Training of Cadres In The Context of Emergency Identification of Pregnant Women During The Covid 19 Pandemic

The Covid-19 pandemic has changed many things, including the policy direction for the schedule of examinations for pregnant women, which was initially at least four times during pregnancy to one time, as long as the pregnancy is not problematic. In the midst of the COVID-19 pandemic, many pregnant women are reluctant to check their pregnancy at the hospital for fear of contracting the Corona virus, even though pregnancy checks still need to be carried out regularly. The purpose of this community service is to provide training to health cadres regarding emergencies in pregnancy so that cadres can provide assistance in order to identify emergency conditions during pregnancy during the COVID-19 pandemic. The method of activities carried out is cadre training and assistance to pregnant women. The results showed that after the training activities, the level of knowledge of cadres on emergency services in pregnant women increased and pregnant women in the high risk category were 53.7%. In conclusion, this community service program has succeeded in increasing the knowledge of cadres in assisting pregnant women during the COVID-19 pandemic.

HOUSEHOLD WASTE MANAGEMENT IN MEDAN CITY

The main problem in the solid waste sector in Medan City is the large number of illegal dumping. This study is to obtain an overview of the waste management that has been carried out so far, to inventory the problems of waste management system, to design a waste management model, and to provide recommendations for waste management system. This research used descriptive qualitative method. Based on the SSK instrument, it was known that the diagram of the waste sanitation system in Medan City had 6 categories. There were 18 villages in Medan City at very high risk category, 7 villages in the high-risk category, 51 villages at moderate risk category, and 75 villages at low risk category. Waste zoning in Medan City consists of 4 zones. Based on SWOT analysis which determine the objectives, targets and strategies for developing solid waste management in Medan City was in the fourth quadrant, it was a defensive strategy. The position of internal and external factors in the solid waste sub-sector in this quadrant showed that weaknesses and threats were more dominant than strengths and opportunities.

An Evaluation of Omega-3 Status and Intake in Canadian Elite Rugby 7s Players

Background: EPA and DHA n-3 FA play crucial roles in both neurological and cardiovascular health and high dietary intakes along with supplementation suggest potential neuroprotection and concussion recovery support. Rugby athletes have a high risk of repetitive sub-concussive head impacts which may lead to long-term neurological deficits, but there is a lack of research looking into n-3 FA status in rugby players. We examined the dietary n-3 FA intake through a FFQ and n-3 FA status by measuring the percentage of n-3 FA and O3I in elite Canadian Rugby 7s players to show distribution across O3I risk zones; high risk, <4%; intermediate risk, 4 to 8%; and low risk, >8%. Methods: n-3 FA profile and dietary intake as per FFQ were collected at the beginning of the 2017–2018 Rugby 7s season in male (n = 19; 24.84 ± 2.32 years; 95.23 ± 6.93 kg) and female (n = 15; 23.45 ± 3.10 years; 71.21 ± 5.79 kg) athletes. Results: O3I averaged 4.54% ± 1.77, with female athlete scores slightly higher, and higher O3I scores in supplemented athletes (4.82% vs. 3.94%, p = 0.183), with a greater proportion of non-supplemented athletes in the high-risk category (45.5% vs. 39.1%). Dietary intake in non-supplemented athletes did not meet daily dietary recommendations for ALA or EPA + DHA compared to supplemented athletes. Conclusions: Overall, despite supplementation, O3I score remained in the high-risk category in a proportion of athletes who met recommended n-3 FA dietary intakes, and non-supplemented athletes had a higher proportion of O3I scores in the high-risk category, suggesting that dietary intake alone may not be enough and athletes may require additional dietary and n-3 FA supplementation to reduce neurological and cardiovascular risk.

Promotion of a healthy lifestyle in Russia and China The first results of COVID-19 and trends in the post-COVID economy

The COVID-19 pandemic has not only become a test for all mankind, but also gave reason to rethink the attitude to their health not only for people from the high-risk category, but also for everyone. Before the pandemic, the concept of a healthy lifestyle was gaining a powerful economic momentum (popularization of communities associated with fitness products, advertising, healthy products, etc.). But has the trend changed after the restrictions were eased? The purpose of this paper is to find out whether the healthy lifestyle concept affected the preservation of the health of the nation during the pandemic (is there a link between the level of national health and the degree of resistance to pandemics?). The study focuses on two countries — Russia and China. The difference in the population’s perception of the healthy lifestyle concept, promotion of a healthy lifestyle at the governmental level, and the assessment of its effectiveness are determined based on the analysis of secondary statistical data, a survey of 1,230 respondents from Russia and China in late 2020 — early 2021, as well as using econometric factor analysis. The results obtained can be scaled to the rest of the BRICS countries in order to adapt existing state programs to preserving the health of nations in the future.

Risk-Based Multi-Objective Cross-Asset Budget Planning and Allocation Framework for the City of Sugar Land Integrated Asset Management System (IAMS)

An Integrated Asset Management System (IAMS) is a strategic asset management system that combines the assets of different categories into a system to prioritize their maintenance. This paper proposes a risk-based reliability-centric IAMS framework which works on the principle that the risk associated with the failure of an asset is a function of its direct and indirect costs. The direct costs are the costs associated with the replacement of the assets, whereas the indirect costs are the risks that the city faces following the failure. The framework is applied to the asset database of the City of Sugar Land, TX. The results of the model are analyzed in terms of a reduction in the number of assets in a very high-risk category in the risk matrix, the network level expected annual failure rate, and an increase in the network level average reliability.

Association between Hypomagnesemia, COVID-19, Respiratory Tract and Lung Disease

The complexity of COVID-19 is also related to the multiple molecular pathways triggered by SARS-CoV-2, which is able to cause type I pneumocyte death, trigger intravascular coagulation, interfere with the renin-angiotensin system, dysregulate iron metabolism, ending with the insurgence of a cytokine storm which may lead to death. Old adults with obesity, hypertension, and diabetes are among the high-risk category groups more prone to SARS-CoV-2 infection. Magnesium has been reported to play a major role both in physiology and in pathology, particularly in elderly people, regulating cytotoxic functions of natural killer (NK) cells and CD8+ T lymphocytes. In spite of the absence of controlled trials, the possibility of magnesium supplementation for supportive treatment in patients with COVID-19 should be encouraged. This could be useful in all phases of the COVID-19 disease.

1251 Risk Stratification in the Management of Post-Tonsillectomy Haemorrhage

Aim Tonsillectomy represents 17% of the elective workload in ENT and post-tonsillectomy haemorrhage is the most significant complication of this procedure. Accordingly, the GIRFT (Getting It Right First Time) report for ENT surgery focusses on the prevention of post-tonsillectomy bleeding. However, there is little guidance on the management of post-tonsillectomy haemorrhage. A local guideline for the management of post-tonsillectomy haemorrhage was introduced in 2020 based on expert consensus. This audit examines the management of patients readmitted with post-tonsillectomy haemorrhage in 2019 and compares this to the management suggested in the new guideline. Method Patients readmitted with post-tonsillectomy haemorrhage within 30 days of a tonsillectomy performed in 2019 were identified. These were retrospectively stratified into risk categories according to both patient and clinical factors. Management was audited against the new guideline including both the initial patient assessment and the treatment suggested for their respective risk category. Results Fifteen patients were identified and stratified into low, medium and high-risk categories. All patients in the “low risk” category were successfully treated conservatively. One patient from the “medium risk” category had a further bleed as an inpatient during the proposed period of observation in the new guideline and was thereafter treated as “high risk”. Within the “high risk” category two patients required return to theatre for arrest of post-tonsillectomy haemorrhage. Conclusions These results show that the risk stratification proposed in these guidelines may be useful in the management of post-tonsillectomy haemorrhage. Amendments to the guideline and a re-audit are in progress.

LENT score in prognostic assessment of malignant pleural effusion – the impact of target therapy

Introduction: Malignant pleural effusion (MPE) is a common manifestation in patients with advanced lung cancer. The LENT score was developed as a risk stratification system to predict the survival of these patients. However, following the discovery of molecular markers and a new era of personalized therapy, prognostic estimation became a challenging exercise. The aim of this study was to evaluate the performance of LENT score in predicting MPE survival in EGFR and ALK mutated lung adenocarcinoma. Methods: A retrospective single-center study of patients with MPE from lung adenocarcinoma followed between January 2008 to December 2018. Results: Forty-two patients were included in the study (mean age 76.4 ± 12.6 years, 52% female). Of these patients, 29% exhibited EGFR gene mutation or ALK gene translocation and received tyrosine kinase inhibitor therapy (TKI), in contrast to 71% of patients without identification of mutational factors and receiving conventional chemotherapy. Based on LENT score, in the sub-group treated with conventional chemotherapy, 67% had a moderate-risk category and 33% a high-risk category, with a median overall survival (OS) of 109 (31-406) and 36 (11-77) days, respectively. In the sub-group treated with targeted therapy, 75% were in a moderate-risk category and 25% in a high-risk category with a median OS of 1033 (245-1710) and 238 (27-not available) days, respectively. Patients receiving targeted therapy had a longer survival than patients receiving conventional chemotherapy in all LENT score risk categories (p<0.05). Conclusions: OS in patients with MPE due to lung adenocarcinoma was similar to that predicted by the LENT score, except for patients with EGFR mutation or ALK translocation. In this subgroup, the LENT score seems to underestimate the prognosis. Although this study has limitations regarding sample size, it does reveal, in the present time, some inaccuracy of the LENT score, demonstrating that it needs to be reviewed and revalidated in view of recent therapeutic advances.