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Gaylard, D. G., et I. Wilson. « Resuscitation on labour wards ». Anaesthesia 41, no 6 (juin 1986) : 651–52. http://dx.doi.org/10.1111/j.1365-2044.1986.tb13067.x.
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Laine, Juha, Anja Noro, Harriet Finne-Soveri et Unto Häkkinen. « Patient- and ward-level determinants of nursing time in nursing facilities ». Journal of Health Services Research & ; Policy 10, no 4 (1 octobre 2005) : 226–31. http://dx.doi.org/10.1258/135581905774414178.
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Objectives: To explore the patient- and ward-level determinants of wage-adjusted nursing time in long-term care wards for the elderly with a view to improving efficiency of the use of labour resources. Methods: The wage-adjusted nursing time given to patients was obtained from a time measurement study. Patient characteristics were based on the Minimum Data Set 2.0 of the Resident Assessment Instrument for nursing homes. Ordinary least-squares regression analysis and multilevel modelling were used to disentangle the effect of patient- and ward-level factors on nursing time. Results: A significant difference in wage-adjusted nursing time between wards was detected, which was partly explained by characteristics of patients in wards. The combination of patients' physical functioning and cognition and the Resource Utilization Groups RUG-III/22 resource use classification explained 20–25% of patients' nursing time over a 24-hour period. Variables related to the operational environment of the ward did not explain differences in wage-adjusted nursing time once the patient profile of the ward had been controlled for. The results also showed notable unmeasured patient and ward level effects, inefficiency and randomness in the allocation of nursing time. Conclusions: By improving the allocation and use of labour resources, the substantial variation in nursing time between wards could be diminished. Managers should allocate their staff primarily according to patients' resource needs.
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Ntombana, Rala, James Sindiwe et Tshotsho Ntombodidi. « Opinions of labouring women about companionship in labour wards ». African Journal of Midwifery and Women's Health 8, no 3 (2 juillet 2014) : 123–27. http://dx.doi.org/10.12968/ajmw.2014.8.3.123.
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Namwaya, Ziidah, Imelda Namagembe, Dan Kaye, Gorrette Nalwadda, Grace Edwards et Rose Chalo Nabirye. « Midwives' practice and perception of labour and delivery care at the Mulago National Referral Hospital, Uganda ». African Journal of Midwifery and Women's Health 14, no 1 (2 janvier 2020) : 1–12. http://dx.doi.org/10.12968/ajmw.2018.0024.
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Background/Aims The majority of maternal deaths occur during labour, delivery, or within the first 4 hours after birth. This can be reduced by the care that midwives provide. At Mulago Hospital, little is documented on midwives' current practice and their perception of care offered during labor and delivery. The number of maternal and neonatal deaths as a result of preventable causes such as postpartum haemorrhage, obstructed labour, ruptured uterus and sepsis remains high. The aim of this study was to document the current practice of midwives, explore midwives' perception towards practice and identify factors that influence practice during birth in Uganda, to identify possible areas for improvement. Methods A cross-sectional study was conducted of midwives working in the three labour wards at the Mulago National referral hospital: the general ward, the private ward and the midwifery-led ward. Midwives' perceptions were explored using a semi-structured questionnaire, which asked midwives about their current practice and their perception of the care offered. Findings Care was found to be lacking in several areas. Only one-fifth (20.0%) of midwives reported always checking temperature every 4 hours. Only 20.5% reported that women are always supported in being mobile during labour. Less than half of the midwives (44.4%) knew the recommended drugs for managing the third stage of labour. Infection prevention practices were poor. Only 54% of midwives knew how to prepare magnesium sulphate for management of severe pre-eclampsia and eclampsia. Overall, the general labour ward was found to have the most gaps in midwives' knowledge. Lack of continuing education, supplies, teamwork and clinical guidelines were reported to affect practice. Staff shortages and midwives' decisions being underlooked by obstetricians were also reported to affect practice. Conclusions Overall, the study found that midwifery practice is suboptimal in key areas such as infection prevention, use of a partograph, and management of pre-eclampsia and eclampsia. Continuous professional development, provision of resources, and strengthening teamwork are recommended to improve maternal health outcomes at Mulago Hospital.
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Arnott, A. J. Harrold, Pauline Lync, N. « Variations in oxytocin regimes in Scottish labour wards in 1998 ». Journal of Obstetrics and Gynaecology 20, no 3 (janvier 2000) : 235–38. http://dx.doi.org/10.1080/01443610050009502.
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Lavender, Tina, Grace Omoni, Karen Lee, Sabina Wakasiaka, James Watiti et Matthews Mathai. « Students’ experiences of using the partograph in Kenyan labour wards ». African Journal of Midwifery and Women's Health 5, no 3 (juillet 2011) : 117–22. http://dx.doi.org/10.12968/ajmw.2011.5.3.117.
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Egwuatu, Tenny G. O., Adesola O. Olalekan, Godwin O. Orkeh, Tochukwu F. Egwuatu, Vincent O. Rotimi et Folasade T. Ogunsola. « Characterization of Methicillin Resistant Staphylococcus haemolyticus Isolated from Neonatal, Postnatal and Labour Wards in Lagos, Nigeria ». Pan African Journal of Life Sciences 2, no 1 (1 juin 2019) : 60–66. http://dx.doi.org/10.36108/pajols/9102/20(0110).
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Introduction: Staphylococcus haemolyticus is an important etiological agent of hospital infections but its epidemiological significance has not been studied in our institution. We therefore determine the prevalence, colonization rates and source of hospital-acquired Methicillin resistant Staphylococcus haemolyticus (MRSH) in Lagos, Nigeria. Methods: Axilla and umbilicus swab samples were collected from neonates (346), hand, nasal and axilla from health care workers (125), HVS from mothers (26) at the Lagos University Teaching Hospital (LUTH) and also samples from the environment (28). Using standard bacteriological methods, the samples were screened for S. haemolyticus. Possible person–to-person transmission was investigated by means of pulsed field gel electrophoresis. Results: Out of 525 samples collected, 112 (21.3%) were S. haemolyticus of which 17 (15.2%) were (MRSH). Neonates’ samples had 8 (15.0%) MRSH and 6 (30%) were Medical Doctors had their samples positive for MRSH. Also, 3 (11.1%) nurses’ samples were MRSH. None of the S. haemolyticus obtained from the mothers and the environment was MRSH. Pulsed field Gel Electrophoresis (PFGE) identified three main PFGE types (Type 1, 2 and 3) in the hospital. Type 1 and type 3 from babies in Neonatal unit. Type 2 and type 3 in babies from post-natal ward. Four doctors in the labour and neonatal wards had type 1 which was also recovered from a nurse on the labour ward. Conclusion: It appeared that the source of MRSH was from the hand and anterior nares of Healthcare workers in labour ward and Neonatal unit. This further highlights the need for proper infection con-trol practice in the institution, especially single use of gloves for patients’ management.
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Anand, Nikhil, et Hardik Shah. « A clinical study of maternal outcome in post dated pregnancy in a tertiary care hospital ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no 9 (26 août 2019) : 3573. http://dx.doi.org/10.18203/2320-1770.ijrcog20193777.
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Background: Pregnancy lasting beyond 40 weeks is a known complication of normal delivery. Studies have found incidence between 2-14%. Post-dated pregnancy carries specific hazards to both mother and fetus. While mothers are faced with problems like increased incidences of induced labour, instrumental delivery and LSCS with associated morbidities, fetuses are faced with morbidities ranging from IUGR to macrosomia. We here tried to study maternal outcome in post-dated pregnancy. The objective is to study maternal outcome in post-dated pregnancy and to compare maternal outcome in spontaneous versus induced labour in post-dated pregnancy.Methods: This study was done at a tertiary care hospital in obstetrics and gynecology department for duration of 18 months. After screening according to inclusion criteria, all patients who were admitted in labour wards were grouped in two groups according to clinical examination. First group consists of patients with spontaneous onset of labour and second group consists of patients with induction of labour. In each group same protocol for fetal monitoring were performed, and labor monitored according to standard partograph. Maternal outcomes in both groups were studied.Results: Maternal outcomes were nearly same in both groups; induced and spontaneous onset of labour, except rate of LSCS, Which was more in induced group though not statistically significant.Conclusions: Women with uncomplicated post dated pregnancies with good bishop score should be allowed spontaneous labour and those with poor bishop should be offered induction of labour, while women with any complicating factors LSCS should be considered.
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Anand, Nikhil, et Hardik Shah. « Comparison of fetal outcome in spontaneous versus induced labor in postdated pregnancy : a study in a tertiary care centre ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no 10 (26 septembre 2018) : 4081. http://dx.doi.org/10.18203/2320-1770.ijrcog20184132.
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Background: Pregnancy lasting beyond 40 weeks is a known complication of normal delivery. Various studies have found incidence between 2-14%. Post-dated pregnancy carries specific hazards to both mother and fetus. While mothers are faced with problems like increased incidences of induced labour, instrumental delivery and LSCS with associated morbidities, fetuses are faced with morbidities ranging from IUGR to macrosomia. Authors tried to study fetal outcome in post-dated pregnancy present study. The objective is to compare fetal outcome in spontaneous versus induced labour in post-dated pregnancy.Methods: This is a prospective cross-sectional study done at a tertiary care hospital in obstetrics and gynecology in duration of 18 months. After screening according to inclusion criteria, all patients who were admitted in labour wards are selected and two groups were created according to clinical examination. First group consists of patients with spontaneous onset of labour and second group consists of patients with induction of labour. In each group USG, NST and BPP were performed, and labor monitored according to standard partograph. Fetal outcomes in both groups were studied.Results: Fetal outcomes were nearly same in both groups, induced and spontaneous onset of labour, except a few like thick meconium which was common in spontaneous onset group while rate of LSCS was more in induced group.Conclusions: Women with uncomplicated pregnancies should be offered induction of labour, while women with any complicating factors LSCS should be considered.
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McCreight, Bernadette Susan. « Perinatal grief and emotional labour : a study of nurses’ experiences in gynae wards ». International Journal of Nursing Studies 42, no 4 (mai 2005) : 439–48. http://dx.doi.org/10.1016/j.ijnurstu.2004.07.004.
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Homer, Caroline S. E., Seong L. Cheah, Chris Rossiter, Hannah G. Dahlen, David Ellwood, Maralyn J. Foureur, Della A. Forster et al. « Maternal and perinatal outcomes by planned place of birth in Australia 2000 – 2012 : a linked population data study ». BMJ Open 9, no 10 (octobre 2019) : e029192. http://dx.doi.org/10.1136/bmjopen-2019-029192.
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ObjectiveTo compare perinatal and maternal outcomes for Australian women with uncomplicated pregnancies according to planned place of birth, that is, in hospital labour wards, birth centres or at home.DesignA population-based retrospective design, linking and analysing routinely collected electronic data. Analysis comprised χ2tests and binary logistic regression for categorical data, yielding adjusted ORs. Continuous data were analysed using analysis of variance.SettingAll eight Australian states and territories.ParticipantsWomen with uncomplicated pregnancies who gave birth between 2000 and 2012 to a singleton baby in cephalic presentation at between 37 and 41 completed weeks’ gestation. Of the 1 251 420 births, 1 171 703 (93.6%) were planned in hospital labour wards, 71 505 (5.7%) in birth centres and 8212 (0.7%) at home.Main outcome measuresMode of birth, normal labour and birth, interventions and procedures during labour and birth, maternal complications, admission to special care/high dependency or intensive care units (mother or infant) and perinatal mortality (intrapartum stillbirth and neonatal death).ResultsCompared with planned hospital births, the odds of normal labour and birth were over twice as high in planned birth centre births (adjusted OR (AOR) 2.72; 99% CI 2.63 to 2.81) and nearly six times as high in planned home births (AOR 5.91; 99% CI 5.15 to 6.78). There were no statistically significant differences in the proportion of intrapartum stillbirths, early or late neonatal deaths between the three planned places of birth.ConclusionsThis is the first Australia-wide study to examine outcomes by planned place of birth. For healthy women in Australia having an uncomplicated pregnancy, planned births in birth centres or at home are associated with positive maternal outcomes although the number of homebirths was small overall. There were no significant differences in the perinatal mortality rate, although the absolute numbers of deaths were very small and therefore firm conclusions cannot be drawn about perinatal mortality outcomes.
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Messina, Anthony M. « Ethnic Minority Representation and Party Competition in Britain : The Case of Ealing Borough ». Political Studies 35, no 2 (juin 1987) : 224–38. http://dx.doi.org/10.1111/j.1467-9248.1987.tb01885.x.
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This article critically assesses claims that the Conservative and Labour Parties' neglect of Britain's non-white population is due to its relatively small size and/or its geographical concentration in ‘safe’, predominantly white, Labour constituencies. Rather, it is demonstrated that in the London Borough of Ealing, where non-whites comprise a quarter of the population and neither major party enjoys political predominance, a number of intra-party constraints (e.g. ideology) combine with electoral disincentives (e.g. addressing non-white demands could alienate whites in the handful of electorally marginal wards which decide the parliamentary balance) to impel both parties to neglect non-white interests.
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Parvin, Most Morsheda, M. F. K. Al Mannah et Esrat Jahan Sathi. « Nurses’ Knowledge Regarding Contraceptive Methods at Dinajpur Medical College Hospital ». Randwick International of Social Science Journal 2, no 2 (30 avril 2021) : 106–12. http://dx.doi.org/10.47175/rissj.v2i2.220.
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This study was carried out on Nurses Knowledge Regarding Contraceptives Methods in Dinajpur Medical college Hospital, Dinajpur. The descriptive co relational design was used to explore the nurse’s knowledge and practice regarding contraceptives methods used in Dinajpur Medical college Hospital, Dinajpur. The study was conducted in thirty-two wards under four selected units, including 1) Gynae ward 2) Labour ward 3) Family planning centre. 50 nurses were selected for this study. The instrument developed by the researcher was divided into three sections, including 1) Demographic Questionnaire 2) Nurses’ knowledge regarding contraceptives methods Questionnaire 3) Nurses’ practice regarding contraceptives methods Questionnaire. The age of the participated nurses was 30-39 years 28%, 40-49 years 66%, 50+ above 4%. Of them, a male nurse was 12% and a female 88%. No unmarried nurse has participated, and 96% were married, and the remaining 4% were a widow. Professional qualification, Diploma in Nursing and Diploma in Midwifery 76%, B. Sc. in public Health 0%, M. Ph / M. Sc. 10%.
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Ahmed, Seid Mussa, Johanne Sundby, Yesuf Ahmed Aragaw et Hedvig Nordeng. « Medicinal plants used among pregnant women in a tertiary teaching hospital in Jimma, Ethiopia : a cross-sectional study ». BMJ Open 11, no 8 (août 2021) : e046495. http://dx.doi.org/10.1136/bmjopen-2020-046495.
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ObjectiveThe aim of this study was to investigate and describe the use of medicinal plants during pregnancy among women admitted in the Maternity and Gynaecology wards at Jimma University Medical Centre (JUMC) in the southwest Ethiopia.DesignCross-sectional study.SettingMaternity and Gynaecology wards at JUMC.Participants1117 hospitalised pregnant women or postpartum women.Main outcome measuresOur primary outcomes of interest were the prevalence of use, types of medicinal plants used and their utilisation among pregnant women.MethodsData were collected through structured face-to-face interviews of pregnant women or postpartum women and review of patient medical records between February and June 2017.ResultsOverall, 28.6% of the women reported use of at least one medicinal plant during the pregnancy. Twenty-seven different types of medicinal plants were used. The most commonly used medicinal plants were Linum usitatissimum L. (flaxseed—use with caution) 22.0%, Ocimum lamiifolium L. (damakessie—safety unknown) 3.6% and Carica papaya L. (papaya—use with caution) 3.1%. The most common reason for use was preparation, induction or shortening of labour. Lack of access to health facility (mainly health posts), admission to maternity ward, khat chewing and alcohol consumption were the strongest predictors of medicinal plants use during pregnancy (OR >2). Only five medicinal plants used by women had sufficient evidence to be classified as safe to use in pregnancy.ConclusionsAlmost one-third of women at the tertiary hospital in Ethiopia reported use of medicinal plants during pregnancy, most frequently to prepare, induce, reduce the intensity or shorten duration of labour. Increased awareness about potential benefits or risks of medicinal plants use during pregnancy among healthcare professionals and patients, and increased access to childbirth providing healthcare facilities are important in order to promote safer pregnancies and better health outcomes for women and their unborn children.
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Bowers, Tayla R., et Eamon J. Duffy. « Quality of antimicrobial prescribing improved by the introduction of ePrescribing at Auckland City Hospital ». Health Informatics Journal 26, no 4 (20 février 2020) : 2375–82. http://dx.doi.org/10.1177/1460458220905163.
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Improving antimicrobial prescribing is a difficult process often requiring labour-intensive, multi-modal interventions. Many hospitals have introduced ePrescribing systems but the effect on antimicrobial prescribing, without treatment choice decision support systems, has not been well described. We sought to determine whether the introduction of ePrescribing improved prescribing quality. Patient records for inpatients on four rehabilitation wards, two using ePrescribing and two using the National Medication Chart, during February 2017, were retrospectively reviewed to identify all antimicrobial prescriptions, which were then reviewed for quality. Documentation of indication was significantly better on ePrescribing wards (45/46, 98%) compared to National Medication Chart wards (47/59, 80%). Adherence to guidelines (32/46, 70% vs 33/59, 56%), appropriateness of therapy (42/46, 91% vs 50/59, 85%) and documentation of duration, stop or review dates (35/46, 76% vs 38/59, 64%) did not significantly differ. ePrescribing can improve the quality of antimicrobial prescribing when Antimicrobial Stewardship principles are used in system customisation but cannot address all factors impacting on prescribing quality.
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EZE Ojerinde, Ogonna, Adenike Onibokun et Onoja Matthew Akpa. « Knowledge and practice of pain management among nurses in labour wards in Ibadan, Nigeria ». African Journal of Midwifery and Women's Health 10, no 3 (2 juillet 2016) : 132–37. http://dx.doi.org/10.12968/ajmw.2016.10.3.132.
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Bergh, Ingrid H. E., Anna Johansson, Annelie Bratt, Anette Ekström et Lena B. Mårtensson. « Assessment and documentation of women's labour pain : A cross-sectional study in Swedish delivery wards ». Women and Birth 28, no 2 (juin 2015) : e14-e18. http://dx.doi.org/10.1016/j.wombi.2015.01.010.
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SMYTH, JAMES J. « RESISTING LABOUR : UNIONISTS, LIBERALS, AND MODERATES IN GLASGOW BETWEEN THE WARS ». Historical Journal 46, no 2 (juin 2003) : 375–401. http://dx.doi.org/10.1017/s0018246x0300298x.
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This article examines the co-operation between unionists and liberals in inter-war Glasgow. As with the parliamentary challenge of labour, unionists and liberals were confronted at the local level also. The usual response was some sort of municipal alliance or pact. In Scotland, where unionist support for continuing links with liberals was particularly pronounced, this took the form of specific ‘moderate’ parties created to contest local elections. This strategy was markedly successful in keeping labour out of office. The moderates secured their majority in Glasgow by completely dominating the middle-class wards and winning a number of working-class seats. Moderate success is examined through the essential unity of the middle-class vote, the more limited local franchise, and religious sectarianism. However, it became increasingly difficult for the moderates to satisfy both their middle-class and working-class supporters. The sudden emergence of a militant protestant party in the depths of the depression provided a temporary vehicle of protest, which split the moderate vote and allowed labour in to power in 1933.
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KESSING, L. V., E. AGERBO et P. B. MORTENSEN. « Does the impact of major stressful life events on the risk of developing depression change throughout life ? » Psychological Medicine 33, no 7 (25 septembre 2003) : 1177–84. http://dx.doi.org/10.1017/s0033291703007852.
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Background. It is unclear whether there is an interaction of ageing on the association between major life events and onset of depression.Method. This was a population-based nested case–control study with linkage of the Danish Psychiatric Central Research Register and the Integrated Database for Longitudinal Labour Market Research. The study includes data on all admissions at psychiatric wards in Denmark from 1981 to 1998 and data on sociodemographic variables and death/suicide of first-degree relatives.Results. A total of 13006 patients who received a diagnosis of depression at the first ever admission at a psychiatric ward and a gender- and age-matched control group of 260108 subjects were identified. A recent divorce and recent unemployment and suicide of a relative (mother, father, sibling, child, spouse) were associated with increased risk of being admitted for the first time ever at a psychiatric ward with a diagnosis of depression whereas death of a relative by causes other than suicide years had no significant effect. In general, no interaction was found with age with any of the variables, totally, or for men or women, separately.Conclusions. The susceptibility to major life stressors does not seem to change throughout life.
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BAILEY, SIMON, KEZIA SCALES, JOANNE LLOYD, JUSTINE SCHNEIDER et ROB JONES. « The emotional labour of health-care assistants in inpatient dementia care ». Ageing and Society 35, no 2 (21 août 2013) : 246–69. http://dx.doi.org/10.1017/s0144686x13000573.
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ABSTRACTAlthough there is much written on the emotional labour of nursing, there is little research grounded in the experience of so-called ‘unqualified’ care assistants. This paper is drawn from an ethnographic study conducted with care assistants on three dementia care wards in one mental health trust within the United Kingdom National Health Service (NHS). We describe the emotional labour carried out by care assistants in their attempts to provide personalised care for people whose cognitive degeneration renders conventional relationship-building very difficult, produces unpredictable ‘challenging behaviour’ and calls into question the notion of ‘feeling rules’. This context requires the ability to strike a balance between emotional engagement and detachment, and it is the complexities of this relationship that are the focus of this paper, arguing that a degree of detachment is a prerequisite to engagement in this context. In conclusion, we argue that the contribution of care assistants in this context needs to be better acknowledged, supported and remunerated.
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Bangal, Vidyadhar B. « Work place based assessment of medical interns on surgical asepsis following training in Obstetrics and Gynecology ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no 12 (23 novembre 2017) : 5609. http://dx.doi.org/10.18203/2320-1770.ijrcog20175290.
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Background: Internship programme for medical interns is meant to develop basic skills and to have experience in management of common illnesses and emergencies. Medical interns are often posted to the clinical disciplines, without adequate instructions on surgical asepsis and bio-safety measure. Training need was identified for interns in the subject of surgical asepsis.Methods: Hands on training programme was organized for interns that included common procedures performed by them in wards, operation theatre and labour room complex on day to day basis. A pre and post test was performed to assess the gain in knowledge by interns. Subsequently, interns were supervised by residents, nurses and faculty members in labour room, operation theatre and wards. The observations were documented, and immediate feedback was given to interns. Feedback from interns was obtained at the end of the rotation in Obstetrics and Gynecology.Results: There was significant gain in knowledge by interns following training programme. Interns adopted good aseptic precautions during their posting. Compliance to aseptic precautions was significantly more in female interns as compared to male. A demand got generated from other batches of interns in conducting similar training programme for them. Nurses, faculty members and co-ordinator of internship programme gave positive feedback about the changes observed in the batch of interns who underwent training as compared to previous batches.Conclusions: Adoption of techniques of surgical asepsis by interns was improved following training programme held at the beginning of rotation posting in Obstetrics and Gynecology. It is recommended to include the topic in internship orientation programme.
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Ferrera, Maurizio. « FROM THE WELFARE STATE TO THE SOCIAL INVESTMENT STATE ». Revista Direito das Relações Sociais e Trabalhistas 3, no 1 (9 octobre 2019) : 53–71. http://dx.doi.org/10.26843/mestradodireito.v3i1.101.
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This paper discusses the basic rationale which has inspired the intellectual and policy reorientation towards “social investment”, with particular attention to child policy. The firstsection outlines the main features of the social investment approach, contrasting it with the more traditional “Fordist” approach. The second and third sections explain why and how early childhood education and care canmake a difference in termsofbothefficiencyandequity.Thefourthsectionbrieflysummarizes the British experience under New Labour, while the fifth section discusses issues of quality and accessibility. The conclusion wraps up, underlining the need to step up the shift to- wards social investment, overcoming the political obstaclesto reform.
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Read, Rosie. « Caring Values and the Value of Care : Women, Maternalism and Caring Work in the Czech Republic ». Contemporary European History 28, no 4 (31 octobre 2019) : 500–511. http://dx.doi.org/10.1017/s0960777319000122.
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AbstractThis article examines maternalism in the Czech Republic by exploring how waged and unwaged forms of caring work were framed through discourses of women's innately caring nature in the late twentieth century. Present-day hospital volunteering programmes, which bring female, lay volunteers onto hospital wards to provide unwaged care to patients, are inscribed by maternalist tropes historically associated with domestic work and family care, rather than the neutral expertise associated with female waged care workers in public, institutional settings. The article assesses the contemporary reinvention of maternalist discourses and their capacity to mobilise unwaged caring labour.
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CHOU, WINSTON, et RAFAELA DANCYGIER. « Why Parties Displace Their Voters : Gentrification, Coalitional Change, and the Demise of Public Housing ». American Political Science Review 115, no 2 (23 février 2021) : 429–49. http://dx.doi.org/10.1017/s0003055421000058.
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Across advanced economies, affordable housing shortages are pushing low-income voters out of cities. Left governments frequently exacerbate these shortages by eliminating public housing. Why does the Left pursue policies that displace its voters? We argue that the Left’s long-term rebalancing towards the middle class and away from an increasingly stigmatized “underclass” has significantly attenuated the trade-offs inherent in reducing affordable housing. Focusing on the UK, we demonstrate that by alienating low-income voters politically and reshuffling them across districts, housing crises have significant costs for Labour. Yet, drawing on interviews, we show that displacement is nonetheless compatible with electoral interests: the displaced make room for richer voters whom politicians believe will also support Labour. A quantitative analysis of Greater London’s 32 local authorities and 624 wards further documents trends in line with coalitional rebalancing. Taken together, our findings demonstrate that electoral foundations are key to understanding housing crises and gentrification.
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Ashcroft, Brenda. « Labour ward incidents and potential claims – lessons learned from research ». Clinical Risk 14, no 6 (novembre 2008) : 235–38. http://dx.doi.org/10.1258/cr.2008.080081.
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This paper provides an insight into the underlying factors involved in potential cerebral palsy and/or shoulder dystocia claims. The research was undertaken to identify the root causes of 37 cases of birth asphyxia in term infants severe enough to warrant admission to neonatal care units in the north-west of England between 2001 and 2002. All available staff ( n = 93) providing care during critical periods were interviewed by the author using the cognitive interviewing technique. These included 81 midwives, two consultant obstetricians, eight registrars and two senior house officers. An expert panel consisting of consultant obstetricians, midwives, a consultant neonatologist and the researcher applied the Bolam test to identify instances where care had been substandard and injury caused as a result. Although the cases were often complex, covering more than one shift and over more than one stage of labour, the most dangerous time appeared to be during the night shift (19 cases, 51%), followed by the evening shift (13 cases, 35%) and then the day shift (five cases, 14%). The main problems include: failure to respond appropriately to signs of fetal hypoxia (26 cases, 70%); undiagnosed obstruction (22 cases, 59%), which was broken down into failure to identify cephalopelvic disproportion (13 cases, 35%); and shoulder dystocia (nine cases, 24%). Delayed resuscitation of the infant occurred in 26 cases (80%), and in 18 cases (49%) there was excessive and inappropriate use of Syntocinon. All cases involved human error, either through a delay or failure to take action, or taking inappropriate action. However, these were all underpinned and perpetuated by system and cultural errors present in the labour wards, such as allowing unsupported and inexperienced personnel to work in a position for which they lacked the necessary skill and experience. This was perpetuated by the customary practice of using unsupervised junior medical staff in a first on-call position for complications, and also of failing to sustain safe midwifery staffing levels. This in turn prevented support for more inexperienced staff. Consequently, when inexperienced midwives and obstetricians were left unsupervised in charge of complicated cases, it created accidents waiting to happen. When unsupervised and inexperienced paediatricians attended the birth of an asphyxiated infant, the child's condition deteriorated further when they were unable to resuscitate it. If such system and cultural errors as these are not rectified, the current high rate of damaged babies is likely to continue.
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Simbar, Masoumeh, Farideh Ghafari, Shahnaz Tork Zahrani et Hamid Alavi Majd. « Assessment of quality of midwifery care in labour and delivery wards of selected Kordestan Medical Science University hospitals ». International Journal of Health Care Quality Assurance 22, no 3 (mai 2009) : 266–77. http://dx.doi.org/10.1108/09526860910953539.
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Lundgren, Ingela, Karin Andrén, Eva Nissen et Marie Berg. « Care seeking during the latent phase of labour – Frequencies and birth outcomes in two delivery wards in Sweden ». Sexual & ; Reproductive Healthcare 4, no 4 (décembre 2013) : 141–46. http://dx.doi.org/10.1016/j.srhc.2013.09.001.
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Kao, M. H., et C. P. Chie-Pein Chen. « The effects of support interventions on anxiety and depression in women with preterm labor during hospitalization ». European Psychiatry 41, S1 (avril 2017) : S736—S737. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1352.
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AimTo examine the effects of support interventions on anxiety, depression in women hospitalized with preterm labour at admission and 2 weeks.BackgroundHospitalized pregnant women with preterm labour have significantly higher anxiety and depression levels. Few studies have explored the effects of support interventions on anxiety, depression in such women.MethodsA randomized, single-blind experimental design was used. The control group (n = 103) and intervention group (n = 140) were recruited from the maternity wards of one medical centre in northern Taiwan between January 2013 and April 2015. The control group received routine nursing care. The experimental group received support interventions, which included an interview, distraction methods and assistance with daily living needs. Groups were evaluated with the Beck anxiety inventory, Edinburgh Postnatal Depression Scale and at admission and 2 weeks of hospitalization.ResultsThere were no significant differences between groups for demographics, obstetric characteristics, or birth outcomes. For the control group, anxiety and depression scores increased significantly decreased 2 weeks after hospitalization. The intervention group had a small, but significant, increase in anxiety and no significant change in depression at 2 weeks. Participants who received 2 weeks of support intervention had significantly lower anxiety and depression scores than the control group.ConclusionsProviding interventional support could reduce anxiety and depression for women with preterm labour during hospitalization.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Cunningham, John D. « Experiences of Australian mothers who gave birth either at home, at a birth centre, or in hospital labour wards ». Social Science & ; Medicine 36, no 4 (février 1993) : 475–83. http://dx.doi.org/10.1016/0277-9536(93)90409-w.
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Anne. G., Gongwe, et Kongolo M. « Resource Use Efficiency in Maize Production by Small-Scale Farmers in Two Districts of Mwanza Region, Tanzania ». International Journal of Regional Development 7, no 1 (9 juin 2020) : 27. http://dx.doi.org/10.5296/ijrd.v7i1.17162.
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This study investigates the resource use efficiency in the production of maize by small-scale farmers in Mwanza region. Specifically, the study seeks to determine what the resources that farmers use in maize production and also seeks to determine the challenges that farmers face in maize production in the study area. This study was conducted in two districts of Mwanza region. In each of the district, the study sampled three wards and randomly selected twelve small-scale farmers from each of the three wards selected. In total 72 small-scale farmers were selected from whom the data was collected. A Cobb-Douglas production function was used to fit and analyse the data for its good fit. The R² was 0.77, indicating that 77 percent of the variation in dependent variable was explained by the independent variables of the model. The use of inputs in the production of maize was noted to be increasing returns to scale. The results indicated that variables land (X1), labour (X2), age (X6), and experience (X8) were all positive and significant at the 1% while soil preparation (X4) variable was negative but significant at the 5%. The major constraints to maize production included lack of fertilizer (manure), finance (capital) and access to land. The study concluded that more exposure of small-scale farmers to frequent extension services is important to assist them to produce efficiently.
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B. P., Sri Vidya, Shashikumar N. S. et Manohar R. « Study of analgesics usage in third trimester of pregnancy and its ill effects on pregnancy course and outcome ». International Journal of Basic & ; Clinical Pharmacology 6, no 9 (22 août 2017) : 2282. http://dx.doi.org/10.18203/2319-2003.ijbcp20173760.
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Background: Pregnancy is a special physiological state. Pregnancy care is one of the greatest challenges in medicine as it demands a special care in the use of drugs because of altered physiology. At least 10 percent of birth defects are thought to result from maternal drug exposures. NSAIDS are one of the most commonly used medications during pregnancy (17%) to treat painful events during pregnancy.Methods: A prospective observational study was conducted after taking approval from the Institutional ethical committee and study was conducted for a period of one year. Antenatal clinics and inpatients wards of department of obstetrics and Gynaecology were visited and all the pregnant women with exposure to analgesics during third trimester and at the time of labour were included in the study. Information regarding the analgesics exposure either prescribed by the physician or self-medicated was collected.Results: Total 1520 pregnant women were included in the study over a period of one year. Analgesic exposure was seen in 77.1% of pregnant women during labour. Most common analgesic used to relieve labour pain was tramadol. 22.9% pregnant women were exposed to analgesics during third trimester, among them exposure to paracetamol was observed in 14% of pregnant women and to tramadol in 8.9%. Indications for usage of these analgesics during pregnancy were fever with myalgia (45.8%), false labour pain (37%), and headache (11.4%).Conclusions: Study showed that there is a positive association between analgesics exposure during third trimester of pregnancy particularly to paracetamol exposure and preterm delivery. Association between paracetamol exposure and low birth weight was also observed in this study but this finding could be due to more number of preterm deliveries which could not be ruled out in this study. Further studies have to be conducted to confirm the association since there are only limited numbers of studies done till now.
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Jnawali, Arjun Dev, et Sushma Marahatta. « Assessment of Home Garden : A Case of Purkot VDC, Tanahun District ». International Journal of Applied Sciences and Biotechnology 7, no 4 (28 décembre 2019) : 459–62. http://dx.doi.org/10.3126/ijasbt.v7i4.26923.
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Growing different crop species in combination with mushroom, honey bee, livestock around homestead is an ancient practice of home gardening where marginal land, labour, limited capital with simple tools and technology are used. A survey was conducted in Purkot VDC of Tanahun district in April 2015 with the purpose of assessing the status and annual income of home garden. Data was collected through purposive method by using structured questionnaire at four wards of the VDC. The economic return was assessed through calculating the local retail value of the product without considering cost associated with it. The average annual income of home garden was NRs. 33528.65 from average 377.78 m2 (0.76 Ropani) home garden, derived from cultivation of vegetables, fruits, legumes, medicinal & aromatic plants and cereals. About 65 % household involved in multistoried gardening with the objective of home consumption (66.7 %). Home garden of study area was truly vegetable based (100 %). Income of home garden was determined by objectives of gardening, education level of respondents and type of species grown. The key problem of home garden was insufficient water (81.2 % of cases), incidence of disease insect/pest (66.7 % of cases), weather and climatic impact (56.2 %), animal trespass (41.7 %) and labour insufficiency in gardening (31.2 %).
Int. J. Appl. Sci. Biotechnol. Vol 7(4): 453-456
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Ifabiyi, P. I., B. Oladele et Wahab Salau. « Water Poverty Assessment in Olorunsogo Local Government Area of Oyo State, Nigeria ». Geosfera Indonesia 5, no 1 (10 avril 2020) : 92. http://dx.doi.org/10.19184/geosi.v5i1.13438.
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Poor access to water is often linked to poverty, human welfare, health, nutritional status, and household labour. This paper is aimed at contributing to the debate surrounding water poverty in the rural areas. Primary data obtained covering water resources, access, capacity, uses, and environment were collected using closed-ended questionnaires. Altogether, 370 household heads were sampled and were selected by systematic random sampling technique. Multiple correlations, factor analysis and multiple regression methods were used to determine the level of relationship between the Water Poverty Index (WPI) components. The results revealed that: WPI is the highest in Elenke/Sagbo (72.3%) and the lowest in Onigbeti II/Sagbon (55.5%). Also, WPI has a strong positive relationship with resources (r = .656), capacity (r = .705) and environment at 95%. Percentages of explanations of WPI ranges from 86.45% in Onigbeti I to 50.99% in Aboke.The results of multiple regression between WPI and components showed that components were weak predictors in 5 wards (Onigbeti III &IV, Onigbeti II , Onigbeti I, Seriki Agbele Aboke and Abogun wards). The paper posits that access to water in Olorunsogo Local Government Area (LGA) is generally reasonable. The paper suggests stronger government presence to improve and sustain the level of access.
Keywords : Water Poverty; Access; Capacity; Uses; Environment; Resources; Factor Analysis
Copyright (c) 2020 Geosfera Indonesia Journal and Department of Geography Education, University of Jember
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Muntenda, Bartholomeus M., Vistolina Nuuyoma et Ruth Stern. « The perceptions of women on child birthing in a public-health facility in a peri-urban area in Kavango east region, Namibia ». International Journal of Healthcare 3, no 2 (25 juillet 2017) : 37. http://dx.doi.org/10.5430/ijh.v3n2p37.
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Purpose: The study explored the perceptions of women on child birthing in a public-health facility in a peri-urban area of the Kavango east region.Methods: A qualitative case study was conducted with women residing in Kehemu settlement, who have given birth either using a public-health facility or outside a public facility with the assistance of traditional birth attendants. Data were collected via three focus group discussions with 21 women (n = 21) who were purposively selected. Discussions were conducted in a local language and all were audio recorded with the participants’ permission. Data were transcribed and translated into English for analysis. The process of data reduction was used to analyse the study data.Results: Women were found to prefer child birthing at a public hospital because they considered nurses and midwives to be knowledgeable, caring and skilled people with regard to managing a woman in labour. However, although some women prefer to deliver at a public hospital, circumstances such as lack of transport – especially at night-time – prevent them from reaching the hospital. Moreover, some women indicated that nurses’ attitudes, the ill timing of labour and the wrong advice were hindrances to public hospital child birthing. Women stated more nurses, more supplies of the items used in child birthing, the provision of pain relief during labour, and a change in nurses’ attitudes as being some of the improvements which would make public hospital maternity wards more user-friendly.Conclusions: The women perceived child birthing at the public-health facility as being generally good, affordable and acceptable. However, there is a need for more interventions to make the public-health facility more user-friendly and accessible to all.
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Ramalingappa, Padmasri, KP Somya et MV Akhila. « Factors Effecting Intimate Partner Violence among Pregnant Women at a Centre in Karnataka ». Nepal Journal of Obstetrics and Gynaecology 12, no 2 (1 novembre 2018) : 52–57. http://dx.doi.org/10.3126/njog.v12i2.19954.
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Aims: To determine the prevalence of intimate partner violence among pregnant women and to evaluate associated sociodemographic factors.Methods: This is a prospective cohort study which was carried out in the outpatient department, antenatal and labour wards among 635 antenatal women above 34 weeks of gestation. A pretested questionnaire was used and women were divided into two groups based on presence or absence of intimate partner violence. The sociodemographic details of the women were taken in both groups and data were analyzed for statistical significance using SPSS version 16.Results: The incidence of intimate partner violence was 52.8% out of which 30.7% were positive for physical violence, 23.4% for sexual violence and 46.3% for emotional violence. Sociodemographic factors like lower socioeconomic status, Hindu religion, economically not independent, unemployed husband, problems with in-laws, dowry at marriage, alcoholic and smoker spouse was associated with significantly more domestic violence (p<0.05).Conclusions: Iintimate partner violence is not uncommon and under reported.
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Ogunrewo, Tolulope O., Olugboyega A. Oyewole, Richard A. Omoyeni, Mosimabale J. Balogun et Michael O. Okunola. « Incidence of pediatric long bone fractures at the university college hospital Ibadan ». International Journal of Research in Orthopaedics 6, no 4 (23 juin 2020) : 655. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20202674.
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<p class="abstract"><strong>Background:</strong> Individuals within the paediatric age group sustain different types of fractures, as such the need to determine the incidence and pattern of long bone fractures among patients 16 years and below admitted through the different wards of admittance of the university college hospital Ibadan.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective hospital-based study involving patients 16 years and below admitted through the accident and emergency department, the children emergency department, the neonatal ward and labour ward of the hospital between January 2013 and December 2018 at the university college hospital Ibadan. Using a proformal completed from the electronically stored data that captured the patient’s history, examination findings, X-ray film and treatment offered which was collected on a weekly basis.<strong></strong></p><p class="abstract"><strong>Results:</strong> 25.13% of the patients reviewed within the study period were paediatric patients. A total of 337 paediatric patients were reviewed. There were 124 female and 213 males with ratio (F:M-1:1.7). The fractures were mostly secondary to fall and road traffic crash accounting for 68.54% and 23.15% respectively. 65.12% of the fractures involve the bone of the upper limbs while 34.98% occur in the bones of the lower limbs. The radius and the ulnar bones are the most affected. Transverse fracture is the most common pattern observed.</p><p class="abstract"><strong>Conclusions:</strong> More than 20% of the reviewed population was in the paediatric age group and the radius and ulnar bones were the most commonly fractured bone in this age group. They usually follow trivial falls.</p>
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Okoror, Collins E. M. « Maternal and perinatal outcome in women with eclampsia : a retrospective study at the University of Benin Teaching Hospital ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no 1 (26 décembre 2018) : 108. http://dx.doi.org/10.18203/2320-1770.ijrcog20185404.
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Background: Eclampsia is a serious obstetric complication with attendant high maternal and perinatal morbidity and mortality especially in the developing countries. This study aims to assess the maternal and perinatal outcomes of eclampsia and suggest ways to improve them.Methods: This was a 5-year retrospective study (2009-2013) of cases of eclampsia managed at the University of Benin Teaching Hospital, Benin City, Nigeria. The number of cases managed was obtained from records at the emergency room, labour ward, theatre, lying-in wards and special care baby unit and case notes of patients satisfying the inclusion criteria retrieved from the medical records library.Results: The prevalence of eclampsia was 1.99% of total deliveries. It was highest in teenagers (29%), nulliparous (3.1%) and the unbooked (8.5%). Antepartum eclampsia accounted for 69.6% of the cases and a majority (74.6%) was delivered by emergency caesarean section. Eclampsia resulted in 27.78% of total maternal mortality, case fatality rate of 15.96% and eclampsia-related maternal mortality ratio of 318/100,000 deliveries. Perinatal mortality rate was 131/1000 eclamptic deliveries.Conclusions: The maternal outcome worsened with increasing blood pressure, number of convulsion episodes prior to presentation, the time interval between 1st convulsions to delivery, level of proteinuria on dip stick and reduced urine output. Vaginal delivery was associated with more early neonatal deaths and birth asphyxia. More awareness and enabling factors should be created for more women to access antenatal facilities. The government should be committed to providing emergency obstetric care facilities in our hospitals for effective management of eclampsia.
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Gon, Giorgia, Sandra Virgo, Mícheál de Barra, Said M. Ali, Oona M. Campbell, Wendy J. Graham, Stephen Nash, Susannah L. Woodd et Marijn de Bruin. « Behavioural Determinants of Hand Washing and Glove Recontamination before Aseptic Procedures at Birth : A Time-and-Motion Study and Survey in Zanzibar Labour Wards ». International Journal of Environmental Research and Public Health 17, no 4 (24 février 2020) : 1438. http://dx.doi.org/10.3390/ijerph17041438.
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Recent research calls for distinguishing whether the failure to comply with World Health Organisation hand hygiene guidelines is driven by omitting to rub/wash hands, or subsequently recontamination of clean hands or gloves prior to a procedure. This study examined the determinants of these two behaviours. Across the 10 highest-volume labour wards in Zanzibar, we observed 103 birth attendants across 779 hand hygiene opportunities before aseptic procedures (time-and-motion methods). They were then interviewed using a structured cross-sectional survey. We used mixed-effect multivariable logistic regressions to investigate the independent association of candidate determinants with hand rubbing/washing and avoiding glove recontamination. After controlling for confounders, we found that availability of single-use material to dry hands (OR:2.9; CI:1.58–5.14), a higher workload (OR:29.4; CI:12.9–67.0), more knowledge about hand hygiene (OR:1.89; CI:1.02–3.49), and an environment with more reminders from colleagues (OR:1.20; CI:0.98–1.46) were associated with more hand rubbing/washing. Only the length of time elapsed since donning gloves (OR:4.5; CI:2.5–8.0) was associated with avoiding glove recontamination. We identified multiple determinants of hand washing/rubbing. Only time elapsed since washing/rubbing was reliably associated with avoiding glove recontamination. In this setting, these two behaviours require different interventions. Future studies should measure them separately.
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Musyoka, John Kennedy, Hezron Nyarindo Isaboke et Samuel Njiri Ndirangu. « Farm-Level Value Addition among Small-scale Mango Farmers in Machakos County, Kenya ». Journal of Agricultural Extension 24, no 3 (13 août 2020) : 85–97. http://dx.doi.org/10.4314/jae.v24i3.8.
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The study examined farm-level value addition among small-scale mango farmers in Machakos County, Kenya. A sample size of 352 small-scale mango farmers was proportionately selected from six wards of the study area. A structured interview schedule was used for data collection. Percentage and Heckman two-stage selection model were employed in data analysis. The result showed that only 33.52% of the farmers practised mango value addition. Off-farm income, access to cold storage facilities, price of value-added products, group membership, extension contact, farmers’ awareness, amount of credit and hired labour positively influenced mango farm-level value addition. Training, farmers’ awareness and access to cold storage facilities positively influenced the proportion of mangoes value added at farm-level, while distance to market and livestock equivalence precipitated a negative effect on the proportion of mangoes value added. Relevant authorities in the County should provide adequate and up to date mango storage facilities and improve methods of extension delivery in order to increase the uptake of mango farm-level value addition among small-scale farmers.
Keywords: Farm-level value addition, extent of participation
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Beltman, J. J., M. Fitzgerald, L. Buhendwa, M. Moens, M. Massaquoi, J. Kazima, N. Alide et J. van Roosmalen. « Accelerated HIV testing for PMTCT in maternity and labour wards is vital to capture mothers at a critical point in the programme at district level in Malawi ». AIDS Care 22, no 11 (13 août 2010) : 1367–72. http://dx.doi.org/10.1080/09540121003758473.
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Baranova, Irina V. « German Charity in St. Petersburg : The Contribution of the Pastor A. Mazing to the Establishment and Organization of “The Evangelical House of Diligenceˮ ». IZVESTIYA VUZOV SEVERO-KAVKAZSKII REGION SOCIAL SCIENCE, no 1 (209) (30 mars 2021) : 48–53. http://dx.doi.org/10.18522/2687-0770-2021-1-48-53.
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The role of the “Evangelical house of diligenceˮ in the religious space of St. Petersburg is considered. The tradition of creating “Houses of diligenceˮ originated in St. Petersburg in the 19th century and began to revive again in the city on the Neva River at the beginning of the 21st century. At present time a few “Houses of diligenceˮ operate as rehabilitation centers for children and adults with disabilities engaging them in various workshops and other labour activities. It is obvious that the possibility of providing unemployed citizens with social assistance through the provision of temporary work, as well as assistance in their further employment, does not lose its relevance. The goal of this paper is to assess the role of “The Evangelical house of diligenceˮ in the religious space of Saint Petersburg. During the writing of this paper we used materials from the Russian Central State Historical Archive of St. Petersburg. For the main research we used chronological and comparative historical methods of analysis. Using the chronological analysis, we explored the sequence of formation and development of “The Evangelical house of diligenceˮ. Using comparative historical analysis, we determined the structure of that institutions, sources of his financing and the underlying mechanism of his operation. The article makes an effort to evaluate the role of pastor A. Mazing in organisation of “The Evangelical house of diligenceˮ. Management of “The Evangelical house of diligenceˮ and in addition to organising of the temporary employment to those in need of the Evangelical Lutheran faith, was providing charitable assistance to the disabled individuals. It was also involved in creations of a hospice and a shelter for alcoholics. In that “institution of labour assistance” they paid a special attention to the concerns for morality of the wards in accordance with the canons of the Evangelical-Lutheran Church, therefore they prioritised the faithful of this Church dur-ing the admission. “The Evangelical house of diligenceˮ was offering its workers in need an option to live on the premises, which was a welcome offer especially during wintertime.
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Brocklehurst, Peter, David Field, Keith Greene, Edmund Juszczak, Sara Kenyon, Louise Linsell, Chris Mabey et al. « Computerised interpretation of the fetal heart rate during labour : a randomised controlled trial (INFANT) ». Health Technology Assessment 22, no 9 (février 2018) : 1–186. http://dx.doi.org/10.3310/hta22090.
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BackgroundContinuous electronic fetal monitoring (EFM) in labour is widely used and computerised interpretation has the potential to increase its utility.ObjectivesThis trial aimed to find out whether or not the addition of decision support software to assist in the interpretation of the cardiotocograph (CTG) reduced the number of poor neonatal outcomes, and whether or not it was cost-effective.DesignTwo-arm individually randomised controlled trial. The allocations were computer generated using stratified block randomisation employing variable block sizes. The trial was not masked.SettingLabour wards in England, Scotland and the Republic of Ireland.ParticipantsWomen in labour having EFM, with a singleton or twin pregnancy, at ≥ 35 weeks’ gestation.InterventionsDecision support or no decision support.Main outcome measuresThe primary outcomes were (1) a composite of poor neonatal outcome {intrapartum stillbirth or early neonatal death (excluding lethal congenital anomalies), or neonatal morbidity [defined as neonatal encephalopathy (NNE)], or admission to a neonatal unit within 48 hours for ≥ 48 hours (with evidence of feeding difficulties, respiratory illness or NNE when there was evidence of compromise at birth)}; and (2) developmental assessment at the age of 2 years in a subset of surviving children.ResultsBetween 6 January 2010 and 31 August 2013, 47,062 women were randomised and 46,042 were included in the primary analysis (22,987 in the decision support group and 23,055 in the no decision support group). The short-term primary outcome event rate was higher than anticipated. There was no evidence of a difference in the incidence of poor neonatal outcome between the groups: 0.7% (n = 172) of babies in the decision support group compared with 0.7% (n = 171) of babies in the no decision support group [adjusted risk ratio 1.01, 95% confidence interval (CI) 0.82 to 1.25]. There was no evidence of a difference in the long-term primary outcome of the Parent Report of Children’s Abilities-Revised with a mean score of 98.0 points [standard deviation (SD) 33.8 points] in the decision support group and 97.2 points (SD 33.4 points) in the no decision support group (mean difference 0.63 points, 95% CI –0.98 to 2.25 points). No evidence of a difference was found for health resource use and total costs. There was evidence that decision support did change practice (with increased fetal blood sampling and a lower rate of repeated alerts).LimitationsStaff in the control group may learn from exposure to the decision support arm of the trial, resulting in improved outcomes in the control arm. This was identified in the planning stage and felt to be unlikely to have a significant effect on the results. As this was a pragmatic trial, the response to CTG alerts was left to the attending clinicians.ConclusionsThis trial does not support the hypothesis that the use of computerised interpretation of the CTG in women who have EFM in labour improves the clinical outcomes for mothers or babies.Future workThere continues to be an urgent need to improve knowledge and training about the appropriate response to CTG abnormalities, including timely intervention.Trial registrationCurrent Controlled Trials ISRCTN98680152.FundingThis project was funded by the National Institute for Health Research (NIHR) HTA programme and will be published in full inHealth Technology Assessment; Vol. 22, No. 9. See the NIHR Journals Library website for further project information. Sara Kenyon was part funded by the NIHR Collaboration for Leadership in Applied Health Research and Care West Midlands.
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Tucker, J., G. Parry, G. Penney, M. Page et V. Hundley. « Is midwife workload associated with quality of process of care (continuous electronic fetal monitoring [CEFM]) and neonatal outcome indicators ? A prospective study in consultant-led labour wards in Scotland ». Paediatric and Perinatal Epidemiology 17, no 4 (octobre 2003) : 369–77. http://dx.doi.org/10.1046/j.1365-3016.2003.00524.x.
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Gueye, M., Md Ndiaye Gueye, M. Mbaye, M. Abdoulaye, A. Diouf, M. Wade, A. Diakhate, I. Aidibe et Jc Moreau. « Crossing the Line to Electronic Medical Records in Subsaharian Africa : An Obstetric and Neonatal Information System with Perinatal Indicators Dashboard ». Journal of Health Science Research 2, no 1 (6 juin 2017) : 14. http://dx.doi.org/10.18311/jhsr/2017/15932.
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Objectives: This study reports our experience in the use of a perinatal electronic medical record, E_Perinatal, by giving examples of its potential for the analysis of clinical data and the involvement of the indicators produced in the improvement of Emergency Obstetric and Neonatal Care in Africa. Methodology: This is a study that was conducted in the scenario of a Level II Health Centre in Senegal. The methodology of the study followed the following steps: an inventory of the use of electronic tools in labour wards in Senegal, an exploratory survey of the scenario of obstetric and neonatal care, simultaneous elaboration of an electronic medical record in obstetrics and neonatology and selection of obstetric and neonatal care indicators to automatically generated and implement the information system. The recording was retrospective and continuous from January 2015 to December 2016. Results: This database automates the storage of obstetric data, including antenatal care, obstetric ultrasound, hospital admissions, prescribing, etc., providing easy access to patient data from anywhere in the hospital, produce timely reports and graphs to refer to clinician correspondents, store and electronically transfer birth data to authorities, and store data for ad hoc queries and search statistics. Conclusion: E_Perinatal has demonstrated in a scenario of an intermediate health facility its usefulness and ease of use. Scaling up in a developing country will help to better understand the real problems and help to reduce maternal and neonatal mortality.
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Gueye, M., Md Ndiaye Gueye, M. Mbaye, M. Abdoulaye, A. Diouf, M. Wade, A. Diakhate, I. Aidibe et Jc Moreau. « Crossing the Line to Electronic Medical Records in Subsaharian Africa : An Obstetric and Neonatal Information System with Perinatal Indicators Dashboard ». Journal of Health Science Research 2, no 1 (6 juin 2017) : 14. http://dx.doi.org/10.18311/jhsr/0/15932.
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Objectives: This study reports our experience in the use of a perinatal electronic medical record, E_Perinatal, by giving examples of its potential for the analysis of clinical data and the involvement of the indicators produced in the improvement of Emergency Obstetric and Neonatal Care in Africa. Methodology: This is a study that was conducted in the scenario of a Level II Health Centre in Senegal. The methodology of the study followed the following steps: an inventory of the use of electronic tools in labour wards in Senegal, an exploratory survey of the scenario of obstetric and neonatal care, simultaneous elaboration of an electronic medical record in obstetrics and neonatology and selection of obstetric and neonatal care indicators to automatically generated and implement the information system. The recording was retrospective and continuous from January 2015 to December 2016. Results: This database automates the storage of obstetric data, including antenatal care, obstetric ultrasound, hospital admissions, prescribing, etc., providing easy access to patient data from anywhere in the hospital, produce timely reports and graphs to refer to clinician correspondents, store and electronically transfer birth data to authorities, and store data for ad hoc queries and search statistics. Conclusion: E_Perinatal has demonstrated in a scenario of an intermediate health facility its usefulness and ease of use. Scaling up in a developing country will help to better understand the real problems and help to reduce maternal and neonatal mortality.
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Phan, Yih Chyn, Jonathan Cobley et Wasim Mahmalji. « Cost Analysis and Service Delivery on Using Isiris α™ To Remove Ureteric Stents ». Journal of Endoluminal Endourology 1, no 1 (16 avril 2018) : e3-e16. http://dx.doi.org/10.22374/jeleu.v1i1.5.
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Introduction
Isiris α™ (Coloplast®) is an innovative single-use disposable flexible cystoscope with an integrated ureteric stent grasper designed specifically to remove ureteric stents. It allows clinicians to remove ureteric stents easily on the wards or in clinics without the need of arranging a routine and dedicated flexible cystoscopy appointment for patients. We evaluated Isiris α’s practical use and cost analysis against traditional reusable endoscopes.
Method
We compared the cost of removing ureteric stents using Isiris α™ in 10 patients prospectively versus traditional flexible cystoscopes in 10 patients retrospectively. The costs of the equipment, medications, reprocess machines, and utility costs were consulted from the relevant departments and companies. As for labour cost, we have sourced British Medical Association (BMA) and Royal College of Nursing (RCN) websites.
Results
From our study, it costs £260.65 and £123.41 on average to remove a ureteric stent using Isiris α™ and traditional flexible cystoscope respectively (p<0.001). Stent removal in the endoscopy department was delayed in 60% of patients, on average 6.4 days, compared to 0% of patients using Isiris α™ (p = 0.048).
Conclusion
Although Isiris α™ is shown to be a more expensive option to remove ureteric stents based on our analysis, it still provides clinicians flexibility and ease in removing ureteric stents in the outpatient clinic, reducing the pressure and demand for dedicated flexible cystoscopy slots in the endoscopy department.
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Bola Bosongo, Gode, Jean Ndembo Longo, Jacqui Goldin et Vincent Lukanda Muamba. « Socioeconomic impacts of floods and droughts in the middle Zambezi river basin ». International Journal of Climate Change Strategies and Management 6, no 2 (13 mai 2014) : 131–44. http://dx.doi.org/10.1108/ijccsm-03-2013-0016.
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Purpose – The purpose of the paper is to analyse how floods and droughts affect communities' livelihood in the middle Zambezi river basin and coping mechanisms which households apply to counter the impact of floods and droughts. Design/methodology/approach – The method adopted was semi-structured interviews, focus group discussions and semi-structured questionnaires. Findings – Thematic analysis shows that the major issues affecting communities' livelihood in the middle Zambezi river basin are related to frequent floods and droughts. Floods are due to heavy seasonal rainfall which occurs at the peak of the rainfall season. As for droughts, the frequency of dry-spells of 20 days on average has been observed during the crop season. The impacts of floods and droughts in the district, notably in some wards such as Kanyemba, are the reduction of crop production, food shortages, reduction of agriculture derived income and erosion of social network. Households have responded to these impacts through a number of coping mechanisms including disposal of assets, labour migration, stream bank and floodplain cultivation, piecework, remittance, wild production and fishing. However, such coping mechanisms are short term and some of them are in conflict with the country's environmental laws. Originality/value – This paper reports a study on the first such finding related to socioeconomic impact of floods and droughts on households located in the middle Zambezi valley which is 500 km from Harare with a specific focus on traditional coping strategies in the face of disasters.
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Oliveira, J., M. Machado, E. Cunha, K. M. Mansilla, E. Vieira Melo et E. Oliva-costa. « Prevalence of depressive symptoms among inpatients at the university hospital of Sergipe, Brazil ». European Psychiatry 41, S1 (avril 2017) : s499—s500. http://dx.doi.org/10.1016/j.eurpsy.2017.01.625.
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IntroductionDepressive Symptoms (DS) generate a public and economic health problem, with decreasing productivity, labour market withdrawal and increased demand for health services. Studies show that in hospitalized patients, DS rates are higher than in the general population, in medical practice, however, they are under diagnosed or under-treated. Consultation Liaison Psychiatry (LP) can prevent aggravation of the psychic symptoms by early identification of them and by integration of psychiatry with the other medical specialties.ObjectivesTo estimate the prevalence of DS and associated factors in inpatients and the frequency of consultation LP.MethodsA cross-sectional study was carried out in March 2016, with 87 patients hospitalized in the clinical and surgical wards at the University Hospital (Sergipe/BR), through two instruments: (1) Structured Questionnaire prepared by the authors, (2) Beck Depression Inventory (BDI). Data analysis through descriptive and analytical statistics with final step of logistic regression.ResultsThe prevalence of DS were 54%, of which 24% correspond to moderate and severe symptoms, and only 3.4% of the patients had a LP. In Logistic Regression, the only factor associated with DS was the reason for hospitalization. Clinical causes (87.2%) were 9.24 times more likely to develop DS than surgical causes.ConclusionsResults suggest a high prevalence of inpatients with some psychic symptom. Physicians did not detect these symptoms and, therefore, LP request was low. These data reinforce the importance of LP for early identification of DS that should be stimulated during medical training.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Adisasmita, Asri, Yulia Izati, Septyana Choirunisa, Hadi Pratomo et Luzy Adriyanti. « Kangaroo mother care knowledge, attitude, and practice among nursing staff in a hospital in Jakarta, Indonesia ». PLOS ONE 16, no 6 (4 juin 2021) : e0252704. http://dx.doi.org/10.1371/journal.pone.0252704.
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Background Kangaroo mother care (KMC) has been proven to decrease rates of morbidity and mortality among premature and low-birth-weight infants. Thus, this study aimed to obtain baseline data regarding KMC knowledge, attitudes, and practices (KAP) among nursing staff caring for mothers and newborns in a hospital in Indonesia. Methods This cross-sectional study included 65 participants from three hospital wards at Koja District Hospital, North Jakarta. Participants included 29 perinatal ward nurses, 21 postnatal ward nurses and midwives, and 15 labor ward midwives. Data on KAP of KMC were collected using a self-administered questionnaire with closed-ended questions. Each questionnaire can be completed in approximately 1 hour. Results Among the included nursing staff, 12.3% (8/65) were determined to have received specific training on KMC, whereas 21.5% (14/65) had received more general training that included KMC content. About 46.2% of the nursing staff had good knowledge concerning KMC, 98.5% had good knowledge of KMC benefits, and 100% had a positive attitude toward KMC. All perinatal ward nurses had some experience assisting and implementing KMC. Some KAP that were observed among the nursing staff included lack of knowledge about the eligible infant weight for KMC and weight gain of infants receiving KMC, lack of education/training about KMC, and concerns regarding necessary equipment in KMC wards. Conclusions This study identified several issues that need to be addressed, including knowledge of feeding and weight gain, workload, incubator use, and the need for well-equipped KMC wards. We recommend that hospitals improve their nursing staff’s knowledge of KMC and establish well-equipped KMC wards.
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Russell, I. F. « Labour ward clocks ». Anaesthesia 58, no 9 (1 août 2003) : 930–31. http://dx.doi.org/10.1046/j.1365-2044.2003.03362_27.x.
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