Search results for: diversity and tirunesh beijing hospital
Commenced in January 2007
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Edition: International
Paper Count: 3967

Search results for: diversity and tirunesh beijing hospital

3607 Operating Model of Obstructive Sleep Apnea Patients in North Karelia Central Hospital

Authors: L. Korpinen, T. Kava, I. Salmi

Abstract:

This study aimed to describe the operating model of obstructive sleep apnea. Due to the large number of patients, the role of nurses in the diagnosis and treatment of sleep apnea was important. Pulmonary physicians met only a minority of the patients. The sleep apnea study in 2018 included about 800 patients, of which about 28% were normal and 180 patients were classified as severe (apnea-hypopnea index [AHI] over 30). The operating model has proven to be workable and appropriate. The patients understand well that they may not be referred to a pulmonary doctor. However, specialized medical follow-up on professional drivers continues every year.

Keywords: sleep, apnea patient, operating model, hospital

Procedia PDF Downloads 111
3606 Preventive Effects of Motorcycle Helmets on Clinical Outcomes in Motorcycle Crashes

Authors: Seung Chul Lee, Jooyeong Kim, Ki Ok Ahn, Juok Park

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Background: Injuries caused by motorcycle crashes are one of the major public health burdens leading to high mortality, functional disability. The risk of death among motorcyclists is 30 times greater than that among car drivers, with head injuries the leading cause of death. The motorcycle helmet is crucial protective equipment for motorcyclists. Aims: This study aimed to measure the protective effect of motorcycle helmet use on intracranial injury and mortality and to compare the preventive effect in drivers and passengers. Methods: This is a cross-sessional study based on the Emergency Department (ED)–based Injury In-depth Surveillance (EDIIS) database from 23 EDs in Korea. All of the trauma patients injured in motorcycle crashes between January 1, 2013 and December 31, 2016 were eligible, excluding cases with unknown helmet use and outcomes. The primary and secondary outcomes were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of helmet use for study outcomes after adjusting for potential confounders. Using interaction models, we compared the protective effect of helmet use on outcomes across driving status (driver and passenger). Results: Among 17,791 eligible patients, 10,668 (60.0%) patients were wearing helmets at the time of the crash, 2,128 (12.0%) patients had intracranial injuries and 331 (1.9%) patients had in-hospital death. 16,381 (92.1%) patients were drivers and 1410 (7.9%) patients were passengers. 62.6% of drivers and 29.1% of passengers were wearing helmets at the time of the crash. Compared to un-helmeted group, the helmeted group was less likely to have an intracranial injury(8.0% vs. 17.9%, AOR: 0.43 (0.39-0.48)) and in-hospital mortality (1.0% vs. 3.2%, AOR: 0.29 (0.22-0.37)).In the interaction model, AORs (95% CIs) of helmet use for intracranial injury were 0.42 (0.38-0.47) in drivers and 0.61(0.41-0.90) in passengers, respectively. There was a significant preventive effect of helmet use on in-hospital mortality in drivers (AOR: 0.26(0.21–0.34)). Discussion and conclusions: Wearing helmets in motorcycle crashes reduced intracranial injuries and in-hospital mortality. The preventive effect of motorcycle helmet use on intracranial injury was stronger in drivers than in passengers. There was a significant preventive effect of helmet use on in-hospital mortality in driver but not in passengers. Public health efforts to increase motorcycle helmet use are needed to reduce health burden from injuries caused by motorcycle crashes.

Keywords: intracranial injury, helmet, mortality, motorcycle crashes

Procedia PDF Downloads 164
3605 Impact of Audit Committee on Real Earnings Management: Cases of Netherlands

Authors: Sana Masmoudi Mardassi, Yosra Makni Fourati

Abstract:

Regulators highlight the importance of the Audit Committee (AC) as a key internal corporate governance mechanism. One of the most important roles of this committee is to oversee the financial reporting process. The purpose of this paper is to examine the link between the characteristics of an audit committee and the financial reporting quality by investigating whether the characteristics of audit committees are associated with improved financial reporting quality, especially the Real Earnings Management. In the current study, a panel data from 80 nonfinancial companies listed on the Amsterdam Stock Exchange during the period between 2010 and 2017 were used. To measure audit committee characteristics, four proxies have been used, specifically, audit committee independence, financial expertise, gender diversity and AC meetings. For this research, a linear regression model was used to identify the influence of a set of board characteristics of the audit committee on real earnings management after controlling for firm audit committee size, leverage, size, loss, growth and board size. This research provides empirical evidence of the association between audit committee independence, financial expertise, gender diversity and meetings and Real Earnings Management (REM) as a proxy of financial reporting quality. The study finds that independence and AC Gender diversity are strongly related to financial reporting quality. In fact, these two characteristics constrain REM. The results also suggest that AC- financial expertise reduces to some extent, the likelihood of engaging in REM. These conclusions provide support then to the audit committee requirement under the Dutch Corporate Governance Code rules regarding gender diversity and AC meetings.

Keywords: audit committee, financial expertise, independence, real earnings management

Procedia PDF Downloads 148
3604 The Efficiency of AFLP and ISSR Markers in Genetic Diversity Estimation and Gene Pool Classification of Iranian Landrace Bread Wheat (Triticum Aestivum L.) Germplasm

Authors: Reza Talebi

Abstract:

Wheat (Triticum aestivum) is one of the most important food staples in Iran. Understanding genetic variability among the landrace wheat germplasm is important for breeding. Landraces endemic to Iran are a genetic resource that is distinct from other wheat germplasm. In this study, 60 Iranian landrace wheat accessions were characterized AFLP and ISSR markers. Twelve AFLP primer pairs detected 128 polymorphic bands among the sixty genotypes. The mean polymorphism rate based on AFLP data was 31%; however, a wide polymorphism range among primer pairs was observed (22–40%). Polymorphic information content (PIC value) calculated to assess the informativeness of each marker ranged from 0.28 to 0.4, with a mean of 0.37. According to AFLP molecular data, cluster analysis grouped the genotypes in five distinct clusters. .ISSR markers generated 68 bands (average of 6 bands per primer), which 31 were polymorphic (45%) across the 60 wheat genotypes. Polymorphism information content (PIC) value for ISSR markers was calculated in the range of 0.14 to 0.48 with an average of 0.33. Based on data achieved by ISSR-PCR, cluster analysis grouped the genotypes in three distinct clusters. Both AFLP and ISSR markers able to showed that high level of genetic diversity in Iranian landrace wheat accessions has maintained a relatively constant level of genetic diversity during last years.

Keywords: wheat, genetic diversity, AFLP, ISSR

Procedia PDF Downloads 425
3603 Job Stress Among the Nurses of the Emergency Department of Selected Saudi Hospital

Authors: Mahmoud Abdel Hameed Shahin

Abstract:

Job demands that are incompatible with an employee's skills, resources, or needs cause unpleasant emotional and physical reactions known as job stress. Nurses offer care in hospital emergency rooms all around the world, and since they operate in such a dynamic and unpredictable setting, they are constantly under pressure. It has been discovered that job stress has harmful impacts on nurses' health as well as their capacity to handle the demands of their jobs. The purpose of this study was to evaluate the level of job stress experienced by the emergency department nurses at King Fahad Specialist Hospital in Buraidah City, Saudi Arabia. In October 2021, a cross-sectional descriptive study was conducted. 80 nurses were conveniently selected for the study, the bulk of them worked at King Fahad Specialist Hospital's emergency department. An electronic questionnaire with a sociodemographic data sheet and a job stress scale was given to the participating nurses after ethical approval was received from the Ministry of Health's representative bodies. Using SPSS Version 26, both descriptive and inferential statistics were employed to analyze and tabulate the acquired data. According to the findings, the factors that contributed to the most job stress in the clinical setting were having an excessive amount of work to do and working under arbitrary deadlines, whereas the factors that contributed to the least stress were receiving the proper recognition or rewards for good work. In the emergency room of King Fahad Specialist Hospital, nurses had a moderate level of stress (M=3.32 ± 0.567/5). Based on their experience, emergency nurses' levels of job stress varied greatly, with nurses with less than a year of experience notably experiencing the lowest levels of job stress. The amount of job stress did not differ significantly based on the emergency nurses' age, nationality, gender, marital status, position, or level of education. The causes and impact of stress on emergency nurses should be identified and alleviated by hospitals through the implementation of interventional programs.

Keywords: emergency nurses, job pressure, Qassim, Saudi Arabia, job stress

Procedia PDF Downloads 161
3602 Computing the Similarity and the Diversity in the Species Based on Cronobacter Genome

Authors: E. Al Daoud

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The purpose of computing the similarity and the diversity in the species is to trace the process of evolution and to find the relationship between the species and discover the unique, the special, the common and the universal proteins. The proteins of the whole genome of 40 species are compared with the cronobacter genome which is used as reference genome. More than 3 billion pairwise alignments are performed using blastp. Several findings are introduced in this study, for example, we found 172 proteins in cronobacter genome which have insignificant hits in other species, 116 significant proteins in the all tested species with very high score value and 129 common proteins in the plants but have insignificant hits in mammals, birds, fishes, and insects.

Keywords: genome, species, blastp, conserved genes, Cronobacter

Procedia PDF Downloads 477
3601 Evaluation of Hospital Antibiotic Policy Implementation at the Oncosurgery Ward: A Six Years' Experience

Authors: Aneta Nitsch-Osuch, Damian Okrucinski, Magdalena Dawgialło, Izabela Gołębiak, Ernest Kuchar

Abstract:

The Hospital Antibiotic Policy (HAP) should be implemented to rationalize the antibiotic use and to decrease the risk of spreading of spreading of resistant bacteria. The aim of our study was to describe the antibiotic consumption patterns at the single oncosurgery ward before and after implementation of the HAP. We conducted a retrospective analysis of the antibiotic use at the Oncosurgery Ward in Warsaw (Poland) in years 2011-2016. Calculations were based on daily defined doses (DDDs), DDDs/100 hospitalizations and DDDs/100 person-days, drug utilization rates (DU 90% and DU 100%) were also analysed. After implementation of the HAP, the total antibiotic consumption increased (365.35 DDD in 2011 vs. 1359,22 DDD in 2016). The significant change was observed in antibiotic consumption patterns: the use of amoxicillin clavulanate and carbapenems or glycopeptides decreased significantly (p < 0,05), while the use of ciprofloxacin and aminoglycosides increased (p < 0,05). The DU100% rate varied from 6 in 2011 to 12 in 2016; while DU 90% rate varied from 2 in 2011 to 3-5 in 2013-2016. Although the implementation of the HAP did not result in the decreased total antibiotic consumption, it provided favorable changes in the antibiotic consumption patterns.

Keywords: antibiotics, hospital, policy, stewardship

Procedia PDF Downloads 218
3600 The Impact of Audit Committee on Real Earnings Management: Evidence from Netherlands

Authors: Sana Masmoudi, Yosra Makni

Abstract:

Regulators highlight the importance of the Audit Committee (AC) as a key internal corporate governance mechanism. One of the most important roles of this committee is to oversee the financial reporting process. The purpose of this paper is to examine the link between the characteristics of an audit committee and the financial reporting quality by investigating whether the formation of audit committees and their characteristics are associated with improved financial reporting quality. This study provides empirical evidence of the association between audit committee independence, financial expertise, gender diversity, and meetings and Real Earnings Management (REM) as a proxy of financial reporting quality. Using data from, with a sample of 80 companies listed on the Amsterdam Stock Exchange during 2010-2017, the study finds that independence and AC Gender diversity are strongly related to financial reporting quality. In fact, these two characteristics constrain REM. The results also suggest that AC-financial expertise reduces to some extent, the likelihood of engaging in REM. These conclusions provide support then to the audit committee requirement under the Dutch Corporate Governance Code rules regarding gender diversity and AC meetings.

Keywords: audit committee, financial expertise, independence, real earnings management

Procedia PDF Downloads 153
3599 Dietary Diversity and Nutritional Status of Adolescents Attending Public Secondary Schools in Oyo State Nigeria

Authors: Nimot Opeyemi Wahab

Abstract:

Poor nutritional status during adolescence is a reflection of inadequate intake of nutrients. This can also be associated with a lack of consumption of diverse food. This study assessed the nutritional status and dietary diversity score (DDS) of in-school adolescents in Ibadan North, North East, and Ibadan South West Local Government Areas (LGA) of Oyo State, Nigeria. A cross-sectional study involving 3,510 in-school adolescents from the three LGA was conducted. Nutrient intake was measured using a validated 24-hour dietary recall, and the anthropometric measurement was also taken. Dietary diversity score (DDS) was assessed using the Individual Dietary Diversity Score (WDDS) of nine food groups. Participants were between 10-19years, and the mean age was 14.76±1.68, 15.32±1.77, and 15.45±1.62 in Ibadan North, Ibadan North East, and Ibadan South West, respectively. About 48% of the participants were male (47.9%), while 52.1% were female. BMI-for-age showed that 92.1%, 5.4%, 2.1%, and 0.4% of the participants were normal, underweight, overweight, and obese, respectively. The mean energy intake (143.193±695.98) of the female respondents was more than that of the male respondents (1406.86±767.41). The macronutrients intake (protein, carbohydrates, fiber, and fats) of the female participants was also found to be more than that of the male participants, with a non-significant difference of 0.336, 0.530, 0.234, and 0.069 (at p< 0.05). Out of all the vitamin intake, only vitamin C was found to be statistically different (p=0.038) at p<0.05 between the male and female respondents. Of all the mineral intake, only phosphorus showed a higher intake (575.20±362.12) among female respondents than the male respondents. The mean DDS of all participants was 4.59±0.939. The majority of the participants, 1183 (80.9%), were within the medium DDS category, 9.9% were low, while 1.5% were in the high category: of which males were 474 (71.5%) and females were 709 (88.6%). Participants from Ibadan North were 941(88.5%), and those from South West were 242(60.5%). A non-significant difference in the mean score of participants from the two locations (p=0.467) was also found. A negative correlation exists between DDS and BMI-for age (-0.11), DDS, and energy intake (-0.46) in Ibadan North and South West LGA. The nutritional status of in-school adolescents was normal, and DDS was within the medium category. Nutrition intervention regarding the consumption of diverse food is necessary among adolescents.

Keywords: nutritional status, dietary diversity, adolescents, nutrient intake

Procedia PDF Downloads 53
3598 Disability Management and Occupational Health Enhancement Program in Hong Kong Hospital Settings

Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

Abstract:

Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

Procedia PDF Downloads 184
3597 A Prospective Audit to Look into Antimicrobial Prescribing in the Clinical Setting: In a Teaching Hospital in the UK

Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

Abstract:

Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

Procedia PDF Downloads 283
3596 Study on the Effect of Weather Variables on the Spider Abundance in Two Ecological Zones of Ogun State, Nigeria

Authors: Odejayi Adedayo Olugbenga, Aina Adebisi

Abstract:

Weather variables (rainfall and temperature) affect the diversity and abundance of both fauna and flora species. This study compared the weather variables with spider abundance in two ecological zones of Ogun State, Nigeria namely Ago-iwoye (Rainforest) in the Ijebu axis and Aiyetoro (Derived Savannah) in the Yewa axis. Seven study sites chosen by Simple Random Sampling in each ecosystem were used for the study. In each sampling area, a 60 m x 120 m land area was marked and sampled, spider collection techniques were; hand picking, use of sweep netting, and Pitfall trap. Adult spiders were identified to the species level. Species richness was estimated by a non-parametric species estimator while the diversity of spider species was assessed by Simpson Diversity Index and Species Richness by One-way Analysis of Variance. Results revealed that spiders were more abundant in rainforest zones than in derived savannah ecosystems. However, the pattern of spider abundance in rainforest zone and residential areas were similar. During high temperatures, the activities of spiders tended to increase according to this study. In contrast, results showed that there was a negative correlation between rainfall and spider species abundance in addition to a negative and weak correlation between rainfall and species richness. It was concluded that heavy downpour has lethal effects on both immature and sometimes matured spiders, which could lead to the extinction of some unknown species of spiders. Tree planting should be encouraged, as this shelters the spider.

Keywords: spider, abundance, species richness, species diversity

Procedia PDF Downloads 67
3595 Genetic Diversity of Sugar Beet Pollinators

Authors: Ksenija Taški-Ajdukovic, Nevena Nagl, Živko Ćurčić, Dario Danojević

Abstract:

Information about genetic diversity of sugar beet parental populations is of a great importance for hybrid breeding programs. The aim of this research was to evaluate genetic diversity among and within populations and lines of diploid sugar beet pollinators, by using SSR markers. As plant material were used eight pollinators originating from three USDA-ARS breeding programs and four pollinators from Institute of Field and Vegetable Crops, Novi Sad. Depending on the presence of self-fertility gene, the pollinators were divided into three groups: autofertile (inbred lines), autosterile (open-pollinating populations), and group with partial presence of autofertility gene. A total of 40 SSR primers were screened, out of which 34 were selected for the analysis of genetic diversity. A total of 129 different alleles were obtained with mean value 3.2 alleles per SSR primer. According to the results of genetic variability assessment the number and percentage of polymorphic loci was the maximal in pollinators NS1 and tester cms2 while effective number of alleles, expected heterozygosis and Shannon’s index was highest in pollinator EL0204. Analysis of molecular variance (AMOVA) showed that 77.34% of the total genetic variation was attributed to intra-varietal variance. Correspondence analysis results were very similar to grouping by neighbor-joining algorithm. Number of groups was smaller by one, because correspondence analysis merged IFVCNS pollinators with CZ25 into one group. Pollinators FC220, FC221 and C 51 were in the next group, while self-fertile pollinators CR10 and C930-35 from USDA-Salinas were separated. On another branch were self-sterile pollinators ЕL0204 and ЕL53 from USDA-East Lansing. Sterile testers cms1 and cms2 formed separate group. The presented results confirmed that SSR analysis can be successfully used in estimation of genetic diversity within and among sugar beet populations. Since the tested pollinator differed considering the presence of self-fertility gene, their heterozygosity differed as well. It was lower in genotypes with fixed self-fertility genes. Since the most of tested populations were open-pollinated, which rarely self-pollinate, high variability within the populations was expected. Cluster analysis grouped populations according to their origin.

Keywords: auto fertility, genetic diversity, pollinator, SSR, sugar beet

Procedia PDF Downloads 444
3594 Hospital Acquired Bloodstream Infections Among Patients With Hematological and Solid Malignancies: Epidemiology, Causative Pathogens and Mortality

Authors: Marah El-Beeli, Abdullah Balkhair, Zakaryia Al Muharmi, Samir Al Adawi, Mansoor Al-Jabri, Abdullah Al Rawahi, Hazaa Al Yahyae, Eman Al Balushi, Yahya M. Al-Farsi

Abstract:

The health care service and the anticancer chemotherapeutics has changed the natural history of cancer into manageable chronic disease and improve the cancer patient’s lifestyle and increase the survival time. Despite that, still, infection is the major dilemma opposing the cancer patient either because of the clinical presentation of the cancer type and impaired immune system or as a consequence of anticancer therapy. This study has been conducted to1) track changes in the epidemiology of hospital-acquired bloodstream infections among patients with malignancies in the last five years. 2) To explore the causative pathogens and 3) the outcome of HA-BSIs in patients with a different types of malignancies. An ampi-directional study (retrospective and prospective follow up) of patients with malignancies admitted at Sultan Qaboos University hospital (570-bed tertiary hospital) during the study period (from January 2015 to December 2019). The cumulative frequency and prevalence rates of HA-BSIs by patients and isolates were calculated. In addition, the cumulative frequency of participants with single versus mixed infections and types of causative micro-organisms of HA-BSIs were obtained. A total of 1246 event of HA-BSIs has occurred during the study period. Nearly the third (30.25%) of the HA-BSI events was identified among 288 patients with malignancies. About 20% of cases were mixed infections (more than one isolate). Staphylococcus spp were the predominant isolated pathogen (24.7%), followed by Klebsiella spp (15.8%), Escherichia spp (13%), and Pseudomonas spp (9.3%). About half (51%) of cases died in the same year, and (64%) of the deaths occur within two weeks after the infection. According to the observations, no changes in the trends of epidemiology, causative pathogens, morbidity, and mortality rates in the last five years.

Keywords: epidemiology, haematological malignancies, hospital acquired bloodstream infections, solid malignancies

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3593 Attitude to Cultural Diversity and Inclusive Pedagogical Practices in the Classroom: A Correlational Study

Authors: Laura M. Espinoza, Karen A. Hernández, Diana B. Ledezma

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Currently, in Chile, migratory movements are generated, where the country receives constantly people from Latin America such as Colombia, Peru, Venezuela, Haiti, among others. This phenomenon has reached the schools of Chile, where immigrant children and adolescents are educated in a context of cultural diversity. However, education professionals face this recent phenomenon without prior preparation to carry out their pedagogical practices in the classroom. On the other hand, research on how to understand and guide the processes of cultural diversity especially within the school is even scarce and recent in Latin America and specifically in Chile. The general purpose of the study is to analyze the relationships between teaching efforts towards multiculturalism and inclusive pedagogical practices in the schools of the city of La Serena and Coquimbo, in Chile. The study refers to a quantitative approach, with a correlational design. The selection of the participants was not intentional probabilistic. It comprises 88 teachers of preschool, primary, secondary and special education, who work in two schools with similar characteristics. For the collection of information on the independent variable, the attitude scale towards Immigration and the attitude scale towards Multiculturalism in the school are applied. To obtain information on the independent variable, the guide for the evaluation of inclusive practices in the classroom is applied. Both instruments have statistical validation. A Spearman correlation analysis was made to achieve the objective of the study. Among the main findings, we will find the relationships between the positive perceptions of multiculturalism at school and inclusive practices such as the physical conditions of the classroom, planning, methodology, use of time and evaluation. These findings are relevant to the teaching and learning processes of students in Chilean classrooms and contribute to literature for the understanding of educational processes in contexts of cultural diversity.

Keywords: cultural diversity, immigration, inclusive pedagogical practices, multiculturalism

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3592 Improved Cooperative Communication Scheme in the Edge of Cell Coverage

Authors: Myoung-Jin Kim, Yeong-Seop Ahn, Hyun-Jee Yang, Hyoung-Kyu Song

Abstract:

This paper proposes the new cooperative communication scheme for the wireless communication system. When the receiver is located in the edge of coverage, the signal from the transmitter is distorted by the inter-cell interference (ICI) and power reduction by distance. In order to improve communication performance, the proposed scheme adds the relay. By using the relay, the receiver receives the signal from the transmitter and relay at the same time. Therefore, the new cooperative communication scheme obtains diversity gain and is improved by the relay.

Keywords: cooperative communication, diversity gain, OFDM, MIMO

Procedia PDF Downloads 593
3591 Trends of Cancer Patients Who Underwent Curative/radical Radiotherapy at Radiotherapy Center, Tikur Anbessa Specialized Hospital

Authors: Emeshaw Damtew Zebene, Edom Seife, Hagos Tesfay, Gurja Belay

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Background: cancer incidence and mortality has grown rapidly throughout the world. Aging of the population, urbanization, physical inactivity, economic growth followed by smoking and drinking contributed a lot for the increased incidence of cancer all over the globe. Objective: the aim of this study was to assess a one-year trend of cancer patients who underwent curative/radical radiotherapy at radiotherapy center, Tikur Anbessa specialized hospital, Ethiopia. Methodology: We performed a prospective descriptive study of cancer patients treated with LINAC at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia, from April 2021- March 2022. A standardized questionnaire was used to collect sociodemographic and clinical characteristics of the patients. Descriptive statistics and chi-square results were generated using SPSS version 24. The level of significance was obtained at 0.05. Results: Sixty-four (64) curative/radical patients-44 females and 20 males were analyzed. Majority, 27(42.2%), of the patients age range from 45 to 64, and 45(70%) of them were urban residents where a group of higher gynecologic cancer was observed.78% of the patients were with locally advanced cancer, and 54(84.4%) of them had no awareness about cancer. Generally, head & neck cancer were found the most prevalent cancer 20(31.3%), and the leading cause of cancer among women was cervical cancer 17(38.6%), where about half 7(15.9%) of them were HIV positive. Conclusion: Our finding revealed that most of curative/radical patients presented at a locally advanced stage of the disease. Hence, maintaining the already available teletherapy machines and installing additional radiotherapy centers may help in treating the patients at the early stage of the disease. Since almost all of our study participants did not have information about cancer, awareness raising mechanisms should be done. Additionally, understanding differences in cancer incidence between urban and rural is important. Key words: Cancer, Curative/radical, Radiotherapy, Tikur Anbessa Specialized Hospital

Keywords: cancer, curative/radical, radiotherapy, tkur anbessa specialized hospital

Procedia PDF Downloads 63
3590 An Efficient Strategy for Relay Selection in Multi-Hop Communication

Authors: Jung-In Baik, Seung-Jun Yu, Young-Min Ko, Hyoung-Kyu Song

Abstract:

This paper proposes an efficient relaying algorithm to obtain diversity for improving the reliability of a signal. The algorithm achieves time or space diversity gain by multiple versions of the same signal through two routes. Relays are separated between a source and destination. The routes between the source and destination are set adaptive in order to deal with different channels and noises. The routes consist of one or more relays and the source transmits its signal to the destination through the routes. The signals from the relays are combined and detected at the destination. The proposed algorithm provides a better performance than the conventional algorithms in bit error rate (BER).

Keywords: multi-hop, OFDM, relay, relaying selection

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3589 Characterization of Screening Staphylococcus aureus Isolates Harboring mecA Genes among Intensive Care Unit Patients from Tertiary Care Hospital in Jakarta, Indonesia

Authors: Delly C. Lestari, Linosefa, Ardiana Kusumaningrum, Andi Yasmon, Anis Karuniawati

Abstract:

The objective of this study is to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mecA genes from screening isolates among intensive care unit (ICU) patients. All MRSA screening isolates from ICU’s patients of Cipto Mangunkusumo Hospital during 2011 and 2014 were included in this study. Identification and susceptibility test was performed using Vitek2 system (Biomereux®). PCR was conducted to characterize the SCCmec of S. aureus harboring the mecA gene on each isolate. Patient’s history of illness was traced through medical record. 24 isolates from 327 screening isolates were MRSA positive (7.3%). From PCR, we found 17 (70.8%) isolates carrying SCCmec type I, 3 (12.5%) isolates carrying SCCmec type III, and 2 (8.3%) isolates carrying SCCmec type IV. In conclusion, SCCmec type I is the most prevalent MRSA colonization among ICU patients in Cipto Mangunkusumo Hospital.

Keywords: MRSA, mecA genes, ICU, colonization

Procedia PDF Downloads 214
3588 Palliative Care Referral Behavior Among Nurse Practitioners in Hospital Medicine

Authors: Sharon Jackson White

Abstract:

Purpose: Nurse practitioners (NPs) practicing within hospital medicine play a significant role in caring for patients who might benefit from palliative care (PC) services. Using the Theory of Planned Behavior, the purpose of this study was to examine the relationships among facilitators to referral, barriers to referral, self-efficacy with end-of-life discussions, history of referral, and referring to PC among NPs in hospital medicine. Hypotheses: 1) Perceived facilitators to referral will be associated with a higher history of referral and a higher number of referrals to PC. 2) Perceived barriers to referral will be associated with a lower history of referral and a lower number of referrals to PC. 3) Increased self-efficacy with end-of-life discussions will be associated with a higher history of referral and a higher number of referrals to PC. 4) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the history of referral to PC. 5) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the number of referrals to PC. Significance: Previous studies of referring patients to PC within the hospital setting care have focused on physician practices. Identifying factors that influence NPs referring hospitalized patients to PC is essential to ensure that patients have access to these important services. This study incorporates the SNRS mission of advancing nursing research through the dissemination of research findings and the promotion of nursing science. Methods: A cross-sectional, predictive correlational study was conducted. History of referral to PC, facilitators to referring to PC, barriers to referring to PC, self-efficacy in end-of-life discussions, and referral to PC were measured using the PC referral case study survey, facilitators and barriers to PC referral survey, and self-assessment with end-of-life discussions survey. Data were analyzed descriptively and with Pearson’s Correlation, Spearman’s Rho, point-biserial correlation, multiple regression, logistic regression, Chi-Square test, and the Mann-Whitney U test. Results: Only one facilitator (PC team being helpful with establishing goals of care) was significantly associated with referral to PC. Three variables were statistically significant in relation to the history of referring to PC: “Inclined to refer: PC can help decrease the length of stay in hospital”, “Most inclined to refer: Patients with serious illnesses and/or poor prognoses”, and “Giving bad news to a patient or family member”. No predictor variables contributed a significant variance in the number of referrals to PC for all three case studies. There were no statistically significant results showing a relationship between the history of referral and referral to PC. All five hypotheses were partially supported. Discussion: Findings from this study emphasize the need for further research on NPs who work in hospital settings and what factors influence their behaviors of referring to PC. Since there is an increase in NPs practicing within hospital settings, future studies should use a larger sample size and incorporate hospital medicine NPs and other types of NPs that work in hospitals.

Keywords: palliative care, nurse practitioners, hospital medicine, referral

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3587 Prevention of Green Gentrification: The Case of the Sustainable Urban Policy in Paris

Authors: Elise Machline

Abstract:

In the late 1980’s, sustainable urban development emerged in Europe. Sustainable neighborhoods are one attempt to implement sustainable urban energy planning in the city. So, for twenty years, projects of sustainable neighborhoods (or ‘eco-neighborhoods’) have emerged in Europe. Debates about sustainability no longer restrict it to environmental concerns (to limit greenhouse gas emissions), but rather extend to the economic and social dimensions. A growing number of empirical studies demonstrate that sustainable urbanism yield rental/sale premia, as well as higher occupancy rates and thus higher asset values. For example, European eco neighborhood projects usually focus on the middle to upper classes, given the costs involved in renting or buying the dwellings built in such projects. As a result sustainable residential buildings are not affordable and their construction tends to have a gentrifying effect. An increasing number of countries are institutionalizing green strategies for affordable housing. In France, the sustainable neighborhoods ‘ecoquartier’ must meet environmental performance criteria, have a potential for economic development and, provide social and functional diversity. The issue of social diversity trough the provision of affordable housing has emerged as a dimension of public housing policies. Thus, the ecoquartier residential buildings must be both energy efficient and affordable. Through the Parisian example our study considers how the concept of social diversity and other elements of sustainability are illustrated in the ecoquartiers and whether the authorities have been able to avoid gentrification when implementing a sustainable urban policy.

Keywords: sustainable neighborhoods, social diversity, social housing policies, green buildings

Procedia PDF Downloads 336
3586 Equipment Donation: A Perspective from a Teaching Tertiary Care Hospital in North India

Authors: Jitender Sodhi, Shweta Talati, A. K. Gupta, Pankaj Arora

Abstract:

Background:Equipment donation to hospitals in resource-limited settings can significantly benefit services in these settings albeit requires important ethical, practical and financial issues to be considered before accepting donations. Objective: To understand the decision making process leading to acceptance/ rejection/ deferment of equipment donation from the perspective of a public sector teaching tertiary care hospital. Design: Retrospective, record based study. Setting: 2000-bedded public sector teaching tertiary care hospital in North India. Methods: A total of 30 cases of equipment donation from March 2010-October 2013, were analysed for their decision process leading to acceptance/rejection/deferment.Each case was studied retrospectively and data pertaining to the agenda and decision taken was collected. Results: A total of 30 cases of equipment donation received from March 2010- October 2013 were screened, out of which 17 (56.6%) were for diagnostic purpose and 13 (43.3%) for therapeutic purpose. Out of 30 cases, 16 (53.3%) were accepted and 8 (26.6%) were rejected. The remaining 6 cases included 3 (10%) which required further clarification and other 3 (10%) which were out of the domain of committee. Conclusion: This study highlights the importance of equipment donation in resource limited settings and considerations involved while making decisions for acceptance/rejections/defermentof such donations.

Keywords: equipment donation, teaching hospital, decision-making, North India

Procedia PDF Downloads 276
3585 Pattern of Bacterial Isolates and Antimicrobial Resistance at Ayder Comprehensive Specialized Referral Hospital in Northern Ethiopia: A Retrospective Study

Authors: Solomon Gebremariam, Mulugeta Naizigi, Aregawi Haileselassie

Abstract:

Background: Knowledge of the pattern of bacterial isolates and their antimicrobial susceptibility is crucial for guiding empirical treatment and infection prevention and control measures. Objective: The aim of this study was to analyze the pattern of bacterial isolates and their susceptibility patterns from various specimens. Methods: Retrospectively, a total of 1067 microbiological culture results that were isolated, characterized, and identified by standard microbiological methods and whose antibiotic susceptibility was determined using CLSI guidelines between 2017 and 2019 were retrieved and analyzed. Data were entered and analyzed using the Stata release 10.1 statistical package. Result: The positivity rate of culture was 26.04% (419/1609). The most common bacteria isolated were S. aureus 23.8% (94), E. coli 15.1% (60), Klebsiella pneumonia 14.1% (56), Pseudomonas aeruginosa 8.5% (34), and CONS 7.3% (29). S. aureus and CONS showed a high (58.1% - 96.2%) rate of resistance to most antibiotics tested. They were less resistant to Vancomycin which is 18.6% (13/70) and 11.8% (2/17), respectively. Similarly, the resistance of E. coli, Klebsella pneumonia, and Pseudomonas aeruginosa was high (69.4% - 100%) to most antibiotics. They were less resistant to Ciprofloxacilin, which is 41.1% (23/56), 19.2% (10/52), and 16.1% (5/31), respectively. Conclusion: This study has shown that there is a high rate of antibiotic resistance among bacterial isolates in this hospital. A combination of Vancomycin and Ciprofloxacin should be considered in the choice of antibiotics for empirical treatment of suspected infections due to S. aureus, CONS, E. coli, Klebsiella pneumonia, Pseudomonas such as in infections within hospital setup.

Keywords: antimicrobial, resistance, bacteria, hospital

Procedia PDF Downloads 49
3584 Influence of Settlements and Human Activities on Beetle Diversity and Assemblage Structure at Small Islands of the Kepulauan Seribu Marine National Park and Nearby Java

Authors: Shinta Holdsworth, Jan Axmacher, Darren J. Mann

Abstract:

Beetles represent the most diverse insect taxon, and they contribute significantly to a wide range of vital ecological functions. Examples include decomposition by bark beetles, nitrogen recycling and dung processing by dung beetles or pest control by predatory ground beetles. Nonetheless, research into the distribution patterns, species richness and functional diversity of beetles particularly from tropical regions remains extremely limited. In our research, we aim to investigate the distribution and diversity patterns of beetles and the roles they play in small tropical island ecosystems in the Kepulauan Seribu Marine National Park and on Java. Our research furthermore provides insights into the effects anthropogenic activities have on the assemblage composition and diversity of beetles on the small islands. We recorded a substantial number of highly abundant small island species, including a substantial number of unique small island species across the study area, highlighting these islands’ potential importance for the regional conservation of genetic resources. The highly varied patterns observed in relation to the use of different trapping types - pitfall traps and flight interception traps (FITs) - underscores the need for complementary trapping strategies that combine multiple methods for beetle community surveys in tropical islands. The significant impacts of human activities have on the small island beetle faunas were also highlighted in our research. More island beetle species encountered in settlement than forest areas shows clear trend of positive links between anthropogenic activities and the overall beetle species richness. However, undisturbed forests harboured a high number of unique species, also in comparison to disturbed forests. Finally, our study suggests that, with regards to different feeding guilds, the diversity of herbivorous beetles on islands is strongly affected by the different levels of forest cover encountered.

Keywords: beetle diversity, forest disturbance, island biogeography, island settlement

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3583 The Antimicrobial Activity of Marjoram Essential Oil Against Some Antibiotic Resistant Microbes Isolated from Hospitals

Authors: R. A. Abdel Rahman, A. E. Abdel Wahab, E. A. Goghneimy, H. F. Mohamed, E. M. Salama

Abstract:

Infectious diseases are a major cause of death worldwide. The treatment of infections continues to be problematic in modern time because of the severe side effects of some drugs and the growing resistance to antimicrobial agents. Hence, the search for newer, safer and more potent antimicrobials is a pressing need. Herbal medicines have received much attention as a source of new antibacterial drugs since they are considered time-tested and comparatively safe both for human use and the environment. In the present study, the antimicrobial activity of marjoram (Origanum majorana L.) essential oil on some gram positive and gram negative reference bacteria, as well as some hospital resistant microbes, was tested. Marjoram oil was extracted and the oil chemical constituents were identified using GC/MS analysis. Staphylococcus aureas ATCC 6923, Pseudomonus auregonosa ATCC 9027, Bacillus subtilis ATCC 6633, E. coli ATCC 8736 and two hospital resistant microbes isolates 16 and 21 were used. The two isolates were identified by biochemical tests and 16s rRNA as proteus spp. and Enterococcus facielus. The effect of different concentrations of essential oils on bacterial growth was tested using agar disk diffusion assay method to determine the minimum inhibitory concentrations and using micro dilution method to determine the minimum bactericidal concentrations. Marjoram oil was found to be effective against both reference and hospital resistance strains. Hospital strains were more resistant to marjoram oil than reference strains. P. auregonosa growth was completely inhibited at a low concentration of oil (4µl/ml). The other reference strains showed sensitivity to marjoram oil at concentrations ranged from 5 to 7µl/ml. The two hospital strains showed sensitivity at media containing 10 and 15µl/ml oil. The major components of oil were terpineol, cis-beta (23.5%), 1,6 – octadien –3-ol,3,7-dimethyl, 2 aminobenzoate (10.9%), alpha terpieol (8.6%) and linalool (6.3%). Scanning electron microscope (SEM) and transmission electron microscope (TEM) analysis were used to determine the difference between treated and untreated hospital strains. SEM results showed that treated cells were smaller in size than control cells. TEM data showed that cell lysis has occurred to treated cells. Treated cells have ruptured cell wall and appeared empty of cytoplasm compared to control cells which shown to be intact with normal volume of cytoplasm. The results indicated that marjoram oil has a positive antimicrobial effect on hospital resistance microbes. Natural crude extracts can be perfect resources for new antimicrobial drugs.

Keywords: antimicrobial activity, essential oil, hospital resistance microbes, marjoram

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3582 Hybrid Speciation and Morphological Differentiation in Senecio (Senecioneae, Asteraceae) from the Andes

Authors: Luciana Salomon

Abstract:

The Andes hold one of the highest plant species diversity in the world. How such diversity originated is one of the most intriguing questions in studies addressing the pattern of plant diversity worldwide. Recently, the explosive adaptive radiations found in high Andean groups have been pointed as major triggers of this spectacular diversity. The Andes are one of the most species-rich area for the largest genus from the Asteraceae family, Senecio. There, the genus presents an incredible variation in growth form and ecological niche space. If this diversity of Andean Senecio can be explained by a monophyletic origin and subsequent radiation has not been tested up to now. Previous studies trying to disentangle the evolutionary history of some Andean Senecio struggled with the relatively low resolution and support of the phylogenies, which is indicative of recently radiated groups. Using Hyb-Seq, a powerful approach is available to address phylogenetic questions in groups whose evolutionary histories are recent and rapid. This approach was used for Senecio to build a phylogenetic backbone on which to study the mechanisms shaping its hyper-diversity in the Andes, focusing on Senecio ser. Culcitium, an exclusively Andean and well circumscribed group presenting large morphological variation and which is widely distributed across the Andes. Hyb-Seq data for about 130 accessions of Seneciowas generated. Using standard data analysis work flows and a newly developed tool to utilize paralogs for phylogenetic reconstruction, robustness of the species treewas investigated. Fully resolved and moderately supported species trees were obtained, showing Senecio ser. Culcitium as monophyletic. Within this group, some species formed well-supported clades congruent with morphology, while some species would not have exclusive ancestry, in concordance with previous studies showing a geographic differentiation. Additionally, paralogs were detected for a high number of loci, indicating duplication events and hybridization, known to be common in Senecio ser. Culcitium might have lead to hybrid speciation. The rapid diversification of the group seems to have followed a south-north distribution throughout the Andes, having accelerated in the conquest of new habitats more recently available: i.e., Montane forest, Paramo, and Superparamo.

Keywords: evolutionary radiations, andes, paralogy, hybridization, senecio

Procedia PDF Downloads 109
3581 The Effects of Globalization on Health: A Case of Kenyatta National Hospital Healthcare Services

Authors: S. Ithai, A. Oloo

Abstract:

The emergence of globalization has cultivated an international consensus that without economic development; it is very unlikely that a country may realize social or political development. It is equally important to note that the economic effect on social development automatically influence the country healthcare services as healthcare systems are improved and adopted. For decades and before 1980's, the colonial and the Governments of Kenya had pursued a goal to provide free healthcare services to its citizen with minimal success; but as population increased, this endeavor became almost a mirage. The challenge called for a change of strategy with introduction of cost sharing which also could not guarantee sustainability of healthcare services in the country due to increased number of poor people and poverty. An involvement of multisectral approach to provision of health individual, collaboration and adoption of all dimensions through globalization provides a ray of hope to not only economic, political and social development but also guaranteed equitable and reliable healthcare systems in Kenya and specifically referral healthcare services at KNH. With the advent of globalization, KNH has made positive strides that have guaranteed patients with reliable healthcare services. These include increased donor funding, collaboration levels, training and research as well as enhanced the hospital relations with international partners. During this period, the hospital has increased number of local doctors and nurses, enhanced transfer of skills, innovations and technologies which are driving forces to quality and efficient healthcare services. The period has also brought in challenges for the hospital which include increased competition, attraction of qualified nurses and doctors to international are some the issues that have made the hospital to spend more resources in research and development in order to stay afloat. This paper reveals the link between globalization and healthcare and its influence on institution policy choice. However, the process is not expected to take place automatically without institutional initiatives if KNH is to reap the benefits of globalization. KNH need to make use of the existing infrastructure, human resources and donor confidence, the opportunities that are indeed important in propelling KNH toward Vision 2030 and achieving the desired Millennium Development Goals (MDGs).

Keywords: globalization, Kenyatta National Hospital, native, healthcare

Procedia PDF Downloads 322
3580 A Nutritional Wellness Program for Overweight Health Care Providers in Hospital Setting: A Randomized Controlled Trial Pilot Study

Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

Abstract:

Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.

Keywords: weight management, weight control, health care providers, hospital

Procedia PDF Downloads 231
3579 Trees in Different Vegetation Types of Mt. Hamiguitan Range, Davao Oriental, Mindanao Island, Philippines

Authors: Janece Jean A. Polizon, Victor B. Amoroso

Abstract:

Mt. Hamiguitan Range in Davao Oriental, Mindanao Island, Philippines is the only protected area with pygmy forest and a priority site for protection and conservation. This range harbors different vegetation types such as agroecosystem, dipterocarp forest, montane forest and mossy forest. This study was conducted to determine the diversity of trees and shrubs in different vegetation types of Mt. Hamiguitan Range. Transect walk and 16 sampling plots of 20 x 20 m were established in the different vegetation types. Specimens collected were classified and identified using the Flora Malesiana and type images. Assessment of status was determined based on International Union for the Conservation of Nature (IUCN). There were 223 species of trees, 141 genera and 71 families. Of the vegetation types, the pygmy forest obtained a comparatively high diversity value of H=1.348 followed by montane forest with H=1.284. The high species importance value (SIV) of Diospyros philippinensis for trees indicates that these species have an important role in regulating the stability of the ecosystem. The tree profile of the pygmy forest is different due to the ultramafic substrate causing the dwarfness of the trees. These forest types should be given high priority for protection and conservation.

Keywords: diversity, Mt Hamiguitan, vegetation, trees, shrubs

Procedia PDF Downloads 386
3578 Delays for Emergency Cesarean Sections and Neonatal Outcomes in Three Rural District Hospitals in Rwanda: A Retrospective Cross-Sectional Study

Authors: J. Niyitegeka, G. Nshimirimana, A. Silverstein, J. Odhiambo, Y. Lin, T. Nkurunziza, R. Riviello, S. Rulisa, P. Banguti, H. Magge, M. Macharia, J. P. Dushime, R. Habimana, B. Hedt-Gauthier

Abstract:

In low-resource settings, women needing an emergency cesarean section experiences various delays in both reaching and receiving care that is often linked to poor neonatal outcomes. In this study, we quantified different measures of delays and assessed the association between these delays and neonatal outcomes at three rural district hospitals in Rwanda. This retrospective study included 441 neonates and their mothers who underwent emergency cesarean sections in 2015 at Butaro, Kirehe and Rwinkwavu District Hospitals. Four possible delays were measured: Time from start of labor to district hospital admission, travel time from a health center to the district hospital, time from admission to surgical incision, and time from the decision for the emergency cesarean section to surgical incision. Neonatal outcomes were categorized as unfavorable (APGAR < 7 or death) and favorable (APGAR ≥ 7). We assessed the relationship between each type of delay and neonatal outcomes using multivariate logistic regression. In our study, 38.7% (108 out of 279) of neonates’ mothers labored for 12 to 24 hours before hospital admission and 44.7% (159 of 356) of mothers were transferred from health centers that required 30 to 60 minutes of travel time to reach the district hospital. 48.1% (178 of 370) of caesarean sections started within five hours after admission and 85.2% (288 of 338) started more than thirty minutes after the decision for the emergency cesarean section was made. Neonatal outcomes were significantly worse among mothers with more than 90 minutes of travel time from the health center to the district hospital compared to health centers attached to the hospital (OR = 5.12, p = 0.02). Neonatal outcomes were also significantly different depending on decision to incision intervals; neonates with cesarean deliveries starting more than thirty minutes after decision had better outcomes than those started immediately (OR = 0.32, p = 0.04). Interventions that decrease barriers to access to maternal health care services can improve neonatal outcome after emergency cesarean section. Triaging could explain the inverse relationship between time from decision to incision and neonatal outcome; this must be studied more in the future.

Keywords: Africa, emergency obstetric care, rural health delivery, maternal and child health

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