Search results for: disabled children.

Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

Abstract:

Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, Burns, FLAMES, scoring systems, outcome.

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Authors: Natasha Bhate

Abstract:

Contraception is important in helping to reduce maternal and infant mortality rates by allowing women to control the number and spacing in-between their children. It also reduces the need for unsafe abortions. Women worldwide use contraception; however, the contraceptive prevalence rate is still relatively low in Central American countries like Guatemala. There is also an unmet need for contraception in Guatemala, which is more significant in rural, indigenous women due to barriers preventing contraceptive use. The study objective was to investigate and analyse the current barriers women face, in Guatemala, Panajachel and the surrounding areas, in using contraception, with a view of identifying ways to overcome these barriers. This included exploring the contraceptive barriers women believe exist and the influence of males in contraceptive decision making. The study took place at a charity in Panajachel, Guatemala, and had a cross-sectional, qualitative design to allow an in-depth understanding of information gathered. This particular study design was also chosen to help inform the charity with qualitative research analysis, in view of their intent to create a local reproductive health programme. A semi-structured interview design, including photo facilitation to improve cross-cultural communication, with interpreter assistance, was utilized. A pilot interview was initially conducted with small improvements required. Participants were recruited through purposive and convenience sampling. The study host at the charity acted as a gatekeeper; participants were identified through attendance of the charity’s women’s-initiative programme workshops. 20 participants were selected and agreed to study participation with two not attending; a total of 18 participants were interviewed in June 2017. Interviews were audio-recorded and data were stored on encrypted memory sticks. Framework analysis was used to analyse the data using NVivo11 software. The University of Leeds granted ethical approval for the research. Religion, language, the community, and fear of sickness were examples of existing contraceptive barrier themes recognized by many participants. The influence of men was also an important barrier identified, with themes of machismo and abuse preventing contraceptive use in some women. Women from more rural areas were believed to still face barriers which some participants did not encounter anymore, such as distance and affordability of contraceptives. Participants believed that informative workshops in various settings were an ideal method of overcoming existing contraceptive barriers and allowing women to be more empowered. The involvement of men in such workshops was also deemed important by participants to help reduce their negative influence in contraceptive usage. Overall, four recommendations following this study were made, including contraceptive educational courses, a gender equality campaign, couple-focused contraceptive workshops, and further qualitative research to gain a better insight into men’s opinions regarding women using contraception.

Keywords: Barrier, contraception, machismo, religion.

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Authors: Julia Terlet, Thomas H. Beach, Yacine Rezgui

Abstract:

Urbanization, population growth, climate change and the current increase in water demand have made the adoption of innovative demand management strategies crucial to the water industry. Water conservation in urban areas has to be improved by encouraging consumers to adopt more sustainable habits and behaviours. This includes informing and educating them about their households’ water consumption and advising them about ways to achieve significant savings on a daily basis. This paper presents a study conducted in the context of the European FP7 WISDOM Project. By integrating innovative Information and Communication Technologies (ICT) frameworks, this project aims at achieving a change in water savings. More specifically, behavioural change will be attempted by implementing smart meters and in-home displays in a trial group of selected households within Cardiff (UK). Using this device, consumers will be able to receive feedback and information about their consumption but will also have the opportunity to compare their consumption to the consumption of other consumers and similar households. Following an initial survey, it appeared necessary to implement these in-home displays in a way that matches consumer's motivations to save water. The results demonstrated the importance of various factors influencing people’s daily water consumption. Both the relevant literature on the subject and the results of our survey therefore led us to include within the in-home device a variety of elements. It first appeared crucial to make consumers aware of the economic aspect of water conservation and especially of the significant financial savings that can be achieved by reducing their household’s water consumption on the long term. Likewise, reminding participants of the impact of their consumption on the environment by making them more aware of water scarcity issues around the world will help increasing their motivation to save water. Additionally, peer pressure and social comparisons with neighbours and other consumers, accentuated by the use of online social networks such as Facebook or Twitter, will likely encourage consumers to reduce their consumption. Participants will also be able to compare their current consumption to their past consumption and to observe the consequences of their efforts to save water through diverse graphs and charts. Finally, including a virtual water game within the display will help the whole household, children and adults, to achieve significant reductions by providing them with simple tips and advice to save water on a daily basis. Moreover, by setting daily and weekly goals for them to reach, the game will expectantly generate cooperation between family members. Members of each household will indeed be encouraged to work together to reduce their water consumption within different rooms of the house, such as the bathroom, the kitchen, or the toilets. Overall, this study will allow us to understand the elements that attract consumers the most and the features that are most commonly used by the participants. In this way, we intend to determine the main factors influencing water consumption in order to identify the measures that will most encourage water conservation in both the long and short term.

Keywords: Behavioural change, ICT technologies, water consumption, water conservation.

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