review of Toronto intersections

This project uses a practical procedure for conducting in-service road safety reviews of existing intersections. The procedure in this project is based on current experience in Canada and other countries and applies road safety engineering research to the Canadian environment. An in-service road safety review is an in-depth engineering study of an existing road using road safety priniciples with the aim of identifying cost-effective countermeasures that would improve road safety and operations for all road users. A review can be done for any road section, intersection, or interchange, and is generally most effective when conducted at locations where a high collision risk has been identified. In-service reviews typically include a structured review of collision history, geometric characteristics, and traffic, operational efficiency and could also include traffic conflict observations and a human factors assessment. The main output from in-service road safety reviews is the identification of road safety problems and the development of cost-effective countermeasures to overcome these road safety problems.

Inservice road safety audit review of Toronto intersections

This project uses a practical procedure for conducting in-service road safety reviews of existing intersections. The procedure in this project is based on current experience in Canada and other countries and applies road safety engineering research to the Canadian environment. An in-service road safety review is an in-depth engineering study of an existing road using road safety priniciples with the aim of identifying cost-effective countermeasures that would improve road safety and operations for all road users. A review can be done for any road section, intersection, or interchange, and is generally most effective when conducted at locations where a high collision risk has been identified. In-service reviews typically include a structured review of collision history, geometric characteristics, and traffic, operational efficiency and could also include traffic conflict observations and a human factors assessment. The main output from in-service road safety reviews is the identification of road safety problems and the development of cost-effective countermeasures to overcome these road safety problems.

A multicenter prospective audit to investigate the current management of patients undergoing anti-reflux surgery in the UK: Audit & Review of Anti-Reflux Operations & Workup

Background There are a variety of surgical and endoscopic interventions available to treat gastroesophageal reflux disease. There is, however, no consensus on which approach is best. The aim of this national audit is to describe the current variation in the UK clinical practice in relation to anti-reflux surgery (ARS) and to report adherence to available clinical guidelines. Methods This national audit will be conducted at centers across the UK using the secure online web platform ALEA. The study will comprise two parts: a registration questionnaire and a prospective multicenter audit of ARS. All participating centers will be required to complete the registration questionnaire comprising details regarding pre-, peri-, and post-operative care pathways and whether or not these are standardized within each center. Following this, a 12-month multicenter prospective audit will be undertaken to capture data including patient demographics, predominant symptoms, preoperative investigations, surgery indication, intraoperative details, and postoperative outcomes within the first 90 days. Local teams will retain access to their own data to facilitate local quality improvement. The full dataset will be reported at national and international scientific congresses and will contribute to peer-reviewed publications and national quality improvement initiatives. Conclusions This study will identify and explore variation in the processes and outcomes following ARS within the UK using a collaborative cohort methodology. The results generated by this audit will facilitate local and national quality improvement initiatives and generate new possibilities for future research in anti-reflux interventions.

The Various Models of Marketing Audit

This paper examines the problem of marketing control. The goal of the article is a scientific reflection on the model presentation of marketing audit. Review of the marketing literature on marketing audit presents various conceptual, structural or process models. Yet, these proposals did not play a role significant enough so that auditing would become a widely used marketing control tool. That is why, author presents an outline of the proprietary marketing audit model which (in conceptual and semantic approach), thanks to specifying the strategic nature of this control tool, can stimulate its popularization in marketing management practice. The conceptual model presents in an descriptive and graphic form the audit architecture, endogenous conditions (orientation, excellence, strategy, tactical and operational control), components of the audit activities and the planes of the assessment being carried out. The semantic model defines marketing audit as a logical and resulting system, which, by using the possibilities offered by specific control methods, allows for comprehensive, structured, regular, objective, independent and professional contextual assessment (preparation and implementation of marketing strategies). These models are a stimulus for discussion and further search for optimal ways of marketing control, both on a methodological and pragmatic level.