Sample records for hospital benin city

  1. Pattern of skin diseases at university of Benin teaching hospital, Benin city, Edo State, South-South Nigeria: a 12 month prospective study.

    PubMed

    Ukonu, Agwu Bob; Eze, E U

    2012-04-28

    This study aims to look at the pattern and incidence of skin diseases seen in Dermatology/Venereology clinic at the University of Benin Teaching Hospital, Benin City, Edo State, South-South Zone, Nigeria and compare it with other zones of Nigeria. This was a prospective study on pattern and incidence of skin diseases in new patients presenting at the Dermatology/ Venereology outpatient clinic of the University of Benin Teaching Hospital, Benin City, Edo State, South-South, Nigeria, from September 2006 to August 2007. All patients were seen by the researchers. Diagnosis were made clinically and sometimes with the support of histopathology. A total number of 4786 patients were seen during the study period and these comprised 2647 HIV/AIDS patients and 2112 pure Dermatological patients. Out of 4786 patients, 755 (15.8%) were new patients. The new patients comprised 96 (12.7%) children patients (< 15 years) and 659 (83.7%) adult patients (>15years). The ages of the patients ranged from 2 weeks to 80 years and more than two-third were < 40 years. There were 354 males (46.9%) and 401 females (53.1%). This represents female: male ratio of 1.1: 1. Eczematous dermatitis accounted for 20.9% of the skin diseases and was the most common of the skin diseases observed. This is consistent with observation from other zones in Nigeria. Other skin diseases observed in order of frequencies include: Papulosqamous disorder (9.0%), Infectious skin diseases like fungal, viral, bacterial and parasitic infestation, at 7.9%, 7.7%, 2.3% and 2.1% respectively. Pigmentary disorders (5.0%), hair disorders (4.2%) and Benign neoplastic skin disease (6.5%). All the patients that had neurofibromatosis were females (1.9%). HIV-related skin diseases were observed to have increased remarkably (7.9%) with Kaposi's sarcoma, papular pruritic eruptions and drug eruptions being the commonest mode of presentation. The current pattern of skin diseases in Benin City, South-South Nigeria seems to

  2. Morbidity and mortality among road users in Benin-City, Nigeria.

    PubMed

    Nzegwu, M A; Banjo, A A F; Akhiwu, W; Aligbe, J U; Nzegwu, C O

    2008-09-01

    Murray and Krug had reported that road traffic injuries are a major cause of death globally, with disproportionate number occurring in developing counties. Seventy out of 308 deaths that occurred in Benin City from August 2002-July 2003, representing 22.7% of all deaths was due to road traffic injuries. Despite this observation, there is a paucity of data on road traffic morbidity and mortality. The aim of this study was to evaluate patterns of morbidity and mortality among drivers and passengers of cars involved in road traffic accidents in Benin-City Nigeria from August 2002-July 2003 as a base line data. Eighty-seven car drivers and passengers who were studied were part of a larger study, involved in a road traffic accident and brought to the accident and emergency units of either the University of Benin Teaching Hospital or the State Specialist Hospital between August 2002-July 2003.The injured ones were examined and dead patients had autopsy done on them. Over all, out of 283 total accidents cases reviewed in the period of study 87 were car occupants representing 30.7% of all accident cases, and 67 patients (23.7%) sustained varying injuries, while 20 patients (7.1%) died. Commercial cars were involved in majority of cases 85%. Males were also more in number. Intracranial hemorrhage was the predominant cause of death. Occupants of cars accounted for the singular most common category of morbidity and mortality among all road users. The male to female ratio was 2.1:1. Windscreen injuries most commonly associated with facial and head injuries represented the commonest cause of morbidity and mortality. The commonest autopsy finding as cause of death was intra-cranial hemorrhage.

  3. Hypertension and Diabetes Self-care Activities: A Hospital Based Pilot Survey in Benin City, Nigeria.

    PubMed

    Egbi, O G; Ofili, A N; Oviasu, E

    2015-06-01

    The burden of hypertension and diabetes is on the increase globally with its attendant complications. Although self-care activities are critical to the successful management of both conditions, there are only a few reports on such activities, especially in this part of the world. This pilot study was therefore undertaken to assess the self-care activities among hypertensive and diabetic patients in Benin City. Hypertensive and diabetic patients were consecutively recruited from the out- patient department of the University of Benin Teaching Hospital. The questionnaires were developed based on past assessment scales such as the Hypertension Self-Care Activity Level Effects (H-SCALE) and the Summary of Diabetes Self-Care Assessment (SDSCA) for hypertensive and diabetic participants respectively. A total of 85(32 hypertensive, 24 diabetic and 29 co-morbid hypertensive diabetic) participants completed the study. Only 14 (16.5%) subjects had good self-care practice, 39 (45.9%) had fair practice while poor self-care practice was found in 32 (37.6%) subjects. Adherence to medications, clinic adherence, use of self-monitoring devices, regular exercising and dietician contact were generally low. However, only a relatively few subjects smoked tobacco or took significant alcohol. The health-related self-care practice among the patients was generally not good. There was no significant difference in the overall level of self-care among hypertensive, diabetic patients or those with co-morbid conditions. There is need for more aggressive health education aimed at improving the current health-related self-care habits among these patients.

  4. Compliance with seat belt use in Benin City, Nigeria.

    PubMed

    Iribhogbe, Pius Ehiawaguan; Osime, Clement Odigie

    2008-01-01

    Trauma is a major cause of death and disability worldwide. A quarter of all fatalities due to injury occur due to road traffic crashes with 90% of the fatalities occurring in low- and medium-income countries. Poor compliance with the use of seat belts is a problem in many developing countries. The aim of this study was to evaluate the level of seatbelt compliance in motor vehicles in Benin City, Nigeria. A five-day, observational study was conducted in strategic locations in Benin City. The compliance rates of drivers, front seat passengers, and rear seat passengers in the various categories of vehicles were evaluated, and the data were subjected to statistical processing using the Program for Epidemiology. A total of 369 vehicles were observed. This consisted of 172 private cars, 64 taxis, 114 buses, 15 trucks, and four other vehicles. The seat belt compliance rate for drivers was 52.3%, front seat passengers 18.4%, and rear seat passengers 6.1%. Drivers of all categories of vehicles were more likely to use the seat belt compared to front seat passengers (p = 0.000) and rear seat passengers (p = 0.000). Drivers of private cars were more likely to use seat belts compared to taxi drivers (p = 0.000) and bus drivers (p = 0.000). Front seat passengers in private cars were more likely to use the seat belt compared to front seat passengers in taxis (p = 0.000) and buses (p = 0.000). Rear seat passengers in private cars also were more likely to use seat belts compared to rear seat passengers in taxis (p = 0.000) and buses (p = 0.000). Compliance with seat belt use in Benin City is low. Legislation, educational campaigns, and enforcement of seat belt use are needed.

  5. Tubal factor infertility in Benin City, Nigeria - sociodemographics of patients and aetiopathogenic factors.

    PubMed

    Umeora, O U J; Mbazor, J O; Okpere, E E

    2007-04-01

    In Africa, infertility constitutes a major gynaecological complaint and causes enormous socio-psychological stress to the patients. This study examined retrospective data at the University of Benin Teaching Hospital, Benin City, Nigeria, over a 5-year period to determine the factors associated with tubal infertility. Tubal infertility was confirmed in 13.5% of the 1181 new cases of infertility over the study period. The mean age of the patients was 33.2+/-9.5 years. Over 65% were nulliparous and all socioeconomic classes were affected. Major associated factors included infections such as post-abortal sepsis, puerperal sepsis and pelvic inflammatory disease (PID). Infertility is largely preventable. Attention should be focused on reducing the incidence of unsafe abortion and its consequences, providing clean and safe delivery as well as reducing the incidence of and ensuring proper treatment of any cases of PID. Infertility is largely preventable. Attention should be focused on reducing the incidence of unsafe abortion and its consequences, providing clean and safe delivery as well as reducing the incidence of and ensuring proper treatment of any cases of PID.

  6. Determinants of cord care practices among mothers in Benin City, Edo State, Nigeria.

    PubMed

    Abhulimhen-Iyoha, B I; Ibadin, M O

    2012-01-01

    Mothers care for their infants' umbilical cord stump in various ways. Different cord care practices have been documented; some are beneficial while others are harmful. Who and what influence the cord care practiced by mothers have, however, not been fully explored particularly in the study locale. The objective of this study was to determine the factors that influence cord care practices among mothers in Benin City. The study subjects included 497 mothers who brought their babies to Well Baby/Immunization Clinic at the University of Benin Teaching Hospital (UBTH), Benin City, Edo State, between July and August 2009. A structured questionnaire served as an instrument to extract information on their biodata and possible determinants of cord care practices. Significantly older women (P=0.023), educated mothers (P=0.029), and those who had male babies (P=0.013) practiced beneficial cord stump care practices. Beneficial cord care practice increased with increasing maternal educational status. The best predictors of beneficial cord care practices are maternal level of education (P=0.029) and infant's sex (P=0.013). The use of harmful cord care practices was more common among mothers who delivered outside the Teaching hospitals. Most (71.2%) of the mothers were aware of hygienic/beneficial cord care. The choices of cord care methods eventually practiced by mothers were influenced mainly by the disposition of nurses (51.3%), participants' mothers (32.0%), and their mothers-in-law (5.8%). There was no significant relationship between cord care practice on one hand and maternal parity, tribe, and socioeconomic classes on the other. The need for female education is again emphasized. The current findings strongly justify the need for public enlightenment programs, using the mass media and health talks in health facilities, targeting not only women of reproductive age but also secondary audience like their mothers, mothers-in-law, nurses, and attendants at health facilities

  7. The Epidemiological features of lymphoid malignancies in Benin City, Nigeria: a 15 years study

    PubMed Central

    Omoti, Caroline Edijana; Nwannadi, Alexander Ikenna; Obieche, Jude Chike; Olu-Eddo, Adesuwa Noma

    2012-01-01

    Introduction Lymphoid malignancies compose a wide spectrum of different morphologic and clinical syndromes known to vary widely throughout the world. The purpose of this study is to determine the prevalence and time trends of lymphoid malignancies. Methods A 15 (May 1st 1996-April 30th 2010) years study of all patients who had lymph node biopsy at the Department of Haematology and Pathology, University of Benin Teaching Hospital, Benin City, Nigeria. Results The 391 patients had a male preponderance (M:F; 1.6:1). An increase in the lymphoid malignant cases was noted from 95 cases in the first 5-year interval (1996–2000) to 179 cases in the last 5-year interval (2006–2010) giving an average increase of 84.0%. Non-Hodgkins lymphoma (61.1%) and chronic lymphocytic leukaemia (18.2%) were the most frequent followed by Hodgkin's lymphoma and myeloma with equal proportions of 9.0% each. A positive correlation with a significant linear trends was obtained (r=0.1949, p<0.0001). Geographic areas at risk were found mainly in patients residing in Delta State (67.0%) which is a major oil producing state and Edo State (30.4%) where the hospital is located, both in the Niger Delta Region of Nigeria. Conclusion Future research into environmental agents and genetic makeup/HLA typing of patients can be carried out. PMID:22368753

  8. HISTOPATHOLOGICAL EVALUATION OF H. PYLORI ASSOCIATED GASTRIC LESIONS IN BENIN CITY, NIGERIA.

    PubMed

    Udoh, M O; Obaseki, D E

    2012-12-01

    Endoscopic biopsy of the gastric mucosa allows early diagnosis, grading, staging and classification of gastric diseases. Helicobacter pylori, has been recognized as a major aetiologic factor for chronic gastritis, benign gastric ulcers and gastric adenocarcinoma and lymphoma. The loco-regional variability in the prevalence of Helicobacter pylori and associated diseases in Nigeria, emphasise the need for evaluation of subsets of a heterogeneous population like ours. To determine the frequency of helicobacter pylori in gastric endoscopic biopsies and document the pathology of gastric lesions commonly associated with Helicobacter pylori infection. Retrospective descriptive study. University of Benin Teaching Hospital (UBTH), and Biogenics Histopathology Laboratory (a private Histopathology Laboratory), both based in Benin City, Niger Delta region of Nigeria. Endoscopic gastric biopsies recorded in the surgical pathology register of the department from 2005-2009 were studied and relevant demographic and clinical information extracted from the registers, original request cards and patient case files. The clinical data and slides processed from paraffin embedded tissue blocks of endoscopic biopsies of gastric lesions seen from year 2005 to 2009 were studied, analyzed and statistically presented. Total number of specimens studied was 142. Chronic gastritis was present in 117(82.39%) specimens; 9(6.34%) were benign gastric ulcers; 3(2.11%) were gastric polyps; and 11(7.75%) were gastric malignancies. Helicobacter pylori, was demonstrated in 55.6% of all specimens. The peak age for Chronic Gastritis and Gastric Cancer is the 6th decade. Amongst patients with chronic gastritis, inflammatory activity was present in 65%; atrophy in 53%; and intestinal metaplasia in 16.6%. All gastric malignancies seen were intestinal type adenocarcinomas. The spectrum of lesions diagnosed in gastric endoscopic biopsy specimens in Benin, their frequency and associations are largely comparable

  9. Intestinal helminthiasis and nutritional status of children living in orphanages in Benin City, Nigeria.

    PubMed

    Nwaneri, D U; Omuemu, V O

    2013-01-01

    Intestinal helminths are often associated with poor growth and reduced physical activities, and may worsen already compromised nutritional status of children living in orphanages. To determine the relationship between intestinal helminthiasis and nutritional status of children living in orphanages in Benin City, Nigeria. A cross sectional study carried out from January to April 2011 in orphanages in Benin City, Nigeria. Fresh stool samples from 140 children (0-17 years) living in 10 orphanages in Benin City, were analyzed using the Kato-Katz technique for the detection of ova of helminths between January and April 2011. Physical growth of the children was classified as stunted, wasted, and under-weight using height for age Z-score, weight for height Z-score, and weight for age Z-score below -2 standard deviation of the reference median, respectively, in the World Health Organization growth chart. The data obtained was entered into spread sheet using the Microsoft Excel 2007 and the analysis was done using the Statistical Package for Social Sciences (SPSS) software versions 11.0 and 16.0 (SPSS Inc Chicago, IL, USA). Prevalence of intestinal helminthiasis was 20.7% and was observed highest in children aged 12-17 years. Ascaris lumbricoides and Trichuris trichiura were the intestinal helminths isolated. Nearly all infected subjects had significant stunted growth ( P = 0.014) and another one-quarter were significantly under-weight ( P = 0.021) when compared with noninfected subjects. Intestinal helminthiasis is associated with under-weight and stunted growth.

  10. Prevalence and intensity of intestinal helminthiasis in children living in orphanages in Benin City, Nigeria.

    PubMed

    Nwaneri, D U; Omuemu, V O

    2012-09-01

    Orphans may be envisaged to have sub-optimal care and may be predisposed to high worm burden. This study was undertaken to determine prevalence and intensity of intestinal helminthiasis in children living in orphanages in Benin City, Nigeria. Fresh stool samples from 150 children (0-17 years) living in 10 orphanages in Benin City, were analyzed using the Kato-Katz technique for the detection of ova of helminths between January and April, 2011. The subjects consisted of 62 (41.3%) males and 88 (58.7%)females; mean age (+/- standard deviation SD) 7.0 +/- 4.6 years, and mean (+/- SD) years lived in the orphanage was 4.0 +/- 3.7 years. Prevalence of intestinal helminthiasis was 20.7% and this prevalence was highest in children ages 12-17years, children who had lived longer years in the orphanages and in orphanages with poor child/care-giver ratio (orphanage F = 12.0: 1 and orphanage H = 7.3: 1). Mean (+/- SD) age (8.7 +/- 4.5 years) of infected subjects was significantly higher than (6.6 +/- 4.5 years) observed in non-infected subjects (p = 0.023). Ascaris lumbricoides and Trichuris trichiura were the intestinal helminths isolated. Intensity of intestinal helminths was light in 24/31 (77.4%) and moderate in 7/31 (22.6%) infected subjects. Median egg per gram was 999 eggs per gram and range was 48-8000. Improved child/care-giver ratio in orphanages will reduce worm burden in orphanages in Benin City.

  11. Patterns of morbidity and mortality amongst motorcycle riders and their passengers in Benin-City Nigeria: one-year review.

    PubMed

    Nzegwu, M A; Aligbe, J U; Banjo, A A F; Akhiwui, W; Nzegwu, C O

    2008-06-01

    To evaluate patterns of morbidity and mortality among bike riders and pillion seat passengers involved in road traffic accidents in Benin-City Nigeria between August 2003-July 2004. A total of Fifty-one bike riders and pillion seat passengers, who participated in this study were part of a larger study, involved in a road traffic accident and were brought to the accident and emergency unit of either the University of Benin Teaching Hospital (UBTH) or the State Specialist Hospital between August 2002-July 2003.The injured ones were examined and dead patients had an autopsy done on them A total of 51 cases of bikes riders/pillion seat passenger accidents were recorded representing 18% of total accidents. 35 motorbike riders/pillion seat passengers were struck down by cars (68.6%). Seven bike riders/pillion seat passengers (13.5%) were struck by articulated vehicles. 7 bike riders/pillion seat passengers representing 13.5% of cases were stuck by buses, 2 (3.9%) pillion seat passengers fell of bikes from epilepsies and sustained secondary injuries. Males were more in number with a ratio of 2.5; 1. One hundred percent (100%) or all motorcyclist and their passengers did not use helmets. Cars struck down most bike riders and their pillion seat passengers. Males were more than females in number. The commonest autopsy findings as cause of death was intr a-cranial hemorrhage preventable by the use of crash helmets.

  12. Benin.

    PubMed

    1984-11-01

    Focus in this discussion of Benin is on the following: the people; geography; history; government and political conditions; economy; defense; foreign relations; and relations between the US and Benin. The population totaled 3.8 million in 1983 with an annual growth rate of 2.6%. The infant mortality rate is 45/1000 and life expectancy 46.9 years. The population comprises about 20 sociocultural groups. 4 groups -- the Fon, Aja, Bariba, and Yoruba -- account for more than half of the population. The name was changed from Dahomey to the People's Republic of Benin in 1975. 2 years after the military coup d'etat in 1972, Marxism-Leninism was declared the guiding philosophy of the new government. Marxism-Leninism remains the official doctrine, but the government has moved to take account of popular resistance to a radical social transformation, as well as problems encountered in attempting to establish a centrally directed economy. Benin is ranked as 1 of the world's 35 poorest countries. The commercial, industrial, and agricultural sectors are all experiencing severe problems. The government's newest 5 year plan for 1983-88 places a stronger emphasis on developing agriculture. In so doing, the government hopes to assure its own domestic needs and to become a supplier of basic foodstuffs to the region. Benin's Armed Forces number about 3000 personnel. Benin is a member of the Non-Aligned Movement and the Organization of African Unity. Relations with France are important because of historical, cultural, economic, and aid links. After 1972, relations between the US and Benin became strained as Benin moved to strengthen its ties with the Soviet Union and other socialist countries and mounted harsh propaganda attacks on the US.

  13. Prevalence of asymptomatic bacteriuria among pregnant women in Benin City, Nigeria.

    PubMed

    Akerele, J; Abhulimen, P; Okonofua, F

    2001-03-01

    A semi-quantitative screening for asymptomatic bacteriuria was carried out in the first trimester of 500 consecutive pregnant women in Benin City. The purpose was to provide baseline data and rational therapy for asymptomatic bacteriuria in pregnant women. Of the 500 women screened, 433 clinical specimens showed significant bacteriuria, representing an incidence of 86.6%. Of this number, 38 (7.4%) were of mixed bacterial colonies while 395 (91%) were of single bacterial colonies. Staphylococcus aureus (29.8%), Escherichia coli (29.1%) and Klebsiella pneumoniae (21.5%) were the most frequently isolated pathogens. The high incidence of asymptomatic bacteriuria in pregnancy correlated significantly (P < 0.05) with the observed high proportion of pyuria. On average, sensitivity of the pathogens was ciprofloxacin 99.7%; ceftazidime 81.6%; co-trimoxazole 79.4%; augmentin 71.4%; nalidixic acid 61.7%; nitrofurantoin 61.%; gentamycin 56.9% and ampicillin 25.4%. S. aureus was most sensitive, while Proteus mirabilis was least sensitive among the pathogens. Rational therapy of asymptomatic bacteriuria in pregnant women may prevent associated risks such as pyelonephritis and pre-eclampsia.

  14. 26. 'CITY HOSPITAL, BLACKWELL'S ISLAND.' (Source: New York City Department ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    26. 'CITY HOSPITAL, BLACKWELL'S ISLAND.' (Source: New York City Department of Public Finance, Real Estate Owned by the City of New York under Jurisdiction of the Department of Public Charities, 1909.) - Island Hospital, Roosevelt Island, New York County, NY

  15. Sources of Stress among Undergraduate Students in the University of Benin, Benin City, Nigeria: Implications for Counselling

    ERIC Educational Resources Information Center

    Alika, Ijeoma Henrietta

    2012-01-01

    The study examined the role of inadequate facilities/accommodation, poor health, emotional problems, socio-economic status and poor time management as sources of stress among University of Benin undergraduates. The research instrument used was a questionnaire. The survey method was adopted for the study. Seven hundred and fifty respondents were…

  16. Sanitary conditions of food vending sites and food handling practices of street food vendors in Benin City, Nigeria: implication for food hygiene and safety.

    PubMed

    Okojie, P W; Isah, E C

    2014-01-01

    To determine the sanitary conditions of vending sites as well as food handling practices of street food vendors in Benin City, Nigeria. A descriptive cross-sectional study was done using an observational checklist and researcher-administered questionnaire. 286 randomly selected vending units were surveyed, and their operators interviewed on their food handling practices. A higher proportion, 259 (90.5%), of the observed vending sites appeared clean. The following sanitary facilities were observed in and around the respective food premises of the respondents: waste bin, 124 (43.4%), refuse dumpsite, 41 (14.3%), wash hand basin, 201 (71.2%), hand towel, 210 (73.4%), and soap, 220 (76.9%). There were also the presence of flies 118, (41.3%), and the presence of rats/cockroaches, 7 (2.4%). Respondents with tertiary education, 5 (38.5%), vended foods in environment with good hygiene status compared to those with secondary, 45 (31.7%), and primary education, 33 (27.3%). There was no statistically significant association between educational status and the hygiene status of food premise (P = 0.362). This study showed that street food vending sites in Benin City were sanitary and that food vendors had good food handling practices.

  17. Knowledge and practice of food hygiene and safety among food handlers in fast food restaurants in Benin City, Edo State.

    PubMed

    Isara, A R; Isah, E C

    2009-09-01

    To assess the knowledge and practice of food hygiene and safety among food handlers in fast food restaurants in Benin City, Edo State. A descriptive cross-sectional study was carried out among 350 respondents who were selected by means of a systematic sampling method and interviewed using a semi-structured researcher-administered questionnaire. An observational checklist was thereafter used to inspect their personal hygiene status. The mean age of the food handlers was 26.4 +/- 6.1 years. Two hundred and twenty eight (65.1%) were females while 34.9% were males. A majority (98%) of the respondents had formal education. There was good knowledge and practice of food hygiene and safety among the respondents. Knowledge was significantly influenced by previous training in food hygiene and safety (p = 0.002). Food handlers who had worked for longer years in the fast food restaurants had better practice of food hygiene and safety (p = 0.036). The level of education of respondents did not significantly influenced their practice of food hygiene and safety (p = 0.084). Although, 299 (85.4%) food handlers were generally clean, skin lesions was seen in 4 (7.3%) of them. This study showed good knowledge and practice of food hygiene and safety by food handlers in the fast food restaurants in Benin City, but there is need for improvement through training and retraining of food handlers by the management of the restaurants and the local government authorities.

  18. Asymptomatic urinary tract infection among pregnant women receiving ante-natal care in a traditional birth home in Benin City, Nigeria.

    PubMed

    Oladeinde, Bankole H; Omoregie, Richard; Oladeinde, Oladapo B

    2015-01-01

    A good proportion of pregnant women patronize traditional birth homes in Nigeria for ante-natal care. This study aimed at determining the prevalence, risk factors, and susceptibility profile of etiologic agents of urinary tract infection among ante-natal attendees in a traditional birth home in Benin City, Nigeria. Clean-catch urine was collected from 220 pregnant women attending a traditional birth home in Benin City, Nigeria. Urine samples were processed, and microbial isolates identified using standard bacteriological procedures. A cross-sectional study design was used. The prevalence of urinary tract infection among pregnant women was 55.0%, significantly affected by parity and gestational age (P<0.05). Mixed infection was recorded among 13(10.7%) pregnant women, and was unaffected by maternal age, parity, gravidity, gestational age, and educational status. Irrespective of trimester Escherichia coli was the most prevalent etiologic agent of urinary tract infection, followed by Staphylococcus aureus. The flouroquinolones were the most effective antibacterial agents, while Sulphamethoxazole-trimetoprim, Amoxicillin, Nalidixic acid, and Nitrofurantoin had poor activity against uropathogens isolated. The prevalence of urinary tract infection among pregnant women was 55.0% and significantly affected by gestational age and parity. The most prevalent etiologic agent observed was Escherichia coli. With the exception of the flouroquinolones, aminoglycoside, and Amoxicillin-cluvanate, the activity of other antibiotics used on uropathogens were poor. Health education of the traditional birth attendant and her clients by relevant intervention agencies is strongly advocated.

  19. Benin.

    PubMed

    1989-03-01

    In 1988, Benin had a population of 4 million and an annual growth rate of 3.6%. Life expectancy was 49 years, and infant mortality stood at 116/1000 live births. Primary school enrollment is about 65%, with 6 years of compulsory education, and the adult literacy rate is only 11%. Of the labor force of 1.9 million, 72% are engaged in agriculture. Benin's gross domestic product was US$1497 million in 1987, with an annual growth rate of 7.1% and a per capita income of $374. Despite the Marxist-Leninist ideology of the Kerekou Government, many government-controlled sectors of the economy are being privatized and private foreign firms have been authorized to operate in Benin's transport sector. These changes have been necessitated by heavy losses suffered by nationalized industries and the worsening economic situation. Benin's economy, heavily dependent on regional trade and the export of cotton and crude oil, has been severely affected by ineffective government policies, regional recession, the collapse of world commodity prices, heavy external debt, balance of payment deficits, and very low foreign exchange reserves and liguidity. The 5-Year Plan (1983-88) emphasized the development of agriculture and the goal of becoming a supplier of basic foodstuffs to the region.

  20. Humanised care and a change in practice in a hospital in Benin.

    PubMed

    Fujita, Noriko; Perrin, Xavier R; Vodounon, Joséf A; Gozo, Michel K; Matsumoto, Yasuyo; Uchida, Sanae; Sugiura, Yasuo

    2012-08-01

    to describe the process of introduction and implementation of humanised care (humanised childbirth); to determine how the practice of humanised care affects midwives, obstetricians, and other service providers in the hospital; and to determine the factors influencing the change in practice. a qualitative study with grounded theory approach. A semi-structured, in-depth individual interview was conducted for data collection with open coding and a constant comparative analysis until the saturation of concepts. mothers' and children's hospital functioning as a top referral centre in Benin. 16 hospital staff, including 6 midwives. humanised care was initiated by midwives with hesitation and difficulties. Midwives and obstetricians learned that a supportive environment for women could produce a positive birth outcome without medication. Communication between the midwives and women and their families improved with a higher level of appreciation of the care provided by the midwives among the women and their families. Humanised care appears to affect the professional value of midwives, their levels of job satisfaction, and their personal motivation for work towards improving their performance. A positive influence on obstetricians and other staff was observed. These individuals were inspired to make changes in hospital culture to improve care, to avoid unnecessary interventions, and to improve communication. Important factors in achieving favourable results were the leadership and commitment of the hospital management team and the recognition and support they extended towards the hospital staff, especially the midwives. a system of humanised care that stresses improved communication between the women giving birth, their families, and care providers, based on respect for women's dignity and liberty, and avoidance of unnecessary intervention can be promoted with proper managerial support. This system can promote favourable changes in hospital practice, which are helpful in

  1. Determinants of routine immunization costing in Benin and Ghana in 2011.

    PubMed

    Ahanhanzo, Césaire Damien; Huang, Xiao Xian; Le Gargasson, Jean-Bernard; Sossou, Justin; Nyonator, Frank; Colombini, Anais; Gessner, Bradford D

    2015-05-07

    Existing tools to evaluate costs do not always capture the heterogeneity of costs at the facility level. This study seeks to address this issue through an analysis of determinants of health facility immunization costs. A statistical analysis on facility routine delivery and vaccine costs was conducted using ordinary least squares regression. Explanatory variables included the number of doses administered; proportion of time spent by facility staff on immunization; average staff wage; whether the health facility had enough staff; presence of cold chain equipment; distance to a vaccine collection point; and, facility ownership. Data were drawn from representative samples of primary care facilities in Benin and Ghana (46 and 50 facilities, respectively) collected as part of the EPIC studies. Weighted average RI immunization facility cost was US$ 16,459 in Ghana and US$ 14,994 in Benin. The regression found total doses administered to be positively and significantly associated with facility cost in both countries. A 10% increase in doses resulted in a 4% increase in cost in Ghana, and a 7.5% increase in Benin. In Ghana, the proportion of immunization time, presence of cold chain, and sufficiency of staff were positively and significantly associated with total cost. In Benin, facility cost was negatively and significantly related to distance to the vaccine collection point. In the pooled sample, facilities in capital cities were associated with significantly higher costs. This study provides evidence on the importance of the level of scale in determining facility immunization cost, as well as the role of availability of health workers and time they spend on immunization in Ghana and Benin. This type of analysis can provide insights into the costs of scaling up immunization services, and can assist with development of more efficient immunization strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. 25. 'VIEW OF CITY HOSPITAL DISTRICT, BLACKWELL'S ISLAND, FROM MANHATTAN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    25. 'VIEW OF CITY HOSPITAL DISTRICT, BLACKWELL'S ISLAND, FROM MANHATTAN SHORE.' (Source: New York City Department of Public Finance, Real Estate Owned by the City of New York Under Jurisdiction of the Department of Public Charities, 1909.) - Island Hospital, Roosevelt Island, New York County, NY

  3. [Brief history of the First Hospital of Harbin City (1913-2013)].

    PubMed

    Ji, Y; Li, Z P

    2017-03-28

    In 1913, after the Russian Prostitutes Sanatorium of Harbin Eastern Railway was received by the board of directors, they established the "Harbin City Board Hospital" and funded its expansion. In March 1926, the provisional Committee of the Harbin autonomous renamed the "City Board of First Hospital" to "The Public Hospital" . In November 1926, "The Public Hospital" was renamed as "Harbin Special Municipal Hospital" by the Harbin City Council and further funds were invested in its construction. In 1931, the Japanese invaded Northeast China, and controlled the "City Hospital" . In 1946, when Harbin was liberated, after the Communist's take-over of the Hospital, it developed sustainedly since then. From 1946-1949, The First Hospital of Harbin City dispatched manpower, material resources, and financial resources to support the people's Liberation Army, establishedthe medical service team, received and treated the wounded. From the 1930s, the Hospital was involved in the treatment of cholera, plague, scarlet fever, typhus and other infectious diseases, and participated in the medical rescue in Wenchuan of Sichuan and Xinjiang Aletai area. From 1928, the Hospital took over from Binjiang Hospital as the Teaching Hospital of Harbin Medical School, and later became the Harbin Medical University Teaching Hospital. It made contribution to the training of medical students.

  4. Exposition and Synthesis of Benin Bronze Casting: Emphasis on the Olotan Casters of Benin

    ERIC Educational Resources Information Center

    Ifeta, Chris Funke

    2016-01-01

    The introduction of Western education to Nigeria has brought in its wake great strides toward development. Changes in Benin dates far back to the dawn of the 20th century. This paper investigates the critical role of education in development. The paper integrates interview data collected from bronze casters in Benin. The first section of the paper…

  5. [Family planning in Benin: what future?].

    PubMed

    Danlodji, R

    1993-01-01

    In Benin, family planning began in the late 1960s, but its activities were not clear or specific. It made small strides in private clinics until a family planning association was formed, later named the Beninese Association to Promote the Family (ABPF). Family planning promoters maintain that reduction in births per couple is necessary for economic development in Africa. Family planning detractors think that a child is a fruit of God and that family planning impedes his or her coming to the world. ABPF has worked much to promote Beninese families, but it is still not well known. Despite the associations efforts and those of many other institutions, contraceptive prevalence is low and the abortion rate and its risks remain high, namely, death, infertility, and contraction of various diseases. Thus, it is important to rethink family planning strategies. All intervening parties should coordinate activities to better reach urban and rural populations. Many rural inhabitants go to cities to escape poverty and the misery evoked by their family size and meager earnings only to find unemployment in the cities. In order for family planning to have an effect in Benin, it is important to begin working with youth. Any family planning strategy must consider their aspirations. The youth are inclined to be more receptive to family planning than the adults who do not want to give up old habits. Yet, contraceptive use in 14-20 year olds is low even though sexual activity is high. Since the youth want a small family size, a small plot of land, a care, and a successful life, it is important to give priority to jobs. We need to educate the youth so they can freely decide their family size. Socioeconomic reasons are the primary factor pushing people to accept family planning, followed by health reasons. Research is needed to learn why contraceptive prevalence is still low.

  6. For-profit hospital finds it can't beat City Hall--that is, the financing deal offered by the city.

    PubMed

    Nemes, J

    1992-02-24

    American International Hospital in Zion, Ill., doesn't lack support from city hall. In an unusual transaction for an investor-owned hospital, the city recently sold $20 million in taxable debt for the purpose of lending the proceeds to the hospital to help finance a replacement facility. The deal saved the hospital, the area's largest employer, as much as 2.5 percentage points on the interest rate.

  7. Association of anti-Chlamydia antibodies with ectopic pregnancy in Benin city, Nigeria: a case-control study.

    PubMed

    Agholor, K; Omo-Aghoja, L; Okonofua, F

    2013-06-01

    Ectopic pregnancy remains a major public health problem especially in many developing countries where it is a significant contributor to pregnancy related morbidity and mortality. To determine the association between prior Chlamydia trachomatis infection and the risk of ectopic pregnancy. A case-control study from two tertiary health care facilities in Benin City, Nigeria. Ninety eight women with ectopic pregnancy (cases) and another 98 women with uncomplicated intrauterine pregnancy (controls) matched for age, were interviewed using a semi-structured questionnaire and evaluated for serological evidence of prior Chlamydia trachomatis infection. The antibody titres in cases (48%) were significantly higher than in controls (16.3%) (p<0.001). However, the association between Chlamydia antibodies and ectopic pregnancy was attenuated when the effects of indicators of previous pelvic infections, socio-demographic characteristics, contraceptive and sexual history were controlled for. Primary level of education (OR = 6.32; CI, 2.31 - 17.3), three or more lifetime sexual partners (OR = 5.71; CI, 2.39 - 13.65) and prior history of vaginal discharge (OR = 5.00; CI, 2.03 - 12.3) were more likely to be associated with ectopic pregnancy than with the presence of antibodies to Chlamydia trachomatis (OR = 2.82; 95% CI, 1.33 - 5.95). The Population Attributable Risk was 30.9%. Chlamydial infections play only a limited role in the pathogenesis of ectopic pregnancy.

  8. [Economic hardship and fallout on households of the management of hydrocephalus in Benin].

    PubMed

    Gandaho, Hugues Jean-Thierry; Hounton, Sennen Houesse; Kelani, Amina; Darga, Christian; Hoinsou-Hans, Isaac; Agbani, Florence; Lalya, Francis; Koumakpayi, Sikiratou; Ayivi, Blaise

    2017-04-27

    Objectives: The socioeconomic profile of households and families of children attending hospital for hydrocephalus were documented and analysed. Main costs related to diagnosis and care were reviewed. The emotional fallout and social well-being of families were also analysed. Methods: This retrospective cross-sectional study (January 2006 to January 2015) was based on costs borne by households and families for neurosurgical care of children with hydrocephalus. Results: Sixty children (1 day to 12 years old) had been hospitalized for hydrocephalus in Cotonou-Benin. In 19 cases, the families were single-parent families. In 44 cases, the parents were self-employed workers or private company employees. Public servants, eligible for national health system assistance, accounted for a mere 16 cases. Twenty six children did not receive any financial support, whereas the total average care-related out-of-pocket expenditure for families during the hospital stay was approximately €1,777 (1,117,500 FCFA), i.e. almost 14 times the average monthly income reported by the parents (82,600 FCFA – approximately €120). After hospitalization, 31 mothers had lost their jobs and 21 couples experienced marital issues and their plans to have children. Twelve recent separations were recorded, as well as one indirect maternal death related to depression. Conclusion: In Benin Republic, surgical care for paediatric hydrocephalus represents catastrophic out-of-pocket expenditures for households and families and other living expenses. Families experience significant emotional fallout with effects on couple relationships and survival.

  9. Driver-related risk factors in commercial motorcycle (okada) crashes in Benin City, Nigeria.

    PubMed

    Iribhogbe, Pius Ehiawaguan; Odai, Emeka Danielson

    2009-01-01

    There has been global concern regarding road traffic injuries. Motorcyclists constitute a high proportion of fatalities in road traffic crashes. Commercial motorcyclists (Okadas) constitute a unique group in this regard. The purpose of this study was to evaluate driver-related risk factors in Okada accidents in Benin City, Nigeria. This was a prospective study. Interviewers administered questionnaires which were used to assess Okada drivers during a two-month period (November-December 2006). A total of 996 Okada drivers were interviewed, 995 males and one female. Their ages ranged from 16-80 years with a mean age of 36.4 +/-2.4 years. In the majority of cases, the maximum educational level achieved was primary or secondary. The majority of Okada drivers (82.8%) took to the Okada business as a last resort. Driver's licenses for Okada operation were possessed by 73.5% of drivers, but only 27.2% had taken a road test before being given a license. No form of training on the use of Okadas was received by 45% of drivers before they commenced operations. Crash helmets were owned by 56.4%, but they did not use them on a regular basis. Inconvenience was the reason provided for poor compliance by 52.7% of drivers. Regular intake of alcohol was present in 39.8% of drivers. Okada drivers are mainly young males with a low level of education who are ill-prepared and ill-equipped for the road. This is a recipe for traffic crash-related injuries and fatal motorcycle crashes. There is an urgent need for job creation, better licensing procedures, road safety education, national legislation, and enforcement of crash helmet laws as well as alcohol breath tests for Okada drivers in Nigeria.

  10. Insecticide resistance status in Anopheles gambiae in southern Benin

    PubMed Central

    2010-01-01

    Background The emergence of pyrethroid resistance in Anopheles gambiae has become a serious concern to the future success of malaria control. In Benin, the National Malaria Control Programme has recently planned to scaling up long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) for malaria prevention. It is, therefore, crucial to monitor the level and type of insecticide resistance in An. gambiae, particularly in southern Benin where reduced efficacy of insecticide-treated nets (ITNs) and IRS has previously been reported. Methods The protocol was based on mosquito collection during both dry and rainy seasons across forty districts selected in southern Benin. Bioassay were performed on adults collected from the field to assess the susceptibility of malaria vectors to insecticide-impregnated papers (permethrin 0.75%, delthamethrin 0.05%, DDT 4%, and bendiocarb 0.1%) following WHOPES guidelines. The species within An. gambiae complex, molecular form and presence of kdr and ace-1 mutations were determined by PCR. Results Strong resistance to permethrin and DDT was found in An. gambiae populations from southern Benin, except in Aglangandan where mosquitoes were fully susceptible (mortality 100%) to all insecticides tested. PCR showed the presence of two sub-species of An. gambiae, namely An. gambiae s.s, and Anopheles melas, with a predominance for An. gambiae s.s (98%). The molecular M form of An. gambiae was predominant in southern Benin (97%). The kdr mutation was detected in all districts at various frequency (1% to 95%) whereas the Ace-1 mutation was found at a very low frequency (≤ 5%). Conclusion This study showed a widespread resistance to permethrin in An. gambiae populations from southern Benin, with a significant increase of kdr frequency compared to what was observed previously in Benin. The low frequency of Ace-1 recorded in all populations is encouraging for the use of bendiocarb as an alternative insecticide to pyrethroids for IRS

  11. Prevalence of Malaria and Anemia among Pregnant Women Attending a Traditional Birth Home in Benin City, Nigeria

    PubMed Central

    Oladeinde, Bankole Henry; Omoregie, Richard; Odia, Ikponmwosa; Oladeinde, Oladapo Babatunde

    2012-01-01

    Objectives To determine the prevalence of malaria and anemia among pregnant women attending a traditional birth center as well as the effect of herbal remedies, gravidity, age, educational background and malaria prevention methods on their prevalence. Methods Blood specimens were collected from 119 pregnant women attending a Traditional Birth Home in Benin City, Nigeria. Malaria parasitemia was diagnosed by microscopy while anemia was defined as hemoglobin concentration <11 g/dL. Results The prevalence of malaria infection was (OR=4.35 95% CI=1.213, 15.600; p=0.016) higher among primigravidae (92.1%). Pregnant women (38.5%) with tertiary level of education had significantly lower prevalence of malaria infection (p=0.002). Malaria significantly affected the prevalence of anemia (p<0.05). Anemia was associated with consumption of herbal remedies (OR=2.973; 95% CI=1.206, 7.330; p=0.017). The prevalence of malaria parasitemia and anemia were not affected by malaria prevention methods used by the participants. Conclusion The overall prevalence of malaria infection and anemia observed in this study were 78.9% and 46.2%, respectively. Higher prevalence of malaria infection was associated with primigravidae and lower prevalence with tertiary education of subjects. Anemia was associated with consumption of herbal remedies. There is urgent need to control the prevalence of malaria and anemia among pregnant women attending traditional birth homes. PMID:22811774

  12. Antimicrobial consumption at Auckland City Hospital: 2006-2009.

    PubMed

    Ticehurst, Rob; Thomast, Mark

    2011-04-15

    We aimed to determine the level of antimicrobial consumption by adult inpatients at Auckland City Hospital (Auckland, New Zealand) and to compare our findings with those in other developed nations. We used the computerised records of the central Auckland District Health Board (ADHB) pharmacy to measure the amount of antimicrobials dispensed to inpatients (excluding psychiatric units, day stay units and outpatient clinics) during 2006 to 2009. The total weight of each antimicrobial dispensed was used to determine the number of defined daily doses (DDDs) dispensed. The Information Management and Technical Services department of ADHB provided data on the number of admissions and inpatient days, and these data, together with information from the 2006 census, were used to calculate antimicrobial consumption for adult inpatients measured in DDDs/100 admissions, DDDs/100 inpatient days and DDDs/1000 population. Total antimicrobial consumption by adult inpatients increased from 74 DDDs/100 inpatient days in 2006 to 80.3 DDDs/100 inpatient days in 2009. The level of consumption did not vary greatly with the season. The total level of consumption was very similar to that seen in adult inpatients in hospitals in Australia and Scandinavian countries. The level of consumption of fluoroquinolones, third or fourth generation cephalosporins, carbapenems and vancomycin (antimicrobial classes that are not available for unrestricted use in Auckland City Hospital) was comparable to or less than that seen in adult inpatients in hospitals in Australia or Scandinavian countries. Beta-lactamase susceptible penicillins (such as benzyl penicillin and phenoxymethylpenicillin) comprised a relatively small proportion of total penicillin use and beta-lactamase inhibitor combinations (predominantly amoxicillin/clavulanate) a relatively large proportion of total penicillin use, when compared with Scandinavian hospitals. The antimicrobial stewardship programme at Auckland City Hospital has

  13. Human immunodeficiency virus (HIV) seropositivity and hepatitis B surface antigenemia (HBSAG) among blood donors in Benin city, Edo state, Nigeria.

    PubMed

    Umolu, Patience Idia; Okoror, Lawrence Ehis; Orhue, Philip

    2005-03-01

    Human Immunodeficiency Virus and Hepatitis B virus are blood borne pathogens that can be transmitted through blood transfusion and could pose a huge problem in areas where mechanisms of ensuring blood safety are suspect. This study became necessary in a population where most of the blood for transfusion is from commercial blood donors. A total of 130 donors comprising 120 commercial donors and 10 voluntary donors were tested for antibodies to human immunodeficiency virus and hepatitis B surface antigen in Benin city using Immunocomb HIV - 1 and 2 Biospot kit and Quimica Clinica Aplicada direct latex agglutination method respectively. Thirteen (10%) samples were HIV seropositive and 7(5.8%) were HBsAg positive. The age bracket 18 - 25years had the highest numbers of donors and also had the highest number of HBsAg positive cases (7.8%) while the age group 29 - 38years had highest number of HIV seropositive cases. High prevalence of HIV antibodies and Hepatitis B surface antigen was found among commercial blood donors. Appropriate and compulsory screening of blood donors using sensitive methods, must be ensured to prevent post transfusion hepatitis and HIV.

  14. Out of the frying pan: New York City hospitals in an age of deregulation.

    PubMed

    Salit, Sharon; Fass, Steven; Nowak, Mark

    2002-01-01

    For several decades New York City hospitals had been distinguished by their tightly regulated environment, chronically weak finances, high occupancy rates, teaching intensity, dependency on public payers, low managed care penetration, and minimal merger activity. Then in the late 1990s a rapid convergence of forces--the Balanced Budget Act, managed care growth, state deregulation of commercial rates, escalating costs, and plunging hospital occupancy rates--threw the city's hospital industry into turmoil. In this paper we describe this period of turbulent change that has left most of the city's safety-net and small community hospitals near bankruptcy.

  15. A 20 year retrospective analysis of medicolegal deaths in a tertiary hospital setting in Nigeria.

    PubMed

    Akhiwu, W O; Nwafor, C C; Igbe, A P

    2013-01-01

    To determine and classify the various types of medicolegal deaths as seen at University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. This is a retrospective study of all the medicolegal deaths seen in the Department of Histopathology, (UBTH, Benin City over a 20 year period (January 1990-December 2009) as recorded in the autopsy registers of the department. A total of 5035 autopsies were done during the period, 89% of which were coroner cases. Four thousand, four hundred and eighty-one coroner cases representing 12.5% of all bodies received by the mortuary during the period were studied. The male to female ratio was 1.9:1, with an overall mean age of 38.3 years. The ages ranged from 1 day to 101 years with a peak incidence in the 25-44 years age group. A total of 553 children and 3928 adults were involved. The commonest indication for coroner's autopsy was sudden unexpected natural deaths (SUNDs) which accounted for 65.5% of the cases. Other causes of death were accidents, homicide, suicide, and undetermined causes representing 28.6, 5.0, 0.5, and 0.4%, respectively. Commonest cause of SUND was cardiovascular diseases with complications of hypertension being the most common CVS disease (26.9%). Road traffic accident was the commonest form of accident causing death (88.7%). Public enlightenment and health education about routine medical screening will help to reduce causes of natural deaths. This study shows the pattern of medicolegal autopsies in UBTH and this preliminary data will provide a baseline for future research and help in formulating policies to help in reduction of preventable causes of death.

  16. Use of hospital-based ambulatory care in New York City's Health Manpower Shortage Areas.

    PubMed Central

    Stager, D F; Krasner, M I; Goodwin, E J

    1987-01-01

    The development of a comprehensive data base for hospital-based ambulatory care has made possible the accurate determination of each community's use of hospitals in New York City and permits a reliable estimation of all ambulatory care received by residents of Health Manpower Shortage Areas (HMSAs). In spite of the city's abundant supply of private practitioners and widespread Medicaid coverage, residents of HMSAs in New York City are heavily dependent on hospital-based ambulatory care. Contrary to commonly held notions, however, HMSA residents do not appear to overuse hospital-based ambulatory care. Rather, that use appears to be quite modest, given their poorer health status. PMID:3101118

  17. Dental care knowledge and practice of a group of health workers in benin city, Nigeria.

    PubMed

    Amuh, Vo; Okojie, Oh; Ehizele, Ao

    2014-09-01

    The correlation between knowledge of dental care knowledge and its practice varies among the different health professionals. The aim of the following study is to assess the knowledge and practice of health workers in a private medical health facility on dental care. A descriptive cross-sectional study was carried out on the health workers in Faith Medical Center, Benin City, Nigeria. A self-administered questionnaire, containing 31 open and closed questions was used for data collection to assess their knowledge and practice of dental care. The data was analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0 (Chicago, IL, USA) and WIN PEPI software version 11.15. None of the respondents had a poor knowledge of dental care, but majority had poor practice. The pattern of distribution of knowledge and practice of dental care observed in this study was not significantly affected by age, gender, occupation and working experience. The entire respondents knew that bleeding from the gum is not normal and 96.2% (75/78) gave correct causes of bleeding gums. Majority 88.5% (69/78) also knew that tooth decay is not normal, but fewer 66.6% (52/78) knew the correct causes of tooth decay. Only 37.2% (29/75) of the respondents took correct action after experiencing a toothache (i.e., consulting a dentist for proper management) and majority 80.8% (63/78) and 76.1% (60/78) still make use of toothpicks, which is considered as potentially harmful and frequently consume cariogenic diet respectively. There is a good knowledge of dental care, but poor oral health practices among the studied health workers. Oral health education to correct their improper practices is therefore highly advocated.

  18. Falls from heights: epidemiology and pattern of injury at the accident and emergency centre of the University of Benin Teaching Hospital.

    PubMed

    Osifo, Osarumwense David; Iribhogbe, Pius; Idiodi-Thomas, Hestia

    2010-05-01

    Knowledge of the epidemiology and the pattern of injury sustained following falls from heights may be crucial in formulating policy aimed at prevention and improved outcome of victims. This study aims to determine the epidemiology and the spectrum of injury sustained following falls from heights at a referral trauma centre in a developing country. This study is a retrospective analysis of cases of falls from heights between June 2007 and May 2008 at the Accident and Emergency Center of the University of Benin Teaching Hospital. Eighty-four patients aged between 1 and 60 years (median: 24 years) comprising 54 males and 30 females with a male/female ratio of 1.8:1 were managed. All the falls were accidental and occurred mainly among males aged between 18 and 30 years, with a peak incidence between March and May, which coincided with rainy and harvest seasons (P<0.0001). Consequently, falls from moving vehicles 13 (15.5%); off the top of buildings at construction sites, eight (9.5%), staircase, six (7.1%); and treetops, six (7.1%) were common. Children fell mainly indoors from relatively lower heights. Eighty (95.2%) patients sustained injury that ranged from minor abrasions (12; 14.3%) to severe life-threatening head injury (15; 17.9%), which resulted in one (1.2%) death. Sympathisers and passersby were rescuers who gave first aid and brought the patients to the centre using hazardous public transport with a mean time lag of 12h (range: 2-48 h) between the falls and presentation. Falls from heights were common in Benin. Health awareness programmes and a proper government policy will reduce incidences and improve outcome. (c) 2009 Elsevier Ltd. All rights reserved.

  19. Urbanisation, nutrition transition and cardiometabolic risk: the Benin study.

    PubMed

    Delisle, Hélène; Ntandou-Bouzitou, Gervais; Agueh, Victoire; Sodjinou, Roger; Fayomi, Benjamin

    2012-05-01

    A rising prevalence of CVD and diabetes has been observed in sub-Saharan Africa, particularly in cities. The aim of the present study conducted in Benin was to examine the mediating role of nutrition transition in the relationship of urbanisation level and socio-economic status (SES) to cardiometabolic risk markers. A total of 541 subjects in apparent good health were randomly selected from the main city of Cotonou, a small town and its surrounding rural areas. SES was assessed based on a proxy for income and on education. Dietary intake and physical activity were assessed with at least two non-consecutive 24 h recalls. Scores for micronutrient adequacy and preventive diet were used as indicators of diet quality. Cardiometabolic risk markers were BMI, waist circumference (WC), blood pressure, serum cholesterol and insulin resistance according to homeostasis model assessment. A more advanced stage of nutrition transition, which correlated with lower diet quality scores and less physical activity, was observed in the large city compared with less urbanised locations. More obesity and more adverse cholesterol profiles, but also lower blood pressure, were present in the large city. Urbanisation, income, sedentary lifestyle and alcohol consumption, but not diet quality, independently contributed to higher BMI and WC. Higher micronutrient adequacy was independently associated with a better cholesterol profile. The study confirmed the positive rural-urban gradient in nutrition transition and cardiometabolic risk, except for blood pressure. This risk could be mitigated by a more adequate diet, particularly micronutrient intake, and a more active lifestyle.

  20. Hospital discharge rates before and after implementation of a city-wide smoking ban in a Texas city, 2004-2008.

    PubMed

    Head, Phil; Jackson, Bradford E; Bae, Sejong; Cherry, Debra

    2012-01-01

    The objective of this study was to examine hospital discharge data on 5 tobacco-related diagnoses before and after implementation of a smoking ban in a small Texas city. We compared hospital discharge rates for 2 years before and 2 years after implementation of the ban in the intervention city with discharge rates during the same time in a similar city with no ban. The discharge rates for blacks and whites combined declined significantly after the ban in the intervention city for acute myocardial infarction (MI) (rate ratio [RR], 0.74; 95% confidence interval [CI], 0.65-0.85) and for stroke or cerebrovascular accident (RR, 0.71; 95% CI, 0.62-0.82); discharge rates in the intervention city also declined significantly for chronic obstructive pulmonary disease (RR, 0.64; 95% CI, 0.54-0.75) and asthma (RR, 0.69; 95% CI, 0.52-0.91) for whites only. Discharge rates for 4 of 5 diagnoses in the control city did not change. Although postban reduction in acute MI is well documented, this is one of the first studies to show a racial disparity in health benefits and a decline in tobacco-related diagnoses other than acute MI after implementation of a city-wide smoking ban.

  1. Grade pending: lessons for hospital quality reporting from the New York City restaurant sanitation inspection program.

    PubMed

    Ryan, Andrew M; Detsky, Allan S

    2015-02-01

    Public quality reporting programs have been widely implemented in hospitals in an effort to improve quality and safety. One such program is Hospital Compare, Medicare's national quality reporting program for US hospitals. The New York City sanitary grade inspection program is a parallel effort for restaurants. The aims of Hospital Compare and the New York City sanitary inspection program are fundamentally similar: to address a common market failure resulting from consumers' lack of information on quality and safety. However, by displaying easily understandable information at the point of service, the New York City sanitary inspection program is better designed to encourage informed consumer decision making. We argue that this program holds important lessons for public quality reporting of US hospitals. © 2014 Society of Hospital Medicine.

  2. Hospitalization Rates Among People With HIV/AIDS in New York City, 2013.

    PubMed

    Lazar, Rachael; Kersanske, Laura; Xia, Qiang; Daskalakis, Demetre; Braunstein, Sarah L

    2017-08-01

    Hospitalizations are an important indicator of healthcare quality and access for people with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). This study assesses hospitalization rates among people with HIV/AIDS in New York City. We performed a deterministic match between people in the New York City HIV surveillance registry alive as of 1 January 2013 and diagnosed with HIV as of 31 December 2013 and patient-level inpatient hospitalization records during 2013. Event-level data were analyzed to determine characteristics of and reasons for hospitalizations. Primary diagnoses were classified using the International Classification of Diseases, Ninth Revision, Clinical Modification. We estimated hospitalization rates as the number of hospitalizations per 100 person-years for all causes, AIDS-defining illnesses, and non-AIDS-defining infections. Nearly one-fifth of hospitalizations were attributed to non-AIDS-defining infections, whereas AIDS-defining illness diagnoses were infrequent (3.6% of hospitalizations). Other common causes were cardiovascular (10.9%) and substance use (9.8%). The estimated all-cause hospitalization rate was 36.7 per 100 person-years. Higher all-cause hospitalization rates were observed among females (46.8 per 100 person-years), Black and Latino/Hispanic people (41.8 and 39.5 per 100 person-years, respectively), people living in high-poverty neighborhoods (47.4 per 100 person-years), and people with a history of injection drug use (74.9 per 100 person-years). The estimated AIDS-defining illness and non-AIDS-defining infection hospitalization rates were 1.3 and 7.2 per 100 person-years, respectively. People with HIV in New York City were frequently hospitalized. While AIDS-defining illnesses were relatively rare, non-AIDS-defining infection hospitalizations were more common. Disparities in hospitalization rates indicate a need for targeted improved primary care and comorbid disease management. © The Author 2017

  3. Distribution of causes of maternal mortality during delivery and post-partum: results of an African multicentre hospital-based study.

    PubMed

    Thonneau, Patrick F; Matsudai, Tomohiro; Alihonou, Eusèbe; De Souza, Jose; Faye, Ousseynou; Moreau, Jean-Charles; Djanhan, Yao; Welffens-Ekra, Christiane; Goyaux, Nathalie

    2004-06-15

    To assess the maternal mortality ratio in maternity units of reference hospitals in large west African cities, and to describe the distribution of complications and causes of maternal deaths. Prospective descriptive study in twelve reference maternities located in three African countries (Benin, Ivory Coast, Senegal). Data (clinical findings at hospital entry, medical history, complications, type of surgery, vital status of the women at discharge) were collected from obstetrical and surgical files and from admission hospital registers. All cases of maternal deaths were systematically reviewed by African and European staff. Of a total of 10,515 women, 1495 presented a major obstetric complication with dystocia or inappropriate management of the labour phase as the leading cause. Eighty-five maternal deaths were reported, giving a global hospital-based maternal mortality ratio of 800/100,000. Hypertensive disorders were involved in 25/85 cases (29%) and post-partum haemorrhage in 13/85 cases (15%). Relatively few cases (14) of major sepsis were reported, leading to three maternal deaths. The results of this multicentre study confirm the high rates of maternal mortality in maternity units of reference hospitals in large African cities, and in addition to dystocia the contribution of hypertensive disorders and post-partum haemorrhage to maternal deaths.

  4. Dental aesthetic self-perception and desire for orthodontic treatment among school children in Benin City, Nigeria.

    PubMed

    Ajayi, Emmanuel O

    2011-01-01

    The availability of information on the individual perception of own's dental appearance and desire to uptake orthodontic treatment is of importance in the planning of orthodontic care within a population. The subjective assessment of personal dental appearance and desire for orthodontic treatment was appraised among Nigerian children. The study was conducted among 91 school children (33 boys, 58 girls) aged 12 years old in Benin City, south-southern region of Nigeria. The satisfaction of the subjects with the arrangement of their anterior teeth and desire to straighten their teeth was determined using a questionnaire. The subjects were further asked to rank their dental attractiveness in relation to the photographs in the Aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). The need for orthodontic treatment among the subjects was also assessed by the examiner with the Aesthetic component of IOTN. Chi-square tests were used for data analysis. The result revealed that more than three-quarters (76.9%) of the subjects were satisfied with their dental aesthetics while 23.1% desired to have orthodontic treatment. The boys expressed significantly higher level of dissatisfaction with their dental aesthetics and a greater desire to have orthodontic treatment (P < 0.05). Most subjects (92.3%) rated their dental attractiveness in the "little to no need" orthodontic treatment grade on the AC scale. The normative borderline treatment need was higher than subjective borderline need but there was consistency in distribution of 4.4% in definite need treatment grade by the subjects and examiner. The majority of the children rated their teeth as aesthetically satisfactory but there were gender differences in perception of dental aesthetics and desire for orthodontic treatment among this sample of Nigerian children.

  5. Black/white differences in very low birth weight neonatal mortality rates among New York City hospitals.

    PubMed

    Howell, Elizabeth A; Hebert, Paul; Chatterjee, Samprit; Kleinman, Lawrence C; Chassin, Mark R

    2008-03-01

    We sought to determine whether differences in the hospitals at which black and white infants are born contribute to black/white disparities in very low birth weight neonatal mortality rates in New York City. We performed a population-based cohort study using New York City vital statistics records on all live births and deaths of infants weighing 500 to 1499 g who were born in 45 hospitals between January 1, 1996, and December 31, 2001 (N = 11 781). We measured very low birth weight risk-adjusted neonatal mortality rates for each New York City hospital and assessed differences in the distributions of non-Hispanic black and non-Hispanic white very low birth weight births among these hospitals. Risk-adjusted neonatal mortality rates for very low birth weight infants in New York City hospitals ranged from 9.6 to 27.2 deaths per 1000 births. White very low birth weight infants were more likely to be born in the lowest mortality tertile of hospitals (49%), compared with black very low birth weight infants (29%). We estimated that, if black women delivered in the same hospitals as white women, then black very low birth weight mortality rates would be reduced by 6.7 deaths per 1000 very low birth weight births, removing 34.5% of the black/white disparity in very low birth weight neonatal mortality rates in New York City. Volume of very low birth weight deliveries was modestly associated with very low birth weight mortality rates but explained little of the racial disparity. Black very low birth weight infants more likely to be born in New York City hospitals with higher risk-adjusted neonatal mortality rates than were very low birth weight infants, contributing substantially to black-white disparities.

  6. Intestinal helminthiasis in children with chronic neurological disorders in Benin City, Nigeria: intensity and behavioral risk factors.

    PubMed

    Nwaneri, Damia Uchechukwu; Ibadin, Michael Okoeguale; Ofovwe, Gabriel Egberue; Sadoh, Ayebo Evawere

    2013-05-01

    Behavioral aberrations such as nail biting, finger sucking, and pica have been postulated as risk factors that enhance helminths ova transmission. These aberrations may present commonly in children with chronic neurological disorders and predispose them to heavy intensity of intestinal helminthiasis. This comparative cross-sectional study was to determine the prevalence, intensity, and behavioral risk factors for intestinal helminthiasis in children with chronic neurological disorders and apparently healthy controls. Fresh stool samples from 155 children (2-17 years) with chronic neurological disorders seen at the child neurology clinic and 155 age and sex matched controls from nursery and primary schools in Benin City were analyzed using the Kato-Katz technique for detection of ova of helminths from November 2008 to April 2009. The prevalence of intestinal helminthiasis (31.0%) was significantly higher in children with chronic neurological disorders compared with the controls (19.4%) (P=0.03). The intensity of infections in both groups was light ranging 24-144 eggs per gram. Ascaris lumbricoides, Trichuris trichiura and hookworm were the intestinal helminths isolated in both groups. Behavioral aberrations were significantly more represented in the subjects than in the controls (P<0.0001, OR=2.8). Nail biting and encopresis were the most significant independent predictors of intestinal helminthiasis (P=0.025 and 0.001, respectively) in the subjects only. Hand washing with water and soap after defecation and frequent de-worming exercise were practices significantly associated with decreased prevalence of intestinal helminthiasis in the subjects and controls. Behavioral modification in children with chronic neurological disorders should be an integral part of the control program for intestinal helminthiasis.

  7. Factors affecting in-hospital heat-related mortality: a multi-city case-crossover analysis.

    PubMed

    Stafoggia, M; Forastiere, F; Agostini, D; Caranci, N; de'Donato, F; Demaria, M; Michelozzi, P; Miglio, R; Rognoni, M; Russo, A; Perucci, C A

    2008-03-01

    Several studies have identified strong effects of high temperatures on mortality at population level; however, individual vulnerability factors associated with heat-related in-hospital mortality are largely unknown. The objective of the study was to evaluate heat-related in-hospital mortality using a multi-city case-crossover analysis. We studied residents of four Italian cities, aged 65+ years, who died during 1997-2004. For 94,944 individuals who died in hospital and were hospitalised two or more days before death, demographics, chronic conditions, primary diagnoses of last event and hospital wards were considered. A city-specific case-crossover analysis was performed to evaluate the association between apparent temperature and mortality. Pooled odds ratios (OR) of dying on a day with a temperature of 30 degrees C compared to a day with a temperature of 20 degrees C were estimated with a random-effects meta-analysis. We estimated an overall OR of 1.32 (95% confidence interval: 1.25, 1.39). Age, marital status and hospital ward were important risk indicators. Patients in general medicine were at higher risk than those in high and intensive care units. A history of psychiatric disorders and cerebrovascular diseases gave a higher vulnerability. Mortality was greater among patients hospitalised for heart failure, stroke and chronic pulmonary diseases. In-hospital mortality is strongly associated with high temperatures. A comfortable temperature in hospitals and increased attention to vulnerable patients during heatwaves, especially in general medicine, are necessary preventive measures.

  8. Evaluation of Patient Safety Indicators in Semnan City Hospitals by Using the Patient Safety Friendly Hospital Initiative (PSFHI).

    PubMed

    Babamohamadi, Hassan; Nemati, Roghayeh Khabiri; Nobahar, Monir; Keighobady, Seifullah; Ghazavi, Soheila; Izadi-Sabet, Farideh; Najafpour, Zhila

    2016-08-01

    Nowadays, patient safety issue is among one of the main concerns of the hospital policy worldwide. This study aimed to evaluate the patient safety status in hospitals affiliated to Semnan city, using the WHO model for Patient Safety Friendly Hospital Initiatives (PSFHI) in summer 2014. That was a cross sectional descriptive study that addressed patient safety , which explained the current status of safety in the Semnan hospitals using by instrument of Patient safety friendly initiative standards (PSFHI). Data was collected from 5 hospitals in Semnan city during four weeks in May 2014. The finding of 5 areas examined showed that some components in critical standards had disadvantages. Critical standards of hospitals including areas of leadership and administration, patient and public involvement and safe evidence-based clinical practice, safe environment with and lifetime education in a safe and secure environment were analyzed. The domain of patient and public involvement obtained the lowest mean score and the domain of safe environment obtained the highest mean score in the surveyed hospitals. All the surveyed hospitals had a poor condition regarding standards based on patient safety. Further, the identified weak points are almost the same in the hospitals. Therefore, In order to achieve a good level of all aspects of the protocol, the goals should be considered in the level of strategic planning at hospitals. An effective execution of patient safety creatively may depend on the legal infrastructure and enforcement of standards by hospital management, organizational liability to expectation of patients, safety culture in hospitals.

  9. Oklahoma City's killer tornadoes: how local hospitals responded to yet another extreme disaster.

    PubMed

    1999-09-01

    On the evening of May 3rd, a group of high-powered tornadoes tore through Oklahoma--leaving more than 40 people dead and hundreds injured. The main twister formed about 45 miles south of Oklahoma City and was classified F5, the most severe type of tornado, with winds of more than 260 mph. It cut a path one mile wide; stayed on the ground for more than four hours; and, along with other twisters, demolished 60 miles of countryside. More than 7,000 homes were destroyed or damaged, and more than 5,000 families were left homeless. Oklahoma City was hit the hardest, with about 1,500 homes leveled in the storm. A total of 755 people were injured in Oklahoma City and the surrounding area, testing local hospital disaster plans to the maximum. The same hospitals had been called on in April 1995 to handle the over 500 persons injured in the bombing of the Alfred P. Murrah Federal Building, a terrorist blast that killed 168. The hospitals' latest response to a disaster situation is recorded in this report.

  10. Seasonal water demand in Benin's agriculture.

    PubMed

    Gruber, Ina; Kloos, Julia; Schopp, Marion

    2009-01-01

    This paper describes and analyzes agricultural water demands for Benin, West Africa. Official statistical data regarding water quantities as well as knowledge on factors influencing the demand for water are extremely rare and often reveal national trends without considering regional or local differences. Thus policy makers usually work with this estimated and aggregated data, which make it very difficult to adequately address regional and local development goals. In the framework of an interdisciplinary analysis the following paper provides insight into water quantification and detects water problems under seasonal aspects for agriculture according to regional differences. Following the definition of the Food and Agriculture Organization [FAO, 1995. Water Report 7. Irrigation in Africa in Figures. Rome] agriculture is divided into irrigation and livestock watering, which were analyzed using different field methods. The study reveals that although water supply in absolute terms seems to be sufficient in Benin, seasonal water problems occur both in irrigation and in livestock management. Thus arising seasonal water problems are not the consequence of general water scarcity but more linked to three major problems. These problems emerge from difficulties in technical equipment and financial means of farmers, from the specific local conditions influencing the access to water sources and the extraction of groundwater, and third from the overall low organizational structure of water management. Therefore regional differences as well as a general improvement of knowledge on better management structures, technical know how, and access to credits for farmers need to be considered in national strategies in order to improve the agricultural water usage in Benin.

  11. Pilot of a mobile money school fee payment system in rural Benin.

    PubMed

    Adida, Claire L; Chabi Bouko, Adam; Verink, Alex; Chockalingam, Ganz; Burney, Jennifer

    2018-01-01

    We present a rationale for, and results from, the pilot of a direct individual-to-institution remittance system in the context of school fee payment in rural Benin. Data confirm that school fees act as an impediment to educational attainment, and in very rural poor settings such as northern Benin, students often depend on extended family and kinship networks to pay fees. But existing remittance options are costly, in terms of fees, time, and risk. We pilot a new technology bundle in a single public high school in northeastern Benin, and evaluate its effectiveness. Here we describe the technical and institutional implementation of the project, as well as our findings from the first year of operation. We discuss takeaways and implications for scale-up.

  12. Pilot of a mobile money school fee payment system in rural Benin

    PubMed Central

    Chabi Bouko, Adam; Verink, Alex; Chockalingam, Ganz; Burney, Jennifer

    2018-01-01

    We present a rationale for, and results from, the pilot of a direct individual-to-institution remittance system in the context of school fee payment in rural Benin. Data confirm that school fees act as an impediment to educational attainment, and in very rural poor settings such as northern Benin, students often depend on extended family and kinship networks to pay fees. But existing remittance options are costly, in terms of fees, time, and risk. We pilot a new technology bundle in a single public high school in northeastern Benin, and evaluate its effectiveness. Here we describe the technical and institutional implementation of the project, as well as our findings from the first year of operation. We discuss takeaways and implications for scale-up. PMID:29889839

  13. Changes in HIV-related hospitalizations during the HAART era in an inner-city hospital.

    PubMed

    Pulvirenti, Joseph; Muppidi, Uma; Glowacki, Robert; Cristofano, Michael; Baker, Laurie

    2007-08-01

    We evaluated admissions of HIV-positive persons to an inner-city hospital from 2000 to 2005. There was a decline in the number of substance abusers, homeless persons, injection drug abusers, and African Americans, and there was an increase in patients older than 50 years. There were no significant changes in CD4 counts or in utilization of highly active antiretroviral therapy,m but there were more admissions of persons with HIV RNA levels less than 1000 copies/mL, internal medicine problems, cancers, and skin infections. Changes in the demographics of this patient population may reflect external factors (eg, gentrification of low-income housing areas, opening of a new hospital). Lower viral loads suggest better response in those on a highly active antiretroviral regimen, and changes in diagnoses leading to hospitalization may reflect the aging of the HIV population.

  14. Analysis of hospitalization occurred due to motorcycles accidents in São Paulo city

    PubMed Central

    Gorios, Carlos; Armond, Jane de Eston; Rodrigues, Cintia Leci; Pernambuco, Henrique; Iporre, Ramiro Ortiz; Colombo-Souza, Patrícia

    2015-01-01

    OBJECTIVE: To characterize the motorcycle accidents occurred in the city of São Paulo, SP, Brazil in the year 2013, with emphasis on information about hospital admissions from SIH/SUS. METHODS: This is a retrospective cross-sectional study. The study covered 5,597 motorcyclists traumatized in traffic accident during the year 2013 occurred in the city of São Paulo. A survey was conducted using secondary data from the Information System of Hospitalization Health System (SIH/SUS). RESULTS: In 2013, in the city of São Paulo there were 5,597 admissions of motorcyclists traumatized in traffic accidents, of which 89.8% were male. The admission diagnosis were: leg fracture, femur fracture, and intracranial injury. CONCLUSION: This study confirms other preliminary studies on several points, among which stands out the highest prevalence of male young adults. Level of Evidence II, Retrospective Study. PMID:26327804

  15. Expected hazards and hospital beds in host cities of the 2014 FIFA World Cup in Brazil.

    PubMed

    Miranda, Elaine Silva; Shoaf, Kimberley; Silva, Raulino Sabino da; Freitas, Carolina Figueiredo; Osorio-de-Castro, Claudia Garcia Serpa

    2017-06-12

    Planning for mass gatherings involves health system preparedness based on an understanding of natural and technological hazards identified through prior risk assessment. We present the expected hazards reported by health administrators of the host cities for the 2014 FIFA World Cup in Brazil and discuss the hazards considering minimal available public hospital beds in the 12 cities at the time of the event. Four different groups of respondents were interviewed: pharmaceutical service administrators and overall health administrators at both the municipal and hospital levels. The hospital bed occupancy rate was calculated, based on the Brazilian Health Informatics Department (DATASUS). The number of surplus beds was calculated using parameters from the literature regarding surge and mass casualty needs and number of unoccupied beds. In all groups, physical injuries ranked first, followed by emerging and endemic diseases. Baseline occupancy rates were high (95%CI: 0.93-2.19) in all 12 cities. Total shortage, considering all the cities, ranged from -47,670 (for surges) to -60,569 beds (for mass casualties). The study can contribute to discussions on mass-gathering preparedness.

  16. Indigenous knowledge on landraces and fonio-based food in Benin.

    PubMed

    Ballogou, Vénérande Y; Soumanou, Mohamed M; Toukourou, Fatiou; Hounhouigan, Joseph D

    2014-01-01

    Fonio is a traditional cereal cultivated in many West African countries, where farmers are often the guardians of a rich diversity of landraces or traditional varieties. An investigation conducted in northwest of Benin on indigenous knowledge about fonio landraces and fonio-based traditional foods allowed us to inventory 35 landraces identified by the farmers. Ipormoa, Namba, Icantoni or Kopognakè or Icantoga and Iporhouwan landraces were good to cook paste and couscous and easy to dehusk. Besides, Ipormoa and Iporhouwan landraces had interesting agronomic characteristics. Paste, porridge, and couscous were the main fonio-based foods consumed by farmers in northwest of Benin.

  17. Discourses of Education, Protection, and Child Labor: Case Studies of Benin, Namibia and Swaziland

    ERIC Educational Resources Information Center

    Nordtveit, Bjorn Harald

    2010-01-01

    This article analyses discontinuities between local, national and international discourse in the fields of education, protection of children, and child labor, using Benin, Namibia and Swaziland as case studies. In Benin, child abuse and child labor are related to poverty, whereas in Namibia and Swaziland they are also interrelated with HIV/AIDS.…

  18. An Evaluation of the Outcomes of Mutual Health Organizations in Benin

    PubMed Central

    Haddad, Slim; Ridde, Valery; Yacoubou, Ismaelou; Mák, Geneviève; Gbetié, Michel

    2012-01-01

    Background Mutual health organizations (MHO) have been seen as a promising alternative to the fee-based funding model but scientific foundations to support their generalization are still limited. Very little is known about the extent of the impact of MHOs on health-seeking behaviours, quality and costs. Methodology/Principal Findings We present the results of an evaluation of the effects attributable to membership in an MHO in a rural region of Benin. Two prospective studies of users (parturients and hospitalized patients) were conducted on the territory of an inter-mutual consisting of 10 MHOs and as many healthcare centres (one, Ouessé, serving as a referral hospital) and one hospital (Papané). Members and non-members were matched (142 pairs of parturients and 109 triads of hospitalized patients) and multilevel multiple regression was used. Results show that member parturients went to healthcare centres sooner (p = 0.049) and were discharged more quickly after delivery (p = 0.001) than non-members. Length of stay in some cases was longer for hospitalized member parturients (+41%). Being a member did not shorten hospital stay, total length of episode of care, or time between appearance of symptoms and recourse to care. Regarding expenses, member parturients paid one-third less than non-members for a delivery. For hospitalized patients, the average savings for members was around $35 US. Total expenses incurred by patients hospitalized at Papané Hospital were higher than at Ouessé but the two hospitals’ relative advantages were comparable at −36% and −39%, respectively. Conclusion/Significance These results confirm mutual health organizations’ capacity to protect households financially, even if benefits for the poor have not been clearly determined. The search for scientific evidence should continue, to understand their impacts with regard to services obtained by their members. PMID:23077556

  19. An Intervention to Increase Availability of Healthy Foods and Beverages in New York City Hospitals: The Healthy Hospital Food Initiative, 2010-2014.

    PubMed

    Moran, Alyssa; Krepp, Erica M; Johnson Curtis, Christine; Lederer, Ashley

    2016-06-09

    Hospitals serve millions of meals and snacks each year; however, hospital food is often unhealthy. Hospitals are ideal settings for modeling healthy eating, but few programs have sought to improve nutrition in all venues where food is served. The New York City Department of Health and Mental Hygiene created the Healthy Hospital Food Initiative (HHFI) to improve the healthfulness of food served in hospitals. The HHFI built on prior work implementing mandatory nutrition standards for patient meals and vending in public hospitals. Public hospitals joined the HHFI by voluntarily adopting standards for cafeterias and cafés. Private hospitals joined by implementing nutrition standards for patient meals, food and beverage vending machines, and cafeterias and cafés. Hospitals were recruited from 2010 through 2014 and provided technical assistance from health department staff. Implementation in each of the 4 areas was monitored through on-site assessments and menu review. Twenty-eight hospital cafeterias and cafés were evaluated at baseline and at the end of the HHFI to assess changes. Sixteen public hospitals and 24 private hospitals joined the HHFI. Most (n = 18) private hospitals implemented standards in at least 2 areas. In cafeterias, most hospitals introduced a healthy value meal (n = 19), removed unhealthy items from the entrance and checkout (n = 18), increased whole grains to at least half of all grains served (n = 17), and reduced calories in pastries and desserts (n = 15). Most New York City hospitals joined the HHFI and voluntarily adopted rigorous nutrition standards. Partnerships between hospitals and local government are feasible and can lead to significant improvements in hospital food environments.

  20. Hospital marketing: characterization of marketing actions in private hospitals in the city of São Paulo - Brazil.

    PubMed

    Leiderman, Eduardo Blay; Padovan, Jorge Luis; Zucchi, Paola

    2010-01-01

    Characterize the marketing actions in private hospitals in the city of São Paulo, the organizational structure of the marketing area, the target public of marketing actions and the media used. Exploratory cross-sectional study, carried out by a survey made with hospital administrators. The hospitals studied were clearly divided in two groups whose differentials are statistically significant: 1. good infrastructure and equipment, with a well-defined investment policy in marketing; 2. worse infrastructure and less equipment, with lower proportional investment in marketing. 1. The actions most used are the evaluation of patients/caregivers satisfaction, web site and dissemination of the hospital services. 2. The hospital administrators attribute a level of significant importance to the application of hospital marketing concepts. 3. There is a marketing structure in most of the hospitals studied. 4. The hospitals consider as extremely or very important publics: patients and relatives, doctors, collaborators, health plans and community. 5. The media most used are the most simple and of lower cost. 6. There is a statistically significant correlation between the higher investment in marketing and the best infrastructure. 7. The studied hospitals apply the concept of marketing in a restricted way.

  1. Epidemiology and pattern of paediatric and adolescent trauma deaths in a level 1 trauma centre in Benin city, Nigeria.

    PubMed

    Osifo, Osarumwense David; Iribhogbe, Pius Ehiawaguan; Ugiagbe, Ezekiel Enoghama

    2012-11-01

    Trauma is a common cause of death amongst children/adolescents, and data on its epidemiology and pattern are crucial for policy formulation. The aim of this study was to determine the epidemiology and pattern of paediatric/adolescent trauma death in a Nigerian referral trauma centre. The clinical and autopsy data of all paediatric/adolescent trauma death at the University of Benin Teaching Hospital between 1999 and 2010 were analysed in a retrospective study. Of 905 trauma-related deaths, 78 (9%) involved children/adolescents who comprised 49 males and 29 females, with a male/female ratio 1.7:1 and a mean age of 9.2 ± 5 years (range <1-18 years). The Injury-Arrival time varied from 1h to 4 days (mean 18 h). Thirteen (17%) cases were dead on arrival (DOA), and majority of the deaths occurred within the first week on admission. Road traffic accident (RTA), accounting for 61 (78%) cases, was the leading cause of trauma death. Other causes included burns, eight (10%); gunshot injury, five (6%); and stab and sport injuries, two (3%) cases each. Head injury which occurred in 44 (56%) cases was the commonest cause of death, followed by haemorrhagic shock in 25 (32%), hypovolaemic shock in five (6%), septic shock in three (4%) and spinal cord injury in one (1%). Head injury following RTA was the major cause of paediatric/adolescent trauma deaths. Increased road safety campaign, appropriate injury control policies, legislations, enforcement, development of high-quality trauma system, and emergency medical services are advocated. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. [City-hospital network and quality control of officinal preparations].

    PubMed

    Curti, C; Gallice, S; Lamy, E; Rathelot, P; Vanelle, P

    2018-05-01

    In a hospital environment, the quality control of the hospital preparations allows to release homogeneous batches in a secure way. These controls are totally integrated into the process of production and can also, in certain cases, be realized for high-alert magistral preparations. In community pharmacy, these controls were not required, but the Agence régionale de santé (ARS) recently incited compounding community pharmacies to realize this type of analyses. This decision motivated the creation of a collaboration between the pharmacy department of a French teaching hospital and a society including around thirty community pharmacies having a preparatory. Twenty community pharmacies distributed on all the territory have submitted one of their pediatric preparation, capsules of captopril 2mg, to the pharmacopoeia controls usually realized in the industry or hospital. All the analyzed batches were in agreement with European Pharmacopeia specifications. We shall present the rational of this work, the results as well as the numerous perspectives offered by this new type of collaboration joining completely the logic of a network city-hospital allowing the improvement of security of the medication circuit in France. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  3. Effect of cause-of-death training on agreement between hospital discharge diagnoses and cause of death reported, inpatient hospital deaths, New York City, 2008-2010.

    PubMed

    Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio; Madsen, Ann

    2015-01-15

    Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to

  4. Village-Level Identification of Nitrate Sources: Collaboration of Experts and Local Population in Benin, Africa

    NASA Astrophysics Data System (ADS)

    Crane, P.; Silliman, S. E.; Boukari, M.; Atoro, I.; Azonsi, F.

    2005-12-01

    Deteriorating groundwater quality, as represented by high nitrates, in the Colline province of Benin, West Africa was identified by the Benin national water agency, Direction Hydraulique. For unknown reasons the Colline province had consistently higher nitrate levels than any other region of the country. In an effort to address this water quality issue, a collaborative team was created that incorporated professionals from the Universite d'Abomey-Calavi (Benin), the University of Notre Dame (USA), Direction l'Hydraulique (a government water agency in Benin), Centre Afrika Obota (an educational NGO in Benin), and the local population of the village of Adourekoman. The goals of the project were to: (i) identify the source of nitrates, (ii) test field techniques for long term, local monitoring, and (iii) identify possible solutions to the high levels of groundwater nitrates. In order to accomplish these goals, the following methods were utilized: regional sampling of groundwater quality, field methods that allowed the local population to regularly monitor village groundwater quality, isotopic analysis, and sociological methods of surveys, focus groups, and observations. It is through the combination of these multi-disciplinary methods that all three goals were successfully addressed leading to preliminary identification of the sources of nitrates in the village of Adourekoman, confirmation of utility of field techniques, and initial assessment of possible solutions to the contamination problem.

  5. Estimating the Hospital Delivery Costs Associated With Severe Maternal Morbidity in New York City, 2008-2012.

    PubMed

    Howland, Renata E; Angley, Meghan; Won, Sang Hee; Wilcox, Wendy; Searing, Hannah; Tsao, Tsu-Yu

    2018-02-01

    To quantify the average and total hospital delivery costs associated with severe maternal morbidity in excess of nonsevere maternal morbidity deliveries over a 5-year period in New York City adjusting for other sociodemographic and clinical factors. We conducted a population-based cross-sectional study using linked birth certificates and hospital discharge data for New York City deliveries from 2008 to 2012. Severe maternal morbidity was defined using a published algorithm of International Classification of Diseases, 9 Revision, Clinical Modification disease and procedure codes. Hospital costs were estimated by converting hospital charges using factors specific to each year and hospital and to each diagnosis. These estimates approximate what it costs the hospital to provide services (excluding professional fees) and were used in all subsequent analyses. To estimate adjusted mean costs associated with severe maternal morbidity, we used multivariable regression models with a log link, gamma distribution, robust standard errors, and hospital fixed effects, controlling for age, race and ethnicity, neighborhood poverty, primary payer, number of deliveries, method of delivery, comorbidities, and year. We used the adjusted mean cost to determine the average and total hospital delivery costs associated with severe maternal morbidity in excess of nonsevere maternal morbidity deliveries from 2008 to 2012. Approximately 2.3% (n=13,502) of all New York City delivery hospitalizations were complicated by severe maternal morbidity. Compared with nonsevere maternal morbidity deliveries, these hospitalizations were clinically complicated, required more and intensive clinical services, and had a longer stay in the hospital. The average cost of delivery with severe maternal morbidity was $14,442 (95% CI $14,128-14,756), compared with $7,289 (95% CI $7,276-7,302) among deliveries without severe maternal morbidity. After adjusting for other factors, the difference between deliveries

  6. Steps Toward Creating A Therapeutic Community for Inpatients Suffering from Chronic Ulcers: Lessons from Allada Buruli Ulcer Treatment Hospital in Benin

    PubMed Central

    Amoussouhoui, Arnaud Setondji; Johnson, Roch Christian; Sopoh, Ghislain Emmanuel; Agbo, Ines Elvire; Aoulou, Paulin; Houezo, Jean-Gabin; Tingbe-Azalou, Albert; Boyer, Micah; Nichter, Mark

    2016-01-01

    Background Reducing social distance between hospital staff and patients and establishing clear lines of communication is a major challenge when providing in-patient care for people afflicted by Buruli ulcer (BU) and chronic ulcers. Research on hospitals as therapeutic communities is virtually non-existent in Africa and is currently being called for by medical anthropologists working in the field of health service and policy planning. This paper describes a pioneering attempt to establish a therapeutic community for patients suffering from BU and other chronic ulcers requiring long term hospital care in Benin. Methods A six-month pilot project was undertaken with the objectives of establishing a therapeutic community and evaluating its impact on practitioner and patient relations. The project was designed and implemented by a team of social scientists working in concert with the current and previous director of a hospital serving patients suffering from advanced stage BU and other chronic ulcers. Qualitative research initially investigated patients’ understanding of their illness and its treatment, identified questions patients had about their hospitalization, and ascertained their level of social support. Newly designed question–answer health education sessions were developed. Following these hospital wide education sessions, open forums were held each week to provide an opportunity for patients and hospital staff to express concerns and render sources of discontent transparent. Patient group representatives then met with hospital staff to problem solve issues in a non-confrontational manner. Psychosocial support for individual patients was provided in a second intervention which took the form of drop-in counseling sessions with social scientists trained to serve as therapy facilitators and culture brokers. Results Interviews with patients revealed that most patients had very little information about the identity of their illness and the duration of their

  7. An Intervention to Increase Availability of Healthy Foods and Beverages in New York City Hospitals: The Healthy Hospital Food Initiative, 2010–2014

    PubMed Central

    Krepp, Erica M.; Johnson Curtis, Christine; Lederer, Ashley

    2016-01-01

    Background Hospitals serve millions of meals and snacks each year; however, hospital food is often unhealthy. Hospitals are ideal settings for modeling healthy eating, but few programs have sought to improve nutrition in all venues where food is served. Community Context The New York City Department of Health and Mental Hygiene created the Healthy Hospital Food Initiative (HHFI) to improve the healthfulness of food served in hospitals. The HHFI built on prior work implementing mandatory nutrition standards for patient meals and vending in public hospitals. Public hospitals joined the HHFI by voluntarily adopting standards for cafeterias and cafés. Private hospitals joined by implementing nutrition standards for patient meals, food and beverage vending machines, and cafeterias and cafés. Methods Hospitals were recruited from 2010 through 2014 and provided technical assistance from health department staff. Implementation in each of the 4 areas was monitored through on-site assessments and menu review. Twenty-eight hospital cafeterias and cafés were evaluated at baseline and at the end of the HHFI to assess changes. Outcome Sixteen public hospitals and 24 private hospitals joined the HHFI. Most (n = 18) private hospitals implemented standards in at least 2 areas. In cafeterias, most hospitals introduced a healthy value meal (n = 19), removed unhealthy items from the entrance and checkout (n = 18), increased whole grains to at least half of all grains served (n = 17), and reduced calories in pastries and desserts (n = 15). Interpretation Most New York City hospitals joined the HHFI and voluntarily adopted rigorous nutrition standards. Partnerships between hospitals and local government are feasible and can lead to significant improvements in hospital food environments. PMID:27281392

  8. [Promotion of community-based care in Africa: example of community general practice in Benin].

    PubMed

    Caplain, Roland; Yacoubou, Ismaïl; Adedemy, Didier; Sani, Alidou; Takam, Sandrine; Desplats, Dominique

    2014-01-01

    Considerable effort has been made to provide rural African populations with basic health care, but the quality of this care remains unsatisfactory due to the absence of first-line GPs. This is a paradoxical situation in view of the large number of physicians trained in medical schools in French-speaking Africa and Madagascar. of the lack of GPs working in rural areas is a real concern, as many young doctors remain unemployed in cities. For more than 20 years, the NGO Santé Sud has proposed a Community General Medicine concept, which, combined with a support system, has allowed the installation of more than 200 community GPs in Mali and Madagascar. The advantage of this concept is that it provides family medicine and primary health care in the same practice. Since 2009, Santé Sud supports an installation project in rural areas of northern Benin, where community GPs work independently, as a complementary partner of the public sector. Since 2013, the installation process comprises a university degree created with the University of Parakou Faculty of Medicine. Based on this experience in Benin, the authors show that the presence of a first-line general practitioner is an original strategy that provides a major contribution to health promotion : reducing health inequalities between rural and urban populations, allowing women to receive medically assisted childbirth close to home, developing family planning activities, education and health care for chronic diseases, strengthening health coverage by participating in vaccination campaigns, etc. Due to their functions and proximity, community GPs represent an added value for health promotion.

  9. [Differential mortality according to region of residence in Benin].

    PubMed

    Laourou, H M

    1995-01-01

    "The first mortality tables of Benin elaborated by direct estimation for the whole country deal with relatively different regional realities. It is in this regard that the data, whether it is death from multiround surveys or information about survival of parents, allows one to distinguish between the North (with a higher mortality) and the South (which has a lower mortality). Moreover, this differential study reveals that the level of male adult mortality after 35 years in the South, is well above the national average, probably because of the increase in deaths through violence (road accident or victim of a fire) in this part of Benin....The originality of this study is to have highlighted the mortality differentials at almost all age groups of life...." (SUMMARY IN ENG AND ITA) excerpt

  10. Special report. The Oklahoma City bombing: mass casualties and the local hospital response.

    PubMed

    1995-09-01

    A morning blast at the Alfred P. Murrah Federal Building, Oklahoma City, OK, on April 19, 1995, killed 168 persons and injured more than 500 in the worst terrorist attack in U.S. history. Hospital workers, physicians, and volunteers at nine hospitals there mobilized, put their disaster emergency plans into operation, and treated 466 persons in emergency rooms--many of them later being admitted as patients. To complicate matters, two of the hospitals received bomb threats called in after the disaster. This report will look at the security plans put into force by each of the nine hospitals; the handling of the great influx of persons, including victims, relatives, friends, concerned persons, volunteers, and the news media; and the lessons hospital officials learned from their experiences.

  11. Insect Fauna Associated With Anacardium occidentale (Sapindales: Anacardiaceae) in Benin, West Africa

    PubMed Central

    Agboton, C.; Onzo, A.; Ouessou, F. I.; Goergen, G.; Vidal, S.; Tamò, M.

    2014-01-01

    Abstract Cashew, Anacardium occidentale L. (Sapindales: Anacardiaceae), is an important cash crop in Benin. However, its production is threatened by several biotic factors, especially insects. In Benin, very few studies have focused on insects and just listed species commonly found on cashew worldwide. The present investigation fills this gap by presenting an exhaustive inventory of insect species associated with this crop in the country. The survey was carried out from September 2009 to August 2010 in 22 cashew orchards (5 young and 17 mature) distributed over three major agroecological zones where cashew is most produced in the country. Insects were collected using chemical knock-down technique and visual observation followed by capture with sweep net. In addition, infested plant organs were sampled and incubated to collect emerging insects. In total, 262 insect species were recorded and identified. Among them, the wood borer Apate terebrans Pallas, the leafminer Eteoryctis gemoniella Stainton, and the mirid bugs Helopeltis schoutedeni Reuter., and Helopeltis anacardii Miller., appeared as the most important insect species attacking cashew in Benin. Beneficial insects encountered included some predators, parasitoids, and pollinators. Few vertebrate predators were also recorded on the trees. Differences in agroecological conditions or in field cleanliness did not affect the number of insect species encountered in the cashew orchards. The results of this study represent an important baseline data for the design and implementation of strategies for cashew protection in Benin. PMID:25434033

  12. Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010

    PubMed Central

    Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio

    2015-01-01

    Introduction Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. Methods We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Results Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Conclusion Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions

  13. C4 plant isotopic composition (delta13C) evidence for urban CO2 pollution in the city of Cotonou, Benin (West Africa).

    PubMed

    Kèlomé, Nelly C; Lévêque, Jean; Andreux, Francis; Milloux, Marie-Jeanne; Oyédé, Lucien-Marc

    2006-08-01

    The carbon isotopic composition (delta13C) of plants can reveal the isotopic carbon content of the atmosphere in which they develop. The delta13C values of air and plants depend on the amount of atmospheric fossil fuel CO2, which is chiefly emitted in urban areas. A new indicator of CO2 pollution is tested using the delta13C variation in a C4 grass: Eleusine indica. A range of about 4 per thousand delta units was observed at different sites in Cotonou, the largest city in the Republic of Benin. The highest delta13C values, from -12 per thousand to -14 per thousand, were found in low traffic zones; low delta13C values, from -14 per thousand to -16 per thousand, were found in high traffic zones. The amount of fossil fuel carbon assimilated by plants represented about 20% of the total plant carbon content. An overall decrease in plant delta13C values was observed over a four-year monitoring period. This decrease was correlated with increasing vehicle traffic. The delta13C dataset and the corresponding geographical database were used to map and define zones of high and low 13C-depleted CO2 emissions in urban and sub-urban areas. The spatial distribution follows dominant wind directions, with the lowest emission zones found in the southwest of Cotonou. High CO2 emissions occurred in the north, the east and the center, providing evidence of intense anthropogenic activity related to industry and transportation.

  14. Pre-hospitalization, hospitalization, and post-hospitalization costs of patients with neurocysticercosis treated at the Instituto Nacional de Neurologia y Neurocirugia (INNN) in Mexico City, Mexico.

    PubMed

    Bhattarai, Rachana; Carabin, Hélène; Flores-Rivera, Jose; Corona, Teresa; Proaño, Jefferson V; Flisser, Ana; Budke, Christine M

    2018-01-01

    The objective of this study was to estimate the direct costs associated with the diagnosis and treatment of neurocysticercosis (NCC) during pre-hospitalization, hospitalization, and post-hospitalization periods for 108 NCC patients treated at the Instituto Nacional de Neurologia y Neurocirugia (INNN) in Mexico City, Mexico. Information on clinical manifestations, diagnostic tests, hospitalizations, surgical procedures, prescription medication, and other treatments was collected via medical chart reviews. Uncertain values for costs and frequency of treatments were imputed using bootstrap techniques. The average per-patient pre-hospitalization and hospitalization costs were US$ 257 (95% CI: 185 - 329) and US$ 2,576 (95% CI: 2,244 - 2,908), respectively. Post-hospitalization costs tended to decrease over time, with estimates for the first five years post-hospitalization of US$ 475 (95% CI: 423 - 527), US$ 228 (95% CI: 167 - 288), US$ 157 (95% CI: 111 - 202), US$ 150 (95% CI: 106 - 204), and US$ 91 (95% CI: 27 - 154), respectively. NCC results in a significant economic burden for patients requiring hospitalization, with this burden continuing years post-hospitalization.

  15. Evaluation of Hospitals' Disaster Preparedness Plans in the Holy City of Makkah (Mecca): A Cross-Sectional Observation Study.

    PubMed

    Al-Shareef, Ali S; Alsulimani, Loui K; Bojan, Hattan M; Masri, Taha M; Grimes, Jennifer O; Molloy, Michael S; Ciottone, Gregory R

    2017-02-01

    Makkah (Mecca) is a holy city located in the western region of the Kingdom of Saudi Arabia. Each year, millions of pilgrims visit Makkah. These numbers impact both routine health care delivery and disaster response. This study aimed to evaluate hospitals' disaster plans in the city of Makkah. Study investigators administered a questionnaire survey to 17 hospitals in the city of Makkah. Data on hospital characteristics and three key domains of disaster plans (general evaluation of disaster planning, structural feasibility of the hospitals, and health care worker knowledge and training) were collated and analyzed. A response rate of 82% (n=14) was attained. Ten (71%) of the hospitals were government hospitals, whereas four were private hospitals. Eleven (79%) hospitals had a capacity of less than 300 beds. Only nine (64%) hospitals reviewed their disaster plan within the preceding two years. Nine (64%) respondents were drilling for disasters at least twice per year. The majority of hospitals did not rely on a hazard vulnerability analysis (HVA) to develop their Emergency Operations Plan. Eleven (79%) hospitals had the Hospital Incident Command Systems (HICS) present in their plans. All hospitals described availability of some supplies required for the first 24 hours of a disaster response, such as: N95 masks, antidotes for nerve agents, and antiviral medications. Only five (36%) hospitals had a designated decontamination area. Nine (64%) hospitals reported ability to re-designate inpatient wards into an intensive care unit (ICU) format. Only seven (50%) respondents had a protocol for increasing availability of isolation rooms to prevent the spread of airborne infection. Ten (71%) hospitals had a designated disaster-training program for health care workers. Makkah has experienced multiple disaster incidents over the last decade. The present research suggests that Makkah hospitals are insufficiently prepared for potential future disasters. This may represent a

  16. Role of Adult Asthma Education in Improving Asthma Control and Reducing Emergency Room Utilization and Hospital Admissions in an Inner City Hospital

    PubMed Central

    Mishra, Rashmi; Venkatram, Sindhaghatta; George, Teresa; Luo, Kristina; Diaz-Fuentes, Gilda

    2017-01-01

    Objective. Asthma education programs have been shown to decrease healthcare utilization and improve disease control and management. The purpose of our study was to evaluate the impact of an outpatient adult asthma education program in an inner city hospital caring for patients with low socioeconomic and educational status. Methods. An asthma education program was implemented in September 2014. Patients who received education from September 2014 to July 2015 were evaluated. Outcomes were compared for the same group of patients before and after education. Primary outcomes were emergency room (ER) visits and hospital admissions. Secondary outcomes were change in Asthma Control Test (ACT) score and number of pulmonary clinic visits. Results. Asthma education significantly decreased number of patients requiring ER visits and hospital admissions (p = 0.0005 and p = 0.0015, resp.). Asthma control as per ACT score ≥ 20 improved with education (p = 0.0001) with an increase in clinic visits (p = 0.0185). Conclusions. Our study suggests that implementation of a structured asthma education program in an inner city community hospital has a positive impact on reduction of ER visits and hospital admissions with improvement in asthma control. Institutional Review Board Clinical Study registration number is 01081507. PMID:28546781

  17. [Evaluation of a new polyvalent antivenom against snakebite envenomation (Inoserp® Panafricain) in two different epidemiological settings: Northern Benin and Maritime Guinea].

    PubMed

    Chippaux, J-P; Baldé, M C; Sessinou, É; Yéro Boiro, M; Massougbodji, A

    2015-01-01

    The authors evaluated the safety and efficacy of Inoserp(®) Pan Africa, a new polyvalent antivenom composed of highly purified and lyophilized fragments of F(ab')2 immunoglobulins, recently registered in Benin and Guinea. We treated 100 patients in northern Benin (Atacora) and 109 in Maritime Guinea (Kindia) with confirmed envenomation. Treatment consisted of intravenous administration of 1 vial for uncomplicated envenomation, and 2 vials for hemorrhagic or neurotoxic envenomation. The dose was repeated when bleeding or signs of neurotoxicity persisted or appeared. In Atacora, on arrival at the hospital, 90% of patients had incoagulable blood, and 50% were bleeding. The resolution of these bleeding disorders was obtained in less than 3 hours for 50% of the patients and in less than 24 hours for 98%. Four patients died. In Kindia, 96 patients (88%) presented viper bites with pain + edema and 13 (12 %) others showed elapid (ptosis, dyspnea) envenomation. One patient bitten by a member of the Elapidae family, died despite early treatment. In Benin, protocol deviations for 60% of patients led to significant underdosing of the antivenom; the proportion was much lower (2%) in Guinea. Signs of intolerance after Inoserp(®) Pan Africa administration were reported in 8% of patients. All these symptoms were mild and disappeared rapidly after an antihistamine or corticosteroid treatment. Treatment using intravenous Inoserp(®) Pan Africa appeared to be well tolerated and effective against snakebite envenomation in both epidemiological settings.

  18. Characteristics of Asthmatic Patients with and without Repeat Emergency Department Visits at an Inner City Hospital

    PubMed Central

    Pai, Sucheta; Mancuso, Carol A.; Loganathan, Raghu; Boutin-Foster, Carla; Basir, Riyad; Kanna, Balavenkatesh

    2014-01-01

    Objective The objective of this study was to document the frequency and clinical characteristics associated with repeat emergency department (ED) visits for asthma in an inner city population with a high burden of asthma. Methods During an ED visit for asthma in an inner city hospital (‘index visit’), patients completed a valid survey addressing disease and behavioral factors. Hospital records were reviewed for information about ED visits and hospitalizations for asthma during the 12 months before and the 90 days after the index visit. Results 192 patients were enrolled; the mean age was 42 years, 69% were women, 36% were black, 54% were Latino, 69% had Medicaid, and 17% were uninsured. 100 patients (52%) were treated and released from the ED, 88 patients (46%) were hospitalized, and 4 patients (2%) left against medical advice. During the subsequent 90 days, 64 patients (33%) had at least one repeat ED visit for asthma and 27 (14%) were hospitalized for asthma. In a multivariate model, more past ED visits (OR 1.7, 95% CI 1.4, 2.1; p<.0001) and male gender (OR 2.5, 95% CI 1.2, 5.4; p=.02) remained associated with having a repeat ED visit. Most patients had the first repeat ED visit within 30 days and 18 returned within only 7 days. Among all patients with a repeat visit, those who were not hospitalized for the index visit were more likely to have a repeat visit within 7 days (37%) compared to those who were hospitalized (17%) (p=.05 in multivariate analysis). Conclusions Repeat ED visits were prevalent among inner city asthma patients and most occurred shortly after the index visit. The strongest predictors of repeat visits were male gender and more ED visits in the 12 months before the index visit. PMID:24588683

  19. Characteristics of asthmatic patients with and without repeat emergency department visits at an inner city hospital.

    PubMed

    Pai, Sucheta; Mancuso, Carol A; Loganathan, Raghu; Boutin-Foster, Carla; Basir, Riyad; Kanna, Balavenkatesh

    2014-08-01

    Abstract Objective: The objective of this study was to document the frequency and clinical characteristics associated with repeat emergency department (ED) visits for asthma in an inner city population with a high burden of asthma. During an ED visit for asthma in an inner city hospital ('index visit'), patients completed a valid survey addressing disease and behavioral factors. Hospital records were reviewed for information about ED visits and hospitalizations for asthma during the 12 months before and the 90 days after the index visit. One hundred and ninety-two patients were enrolled; the mean age was 42 years, 69% were women, 36% were black, 54% were Latino, 69% had Medicaid, and 17% were uninsured. 100 patients (52%) were treated and released from the ED, 88 patients (46%) were hospitalized, and 4 patients (2%) left against medical advice. During the subsequent 90 days, 64 patients (33%) had at least one repeat ED visit for asthma and 27 (14%) were hospitalized for asthma. In a multivariate model, more past ED visits (OR 1.7, 95% CI 1.4, 2.1; p < 0.0001) and male gender (OR 2.5, 95% CI 1.2, 5.4; p = 0.02) remained associated with having a repeat ED visit. Most patients had the first repeat ED visit within 30 days and 18 returned within only 7 days. Among all patients with a repeat visit, those who were not hospitalized for the index visit were more likely to have a repeat visit within 7 days (37%) compared to those who were hospitalized (17%) (p = 0.05 in multivariate analysis). Repeat ED visits were prevalent among inner city asthma patients and most occurred shortly after the index visit. The strongest predictors of repeat visits were male gender and more ED visits in the 12 months before the index visit.

  20. Epidemiology of hepatitis E virus infection during pregnancy in Benin.

    PubMed

    De Paschale, Massimo; Ceriani, Cristina; Romanò, Luisa; Cerulli, Teresa; Cagnin, Debora; Cavallari, Serena; Ndayake, Joseph; Zaongo, Dieudonné; Diombo, Kouma; Priuli, Gianbattista; Viganò, Paolo; Clerici, Pierangelo

    2016-01-01

    Hepatitis E virus (HEV) is the cause of enterically transmitted non-A, non-C hepatitis (an infection that is particularly severe during pregnancy) in tropical and subtropical countries. As there are no published data concerning the prevalence of HEV antibodies in Benin, their presence was investigated in pregnant women undergoing routine HIV screening in a rural area in northern Benin and in pregnant women with acute non-A, non-C hepatitis. A total of 278 serum samples were collected from asymptomatic pregnant women in 2011 were tested for HEV and hepatitis A virus (HAV) antibodies, and the HEV IgM-positive samples were further tested for HEV-RNA. A further seven samples of pregnant women with acute non-A, non-C hepatitis collected during episodes of acute hepatitis in 2005 were also analysed. Of the 278 samples collected in 2011, 16.19% were positive for HEV IgG and 1.44% for HEV IgM (none positive for HEV-RNA), and 99.64% were positive for total HAV antibodies (none positive for HAV IgM). Six of the seven samples collected in 2005 were positive for HEV IgG and IgM, and two were also positive for HEV-RNA. The circulation of HEV infection is significant among pregnant women in Benin, in whom the consequences may be fatal. © 2015 John Wiley & Sons Ltd.

  1. THE IMPACT OF MEASURES OF SOCIOECONOMIC STATUS ON HOSPITAL PROFILING IN NEW YORK CITY

    PubMed Central

    Blum, Alexander B.; Egorova, Natalia N.; Sosunov, Eugene A.; Gelijns, Annetine C.; DuPree, Erin; Moskowitz, Alan J.; Federman, Alex D.; Ascheim, Deborah D.; Keyhani, Salomeh

    2014-01-01

    Background Current 30-day readmission models used by the Center for Medicare and Medicaid Services for the purpose of hospital-level comparisons lack measures of socioeconomic status (SES). We examined whether the inclusion of a SES measure in 30-day congestive heart failure (CHF) readmission models changed hospital risk standardized readmission rates (RSRR) in New York City (NYC) hospitals. Methods and Results Using a Centers for Medicare & Medicaid Services (CMS)-like model we estimated 30-day hospital-level RSRR by adjusting for age, gender and comorbid conditions. Next, we examined how hospital RSRRs changed relative to the New York City mean with inclusion of the Agency for Healthcare Research and Quality (AHRQ) validated SES index score. In a secondary analysis, we examined whether inclusion of the AHRQ SES Index score in 30-day readmission models disproportionately impacted the RSRR of minority-serving hospitals. Higher AHRQ SES scores, indicators of higher socioeconomic status, were associated with lower odds, 0.99, of 30-day readmission (p< 0.019). The addition of the AHRQ SES index did not change the model’s C statistic (0.63). After adjustment for the AHRQ SES index, one hospital changed status from “worse than the NYC average” to “no different than the NYC average”. After adjustment for the AHRQ SES index, one NYC minority-serving hospital was re-classified from “worse” to “no different than average”. Conclusions While patients with higher SES were less likely to be admitted, the impact of SES on readmission was very small. In NYC, inclusion of the AHRQ SES score in a CMS based model did not impact hospital-level profiling based on 30-day readmission. PMID:24823956

  2. The contribution of geography to black/white differences in the use of low neonatal mortality hospitals in New York City.

    PubMed

    Hebert, Paul L; Chassin, Mark R; Howell, Elizabeth A

    2011-02-01

    Racial differences in the use of high-quality hospital care contribute to racial disparities in mortality for very low birth weight (VLBW) neonates. We explored the role that geographic distribution of hospitals plays in the racial disparity in the use of top-tier hospitals by mothers of VLBW neonates in New York City. Retrospective analysis of Vital Statistics and administrative databases. VLBW deliveries in New York City from 1996 to 2001 to non-Hispanic Black (n = 4947) and non-Hispanic White (n = 1615) mothers. Black mothers were less likely to deliver in a top-tier hospitals (White = 44%, Black = 28%; P < 0.001) and top-tier hospitals were less likely to be located in Black mothers' neighborhoods (White = 40%, Black = 33%; P < 0.001). Distance, however, did not contribute to the disparity in use of top-tier hospitals. Non-Hispanic Black mothers lived marginally closer to a top-tier hospital than non-Hispanic White mothers (0.65 miles closer; P < 0.001), and mothers of both the races often bypassed their neighborhood hospital (Black = 62% bypassed, White = 71%; P < 0.001). Inattention to recommended prenatal behaviors was associated with using a closer hospital, suggesting that geographic proximity was most important to mothers of vulnerable neonates. Purported measures of hospital quality such as Neonatal Intensive Care Unit level and volume were more strongly associated with use of hospital for White mothers than for Black mothers. The influence of geography on the use of top-tier hospitals for mothers of VLBW neonates is complex. Other personal and hospital characteristics, not just distance or geography, also influenced hospital use in New York City.

  3. LISREL Model Medical Solid Infectious Waste Hazardous Hospital Management In Medan City

    NASA Astrophysics Data System (ADS)

    Simarmata, Verawaty; Siahaan, Ungkap; Pandia, Setiaty; Mawengkang, Herman

    2018-01-01

    Hazardous and toxic waste resulting from activities at most hospitals contain various elements of medical solid waste ranging from heavy metals that have the nature of accumulative toxic which are harmful to human health. Medical waste in the form of gas, liquid or solid generally include the category or the nature of the hazard and toxicity waste. The operational in activities of the hospital aims to improve the health and well-being, but it also produces waste as an environmental pollutant waters, soil and gas. From the description of the background of the above in mind that the management of solid waste pollution control medical hospital, is one of the fundamental problems in the city of Medan and application supervision is the main business licensing and control alternatives in accordance with applicable regulations.

  4. An Assessment of Host Associations, Geographic Distributions, and Genetic Diversity of Avian Chewing Lice (Insecta: Phthiraptera) from Benin.

    PubMed

    Takano, Oona M; Mitchell, Preston S; Gustafsson, Daniel R; Adite, Alphonse; Voelker, Gary; Light, Jessica E

    2017-04-01

    Host associations of highly host-specific chewing lice (Insecta: Phthiraptera) across multiple avian species remains fairly undocumented in the West African country of Benin. Two hundred and seventeen bird specimens collected from multiple localities across Benin and housed at the Texas A&M University Biodiversity Research and Teaching Collections were examined for lice. Lice were identified and genetic data (mitochondrial COI and nuclear EF-1α genes) were obtained and phylogenetically analyzed. In total, we found 15 host associations, 7 of which were new to science. Genetically, most lice from Benin were unique and could represent new species. Based on host associations and unique genetic lineages, we estimate we discovered a minimum of 4 and possibly as many as 8 new chewing louse species. Given the lack of current data on chewing louse species distributions in Benin, this study adds to the knowledge of host associations, geographic distribution, and genetic variability of avian chewing louse species in West Africa.

  5. "You Who Have Been to School, What Have You Become?": An Ethnographic Study of University Life in Benin

    ERIC Educational Resources Information Center

    Hessling O'Neil, Marcy

    2012-01-01

    This dissertation examines the relationship between higher education and social mobility among students and their families in Benin, West Africa. In this study I draw on ethnographic research conducted at the public University of Abomey-Calavi in Cotonou, Benin in 2010. I utilize interviews, historical documents, and participant observation to…

  6. [Investigation on current situation of malaria blood examinations in township-level hospitals of Nantong City].

    PubMed

    Gui-Sheng, Ding; Cai-Qun, Cao; Ping, Miao; Mei-Fang, Gu; Xiao-Bin, Cao

    2016-11-18

    To understand the quality of malaria blood examinations in township-level hospitals, so as to provide the evidence for continuing the malaria blood examinations in the stage of post-malaria elimination. A total of 64 township hospitals were investigated and 640 negative malaria blood slides were scored individually according to 10 indicators in "Malaria Elimination Technical Scheme" in 2013 and 2014. The single and multiple indicators were calculated, and the work of blood examinations and situation of technicians were investigated. The data of malaria blood examinations and patient discovery in township hospitals of Nantong City were collected and analyzed during the period of 2011-2014. For the single indicator, 29.5% of the thick blood films did not reach the standard, and 35.8% of thin blood films did not reach the standard. For the multiple indicators, blood slides with more than 4 indicators below the standard (poor quality) accounted for 32.5%. From malaria blood examinations and malaria situation, the number of slides was 194 635 during the period of 2011-2014, and there were no local vivax malaria casesin 4 consecutive years from 2011 to 2014, and local malaria has been effectively controlled in Nantong City. For health facilities where malaria patients initially presented, the township and village level accounted for 16.3%, and county and higher level accounted for 83.7%. The quality of malaria blood examinations in township level hospitals of Nantong City is not high and the microscopic examination has a relatively low efficiency in the discovery of malaria cases. A new model for malaria blood examinations needs to be further explored.

  7. Lifelong learning as an instrument for human capital development in Benin

    NASA Astrophysics Data System (ADS)

    Biao, Idowu

    2015-10-01

    A review of the Benin education system shows that it is still heavily school-based. Yet, a high level of wastage is currently being recorded at school level (about 50% success rate at primary level, about 40% success rate at high school level and about 1% enrolment rate of qualified candidates and success rate at tertiary level), leading to the unintentional creation of a large population of unskilled and unproductive youths and adults. Integrated education systems which hold great potential and opportunities for both initial and continuing education remain hardly explored and virtually untapped. Yet, the challenges of the 21st century are such that only the unveiling and continuous cultivation of multi-faceted human capital can help individual citizens lead both a productive and fulfilled life. Formal education alone or non-formal education alone, irrespective of how well each is delivered, is no longer sufficient in facing up to the multifarious challenges of the 21st century. If education is to serve Benin beneficially in this century, the current national system of education must be reoriented to free up citizens' human capital through the implementation of an integrated educational system. This article proposes a new national education system which is rooted in the concept of lifelong learning and combines formal and non-formal systems of education for Benin.

  8. Risk Factors for Nonelective Hospitalization in Frail and Older Adult, Inner-City Outpatients.

    ERIC Educational Resources Information Center

    Damush, Teresa M.; Smith, David M.; Perkins, Anthony J.; Dexter, Paul R.; Smith, Faye

    2004-01-01

    Purpose: In our study, we sought to improve the accuracy of predicting the risk of hospitalization and to identify older, inner-city patients who could be targeted for preventive interventions. Design and Methods: Participants (56% were African American) in a randomized trial were from a primary care practice and included 1,041 patients living in…

  9. Non-consensual sex in Benin.

    PubMed

    Gharoro, E P; Enabudoso, E J; Sodje, D K J

    2011-01-01

    The objective of the study is to investigate the prevalence and risk factors of non-consensual sex/rape in Benin. We surveyed 580 females in the University Community of Benin, 414 questionnaires were sufficiently completed for analysis. Seventy-six (18.4%) respondents reported that they had been victims of non-consensual sex (NCS), 36 in their current relationship. The unmarried single respondents had the lowest mean age at NCS experience of 18 years, while the divorced victims had the highest mean age of 32.5 ( P = 0.000). There was a major exposure peak age at 19 years with a smaller peak at 25. The majority of sex offenders were their present partners and next the husbands (22.2%). The father was the perpetrator on one (2.78%) occasion, while armed robbers raped two of the victims. Eighteen of the seventy-six respondents made a formal report. Cumulatively, 95.4% of the respondents felt it was futile reporting, four (5.3%) felt it was not all a bad experience. The risk of being infected with the HIV/AIDS virus was the worst fear. Ninety-five of four hundred and fourteen respondents want the public and parents to be educated, 64 would like the penal code to be tougher and better implemented, while 64 (14.0%) crave for a dress code for the University community. The self-reported incidence of NCS is high, majority were not formally reported as most of the sex offenders were the (ex)partners of the victims. There was a major exposure peak age at 19 with a smaller peak at 25 years. There was a condoned sense of futility and frustration in reporting.

  10. Use of Nutrition Standards to Improve Nutritional Quality of Hospital Patient Meals: Findings from New York City's Healthy Hospital Food Initiative.

    PubMed

    Moran, Alyssa; Lederer, Ashley; Johnson Curtis, Christine

    2015-11-01

    Most hospital patient meals are considered regular-diet meals; these meals are not required to meet comprehensive nutrition standards for a healthy diet. Although programs exist to improve nutrition in hospital food, the focus is on retail settings such as vending machines and cafeterias vs patient meals. New York City's Healthy Hospital Food Initiative (HHFI) provides nutrition standards for regular-diet meals that hospitals can adopt, in addition to retail standards. This study was undertaken to describe regular-diet patient menus before and after implementation of the HHFI nutrition standards. The study involved pre- and post- menu change analyses of hospitals participating in the HHFI between 2010 and 2014. Eight New York City hospitals, selected based on voluntary participation in the HHFI, were included in the analyses. Nutritional content of regular-diet menus were compared with the HHFI nutrition standards. Nutrient analysis and exact Wilcoxon signed-rank tests were used for the analysis of the data. At baseline, no regular-diet menu met all HHFI standards, and most exceeded the daily limits for percentage of calories from fat (n=5), percentage of calories from saturated fat (n=5), and milligrams of sodium (n=6), and they did not meet the minimum grams of fiber (n=7). Hospitals met all key nutrient standards after implementation, increasing fiber (25%, P<0.01) and decreasing sodium (-19%, P<0.05), percentage of calories from fat (-24%, P<0.01), and percentage of calories from saturated fat (-21%, P<0.05). A significant increase was seen in fresh fruit servings (667%, P<0.05) and decreases in full-fat and reduced-fat milk servings (-100%, P<0.05), refined grain servings (-35%, P<0.05), and frequency of desserts (-92%, P<0.05). Regular diet menus did not comply with the HHFI nutrition standards at baseline. Using the HHFI framework, hospitals significantly improved the nutritional quality of regular-diet patient menus. The standards were applied across

  11. Limited sterile processing capabilities for safe surgery in low-income and middle-income countries: experience in the Republic of Congo, Madagascar and Benin.

    PubMed

    Fast, Olive; Fast, Christina; Fast, Dan; Veltjens, Suzanne; Salami, Zouliha; White, Michelle C

    2017-01-01

    It is highly difficult to perform safe surgery without sterile instruments, yet the capacity to adequately clean, disinfect and sterilise surgical instruments in low-income and middle-income countries is largely unknown. Sterile Processing Education Charitable Trust developed an assessment tool and, in partnership with Mercy Ships, evaluated the sterile processing capacity in 59 facilities in Madagascar, Benin and the Republic of Congo. This data-driven analysis paper illustrates how lack of sterile processing capacity acts as a barrier to safe surgical care. Our tool identified widespread lack of knowledge of techniques and resources needed for sterile processing. Only 12% of workers in Republic of Congo and Benin had sterile processing training and none in Madagascar. None of the hospitals surveyed met basic standards for cleaning, disinfection and sterilisation as defined by the WHO/Pan American Health Organization. Examples of poor practice included lack of cleaning supplies (basic brushes and detergents), incorrect drying and storage of surgical instruments, and inattention to workflow causing cross-contamination. Bleach (sodium hypochlorite) solutions, damaging to instruments, were used universally. In our experience, using an assessment tool allowed identification of specific gaps in sterile processing capacity. Many of the gaps are amenable to simple solutions requiring minimal resources and achievable by most hospitals. We recommend that stakeholders seeking to strengthen surgical health systems in low-resource settings incorporate sterile processing capacity assessments and training into their programmes.

  12. Limited sterile processing capabilities for safe surgery in low-income and middle-income countries: experience in the Republic of Congo, Madagascar and Benin

    PubMed Central

    Fast, Olive; Fast, Christina; Fast, Dan; Veltjens, Suzanne; Salami, Zouliha

    2017-01-01

    It is highly difficult to perform safe surgery without sterile instruments, yet the capacity to adequately clean, disinfect and sterilise surgical instruments in low-income and middle-income countries is largely unknown. Sterile Processing Education Charitable Trust developed an assessment tool and, in partnership with Mercy Ships, evaluated the sterile processing capacity in 59 facilities in Madagascar, Benin and the Republic of Congo. This data-driven analysis paper illustrates how lack of sterile processing capacity acts as a barrier to safe surgical care. Our tool identified widespread lack of knowledge of techniques and resources needed for sterile processing. Only 12% of workers in Republic of Congo and Benin had sterile processing training and none in Madagascar. None of the hospitals surveyed met basic standards for cleaning, disinfection and sterilisation as defined by the WHO/Pan American Health Organization. Examples of poor practice included lack of cleaning supplies (basic brushes and detergents), incorrect drying and storage of surgical instruments, and inattention to workflow causing cross-contamination. Bleach (sodium hypochlorite) solutions, damaging to instruments, were used universally. In our experience, using an assessment tool allowed identification of specific gaps in sterile processing capacity. Many of the gaps are amenable to simple solutions requiring minimal resources and achievable by most hospitals. We recommend that stakeholders seeking to strengthen surgical health systems in low-resource settings incorporate sterile processing capacity assessments and training into their programmes. PMID:29225957

  13. Can hospital audit teams identify case management problems, analyse their causes, identify and implement improvements? A cross-sectional process evaluation of obstetric near-miss case reviews in Benin.

    PubMed

    Borchert, Matthias; Goufodji, Sourou; Alihonou, Eusèbe; Delvaux, Thérèse; Saizonou, Jacques; Kanhonou, Lydie; Filippi, Véronique

    2012-10-11

    Obstetric near-miss case reviews are being promoted as a quality assurance intervention suitable for hospitals in low income countries. We introduced such reviews in five district, regional and national hospitals in Benin, West Africa. In a cross-sectional study we analysed the extent to which the hospital audit teams were able to identify case management problems (CMPs), analyse their causes, agree on solutions and put these solutions into practice. We analysed case summaries, women's interview transcripts and audit minutes produced by the audit teams for 67 meetings concerning one woman with near-miss complications each. We compared the proportion of CMPs identified by an external assessment team to the number found by the audit teams. For the latter, we described the CMP causes identified, solutions proposed and implemented by the audit teams. Audit meetings were conducted regularly and were well attended. Audit teams identified half of the 714 CMPs; they were more likely to find managerial ones (71%) than the ones relating to treatment (30%). Most identified CMPs were valid. Almost all causes of CMPs were plausible, but often too superficial to be of great value for directing remedial action. Audit teams suggested solutions, most of them promising ones, for 38% of the CMPs they had identified, but recorded their implementation only for a minority (8.5%). The importance of following-up and documenting the implementation of solutions should be stressed in future audit interventions. Tools facilitating the follow-up should be made available. Near-miss case reviews hold promise, but their effectiveness to improve the quality of care sustainably and on a large scale still needs to be established.

  14. Can hospital audit teams identify case management problems, analyse their causes, identify and implement improvements? A cross-sectional process evaluation of obstetric near-miss case reviews in Benin

    PubMed Central

    2012-01-01

    Background Obstetric near-miss case reviews are being promoted as a quality assurance intervention suitable for hospitals in low income countries. We introduced such reviews in five district, regional and national hospitals in Benin, West Africa. In a cross-sectional study we analysed the extent to which the hospital audit teams were able to identify case management problems (CMPs), analyse their causes, agree on solutions and put these solutions into practice. Methods We analysed case summaries, women’s interview transcripts and audit minutes produced by the audit teams for 67 meetings concerning one woman with near-miss complications each. We compared the proportion of CMPs identified by an external assessment team to the number found by the audit teams. For the latter, we described the CMP causes identified, solutions proposed and implemented by the audit teams. Results Audit meetings were conducted regularly and were well attended. Audit teams identified half of the 714 CMPs; they were more likely to find managerial ones (71%) than the ones relating to treatment (30%). Most identified CMPs were valid. Almost all causes of CMPs were plausible, but often too superficial to be of great value for directing remedial action. Audit teams suggested solutions, most of them promising ones, for 38% of the CMPs they had identified, but recorded their implementation only for a minority (8.5%). Conclusions The importance of following-up and documenting the implementation of solutions should be stressed in future audit interventions. Tools facilitating the follow-up should be made available. Near-miss case reviews hold promise, but their effectiveness to improve the quality of care sustainably and on a large scale still needs to be established. PMID:23057707

  15. Integrating HIV testing and care into tuberculosis services in Benin: programmatic aspects.

    PubMed

    Ferroussier, O; Dlodlo, R A; Capo-Chichi, D; Boillot, F; Gninafon, M; Trébucq, A; Fujiwara, P I

    2013-11-01

    Between 2005 and 2008, the diagnosis and care of human immunodeficiency virus (HIV) infection and tuberculosis (TB) services were integrated in Benin. The appointment of a TB-HIV Coordinator by the National Tuberculosis Control Programme and quarterly supervisory visits to TB clinics have bolstered the implementation of integrated HIV-TB activities. HIV testing and cotrimoxazole preventive therapy were integrated smoothly into the TB services. The strategy chosen to facilitate access of HIV-positive TB patients to antiretroviral treatment contributed to greater integration over time, but perpetuated, for some, the burden of attending two facilities. The integration and decentralisation of TB and HIV care services at national level in Benin resulted in a high uptake of HIV services among TB patients.

  16. The malaria testing and treatment landscape in Benin.

    PubMed

    Zinsou, Cyprien; Cherifath, Adjibabi Bello

    2017-04-26

    Since 2004, artemisinin-based combination therapy (ACT) has been the first-line treatment for uncomplicated malaria in Benin. In 2016, a medicine outlet survey was implemented to investigate the availability, price, and market share of anti-malarial treatment and malaria diagnostics. Results provide a timely and important benchmark to measure future interventions aimed at increasing access to quality malaria case management services. Between July 5th to August 6th 2016, a cross sectional, nationally-representative malaria outlet survey was conducted in Benin. A census of all public and private outlets with potential to distribute malaria testing and/or treatment was implemented among 30 clusters (arrondissements). Outlets were eligible for inclusion in the study if they met at least one of three study criteria: (1) one or more anti-malarials reportedly in stock on the day of the survey; (2) one or more anti-malarials reportedly in stock within the 3 months preceding the survey; and/or (3) provided malaria blood testing. An audit was completed for all anti-malarials, malaria rapid diagnostic tests (RDT) and microscopy. 7260 outlets with the potential to sell or distribute anti-malarials were included in the census and 2966 were eligible and interviewed. A total of 17,669 anti-malarial and 494 RDT products were audited. Quality-assured ACT was available in 95.0% of all screened public health facilities and 59.4% of community health workers (CHW), and availability of malaria blood testing was 94.7 and 68.4% respectively. Sulfadoxine-pyrimethamine (SP) was available in 73.9% of public health facilities and not found among CHWs. Among private-sector outlets stocking at least one anti-malarial, non-artemisinin therapies were most commonly available (94.0% of outlets) as compared to quality-assured ACT (36.1%). 31.3% of the ACTs were marked with a "green leaf" logo, suggesting leakage of a co-paid ACT into Benin's unsubsidized ACT market from another country. 78.5% of

  17. Factors affecting turnover intentions among public hospital doctors in a middle-level city in central China.

    PubMed

    Zhang, Fengfan; Luo, Zhenni; Chen, Ting; Min, Rui; Fang, Pengqian

    2017-05-01

    Objective The aim of the present study was to explore prominent factors affecting turnover intentions among public hospital doctors in urban areas, particularly in Xiangyang City, Hubei Province, a middle-level city in central China. Methods Questionnaires were used to collect data from 284 public hospital doctors. Pearson's Chi-squared was used to assess whether sociodemographic and other factors were related to the turnover intentions of public hospital doctors. Binary logistic regression was performed to determine the significant factors that influence turnover intentions. Results The analysis revealed that 28.2% of public hospital doctors intended to leave the hospital where they were currently employed. Dissatisfaction with working conditions and hospital management processes, as well as work pressures, were significant factors contributing to the turnover intentions of public hospital doctors. Conclusion Research into turnover intentions indicates that public hospital doctors surveyed in urban China give greater weight to their professional environment and career development rather than salary in their employment decisions. What is known about the topic? Turnover of medical staff is a concern to hospital administrators because it is costly and detrimental to organisational performance and quality of care. Most studies have focused on the effects of individual and organisational factors on nurses' intentions to leave their employment. Income dissatisfaction was one of the determining factors of turnover intentions in previous studies. What does this paper add? The satisfaction of public hospital doctors with regard to income is not a determining factor of turnover intentions. In contrast with findings of previous studies, the doctors in public hospitals in urban China in the present study gave greater weight to their professional environment and career development in their employment decisions. What are the implications for practitioners? The findings suggest

  18. [Research Ethics in Partnership with Benin : A call for Solidarity].

    PubMed

    Bergeron, Michel

    2017-05-22

    Over the last decade, research ethics has developed in Benin partly through a partnership with Quebec. This partnership has evolved using TCPS2, the Canadian framework in research ethics. In doing so, three main values were put forward : respect for human dignity, respect for cultural diversity and solidarity. Over that time period, research ethics in Benin has structured through new Research Ethics Committees (REC) and though participation of those involved in research with human beings. REC members, researchers and students have acquired the needed tools to resolve most of the ethical dilemmas that could arise in the future making it one of the positive results of this partnership. Retrospectively, it has also been a situation where the Van Rensselaer Potter's perspective on bioethics has emerged in a French-speaking context where the spoken language and the French cultural approach is of great importance.

  19. The Sewol Ferry Disaster: Experiences of a Community-Based Hospital in Ansan City.

    PubMed

    Park, Jong-Hak; Cho, Hanjin; Kim, Joo Yeong; Song, Joo-Hyun; Moon, Sungwoo; Cha, Sang Hoon; Choi, Byung-Min; Han, Chang-Su; Ko, Young-Hoon; Lee, Hongjae

    2017-06-01

    The Sewol ferry disaster is one of the most tragic events in Korea's modern history. Among the 476 people on board, which included Danwon High School students (324) and teachers (14), 304 passengers died in the disaster (295 recovered corpses and 9 missing) and 172 survived. Of the rescued survivors, 72 were attending Danwon High School, located in Ansan City, and residing in a residence nearby. Because the students were young, emotionally susceptible adolescents, both the government and the parents requested the students be grouped together at a single hospital capable of appropriate psychiatric care. Korea University Ansan Hospital was the logical choice, as the only third-tier university-grade hospital with the necessary faculty and facilities within the residential area of the families of the students. We report the experiences and the lessons learned from the processes of preparing for and managing the surviving young students as a community-based hospital. (Disaster Med Public Health Preparedness. 2017;11:389-393).

  20. System redesign of the immunization supply chain: Experiences from Benin and Mozambique.

    PubMed

    Prosser, Wendy; Jaillard, Philippe; Assy, Emmanuelle; Brown, Shawn T; Matsinhe, Graça; Dekoun, Mawutondji; Lee, Bruce Y

    2017-04-19

    Evidence suggests that immunization supply chains are becoming outdated and unable to deliver needed vaccines due to growing populations and new vaccine introductions. Redesigning a supply chain could result in meeting current demands. The Ministries of Health in Benin in Mozambique recognized known barriers to the immunization supply chain and undertook a system redesign to address those barriers. Changes were made to introduce an informed push system while consolidating storage points, introducing transport loops, and increasing human resource capacity for distribution. Evaluations were completed in each country. Evaluation in each country indicated improved performance of the supply chain. The Effective Vaccine Management (EVM) assessment in Benin documented notable improvements in the distribution criteria of the tool, increasing from 40% to 100% at the district level. In Mozambique, results showed reduced stockouts at health facility level from 79% at baseline to less than 1% at endline. Coverage rates of DTP3 also increased from 68.9% to 92.8%. Benin and Mozambique are undertaking system redesign in order to respond to constraints identified in the vaccine supply chain. Results and learnings show improvements in supply chain performance and make a strong case for system redesign. These countries demonstrate the feasibility of system redesign for other countries considering how to address outdated supply chains. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  1. Insular pathways to health care in the city: a multilevel analysis of access to hospital care in urban Kerala, India.

    PubMed

    Levesque, Jean-Frédéric; Haddad, Slim; Narayana, Delampady; Fournier, Pierre

    2007-07-01

    To identify individual and urban unit characteristics associated with access to inpatient care in public and private sectors in urban Kerala, and to discuss policy implications of inequalities in access. We analysed the NSSO survey (1995-1996) for urban Kerala with regard to source and trajectories of hospitalization. Multinomial multilevel regression models were built for 695 cases nested in 24 urban units. Private sector accounts for 62% of hospitalizations. Only 31% of hospitalizations are in free wards and 20% of public hospitalizations involve payment. Hospitalization pathways suggest a segmentation of public and private health markets. Members of poor and casual worker households have lower propensity of hospitalization in paying public wards or private hospitals. There were important variations between cities, with higher odds of private hospitalization in towns with fewer hospital beds overall and in districts with high private-public bed ratios. Cities from districts with better economic indicators and dominance of private services have higher proportion of private hospitalizations. The private sector is the predominant source of inpatient care in urban Kerala. The public sector has an important role in providing access to care for the poor. Investing in the quality of public services is essential to ensure equity in access.

  2. Association of neighborhood-level factors with hospitalization for community-associated methicillin-resistant Staphylococcus aureus, New York City, 2006: a multilevel observational study.

    PubMed

    Farr, Amanda M; Marx, Melissa A; Weiss, Don; Nash, Denis

    2013-02-13

    Hospitalizations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection have increased in New York City, with substantial geographic variation across neighborhoods. While individual-level risk factors, such as age, sex, HIV infection, and diabetes have been described, the role of neighborhood-level factors (e.g., neighborhood HIV prevalence or income) has not been examined. To explore plausible neighborhood-level factors associated with CA-MRSA-related hospitalizations, a retrospective analysis was conducted using New York City hospital discharges from 2006 and New York City-specific survey and health department surveillance data. CA-MRSA-related hospitalizations were identified using diagnosis codes and admission information. Associations were determined by using sex-specific multilevel logistic regression. The CA-MRSA hospitalization rate varied by more than six-fold across New York City neighborhoods. Females hospitalized with CA-MRSA had more than twice the odds of residing in neighborhoods in the highest quintile of HIV prevalence (adjusted odds ratio [AOR](Q5 vs. Q1) 2.3, 95% CI: 1.2, 2.7). Both males and females hospitalized with CA-MRSA had nearly twice the odds of residing in neighborhoods with moderately high proportion of men who have sex with men (MSM) residing in the neighborhood (males: AOR(Q4 vs. Q1) 1.7, 95% CI: 1.1, 2.7; females: AOR(Q4 vs. Q1) 2.0, 95% CI: 1.1, 3.6); but this association did not hold for neighborhoods in the highest quintile (males: AOR(Q5 vs. Q1) 1.2, 95% CI: 0.76, 1.8; females: AOR(Q5 vs. Q1) 1.5, 95% CI: 0.82, 2.7). Neighborhood-level characteristics were associated with CA-MRSA hospitalization odds, independent of individual-level risk factors, and may contribute to the population-level burden of CA-MRSA infection.

  3. Do free caesarean section policies increase inequalities in Benin and Mali?

    PubMed

    Ravit, Marion; Audibert, Martine; Ridde, Valéry; De Loenzien, Myriam; Schantz, Clémence; Dumont, Alexandre

    2018-06-05

    Benin and Mali introduced user fee exemption policies focused on caesarean sections (C-sections) in 2005 and 2009, respectively. These policies had a positive impact on access to C-sections and facility based deliveries among all women, but the impact on socioeconomic inequality is still highly uncertain. The objective of this study was to observe whether there was an increase or a decrease in urban/rural and socioeconomic inequalities in access to C-sections and facility based deliveries after the free C-section policy was introduced. We used data from three consecutive Demographic and Health Surveys (DHS): 2001, 2006 and 2011-2012 in Benin and 2001, 2006 and 2012-13 in Mali. We evaluated trends in inequality in terms of two outcomes: C-sections and facility based deliveries. Adjusted odds ratios were used to estimate whether the distributions of C-sections and facility based deliveries favoured the least advantaged categories (rural, non-educated and poorest women) or the most advantaged categories (urban, educated and richest women). Concentration curves were used to observe the degree of wealth-related inequality in access to C-sections and facility based deliveries. We analysed 47,302 childbirths (23,266 in Benin and 24,036 in Mali). In Benin, we found no significant difference in access to C-sections between urban and rural women or between educated and non-educated women. However, the richest women had greater access to C-sections than the poorest women. There was no significant change in these inequalities in terms of access to C-sections and facility based deliveries after introduction of the free C-section policy. In Mali, we found a reduction in education-related inequalities in access to C-sections after implementation of the policy (p-value = 0.043). Inequalities between urban and rural areas had already decreased prior to implementation of the policy, but wealth-related inequalities were still present. Urban/rural and socioeconomic inequalities in

  4. SEM Model Medical Solid Waste Hospital Management In Medan City

    NASA Astrophysics Data System (ADS)

    Simarmata, Verawaty; Pandia, Setiaty; Mawengkang, Herman

    2018-01-01

    In daily activities, hospitals, as one of the important health care unit, generate both medical solid waste and non-medical solid waste. The occurrence of medical solid waste could be from the results of treatment activities, such as, in the treatment room for a hospital inpatient, general clinic, a dental clinic, a mother and child clinic, laboratories and pharmacies. Most of the medical solid waste contains infectious and hazardous materials. Therefore it should be managed properly, otherwise it could be a source of new infectious for the community around the hospital as well as for health workers themselves. Efforts surveillance of various environmental factors need to be applied in accordance with the principles of sanitation focuses on environmental cleanliness. One of the efforts that need to be done in improving the quality of the environment is to undertake waste management activities, because with proper waste management is the most important in order to achieve an optimal degree of human health. Health development in Indonesian aims to achieve a future in which the Indonesian people live in a healthy environment, its people behave clean and healthy, able to reach quality health services, fair and equitable, so as to have optimal health status, health development paradigm anchored to the healthy. The healthy condition of the individual and society can be influenced by the environment. Poor environmental quality is a cause of various health problems. Efforts surveillance of various environmental factors need to be applied in accordance with the principles of sanitation focuses on environmental cleanliness. This paper proposes a model for managing the medical solid waste in hospitals in Medan city, in order to create healthy environment around hospitals.

  5. Genetic divergence in northern Benin sorghum (Sorghum bicolor L. Moench) landraces as revealed by agromorphological traits and selection of candidate genotypes.

    PubMed

    Dossou-Aminon, Innocent; Loko, Laura Yêyinou; Adjatin, Arlette; Ewédjè, Eben-Ezer B K; Dansi, Alexandre; Rakshit, Sujay; Cissé, Ndiaga; Patil, Jagannath Vishnu; Agbangla, Clément; Sanni, Ambaliou; Akoègninou, Akpovi; Akpagana, Koffi

    2015-01-01

    Sorghum [Sorghum bicolor (L.) Moench] is an important staple food crop in northern Benin. In order to assess its diversity in Benin, 142 accessions of landraces collected from Northern Benin were grown in Central Benin and characterised using 10 qualitative and 14 quantitative agromorphological traits. High variability among both qualitative and quantitative traits was observed. Grain yield (0.72-10.57 tons/ha), panicle weight (15-215.95 g), days to 50% flowering (57-200 days), and plant height (153.27-636.5 cm) were among traits that exhibited broader variability. Correlations between quantitative traits were determined. Grain yield for instance exhibited highly positive association with panicle weight (r = 0.901, P = 0.000) and 100 seed weight (r = 0.247, P = 0.000). UPGMA cluster analysis classified the 142 accessions into 89 morphotypes. Based on multivariate analysis, twenty promising sorghum genotypes were selected. Among them, AT41, AT14, and AT29 showed early maturity (57 to 66 days to 50% flowering), high grain yields (4.85 to 7.85 tons/ha), and shorter plant height (153.27 to 180.37 cm). The results obtained will help enhancing sorghum production and diversity and developing new varieties that will be better adapted to the current soil and climate conditions in Benin.

  6. Validity of equations using knee height to predict overall height among older people in Benin.

    PubMed

    Jésus, Pierre; Mizéhoun-Adissoda, Carmelle; Houinato, Dismand; Preux, Pierre-Marie; Fayemendy, Philippe; Desport, Jean-Claude

    2017-10-01

    Chumlea's formulas are a validated means of predicting overall height from knee height (KH) among people >60 y of age, but, to our knowledge, no formula is validated for use in African countries, including Benin. The aim of this study was to compare height provided by predictive formulas using KH to measured height in an elderly population in Benin. Individuals >60 y of age in Benin underwent nutritional assessment with determination of weight, body mass index (BMI), height, and KH. A Bland-Altman analysis was carried out by sex and age. The percentage of predictions accurate to ±5 cm compared with the measured height was calculated. The tested formulas were Chumlea's formulas for non-Hispanic Black people (CBP) and two formulas for use among Caucasians. Data from 396 individuals (81.1% male) were analyzed. The three formulas achieved 98% accuracy, but with 4.6% risk for error (±2 SD: -6 to +9 cm), which appeared to make them unfit for the whole population. Nevertheless, if a level of prediction ±5 cm is considered acceptable in clinical practice, the CBP formula achieved 83.1% accuracy. Moreover, there was no significant difference in BMI calculated with the measured and the predicted height, and the nutritional status based on BMI did not differ. CBP formulas seem applicable in 83% of cases (±5 cm) to assess the height with KH of older people in Benin and do not overestimate the prevalence of malnutrition. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Enhancing Correctional Education through Community Theatre: The Benin Prison Experience

    ERIC Educational Resources Information Center

    Okhakhu, Marcel; Evawoma-Enuku, Usiwoma

    2011-01-01

    This paper seeks to establish the relationship between Popular Theatre and Correctional Education. The Benin Prison experiment is the springboard for this laudable and valuable link. The paper strives stridently to show the value of Popular Theatre as a vehicle for achieving correctional values in a Correction centre. More than anything else, it…

  8. [Evaluation of customer satisfaction with the hospital catering system in the city of Palermo (Italy)].

    PubMed

    Firenze, Alberto; Morici, Mariagrazia; Calamus, Giuseppe; Gelsomino, Viviana; Aprea, Luigi; Di Benedetto, Antonino; Muangala, Muana A Luila; Centineo, Giovanni; Romano, Nino

    2009-01-01

    The aim of the study was to evaluate patients' customer satisfaction with the hospital catering services of two public hospitals and one private sector hospital in the city of Palermo (Italy). A multiple choice questionnaire was administered by face-to-face interview to 207 of 227 hospitalized patients. Positive responses regarding the perceived quality of food were given especially by patients of the private sector hospital, 80% of which reported being satisfied with the catering service. A higher percentage of patients in the private sector hospital were satisfied with the food distribution modalities with respect to the two public hospitals. Only 3% of patients in the private sector hospital required their families to bring food from home, with respect to 7.9% and 30% respectively in the two public hospitals. Private sector patients also reported appreciating the wide availability of food and the help given by health care workers (79% vs a mean of 55% in the two public hospitals). No differences were found amongst hospitals with regards to the hygienic characteristics of meals. The results of this study indicate the need to make changes in the management of the catering service of one of the involved public hospitals especially.

  9. Abusive Head Trauma at a Tertiary Care Children's Hospital in Mexico City. A Preliminary Study

    ERIC Educational Resources Information Center

    Diaz-Olavarrieta, Claudia; Garcia-Pina, Corina A.; Loredo-Abdala, Arturo; Paz, Francisco; Garcia, Sandra G.; Schilmann, Astrid

    2011-01-01

    Objectives: Determine the prevalence, clinical signs and symptoms, and demographic and family characteristics of children attending a tertiary care hospital in Mexico City, Mexico, to illustrate the characteristics of abusive head trauma among this population. Methods: This is a cross-sectional descriptive study of infants and children under 5,…

  10. Health effects of night shift duty on nurses in a university teaching hospital in Benin City, Nigeria.

    PubMed

    Isah, E C; Iyamu, O A; Imoudu, G O

    2008-06-01

    This study is aimed at identifying the effects of night shift duty on the health and wellbeing of nurses in order to make recommendations on ways of ameliorating them. The study was ofa cross sectional descriptive type using a total sample of nurses in the hospital. Data collection was by means of a semi-structured self-administered questionnaire and the analysis by the computer Programme for Epidemiologists (PEPI). The response rate was 79.3% with a total of 211 (68.1%) having one or more health complaints, which included muscle ache and pains (58.7%), frequent headaches (21.9%), lack of concentration (21.3%) and a negative effect on social life (66.1%). The younger nurses disliked night shift more than the older ones (2 = 57.5, df=6, p = 0.000) and 57.7% felt they were less productive during night shift. The shorter the period of sleep after the night shift, the lesser the level of productivity and the more the manifestation of health symptoms (2 = 45.5, df = 4, p = 0.000 and 2 = 29.0, df = 2, p = 0.000 respectively). Night shift duty caused both medical and psychological problems on the nurses. There is a need for medical surveillance, educational programme and the application of sleep hygiene techniques for shift working nurses.

  11. [Porto and the construction of the modern city: the case of Hospital Geral de Santo António in the eighteenth and nineteenth centuries].

    PubMed

    da Silva, Helena

    2014-01-01

    During a period of demographic and urban growth of the city of Porto, the need arose for a new hospital. The Santa Casa da Misericórdia of Porto, in charge of erecting the new health facility, appointed the British architect John Carr to design the project. By means of the analysis of a set of archival sources and sundry literature on the topic, we examine the criteria chosen for the design and construction of Hospital Geral de Santo António and if it fulfilled expectations, becoming a special space in the city. This article opens up a perspective on the study of the development of the city and the creation of this health facility, contributing to the historical trajectory of hospital architecture.

  12. Pattern of asymptomatic bacteriuria among pregnant women attending an antenatal clinic at a private health facility in Benin, South-South Nigeria.

    PubMed

    Alfred, Aiyebelehin O; Chiedozie, Ike; Martin, Duru U

    2013-01-01

    The objective was to establish the characteristics of antenatal attendees in Faith Medical Centre, a private health facility in Benin City who have asymptomatic bacteriuria (ASB) as well as to determine the relationship between ASB and socioeconomic status. It was a descriptive, cross-sectional study involving 240 pregnant women who presented in the course of antenatal care from January to April 2009. With the aid of a questionnaire patients who were recruited for the study had their socio-demographic data and relevant gynecological and drug history recorded. A physical examination was done to document temperature, height, weight and symphysiofundal height. A clean-catch midstream urine sample was collected for microscopy and culture. White blood cell count of≥5/hpf and/or bacteria count of≥1/hpf of urine was considered significant for urine microscopy and a single colony count of ≥105/ml from two consecutive urine samples was considered significant for urine culture. The prevalence of ASB was 13.8% by urine culture and 43.8% by urine microscopy among antenatal attendees in Faith Medical Centre, Benin City. There was no relationship between ASB and socio-economic factor (P value=0.1267). There was also no significant specific trend between ASB and age (P value=0.0578). Using urine culture as gold standard, the sensitivity of urine microscopy was 90.9%, the specificity was 49.3%, the positive predictive value was 22.2% and the negative predictive value was 97.1%. ASB in pregnancy is common in Faith Mediplex and has no statistically significant relationship with socioeconomic status. The current practice of diagnosing and treating ASB based on urine microscopy needs to be reviewed since the specificity of urine microscopy is very low. Also the practice of screening pregnant women only at the time of booking can lead to under-diagnosis of ASB. This is so because most women who develop this condition later in the course of antenatal care will be missed."

  13. Antenatal screening for Toxoplasma gondii, Cytomegalovirus, rubella and Treponema pallidum infections in northern Benin.

    PubMed

    De Paschale, Massimo; Ceriani, Cristina; Cerulli, Teresa; Cagnin, Debora; Cavallari, Serena; Cianflone, Annalisa; Diombo, Kouma; Ndayaké, Joseph; Aouanou, Guy; Zaongo, Dieudonné; Priuli, Gianbattista; Viganò, Paolo; Clerici, Pierangelo

    2014-06-01

    Toxoplasma gondii, cytomegalovirus (HCMV) and rubella virus infections are among the most serious of those contracted during pregnancy in terms of foetal consequences. Toxoplasma, HCMV and rubella antibody screening is unusual in Africa, and there are few published data. The aim of this study was to evaluate the prevalence of these markers among pregnant women in northern Benin on the occasion of routine syphilis screening. Toxoplasma, HCMV and rubella IgG and IgM antibodies were determined in the serum of 283 women attending Saint Jean de Dieu de Tanguiéta hospital, using an enzyme immunoassay, and IgM were confirmed using an enzyme-linked fluorescent assay (ELFA). In the case of IgM positivity, the avidity of anti-HCMV and anti-Toxoplasma IgG was measured. Total anti-Treponema pallidum antibodies were determined using an enzyme immunoassay and confirmed by immunoblotting. In the case of positivity, the Venereal Disease Research Laboratory (VDRL) test was used. The prevalence of anti-Toxoplasma, anti-HCMV, anti-rubella IgG and total anti-Treponema antibodies was, respectively, 30.0%, 100%, 94% and 2.5%. The VDRL test was positive in 62.5% of the anti-Treponema-positive samples. The prevalence of anti-Toxoplasma, anti-HCMV and anti-rubella IgM was, respectively, 0.4%, 1.4% and 0%. There were no statistically significant differences in terms of age class or trimester of pregnancy. Anti-Toxoplasma and anti-HCMV IgG avidity was always high. The prevalence of HCMV and rubella antibodies is high in northern Benin, whereas that of Toxoplasma antibodies is lower. As nearly two-thirds of the pregnant women were anti-Toxoplasma seronegative, antibody screening should be introduced. © 2014 John Wiley & Sons Ltd.

  14. Accumulation patterns and risk assessment of metals and metalloid in muscle and offal of free-range chickens, cattle and goat in Benin City, Nigeria.

    PubMed

    Ogbomida, Emmanuel Temiotan; Nakayama, Shouta M M; Bortey-Sam, Nesta; Oroszlany, Balazs; Tongo, Isioma; Enuneku, Alex Ajeh; Ozekeke, Ogbeide; Ainerua, Martins Oshioriamhe; Fasipe, Iriagbonse Priscillia; Ezemonye, Lawrence Ikechukwu; Mizukawa, Hazuki; Ikenaka, Yoshinori; Ishizuka, Mayumi

    2018-04-30

    The use of free range animals for monitoring environmental health offers opportunities to detect exposure and assess the toxicological effects of pollutants in terrestrial ecosystems. Potential human health risk of dietary intake of metals and metalloid via consumption of offal and muscle of free range chicken, cattle and goats by the urban population in Benin City was evaluated. Muscle, gizzard, liver and kidney samples were analyzed for Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Cd, and Pb concentrations using inductively coupled plasma mass spectrometer (ICP-MS) while Hg was determined using Hg analyzer. Mean concentrations of metals (mg/kg ww) varied significantly depending upon the tissues and animal species. Human health risk estimations for children and adults showed estimated daily intake (EDI) values of tissues below oral reference dose (RfD) threshold for non essential metals Cd, As, Pb and Hg thus strongly indicating no possible health risk via consumption of animal based food. Calculated Hazard quotient (THQ) was less than 1 (< 1) for all the metals analyzed for both adult and children. However, Cd and As had the highest value of THQ suggestive of possible health risk associated with continuous consumption of Cd and As contaminated animal based foods. Hazard Index (HI) for additive effect of metals was higher in chicken liver and gizzard for children and chicken liver for adults. Thus, HI indicated that chicken liver and gizzard may contribute significantly to adult and children dietary exposure to heavy metals. Principal component analysis (PCA) showed a clear species difference in metal accumulation between chickens and the ruminants. This study provides baseline data for future studies and also valuable evidence of anthropogenic impacts necessary to initiate national and international policies for control of heavy metal and metalloid content in food items. Copyright © 2017. Published by Elsevier Inc.

  15. Management of information within emergencies departments in developing countries: analysis at the National Emergency Department in Benin.

    PubMed

    Ahanhanzo, Yolaine Glèlè; Kpozehouen, Alphonse; Sopoh, Ghislain; Sossa-Jérôme, Charles; Ouedraogo, Laurent; Wilmet-Dramaix, Michèle

    2016-01-01

    The management of health information is a key pillar in both emergencies reception and handling facilities, given the strategic position and the potential of these facilities within hospitals, and in the monitoring of public health and epidemiology. With the technological revolution, computerization made the information systems evolve in emergency departments, especially in developed countries, with improved performance in terms of care quality, productivity and patient satisfaction. This study analyses the situation of Benin in this field, through the case of the Academic Clinic of Emergency Department of the National University Teaching Hospital of Cotonou, the national reference hospital. The study is cross-sectional and evaluative. Collection techniques are literature review and structured interviews. The components rated are resources, indicators, data sources, data management and the use-dissemination of the information through a model adapted from Health Metrics Network framework. We used quantitative and qualitative analysis. The absence of a regulatory framework restricts the operation of the system in all components and accounts for the lack and inadequacy of the dedicated resources. Dedication of more resources for this system for crucial needs such as computerization requires sensitization and greater awareness of the administrative authorities about the fact that an effective health information management system is of prime importance in this type of facility.

  16. Mass concentration, optical depth and carbon composition of particulate matter in the major southern West African cities of Cotonou (Benin) and Abidjan (Côte d'Ivoire)

    NASA Astrophysics Data System (ADS)

    Djossou, Julien; Léon, Jean-François; Barthélemy Akpo, Aristide; Liousse, Cathy; Yoboué, Véronique; Bedou, Mouhamadou; Bodjrenou, Marleine; Chiron, Christelle; Galy-Lacaux, Corinne; Gardrat, Eric; Abbey, Marcellin; Keita, Sékou; Bahino, Julien; Touré N'Datchoh, Evelyne; Ossohou, Money; Awanou, Cossi Norbert

    2018-05-01

    Air quality degradation is a major issue in the large conurbations on the shore of the Gulf of Guinea. We present for the first time PM2.5 time series collected in Cotonou, Benin, and Abidjan, Côte d'Ivoire, from February 2015 to March 2017. Measurements were performed in the vicinity of major combustion aerosol sources: Cotonou/traffic (CT), Abidjan/traffic (AT), Abidjan/landfill (AL) and Abidjan/domestic fires (ADF). We report the weekly PM2.5 mass and carbonaceous content as elemental (EC) and organic (OC) carbon concentrations. We also measure the aerosol optical depth (AOD) and the Ångström exponent in both cities. The average PM2.5 mass concentrations were 32 ± 32, 32 ± 24 and 28 ± 19 µg m-3 at traffic sites CT and AT and landfill site AL, respectively. The domestic fire site shows a concentration of 145 ± 69 µg m-3 due to the contribution of smoking and roasting activities. The highest OC and EC concentrations were also measured at ADF at 71 ± 29 and 15 ± 9 µg m-3, respectively, while the other sites present OC concentration between 8 and 12 µg m-3 and EC concentrations between 2 and 7 µg m-3. The OC / EC ratio is 4.3 at CT and 2.0 at AT. This difference highlights the influence of two-wheel vehicles using gasoline in Cotonou compared to that of four-wheel vehicles using diesel fuel in Abidjan. AOD was rather similar in both cities, with a mean value of 0.58 in Cotonou and of 0.68 in Abidjan. The seasonal cycle is dominated by the large increase in surface mass concentration and AOD during the long dry season (December-February) as expected due to mineral dust advection and biomass burning activities. The lowest concentrations are observed during the short dry season (August-September) due to an increase in surface wind speed leading to a better ventilation. On the other hand, the high PM2.5 / AOD ratio in the short wet season (October-November) indicates the stagnation of local pollution.

  17. [Scientific production from public hospitals of the City of Buenos Aires, 2017].

    PubMed

    Ibarra, Mariano; Torrents, Milagros; Ossorio, María Fabiana; Ferrero, Fernando

    2018-01-01

    The number of publications in the scientific literature coming from an institution is an indicator of its scientific production. The scientific production of the hospitals of the Government of the City of Buenos Aires (GCBA) has been evaluated previously, but without discriminating how much of that production corresponded to other academic institutions settled there (University of Buenos Aires, UBA, National Council of Scientific Research and Techniques, CONICET). Our objective was to evaluate the publications included in PubMed that correspond to hospitals of the GCBA, describe their main characteristics, and discriminate the contribution of other academic institutions (UBA and CONICET). It is a cross-sectional study based on a PubMed search, using the name of each of the 34 GCBA hospitals, CONICET and UBA in the "affiliation" field. In total, 2727 publications from GCBA hospitals were identified (4.6% of Argentine publications); 73.9% in English, 78.9% in relation to humans, 37.2% in the last 5 years; 6.4% with high level of evidence (clinical trials and meta-analysis), and 28.4% including children. Compared to the national total, the GCBA publications include fewer works in English, more research in humans, more clinical trials and more research in children. Of the publications corresponding to hospitals of the GCBA, 90.4% did not share the affiliation with CONICET or with UBA. In conclusion, the GCBA hospitals generated 4.6% of the total Argentine publications in PubMed; and 90% of these was not shared with UBA or CONICET. Publications from GCBA institutions include more clinical trials and research in children.

  18. Persisting Social Participation Restrictions among Former Buruli Ulcer Patients in Ghana and Benin

    PubMed Central

    de Zeeuw, Janine; Omansen, Till F.; Douwstra, Marlies; Barogui, Yves T.; Agossadou, Chantal; Sopoh, Ghislain E.; Phillips, Richard O.; Johnson, Christian; Abass, K. Mohammed; Saunderson, Paul; Dijkstra, Pieter U.; van der Werf, Tjip S.; Stientstra, Ymkje

    2014-01-01

    Background Buruli ulcer may induce severe disabilities impacting on a person's well-being and quality of life. Information about long-term disabilities and participation restrictions is scanty. The objective of this study was to gain insight into participation restrictions among former Buruli ulcer patients in Ghana and Benin. Methods In this cross-sectional study, former Buruli ulcer patients were interviewed using the Participation Scale, the Buruli Ulcer Functional Limitation Score to measure functional limitations, and the Explanatory Model Interview Catalogue to measure perceived stigma. Healthy community controls were also interviewed using the Participation Scale. Trained native interviewers conducted the interviews. Former Buruli ulcer patients were eligible for inclusion if they had been treated between 2005 and 2011, had ended treatment at least 3 months before the interview, and were at least 15 years of age. Results In total, 143 former Buruli ulcer patients and 106 community controls from Ghana and Benin were included in the study. Participation restrictions were experienced by 67 former patients (median score, 30, IQR; 23;43) while 76 participated in social life without problems (median score 5, IQR; 2;9). Most restrictions encountered related to employment. Linear regression showed being female, perceived stigma, functional limitations, and larger lesions (category II) as predictors of more participation restrictions. Conclusion Persisting participation restrictions were experienced by former BU patients in Ghana and Benin. Most important predictors of participation restrictions were being female, perceived stigma, functional limitations and larger lesions. PMID:25392915

  19. Genetic characterization of the honeybee ectoparasitic mite Varroa destructor from Benin (West Africa) using mitochondrial and microsatellite markers.

    PubMed

    Kelomey, Aude E; Paraiso, Armand; Sina, Haziz; Legout, Hélène; Garnery, Lionel; Baba-Moussa, Lamine

    2017-05-01

    Varroa destructor is one of the scourges of global beekeeping. It was detected for the first time in Benin in 2011 on the honeybee Apis mellifera adansonii. The aim of this study was to identify the strain of Varroa sp. found and study its genetic diversity. In total 183 Varroa mites were sampled in 21 municipalities in Benin. The COI intergenic region of each mite mtDNA was amplified by PCR. The SacI restriction enzyme was used to determine the strains of Varroa sp. Only the Korean (K) haplotype, identical to the most prevalent strain in Africa, was detected. Analysis of the genetic diversity of Varroa mites with eight microsatellite loci (Simple Sequence Repeats) indicated a very low diversity of genotypes. Thus, V. destructor populations from Benin appear to make up a single group. Their clonal wealth ranges from 0.00 to 0.47. This study is an important step forward in the monitoring of the infestation of V. destructor.

  20. Automated External Defibrillators and Survival After Nonresidential Out of Hospital Cardiac Arrest in a Small North American City.

    PubMed

    Lwanga, Anita; Garcia-Sayan, Enrique; Lwanga, Steven; Karreman, Erwin; Mohamed, Amira

    2017-06-15

    Most studies demonstrate that the use of automated external defibrillators (AEDs) during out of hospital cardiac arrest is associated with survival, but the majority of these studies were performed in large cities. With this in mind, the aims of our study were to examine AED placement and variables associated with survival after nonresidential out of hospital cardiac arrest (NROHCA) in a small North American city. Cases of NROHCA and locations with AEDs, in Regina, between January 2010 and December 2014 were reviewed. Common locations for NROHCA were identified, the frequency of AED availability was determined, and the relations between survival and AED presence, bystander initiated cardiopulmonary resuscitation (CPR), or shockable rhythms were determined. Only 20% of cases of NROHCA had an AED present on the premise. The presence of an AED (p = 0.94) was not associated with survival to the emergency department, whereas bystander initiated CPR (p <0.01) and shockable rhythm (p <0.01) were associated with survival to the emergency department. The presence of an AED (p = 0.86) and bystander initiated CPR (p = 0.06) were not associated with survival to discharge from the hospital, whereas the presence of a shockable rhythm was (p <0.01). Multivariable logistic regression analysis demonstrated that the presence of a shockable rhythm was independently associated with survival to the emergency department (OR 11.78, p <0.01) and discharge from the hospital (OR 6.08, p <0.01). The optimal locations for AED placement in cities of similar size and density may need to be reexamined, as the findings may have implications for public policies surrounding AED placement. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Web-Scale Search-Based Data Extraction and Integration

    DTIC Science & Technology

    2011-10-17

    differently, posing challenges for aggregating this information. For example, for the task of finding population for cities in Benin, we were faced with...merged record. Our GeoMerging algorithm attempts to address various ambiguity challenges : • For name: The name of a hospital is not a unique...departments in the same building. For agent-extractor results from structured sources, our GeoMerging algorithm overcomes these challenges using a two

  2. Social responsibility of the hospitals in Isfahan city, Iran: Results from a cross-sectional survey.

    PubMed

    Keyvanara, Mahmoud; Sajadi, Haniye Sadat

    2015-02-12

    Changes in modern societies develop the perception that the external environment is essential in organization's practices, especially in the way they deal with aspects such as human rights, community needs, market demands and environmental interests. These issues are usually under the umbrella of the concept of social responsibility. Given the importance of this concept in the context of health care delivery, suggesting a new paradigm in hospital governance, the aim of this study was to measure the social responsibility in hospitals. A cross-sectional survey was employed to collect data from a sample of 946 hospital staff of Isfahan city. Data was obtained by structured and valid self-administrated questionnaire and analyzed by descriptive and analytic statistics using SPSS. The mean score of hospitals' social responsibility was 3.0 compared with the justified range from 1.0 to 5.0. Results showed that there was a significant relationship between social responsibility score and hospitals' ownership (public or private). Also, there was no significant relationship between social responsibility and type of hospital specialty. It is recommended that hospital managers develop and apply appropriate policies and strategies to improve their hospitals' social responsibility level, especially through concentrating on their staff's working environment. © 2015 by Kerman University of Medical Sciences.

  3. Hospital graduate social work field work programs: a study in New York City.

    PubMed

    Showers, N

    1990-02-01

    Twenty-seven hospital field work programs in New York City were studied. Questionnaires were administered to program coordinators and 238 graduate social work students participating in study programs. High degrees of program structural complexity and variation were found, indicating a state of art well beyond that described in the general field work literature. High rates of student satisfaction with learning, field instructors, programs, and the overall field work experience found suggest that the complexity of study programs may be more effective than traditional field work models. Statistically nonsignificant study findings indicate areas in which hospital social work departments may develop field work programs consistent with shifting organizational needs, without undue risk to educational effectiveness. Statistically significant findings suggest areas in which inflexibility in program design may be more beneficial in the diagnostic related groups era.

  4. Dynamics of cholera epidemics from Benin to Mauritania.

    PubMed

    Moore, Sandra; Dongdem, Anthony Zunuo; Opare, David; Cottavoz, Paul; Fookes, Maria; Sadji, Adodo Yao; Dzotsi, Emmanuel; Dogbe, Michael; Jeddi, Fakhri; Bidjada, Bawimodom; Piarroux, Martine; Valentin, Ouyi Tante; Glèlè, Clément Kakaï; Rebaudet, Stanislas; Sow, Amy Gassama; Constantin de Magny, Guillaume; Koivogui, Lamine; Dunoyer, Jessica; Bellet, Francois; Garnotel, Eric; Thomson, Nicholas; Piarroux, Renaud

    2018-04-01

    The countries of West Africa are largely portrayed as cholera endemic, although the dynamics of outbreaks in this region of Africa remain largely unclear. To understand the dynamics of cholera in a major portion of West Africa, we analyzed cholera epidemics from 2009 to 2015 from Benin to Mauritania. We conducted a series of field visits as well as multilocus variable tandem repeat analysis and whole-genome sequencing analysis of V. cholerae isolates throughout the study region. During this period, Ghana accounted for 52% of the reported cases in the entire study region (coastal countries from Benin to Mauritania). From 2009 to 2015, we found that one major wave of cholera outbreaks spread from Accra in 2011 northwestward to Sierra Leone and Guinea in 2012. Molecular epidemiology analysis confirmed that the 2011 Ghanaian isolates were related to those that seeded the 2012 epidemics in Guinea and Sierra Leone. Interestingly, we found that many countries deemed "cholera endemic" actually suffered very few outbreaks, with multi-year lulls. This study provides the first cohesive vision of the dynamics of cholera epidemics in a major portion of West Africa. This epidemiological overview shows that from 2009 to 2015, at least 54% of reported cases concerned populations living in the three urban areas of Accra, Freetown, and Conakry. These findings may serve as a guide to better target cholera prevention and control efforts in the identified cholera hotspots in West Africa.

  5. Dynamics of cholera epidemics from Benin to Mauritania

    PubMed Central

    Dongdem, Anthony Zunuo; Opare, David; Cottavoz, Paul; Fookes, Maria; Sadji, Adodo Yao; Dzotsi, Emmanuel; Dogbe, Michael; Jeddi, Fakhri; Bidjada, Bawimodom; Piarroux, Martine; Valentin, Ouyi Tante; Glèlè, Clément Kakaï; Rebaudet, Stanislas; Sow, Amy Gassama; Constantin de Magny, Guillaume; Koivogui, Lamine; Dunoyer, Jessica; Bellet, Francois; Garnotel, Eric; Thomson, Nicholas; Piarroux, Renaud

    2018-01-01

    Background The countries of West Africa are largely portrayed as cholera endemic, although the dynamics of outbreaks in this region of Africa remain largely unclear. Methodology/Principal findings To understand the dynamics of cholera in a major portion of West Africa, we analyzed cholera epidemics from 2009 to 2015 from Benin to Mauritania. We conducted a series of field visits as well as multilocus variable tandem repeat analysis and whole-genome sequencing analysis of V. cholerae isolates throughout the study region. During this period, Ghana accounted for 52% of the reported cases in the entire study region (coastal countries from Benin to Mauritania). From 2009 to 2015, we found that one major wave of cholera outbreaks spread from Accra in 2011 northwestward to Sierra Leone and Guinea in 2012. Molecular epidemiology analysis confirmed that the 2011 Ghanaian isolates were related to those that seeded the 2012 epidemics in Guinea and Sierra Leone. Interestingly, we found that many countries deemed “cholera endemic” actually suffered very few outbreaks, with multi-year lulls. Conclusions/Significance This study provides the first cohesive vision of the dynamics of cholera epidemics in a major portion of West Africa. This epidemiological overview shows that from 2009 to 2015, at least 54% of reported cases concerned populations living in the three urban areas of Accra, Freetown, and Conakry. These findings may serve as a guide to better target cholera prevention and control efforts in the identified cholera hotspots in West Africa. PMID:29630632

  6. [Coexistence of maternal overweight or obesity and stunted children in south-western Benin households].

    PubMed

    Dembélé, Bernard; Sossa Jérôme, Charles; Saizonou, Jacques; Makoutodé, Patrick Charles; Mongbo Adé, Virginie; Guedègbé Capo-Chichi, Justine; Dona Ouendo, Marius-Edgard

    To determine the prevalence and determinants of coexistence of maternal overweight or obesity and stunted children (DBM / SCOM) in south-western Benin households. This cross-sectional study was carried out in June 2015 on 357 mother-child pairs randomly selected by a two-stage sampling technique in the city of Comè and its surroundings. Data on socio-economic factors, family, health care, dietary quality were collected by questionnaires, observation and documentary review. Anthropometric measurements were performed in mothers and children. A logistic regression analysis model was used to search for determinants of the coexistence of the two aspects of malnutrition. 19.3% of mothers were overweight and 5.7% were obese. 46% of children were stunted. The prevalence of DBM / SCOM was 11.5%. The main factors associated with DBM/SCOM were the child's age, the mother's occupation, ethnicity, social status and educational level, and the size, economic level, transportation means and food insecurity of the household. A high frequency of the coexistence of maternal overweight or obesity and stunting was observed in Comè households. Interventions based on the identified determinants are needed to act simultaneously on the double burden of malnutrition in Comè.

  7. Development of methane emission factors for enteric fermentation in cattle from Benin using IPCC Tier 2 methodology.

    PubMed

    Kouazounde, J B; Gbenou, J D; Babatounde, S; Srivastava, N; Eggleston, S H; Antwi, C; Baah, J; McAllister, T A

    2015-03-01

    The objective of this study was to develop emission factors (EF) for methane (CH4) emissions from enteric fermentation in cattle native to Benin. Information on livestock characteristics and diet practices specific to the Benin cattle population were gathered from a variety of sources and used to estimate EF according to Tier 2 methodology of the 2006 Intergovernmental Panel on Climate Change (IPCC) Guidelines for National Greenhouse Gas Inventories. Most cattle from Benin are Bos taurus represented by Borgou, Somba and Lagune breeds. They are mainly multi-purpose, being used for production of meat, milk, hides and draft power and grazed in open pastures and crop lands comprising tropical forages and crops. Estimated enteric CH4 EFs varied among cattle breeds and subcategory owing to differences in proportions of gross energy intake expended to meet maintenance, production and activity. EFs ranged from 15.0 to 43.6, 16.9 to 46.3 and 24.7 to 64.9 kg CH4/head per year for subcategories of Lagune, Somba and Borgou cattle, respectively. Average EFs for cattle breeds were 24.8, 29.5 and 40.2 kg CH4/head per year for Lagune, Somba and Borgou cattle, respectively. The national EF for cattle from Benin was 39.5 kg CH4/head per year. This estimated EF was 27.4% higher than the default EF suggested by IPCC for African cattle with the exception of dairy cattle. The outcome of the study underscores the importance of obtaining country-specific EF to estimate global enteric CH4 emissions.

  8. Chinese traffic fatalities and injuries in police reports, hospital records, and in-depth records from one city.

    PubMed

    Qiu, Jun; Zhou, Jihong; Zhang, Liang; Yao, Yuan; Yuan, Danfeng; Shi, Jianguo; Gao, Zhiming; Zhou, Lin; Wang, Zhengguo; Evans, Leonard

    2015-01-01

    Claims of sharp reductions in Chinese traffic casualties after 2002 based on police-reported data have been questioned in the literature. The objective of this study is to determine whether a decline in casualties occurred and to better understand the police data. The first of 2 unrelated studies analyzed data from 210 military hospitals throughout China providing records for inpatients injured in traffic accidents (2001-2007). The second compared in-depth crash records (2000-2006) from one city to officially released data. Hospital data showed that casualties increased from 2002 to 2007. The city investigation showed consistently far more fatalities and injuries in the in-depth data than officially released. For example, in-depth data showed 1,720 fatalities. Only 557 of these were reported officially (data loss = 68%). Disaggregating into 3 regions showed a data loss of 41% in urban areas, 63% in rural areas, and 90% in rural-urban fringe zones. For injuries, data losses were even greater. Traffic fatalities and injuries did not decrease from 2002 to 2006. The in-depth city data contained 3 times as many fatalities and 5 times as many injuries as reported by police. Reasons why this occurred and suggestions to improve data collection and reduce casualties are given.

  9. The Role Of Nonprofit Hospitals In Identifying And Addressing Health Inequities In Cities.

    PubMed

    Carroll-Scott, Amy; Henson, Rosie Mae; Kolker, Jennifer; Purtle, Jonathan

    2017-06-01

    For nonprofit hospitals to maintain their tax-exempt status, the Affordable Care Act requires them to conduct a community health needs assessment, in which they evaluate the health needs of the community they serve, and to create an implementation strategy, in which they propose ways to address these needs. We explored the extent to which nonprofit urban hospitals identified equity among the health needs of their communities and proposed health equity strategies to address this need. We conducted a content analysis of publicly available community health needs assessments and implementation strategies from 179 hospitals in twenty-eight US cities in the period August-December 2016. All of the needs assessments included at least one implicit health equity term (such as disparities , disadvantage , poor , or minorities ), while 65 percent included at least one explicit health equity term ( equity , health equity , inequity , or health inequity ). Thirty-five percent of implementation strategies included one or more explicit health equity terms, but only 9 percent included an explicit activity to promote health equity. While needs assessment reporting requirements have the potential to encourage urban nonprofit hospitals to address health inequities in their communities, hospitals need incentives and additional capacity to invest in strategies that address the underlying structural social and economic conditions that cause health inequities. Project HOPE—The People-to-People Health Foundation, Inc.

  10. Gender-specific responses to climate variability in a semi-arid ecosystem in northern Benin.

    PubMed

    Dah-Gbeto, Afiavi P; Villamor, Grace B

    2016-12-01

    Highly erratic rainfall patterns in northern Benin complicate the ability of rural farmers to engage in subsistence agriculture. This research explores gender-specific responses to climate variability in the context of agrarian Benin through a household survey (n = 260) and an experimental gaming exercise among a subset of the survey respondents. Although men and women from the sample population are equally aware of climate variability and share similar coping strategies, their specific land-use strategies, preferences, and motivations are distinct. Over the long term, these differences would likely lead to dissimilar coping strategies and vulnerability to the effects of climate change. Examination of gender-specific land-use responses to climate change and anticipatory learning can enhance efforts to improve adaptability and resilience among rural subsistence farmers.

  11. Short-term effects of particulate matter constituents on daily hospitalizations and mortality in five South-European cities: results from the MED-PARTICLES project.

    PubMed

    Basagaña, Xavier; Jacquemin, Bénédicte; Karanasiou, Angeliki; Ostro, Bart; Querol, Xavier; Agis, David; Alessandrini, Ester; Alguacil, Juan; Artiñano, Begoña; Catrambone, Maria; de la Rosa, Jesús D; Díaz, Julio; Faustini, Annunziata; Ferrari, Silvia; Forastiere, Francesco; Katsouyanni, Klea; Linares, Cristina; Perrino, Cinzia; Ranzi, Andrea; Ricciardelli, Isabella; Samoli, Evangelia; Zauli-Sajani, Stefano; Sunyer, Jordi; Stafoggia, Massimo

    2015-02-01

    Few recent studies examined acute effects on health of individual chemical species in the particulate matter (PM) mixture, and most of them have been conducted in North America. Studies in Southern Europe are scarce. The aim of this study is to examine the relationship between particulate matter constituents and daily hospital admissions and mortality in five cities in Southern Europe. The study included five cities in Southern Europe, three cities in Spain: Barcelona (2003-2010), Madrid (2007-2008) and Huelva (2003-2010); and two cities in Italy: Rome (2005-2007) and Bologna (2011-2013). A case-crossover design was used to link cardiovascular and respiratory hospital admissions and total, cardiovascular and respiratory mortality with a pre-defined list of 16 PM10 and PM2.5 constituents. Lags 0 to 2 were examined. City-specific results were combined by random-effects meta-analysis. Most of the elements studied, namely EC, SO4(2-), SiO2, Ca, Fe, Zn, Cu, Ti, Mn, V and Ni, showed increased percent changes in cardiovascular and/or respiratory hospitalizations, mainly at lags 0 and 1. The percent increase by one interquartile range (IQR) change ranged from 0.69% to 3.29%. After adjustment for total PM levels, only associations for Mn, Zn and Ni remained significant. For mortality, although positive associations were identified (Fe and Ti for total mortality; EC and Mg for cardiovascular mortality; and NO3(-) for respiratory mortality) the patterns were less clear. The associations found in this study reflect that several PM constituents, originating from different sources, may drive previously reported results between PM and hospital admissions in the Mediterranean area. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Species distribution modelling for Rhipicephalus microplus (Acari: Ixodidae) in Benin, West Africa: comparing datasets and modelling algorithms.

    PubMed

    De Clercq, E M; Leta, S; Estrada-Peña, A; Madder, M; Adehan, S; Vanwambeke, S O

    2015-01-01

    Rhipicephalus microplus is one of the most widely distributed and economically important ticks, transmitting Babesia bigemina, B. bovis and Anaplasma marginale. It was recently introduced to West Africa on live animals originating from Brazil. Knowing the precise environmental suitability for the tick would allow veterinary health officials to draft vector control strategies for different regions of the country. To test the performance of modelling algorithms and different sets of environmental explanatory variables, species distribution models for this tick species in Benin were developed using generalized linear models, linear discriminant analysis and random forests. The training data for these models were a dataset containing reported absence or presence in 104 farms, randomly selected across Benin. These farms were sampled at the end of the rainy season, which corresponds with an annual peak in tick abundance. Two environmental datasets for the country of Benin were compared: one based on interpolated climate data (WorldClim) and one based on remotely sensed images (MODIS). The pixel size for both environmental datasets was 1 km. Highly suitable areas occurred mainly along the warmer and humid coast extending northwards to central Benin. The northern hot and drier areas were found to be unsuitable. The models developed and tested on data from the entire country were generally found to perform well, having an AUC value greater than 0.92. Although statistically significant, only small differences in accuracy measures were found between the modelling algorithms, or between the environmental datasets. The resulting risk maps differed nonetheless. Models based on interpolated climate suggested gradual variations in habitat suitability, while those based on remotely sensed data indicated a sharper contrast between suitable and unsuitable areas, and a patchy distribution of the suitable areas. Remotely sensed data yielded more spatial detail in the predictions. When

  13. The costs of 'free': Experiences of facility-based childbirth after Benin's caesarean section exemption policy.

    PubMed

    Lange, Isabelle L; Kanhonou, Lydie; Goufodji, Sourou; Ronsmans, Carine; Filippi, Véronique

    2016-11-01

    As one of many similar policies in the region, in 2009 Benin launched a free c-section policy in publicly funded hospitals intended to decrease the barriers to facility delivery and the heavy financial burdens on women and their families. We conducted a qualitative study for eight months between 2012 and 2014 to understand women's experiences of care in maternity wards. We carried out semi-structured interviews with 30 women who had delivered via c-section at five hospitals. Two of these hospitals became case study sites where in-depth research was undertaken that consisted of participant observation in each maternity ward and 32 further interviews with women who had complicated, vaginal and c-section deliveries. Overall, women continue to pay for care, both in the form of under-the-table payments to health workers and prescribed payments for services not covered by the policy, though they consider the costs reasonable compared to what the charges were before. Lifting the fees has facilitated conditions for midwives to alert doctors that the procedure might be needed. Partly because c-sections are still feared by most women, in one hospital this led to some women perceiving them as a threat if their labour was progressing more slowly. Implementation of the policy differed greatly between the two case study hospitals. We conclude that some burdens on women's access to care have been addressed but deterrents remain to the improved perception of quality of care on the part of women. Findings detail how important context is to the implementation of the policy, and suggest that similar user-fee removal policies should be accompanied by other measures addressing staff management and quality of care. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Major Determinants of Maternal Near-Miss and Mortality at the Maternity Teaching Hospital, Erbil city, Iraq

    PubMed Central

    Akrawi, Vian Sabri; Al-Hadithi, Tariq Salman; Al-Tawil, Namir Ghanim

    2017-01-01

    Objectives To find out the major determinants of maternal near-miss (NM)and maternal deaths (MDs) in Erbil city, Iraq, by comparative analysis of maternal NMs and MDs. Methods We conducted a hospital-based cross-sectional study in the Maternity Teaching Hospital in Erbil city from 1 June to 31 December 2013. All MDs and NMs that occurred in the hospital during the study period were included in the study. Systematic identification of all eligible women was done. This identification included a baseline assessment of the severe pregnancy-related complications using the World Health Organization NM criteria. Results Severe preeclampsia and postpartum hemorrhage (PPH) constituted the highest proportions of complications in women with potentially life-threatening conditions (PLTCs) (30.5% and 30.0%, respectively). The highest mortality indexes were those for ruptured uterus (16.7) and severe complications of placenta previa (14.2). Factors that were significantly associated with MD (compared to NM) were hepatic dysfunction (p = 0.046), multiple/unspecified disorders (p = 0.003), arrival as an emergency condition by ambulance (p = 0.015), and history of previous cesarean section (p = 0.013). Conclusions Severe preeclampsia and PPH are the main complications that lead to PLTCs. Factors found to be associated with MDs are hepatic dysfunction, multiple/unspecified disorders, arrival as an emergency condition by ambulance, and history of a previous cesarean section. PMID:29026470

  15. Determinants of severe anemia among laboring mothers in Mekelle city public hospitals, Tigray region, Ethiopia.

    PubMed

    Ebuy, Yirga; Alemayehu, Mussie; Mitiku, Mengistu; Goba, Gelila K

    2017-01-01

    Anemia is a global public health problem that has affected a significant number of pregnant mothers worldwide. The World Health Organization has estimated the prevalence of anemia in pregnant women at 18% and 56% in developed and developing countries, respectively. This study aimed to identify factors associated with severe anemia among laboring women in Mekelle city public hospitals, Tigray, Ethiopia. This unmatched case-control study involved 264 (88 = cases and 176 = controls) pregnant women who were recruited when they came for delivery service in Mekelle city public hospitals. The data was collected from July to August, 2016. In this study, a systematic sampling technique was used inselecting controls, but the cases were enrolled until the required sample size was reached. Bivariate and multivariate analyses were conducted to find predictors of severe anemia. Statistically significant predictors of severe anemia were identified at P-value <0.05 and 95% confidence interval. A total of 264 pregnant women who came for delivery services were enrolled in this study. The major predicting variables for the occurrence of severe anemia among laboring women were residency (AOR = 3.28, 95% CI: 1.26-8.48), number of pregnancies (AOR = 2.46, 95% CI: 1.14-5.29), iron folate supplementation (AOR = 3.29, 95% CI: 1.27-8.49), dietary diversification score (AOR = 3.23, 95% CI: 1.19-8.71) and duration of menstrual cycle (AOR = 2.37, 95% CI: 1.10-5.10). The variable 'blood loss during pregnancy' (AOR = 6.63 95% CI: 2.96-14.86) was identified as a strong predictor of the outcome variable, severe anemia. This study identified determinants of severe anemia among laboring women in Mekelle city public hospitals, Northern Ethiopia. To reduce anemia, strengthening health education provision related to the importance of birth spacing and consuming diversified and iron-enriched food should be considered. Moreover, screening of pregnant women for state of anemia during their visits to

  16. Scientific authorship and collaboration network analysis on malaria research in Benin: papers indexed in the web of science (1996-2016).

    PubMed

    Azondekon, Roseric; Harper, Zachary James; Agossa, Fiacre Rodrigue; Welzig, Charles Michael; McRoy, Susan

    2018-01-01

    To sustain the critical progress made, prioritization and a multidisciplinary approach to malaria research remain important to the national malaria control program in Benin. To document the structure of the malaria collaborative research in Benin, we analyze authorship of the scientific documents published on malaria from Benin. We collected bibliographic data from the Web Of Science on malaria research in Benin from January 1996 to December 2016. From the collected data, a mulitigraph co-authorship network with authors representing vertices was generated. An edge was drawn between two authors when they co-author a paper. We computed vertex degree, betweenness, closeness, and eigenvectors among others to identify prolific authors. We further assess the weak points and how information flow in the network. Finally, we perform a hierarchical clustering analysis, and Monte-Carlo simulations. Overall, 427 publications were included in this study. The generated network contained 1792 authors and 116,388 parallel edges which converted in a weighted graph of 1792 vertices and 95,787 edges. Our results suggested that prolific authors with higher degrees tend to collaborate more. The hierarchical clustering revealed 23 clusters, seven of which form a giant component containing 94% of all the vertices in the network. This giant component has all the characteristics of a small-world network with a small shortest path distance between pairs of three, a diameter of 10 and a high clustering coefficient of 0.964. However, Monte-Carlo simulations suggested our observed network is an unusual type of small-world network. Sixteen vertices were identified as weak articulation points within the network. The malaria research collaboration network in Benin is a complex network that seems to display the characteristics of a small-world network. This research reveals the presence of closed research groups where collaborative research likely happens only between members. Interdisciplinary

  17. Lifelong Learning as an Instrument for Human Capital Development in Benin

    ERIC Educational Resources Information Center

    Biao, Idowu

    2015-01-01

    A review of the Benin education system shows that it is still heavily school-based. Yet, a high level of wastage is currently being recorded at school level (about 50% success rate at primary level, about 40% success rate at high school level and about 1% enrolment rate of qualified candidates and success rate at tertiary level), leading to the…

  18. Early outcome of patients undergoing transcatheter aortic valve implantation (TAVI): The Auckland City Hospital experience 2011-2015.

    PubMed

    Wu, Sylvia S Y; Wang, Tom Kai Ming; Nand, Parma; Ramanathan, Tharumenthiran; Webster, Mark; Stewart, Jim

    2016-01-08

    Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement (AVR) in high-risk patients. We report the initial TAVI experience at Auckland City Hospital. The records of patients undergoing TAVI between 2011 and 2015 at Auckland City Hospital were reviewed. We report the procedural success and outcome, including major adverse events (death, stroke, myocardial infarction, bleeding, vascular complications and rehospitalisations), degree of aortic regurgitation and symptom status up to 1-year follow-up. Mean age was 80.7 years and mean Euroscore II and Society of Thoracic Surgeons' scores were 8.2% and 6.3% respectively; 50% had undergone previous cardiac surgery. Successful deployment of the valve was achieved in all patients. The cumulative mortality rates at 30 days, 6 months and 1 year were 2.4%, 6.1% and 12.2% and cumulative stroke rates 1.2%, 3% and 8.2% respectively. Severe aortic regurgitation occurred in 2.3% TAVI is available in the New Zealand public hospital system for patients who are high-risk candidates for AVR. Early results are excellent and indicate that the technology is being used appropriately, according to current access criteria. If the early cost effectiveness data are confirmed, the indications for TAVI may widen.

  19. [Knowledge and attitudes towards second hand smoking among hospitality patronage in five cities in China].

    PubMed

    Liu, Rui-Ling; Yang, Yan; Liu, Xiu-Rong; Chang, Ai-Ling; Gong, Jie; Zhao, Bai-Fan; Liu, Tao; Jiang, Yuan; Hyland, Andrew; Li, Qiang

    2008-05-01

    To understand the knowledge and attitudes towards second hand smoking (SHS) among restaurant or bar patronage in five cities in China. 405 restaurants and bars were conveniently selected in 5 cities as Beijing, Wuhan, Xi'an, Kunming and Guiyang. From each of these hospitality venues, at least 3 patrons, including one smoker, one female non-smoker and one male nonsmoker were asked to answer a questionnaire on their knowledge and attitudes towards SHS and smoking policies in public places. 43.1% of the respondents had good knowledge on SHS hazards. 65% reported that those who smoked around them had never asked for their permission, and about 60% admitted that they had never asked others to stop smoking in front of them. There were almost two thirds of patrons reporting that they once felt discomfort of SHS in restaurants or bars, nearly half of whom chose to leave the venue to avoid exposure to SHS. Though majority of patrons supported '100% smoke-free hospitals, schools and public vehicles' initiations, the proportions of patrons that supporting '100% smoke-free restaurants and bars' initiations were only 30.0% and 19.8%, respectively. In Beijing, logistic regression model analyses showed that those who supporting 100% smoke-free restaurants and bars tended to be non-smokers, aged 25 years or older and to have had at least college education. Also in Beijing, those being female, having at least college education or non-smokers were more likely to choose restaurants and bars with smoking restrictions. Though knowledge on SHS hospitality patronage was still not high or popular for the public to refuse SHS exposure, banning smoking in hospitality venues was public's inclination and would become a trend in public health endeavor.

  20. Assessment of the Contamination of Some Foodstuffs by Escherichia coli O157 in Benin, West Africa

    PubMed Central

    Bankole, Honoré Sourou; Dougnon, Victorien Tamègnon; Johnson, Roch Christian; Dougnon, T. J.; Yehouenou, Boniface; Kougblenou, Sylvain; Agonsa, Maxime; Legonou, Magloire; Dadie, Thomas

    2014-01-01

    Escherichia coli O157 is a pathogenic bacterium causing haemorrhagic colitis. It represents a serious public health problem in Northern America and Europe, which can plague Africa. Most cases of mentioned poisoning were related to contaminated meat products and vegetables. The present work aimed to estimate the prevalence of E. coli O157 in meat and vegetables in Benin. For this purpose, 6 lots of faeces samples from pigs and 8 from cattle were collected at the farms on the outskirts of Cotonou. Similarly, 20 samples of carcasses, 20 samples of intestines and stomach, and 20 surfaces samples of slaughtering equipment were taken. Vegetables and environment materials in gardens have also been sampled for 84 samples. Bacteriological analyses revealed a percentage of contamination of 50% for pig faeces and 25% for cattle ones. All the meats from stalling parks have been contaminated by this bacterium. For vegetables, 14.6% of samples were contaminated by E. coli O157. The presence of this pathovar in animal breeding and slaughtering environment and in the gardens shows that Benin is not aware of the risks of foodborne illness associated with the consumption of contaminated products. Therefore, it urges including that germ in a systematic search during safety control of food products in Benin. PMID:25506362

  1. Contribution to the development of a food guide in Benin: linear programming for the optimization of local diets.

    PubMed

    Levesque, Sarah; Delisle, Hélène; Agueh, Victoire

    2015-03-01

    Food guides are important tools for nutrition education. While developing a food guide in Benin, the objective was to determine the daily number of servings per food group and the portion sizes of common foods to be recommended. Linear programming (LP) was used to determine, for each predefined food group, the optimal number and size of servings of commonly consumed foods. Two types of constraints were introduced into the LP models: (i) WHO/FAO Recommended Nutrient Intakes and dietary guidelines for the prevention of chronic diseases; and (ii) dietary patterns based on local food consumption data recently collected in southern Benin in 541 adults. Dietary intakes of the upper tertile of participants for diet quality based on prevention and micronutrient adequacy scores were used in the LP algorithms. Southern area of the Republic of Benin. Local key-players in nutrition (n 30) from the government, academic institutions, international organizations and civil society were partners in the development of the food guide directed at the population. The number of servings per food group and the portion size for eight age-sex groups were determined. For four limiting micronutrients (Fe, Ca, folate and Zn), local diets could be optimized to meet only 70 % of the Recommended Nutrient Intakes, not 100 %. It was possible to determine the daily number of servings and the portion sizes of common foods that can be recommended in Benin with the help of LP to optimize local diets, although Recommended Nutrient Intakes were not fully met for a few critical micronutrients.

  2. Forging New Partnerships: Lessons from the Dissemination of Agricultural Training Videos in Benin

    ERIC Educational Resources Information Center

    Okry, Florent; Van Mele, Paul; Houinsou, Felix

    2014-01-01

    Purpose: This article evaluates the dissemination and use of rice training videos by radio stations, farmers, farmer associations and extension services in Benin. It pays attention to positive deviants and process innovation within a "hands-off experiment". Design/methodology/approach: Using questionnaires and checklists we interviewed…

  3. Lack of artemisinin resistance in Plasmodium falciparum in northwest Benin after 10 years of use of artemisinin-based combination therapy.

    PubMed

    Ogouyèmi-Hounto, Aurore; Damien, Georgia; Deme, Awa Bineta; Ndam, Nicaise T; Assohou, Constance; Tchonlin, Didier; Mama, Atika; Hounkpe, Virgile Olivier; Moutouama, Jules Doumitou; Remoué, Franck; Ndiaye, Daouda; Gazard, Dorothée Kinde

    2016-01-01

    In Benin, artemisinin-based combination therapy (ACT) has been recommended as the first-line treatment for uncomplicated Plasmodium falciparum malaria since 2004. The emergence in Southeast Asia of parasites that are resistant to artemisinins poses a serious threat to global control of this disease. The presence of artemisinin resistance genotypes in parasite populations in Benin is currently unknown. The present study investigated the prevalence of relevant K13-propeller gene polymorphisms in parasite isolates from the north-western region of Benin. Plasmodium falciparum isolates were collected from children with a confirmed diagnosis of malaria aged 6 months to 5 years in two towns, Cobly and Djougou, in the north-western part of Benin. The study was conducted during the rainy season from July to November 2014 in local health facilities. The K13-propeller gene was amplified in parasite isolates using nested PCR and subsequently sequenced. A total of 108 children were recruited into the study. The efficiency of amplification reactions was 72% (78/108). The propeller domain of the K13 gene was successfully sequenced in 78 P. falciparum isolates; all of them were wild type with no polymorphisms detectable. The absence of mutations in the K13 gene indicates that P. falciparum parasite populations in the study area are still fully susceptible to artemisinins. © A. Ogouyèmi-Hounto et al., published by EDP Sciences, 2016.

  4. Implementation of a decentralized community-based treatment program to improve the management of Buruli ulcer in the Ouinhi district of Benin, West Africa.

    PubMed

    Amoussouhoui, Arnaud Setondji; Sopoh, Ghislain Emmanuel; Wadagni, Anita Carolle; Johnson, Roch Christian; Aoulou, Paulin; Agbo, Inès Elvire; Houezo, Jean-Gabin; Boyer, Micah; Nichter, Mark

    2018-03-01

    Mycobacterium ulcerans infection, commonly known as Buruli ulcer (BU), is a debilitating neglected tropical disease. Its management remains complex and has three main components: antibiotic treatment combining rifampicin and streptomycin for 56 days, wound dressings and skin grafts for large ulcerations, and physical therapy to prevent functional limitations after care. In Benin, BU patient care is being integrated into the government health system. In this paper, we report on an innovative pilot program designed to introduce BU decentralization in Ouinhi district, one of Benin's most endemic districts previously served by centralized hospital-based care. We conducted intervention-oriented research implemented in four steps: baseline study, training of health district clinical staff, outreach education, outcome and impact assessments. Study results demonstrated that early BU lesions (71% of all detected cases) could be treated in the community following outreach education, and that most of the afflicted were willing to accept decentralized treatment. Ninety-three percent were successfully treated with antibiotics alone. The impact evaluation found that community confidence in decentralized BU care was greatly enhanced by clinic staff who came to be seen as having expertise in the care of most chronic wounds. This study documents a successful BU outreach and decentralized care program reaching early BU cases not previously treated by a proactive centralized BU program. The pilot program further demonstrates the added value of integrated wound management for NTD control.

  5. An intervention to improve cause-of-death reporting in New York City hospitals, 2009-2010.

    PubMed

    Madsen, Ann; Thihalolipavan, Sayone; Maduro, Gil; Zimmerman, Regina; Koppaka, Ram; Li, Wenhui; Foster, Victoria; Begier, Elizabeth

    2012-01-01

    Poor-quality cause-of-death reporting reduces reliability of mortality statistics used to direct public health efforts. Overreporting of heart disease has been documented in New York City (NYC) and nationwide. Our objective was to evaluate the immediate and longer-term effects of a cause-of-death (COD) educational program that NYC's health department conducted at 8 hospitals on heart disease reporting and on average conditions per certificate, which are indicators of the quality of COD reporting. From June 2009 through January 2010, we intervened at 8 hospitals that overreported heart disease deaths in 2008. We shared hospital-specific data on COD reporting, held conference calls with key hospital staff, and conducted in-service training. For deaths reported from January 2009 through June 2011, we compared the proportion of heart disease deaths and average number of conditions per death certificate before and after the intervention at both intervention and nonintervention hospitals. At intervention hospitals, the proportion of death certificates that reported heart disease as the cause of death decreased from 68.8% preintervention to 32.4% postintervention (P < .001). Individual hospital proportions ranged from 58.9% to 79.5% preintervention and 25.9% to 45.0% postintervention. At intervention hospitals the average number of conditions per death certificate increased from 2.4 conditions preintervention to 3.4 conditions postintervention (P < .001) and remained at 3.4 conditions a year later. At nonintervention hospitals, these measures remained relatively consistent across the intervention and postintervention period. This NYC health department's hospital-level intervention led to durable changes in COD reporting.

  6. Establishing a general medical outpatient clinic for cancer survivors in a public city hospital setting.

    PubMed

    Goytia, Elliott J; Lounsbury, David W; McCabe, Mary S; Weiss, Elisa; Newcomer, Meghan; Nelson, Deena J; Brennessel, Debra; Rapkin, Bruce D; Kemeny, M Margaret

    2009-11-01

    Many cancer centers and community hospitals are developing novel models of survivorship care. However, few are specifically focused on services for socio-economically disadvantaged cancer survivors. To describe a new model of survivorship care serving culturally diverse, urban adult cancer patients and to present findings from a feasibility evaluation. Adult cancer patients treated at a public city hospital cancer center. The clinic provides comprehensive medical and psychosocial services for patients within a public hospital cancer center where they receive their oncology care. Longitudinal data collected over a 3-year period were used to describe patient demographics, patient needs, and services delivered. Since inception, 410 cancer patients have been served. Demand for services has grown steadily. Hypertension was the most frequent comorbid condition treated. Pain, depression, cardiovascular disease, hyperlipidemia, and bowel dysfunction were the most common post-treatment problems experienced by the patients. Financial counseling was an important patient resource. This new clinical service has been well-integrated into its public urban hospital setting and constitutes an innovative model of health-care delivery for socio-economically challenged, culturally diverse adult cancer survivors.

  7. Particulate matter in Southwestern Africa cities of Cotonou (Benin) and Abidjan (Côte d'Ivoire).

    NASA Astrophysics Data System (ADS)

    Leon, J. F.; Djossou, J.; Liousse, C.; Akpo, A.; Veronique, Y.; Gardrat, E.; Bedou, M.; Bodjrenou, M.

    2017-12-01

    Air quality observations in the major cities of South-Western Africa still remains few with regards to economic growth and the large increase in the urban population. The main cities lying on the Gulf of Guinea experiences low air quality because of the contribution of local emissions and advection of pollutants from the African continent. We present in this paper new observations acquired from February 2015 to March 2017 in the major cities of Cotonou (Bénin) and Abidjan (Côte d'Ivoire). The PM2.5 mass concentration and carbon composition (elemental and organic carbon) were recorded on a weekly basis at 4 different locations representative of major emission sources, i.e. traffic emission, domestic fire and waste burning. Additionally, the aerosol optical depth (AOD) was also recorded daily inside and outside the cities. We observe large similarly between both cities. The mean PM2.5 concentration of around 30 µg.m-3 is coherent with previous studies for sub-Saharan western Africa and is 3 times higher than the concentrations recommended by the World Health Organization. The sampled collected at the domestic fire site shows a large pollution by smoking activity with an average concentration of 145 µg.m-3, nearly 5 times the traffic background. The seasonality of PM2.5 is affected by the contribution of desert dust and biomass burning emissions that is clearly observed from the AOD time series. We observe that dust events contribute sporadically to large amount of PM2.5, above 100 µg.m-3, during the dry seasons. Moreover, the biomass burning activity is also maximum before and during the dry season and contributes to increase the PM2.5 concentration. Low PM2.5 observed during the minor dry season can be explain by an enhancement of the atmospheric dispersion due to the increase in the wind intensity and the absence of biomass burning activity. We observe a significant difference in the carbonaceous aerosols between the traffic site in Abidjan and Cotonou. The

  8. Adoption of endovenous laser treatment as the primary treatment modality for varicose veins: the Auckland City Hospital experience.

    PubMed

    Fernando, Ruchira S W; Muthu, Carl

    2014-08-01

    To assess the effectiveness of adopting endovenous laser treatment (EVLT) as the primary treatment modality for varicose veins at Auckland City Hospital (Auckland, New Zealand). The outcomes of 354 consecutive EVLT procedures performed between 2007 and 2013 were reviewed. Data was collected from a prospectively maintained procedural database and by retrospective chart review. Of the 319 patients who had an ultrasound, at 1 month post-procedure there was a saphenous vein occlusion rate of 96%. Side effects were minimal with no cases of DVT or skin burns and one case of self-limiting neuralgia. The procedure was well tolerated with a median pain score of 3. Since the adoption of EVLT there has been a large increase in the number of patients treated for varicose veins (28 in 2007 compared to 176 in 2013). EVLT is a safe and effective treatment for varicose veins and its adoption has allowed a large increase in the number of varicose vein patients treated at Auckland City Hospital.

  9. MANUFACTURING FACILITY FOR ACTIVATED CARBON AND CERAMIC WATER FILTERS AT THE SONGHAI CENTER, BENIN

    EPA Science Inventory

    Ceramic filters will be manufactured at the Songhai Center in Porto-Novo, Benin for cost-effective drinking water treatment. The efficiency of the ceramic filters will be improved by adding activated carbon cartridges to remove organic and inorganic impurities. The activate...

  10. A Content Analysis of Hospitals' Community Health Needs Assessments in the Most Violent U.S. Cities.

    PubMed

    Fischer, Kyle R; Schwimmer, Henry; Purtle, Jonathan; Roman, Daniel; Cosgrove, Shannon; Current, J J; Greene, Michael B

    2018-04-01

    The emergence of evidence-supported interventions allows hospitals the opportunity to reduce future reinjury among patients who are violently injured. However, hospital knowledge of these interventions and their perceived role in violence prevention is unknown. The Patient Protection and Affordable Care Act created new legal requirements for non-profit hospitals to conduct community health needs assessments (CHNA) every three years to maintain not-for-profit status. In turn, this allows an empiric evaluation of hospital recognition and response to community violence. To do so, this study performed a content analysis of hospital CHNAs from the 20 U.S. cities with the highest violent crime rates. A total of 77 CHNAs were examined for specific violence-related keywords as well as whether violence prevention was listed as a priority community need. Overall, 74% of CHNAs mentioned violence-related terms and only 32% designated violence prevention as a priority need. When discussed, 88% of CHNAs referenced community violence, 42% intimate partner or sexual violence, and 22% child abuse. This study suggests that hospitals may lack awareness of violence as an actionable, preventable public health issue. Further, evidence-based program models are available to hospitals that can reduce the recurrence of assaultive injuries.

  11. Factors associated with antenatal care services utilisation patterns amongst reproductive age women in Benin Republic: An analysis of 2011/2012 benin republic's demographic and health survey data.

    PubMed

    Dansou, Justin; Adekunle, Adeyemi O; Arowojolu, Ayodele O

    2017-01-01

    High maternal and neonatal mortality persist in Benin Republic despite recent improvements. Numerous women and newborns continue to suffer preventable deaths. Although factors associated with the attendance of at least one antenatal care (ANC) visit are well documented, there is little evidence on factors related to compliance with World Health Organization (WHO) recommended four ANC visits. The present study determined the extent to which reproductive age mothers received the ANC check-ups at a health facility focussing on the WHO-recommended regimen. We examined factors related to ANC services utilisation patterns amongst 8701 women recruited in the 2011/2012 Benin Demographic and Health Survey data using multinomial logistic regression. The percentage of mothers with full ANC attendance was 59.56%, 27.61% received less than 4 visits and 12.84% had never attended ANC services. Results showed that out of 13 variables assessed, only the place of residence was not associated with ANC seeking. Amongst significant variables, household wealth index, female education and desire for pregnancy were the most important factors related to ANC services seeking, especially for the achievement of WHO recommended four ANC visits. The relative risk ratio of ANC attendance, for the achievement of WHO recommended four ANC regimens was high amongst mothers from economically well-off households (adjusted relative risk ratio [aRRR] for richest women = 10.6, 95% confidence interval [CI]: 6.16-18.33), educated women (aRRR for primary level = 4.34, 95% CI: 3.00-6.27) and those with desired pregnancies (aRRR = 3.4, 95% CI: 2.58-4.48). To achieve WHO-recommended minimum four ANC visits in Benin Republic, our findings suggest the need to financially support the most economically disadvantaged pregnant women and their families during pregnancy, advocate for reducing unmet needs for family planning, strengthen girls' education, especially by maintaining them in school till completion of at

  12. Analysis of the Internal Bed Regulation Committees from hospitals of a Southern Brazilian city

    PubMed Central

    Soares, Vinícius Sabedot

    2017-01-01

    ABSTRACT Objective To evaluate the composition of the Internal Regulation Committees created in hospitals of a capital city. Methods A cross-sectional descriptive study assessing the structure, processes and results of each Committee. Results The main reasons for implementing the committees were legal issues and overcrowding in the emergency department. The most monitored indicators were the occupancy rate and the mean length of stay, and the most observed results were reductions in the latter. Institutional protocols were developed in 70% of cases, and the degree of support that the Internal Regulation Committee received from the hospital managers was high, despite being only average the support received from the medical teams. Promoting the efficient use of beds seemed to be the main goal. To achieve it, the Internal Regulation Committee had to control hospital capacity at levels that allowed proper and safe bed turnover for patients. The strategies for this were varied and needed to integrate administrative and care issues. Conclusion The Internal Regulation Committees were a management tool with great potential and promising results in the experiences evaluated. PMID:29091157

  13. Management of Childhood Illness at Health Facilities in Benin: Problems and Their Causes

    PubMed Central

    Rowe, Alexander K.; Onikpo, Faustin; Lama, Marcel; Cokou, Francois; Deming, Michael S.

    2001-01-01

    Objectives. To prepare for the implementation of Integrated Management of Childhood Illness (IMCI) in Benin, we studied the management of ill children younger than 5 years at outpatient health facilities. Methods. We observed a representative sample of consultations; after each consultation, we interviewed caregivers and reexamined children. Health workers' performance was evaluated against IMCI guidelines. To identify determinants of performance, statistical modeling was performed and 6 focus groups with health workers were conducted to solicit their opinions. Results. Altogether, 584 children were enrolled and 101 health workers were observed; 130 health workers participated in focus group discussions. Many serious deficiencies were found: incomplete assessment of children's signs and symptoms, incorrect diagnosis and treatment of potentially life-threatening illnesses, inappropriate prescription of dangerous sedatives, missed opportunities to vaccinate, and failure to refer severely ill children for hospitalization. Quantitative and qualitative analyses showed various health facility–, health worker–, caregiver-, and child-related factors as possible determinants of health worker performance. Conclusions. Action is urgently needed. Our results suggest that to improve health care delivery, interventions should target both the health system and the community level. PMID:11574325

  14. Campaign supports new name for TX hospital. Effort expands children's hospital's image and increases awareness.

    PubMed

    2007-01-01

    For years, the North Texas Hospital for Children at Medical City in Dallas struggled with its brand awareness. It's long-winded name was largely unknown among the city's 1.2 million residents. The hospital needed a new name and it needed one fast. The year 2005 proved to be both a burden and an opportunity for the 311-bed pediatric hospital. It survived a legal battle with a local competitor for the right to use the word "children's" in its name, created a new identity, and launched a three-year branding initiative to introduce its new name: Medical City Children's Hospital.

  15. [Origins of institutional Pediatrics: Maternity and Childhood Hospital of Mexico City in the nineteenth century].

    PubMed

    Baeza Bacab, Manuel Antonio

    In June of 1866, the empress Carlota founded the Maternity House in the Department of Secret Births at the Hospice of the Poor. Upon the reinstatement of a republican government, Dr. Ramon Pacheco was appointed director of the Maternity House. Shortly after, in February of 1868, Dr. Luis Fernandez Gallardo established a pavilion for sick children in the Hospital of San Andres. After realizing this pavilion didn't have the adequate conditions to operate properly, and in the need of a children's hospital in Mexico City, Dr. Pacheco merged both institutions in April 2, 1869 -with the help of Ms. Luciana Arrazola- and founded the Maternity and Childhood Hospital, the first institution for the care of ill children in the independent Mexico. Ever since it was founded, Dr. Eduardo Liceaga was in charge of the children's health. Later, with the help of the presidents Juarez, Lerdo de Tejada and Díaz, he was able to consolidate the hospital in academic and health services aspects. This noble institution closed its doors on February 5, 1905, upon its incorporation to the General Hospital of Mexico, after 36 years of working for the welfare of Mexican children. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  16. Emergency Blood Transfusion in Children in a Tertiary Hospital in Nigeria: Indications, Frequency and Outcome.

    PubMed

    Abhulimhen-Iyoha, B I; Israel-Aina, Y T

    2018-01-01

    Blood transfusion is a life-saving procedure in paediatric practice. It is important in replacing blood volume in cases of haemorrhage or providing specific blood components as required. However, the procedure carries some risks and complications. The decision to transfuse, frequency of transfusion and the availability of safe blood and blood products are essential determinants of the success of the procedure. Hence, knowledge of the indications and rate of transfusion is important to ensure that blood for transfusion is safe and made available as at when due. To determine the common indications for blood transfusion, the frequency of transfusion and outcome of transfused patients. Transfusion records of children admitted into the Children Emergency Room (CHER) of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria from January 2010 to December 2011 were retrieved. Information on the patients' biodata, indications for transfusion, type of blood product and outcome were documented. Within the 24 months under review, a total of 4133 patients were admitted, out of which 655 (15.8%) were transfused. The age of the children ranged between one month and 17 years (median and modal age was 2 years). Commonest indications for transfusion were severe malaria (55.4%), sepsis (11.5%) and sickle cell anaemia [SCA] (4.0%). Whole blood constituted the highest type of blood product utilized (99.7%). Of the 655 patients transfused, 226 (34.5%) had multiple transfusions. The frequency of blood transfusion was 1.2 transfusions per day. Ninety two percent (605) of the patients were discharged from CHER while nine (1.4%) discharged against medical advice. Mortality amongst them was 6.2% (41 patients). The ages of the patients (p = 0.56, C.I. = 0.99, 1.01) and the number of blood transfusions (p = 0.66, C.I.= 0.48, 1.60) were not significant predictors of mortality. Majority of the patients were transfused following preventable disease conditions. Reduction of the

  17. Boston City Hospital and the Thorndike Memorial Laboratory: the birth of modern haematology.

    PubMed

    Elrod, Jeffrey M; Karnad, Anand B

    2003-05-01

    Established in 1923, the Thorndike Memorial Laboratory at Boston City Hospital was the first clinical research laboratory in a municipal hospital in the United States of America. Minot and Castle, who were the second and third directors of the Laboratory, were pioneer haematologists and clinical investigators of the highest calibre who created an atmosphere at the Laboratory that would foster patient-centred research and attract the best physician-scientists to work and train there. The haematology research division of the Laboratory made important original contributions to the understanding of the pathophysiology of anaemia, the mechanisms of red cell and platelet destruction and the phagocytic role of the spleen, the nature of haemoglobin (normal and sickle cell), the nature of haemophilia and its therapy and the early classification of lymphoma. It contributed to the Thorndike Memorial Laboratory's worldwide reputation as a model research laboratory and established its reputation as the birthplace of modern haematology.

  18. Social responsibility of the hospitals in Isfahan city, Iran: Results from a cross-sectional survey

    PubMed Central

    Keyvanara, Mahmoud; Sajadi, Haniye Sadat

    2015-01-01

    Background: Changes in modern societies develop the perception that the external environment is essential in organization’s practices, especially in the way they deal with aspects such as human rights, community needs, market demands and environmental interests. These issues are usually under the umbrella of the concept of social responsibility. Given the importance of this concept in the context of health care delivery, suggesting a new paradigm in hospital governance, the aim of this study was to measure the social responsibility in hospitals. Methods: A cross-sectional survey was employed to collect data from a sample of 946 hospital staff of Isfahan city. Data was obtained by structured and valid self-administrated questionnaire and analyzed by descriptive and analytic statistics using SPSS. Results: The mean score of hospitals’ social responsibility was 3.0 compared with the justified range from 1.0 to 5.0. Results showed that there was a significant relationship between social responsibility score and hospitals’ ownership (public or private). Also, there was no significant relationship between social responsibility and type of hospital specialty. Conclusion: It is recommended that hospital managers develop and apply appropriate policies and strategies to improve their hospitals’ social responsibility level, especially through concentrating on their staff’s working environment. PMID:26340391

  19. Determinants of severe anemia among laboring mothers in Mekelle city public hospitals, Tigray region, Ethiopia

    PubMed Central

    Alemayehu, Mussie; Mitiku, Mengistu; Goba, Gelila K.

    2017-01-01

    Introduction Anemia is a global public health problem that has affected a significant number of pregnant mothers worldwide. The World Health Organization has estimated the prevalence of anemia in pregnant women at 18% and 56% in developed and developing countries, respectively. This study aimed to identify factors associated with severe anemia among laboring women in Mekelle city public hospitals, Tigray, Ethiopia. Methods This unmatched case–control study involved 264 (88 = cases and 176 = controls) pregnant women who were recruited when they came for delivery service in Mekelle city public hospitals. The data was collected from July to August, 2016. In this study, a systematic sampling technique was used inselecting controls, but the cases were enrolled until the required sample size was reached. Bivariate and multivariate analyses were conducted to find predictors of severe anemia. Statistically significant predictors of severe anemia were identified at P-value <0.05 and 95% confidence interval. Results A total of 264 pregnant women who came for delivery services were enrolled in this study. The major predicting variables for the occurrence of severe anemia among laboring women were residency (AOR = 3.28, 95% CI: 1.26–8.48), number of pregnancies (AOR = 2.46, 95% CI: 1.14–5.29), iron folate supplementation (AOR = 3.29, 95% CI: 1.27–8.49), dietary diversification score (AOR = 3.23, 95% CI: 1.19–8.71) and duration of menstrual cycle (AOR = 2.37, 95% CI: 1.10–5.10). The variable ‘blood loss during pregnancy’ (AOR = 6.63 95% CI: 2.96–14.86) was identified as a strong predictor of the outcome variable, severe anemia. Conclusion This study identified determinants of severe anemia among laboring women in Mekelle city public hospitals, Northern Ethiopia. To reduce anemia, strengthening health education provision related to the importance of birth spacing and consuming diversified and iron-enriched food should be considered. Moreover, screening of

  20. [Prevalence of depressive and anxiety disorders in cardiovascular outpatients from 14 tertiary general hospitals of 5 Chinese cities].

    PubMed

    Li, Guo; Jiang, Ronghuan; Guo, Chengjun; Liu, Meiyan; Zhang, Lijun

    2014-12-01

    To explore the prevalence of depression and (or) anxiety disorders among cardiovascular outpatients of tertiary general hospitals of five Chinese cities. A hospital-based cross-sectional survey was conducted in the cardiovascular out-patient departments of 14 tertiary general hospitals in five Chinese cities. The patients aged 18 years and over were recruited consecutively, who were conscious and with informed consent, and can finish the questionnaire independently. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using mini international neuropsychiatric interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. Subjects who refused MINI were defined as the case of loss of follow-up. A total 2 123 subjects were included in the survey. The adjusted prevalence rate of depressive and anxiety disorder was 4.05% (86/2 123), the depressive and/or anxiety disorder was 14.27 % (303/2 123), depressive and anxiety disorder and mixed depressive or anxiety disorder was 14.37% (305/2 123) according to MINI. The adjusted prevalence of lifetime depressive and anxiety disorder was 5.37% (114/2 123), depressive and/or anxiety disorder was 16.91% (359/2 123), depressive and anxiety disorder and mixed depressive-anxiety disorder was 17.00% (361/2 123). There is a high prevalence of depressive and anxiety disorder among cardiovascular outpatients from tertiary general hospitals in China. Therefore, doctors must pay attention to this disorder and try to reduce the impact of this disorder in cardiovascular patients.

  1. An indoor radon survey of the X-ray rooms of Mexico City hospitals

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Juarez, Faustino; Reyes, Pedro G.; Espinosa, Guillermo

    This paper presents the results of measurements of indoor radon concentrations in the X-ray rooms of a selection of hospitals in the metropolitan area of Mexico City. The metropolitan area of Mexico City is Mexico's largest metropolitan area by population; the number of patients requiring the use of X-rays is also the highest. An understanding of indoor radon concentrations in X-ray rooms is necessary for the estimation of the radiological risk to which patients, radiologists and medical technicians are exposed. The indoor radon concentrations were monitored for a period of six months using nuclear track detectors (NTD) consisting of amore » closed-end cup system with CR-39 (Lantrack Registered-Sign ) polycarbonate as detector material. The indoor radon concentrations were found to be between 75 and 170 Bq m{sup -3}, below the USEPA-recommended indoor radon action level for working places of 400 Bq m{sup -3}. It is hoped that the results of this study will contribute to the establishment of recommended action levels by the Mexican regulatory authorities responsible for nuclear safety.« less

  2. Lesson From the New York City Out-of-Hospital Uncontrolled Donation After Circulatory Determination of Death Program.

    PubMed

    Wall, Stephen P; Kaufman, Bradley J; Williams, Nicholas; Norman, Elizabeth M; Gilbert, Alexander J; Munjal, Kevin G; Maikhor, Shana; Goldstein, Michael J; Rivera, Julia E; Lerner, Harvey; Meyers, Chad; Machado, Marion; Montella, Susan; Pressman, Marcy; Teperman, Lewis W; Dubler, Nancy N; Goldfrank, Lewis R

    2016-04-01

    In 2006, the Institute of Medicine emphasized substantial potential to expand organ donation opportunities through uncontrolled donation after circulatory determination of death (uDCDD). We pilot an out-of-hospital uDCDD kidney program for New York City in partnership with communities that it was intended to benefit. We evaluate protocol process and outcomes while identifying barriers to success and means for improvement. We conducted a prospective, participatory action research study in Manhattan from December 2010 to May 2011. Daily from 4 to 12 pm, our organ preservation unit monitored emergency medical services (EMS) frequencies for cardiac arrests occurring in private locations. After EMS providers independently ordered termination of resuscitation, organ preservation unit staff determined clinical eligibility and donor status. Authorized parties, persons authorized to make organ donation decisions, were approached about in vivo preservation. The study population included organ preservation unit staff, authorized parties, passersby, and other New York City agency personnel. Organ preservation unit staff independently documented shift activities with daily operations notes and teleconference summaries that we analyzed with mixed qualitative and quantitative methods. The organ preservation unit entered 9 private locations; all the deceased lacked previous registration, although 4 met clinical screening eligibility. No kidneys were recovered. We collected 837 notes from 35 organ preservation unit staff. Despite frequently recounting protocol breaches, most responses from passersby including New York City agencies were favorable. No authorized parties were offended by preservation requests, yielding a Bayesian posterior median 98% (95% credible interval 76% to 100%). In summary, the New York City out-of-hospital uDCDD program was not feasible. There were frequent protocol breaches and confusion in determining clinical eligibility. In the small sample of

  3. The Sociology of the Deceased Harvard Medical Unit at Boston City Hospital.

    PubMed

    Tishler, Peter V

    2015-12-01

    Many graduates of the Harvard Medical Unit (HMU) at Boston City Hospital, in either the clinical training/residency program or the research program at the Thorndike Memorial Laboratory, contributed in major ways to the HMU and constantly relived their HMU experiences. The HMU staff physicians, descending from founder and mentor physicians Francis W. Peabody, Soma Weiss, and George R. Minot, were dedicated to the teaching, development, and leadership of its clinical and research trainees, whose confidence and dedication to patient care as a result of their mentorship led many to lifelong achievements as clinicians, teachers, and mentors. Their experience also led to a lifelong love of the HMU (despite its loss), camaraderie, happiness, and intense friendships with their associates.

  4. A system dynamics approach for hospital waste management in a city in a developing country: the case of Nablus, Palestine.

    PubMed

    Al-Khatib, Issam A; Eleyan, Derar; Garfield, Joy

    2016-09-01

    Hospitals and health centers provide a variety of healthcare services and normally generate hazardous waste as well as general waste. General waste has a similar nature to that of municipal solid waste and therefore could be disposed of in municipal landfills. However, hazardous waste poses risks to public health, unless it is properly managed. The hospital waste management system encompasses many factors, i.e., number of beds, number of employees, level of service, population, birth rate, fertility rate, and not in my back yard (NIMBY) syndrome. Therefore, this management system requires a comprehensive analysis to determine the role of each factor and its influence on the whole system. In this research, a hospital waste management simulation model is presented based on the system dynamics technique to determine the interaction among these factors in the system using a software package, ithink. This model is used to estimate waste segregation as this is important in the hospital waste management system to minimize risk to public health. Real data has been obtained from a case study of the city of Nablus, Palestine to validate the model. The model exhibits wastes generated from three types of hospitals (private, charitable, and government) by considering the number of both inpatients and outpatients depending on the population of the city under study. The model also offers the facility to compare the total waste generated among these different types of hospitals and anticipate and predict the future generated waste both infectious and non-infectious and the treatment cost incurred.

  5. Adolescent and Adult Reasoning about Gender Roles and Fairness in Benin, West Africa

    ERIC Educational Resources Information Center

    Conry-Murray, Clare

    2009-01-01

    This study examined reasoning about gender roles in a traditional society in Benin, West Africa. Ninety-seven male and female adolescents and adults evaluated conflicts between a husband and a wife over gender norms to determine whether gender norms, are judged to be moral or conventional. Although most attributed decision-making power to the…

  6. Implementing for results: Program analysis of the HIV/STI interventions for sex workers in Benin

    PubMed Central

    Semini, Iris; Batona, Georges; Lafrance, Christian; Kessou, Léon; Gbedji, Eugène; Anani, Hubert; Alary, Michel

    2013-01-01

    HIV response has entered a new era shaped by evidence that the combination of interventions impacts the trajectory of the epidemic. Even proven interventions, however, can be ineffective if not to scale, appropriately implemented, and with the right combination. Benin is among the pioneering countries that prioritized HIV prevention for sex workers and clients early on. Effective implementation up to 2006 resulted in consistent condom use among sex workers increasing from 39% to 86.2% and a decline in prevalence of gonorrhea from 5.4% to 1.6%. This study responds to the growing concern that, although proven interventions for female sex workers (FSWs) were expanded in Benin since 2008, indicators of coverage and behaviors are far from satisfactory. The quest to better understand implementation and how to render service delivery efficient and effective resonates with increased emphasis in the international arena on return for investments. Quantitative and qualitative methods were utilized to collect data. The output measured is the number of sex workers seeking Sexually Transmitted Infection (STI) care at user-friendly STI Clinics (SCs). Data were collected for 2010–2011 in nine regions of Benin. While recognizing that commitment to scale up is commendable, the study revealed deficiencies in program design and implementation that undermine outcomes. The selected mix of interventions is not optimal. Allocation of funds is not proportionate to the needs of FSW across regions. Only 5 of 41 SCs were fully functional at time of study. Free distribution of condoms covers only 10% of needs of FSWs. Funding and financing gaps resulted in extended interruptions of services. Successful HIV prevention in Benin will depend on the effective and efficient implementation of well-funded programs in sex work setting. Resources should be aligned to local sex work typology and presence in communities. A national framework defining an appropriate mix of interventions, management

  7. Implementing for results: program analysis of the HIV/STI interventions for sex workers in Benin.

    PubMed

    Semini, Iris; Batona, Georges; Lafrance, Christian; Kessou, Léon; Gbedji, Eugène; Anani, Hubert; Alary, Michel

    2013-01-01

    HIV response has entered a new era shaped by evidence that the combination of interventions impacts the trajectory of the epidemic. Even proven interventions, however, can be ineffective if not to scale, appropriately implemented, and with the right combination. Benin is among the pioneering countries that prioritized HIV prevention for sex workers and clients early on. Effective implementation up to 2006 resulted in consistent condom use among sex workers increasing from 39% to 86.2% and a decline in prevalence of gonorrhea from 5.4% to 1.6%. This study responds to the growing concern that, although proven interventions for female sex workers (FSWs) were expanded in Benin since 2008, indicators of coverage and behaviors are far from satisfactory. The quest to better understand implementation and how to render service delivery efficient and effective resonates with increased emphasis in the international arena on return for investments. Quantitative and qualitative methods were utilized to collect data. The output measured is the number of sex workers seeking Sexually Transmitted Infection (STI) care at user-friendly STI Clinics (SCs). Data were collected for 2010-2011 in nine regions of Benin. While recognizing that commitment to scale up is commendable, the study revealed deficiencies in program design and implementation that undermine outcomes. The selected mix of interventions is not optimal. Allocation of funds is not proportionate to the needs of FSW across regions. Only 5 of 41 SCs were fully functional at time of study. Free distribution of condoms covers only 10% of needs of FSWs. Funding and financing gaps resulted in extended interruptions of services. Successful HIV prevention in Benin will depend on the effective and efficient implementation of well-funded programs in sex work setting. Resources should be aligned to local sex work typology and presence in communities. A national framework defining an appropriate mix of interventions, management

  8. Transactional sex and sexual harassment between professors and students at an urban university in Benin.

    PubMed

    Eller, Amanda

    2016-07-01

    This paper adds to discussion of transactional sex relationships in Africa by examining the distinction between transactional sex and sexual harassment in the context of professor-student relationships and their inherent power dynamics. By exploring the ways in which female university students in urban Benin toe the line between empowered agent and victim, I show how the power differential between professor and student obstructs the professor's ability to objectively determine consent, and examine why, in spite of this differential, male professors are frequently perceived as the victims of these relationships. Ethnographic data were gathered through participant observation on a public university campus in Benin and in-depth interviews and focus groups with 34 students and 5 professors from that university. Findings suggest that the problem of sexual harassment on campus will be difficult to address so long as transactional sex relationships between professors and students are permitted to continue.

  9. Sequence diversity among badnavirus isolates infecting yam (Dioscorea spp.) in Ghana, Togo, Benin and Nigeria.

    PubMed

    Eni, A O; Hughes, J d'A; Asiedu, R; Rey, M E C

    2008-01-01

    We analysed the sequence diversity in the reverse transcriptase (RT)/ribonuclease H (RNaseH) coding region of 19 badnavirus isolates infecting yam (Dioscorea spp.) in Ghana, Togo, Benin, and Nigeria. Phylogenetic analysis of the deduced amino acid sequences revealed that the isolates are broadly divided into two distinct species, each clustering with Dioscorea alata bacilliform virus (DaBV) and Dioscorea sansibarensis bacilliform virus (DsBV). Fourteen isolates had 90-96% amino acid identity with DaBV, while four isolates had 83-84% amino acid identity with DsBV. One isolate from Benin, BN4Dr, was distinct and had 77 and 75% amino acid identity with DaBV and DsBV, respectively, and may be a member of a new badnavirus species infecting yam in West Africa. Viruses of the two main species were present in Ghana, Togo and Benin and were observed to infect both D. alata and D. rotundata indiscriminately. This is the first confirmed report of DsBV infection in yam in Ghana and Togo. The results of this study demonstrate that members of two distinct species of badnaviruses infect yam in the West African yam zone and suggest a putative new species, BN4Dr. We also conclude that these species are not confined to limited geographic regions or specific for yam host species. However, the three badnavirus species are serologically related. The sequence information obtained from this study can be used to develop PCR-based diagnostics to detect members of the various species and/or strains of badnaviruses infecting yam in West Africa.

  10. A Comparison of Health Information Needs between Patients at a Suburban Hospital-based Clinic and two Underserved Inner City Clinics

    PubMed Central

    Hong, Yi; Blackwelder, Mary; Gillis, Rick; Barnas, Gary; Early, Eileen; Jascur, Andrea

    2003-01-01

    A needs assessment was conducted and the results were analyzed to determine and compare the health information seeking habits and needs of outpatients at a suburban hospital-based clinic and at two clinics located in underserved areas of the inner city. PMID:14728370

  11. Reducing hospital admissions and improving the diagnosis of COPD in Southampton City: methods and results of a 12-month service improvement project.

    PubMed

    Wilkinson, Tom; North, Mal; Bourne, Simon C

    2014-08-21

    The British Lung Foundation highlighted Southampton City as a hotspot for patients at future risk of chronic obstructive pulmonary disease (COPD) exacerbations due to severe deprivation levels and a high undiagnosed level of disease based on health economic modelling. We developed a strategy spanning primary and secondary care to reduce emergency admissions of patients with acute exacerbations of COPD and increase the diagnosed prevalence of COPD on general practitioner (GP) registers closer to that predicted from local modelling. A comprehensive 3-year audit of admissions was performed. Patients who had been admitted with an exacerbation to University Hospital Southampton three or more times in the previous 12 months were cohorted and cared for in a consultant-led, but community based, COPD service. Within primary care, a programme of education and case-based finding was delivered to most practices within the city. Thirty-four patients were found to be responsible for 176 admissions (22% of total COPD admissions) to the hospital. These 34 patients required 185 active interventions during the 12-month period but only 39 hospital admissions. The 30-day readmission rate dropped from 13.4 to 1.9% (P<0.01), confirming the contribution the cohort made to readmissions. Prior to the project, the registered Quality Outcomes Framework prevalence of COPD within the city was 1.5; after just 1 year of the project, the prevalence increased from 1.5 to 2.27%. The use of medical intelligence to investigate the underlying processes of COPD hospital admissions led to an effective intervention delivered in a consultant-led model.

  12. The effects of air pollution on hospitalizations for cardiovascular disease in elderly people in Australian and New Zealand cities.

    PubMed

    Barnett, Adrian G; Williams, Gail M; Schwartz, Joel; Best, Trudi L; Neller, Anne H; Petroeschevsky, Anna L; Simpson, Rod W

    2006-07-01

    The goal of this study was to estimate the associations between outdoor air pollution and cardiovascular hospital admissions for the elderly. Associations were assessed using the case-crossover method for seven cities: Auckland and Christchurch, New Zealand; and Brisbane, Canberra, Melbourne, Perth, and Sydney Australia. Results were combined across cities using a random-effects meta-analysis and stratified for two adult age groups: 15-64 years and >/= 65 years of age (elderly). Pollutants considered were nitrogen dioxide, carbon monoxide, daily measures of particulate matter (PM) and ozone. Where multiple pollutant associations were found, a matched case-control analysis was used to identify the most consistent association. In the elderly, all pollutants except O3 were significantly associated with five categories of cardiovascular disease admissions. No associations were found for arrhythmia and stroke. For a 0.9-ppm increase in CO, there were significant increases in elderly hospital admissions for total cardiovascular disease (2.2%) , all cardiac disease (2.8%), cardiac failure (6.0%), ischemic heart disease (2.3%), and myocardial infarction (2.9%). There was some heterogeneity between cities, possibly due to differences in humidity and the percentage of elderly people. In matched analyses, CO had the most consistent association. The results suggest that air pollution arising from common emission sources for CO, NO2, and PM (e.g., motor vehicle exhausts) has significant associations with adult cardiovascular hospital admissions, especially in the elderly, at air pollution concentrations below normal health guidelines. Relevance to clinical and professional practice: Elderly populations in Australia need to be protected from air pollution arising from outdoor sources to reduce cardiovascular disease.

  13. Inter-regional competition and quality in hospital care.

    PubMed

    Aiura, Hiroshi

    2013-06-01

    This study analyzes the effect of episode-of-care payment and patient choice on waiting time and the comprehensive quality of hospital care. The study assumes that two hospitals are located in two cities with different population sizes and compete with each other. We find that the comprehensive quality of hospital care as well as waiting time of both hospitals improve with an increase in payment per episode of care. However, we also find that the extent of these improvements differs according to the population size of the cities where the hospitals are located. Under the realistic assumptions that hospitals involve significant labor-intensive work, we find the improvements in comprehensive quality and waiting time in a hospital located in a small city to be greater than those in a hospital located in a large city. The result implies that regional disparity in the quality of hospital care decreases with an increase in payment per episode of care.

  14. Characteristics and Treatment Outcomes of Retreatment Tuberculosis Patients in Benin

    PubMed Central

    Ade, Serge; Adjibodé, Omer; Wachinou, Prudence; Toundoh, Narcisse; Awanou, Bérénice; Agodokpessi, Gildas; Affolabi, Dissou; Adè, Gabriel; Harries, Anthony D.; Anagonou, Séverin

    2016-01-01

    Objective. To determine among retreatment tuberculosis patients in Benin baseline characteristics, culture, and drug sensitivity testing (DST) results and treatment outcomes. Materials and Methods. A retrospective national cohort study of all retreatment tuberculosis patients in Benin in 2013 using registers and treatment cards. Results. Of 3957 patients with tuberculosis, 241 (6%) were retreatment cases. Compared to new pulmonary bacteriologically confirmed tuberculosis (NPBCT) patients, there were significantly higher numbers of males (P = 0.04), patients from “Atlantique-Littoral” (P = 0.006), patients aged 45–64 years (P = 0.007), and HIV-positive patients (P = 0.04) among those retreated. Overall, 171 (71%) patients submitted sputum for DST, of whom (163) 95% were positive for Mycobacterium tuberculosis on Xpert MTB/RIF and/or culture and 17 (10%) were rifampicin resistant (9 with MDR-TB and 8 monoresistant to rifampicin). For those without MDR-TB (n = 224), treatment success was 93%. Worse outcomes occurred in those with unknown HIV status (RR: 0.27; 0.05–1.45; P < 0.01) while better outcomes occurred in those who relapsed (RR: 1.06, 95 CI: 1.02–1.10, P = 0.04). Conclusion. In 2013, a high proportion of retreatment patients received DST. Treatment success was good although more needs to be done to systematically increase the final follow-up smear examination. Reasons of high losses to follow-up from “Oueme-Plateau” should be investigated. PMID:27110400

  15. The Sociology of the Deceased Harvard Medical Unit at Boston City Hospital

    PubMed Central

    Tishler, Peter V.

    2015-01-01

    Many graduates of the Harvard Medical Unit (HMU) at Boston City Hospital, in either the clinical training/residency program or the research program at the Thorndike Memorial Laboratory, contributed in major ways to the HMU and constantly relived their HMU experiences. The HMU staff physicians, descending from founder and mentor physicians Francis W. Peabody, Soma Weiss, and George R. Minot, were dedicated to the teaching, development, and leadership of its clinical and research trainees, whose confidence and dedication to patient care as a result of their mentorship led many to lifelong achievements as clinicians, teachers, and mentors. Their experience also led to a lifelong love of the HMU (despite its loss), camaraderie, happiness, and intense friendships with their associates. PMID:26604868

  16. [Environmental impact of a public hospital in the city of Lima, Peru].

    PubMed

    Bambarén-Alatrista, Celso; Alatrista-Gutiérrez de Bambarén, María del Socorro

    2014-01-01

    The operation of hospitals produces negative effects on the environment which contributes to air pollution and climate change. The institution in this study is a category III health care facility located in the city of Lima. It generates 4.89 kg/bed/day of solid waste, and consumes 1.36 m3/bed/day of water; 25.22 kWh/bed/day of electricity, and 2.76 liters/bed/day of fuel. The level of PM10 and measured parameters of disposal to the public network are within legal limits, while mobile source noise exceeds the maximum allowable limit. The institution releases into the atmosphere 2,291 tons of CO2 equivalents per year. In conclusion, the institution studied generates a negative impact on the environment.

  17. [High-risk human papilloma virus and cervical intraepithelial neoplasia in women at 2 hospitals in Mexico City].

    PubMed

    Hernández-Hernández, Dulce Ma; García-Carrancá, Alejandro; Guido-Jiménez, Miriam C; González-Sánchez, José Luis; Cruz-Talonia, Fernando; Apresa-García, Teresa; Martínez-Elizondo, Olga A; Ornelas-Bernal, Laura; Alvarado-Cabrera, Isabel; Muñoz, Sergio

    2002-01-01

    To determine the high risk HPV (HR-HPV) association with Cervical Intraepithelial Neoplasia (CIN) in women of two Dysplasia Clinics in Mexico City. Prolective case-control study was done. Women with and without security affiliation attended in Instituto Mexicano del Seguro Social (Hospital 1) and Hospital General de México (Hospital 2) were included in the study. Cases were women with histopathologic diagnosis of CIN and controls were women with negative dysplasia in cytologic study (Pap). Information was obtained by direct interview. HR-HPV was determined by Hybrid Capture II assay, in cervical samples. Bivariate and logistic regression analysis was done. One hundred and two cases and 192 controls from Hospital 1 and 89 cases and 66 controls from Hospital 2 were included. 83.3% and 77.3% of women from Hospital 1 and 2 respectively were positive to HR-HPV. The association HR-HPV and CIN in Hospital 1 was ORa = 40.6, C.I. 95% = 17-96.8; while in Hospital 2 there was not association. Age was an effect modifier in the HR-HVP and CIN association, in Hospital 1. It was observed a correlation between viral load and CIN degree. The HR-HPV infection frequency in controls and CIN I was higher than the reported in other studies. Age was a modifier in the HR-HPV association and CIN. In dysplasia clinics without medical referral system of patients is possible to observe similar risk factors to cervical cancer.

  18. Quality of maize for sale in markets in Benin and Niger.

    PubMed

    Bakoye, O N; Baoua, I B; Seyni, H; Amadou, L; Murdock, L L; Baributsa, D

    2017-03-01

    A follow-up study on the quality of maize for sale in West African public markets was carried out in Benin and Niger from August 15-28, 2013. Complementing the earlier study, this present assessment included not only retailers but also wholesalers and maize producers. Samples were evaluated for parameters related to the physical quality of the maize and for aflatoxin contamination. Most maize value chain actors process their offered grain using traditional methods for threshing, winnowing and drying. Maize for sale in the markets surveyed had an average moisture content ranging between 12 and 14%. Non-grain impurities amounted to 0-2.3% while mouldy grains ranged between 0.2 and 0.8%. The impurity level in grain was three times higher among wholesalers compared to retailers and producers. An insect pest, the Larger Grain Borer ( Prostephanus truncatus (Horn) was found only in Benin but Sitophilus zeamais Motschulsky, Cryptolestes ferrugineus Stephens, and Tribolium castaneum Herbst, were present in maize for sale in the markets in of both countries. Insect pest frequency was 16 times higher in wholesalers' grain compared to that of retailers and producers. Aflatoxin levels exceeding the accepted standard of 20 ppb were noted in markets in both countries. The highest proportion of aflatoxin-contaminated maize was in wholesalers' grain in Malanville market.

  19. Energy survey, study and report of hospitals in Michigan: Appendix A: Volume 2, Bay Medical Center, Bay City, Michigan: Final report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1988-08-01

    This study is part of a three-phased demonstration project to reduce energy consumption in hospitals through practical life-cycle, cost-effective modifications and alterations. Funds for the demonstration project are provided by the American Hospital Association (AHA), the Department of Energy (DOE), and the Department of Health and Human Services (DHHS). Two hospitals in Michigan were selected for the project, Bay Medical Center in Bay City and St. Mary's Hospital in Grand Rapids. The objectives of this study, which is funded by HHS, are to investigate and analyze energy usage of the facilities and to identify all life-cycle, cost-effective changes required tomore » effect a reduction in energy consumption.« less

  20. Prevalence of Needlestick Injuries Among Healthcare Workers in the Accident and Emergency Department of a Teaching Hospital in Nigeria

    PubMed Central

    Isara, AR; Oguzie, KE; Okpogoro, OE

    2015-01-01

    Background: Healthcare workers (HCWs) are continually exposed to hazards from contact with blood and body fluids of patients in the healthcare setting. Aim: To determine the prevalence of needlestick injuries (NSIs) and associated factors among HCWs in the Accident and Emergency Department of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. Subjects and Methods: This was a cross-sectional study. Data were collected using a structured, self-administered questionnaire and analyzed using IBM SPSS version 20. Univariate, bivariate, and binary logistic regression analyses were done. The level of significance was set at P < 0.05. Results: The prevalence of NSIs 12 months preceding the study was 51.0% (50/98). Doctors 8/10 (80.0%) and nurses 28/40 (70.0%) had the highest occurrence. Recapping of needles 19/50 (38.0%) and patient aggression 13/50 (26.0%) were responsible for most injuries. The majority 31/50 (62.0%) of the injuries were not reported. The uptake of postexposure prophylaxis (PEP) was low 11/50 (22.0%). The factors that were significantly associated with NSI include age 30 years and above (odds ratio [OR] =0.28, confidence interval [CI] = 0.11–0.70), work duration of three years and above (OR = 0.29, CI = 0.11–0.75), and being a nurse (OR = 3.38, CI = 1.49–9.93) or a paramedic (OR = 0.18, CI = 0.06–0.52). Conclusion: The high prevalence of NSIs among the HCWs, especially in doctors and nurses is an indication that HCWs in UBTH are at great risk of contracting blood-borne infections. Efforts should be made to ensure that injuries are reported and appropriate PEP undertaken following NSIs. PMID:27057376

  1. Diversity of the Neglected and Underutilized Crop Species of Importance in Benin

    PubMed Central

    Dansi, A.; Vodouhè, R.; Azokpota, P.; Yedomonhan, H.; Assogba, P.; Adjatin, A.; Loko, Y. L.; Dossou-Aminon, I.; Akpagana, K.

    2012-01-01

    Many of the plant species that are cultivated for food across the world are neglected and underutilized. To assess their diversity in Benin and identify the priority species and establish their research needs, a survey was conducted in 50 villages distributed throughout the country. The study revealed 41 neglected and underutilized crop species (NUCS) among which 19 were identified as of priority base on 10 criteria among which included their extent and degree of consumption. Reasons for neglect vary with the producers and the agricultural technicians. Market surveys revealed that NUCS are important source of household incomes and substantially contribute to poverty reduction. Review of the literature available revealed that most of the species are rich in nutrients and have some proven medicinal values and the promotion of their use would help in combating malnutrition and improving the health status of the local populations. The knowledge gaps and research needs are immense on most of the species identified as no concrete scientific data is nationally available. In terms of research, almost all has to be done starting from basic ethnobotanical investigation. The results will help the scientists and students willing to conduct research on NUCS in Benin to better orient their research programs. PMID:22593712

  2. Development of vegetable farming: a cause of the emergence of insecticide resistance in populations of Anopheles gambiae in urban areas of Benin.

    PubMed

    Yadouleton, Anges William M; Asidi, Alex; Djouaka, Rousseau F; Braïma, James; Agossou, Christian D; Akogbeto, Martin C

    2009-05-14

    A fast development of urban agriculture has recently taken place in many areas in the Republic of Benin. This study aims to assess the rapid expansion of urban agriculture especially, its contribution to the emergence of insecticide resistance in populations of Anopheles gambiae. The protocol was based on the collection of sociological data by interviewing vegetable farmers regarding various agricultural practices and the types of pesticides used. Bioassay tests were performed to assess the susceptibility of malaria vectors to various agricultural insecticides and biochemical analysis were done to characterize molecular status of population of An. gambiae. This research showed that:(1) The rapid development of urban agriculture is related to unemployment observed in cities, rural exodus and the search for a balanced diet by urban populations;(2) Urban agriculture increases the farmers' household income and their living standard;(3) At a molecular level, PCR revealed the presence of three sub-species of An. gambiae (An. gambiae s.s., Anopheles melas and Anopheles arabiensis) and two molecular forms (M and S). The kdr west mutation recorded in samples from the three sites and more specifically on the M forms seems to be one of the major resistance mechanisms found in An. gambiae from agricultural areas. Insecticide susceptibility tests conducted during this research revealed a clear pattern of resistance to permethrin (76% mortality rate at Parakou; 23.5% at Porto-Novo and 17% at Cotonou). This study confirmed an increase activity of the vegetable farming in urban areas of Benin. This has led to the use of insecticide in an improper manner to control vegetable pests, thus exerting a huge selection pressure on mosquito larval population, which resulted to the emergence of insecticide resistance in malaria vectors.

  3. Development of vegetable farming: a cause of the emergence of insecticide resistance in populations of Anopheles gambiae in urban areas of Benin

    PubMed Central

    Yadouleton, Anges William M; Asidi, Alex; Djouaka, Rousseau F; Braïma, James; Agossou, Christian D; Akogbeto, Martin C

    2009-01-01

    Background A fast development of urban agriculture has recently taken place in many areas in the Republic of Benin. This study aims to assess the rapid expansion of urban agriculture especially, its contribution to the emergence of insecticide resistance in populations of Anopheles gambiae. Methods The protocol was based on the collection of sociological data by interviewing vegetable farmers regarding various agricultural practices and the types of pesticides used. Bioassay tests were performed to assess the susceptibility of malaria vectors to various agricultural insecticides and biochemical analysis were done to characterize molecular status of population of An. gambiae. Results This research showed that: (1) The rapid development of urban agriculture is related to unemployment observed in cities, rural exodus and the search for a balanced diet by urban populations; (2) Urban agriculture increases the farmers' household income and their living standard; (3) At a molecular level, PCR revealed the presence of three sub-species of An. gambiae (An. gambiae s.s., Anopheles melas and Anopheles arabiensis) and two molecular forms (M and S). The kdr west mutation recorded in samples from the three sites and more specifically on the M forms seems to be one of the major resistance mechanisms found in An. gambiae from agricultural areas. Insecticide susceptibility tests conducted during this research revealed a clear pattern of resistance to permethrin (76% mortality rate at Parakou; 23.5% at Porto-Novo and 17% at Cotonou). Conclusion This study confirmed an increase activity of the vegetable farming in urban areas of Benin. This has led to the use of insecticide in an improper manner to control vegetable pests, thus exerting a huge selection pressure on mosquito larval population, which resulted to the emergence of insecticide resistance in malaria vectors. PMID:19442297

  4. Post-Travel Consultations in a Regional Hub City Hospital, Japan.

    PubMed

    Yaita, Kenichiro; Sakai, Yoshiro; Iwahashi, Jun; Masunaga, Kenji; Hamada, Nobuyuki; Watanabe, Hiroshi

    2016-01-01

    To clarify the characteristics of post-travel consultation services in Japan, particularly in the provinces, we analyzed our post-travel patients in the travel clinic of Kurume University Hospital located in Kurume City (a regional hub City in southwestern Japan). Sixty post-travel patients visited our clinic between April 2008 and October 2014 and participated in this study: 55 were Japanese and five were foreign. We summarized and compared the characteristics of the patients after dividing the Japanese participants into long-term travelers (>14 days) and short-term travelers (≤14 days). The foreign travelers were described in a separate analysis. Of the 55 Japanese travelers, the mean age (± standard deviation) was 37.3 ± 16.3 years, and 36 patients (65%) were men. Southeast Asia was the major destination (30/55, 55%), and business was stated as the major reason for travel (16/55, 29%). Post-exposure rabies prophylaxis (16/55, 29%) was the most common purpose for the consultations. There were 34 participants (62%) who were classified as short-term travelers. Fewer of the short-term travelers stated receiving pre-travel consultations compared with long-term travelers (11% vs. 79%, p=0.0002). The five foreign travelers included one dengue fever patient and two malaria patients. Most post-travel Japanese patients visited our clinic were short-term travelers who had not received any pre-travel consultation. One of the most common complaints, post-exposure rabies prophylaxis, could have been avoided to some extent by appropriate pre-travel consultations. The results of this study suggest that pre-travel consultations should therefore be encouraged for both long- and short-term travelers.

  5. Budgeting and Funding of the Library at the University of Benin, Edo State, Nigeria

    ERIC Educational Resources Information Center

    Osagie, Roseline O.; Orheruata, Matilda U.

    2013-01-01

    This paper presents the findings of a study on funding of the library at the University of Benin in relation to the recurrent budget implementation during the 1992/93 to 1996/97 academic sessions. The findings indicated that the library depended on the central administrations's allocation for its funding. It also showed that the University of…

  6. Clinical utility of the HEART score in patients admitted with chest pain to an inner-city hospital in the USA.

    PubMed

    Patnaik, Soumya; Shah, Mahek; Alhamshari, Yaser; Ram, Pradhum; Puri, Ritika; Lu, Marvin; Balderia, Percy; Imms, John B; Maludum, Obiora; Figueredo, Vincent M

    2017-06-01

    Chest pain is one of the most common presentations to a hospital, and appropriate triaging of these patients can be challenging. The HEART score has been used for such purposes in some countries and only a few validation studies from the USA are available. We aim to determine the utility of the HEART score in patients presenting with chest pain to an inner-city hospital in the USA. We retrospectively screened 417 consecutive patients admitted with chest pain to the observation/telemetry units at Einstein Medical Center Philadelphia. After applying inclusion and exclusion criteria, 299 patients were included in the analysis. Patients were divided into low-risk (0-3) and intermediate-high (≥4)-risk HEART score groups. Baseline characteristics, thrombolysis in myocardial infarction score, need for revascularization during index hospitalization, and major adverse cardiovascular events (MACE) at 6 weeks and 12 months were recorded. There were 98 and 201 patients in the low-score group and intermediate-high-score group, respectively. Compared with the low-score group, patients in the intermediate-high-risk group had a higher incidence of revascularization during the index hospital stay (16.4 vs. 0%; P=0.001), longer hospital stay, higher MACE at 6 weeks (9.5 vs. 0%) and 12 months (20.4 vs. 3.1%), and higher cardiac readmissions. HEART score of at least 4 independently predicted MACE at 12 months (odds ratio 7.456, 95% confidence interval: 2.175-25.56; P=0.001) after adjusting for other risk factors in regression analysis. HEART score of at least 4 was predictive of worse outcomes in patients with chest pain in an inner-city USA hospital. If validated in multicenter prospective studies, the HEART score could potentially be useful in risk-stratifying patients presenting with chest pain in the USA and could impact clinical decision-making.

  7. Fragility fractures at Auckland City Hospital: we can do better.

    PubMed

    Braatvedt, Geoffrey; Wilkinson, Susan; Scott, Marilyn; Mitchell, Paul; Harris, Roger

    2017-12-01

    This study describes in detail the burden of caring for patients aged ≥ 50 years seen in one year with a fragility fracture in a large urban environment and shows that these fractures result in a long length of stay and significant mortality. Intervention to prevent further fracture was poorly done. To examine the epidemiology of fragility fracture in patients over age 50 years and record the number who received appropriate secondary prevention treatment. All patients aged ≥ 50 years presenting with a fracture during the 12 months following July 1 st 2011, to Auckland City Hospital or residing in central Auckland at the time of their fracture, were identified from hospital and Accident Compensation Corporation records. A random sample of 55% of these patient's records were reviewed to establish the type of fracture, prior fracture and falls history, and use of bisphosphonates in the 12 months before presentation. Their length of stay (LOS) by type of fracture was recorded. The use of bisphosphonate drugs in the following 12 months was obtained from centralised national records of prescriptions. 2729 patients aged ≥ 50 years presented with a fragility fracture in the central Auckland region in one year. Fifty-six percent of these patients were seen at Auckland Hospital and of these, 82% patients required admission with a mean LOS of 20 days (SD ± 24 days).The remaining 44% of patients were looked after in the private outpatient sector. Approximately 30% of the admissions were for hip fracture. Sixty-four percent of patients with a fragility fracture did not receive a potent bisphosphonate, 12% were considered not appropriate for treatment, and 24% received a potent bisphosphonate during their admission or in the next 12 months. Approximately 1 in 18 people aged ≥ 50 years presented in one year with a fragility fracture.Secondary prevention strategies were poorly implemented. Additional resources for identifying and initiating secondary fracture prevention

  8. Local cost sharing in Bamako Initiative systems in Benin and Guinea: assuring the financial viability of primary health care.

    PubMed

    Soucat, A; Levy-Bruhl, D; Gbedonou, P; Drame, K; Lamarque, J P; Diallo, S; Osseni, R; Adovohekpe, P; Ortiz, C; Debeugny, C; Knippenberg, R

    1997-06-01

    The fourth in a series of five, this article presents and analyses data on cost recovery and community cost-sharing, two key aspects of the Bamako Initiative which have been implemented in Benin and Guinea since 1986. The data come from approximately 400 health centres and result from the six-monthly monitoring sessions conducted from 1989 to 1993. Community involvement in the financing of local operating costs in the two national scale programmes is also described. In Benin and Guinea, a user fee system generates the community financed revenue with the aim of covering local operating costs including drugs. Health worker salaries remain the responsibility of the government and donor funding covers vaccine and investment costs. Village health committees manage and control resources and revenue. The community is also involved in decision making, strategy definition and quality control. In Benin in 1993, community financing revenue amounted to about US$0.6 per capita per year and generally covered all local recurrent non salary costs except vaccines and left a surplus. Although total costs and revenues were slightly lower in Guinea for the same period, over-all user fee revenue (around US$0.3 per capita per year) covered local recurrent costs (not including salaries or vaccines). A comparison of costs and revenue between regions and individual health centres revealed important differences in cost recovery ratios. In Benin, some centres recovered more than twice the local costs targeted for community financing. Twenty-five per cent of centres in Guinea did not manage to cover their designated local recurrent costs. The longitudinal analysis showed that the level of cost recovery remained stable over time even as preventive care (and especially EPI) coverage rose significantly. To better understand the most important characteristics affecting cost recovery levels, best performing health centres in terms of cost-recovery levels in 1993 were compared to worst performing

  9. Cord blood lead level in an urban inner-city hospital.

    PubMed

    Chawla, S; Elbakoush, F; Natarajan, G; Dwaihy, M; Berry, A; Ravindranath, Y; Bhambhani, K; Narayan, S B

    2016-09-16

    Lead levels were measured by inductively coupled plasma mass spectrometry (ICP-MS) in umbilical cord blood samples of 150 neonates in an urban inner-city hospital. The mean (SD) gestation and birth weight of our cohort were 38.8 (1.7) weeks and 3,217 (519) grams. There were 89% African-Americans, 53% males and 79% were born via vaginal delivery. Mean (SD) maternal age was 24.5 (5.8) years. History of drug abuse and smoking was reported in 8.7% and 10.7% respectively, with only 1 mother reporting a history of high lead level in childhood. Prenatal vitamin intake was reported in 99.3%. Cord blood lead level was available in 144 patients, with lead level of <1μg/dL seen in 141 (97.9%) and>1 in 3 (2.1%) patients. No patient had cord blood lead level of >2μg/dL. High lead levels during childhood in high-risk urban population, however, suggest the need for intensive efforts for prevention of environmental exposure to lead in early childhood.

  10. [Transparency in public sector acquisitions. The case of hospitals in the City of Buenos Aires].

    PubMed

    Rossi, T; Murillo Fort, C; Puente Karolys, J C

    2002-01-01

    This paper deals with corruption and the lack of transparency in public sector purchases as well as with the main instruments to obtain adequate results in purchase negotiation.Firstly, we discuss how corruption causes concern to national governments, international organizations, academic centers, non-governmental organizations and society in general. The consequences of corruption in Argentina and other Latin American countries are highlighted, especially the effect of corruption on economic growth and the way it creates economic inefficiency and inequality.Secondly, the database created by the Subsecretary of Strategic Management of the Autonomous Government of the City of Buenos Aires is analyzed. The central purpose of this study is to evaluate the impact of the Administrative Reform of 1998 on the prices of 24 products acquired by 13 general acute care hospitals from 1998-1999. The weighted prices, the number of units purchased and the total number of contracts given in this period, as well as the products with the greatest utilization rate, are analyzed. Multivariante analysis was used to identify hospitals with appropriate activity and efficient budget administration (activity and negotiation indicators). Price development was analyzed using the regression technique (ordinary least squares), which demonstrated an 8% reduction in prices for the year 1999. The contribution of each hospital to this variation is presented using dummy variables. Thus, six of the 13 hospitals significantly contributed to the decrease in prices. Of these six, three hospitals also contributed to reduction in price dispersion. The results obtained allow us to conclude that, if public hospitals have adequate purchase negotiation instruments and a uniform legal framework, they can achieve a good level of activity. Furthermore, public hospitals can contribute to reductions in price and price dispersion, at the same time as improving efficiency in the assignation and utilization of

  11. Public and Private Hospital Nurses’ Perceptions of the Ethical Climate in Their Work Settings, Sari City, 2011

    PubMed Central

    Ghorbani, Ali Asghar; Hesamzadeh, Ali; Khademloo, Mohammad; Khalili, Salimeh; Hesamzadeh, Shamim; Berger, Valerie

    2014-01-01

    Background: Nurses’ perceptions of ethical climate patterns have certain undeniable effects on hospitals. There is little evidence of possible differences in this element between public and private hospitals and contributing factors. Objectives: This study investigated whether the perceptions of the ethical climate in nurses’ working in public hospitals differ from that of nurses in private hospitals, and which factors may affect nurses’ perceptions. Materials and Methods: A cross-sectional study of randomly selected registered nurses (n = 235), working in four public hospitals affiliated to Mazandaran University of Medical Sciences, and three private hospitals, was conducted in Sari City, Iran. A self-administered questionnaire, containing demographic characteristics and the Hospital Ethical Climate Survey (HECS), were used to assess registered nurses’ perceptions of public and private hospitals ethical climate. An independent t-test and one-way ANOVA were used to analyze the data. Results: Across the five factors of HECS, the highest and lowest mean scores pertained to managers and physicians, respectively, in both public and private hospitals. Nurses who had a conditional employment situation and those working in pediatric intensive care units showed significantly more positive perceptions of the ethical work climate when compared to their peers (P < 0.05). Although the mean score of ethical work climate in private hospitals (3.82 ± 0.61) was higher than that in public hospitals (3.76 ± 0.54), no significant difference was found (P = 0.44). Conclusions: Hospital managers need to discover better ways to promote safety and health programs for their staff according to nurses’ area of work and their type of units. They should also encourage greater levels of participation in safety-enhancing initiatives in the hospital’s ethical climate, especially in the areas of nurses’ perceptions of their physician colleagues, and for nurses with a conditional

  12. Accreditation of Management Communication and Information Systems in Public Hospitals of Sabzevar City, Iran.

    PubMed

    Farzianpour, Fereshteh; Shojaei, Saeed; Arab, Mohammad; Foroushani, Abbas Rahimi

    2016-04-01

    Information systems are "computer systems that collect, store, process, retrieve, show, and provide timely information required in practice, education, management, and research". The purpose of these systems is to support hospital activities in practical, tactical, and strategic levels in order to provide better service to patients. This study aimed to evaluate the communication and information system (MCI) in public hospitals in Sabzevar city in 2014 from the perspective of human resources according to international standards of the Joint Commission Accreditation Hospital (JCAH). This study was a practical, descriptive, cross-sectional study. The study population consisted of Sabzevar nurses who used hospital information system. Sampling was done by classification method and in proportion to the number of nurses in each health care units in hospitals in 2014. The sample size was 200 and after referring to hospitals, 200 questionnaires were completed. Sample size was calculated by the formula n=Z(2)P (1-P)/d(2) with P=0.5, α=0.05, d=0.05, and Z=1.96. Data collection tool was the questionnaire of assessment of hospital information systems of JCAH, which has 124 specific questions, including 6 areas. To assess the effect of demographic variables with MCI standards of two questionnaires (feasibility and implementation), the following steps were taken. 1. Kolmogorov-Smirnov test was used to determine whether responses were normal or not. 2. In case of normal data, t-test was used for dual groups and one-way ANOVA test for groups of three or more. 3. If not normal, Mann-Whitney test was used for dual groups and Kruskal-Wallis test for groups of three or more. Research findings show the mean results of feasibility and implementation of all 6 areas of international standards MCI have feasibility in three hospitals in Sabzevar in 20 sections (H1=105.01±10.468), (H1=196.31±4.662), (H2=104.26±9.099), (H2=195.33±3.778) (H3=106.48±11.545) and (H3=197.57±4

  13. Estimation of the Demand for Hospital Care After a Possible High-Magnitude Earthquake in the City of Lima, Peru.

    PubMed

    Bambarén, Celso; Uyen, Angela; Rodriguez, Miguel

    2017-02-01

    Introduction A model prepared by National Civil Defense (INDECI; Lima, Peru) estimated that an earthquake with an intensity of 8.0 Mw in front of the central coast of Peru would result in 51,019 deaths and 686,105 injured in districts of Metropolitan Lima and Callao. Using this information as a base, a study was designed to determine the characteristics of the demand for treatment in public hospitals and to estimate gaps in care in the hours immediately after such an event. A probabilistic model was designed that included the following variables: demand for hospital care; time of arrival at the hospitals; type of medical treatment; reason for hospital admission; and the need for specialized care like hemodialysis, blood transfusions, and surgical procedures. The values for these variables were obtained through a literature search of the databases of the MEDLINE medical bibliography, the Cochrane and SciELO libraries, and Google Scholar for information on earthquakes over the last 30 years of over magnitude 6.0 on the moment magnitude scale. If a high-magnitude earthquake were to occur in Lima, it was estimated that between 23,328 and 178,387 injured would go to hospitals, of which between 4,666 and 121,303 would require inpatient care, while between 18,662 and 57,084 could be treated as outpatients. It was estimated that there would be an average of 8,768 cases of crush syndrome and 54,217 cases of other health problems. Enough blood would be required for 8,761 wounded in the first 24 hours. Furthermore, it was expected that there would be a deficit of hospital beds and operating theaters due to the high demand. Sudden and violent disasters, such as earthquakes, represent significant challenges for health systems and services. This study shows the deficit of preparation and capacity to respond to a possible high-magnitude earthquake. The study also showed there are not enough resources to face mega-disasters, especially in large cities. Bambarén C , Uyen A

  14. Management of arterial hypertension in Cotonou city, Benin: general practitioners' knowledge, attitudes and practice.

    PubMed

    Houenassi, Martin Dèdonougbo; Codjo, Léopold Houétondji; Dokoui, David; Dohou, Serge Hugues Mahougnon; Wanvoegbe, Armand; Agbodande, Anthelme; Attinsounon, Angelo Cossi; Alassani, Adebayo; Ahoui, Séraphin; Dovonou, Albert Comlan; Adoukonou, Thierry Armel

    2016-08-23

    We aimed to assess the management of hypertensive patients by general practitioners in Cotonou city. This was a cross-sectional study based on a multicentre survey conducted from 1 May to 31 July 2011. We recruited all consenting general practitioners who worked in public and private centres in Cotonou city. We used the 7th report of the Joint National Committee to assess the management of hypertension by general practitioners. A tested and validated self-questionnaire was used to collect the data on hypertension management by general practitioners. In eight centres that approved the study, 41 general practitioners were included. The definition of hypertension was known by 20 (48.8%) practitioners. Only 25 (61.0%) could describe the conditions for blood pressure measurement. Ten of them were unable to list half of the minimum recommended tests for hypertension, and the majority (92.7%) did not have any idea of global cardiovascular risk. The blood pressure goal was known by only 18 (43.9%) practitioners. Lifestyle (82.9%) and monotherapy (70.7%) were the therapeutic modalities most prescribed. Antihypertensive agents commonly used by practitioners were calcium channel blockers (82.9%), angiotensin converting enzyme inhibitors (53.7%) and diuretics (36.6%). The general practitioners referred their patients to cardiologists mainly for uncontrolled hypertension (63.4%) and the onset of acute complications (56.1%). The general practitioners' knowledge of hypertension was insufficient and their management did not reflect international guidelines.

  15. A Landscape-based model for predicting Mycobacterium ulcerans infection (Buruli Ulcer disease) presence in Benin, West Africa.

    PubMed

    Wagner, Tyler; Benbow, M Eric; Burns, Meghan; Johnson, R Christian; Merritt, Richard W; Qi, Jiaguo; Small, Pamela L C

    2008-03-01

    Mycobacterium ulcerans infection (Buruli ulcer [BU] disease) is an emerging tropical disease that causes severe morbidity in many communities, especially those in close proximity to aquatic environments. Research and control efforts are severely hampered by the paucity of data regarding the ecology of this disease; for example, the vectors and modes of transmission remain unknown. It is hypothesized that BU presence is associated with altered landscapes that perturb aquatic ecosystems; however, this has yet to be quantified over large spatial scales. We quantified relationships between land use/land cover (LULC) characteristics surrounding individual villages and BU presence in Benin, West Africa. We also examined the effects of other village-level characteristics which we hypothesized to affect BU presence, such as village distance to the nearest river. We found that as the percent urban land use in a 50-km buffer surrounding a village increased, the probability of BU presence decreased. Conversely, as the percent agricultural land use in a 20-km buffer surrounding a village increased, the probability of BU presence increased. Landscape-based models had predictive ability when predicting BU presence using validation data sets from Benin and Ghana, West Africa. Our analyses suggest that relatively small amounts of urbanization are associated with a decrease in the probability of BU presence, and we hypothesize that this is due to the increased availability of pumped water in urban environments. Our models provide an initial approach to predicting the probability of BU presence over large spatial scales in Benin and Ghana, using readily available land use data.

  16. Trends in hospitalization for community-associated methicillin-resistant Staphylococcus aureus in New York City, 1997-2006: data from New York State's Statewide Planning and Research Cooperative System.

    PubMed

    Farr, Amanda M; Aden, Brandon; Weiss, Don; Nash, Denis; Marx, Melissa A

    2012-07-01

    To describe trends in hospitalizations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in New York City over 10 years and to explore the demographics and comorbidities of patients hospitalized with CA-MRSA infections. Retrospective analysis of hospital discharges from New York State's Statewide Planning and Research Cooperative System database from 1997 to 2006. All patients greater than 1 year of age admitted to New York hospitals with diagnosis codes indicating MRSA who met the criteria for CA-MRSA on the basis of admission information and comorbidities. We determined hospitalization rates and compared demographics and comorbidities of patients hospitalized with CA-MRSA versus those hospitalized with all other non-MRSA diagnoses by multivariable logistic regression. Of 18,226 hospitalizations with an MRSA diagnosis over 10 years, 3,579 (20%) were classified as community-associated. The CA-MRSA hospitalization rate increased from 1.47 to 10.65 per 100,000 people overall from 1997 to 2006. Relative to non-MRSA hospitalizations, men, children, Bronx and Manhattan residents, the homeless, patients with human immunodeficiency virus (HIV) infection, and persons with diabetes had higher adjusted odds of CA-MRSA hospitalization. The CA-MRSA hospitalization rate appeared to increase between 1997 and 2006 in New York City, with residents of the Bronx and Manhattan, men, and persons with HIV infection or diabetes at increased odds of hospitalization with CA-MRSA. Further studies are needed to explore how changes in MRSA incidence, access to care, and other factors may have impacted these rates.

  17. Quality of life of young clinical doctors in public hospitals in China's developed cities as measured by the Nottingham Health Profile (NHP).

    PubMed

    Liang, Ying; Wang, Hanwei; Tao, Xiaojun

    2015-09-24

    In contemporary Chinese society, obstacles such as frequent violence against medical workers and tense doctor-patient relationships affect the health of Chinese doctors. This study attempted to explore the quality of life (QOL) of young clinical doctors in public hospitals in China's developed cities to study the psychometric properties of QOL and related risk factors of doctors' health. This study sampled young doctors aged 15-45 in 18 public hospitals of three cities in East China (Shanghai, Nanjing, and Hangzhou, N = 762). The Nottingham Health Profile was used to measure QOL, the dependent variable of this study. Methodologies such as reliability analysis, mean comparison, and exploratory factor analysis were used to study related psychometric properties. Almost 90 % of young Chinese clinical doctors have a bachelor's degree or above. Approximately 70.4 % of the doctors have relatively low job titles. Among the sample, 76.1 % have a monthly income ranging from USD 326 to USD 1139, and 91.3 % work over eight hours daily. These respondents have poor sleeping habits and mental functions, but have relatively good physical functions. Being female, low education, low job title, low salary, and long work hours are factors associated with doctors' poor QOL. Regression analysis results emphasize the great effect of high education on the improvement of QOL. Young clinical doctors in public hospitals in Chinese developed cities have poor QOL. Reforms on the current medical health system, improving the working environment of doctors and relieve their occupational stress should be required.

  18. Current practices and medico-legal aspects of pre-operative consent.

    PubMed

    Osime, O C; Okojie, O; Osadolor, F; Mohammed, S

    2004-07-01

    Written informed consent is a pre requisite for surgical intervention as it provides the forum for the patient to appreciate implications of the procedure and the doctor to explain details and effects of the surgery. To evaluate the practice of obtaining informed consent pre-operatively by surgeons in Benin City and proffer solutions that would enhance its practice. Cross-sectional study involving surgical patients or their relations or gurdian (in cases involving minors and unconscious patients) who were interviewed with structured ended questionnaires. Study was carried out at the University of Benin Teaching Hospital, Benin City, between 5th July and 6th September 2002. One hundred and thirty-three respondents; 53(39.2%) males and 80(60.2%) females were interviewed. Documentations regarding consent were noted in 118(88.7%) cases. Of these, 74.6% felt they had enough time to reflect on the consent obtained while 48(36.1%) respondents were meeting the individual who obtained their consent for the first time. The content of information offered patients prior to obtaining consent was found to be significantly related to the levels of education (X2= 31.44; P<0.001). Over a hundred respondents were not informed of risk of procedure. Nonetheless over 50% of respondents felt satisfied with information supplied. The quality of consent obtained from the average patient fell below expected standard. There is need for greater awareness amongst administrators of consent on the essence of improving quality of information given and mode of obtaining consent from patients.

  19. Facility evaluation of resigned hospital physicians:managerial implications for hospital physician manpower.

    PubMed

    Cheng, Kao-Chi; Lee, Tsung-Lin; Lin, Yen-Ju; Liu, Chiu-Shong; Lin, Cheng-Chieh; Lai, Shih-Wei

    2016-12-01

    Turnover of physicians might be responsible for reducing patients' trust and affecting hospital performance. This study aimed to understand physicians' psychological status regarding their hospital work environment and the resources of independent practitioners. This was a cross-sectional study with 774 physicians who had resigned from hospitals and were now practicing privately in clinics in Taichung City as its study population. A mail survey with a multidimensional questionnaire was sent to each subject. This study revealed that older physicians were less satisfied regarding the work environment in their respective former hospitals. Male physicians were found to be more satisfied with the tangible resources of their hospitals. Internal medicine physicians were found to be less satisfied overall with the intangible resources. Gynecologists and pediatricians were found to be more satisfied with their hospital environments. The physicians who worked long hours per week reported that they were less satisfied with their job content. The physicians who had opportunities to learn advanced skills and enhance their knowledge were more satisfied with their hospital environment, tangible resources, and intangible resources. In addition, physicians in private hospitals were found to be more satisfied with their job content, but they were less satisfied with work motivation and retention and intangible resources. In addition, physicians who worked in hospitals located in Taichung city reported that they were less satisfied with their tangible resources than the physicians working in hospitals outside of the city. This study focused on the satisfaction of physicians who had already left their respective hospitals instead of current retained physicians. From this study, it is our recommendation that hospital managers should pay closer attention to the real needs and expectations of the physicians they employ, and managers should consider adjusting their managerial perspectives

  20. Effects of severe obstetric complications on women's health and infant mortality in Benin.

    PubMed

    Filippi, Véronique; Goufodji, Sourou; Sismanidis, Charalambos; Kanhonou, Lydie; Fottrell, Edward; Ronsmans, Carine; Alihonou, Eusèbe; Patel, Vikram

    2010-06-01

    To document the impact of severe obstetric complications on post-partum health in mothers and mortality in babies over 12 months in Benin and to assess whether severe complications associated with perinatal death are particularly likely to lead to adverse health consequences. Cohort study which followed women and their babies after a severe complication or an uncomplicated childbirth. Women were selected in hospitals and interviewed at home at discharge, and at 6 and 12 months post-partum. Women were invited for a medical check-up at 6 months and 12 months. The cohort includes 205 women with severe complications and a live birth, 64 women with severe complications and perinatal death and 440 women with uncomplicated delivery. Women with severe complications and a live birth were not dissimilar to women with a normal delivery in terms of post-partum health, except for hypertension [adjusted OR = 5.8 (1.9-17.0)], fever [adjusted OR = 1.71 (1.1-2.8)] and infant mortality [adjusted OR = 11.0 (0.8-158.2)]. Women with complications and perinatal death were at increased risk of depression [adjusted OR = 3.4 (1.3-9.0)], urine leakages [adjusted OR = 2.7 (1.2-5.8)], and to report poor health [adjusted OR = 5.27 (2.2-12.4)] and pregnancy's negative effects on their life [adjusted OR = 4.11 (1.9-9.0)]. Uptake of post-natal services was poor in all groups. Women in developing countries face a high risk of severe complications during pregnancy and delivery. These can lead to adverse consequences for their own health and that of their offspring. Resources are needed to ensure that pregnant women receive adequate care before, during and after discharge from hospital. Near-miss women with a perinatal death appear a particularly high-risk group.

  1. Kansas City Cardiomyopathy Questionnaire Score Is Associated With Incident Heart Failure Hospitalization in Patients With Chronic Kidney Disease Without Previously Diagnosed Heart Failure: Chronic Renal Insufficiency Cohort Study.

    PubMed

    Mishra, Rakesh K; Yang, Wei; Roy, Jason; Anderson, Amanda H; Bansal, Nisha; Chen, Jing; DeFilippi, Christopher; Delafontaine, Patrice; Feldman, Harold I; Kallem, Radhakrishna; Kusek, John W; Lora, Claudia M; Rosas, Sylvia E; Go, Alan S; Shlipak, Michael G

    2015-07-01

    Chronic kidney disease is a risk factor for heart failure (HF). Patients with chronic kidney disease without diagnosed HF have an increased burden of symptoms characteristic of HF. It is not known whether these symptoms are associated with occurrence of new onset HF. We studied the association of a modified Kansas City Cardiomyopathy Questionnaire with newly identified cases of hospitalized HF among 3093 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study who did not report HF at baseline. The annually updated Kansas City Cardiomyopathy Questionnaire score was categorized into quartiles (Q1-4) with the lower scores representing the worse symptoms. Multivariable-adjusted repeated measure logistic regression models were adjusted for demographic characteristics, clinical risk factors for HF, N-terminal probrain natriuretic peptide level and left ventricular hypertrophy, left ventricular systolic and diastolic dysfunction. Over a mean (±SD) follow-up period of 4.3±1.6 years, there were 211 new cases of HF hospitalizations. The risk of HF hospitalization increased with increasing symptom quartiles; 2.62, 1.85, 1.14, and 0.74 events per 100 person-years, respectively. The median number of annual Kansas City Cardiomyopathy Questionnaire assessments per participant was 5 (interquartile range, 3-6). The annually updated Kansas City Cardiomyopathy Questionnaire score was independently associated with higher risk of incident HF hospitalization in multivariable-adjusted models (odds ratio, 3.30 [1.66-6.52]; P=0.001 for Q1 compared with Q4). Symptoms characteristic of HF are common in patients with chronic kidney disease and are associated with higher short-term risk for new hospitalization for HF, independent of level of kidney function, and other known HF risk factors. © 2015 American Heart Association, Inc.

  2. [Evaluation of the quality of screening and management of infant malnutrition in Cotonou, Benin].

    PubMed

    Testa, J; Sinnaeve, O; Ibrahim, Y; Ayivi, B

    2008-02-01

    The purpose of this study was to evaluate the quality of screening and management of infant-juvenile malnutrition in medical/social centres in Cotonou, Benin, the nation's capital and largest city. Study was carried out in 19 public and private medical/social centres selected on the basis of their nutritional activity. Data was collected using 5 methods, i.e., retrospective review of the each centre's records, evaluation of physical resources available at each centre, observation of care providers (n=90), questionnaire concerning nutritional activities for the person in charge of each centre (n=19), and questionnaire about care for the mothers of children consulting at the centres (n=43). The overall prevalence of malnourished children identified by screening at the medical/social centres was low (2.2 %) in comparison with the prevalence of malnutrition in Cotonou (20.3 %). Less than half of the centres (47.4 %) used growth charts. None of the centres had a "thinness chart". Many centres (28.6 %) used material intended for cooking demonstrations. Most centres (75 %) conducted effective Information Education and Communication (IEC) sessions and all authorized centres had required essential medications on hand. Observation of care providers showed that 35% could not perform basic anthropometric measurements. Use of growth charts was lowest among physicians and medical assistants. No doctor provided nutritional counselling. Based on responses to the questionnaire the general knowledge of care providers was good despite the lack of supervision and continuous education. Analysis of the responses of the mothers who brought their children to the centres indicated that malnutrition was never the initial reason for seeking medical attention and only 39 % understood that their child was malnourished upon leaving the centre. These findings indicate that the quality of screening and management of infant-juvenile malnutrition in Cotonou is poor. There is a need to develop a

  3. [Reasons for the construction of Bispebjerg Hospital--a hospital with light, air and freedom of nature].

    PubMed

    Permin, Henrik; Wagner, Peter

    2009-01-01

    Since the 1850ies the city of Copenhagen changed, ramparts were removed or remodelled as parks, industries were established. The new factories and wharfs expanded, labourers were needed; many country people moved into the city to find work and thus the population increased immensely. In Copenhagen a few hospitals only were present around 1850; The Royal Frederik Hospital (now the Museum of applied Arts) was the only hospital in the modern sense of the word. Other institutions with "hospital" as part of their name as e.g. General Hospital (Almindelig Hospital) or Ladegaarden were a mixture of hospital and workhouse and The Royal Maternity Hospital founded in 1750. The wealthy and the upper middle class citizens were nursed or cured at home. At the end of the nineteenth century medical doctors could successfully cure some diseases, and surgeons could after the introduction of the anesthetic and aseptic treatment carry out operations with diminished risks of complications. Copenhagen's first modern hospital, Municipal Hospital (Kommunehospitalet) opened 1863, but in a very short time it was permanently overcrowded. Although two small hospitals Blegdam Hospital (isolation hospital) and the Oresund Hospital (quarantine station) were established a large new hospital was needed. Although the financial situation of the city of Copenhagen was strained due to the expenditures caused by the rapidly growing population within the city itself and the villages incorporated into it, the first social democratic mayor Jens Jensen wanted to secure his voters the same care and treatment as citizens of better means. As this view was accepted by the majority of the city council a hospital in the then modern and functional pavilion system (ascribed to Florence Nightingale) with buildings surrounded by gardens was planned. The architect Martin Nyrop (1849-1921) who had just completed the monumental and beautiful Copenhagen City Hall along with the engineer AC Karsten (1857-1931) and

  4. Extreme temperatures and out-of-hospital coronary deaths in six large Chinese cities.

    PubMed

    Chen, Renjie; Li, Tiantian; Cai, Jing; Yan, Meilin; Zhao, Zhuohui; Kan, Haidong

    2014-12-01

    The seasonal trend of out-of-hospital coronary death (OHCD) and sudden cardiac death has been observed, but whether extreme temperature serves as a risk factor is rarely investigated. We therefore aimed to evaluate the impact of extreme temperatures on OHCDs in China. We obtained death records of 126,925 OHCDs from six large Chinese cities (Harbin, Beijing, Tianjin, Nanjing, Shanghai and Guangzhou) during the period 2009-2011. The short-term associations between extreme temperature and OHCDs were analysed with time-series methods in each city, using generalised additive Poisson regression models. We specified distributed lag non-linear models in studying the delayed effects of extreme temperature. We then applied Bayesian hierarchical models to combine the city-specific effect estimates. The associations between extreme temperature and OHCDs were almost U-shaped or J-shaped. The pooled relative risks (RRs) of extreme cold temperatures over the lags 0-14 days comparing the 1st and 25th centile temperatures were 1.49 (95% posterior interval (PI) 1.26-1.76); the pooled RRs of extreme hot temperatures comparing the 99th and 75th centile temperatures were 1.53 (95% PI 1.27-1.84) for OHCDs. The RRs of extreme temperature on OHCD were higher if the patients with coronary heart disease were old, male and less educated. This multicity epidemiological study suggested that both extreme cold and hot temperatures posed significant risks on OHCDs, and might have important public health implications for the prevention of OHCD or sudden cardiac death. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Family relationship, water contact and occurrence of Buruli ulcer in Benin.

    PubMed

    Sopoh, Ghislain Emmanuel; Barogui, Yves Thierry; Johnson, Roch Christian; Dossou, Ange Dodji; Makoutodé, Michel; Anagonou, Sévérin Y; Kestens, Luc; Portaels, Françoise

    2010-07-13

    Mycobacterium ulcerans disease (Buruli ulcer) is the most widespread mycobacterial disease in the world after leprosy and tuberculosis. How M. ulcerans is introduced into the skin of humans remains unclear, but it appears that individuals living in the same environment may have different susceptibilities. This study aims to determine whether frequent contacts with natural water sources, family relationship or the practice of consanguineous marriages are associated with the occurrence of Buruli ulcer (BU). Case control study. Department of Atlantique, Benin. BU-confirmed cases that were diagnosed and followed up at the BU detection and treatment center (CDTUB) of Allada (Department of the Atlantique, Benin) during the period from January 1st, 2006, to June 30th, 2008, with three matched controls (persons who had no signs or symptoms of active or inactive BU) for age, gender and village of residence per case. Contact with natural water sources, BU history in the family and the practice of consanguineous marriages. A total of 416 participants were included in this study, including 104 cases and 312 controls. BU history in the family (p<0.001), adjusted by daily contact with a natural water source (p = 0.007), was significantly associated with higher odds of having BU (OR; 95% CI = 5.5; 3.0-10.0). The practice of consanguineous marriage was not associated with the occurrence of BU (p = 0.40). Mendelian disorders could explain this finding, which may influence individual susceptibility by impairing immunity. This study suggests that a combination of genetic factors and behavioral risk factors may increase the susceptibility for developing BU.

  6. Determinants of Benin elementary school science teachers' orientation toward inquiry-based instructional practices

    NASA Astrophysics Data System (ADS)

    Gado, Issaou

    The Republic of Benin (West Africa) undertook a nationwide curriculum reform that put an emphasis on inquiry-based instructional practices. Little, if any, research has been conducted to explore factors that could be related to teachers' orientation toward inquiry instructional practices. The purpose of this research study was to investigate factors and concerns that determine Benin elementary school teachers' orientation toward the use of inquiry-based instruction in the teaching of science. The study followed a naturalistic inquiry methodology combining a correlational ex post facto design and an observational case-study design. The theory of Planned Behavior was the conceptual framework used to design the study. Two hundred (N = 200) elementary school teachers and three (n = 3) case study participants were purposively selected. Data was gathered via the Revised Science Attitude Scale (Thompson & Shrigley, 1986), the Science Teachers' Ideological Preference Scale (Jones & Harty, 1978), open-ended questions, interviews, and classroom observations using audiorecorders, videorecorders, and the researcher-contextualized version of the Observational System for the Analysis of Classroom Instruction (Hough, 1966). Qualitative and quantitative data provided a deeper understanding of participants' responses. Quantitative measures indicated that Benin elementary school teachers have positive attitudes toward school science, significant positive orientation toward both inquiry-based instruction and traditional non inquiry-based instruction, and higher orientation toward inquiry-based instruction than traditional non inquiry-based instruction. Attitude toward handling materials for investigations was found to significantly contribute to the prediction of participants' inquiry orientation. Qualitative analyses of participants' responses indicated that the expectations of educational leaders, individual motivation to comply with the program, a perceived control of the

  7. Repetitive Discrepancy between Espoused and In-Use Action Theories for Fishery Intervention in Grand-Popo, Benin

    ERIC Educational Resources Information Center

    Kouevi, Augustin T.; Van Mierlo, Barbara; Leeuwis, Cees

    2011-01-01

    In order to be able to adapt successfully to eco-challenges, interest in change-oriented learning is growing around the world. The authors of this paper aim to assess the occurrence of learning for effective action-taking in successive fishery problem-solving interventions in the municipality of Grand-Popo, South-Western Benin, where interventions…

  8. Effect of Participatory Research on Farmers' Knowledge and Practice of IPM: The Case of Cotton in Benin

    ERIC Educational Resources Information Center

    Togbé, Codjo Euloge; Haagsma, Rein; Aoudji, Augustin K. N.; Vodouhê, Simplice D.

    2015-01-01

    Purpose: This study assesses the effect of participatory research on farmers' knowledge and practice of Integrated Pest Management (IPM) in Benin. The participatory field experiments were carried out during the 2011-2012 cotton growing season, and focused on the development and application of pest management knowledge. Methodology: A…

  9. High Iron Levels Are Associated with Increased Malaria Risk in Infants during the First Year of Life in Benin.

    PubMed

    Moya-Alvarez, Violeta; Cottrell, Gilles; Ouédraogo, Smaila; Accrombessi, Manfred; Massougbodgi, Achille; Cot, Michel

    2017-08-01

    The World Health Organization (WHO) estimates that 40% of children in low-income countries are anemic. Therefore, iron supplements are recommended by WHO in areas with high anemia rates. However, some studies have set into question the benefits of iron supplementation in malaria-endemic regions. In Benin, a west African country with high prevalence of anemia and malaria, no iron supplements are given systematically to infants so far despite the WHO recommendations. In this context, we wanted to investigate the effect of iron levels during the first year of life on malarial risk in Benin considering complementary risk factors. We followed 400 women and their offspring between January 2010 and June 2012 in Allada (Benin). Environmental, obstetric, and numerous clinical, maternal, and infant risk factors were considered. In multilevel models, high iron levels were significantly associated with the risk of a positive blood smear (adjusted odds ratio = 2.90, P < 0.001) and Plasmodium falciparum parasitemia (beta estimate = 0.38, P < 0.001). Infants with iron levels in the lowest quartile were less likely to have a positive blood smear ( P < 0.001), and the risk increased with higher iron levels. Our results appeal for additional evaluation of the effect of different doses of iron supplements on the infant health status, including malaria incidence. Thus, the health status of infants should be compared between cohorts where iron is given either for prevention or anemia treatment, to better understand the effect of iron supplements on infant health.

  10. The impact of environmental and climatic variation on the spatiotemporal trends of hospitalized pediatric diarrhea in Ho Chi Minh City, Vietnam.

    PubMed

    Thompson, Corinne N; Zelner, Jonathan L; Nhu, Tran Do Hoang; Phan, My Vt; Hoang Le, Phuc; Nguyen Thanh, Hung; Vu Thuy, Duong; Minh Nguyen, Ngoc; Ha Manh, Tuan; Van Hoang Minh, Tu; Lu Lan, Vi; Nguyen Van Vinh, Chau; Tran Tinh, Hien; von Clemm, Emmiliese; Storch, Harry; Thwaites, Guy; Grenfell, Bryan T; Baker, Stephen

    2015-09-01

    It is predicted that the integration of climate-based early warning systems into existing action plans will facilitate the timely provision of interventions to diarrheal disease epidemics in resource-poor settings. Diarrhea remains a considerable public health problem in Ho Chi Minh City (HCMC), Vietnam and we aimed to quantify variation in the impact of environmental conditions on diarrheal disease risk across the city. Using all inpatient diarrheal admissions data from three large hospitals within HCMC, we developed a mixed effects regression model to differentiate district-level variation in risk due to environmental conditions from the overarching seasonality of diarrheal disease hospitalization in HCMC. We identified considerable spatial heterogeneity in the risk of all-cause diarrhea across districts of HCMC with low elevation and differential responses to flooding, air temperature, and humidity driving further spatial heterogeneity in diarrheal disease risk. The incorporation of these results into predictive forecasting algorithms will provide a powerful resource to aid diarrheal disease prevention and control practices in HCMC and other similar settings. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. [Exploratory analysis of work engagement: use of the Utrecht scale in Benin].

    PubMed

    Ahanhanzo, Yolaine Glèlè; Kittel, France; Paraïso, Noël Moussiliou; Godin, Isabelle; Wilmet-Dramaix, Michèle; Makoutodé, Michel

    2014-01-01

    Work engagement, an emerging concept in the field of positive psychology in the workplace is not well known in developing countries. Defined as a positive and and fulfilling mindset related to work, it recalls a positive attitude incentive of performance and need to be investigated. In the context of the socioeconomic crisis of health workers, and with the chronic issue of poor quality of data, this study was designed to identify the factors associated with work engagement among health workers. in charge of data collection in the Benin Routine Health Information System. This study was a cross-sectional and analytical study targeting health workers in charge of data collection in public and private health centres. The dependent variable was work engagement and independent variables were sociodemographic and professional features, personal and professional resources and perception of technical factors. Logistic regression was used. The adequacy of the model was tested with the Hosmer-Lemeshow goodness of fit test. The results indicate that the level of work engagement is similar with that observed in previous studies. Predictors identified in logistic regression are perception of technical factors, location of the job, and personal resources, such as level of effort and overcommitment. This study identified factors associated with work engagement in a developing country, and adds to the knowledge concerning this new concept in Benin. The findings can contribute to research for improvement of human resources management in the health sector to achieve real performance and development.

  12. Improving visit cycle time using patient flow analysis in a high-volume inner-city hospital-based ambulatory clinic serving minority New Yorkers.

    PubMed

    Dhar, Sanjay; Michel, Raquel; Kanna, Balavenkatesh

    2011-01-01

    Patient waiting time and waiting room congestion are quality indicators that are related to efficiency of ambulatory care systems and patient satisfaction. Our main purpose was to test a program to decrease patient visit cycle time, while maintaining high-quality healthcare in a high-volume inner-city hospital-based clinic in New York City. Use of patient flow analysis and the creation of patient care teams proved useful in identifying areas for improvement, target, and measure effectiveness of interventions. The end result is reduced visit cycle time, improved provider team performance, and sustained patient care outcomes. © 2010 National Association for Healthcare Quality.

  13. HIV status of partners of HIV positive pregnant women in different regions of Nigeria: matters arising.

    PubMed

    Sagay, A S; Onakewhor, J; Galadanci, H; Emuveyan, E E

    2006-12-01

    This study was conducted to determine the pattern of HIV sero-status of Partners of HIV Positive Pregnant Women in three different regions of Nigeria and to explore the implications for HIV prevention interventions. The Site Coordinators of PMTCT programs in three Nigerian cities obtained data of the HIV status of the partners of HIV positive pregnant women. The selection of Benin City, Jos and Kano was made after consideration of their ethnic, religious and cultural representation of Nigeria. Benin City represents a traditional southern Nigeria city, Kano a traditional northern city and Jos, a middle-belt, ethnically diverse cosmopolitan setting. The data were analyzed using frequencies. A total of 500 partners of HIV infected pregnant women were tested for HIV using Determine Abbott test kits. Positive results were confirmed using Western blot or a second rapid test kit. The city-by-city results showed that in Benin City (Southern Nigeria), 78.8% (104/132) of the partners were HIV negative (sero-discordant), Jos (Middle-Belt) had 48.4% (103/213) sero-discordance while Kano (Northern Nigeria) recorded a sero-discordance rate of only 7.7% (12/155). These results indicate that the dynamics of HIV transmission in marital settings in Nigeria are different in the various regions of the country. Socio-cultural and religious settings play a significant role in HIV transmission among couples. These findings should guide prevention interventions in order to achieve maximal impact.

  14. Traditional treatment of human and animal salmonelloses in Southern Benin: Knowledge of farmers and traditherapists.

    PubMed

    Dougnon, T V; Déguénon, E; Fah, L; Lègba, B; Hounmanou, Y M G; Agbankpè, J; Amadou, A; Koudokpon, H; Fabiyi, K; Aniambossou, A; Assogba, P; Hounsa, E; de Souza, M; Avlessi, F; Dougnon, T J; Gbaguidi, F; Boko, M; Bankolé, H S; Baba-Moussa, L

    2017-06-01

    This study aimed to report medicinal plants that are likely to be used in the control of salmonellosis. A cross-sectional study was conducted in Southern Benin. Semi-structured questionnaires were administered to 150 farmers and 100 traditional therapists in seven high municipalities. This step helped to collect plants that are used in the treatment of animal salmonellosis and typhoid fever in human. The results revealed a low level of use of medicinal plants among breeders who prefer antibiotics such as oxytetracycline (53.55%), tylosine + sulfadimerazine (15.30%), and alphaceryl (19.13%). However, plants such as Moringa oleifera (leaves), Carica papaya (leaves and seeds), and Vernonia amygdalina (leaves) were mostly used by some farmers. From traditional therapists, 57 plant species of 32 families were identified as typhoid fever cures; among which Leguminosae, Asteraceae, and Euphorbiaceae were predominant. Persea americana (22.72%), V. amygdalina (7.57%), and Corchorus olitorius (7.57%) were the most cited by traditherapists for the treatment of typhoid fever in human. This study provides a database for further studies on the in vitro and in vivo efficacy of Benin plant species on Salmonella spp . These evaluations will guarantee the availability of new therapeutic solutions for populations.

  15. Hydatid Disease in Yemeni Patients attending Public and Private Hospitals in Sana’a City, Yemen

    PubMed Central

    Alghoury, Abdulbasit; El-Hamshary, Eman; Azazy, Ahmed; Hussein, Eman; Rayan, Hanan Z.

    2010-01-01

    Objectives Hydatid disease is endemic and represents a major health problem in Yemen. The aim of this study is to determine the magnitude of the problem of hydatidosis in patients attending Public and Private Hospitals at Sana’a city, Yemen. Methods 66 patients with hydatid disease were identified during the period from August 2006 to February 2007. Complete medical history for all CE patients were collected and analyzed. Results Among the 66 CE patients, 67% were females and 33% males. Liver was the most common involved organ. Single cyst was more frequently detected than multiple cysts and approximately 94% of the cysts were ≥5 cm. Moreover, Public hospitals were the main source of patients with CE disease. Conclusion Hydatidosis is still an endemic disease and an important health problem in Yemen which needs to be studied further. Therefore, accurate information on the distribution of the disease is the first step for the control and prevention of the disease. Moreover, it is crucial to investigate the role of different intermediate hosts and genotypes of E. granulosus in humans and animals. PMID:22125707

  16. Molecular detection of establishment and geographical distribution of Brazilian isolates of Neozygites tanajoae, a fungus pathogenic to cassava green mite, in Benin (West Africa)

    PubMed Central

    Hanna, Rachid; von Tiedemann, Andreas

    2010-01-01

    Diagnostic PCR with two specific primer pairs (NEOSSU and 8DDC) were used to monitor the establishment and geographical distribution of Brazilian isolates of Neozygites tanajoae Delalibera, Hajek and Humber (Entomophthorales: Neozygitaceae) released in Benin for the biological control of the cassava green mite, Mononychellus tanajoa (Bondar) (Acari: Tetranychidae). A total of 141 cassava fields were visited and samples of M. tanajoa suspected to be infected by N. tanajoae were collected in 60 fields distributed between the coastal Southern Forest Mosaic (SFM) and the Northern Guinea Savanna (NGS) zones of Benin, West Africa. Analysis of DNA samples of dead mites using the species specific NEOSSU primers revealed the presence of N. tanajoae in 46 fields. The second country specific pair of primers 8DDC revealed the presence of Brazilian isolates of N. tanajoae in 36 fields, representing 78.3% of fields positive for N. tanajoae. Brazilian isolates occurred from SFM to NGS zones in Benin, however, they were concentrated in fields located within former release zones (e.g. Department of Ouémé in the South and Borgou in the North). In contrast, the indigenous African isolates of N. tanajoae were evenly distributed in the sub-humid and humid savannah zones of the country. The mean infection rate of M. tanajoa with indigenous isolates of N. tanajoae was relatively low (5.3%) compared to Brazilian isolates (28%), indicating a higher biocontrol potential of the latter. This first post-release monitoring using PCR techniques showed that the Brazilian strains of N. tanajoae is well established in Benin and spread effectively in this area. PMID:20838883

  17. Harassment among university hospital physicians in four European cities. Results from a cross-sectional study in Norway, Sweden, Iceland and Italy (the HOUPE study).

    PubMed

    Andersen, Gunn Robstad; Aasland, Olaf Gjerlöw; Fridner, Ann; Lövseth, Lise Tevik

    2010-01-01

    The objective of this cross-national study was to identify work-related factors related to the prevalence of harassment, and identify potential similarities and differences in harassment levels and appointed perpetrators within the same professional group across four European cities. 2078 physicians working in university hospitals in Trondheim, Stockholm, Reykjavik, and Padova participated in the study. Questionnaire comprised items on direct and indirect experience of workplace harassment, appointed perpetrators, psychosocial work environment and basic socio-demographics. Harassment was found to be a relatively frequent work environment problem among physicians in all four European cities, with particular high levels in Padova. Role conflict, human resource primacy, empowerment leadership, and control over work pace were all found to be significantly related to workplace harassment. Differences in harassment prevalence and perpetrators indicated a cultural difference between the Italian and the Nordic hospitals. Harassment followed the line of command in Padova in contrast to being a horizontal phenomenon in the Scandinavian hospitals. This may be explained by national differences in organizational systems and traditions. In order to decrease harassment level and create a positive and productive work environment, each organization must employ different strategies in accordance with their harassment patterns.

  18. Oxacilin-resistant Coagulase-negative staphylococci (CoNS) bacteremia in a general hospital at São Paulo city, Brasil

    PubMed Central

    d’Azevedo, P.A.; Secchi, C.; Antunes, A.L.S.; Sales, T.; Silva, F.M.; Tranchesi, R.; Pignatari, A.C.C.

    2008-01-01

    In the last decades, coagulase-negative staphylococci (CoNS), especially Staphylococcus epidermidis have become an important cause of bloodstream infections. In addition, rates of methicillin-resistance among CoNS have increased substantially, leading to the use of glicopeptides for therapy. The objective of this study was to evaluate eleven consecutives clinically relevant cases of oxacillin-resistant CoNS bacteremia in a general hospital localized in São Paulo city, Brazil. Five different species were identified by different phenotypic methods, including S. epidermidis (5), S. haemolyticus (3), S. hominis (1), S. warneri (1) and S. cohnii subsp urealyticus (1). A variety of Pulsed Field Gel Electrophoresis profiles was observed by macrorestriction DNA analysis in S. epidermidis isolates, but two of three S. haemolyticus isolates presented the same profile. These data indicated the heterogeneity of the CoNS isolates, suggesting that horizontal dissemination of these microorganisms in the investigated hospital was not frequent. One S. epidermidis and one S. haemolyticus isolates were resistant to teicoplanin and susceptible to vancomycin. The selective pressure due to the use of teicoplanin in this hospital is relevant. PMID:24031279

  19. E-Learning and North-South collaboration: the experience of two public health schools in France and Benin.

    PubMed

    Edouard, Guévart; Dominique, Billot; Moussiliou, Paraïso Noël; Francis, Guillemin; Khaled, Bessaoud; Serge, Briançon

    2009-10-14

    Distance learning (e-learning) can facilitate access to training. Yet few public health E-learning experiments have been reported; institutes in developing countries experience difficulties in establishing on-line curricula, while developed countries struggle with adapting existing curricula to realities on the ground. In 2005, two schools of public health, one in France and one in Benin, began collaborating through contact sessions organised for Nancy University distance-learning students. This experience gave rise to a partnership aimed at developing training materials for e-Learning for African students. The distance-learning public health course at Nancy teaches public health professionals through a module entitled "Health and Development." The module is specifically tailored for professionals from developing countries. To promote student-teacher exchanges, clarify content and supervise dissertations, contact sessions are organized in centres proximate and accessible to African students. The Benin Institute's main feature is residential team learning; distance-learning courses are currently being prepared. The two collaborating institutions have developed a joint distance-learning module geared toward developing countries. The collaboration provides for the development, diffusion, and joint delivery of teaching modules featuring issues that are familiar to African staff, gives the French Institute credibility in assessing research work produced, and enables modules on specific African issues and approaches to be put online. While E-learning is a viable educational option for public health professionals, periodic contact can be advantageous. Our analysis showed that the benefit of the collaboration between the two institutions is mutual; the French Institute extends its geographical, cultural and contextual reach and expands its pool of teaching staff. The Benin Institute benefits from the technical partnership and expertise, which allow it to offer distance

  20. What Makes Small-Scale Farmers Participate in Financing Agricultural Research and Extension? Analysis of Three Case Studies from Benin

    ERIC Educational Resources Information Center

    Moumouni, Ismail M.; Vodouhe, Simplice D.; Streiffeler, Friedhelm

    2009-01-01

    This paper analyses the organizational, financial and technological incentives that service organizations used to motivate farmers to finance agricultural research and extension in Benin. Understanding the foundations and implications of these motivation systems is important for improving farmer financial participation in agricultural research and…

  1. Hunting, Sale, and Consumption of Bushmeat Killed by Lead-Based Ammunition in Benin.

    PubMed

    Ahmadi, Shukrullah; Maman, Suzanne; Zoumenou, Roméo; Massougbodji, Achille; Cot, Michel; Glorennec, Philippe; Bodeau-Livinec, Florence

    2018-06-01

    Human consumption of animal meat killed by lead ammunition has been reported as a risk factor for elevated blood lead levels. However, little is known about how meat killed by lead ammunition is hunted, prepared, sold, and consumed. We explored the process from hunting to consumption within communities in Benin from the perspective of preventive measures. We conducted 38 semi-structured interviews with hunters ( n = 9) and sellers ( n = 8) of bushmeat and families ( n = 21) as consumers of bushmeat killed by lead ammunition. Data were transcribed, translated, and coded for analysis. We conducted content analysis to identify and describe key themes and processes from hunting to consumption. Many hunters ( n = 7/9) used lead-based ammunition. After the meat is hunted, market sellers often buy it directly from the hunters. Amongst the hunters and sellers, few ( n = 4/17) acknowledged removing the meat impacted by lead shot prior to sale. Many families ( n = 15/21) mentioned consumption of the hunted bushmeat. The meat is cooked before sharing with children. Many families ( n = 19/21) mentioned they look for the remains of the lead shot or remove the meat impacted by the shot. The finding suggests that hunting, sale, and consumption of bushmeat killed by lead ammunition are well-known practices in Allada, Benin. The bushmeat often hunted illegally with lead shot is sold in the markets and eventually consumed by families who attempt to clean the meat impacted by the lead shot before cooking it.

  2. Auckland City Hospital's ortho-geriatric service: an audit of patients aged over 65 with fractured neck of femur.

    PubMed

    Fergus, Lucy; Cutfield, Greer; Harris, Roger

    2011-06-24

    The process of care of older patients with fractured neck of femur at Auckland City Hospital has recently changed with selected patients "fast-tracked" as soon as possible postoperatively to a specialised Older People's Health (OPH) ward. The aims of this study were: to evaluate patient characteristics; to analyse process of care; to compare outcomes in those "fast-tracked" patients with those receiving usual care; and to compare this information with previous data from Auckland City Hospital and other centres in New Zealand. Prospective case record audit of patients with fractured neck of femur aged 65 years and over admitted under Orthopaedics over a 4-month period. 115 patients were audited; mean age was 84 years, 77% were female. Inpatient mortality was 5%. Twenty-four percent of patients had surgery within 24 hours of admission. Of those who did not have surgery within 24 hours, 39% were awaiting operating theatre availability. Median overall length of stay (LOS) was 27 days. Eighty-four percent of patients were transferred to Older Peoples Health. Considering all patients, 70% of those living at home pre-fracture returned home on discharge. However, only 26% of those in Rest Home returned to Rest Home. Overall, 35% of patients were discharged to a higher level of care. Forty-four percent of the group were able to walk unaided prior to hip fracture, but only 1% on discharge. Forty-three patients were "fast-tracked" to Older Peoples Health. Their median overall LOS was 23 days compared to 28 days for those receiving usual care. This was due to the shorter time in Orthopaedics. Thirty-three percent of this group went to a higher level of care on discharge compared to 35% in the group that received usual care. Many patients experience a delay to surgery for non-medical reasons. The percentage transferred to Older Peoples Health is high. Fast-tracking to Older Peoples Health shortens overall length of stay due to fewer days in Orthopaedics. Many patients require a

  3. Pierre Bourdieu and transformative agency: a study of how patients in Benin negotiate blame and accountability in the context of severe obstetric events.

    PubMed

    Béhague, Dominique P; Kanhonou, Lydie G; Filippi, Véronique; Lègonou, Solange; Ronsmans, Carine

    2008-05-01

    This paper explores the social and institutional processes that constrain and enable obstetric patients in Benin to critically evaluate quality of healthcare and to stimulate positive changes in the health system. Based on qualitative data collected as part of a hospital auditing system, the paper analyses semi-structured patient feedback interviews and their function as a primary mechanism through which critical patient evaluation can develop constructively. Using a Bourdieuan framework, we explore the dynamic social conditions that give rise to transformative agency and institutional change. Our results show that hospitals are often permeated with the habitus of employment, kinship and reproductive social fields, through which a number of social, economic and healthcare conflicts, power struggles and blame-inducing interactions emerge. These conflicts generally serve to keep patients quiescent and passive when it comes to developing critical statements of quality of care. In a subset of cases, however, these conflicts are transformed by patients and their family members into opportunities for modifying the values and practices of each habitus in new and creative ways. The active negotiation of social conflict and blame enabled a minority of patients actively to divert blame from themselves and to develop and maintain critical healthcare evaluations.

  4. Baldrige Award cites two hospitals. Baptist, Saint Luke's hospitals honored for quality, performance.

    PubMed

    Rees, Tom

    2004-01-01

    Baptist Hospital Inc., Pensacola, Fla.; and Saint Luke's Hospital, Kansas City, Mo., have received the prestigious Malcolm Baldrige National Quality Award in the category of healthcare. Named for a former secretary of commerce, the award recognizes efficiency, effectiveness and excellence. The two hospitals are among only seven companies in the U.S. to be so recognized this year.

  5. Traditional treatment of human and animal salmonelloses in Southern Benin: Knowledge of farmers and traditherapists

    PubMed Central

    Dougnon, T. V.; Déguénon, E.; Fah, L.; Lègba, B.; Hounmanou, Y. M. G.; Agbankpè, J.; Amadou, A.; Koudokpon, H.; Fabiyi, K.; Aniambossou, A.; Assogba, P.; Hounsa, E.; de Souza, M.; Avlessi, F.; Dougnon, T. J.; Gbaguidi, F.; Boko, M.; Bankolé, H. S.; Baba-Moussa, L.

    2017-01-01

    Aim:: This study aimed to report medicinal plants that are likely to be used in the control of salmonellosis. Materials and Methods:: A cross-sectional study was conducted in Southern Benin. Semi-structured questionnaires were administered to 150 farmers and 100 traditional therapists in seven high municipalities. This step helped to collect plants that are used in the treatment of animal salmonellosis and typhoid fever in human. Results:: The results revealed a low level of use of medicinal plants among breeders who prefer antibiotics such as oxytetracycline (53.55%), tylosine + sulfadimerazine (15.30%), and alphaceryl (19.13%). However, plants such as Moringa oleifera (leaves), Carica papaya (leaves and seeds), and Vernonia amygdalina (leaves) were mostly used by some farmers. From traditional therapists, 57 plant species of 32 families were identified as typhoid fever cures; among which Leguminosae, Asteraceae, and Euphorbiaceae were predominant. Persea americana (22.72%), V. amygdalina (7.57%), and Corchorus olitorius (7.57%) were the most cited by traditherapists for the treatment of typhoid fever in human. Conclusion:: This study provides a database for further studies on the in vitro and in vivo efficacy of Benin plant species on Salmonella spp. These evaluations will guarantee the availability of new therapeutic solutions for populations. PMID:28717307

  6. Association of Ambient Fine Particles With Out-of-Hospital Cardiac Arrests in New York City

    PubMed Central

    Silverman, Robert A.; Ito, Kazuhiko; Freese, John; Kaufman, Brad J.; De Claro, Danilynn; Braun, James; Prezant, David J.

    2010-01-01

    Cardiovascular morbidity has been associated with particulate matter (PM) air pollution, although the relation between pollutants and sudden death from cardiac arrest has not been established. This study examined associations between out-of-hospital cardiac arrests and fine PM (of aerodynamic diameter ≤2.5 μm, or PM2.5), ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide in New York City. The authors analyzed 8,216 out-of-hospital cardiac arrests of primary cardiac etiology during the years 2002–2006. Time-series and case-crossover analyses were conducted, controlling for season, day-of-week, same-day, and delayed/apparent temperature. An increased risk of cardiac arrest in time-series (relative risk (RR) = 1.06, 95% confidence interval (CI): 1.02, 1.10) and case-crossover (RR = 1.04, 95% CI: 0.99, 1.08) analysis for a PM2.5 increase of 10 μg/m3 in the average of 0- and 1-day lags was found. The association was significant in the warm season (RR = 1.09, 95% CI: 1.03, 1.15) but not the cold season (RR = 1.01, 95% CI: 0.95, 1.07). Associations of cardiac arrest with other pollutants were weaker. These findings, consistent with studies implicating acute cardiovascular effects of PM, support a link between PM2.5 and out-of-hospital cardiac arrests. Since few individuals survive an arrest, air pollution control may help prevent future cardiovascular mortality. PMID:20729350

  7. Microbial Contamination of Ice Machines Is Mediated by Activated Charcoal Filtration Systems in a City Hospital.

    PubMed

    Yorioka, Katsuhiro; Oie, Shigeharu; Hayashi, Koji; Kimoto, Hiroo; Furukawa, Hiroyuki

    2016-06-01

    Although microbial contamination of ice machines has been reported, no previous study has addressed microbial contamination of ice produced by machines equipped with activated charcoal (AC) filters in hospitals. The aim of this study was to provide clinical data for evaluating AC filters to prevent microbial contamination of ice. We compared microbial contamination in ice samples produced by machines with (n = 20) and without an AC filter (n = 40) in Shunan City Shinnanyo Municipal Hospital. All samples from the ice machine equipped with an AC filter contained 10-116 CFUs/g of glucose nonfermenting gram-negative bacteria such as Pseudomonas aeruginosa and Chryseobacterium meningosepticum. No microorganisms were detected in samples from ice machines without AC filters. After the AC filter was removed from the ice machine that tested positive for Gram-negative bacteria, the ice was resampled (n = 20). Analysis found no contaminants. Ice machines equipped with AC filters pose a serious risk factor for ice contamination. New filter-use guidelines and regulations on bacterial detection limits to prevent contamination of ice in healthcare facilities are necessary.

  8. Rich anniversary book honors 'The city that doctors built'.

    PubMed

    Botvin, Judith D

    2005-01-01

    Medical City, Dallas, celebrated its 30th anniversary with a special edition of its internal publication. Called "The City That Doctors Built," the substantial book honors the physicians that people this unique specialty hospital.

  9. Virus surveys of Capsicum spp. in the Republic of Benin reveal the prevalence of pepper vein yellows virus and the identification of a previously uncharacterised polerovirus species.

    PubMed

    Afouda, Leonard; Kone, Daouda; Zinsou, Valerien; Dossou, Laurence; Kenyon, Lawrence; Winter, Stephan; Knierim, Dennis

    2017-06-01

    Surveys were conducted in 2014 and 2015 in Southern and Northern Benin, respectively, to identify the viruses infecting peppers (Capsicum spp.). The samples were screened by ELISA for cucumber mosaic virus (CMV), pepper veinal mottle virus (PVMV), potato virus Y (PVY) and tomato yellow leaf curl virus (TYLCV). A generic reverse transcription PCR (RT-PCR) was used to test for the presence of poleroviruses. ELISA tests confirmed the prevalence of all viruses, while the RT-PCR detected pepper vein yellows virus (PeVYV) which is reported for the first time in Benin. A further, divergent polerovirus isolate was detected from a single pepper sample originating from southern Benin. Screening of samples collected from solanaceous plants during virus surveys in Mali (conducted in 2009) also detected this divergent polerovirus isolate in two samples from African eggplants. The complete genome sequence was obtained from the Mali isolate using transcriptome sequencing and by conventional Sanger sequencing of overlapping RT-PCR products. Based on the sequence characteristics of this isolate we propose a new polerovirus species, African eggplant yellowing virus (AeYV).

  10. Physical Science Teachers' Attitudes to and Factors Affecting Their Integration of Technology Education in Science Teaching in Benin

    ERIC Educational Resources Information Center

    Kelani, Raphael R.; Gado, Issaou

    2018-01-01

    Following the calls of international conferences related to the teaching of science and technology, technology education (TE) was integrated as a component of physical sciences programmes in Benin, West Africa. This study investigates physical science teachers' attitudes towards the integration of TE topics in secondary school science curricula in…

  11. [Work schedule management in the health institutions of Abomey-Calavi (Benin)].

    PubMed

    Makoutodé, M; Kassanga, N N; Ouendo, E M; Agueh, V D; Diallo, P M

    1999-12-01

    Work time management of the health personnel of the health institutions in the sub-prefecture of Abomey-Calavi (Benin) This study was carried out with a sample size of 130, comprising health personnel, patients, members of management committees and twelve health institutions of the subprefecture of Abomey-Calavi. The survey was carried out through observation, one-on-one interviews and consultation of documents. The results reveal that work time is poorly managed in almost all of the programmes surveyed. There exist long waiting lines in almost all the health programmes. On average, the traffic report per service is 82 and 10 out of 12 of the programmes investigated do not have an agenda of activities.

  12. Spontaneous Postpartum Clearance of Plasmodium falciparum Parasitemia in Pregnant Women, Benin

    PubMed Central

    Bottero, Julie; Briand, Valérie; Agbowai, Carine; Doritchamou, Justin; Massougbodji, Achille; Cot, Michel

    2011-01-01

    The question of malaria in the postpartum period is controversial. Malaria was investigated during a randomized trial of intermittent preventive treatment in pregnancy in Benin. Women infected at delivery were tested for parasitemia in the early postpartum period; they had not received treatment unless they were symptomatic. Among the 35 of 1,346 infected women, parasitologic follow-up results could not be interpreted in 15 because they were treated for symptoms, 18 cleared parasitemia spontaneously within five days postpartum, and 2 had a strong decrease in parasitemia before being treated. Because the placenta is the privileged site for sequestration of parasites, it facilitates their persistence during pregnancy, and its elimination may rapidly induce their clearance. PMID:21292897

  13. A multipronged approach is associated with improved breast milk feeding rates in very low birth weight infants of an inner-city hospital.

    PubMed

    Dereddy, Narendra R; Talati, Ajay J; Smith, Ashley; Kudumula, Ravi; Dhanireddy, Ramasubbareddy

    2015-02-01

    Breast milk feeding has advantages over formula feeding in premature infants, but its use in them is low. We initiated measures in our inner-city hospital such as starting a dedicated lactation service, counseling the mothers prenatally and postnatally, educating hospital staff, and advocating with our state's Medicaid insurance to provide free home breast pumps. These measures were associated with improvement in our breast milk feeding rates in very low birth weight infants from 22% to 88% over 5 years. This article describes our multipronged approach and can help encourage and guide other units with similar demographics to improve their breast milk feeding rates. © The Author(s) 2014.

  14. Hospital Workers Disaster Management and Hospital Nonstructural: A Study in Bandar Abbas, Iran

    PubMed Central

    Lakbala, Parvin

    2016-01-01

    Introduction: A devastating earthquake is inevitable in the long term and likely in the near future in Iran. The objective of the study was to assess the knowledge of hospital staff to disaster management system in hospital and to determine nonstructural safety assessment in Shahid Mohammadi hospital in Bandar Abbas city of Iran. This hospital is the main referral hospital in Hormozgan province with a capacity of about 450 beds and the highest patient admissions. Methods: The cross-sectional study was conducted in 2013 on 200 healthcare workers at Shahid Mohammadi hospital, in the city of Bandar Abbas, Iran. This hospital is the main referral hospital in Hormozgan province and has a capacity of about 450 beds with highest numbers of patient admissions. Questionnaire and checklist used for assessing health workers knowledge and awareness towards disaster management and nonstructural safety this hospital. Results: This study found that knowledge, awareness, and disaster preparedness of hospital staff need continual reinforcement to improve self efficacy for disaster management. Equipping health care facilities at the time of natural disasters, especially earthquakes are of great importance all over the world, especially in Iran. This requires the national strategies and planning for all health facilities. Conclusion: It seems due to limitations of hospital beds, insufficient of personnel, and medical equipment, health care providers paid greater attention to this issue. Since this hospital is the only educational public hospital in the province, it is essential to pay much attention to the risk management not only to this hospital but at the national level to health facilities. PMID:26573039

  15. Schistosomiasis and Soil Transmitted Helminths Distribution in Benin: A Baseline Prevalence Survey in 30 Districts.

    PubMed

    Boko, Pelagie M; Ibikounle, Moudachirou; Onzo-Aboki, Ablawa; Tougoue, Jean-Jacques; Sissinto, Yollande; Batcho, Wilfrid; Kinde-Gazard, Dorothe; Kabore, Achille

    2016-01-01

    In 2013, Benin developed strategies to control neglected tropical diseases and one of the first step was the disease mapping of the entire country in order to identify endemic districts of schistosomiasis and soil transmitted helminths (STH). This study was carried out in 30 of the 77 districts of Benin. Of these 30 districts 22 were previously treated for Lymphatic Filariasis (LF) using the Ivermectin and Albendazole combination. In each district, five schools were selected and 50 children aged 8 to 14 years were sampled in each school, making a total of 250 children sampled in the district. The schools were selected mainly according to their proximity to lakes or any bodies of water that were likely to have been used by the children. Samples of faeces and urine were collected from each pupil. Urinary schistosomiasis was identified using the urine filtration technique while STH and intestinal schistosomiasis were identified through the Kato Katz method. Overall a total of 7500 pupils were surveyed across 150 schools with a gender ratio of 1:1. Hookworm was identified in all 30 districts with a prevalence ranging from 1.2% (95%CI: 0.0-2.5) to 60% (95%CI: 53.9-66.1). Ascaris lumbricoides was detected in 19 districts with a prevalence rate between 1% (95%CI: 0.0-2.2) and 39% (95%CI: 32.9-45.0). In addition to these common STH, Trichuris trichiura, Enterobius vermicularis and Strongyloides stercoralis were found at low prevalence. Only 16 districts were endemic to Schistosoma mansoni, while 29 districts were endemic to S. haematobium. The S. haematobium prevalence ranged from 0.8% (95% CI: 0.0-1.9) to 56% (95% CI: 50.2-62.5) while the prevalence of S. mansoni varied from 0.4% (95%CI: 0.0-1.2) to 46% (95% CI: 39.8-52.2). The 22 districts, where LF was successfully eliminated, still require mass drug administration (MDA) of albendazole indicating that school-based MDA would be needed even after LF elimination in districts co-endemic to LF and STH in Benin.

  16. Schistosomiasis and Soil Transmitted Helminths Distribution in Benin: A Baseline Prevalence Survey in 30 Districts

    PubMed Central

    Boko, Pelagie M.; Ibikounle, Moudachirou; Onzo-Aboki, Ablawa; Tougoue, Jean-Jacques; Sissinto, Yollande; Batcho, Wilfrid; Kinde-Gazard, Dorothe; Kabore, Achille

    2016-01-01

    In 2013, Benin developed strategies to control neglected tropical diseases and one of the first step was the disease mapping of the entire country in order to identify endemic districts of schistosomiasis and soil transmitted helminths (STH). This study was carried out in 30 of the 77 districts of Benin. Of these 30 districts 22 were previously treated for Lymphatic Filariasis (LF) using the Ivermectin and Albendazole combination. In each district, five schools were selected and 50 children aged 8 to 14 years were sampled in each school, making a total of 250 children sampled in the district. The schools were selected mainly according to their proximity to lakes or any bodies of water that were likely to have been used by the children. Samples of faeces and urine were collected from each pupil. Urinary schistosomiasis was identified using the urine filtration technique while STH and intestinal schistosomiasis were identified through the Kato Katz method. Overall a total of 7500 pupils were surveyed across 150 schools with a gender ratio of 1:1. Hookworm was identified in all 30 districts with a prevalence ranging from 1.2% (95%CI: 0.0–2.5) to 60% (95%CI: 53.9–66.1). Ascaris lumbricoides was detected in 19 districts with a prevalence rate between 1% (95%CI: 0.0–2.2) and 39% (95%CI: 32.9–45.0). In addition to these common STH, Trichuris trichiura, Enterobius vermicularis and Strongyloides stercoralis were found at low prevalence. Only 16 districts were endemic to Schistosoma mansoni, while 29 districts were endemic to S. haematobium. The S. haematobium prevalence ranged from 0.8% (95% CI: 0.0–1.9) to 56% (95% CI: 50.2–62.5) while the prevalence of S. mansoni varied from 0.4% (95%CI: 0.0–1.2) to 46% (95% CI: 39.8–52.2). The 22 districts, where LF was successfully eliminated, still require mass drug administration (MDA) of albendazole indicating that school-based MDA would be needed even after LF elimination in districts co-endemic to LF and STH in

  17. Surveillance of Methicillin-Resistant Staphylococcus aureus in a Pediatric Hospital in Mexico City during a 7-Year Period (1997 to 2003): Clonal Evolution and Impact of Infection Control

    PubMed Central

    Velazquez-Meza, M. E.; Aires de Sousa, M.; Echaniz-Aviles, G.; Solórzano-Santos, F.; Miranda-Novales, G.; Silva-Sanchez, J.; de Lencastre, H.

    2004-01-01

    Between 1997 and 2000 a single multidrug-susceptible methicillin-resistant Staphylococcus aureus clone, M (sequence type 30 [ST30]-staphylococcal cassette chromosome mec [SCCmec] type IV), was present in a pediatric hospital in Mexico City, Mexico. In 2001 the international multidrug-resistant New York-Japan clone (ST5-SCCmec type II) was introduced into the hospital, completely replacing clone M by 2002. PMID:15297554

  18. Comparing Farmer-to-Farmer Video with Workshops to Train Rural Women in Improved Rice Parboiling in Central Benin

    ERIC Educational Resources Information Center

    Zossou, Esperance; Van Mele, Paul; Vodouhe, Simplice D.; Wanvoeke, Jonas

    2009-01-01

    This article deals with the comparison of the conventional training based on two day community workshops and farmer-to-farmer video used as methodologies for the dissemination of improved rice parboiling process in Benin. From November 2007 to May 2008, we interviewed 160 women and 17 women groups who had been exposed to both, one or other of the…

  19. Impact of city police layperson education and equipment with automatic external defibrillators on patient outcome after out of hospital cardiac arrest.

    PubMed

    Stein, Philipp; Spahn, Gabriela H; Müller, Stefan; Zollinger, Andreas; Baulig, Werner; Brüesch, Martin; Seifert, Burkhardt; Spahn, Donat R

    2017-09-01

    Out of hospital cardiac arrest (OHCA) occurs frequently and the outcome is often dismal. Early defibrillation saves lives and brain function in OHCA. The Zurich city police (STAPO) forces were instructed and equipped to provide basic life support (BLS) and to use an AED in 2009. Retrospective observational study comparing period 1 (P1) 2004-2009 before equipping and training of the STAPO and period 2 (P2) 2010-2015 after the implementation. Patients suffering from OHCA of cardiac or presumed cardiac origin in the city of Zurich undergoing CPR by EMS in P1 (n=709) and P2 (n=684) were included. Intervention periods and outcome were compared between the periods. Outcome variables were adjusted for patient age and gender, witnessed status, and defibrillation by the EMS, STAPO, layperson or no defibrillation. In P2, CPR was started by the STAPO in a median of 8 (IQR 6-9) minutes after the arrest and thus significantly earlier (median 3min) than by the EMS (p<0.001). STAPO performed the first defibrillation in a median of 9 (IQR 8-10) minutes and thus significantly earlier (median 6min) than the EMS (p<0.001). Outcome improved significantly in P2: proportion of patients with return of spontaneous circulation (ROSC, P2 35.8%, P1 24.0%, OR 1.8, 95% CI 1.4-2.2, p<0.001), hospital admission (P2 32.2%, P1 21.4%, OR 1.7, 95% CI 1.4-2.2, p<0.001) and survival to hospital discharge (P2 13.6%, P1 6.9%, OR 2.1 95% CI 1.5-3.0, p<0.001). If the patient was firstly defibrillated by the STAPO, ROSC (STAPO 74.4%, adj. OR 2.6, 95% CI 1.3-5.4, p=0.010) and hospital admission (STAPO 72.1%, adj. OR 2.8, 95% CI 1.4-5.6, p=0.005) was higher compared to patients firstly defibrillated by the EMS. Survival to hospital discharge (STAPO 30.2%, adj. OR 1.4, 95% CI 0.7-2.9, p=0.38) was unchanged. Dispatching BLS trained and AED equipped police forces results in earlier and more successful resuscitation of OHCA victims, leading to higher proportions of patients with ROSC, hospital admission and

  20. Levels of organic compounds in interiors (school, home, university and hospital) of Ouargla city, Algeria

    NASA Astrophysics Data System (ADS)

    Boudehane, A.; Lounas, A.; Moussaoui, Y.; Balducci, C.; Cecinato, A.

    2016-11-01

    Indoor environments are affected by a number of organic contaminants, whose concentrations can exceed by orders of magnitude those found outdoors in external air. At this regard, polycyclic aromatic hydrocarbons (PAHs) deserve a special concern. PAHs occur in the air both in the gaseous and particulate forms; they are associated to fine aerosols and soil dust, and deposit on surfaces. Nonetheless, scarce information exists about the PAH pollution of indoor locations in Northern Africa. PAHs were first investigated in dust of interiors in Ouargla (Saharan Algeria), concurrently with n-alkanes and polar organics. Settled dust was collected from pre-cleaned surfaces (0.5 m2 each) at 7 internal locations in total from a school, the city hospital and university, and a home. Three sample series were collected 15, 30 days and random after the preliminary cleaning of surfaces. Contemporarily, organic compounds were collected at 15 locations of the target sites by deploying diffusive samplers over the whole study period to obtain molecular signatures of semi-volatile organic fraction. A consolidated procedure consisting of ultra-sonic bath extraction, semi-preparative column chromatography and gas chromatographic - mass spectrometric analysis was applied for chemical characterization of dusts. n-Alkanes ranged from 3.8 to 41 μg/m2 in dust and 0.17-2.42 μg/m3 in gas phase. PAHs concentrations were 17-89 ng/m2 and 45-182 ng/m3, respectively. Caffeine and nicotine were found both in dust (63-2,02 ng/m2 and 7-284 ng/m2, respectively) and as vapors in air (4-416 ng/m3 and 3.5-60 ng/m3). Two sites were affected by cannabinoids, while traces of nonylphenols occurred at all locations. External air was, on the average, more affected by PAHs than the interiors of school and hospital, but not of university. The compound concentrations show that Ouargla city is seriously polluted and requires actions to improve air quality.

  1. FACTORS ASSOCIATED WITH THE UPTAKE OF SODIUM DICHLOROISOCYANURATE (NADCC) TABLETS AS HOUSEHOLD WATER-TREATMENT PRODUCT AMONG CAREGIVERS OF CHILDREN UNDER FIVE IN BENIN, WEST AFRICA.

    PubMed

    Inungu, Joseph N; Zinsou, Cyprien E; Mustafa, Younis; Singbo, Narcisse

    2016-01-01

    Improving access to safe drinking water is a critical step in mitigating diarrheal diseases that affect millions of children under 5 years throughout the developing world each year. While the delivery of safe water is out of the reach of many countries, the utilization of Sodium dichloroisocyanurate (NaDCC) is a proven cost-effective alternative to prevent diarrhea caused by waterborne pathogens. However, its uptake remains low in many developing countries, such as the Republic of Benin. This study examines the trends and the determinants of NaDCC uptake in Benin. Population Services International and its affiliate conducted two multistage household surveys among caregivers of children under five in Benin to examine the practices towards diarrheal disease in children under five and identify the factors associated with the use of NaDCC in this population. 2912 respondents/caregivers of children under five were interviewed in 2009 versus 3196 in 2011. The proportion of caregivers who reported ever treating water with NaDCC increased from 5.8% in 2009 to 11.5% in 2011, p < 0.001. The logistic regression model showed that caregivers who knew places that sell NaDCC in the community; those who felt capable of utilizing NADCC correctly to treat drinking water as well as caregivers who reported to be Muslim were more likely than their counterparts to use NaDCC as water treatment product. In order to increase the use of NADCC among caregivers, the Government of Benin and its development partners should focus not only on making NADCC available in the community and informing the community members about the different points of sale, but also in building up the capacity and confidence of caregivers in utilizing it.

  2. Statistical Analysis Aiming at Predicting Respiratory Tract Disease Hospital Admissions from Environmental Variables in the City of São Paulo

    PubMed Central

    de Sousa Zanotti Stagliorio Coêlho, Micheline; Luiz Teixeira Gonçalves, Fabio; do Rosário Dias de Oliveira Latorre, Maria

    2010-01-01

    This study is aimed at creating a stochastic model, named Brazilian Climate and Health Model (BCHM), through Poisson regression, in order to predict the occurrence of hospital respiratory admissions (for children under thirteen years of age) as a function of air pollutants, meteorological variables, and thermal comfort indices (effective temperatures, ET). The data used in this study were obtained from the city of São Paulo, Brazil, between 1997 and 2000. The respiratory tract diseases were divided into three categories: URI (Upper Respiratory tract diseases), LRI (Lower Respiratory tract diseases), and IP (Influenza and Pneumonia). The overall results of URI, LRI, and IP show clear correlation with SO2 and CO, PM10 and O3, and PM10, respectively, and the ETw4 (Effective Temperature) for all the three disease groups. It is extremely important to warn the government of the most populated city in Brazil about the outcome of this study, providing it with valuable information in order to help it better manage its resources on behalf of the whole population of the city of Sao Paulo, especially those with low incomes. PMID:20706674

  3. Factors associated with the difficulty in hospital acceptance among elderly emergency patients: A population-based study in Osaka City, Japan.

    PubMed

    Matsuyama, Tasuku; Kitamura, Tetsuhisa; Katayama, Yusuke; Kiyohara, Kosuke; Hayashida, Sumito; Kawamura, Takashi; Iwami, Taku; Ohta, Bon

    2017-12-01

    We aimed to investigate prehospital factors associated with difficulty in hospital acceptance among elderly emergency patients. We reviewed ambulance records in Osaka City from January 2013 through December 2014, and enrolled all elderly emergency patients aged ≥65 years who were transported by on-scene emergency medical service personnel to a hospital that the personnel had selected. The definition of difficulty in hospital acceptance was to the requirement for ≥4 phone calls to hospitals by emergency medical service personnel before receiving a decision from the destination hospitals. Prehospital factors associated with difficulty in hospital acceptance were examined through logistic regression analysis. During the study period, 72 105 elderly patients were included, and 13 332 patients (18.5%) experienced difficulty in hospital acceptance. In the simple linear regression model, hospital selection time increased significantly with an increasing number of phone calls (R 2  = 0.774). In the multivariable analysis, older age (P for trend <0.001), calls from a healthcare facility (adjusted odds ratio [AOR] 1.23, 95% confidence interval [CI] 1.15-1.32), night-time (AOR 2.17, 95% CI 2.08-2.26) and weekend/holidays (AOR 1.43, 95% CI 1.38-1.49) were significantly associated with difficulty in hospital acceptance. A positive association was observed between gastrointestinal emergency-related symptoms and difficulty in hospital acceptance among elderly patients with symptoms of internal disease (AOR 1.71, 95% CI 1.53-1.91). In Japan, which has a rapidly aging population, a comprehensive strategy for elderly emergency patients, especially for advanced age groups or nursing home residents, is required. Geriatr Gerontol Int 2017; 17: 2441-2448. © 2017 Japan Geriatrics Society.

  4. Indigenous knowledge of shea processing and quality perception of shea products in Benin.

    PubMed

    Honfo, Fernande G; Linnemann, Anita R; Akissoe, Noël H; Soumanou, Mohamed M; van Boekel, Martinus A J S

    2012-01-01

    A survey among 246 people belonging to 14 ethnic groups and living in 5 different parklands in Benin revealed different practices to process shea kernels (namely boiling followed sun drying and smoking) and extract shea butter. A relation between parklands, gathering period, and sun-drying conditions was established. Moisture content and appearance of kernels were the selection criteria for users of shea kernels; color was the main characteristic to buy butter. Constraints to be solved are long processing times, lack of milling equipment and high water requirements. Best practices for smoking, sun drying, and roasting operations need to be established for further improvement.

  5. Characterization of Staphylococcus aureus Isolates That Colonize Medical Students in a Hospital of the City of Cali, Colombia

    PubMed Central

    Collazos Marín, Luis Fernando; Estupiñan Arciniegas, Gina; Chavez Vivas, Monica

    2015-01-01

    Introduction. Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) represents a risk for the spread of bacteria. This study characterized the S. aureus isolated from medical students, who were in their clinical rotation at a hospital in the city of Cali. Materials and Methods. 216 students participated in the study and 63 isolates of S. aureus were evaluated for susceptibility and PCR amplification of agr and mecA genes. The origin of MRSA isolates was established by analyzing agr polymorphisms. Results. A total of 29.2% of students were colonized by S. aureus and nasal carriage rate was 23.6% and 14.3% MRSA. Three agr groups (agr II, and agr III) were identified; the agr I group was the most common, with a 35% prevalence; this group is from community origin. Conclusion. The present study demonstrates that medical students carry S. aureus strains, with the threat of spreading them both to community and hospital environments. PMID:26495001

  6. Decrease in mortality rate and hospital admissions for acute myocardial infarction after the enactment of the smoking ban law in São Paulo city, Brazil.

    PubMed

    Abe, Tania M O; Scholz, Jaqueline; de Masi, Eduardo; Nobre, Moacyr R C; Filho, Roberto Kalil

    2017-11-01

    Smoking restriction laws have spread worldwide during the last decade. Previous studies have shown a decline in the community rates of myocardial infarction after enactment of these laws. However, data are scarce about the Latin American population. In the first phase of this study, we reported the successful implementation of the law in São Paulo city, with a decrease in carbon monoxide rates in hospitality venues. To evaluate whether the 2009 implementation of a comprehensive smoking ban law in São Paulo city was associated with a reduction in rates of mortality and hospital admissions for myocardial infarction. We performed a time-series study of monthly rates of mortality and hospital admissions for acute myocardial infarction from January 2005 to December 2010. The data were derived from DATASUS, the primary public health information system available in Brazil and from Mortality Information System (SIM). Adjustments and analyses were performed using the Autoregressive Integrated Moving Average with exogenous variables (ARIMAX) method modelled by environmental variables and atmospheric pollutants to evaluate the effect of smoking ban law in mortality and hospital admission rate. We also used Interrupted Time Series Analysis (ITSA) to make a comparison between the period pre and post smoking ban law. We observed a reduction in mortality rate (-11.9% in the first 17 months after the law) and in hospital admission rate (-5.4% in the first 3 months after the law) for myocardial infarction after the implementation of the smoking ban law. Hospital admissions and mortality rate for myocardial infarction were reduced in the first months after the comprehensive smoking ban law was implemented. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Management of suspected acute coronary syndrome patients admitted to cardiology or non-cardiology services at Auckland City Hospital: implications for future national data collection.

    PubMed

    Wang, Tom Kai Ming; Chow, Kok-Lam; Lin, Aaron; Chataline, Alexei; White, Harvey; Dawes, Matthew; Gamble, Greg; Ellis, Chris

    2018-03-09

    To review the number, characteristics and clinical management of suspected ACS patients admitted to cardiology and non-cardiology services at Auckland City Hospital, to assess differences between these services and to assess the number who would potentially be enrolled in the All New Zealand Acute Coronary Syndrome (ACS) Quality Improvement Programme (ANZACS-QI) database. Auckland City Hospital patient data was extracted from the Australia and New Zealand ACS 'SNAPSHOT' audit, performed over 14 days in May 2012. There were 121 suspected ACS admissions to Auckland City hospital during the audit period, with 45 (37%) patients directly managed by the cardiology service, and 76 (63%) patients cared for by non-cardiology services. Based on the subsequent discharge diagnosis, the cardiology service had more patients with definite ACS than the non-cardiology services; 27/45 (60%) compared to 16/76 (21%), difference (95%CI) 39% (22-56), P<0.0001). Cardiology ACS patients were more likely to undergo echocardiography; 15/27 (56%) compared to 2/16 (13%), difference 42% (18-68), P=0.0089), coronary angiography; 21/27 (78%) compared to 3/16 (19%), difference (95%CI) 59% (34-84), P=0.0003), coronary revascularisation; 18/27 (67%) compared to 3/16 (19%), difference (95%CI) 48% (22-74), P=0.004, and be discharged on two antiplatelet agents; 18/26 (69%) compared to 3/15 (20%), difference (95%CI) 49% (22-76), P=0.0036, or an ACEI/ARB; 20/26 (77%) compared to 5/15 (33%), difference (95%CI) 44% (15-72), P=0.0088. In patients with a discharge diagnosis of definite ACS, those managed by non-cardiology services were less likely to receive guideline-recommended investigations, and management, in this relatively small cohort study. About one-third of all ACS patients are managed by non-cardiology services and would not be recorded by the ANZACS-QI database.

  8. Determinants of parents' reticence toward vaccination in urban areas in Benin (West Africa).

    PubMed

    Fourn, Léonard; Haddad, Slim; Fournier, Pierre; Gansey, Roméo

    2009-10-14

    Despite the efforts of health authorities, vaccination coverage of targeted child populations is still poor in many regions. Parents' reticence has been identified as one cause of this situation. However, there is little data to explain the phenomenon that could support decision-making. The objective of the study was to uncover the determinants of this reticence toward vaccination among the religious population of the cities of Parakou and Cotonou in Benin. This was an exploratory study using a qualitative survey of 12 pastors and 30 faithful from churches that are vaccination-reticent and a control group of the same number of faithful belonging to other churches, all Christian. Individual and group interviews were carried out in the local language using a pre-established and pre-tested guide. The data collected underwent discourse content analysis focused on specific themes. Analysis of the data reveals an erroneous perception of child vaccination. Those who are reticent say vaccination goes against the will of God, that it is a poison from the "white witch doctor", and that those who vaccinate their children are committing a sin. Members of the control group argued against this, but without conviction. They adhere to the principle of obedience to authority, a biblical precept invoked when the vaccinators oblige them to vaccinate their children. Other factors were identified that could explain the reticence, such as the tactlessness of the vaccinators, parents' previous experiences and false rumours about vaccination. The reasons for reticence are mainly related to parents' beliefs in religious principles that are sometimes poorly understood. To limit the spread of this phenomenon, more detailed information and negotiation between the health authorities and the pastors of these churches are essential. ABSTRACT IN FRENCH: See the full article online for a translation of this abstract in French.

  9. Determinants of parents' reticence toward vaccination in urban areas in Benin (West Africa)

    PubMed Central

    2009-01-01

    Background Despite the efforts of health authorities, vaccination coverage of targeted child populations is still poor in many regions. Parents' reticence has been identified as one cause of this situation. However, there is little data to explain the phenomenon that could support decision-making. Objective The objective of the study was to uncover the determinants of this reticence toward vaccination among the religious population of the cities of Parakou and Cotonou in Benin. Methods This was an exploratory study using a qualitative survey of 12 pastors and 30 faithful from churches that are vaccination-reticent and a control group of the same number of faithful belonging to other churches, all Christian. Individual and group interviews were carried out in the local language using a pre-established and pre-tested guide. The data collected underwent discourse content analysis focused on specific themes. Results Analysis of the data reveals an erroneous perception of child vaccination. Those who are reticent say vaccination goes against the will of God, that it is a poison from the "white witch doctor", and that those who vaccinate their children are committing a sin. Members of the control group argued against this, but without conviction. They adhere to the principle of obedience to authority, a biblical precept invoked when the vaccinators oblige them to vaccinate their children. Other factors were identified that could explain the reticence, such as the tactlessness of the vaccinators, parents' previous experiences and false rumours about vaccination. Conclusion The reasons for reticence are mainly related to parents' beliefs in religious principles that are sometimes poorly understood. To limit the spread of this phenomenon, more detailed information and negotiation between the health authorities and the pastors of these churches are essential. Abstract in French See the full article online for a translation of this abstract in French. PMID:19828058

  10. India's Cities in Crisis.

    ERIC Educational Resources Information Center

    Bryjak, George J.

    1984-01-01

    Indian cities are growing rapidly due to natural increase and migration from rural areas. This has caused huge pollution problems and has resulted in overcrowded schools and hospitals. Conflict between religious groups has increased; so has crime. India is modernizing, but not fast enough. (CS)

  11. Effect of Ambient Air Pollution on Hospitalization for Heart Failure in 26 of China's Largest Cities.

    PubMed

    Liu, Hui; Tian, Yaohua; Song, Jing; Cao, Yaying; Xiang, Xiao; Huang, Chao; Li, Man; Hu, Yonghua

    2018-03-01

    There is growing interest in the association between ambient air pollution and congestive heart failure (CHF), but research data from developing countries are very limited. The primary aim of this study was to examine the association between short-term exposure to air pollution and hospital admission for CHF in China. A time-stratified case-crossover study was conducted between 2014 and 2015 in 26 large Chinese cities among 105,501 CHF hospitalizations. Conditional logistic regression models were applied to estimate the percentage changes in CHF admissions in relation to per interquartile range increases in air pollutant concentrations. Air pollution was positively associated with CHF hospitalizations. An interquartile range increase in fine particulate, particulate matter less than 10 µm in aerodynamic diameter, sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone concentrations on the current day corresponded to 1.2% (95% confidence interval [CI] 0.5%, 1.8%), 1.3% (95% CI 0.5%, 2.0%), 1.0% (95% CI 0.2%, 1.7%), 1.6% (95% CI 0.6%, 2.5%), 1.2% (95% CI 0.5%, 1.9%), and 0.4% (95% CI -0.9%, 1.7%) increases in CHF admissions, respectively. In conclusion, our findings contribute to the limited scientific literature concerning the effects of air pollution on CHF risk for high-exposure settings typical in developing countries, which may have significant public health implications for prevention of CHF in China. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Effects of severe obstetric complications on women’s health and infant mortality in Benin

    PubMed Central

    Filippi, Véronique; Goufodji, Sourou; Sismanidis, Charalambos; Kanhonou, Lydie; Fottrell, Edward; Ronsmans, Carine; Alihonou, Eusèbe; Patel, Vikram

    2010-01-01

    Summary Objective To document the impact of severe obstetric complications on post-partum health in mothers and mortality in babies over 12 months in Benin and to assess whether severe complications associated with perinatal death are particularly likely to lead to adverse health consequences. Methods Cohort study which followed women and their babies after a severe complication or an uncomplicated childbirth. Women were selected in hospitals and interviewed at home at discharge, and at 6 and 12 months post-partum. Women were invited for a medical check-up at 6 months and 12 months. Results The cohort includes 205 women with severe complications and a live birth, 64 women with severe complications and perinatal death and 440 women with uncomplicated delivery. Women with severe complications and a live birth were not dissimilar to women with a normal delivery in terms of post-partum health, except for hypertension [adjusted OR = 5.8 (1.9–17.0)], fever [adjusted OR = 1.71 (1.1–2.8)] and infant mortality [adjusted OR = 11.0 (0.8–158.2)]. Women with complications and perinatal death were at increased risk of depression [adjusted OR = 3.4 (1.3–9.0)], urine leakages [adjusted OR = 2.7 (1.2–5.8)], and to report poor health [adjusted OR = 5.27 (2.2–12.4)] and pregnancy’s negative effects on their life [adjusted OR = 4.11 (1.9–9.0)]. Uptake of post-natal services was poor in all groups. Conclusion Women in developing countries face a high risk of severe complications during pregnancy and delivery. These can lead to adverse consequences for their own health and that of their offspring. Resources are needed to ensure that pregnant women receive adequate care before, during and after discharge from hospital. Near-miss women with a perinatal death appear a particularly high-risk group. PMID:20406426

  13. Physical Exposure to Seismic Hazards of Health Facilities in Mexico City, Mexico

    NASA Astrophysics Data System (ADS)

    Rodriguez, S. M.; Novelo Casanova, D.

    2010-12-01

    Although health facilities are essential infrastructure during disasters and emergencies, they are also usually highly vulnerable installations in the case of the occurrence of large and major earthquakes. Hospitals are one of the most complex critical facilities in modern cities and they are used as first response in emergency situations. The operability of a hospital must be maintained after the occurrence of a local strong earthquake in order to satisfy the need for medical care of the affected population. If a health facility is seriously damaged, it cannot fulfill its function when most is needed. In this case, hospitals become a casualty of the disaster. To identify the level of physical exposure of hospitals to seismic hazards in Mexico City, we analyzed their geographic location with respect to the seismic response of the different type of soils of the city from past earthquakes, mainly from the events that occurred on September 1985 (Ms= 8.0) and April 1989 (Ms= 6.9). Seismic wave amplification in this city is the result of the interaction of the incoming seismic waves with the soft and water saturated clay soils, on which a large part of Mexico City is built. The clay soils are remnants of the lake that existed in the Valley of Mexico and which has been drained gradually to accommodate the growing urban sprawl. Hospital facilities were converted from a simple database of names and locations into a map layer of resources. This resource layer was combined with other map layers showing areas of seismic microzonation in Mexico City. This overlay was then used to identify those hospitals that may be threatened by the occurrence of a large or major seismic event. We analyzed the public and private hospitals considered as main health facilities. Our results indicate that more than 50% of the hospitals are highly exposed to seismic hazards. Besides, in most of these health facilities we identified the lack of preventive measures and preparedness to reduce their

  14. Cost of neurocysticercosis patients treated in two referral hospitals in Mexico City, Mexico.

    PubMed

    Bhattarai, Rachana; Carabin, Hélène; Proaño, Jefferson V; Flores-Rivera, Jose; Corona, Teresa; Flisser, Ana; Budke, Christine M

    2015-08-01

    To estimate annual costs related to the diagnosis, treatment and productivity losses among patients with neurocysticercosis (NCC) receiving treatment at two referral hospitals, the Instituto Nacional de Neurologia y Neurocirugia (INNN) and the Hospital de Especialidades of the Instituto Mexicano del Seguro Social (HE-IMSS), in Mexico City from July 2007 to August 2008. Information on presenting clinical manifestations, diagnostic tests, hospitalisations, surgical procedures and other treatments received by NCC outpatients was collected from medical charts, and supplemented by an individual questionnaire regarding productivity losses and out-of-pocket expenses related to NCC. The annual average per-patient direct costs were US$ 503 (95% CI: 414-592) and US$ 438 (95% CI: 322-571) for patients without a history of hospitalisation and/or surgery seen at the INNN and the HE-IMSS, respectively. These costs increased to US$ 2506 (95% CI: 1797-3215) and US$ 2170 (95% CI: 1303-3037), respectively, for patients with a history of hospitalisation and/or surgery. The average annual per-patient indirect costs were US$ 246 (95% CI: 165-324) and US$ 114 (95% CI: 51-178), respectively, using minimum salary wages for individuals not officially employed. The total annual cost for patients who had and had not been hospitalised and/or undergone a surgical procedure for the diagnosis or treatment of NCC corresponded to 212% and 41% of an annual minimum wage salary, respectively. The disease tends to affect rural socioeconomically disadvantaged populations and creates health disparities and significant economic losses in Mexico. © 2015 John Wiley & Sons Ltd.

  15. Mapping of initiatives to increase membership in mutual health organizations in Benin

    PubMed Central

    2012-01-01

    Introduction Mutual health organizations (MHO) have been implemented across Africa to increase access to healthcare and improve financial protection. Despite efforts to develop MHOs, low levels of both initial enrolment and membership renewals continue to threaten their financial viability. The purpose of this study was to map initiatives implemented to increase the pool of MHO members in Benin. Methods A multiple case study was conducted to assess MHOs supported by five major promoters in Benin. Three months of fieldwork resulted in 23 semi-structured interviews and two focus groups with MHO promoters, technicians, elected members, and health professionals affiliated with the MHOs. Fifteen non-structured interviews provided additional information and a valuable source of triangulation. Results MHOs have adopted a wide range of initiatives targeting different entry points and involving a variety of stakeholders. Initiatives have included new types of collective health insurance packages and efforts to raise awareness by going door-to-door and organizing health education workshops. Different types of partnerships have been established to strengthen relationships with healthcare professionals and political leaders. However, the selection and implementation of these initiatives have been limited by insufficient financial and human resources. Conclusions The study highlights the importance of prioritizing sustainable strategies to increase MHO membership. No single MHO initiative has been able to resolve the issue of low membership on its own. If combined, existing initiatives could provide a comprehensive and inclusive approach that would target all entry points and include key stakeholders such as household decision-makers, MHO elected members, healthcare professionals, community leaders, governmental authorities, medical advisors, and promoters. There is a need to evaluate empirically the implementation of these interventions. Mechanisms to promote dialogue between

  16. Mapping of initiatives to increase membership in mutual health organizations in Benin.

    PubMed

    Turcotte-Tremblay, Anne-Marie; Haddad, Slim; Yacoubou, Ismaïlou; Fournier, Pierre

    2012-12-05

    Mutual health organizations (MHO) have been implemented across Africa to increase access to healthcare and improve financial protection. Despite efforts to develop MHOs, low levels of both initial enrolment and membership renewals continue to threaten their financial viability. The purpose of this study was to map initiatives implemented to increase the pool of MHO members in Benin. A multiple case study was conducted to assess MHOs supported by five major promoters in Benin. Three months of fieldwork resulted in 23 semi-structured interviews and two focus groups with MHO promoters, technicians, elected members, and health professionals affiliated with the MHOs. Fifteen non-structured interviews provided additional information and a valuable source of triangulation. MHOs have adopted a wide range of initiatives targeting different entry points and involving a variety of stakeholders. Initiatives have included new types of collective health insurance packages and efforts to raise awareness by going door-to-door and organizing health education workshops. Different types of partnerships have been established to strengthen relationships with healthcare professionals and political leaders. However, the selection and implementation of these initiatives have been limited by insufficient financial and human resources. The study highlights the importance of prioritizing sustainable strategies to increase MHO membership. No single MHO initiative has been able to resolve the issue of low membership on its own. If combined, existing initiatives could provide a comprehensive and inclusive approach that would target all entry points and include key stakeholders such as household decision-makers, MHO elected members, healthcare professionals, community leaders, governmental authorities, medical advisors, and promoters. There is a need to evaluate empirically the implementation of these interventions. Mechanisms to promote dialogue between MHO stakeholders would be useful to

  17. Evaluation of protection induced by immunisation of domestic pigs with deletion mutant African swine fever virus BeninΔMGF by different doses and routes.

    PubMed

    Sánchez-Cordón, Pedro J; Jabbar, Tamara; Berrezaie, Margot; Chapman, Dave; Reis, Ana; Sastre, Patricia; Rueda, Paloma; Goatley, Lynnette; Dixon, Linda K

    2018-01-29

    A live attenuated African swine fever virus (ASFV) vaccine candidate, produced by deletion of several genes belonging to multi-gene families MGF360 and 505 from virulent Benin 97/1 strain (BeninΔMGF), induces protection in pigs against parental virulent strain. In order to better define the safety and efficacy of this attenuated vaccine candidate and to understand protective mechanisms, we extended previous studies by intramuscular immunisation of pigs with the deletion mutant BeninΔMFG at different doses (10 2 , 10 3 , 10 4 TCID 50 ), together with intranasal immunisation at the 10 3 dose. Results demonstrated a strong correlation between both doses and routes of immunisation of BeninΔMFG and the percentage of protection achieved, the onset of clinical signs, the viremia levels reached and the onset of death in non-protected pigs. The results show that the intramuscular route using high doses (10 4 TCID 50 ) is the best option for immunisation. Only transient increase in temperature associated with a peak of virus genome levels was observed in most pigs after immunisation. Then, virus genome levels progressively decreased throughout the experiment until reaching low or undetectable levels in those protected pigs that survived after challenge. The IgM antibody responses following immunisation were detected between day 7-10 post-immunisation and remained at elevated levels for 10-18 days in most pigs before dropping. IgG was detected from day 15 to 21 post-immunisation and maintained at increased levels for the remainder of the experiment in most pigs. Induction of IFNγ and IL-10 was detected by ELISA in sera from some pigs immunised with 10 3 TCID 50 by intramuscular or intranasal route at early times post-immunisation. IL-10 was also detected in serum from some non-protected pigs included in these groups after challenge. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Temporal and Spatial Patterns in Utilization of Mental Health Services During and After Hurricane Sandy: Emergency Department and Inpatient Hospitalizations in New York City.

    PubMed

    He, Fangtao Tony; Lundy De La Cruz, Nneka; Olson, Donald; Lim, Sungwoo; Levanon Seligson, Amber; Hall, Gerod; Jessup, Jillian; Gwynn, Charon

    2016-06-01

    Hurricane Sandy made landfall on October 29, 2012, causing a coastal storm surge and extensive flooding, which led to the closure of several health care facilities in New York City (NYC) and prolonged interruptions in service delivery. The impact on mental health-related emergency department (ED) and inpatient hospital service utilization was studied. Data came from the New York Statewide Planning and Research Cooperative System. We obtained mental health-related data among NYC residents from 2010 to 2013. Patients were grouped into 5 geographic areas, including service areas of closed hospitals, the Hurricane Sandy evaluation zone, and all of NYC. The Farrington method was used to detect increases in ED visits and hospitalizations for the post-Sandy period. Open hospitals experienced a substantial increase in psychiatric ED visits from patients living in the service areas of closed hospitals. This surge in psychiatric ED visits persisted for 4 to 6 months after Hurricane Sandy. However, the increase in psychiatric hospitalizations was observed for 1 to 3 months. Several NYC hospitals received a substantially larger number of ED patients from service areas of closed hospitals after Hurricane Sandy, unlike other hospitals that experienced a decrease. Because of potential surges in the number of psychiatric ED visits, resource allocation to hospitals should be considered. (Disaster Med Public Health Preparedness. 2016;10:512-517).

  19. Five Years After; the Impact of a Participatory Technology Development Programme as Perceived by Smallholder Farmers in Benin and Ghana

    ERIC Educational Resources Information Center

    Sterk, B.; Christian, A. K.; Gogan, A. C.; Sakyi-Dawson, O.; Kossou, D.

    2013-01-01

    Purpose: The article reports effects on livelihoods of a participatory technology development effort in Benin and Ghana (2001-2006), five years after it ended. Design: The study uses data from all smallholders who participated in seven experimental groups, each facilitated by a PhD researcher. Baseline data and controls were not available. In…

  20. Outreach strategies for the promotion of HIV testing and care: closing the gap between health services and female sex workers in Benin.

    PubMed

    Dugas, Marylène; Bédard, Emmanuelle; Batona, Georges; Kpatchavi, Adolphe C; Guédou, Fernand A; Dubé, Eric; Alary, Michel

    2015-03-01

    Regular voluntary counseling and testing is a key component of the fight against HIV/AIDS. In Benin, the project SIDA-1/2/3 established to decrease HIV/sexually transmitted infection (STIs) among female sex workers (FSWs), implemented a multifaceted intervention, including outreach activities. The objective of this article was to present potential advantages and limitations of 3 categories of outreach interventions designed to increase the use of testing services among FSWs in Benin. This analysis is based on ethnographic fieldwork conducted in Benin from June to December 2012. Sixty-six FSWs and 24 health care workers were interviewed. Their narratives revealed 3 main factors impeding the development of appropriate HIV testing behavior. These negative elements can be positioned along a continuum of health care behaviors, with each stage of this continuum presenting its own challenges: fear or lack of motivation to use testing services, inaccessibility of care when the decision to go has been made, and a perceived lack of quality in the care offered at the health care center. Many of these needs seem to be addressed in the outreach strategies tested. However, the study also exposed some potential barriers or limitations to the success of these strategies when applied in this specific context, due to social disruption, mobility, access to care, and hard to reach population. To increase the use of testing services, an outreach strategy based on community workers or peer educators, along with improved access to testing services, would be well adapted to this context and appreciated by both FSWs and health care workers.

  1. Quantifying the domestic market in herbal medicine in Benin, West Africa.

    PubMed

    Quiroz, Diana; Towns, Alexandra; Legba, Sènan Ingrid; Swier, Jorik; Brière, Solène; Sosef, Marc; van Andel, Tinde

    2014-02-12

    Herbal medicine markets are essential in understanding the importance of medicinal plants amongst a country's inhabitants. They are also instrumental in identifying plant species with resource management priorities. To document the diversity of the medicinal plant market in Benin (West Africa), to quantify the weight of traded species in order to evaluate their economic value, and to make a first assessment of their vulnerability for commercial extraction. We quantitatively surveyed 22 market stalls of 16 markets in the country's eight largest urban areas. We collected all plant (parts) following standard botanical methods and recorded uses, prices and local names, and weighed and counted the numbers of sales units. We recorded 307 medicinal products corresponding to ca. 283 species. Thirty-five species were encountered in at least 25% of the surveyed stalls, from which ten are locally endangered or red-listed by the IUCN. Examples of vulnerable species included Caesalpinia bonduc, which has been declared extinct in the wild but is largely cultivated in home gardens, and was exploited for its seeds, roots, and leaves, and Zanthoxylum zanthoxyloides which was harvested for its bark, roots, and leaves. Other top-selling fruits and seeds included red-listed species: Monodora myristica, Xylopia aethiopica, and Schrebera arborea. Top-selling woody plant parts included the roots of Sarcocephalus latifolius, Mondia whitei, and the barks of Khaya senegalensis and Pteleopsis suberosa. All but Sarcocephalus latifolius and Pteleopsis subersosa were species with some threat status. Plants sold at the market were mainly used for ritual purposes, women's health, and to treat malaria and its symptoms. Our results suggest that the domestic medicinal plant market in Benin is of substantial economic importance. A volume of approximately 655 metric tons worth 2.7 million USD is offered for sale annually. Traditional spiritual beliefs seem to be a major driving force behind the trade

  2. Hospitalizations for dental infections: optimally versus nonoptimally fluoridated areas in Israel.

    PubMed

    Klivitsky, Amir; Tasher, Diana; Stein, Michal; Gavron, Etan; Somekh, Eli

    2015-03-01

    Odontogenic infections may result in local, systemic, and even potentially life-threatening complications. The authors investigated whether water fluoridation was associated with reduction in rates of hospitalizations due to odontogenic infections. The authors included cities in Israel that had fluoride concentrations of either 0.7 milligrams per liter or more (optimally fluoridated) or 0.5 mg/L or less (nonoptimally fluoridated) and that had a public water fluoride concentration consistent for the last decade. The authors compared hospitalization rates (per 10,000 children) for odontogenic infections in children younger than 18 years in each socioeconomic group between optimally and nonoptimally fluoridated cities. The authors included 1,413 hospitalizations between January 2005 and December 2011 of children residing in the 38 studied municipalities. The cities with the higher fluoride concentration reported a lower hospitalization rate (2.0 versus 4.3 for cities with a lower fluoride concentration; relative risk [RR]: 2.16; P < .001). When the authors divided cities into 3 socioeconomic groups, a large difference in hospitalization rates was seen in the lowest socioeconomic group (10.1 versus 2.6; RR: 3.79; P < .001) and the middle socioeconomic group (3.6 versus 1.9; RR: 2.35; P < .001) in optimally and nonoptimally fluoridated cities, respectively. No significant difference in hospitalization rates was apparent between the 2 fluoridation groups in the higher socioeconomic level. These results clearly indicate that there is an association between adequacy of water fluoridation and hospitalization due to dental infections among children and adolescents. This effect is more prominent in populations of lower socioeconomic status. Water fluoridation is associated with reduction in dental health disparity. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  3. Predictive Factors of Plasma HIV Suppression during Pregnancy: A Prospective Cohort Study in Benin

    PubMed Central

    Ogouyemi-Hounto, Aurore; Azon-Kouanou, Angèle; d'Almeida, Marcelline; Azondékon, Alain; Alao, Marouf J.; Dossou-Gbété, Véronique; Afangnihoun, Aldric; Girard, Pierre-Marie; Cot, Michel; Zannou, Djimon-Marcel

    2013-01-01

    Objective To investigate the factors associated with HIV1 RNA plasma viral load (pVL) below 40 copies/mL at the third trimester of pregnancy, as part of prevention of mother-to-child transmission (PMTCT) in Benin. Design Sub study of the PACOME clinical trial of malaria prophylaxis in HIV-infected pregnant women, conducted before and after the implementation of the WHO 2009 revised guidelines for PMTCT. Methods HIV-infected women were enrolled in the second trimester of pregnancy. Socio-economic characteristics, HIV history, clinical and biological characteristics were recorded. Malaria prevention and PMTCT involving antiretroviral therapy (ART) for mothers and infants were provided. Logistic regression helped identifying factors associated with virologic suppression at the end of pregnancy. Results Overall 217 third trimester pVLs were available, and 71% showed undetectability. Virologic suppression was more frequent in women enrolled after the change in PMTCT recommendations, advising to start ART at 14 weeks instead of 28 weeks of pregnancy. In multivariate analysis, Fon ethnic group (the predominant ethnic group in the study area), regular job, first and second pregnancy, higher baseline pVL and impaired adherence to ART were negative factors whereas higher weight, higher antenatal care attendance and longer ART duration were favorable factors to achieve virologic suppression. Conclusions This study provides more evidence that ART has to be initiated before the last trimester of pregnancy to achieve an undetectable pVL before delivery. In Benin, new recommendations supporting early initiation were well implemented and, together with a high antenatal care attendance, led to high rate of virologic control. PMID:23555035

  4. Maternal migration and child health: An analysis of disruption and adaptation processes in Benin.

    PubMed

    Smith-Greenaway, Emily; Madhavan, Sangeetha

    2015-11-01

    Children of migrant mothers have lower vaccination rates compared to their peers with non-migrant mothers in low-income countries. Explanations for this finding are typically grounded in the disruption and adaptation perspectives of migration. Researchers argue that migration is a disruptive process that interferes with women's economic well-being and social networks, and ultimately their health-seeking behaviors. With time, however, migrant women adapt to their new settings, and their health behaviors improve. Despite prominence in the literature, no research tests the salience of these perspectives to the relationship between maternal migration and child vaccination. We innovatively leverage Demographic and Health Survey data to test the extent to which disruption and adaptation processes underlie the relationship between maternal migration and child vaccination in the context of Benin-a West African country where migration is common and child vaccination rates have declined in recent years. By disaggregating children of migrants according to whether they were born before or after their mother's migration, we confirm that migration does not lower children's vaccination rates in Benin. In fact, children born after migration enjoy a higher likelihood of vaccination, whereas their peers born in the community from which their mother eventually migrates are less likely to be vaccinated. Although we find no support for the disruption perspective of migration, we do find evidence of adaptation: children born after migration have an increased likelihood of vaccination the longer their mother resides in the destination community prior to their birth. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Predictive factors of plasma HIV suppression during pregnancy: a prospective cohort study in Benin.

    PubMed

    Denoeud-Ndam, Lise; Fourcade, Camille; Ogouyemi-Hounto, Aurore; Azon-Kouanou, Angèle; d'Almeida, Marcelline; Azondékon, Alain; Alao, Marouf J; Dossou-Gbété, Véronique; Afangnihoun, Aldric; Girard, Pierre-Marie; Cot, Michel; Zannou, Djimon-Marcel

    2013-01-01

    To investigate the factors associated with HIV1 RNA plasma viral load (pVL) below 40 copies/mL at the third trimester of pregnancy, as part of prevention of mother-to-child transmission (PMTCT) in Benin. Sub study of the PACOME clinical trial of malaria prophylaxis in HIV-infected pregnant women, conducted before and after the implementation of the WHO 2009 revised guidelines for PMTCT. HIV-infected women were enrolled in the second trimester of pregnancy. Socio-economic characteristics, HIV history, clinical and biological characteristics were recorded. Malaria prevention and PMTCT involving antiretroviral therapy (ART) for mothers and infants were provided. Logistic regression helped identifying factors associated with virologic suppression at the end of pregnancy. Overall 217 third trimester pVLs were available, and 71% showed undetectability. Virologic suppression was more frequent in women enrolled after the change in PMTCT recommendations, advising to start ART at 14 weeks instead of 28 weeks of pregnancy. In multivariate analysis, Fon ethnic group (the predominant ethnic group in the study area), regular job, first and second pregnancy, higher baseline pVL and impaired adherence to ART were negative factors whereas higher weight, higher antenatal care attendance and longer ART duration were favorable factors to achieve virologic suppression. This study provides more evidence that ART has to be initiated before the last trimester of pregnancy to achieve an undetectable pVL before delivery. In Benin, new recommendations supporting early initiation were well implemented and, together with a high antenatal care attendance, led to high rate of virologic control.

  6. Chemical composition and insecticidal activity of plant essential oils from Benin against Anopheles gambiae (Giles)

    PubMed Central

    2013-01-01

    Background Insecticide resistance in sub-Saharan Africa and especially in Benin is a major public health issue hindering the control of the malaria vectors. Each Anopheles species has developed a resistance to one or several classes of the insecticides currently in use in the field. Therefore, it is urgent to find alternative compounds to conquer the vector. In this study, the efficacies of essential oils of nine plant species, which are traditionally used to avoid mosquito bites in Benin, were investigated. Methods Essential oils of nine plant species were extracted by hydrodistillation, and their chemical compositions were identified by GC-MS. These oils were tested on susceptible “kisumu” and resistant “ladji-Cotonou” strains of Anopheles gambiae, following WHO test procedures for insecticide resistance monitoring in malaria vector mosquitoes. Results Different chemical compositions were obtained from the essential oils of the plant species. The major constituents identified were as follows: neral and geranial for Cymbopogon citratus, Z-carveol, E-p-mentha-1(7),8-dien-2-ol and E-p-mentha-2,8-dienol for Cymbopogon giganteus, piperitone for Cymbopogon schoenanthus, citronellal and citronellol for Eucalyptus citriodora, p-cymene, caryophyllene oxide and spathulenol for Eucalyptus tereticornis, 3-tetradecanone for Cochlospermum tinctorium and Cochlospermum planchonii, methyl salicylate for Securidaca longepedunculata and ascaridole for Chenopodium ambrosioides. The diagnostic dose was 0.77% for C. citratus, 2.80% for E. tereticornis, 3.37% for E. citriodora, 4.26% for C. ambrosioides, 5.48% for C. schoenanthus and 7.36% for C. giganteus. The highest diagnostic doses were obtained with S. longepedunculata (9.84%), C. tinctorium (11.56%) and C. planchonii (15.22%), compared to permethrin 0.75%. A. gambiae cotonou, which is resistant to pyrethroids, showed significant tolerance to essential oils from C. tinctorium and S. longepedunculata as expected but was

  7. Groundwater contamination in relation with the increasing urbanization rate in Africa. Case of Cotonou and Porto Novo (Benin).

    NASA Astrophysics Data System (ADS)

    Odeloui, Diane; Celle-Jeanton, Hélène; Huneau, Frédéric; Boukari, Moussa; Alassane, Abdelkarim; Garel, Emilie; Lavastre, Véronique; Bertrand, Guillaume

    2016-04-01

    More than one billion people in the world still have no access to sufficient resources in drinking water (United Nation, 2014). In particular, large cities in Africa have to face several problems: 1) population growth associated with the strongest urbanization rate increase (5% per year) of the world leading to a dramatic increase in good-quality water needs, 2) low levels of solid waste management and sanitation services, 3) insufficient or disconnected water supply services, 4) low knowledge of water resources availabilities. The situation in Benin is a relevant illustration of the problems that Africa has to face to. As many other coastal urban areas in Africa (Showers, 2002; Re et al., 2011), Cotonou and Porto Novo cities have seen a rapid increase of their population as these towns constitute a corridor of transit for the imports and the exports in the nearby countries. Hence, they are very attractive for job hunters, and constitute the administrative centers for the whole country. This rapid population growth amplifies the problem of water supply and may generate serious impacts on groundwater resources: depletion due to overexploitation, salinization due to seawater intrusion and pollution linked to human activities. In order to insure a safe water supply in the context of increasing urbanization and population in the coastal area of Cotonou and Porto Novo, the identification of the main sources of pollution is essential for the implementation of long-term water management procedures. Based on two field campaigns carried out in January-2012 (dry season) and August-2012 (rainy season), hydrochemical analysis have been realized on groundwater sampled from boreholes drilled in the CTA (Continental Terminal Aquifer) and wells dug in the QCA (Quaternary Coastal Aquifer) in order to investigate the origin of salinization and the present time extension of the nitrate contamination. Historical data have also been collected from previous studies in order to

  8. Credit with Health Education in Benin: A Cluster Randomized Trial Examining Impacts on Knowledge and Behavior

    PubMed Central

    Karlan, Dean; Thuysbaert, Bram; Gray, Bobbi

    2017-01-01

    We evaluate whether health education integrated into microcredit lending groups reduces health risks by improving health knowledge and self-reported behaviors among urban and rural borrowers in eastern Benin. In 2007, we randomly assigned 138 villages in the Plateau region of Benin to one of four variations of a group liability credit product, varying lending groups' gender composition and/or inclusion of health education using a 2 × 2 design. Women in villages receiving health education, regardless of gender composition of the groups, showed improved knowledge of malaria and of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), but not of childhood illness danger signs. No significant changes in health behavior were observed except an increase in HIV/AIDS prevention behavior, a result predominantly driven by an increase in respondents' self-reported ability to procure a condom, likely an indicator of increased perceived access rather than improved preventative behavior. Women in villages assigned to mixed-gender groups had significantly lower levels of social capital, compared with villages assigned to female-only groups. This suggests there may be an important trade-off to consider for interventions seeking improved health outcomes and social capital through provision of services to mixed-gender groups. Although bundling health education with microcredit can expand health education coverage and lower service-delivery costs, the approach may not be sufficient to improve health behaviors. PMID:27895268

  9. Assessment of water, sanitation, and hygiene practices and associated factors in a Buruli ulcer endemic district in Benin (West Africa).

    PubMed

    Johnson, Roch Christian; Boni, Gratien; Barogui, Yves; Sopoh, Ghislain Emmanuel; Houndonougbo, Macaire; Anagonou, Esai; Agossadou, Didier; Diez, Gabriel; Boko, Michel

    2015-08-19

    Control of neglected tropical diseases (NTDs) requires multiple strategic approaches including water, sanitation and hygiene services (WASH). Buruli ulcer (BU), one of the 17 NTDs, remains a public health issue in Benin particularly in the district of Lalo. The availability of water as well as good hygiene are important for the management of Buruli ulcer particularly in the area of wound care one of the main component of the treatment of BU lesions. Given the growing importance of WASH in controlling NTDs and in order to assess the baseline for future cross-cutting interventions, we report here on the first study evaluating the level of WASH and associated factors in Lalo, one of the most BU-endemic districts in Benin. A cross-sectional study was carried to assess WASH practices and associated factors in the district of Lalo. Data were collected from 600 heads of household using structured pretested questionnaire and observations triangulated with qualitative information obtained from in-depth interviews of patients, care-givers and community members. Univariate and multivariate analysis were carried to determine the relationships between the potential associated factors and the sanitation as well as hygiene status. BU is an important conditions in the district of Lalo with 917 new cases detected from 2006 to 2012. More than 49 % of the household surveyed used unimproved water sources for their daily needs. Only 8.7 % of the investigated household had improved sanitation facilities at home and 9.7 % had improved hygiene behavior. The type of housing as an indicator of the socioeconomic status, the permanent availability of soap and improved hygiene practices were identified as the main factors positively associated with improved sanitation status. In the district of Lalo in Benin, one of the most endemic for BU, the WASH indicators are very low. This study provides baseline informations for future cross-cutting interventions in this district.

  10. Inequalities in maternal health care utilization in Benin: a population based cross-sectional study.

    PubMed

    Yaya, Sanni; Uthman, Olalekan A; Amouzou, Agbessi; Ekholuenetale, Michael; Bishwajit, Ghose

    2018-05-31

    Ensuring equitable access to maternal health care including antenatal, delivery, postnatal services and fertility control methods, is one of the most critical challenges for public health sector. There are significant disparities in maternal health care indicators across many geographical locations, maternal, economic, socio-demographic factors in many countries in sub-Sahara Africa. In this study, we comparatively explored the utilization level of maternal health care, and examined disparities in the determinants of major maternal health outcomes. This paper used data from two rounds of Benin Demographic and Health Survey (BDHS) to examine the utilization and disparities in factors of maternal health care indicators using logistic regression models. Participants were 17,794 and 16,599 women aged between15-49 years in 2006 and 2012 respectively. Women's characteristics were reported in percentage, mean and standard deviation. Mean (±SD) age of the participants was 29.0 (±9.0) in both surveys. The percentage of at least 4 ANC visits was approximately 61% without any change between the two rounds of surveys, facility based delivery was 93.5% in 2012, with 4.9% increase from 2006; postnatal care was currently 18.4% and contraceptive use was estimated below one-fifth. The results of multivariable logistic regression models showed disparities in maternal health care service utilization, including antenatal care, facility-based delivery, postnatal care and contraceptive use across selected maternal factors. The current BHDS showed age, region, religion were significantly associated with maternal health care services. Educated women, those from households of high wealth index and women currently working were more likely to utilize maternal health care services, compared to women with no formal education, from poorest households or not currently employed. Women who watch television (TV) were 1.31 (OR = 1.31; 95% CI = 1.13-1.52), 1.69 (OR = 1.69; 95% CI

  11. A Prospective Multi-Center Observational Study of Children Hospitalized with Diarrhea in Ho Chi Minh City, Vietnam

    PubMed Central

    Thompson, Corinne N.; Phan, My V. T.; Hoang, Nguyen Van Minh; Minh, Pham Van; Vinh, Nguyen Thanh; Thuy, Cao Thu; Nga, Tran Thi Thu; Rabaa, Maia A.; Duy, Pham Thanh; Dung, Tran Thi Ngoc; Phat, Voong Vinh; Nga, Tran Vu Thieu; Tu, Le Thi Phuong; Tuyen, Ha Thanh; Yoshihara, Keisuke; Jenkins, Claire; Duong, Vu Thuy; Phuc, Hoang Le; Tuyet, Pham Thi Ngoc; Ngoc, Nguyen Minh; Vinh, Ha; Chinh, Nguyen Tran; Thuong, Tang Chi; Tuan, Ha Manh; Hien, Tran Tinh; Campbell, James I.; Chau, Nguyen Van Vinh; Thwaites, Guy; Baker, Stephen

    2015-01-01

    We performed a prospective multicenter study to address the lack of data on the etiology, clinical and demographic features of hospitalized pediatric diarrhea in Ho Chi Minh City (HCMC), Vietnam. Over 2,000 (1,419 symptomatic and 609 non-diarrheal control) children were enrolled in three hospitals over a 1-year period in 2009–2010. Aiming to detect a panel of pathogens, we identified a known diarrheal pathogen in stool samples from 1,067/1,419 (75.2%) children with diarrhea and from 81/609 (13.3%) children without diarrhea. Rotavirus predominated in the symptomatic children (664/1,419; 46.8%), followed by norovirus (293/1,419; 20.6%). The bacterial pathogens Salmonella, Campylobacter, and Shigella were cumulatively isolated from 204/1,419 (14.4%) diarrheal children and exhibited extensive antimicrobial resistance, most notably to fluoroquinolones and third-generation cephalosporins. We suggest renewed efforts in generation and implementation of policies to control the sale and prescription of antimicrobials to curb bacterial resistance and advise consideration of a subsidized rotavirus vaccination policy to limit the morbidity due to diarrheal disease in Vietnam. PMID:25802437

  12. Job stress and burnout among urban and rural hospital physicians in Japan.

    PubMed

    Saijo, Yasuaki; Chiba, Shigeru; Yoshioka, Eiji; Kawanishi, Yasuyuki; Nakagi, Yoshihiko; Ito, Toshihiro; Sugioka, Yoshihiko; Kitaoka-Higashiguchi, Kazuyo; Yoshida, Takahiko

    2013-08-01

    To elucidate the differences in job stress and burnout status of Japanese hospital physicians between large cities, small cities, and towns and villages. Cross-sectional study. Postal self-administered questionnaires were distributed to 2937 alumni of Asahikawa Medical University. Four hundred and twenty-two hospital physicians. The Brief Job Stress Questionnaire was used to evaluate job demand, job control and social support. The Japanese version of the Maslach Burnout Inventory-General Survey (MBI-GS) was used to evaluate burnout. An analysis of covariance was conducted on the mean scores on the Brief Job Stress Questionnaire and the MBI-GS scales after adjusting for sex, age and specialties. In adjusted analyses, the job demand score was significantly different among physicians in the three areas. In Bonferroni post-hoc tests, scores in large cities was significantly higher than those in small cities and towns and villages. The job control score showed a significant difference and a marginally significant trend, with large cities associated with lower job control. There were significant differences in support from supervisors and that from family/friends, and scores in large cities was significantly higher than those in small cities in the post-hoc test. There was a significant effect on the exhaustion scale of the MBI-GS, with large cities associated with higher exhaustion, and scores in large cities was significantly higher than those in small cities. Urban hospital physicians had more job demand, less job control and exhaustion caused by burnout, and rural hospital physicians had less social support. © 2013 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  13. A cross-sectional study of the clinical characteristics of hospitalized children with community-acquired pneumonia in eight eastern cities in China.

    PubMed

    Wang, Xue-Feng; Liu, Jian-Ping; Shen, Kun-Ling; Ma, Rong; Cui, Zhen-Ze; Deng, Li; Shang, Yun-Xiao; Zhao, De-Yu; Wang, Li-Bo; Wan, Li-Ya; Sun, Yi-Qiu; Li, Yan-Ning; Jiang, Zhi-Yan; Xu, Hua; Li, Xin-Min; Wu, Zhen-Qi; Liu, Zhao-Lan; Hu, Ying-Hui; Huang, Yan; He, Chun-Hui; Zhang, Han; Jiang, Yong-Hong; Liu, Hua; Wang, Zi

    2013-12-23

    Community-acquired pneumonia in children is common in China. To understand current clinical characteristics and practice, we conducted a cross-sectional study to analyze quality of care on childhood pneumonia in eight eastern cities in China. Consecutive hospital records between January 1, 2010 and December 31, 2010 were collected from 13 traditional Chinese medicine (TCM) and western medicine (WM) hospitals in February, May, August, and November (25 cases per season, 100 cases over the year), respectively. A predesigned case report form was used to extract data from the hospital medical records. A total of 1298 cases were collected and analyzed. Symptoms and signs upon admission at TCM and WM hospitals were cough (99.3% vs. 98.6%), rales (84.8% vs. 75.0%), phlegm (83.3% vs. 49.1%), and fever (74.9% vs. 84.0%) in frequency. Patients admitted to WM hospitals had symptoms and signs for a longer period prior to admission than patients admitted to TCM hospitals. Testing to identify etiologic agents was performed in 1140 cases (88.4%). Intravenous antibiotics were administered in 99.3% (595/598) of cases in TCM hospitals and in 98.6% (699/700) of cases in WM hospitals. Besides, Chinese herbal extract injection was used more frequently in TCM hospitals (491 cases, 82.1%) than in WM hospitals (212 cases, 30.3%) (p < 0.01). At discharge, 818 cases (63.0%) were clinically cured, with a significant difference between the cure rates in TCM (87.6%) and WM hospitals (42.0%) (OR = 9.8, 95% confidence interval (CI): 7.3 ~ 12.9, p < 0.01). Pathogen and previous medical history were more likely associated with the disappearance of rales (OR = 7.2, 95% CI: 4.8 ~ 10.9). Adverse effects were not reported from the medical records. Intravenous use of antibiotics is highly prevalent in children with community-acquired pneumonia regardless of aetiology. There was difference between TCM and WM hospitals with regard to symptom profile and the use of antibiotics. Intravenous use of herbal

  14. Dominant viral pathologies in the extensive and semi-intensive animal breeding and their treatment mode in ethno veterinary medicine in Benin.

    PubMed

    Kpodékon, T M; Ogni, C A; Dassou, H; Dougnon, T J; Boko, C; Koutinhouin, G B; Goussanou, J S E; Akoegninou, A; Youssao, I

    2015-12-01

    This study aims to identify the dominant viral animal pathologies and to list the traditional recipes used by the breeders for their treatment. The method of data collection was based on a retrospective survey. Thus, 787 breeders and agro-breeders scattered in the eight agro-ecological areas of Benin were interviewed using semi-structured questionnaires. In total, 5 pathologies were reported by breeders. Among those pathologies, foot and mouth disease was reported by all of the breeders of the southern part of Borgou compared with the other areas (p<0.05) and treated by 25 species of medicinal plants. African swine fever was the main pathology reported (22.92%) (p<0.05) in the fishery areas which is controlled by 7 medicinal plants. Pseudorinderpest was more reported (33.78%) (p<0.05) in the cotton area of central Benin and treated by 8 medicinal plants. There is also Newcastle disease that was mostly reported in the Western Atacora and treated by 32 medicinal plants as well as fowl pox which was a more reported in the lands of the bar area and the low-pressure area about 34.48% and 36.17% proportions, respectively, and treated by eight medicinal plants. The breeders in Benin possess rich ethno veterinary knowledge on medicinal plants and their uses in the treatment of livestock. A total of 57 medicinal plants have been inventoried to fight against five major viral diseases as African swine fever, pseudorinderpest and foot and mouth disease. The common plants used to treat viral disease in general were Euphorbia unispina, Euphorbia poissonii, Lannea acida, and Mangifera indica. The most harvested organs on the plants reported in this survey were the barks, the leaves, and the whole plants. To better develop our indigenous resources, it would be important to expand this ethno-pharmacological investigation to other diseases category.

  15. Application of a Time-Stratified Case-Crossover Design to Explore the Effects of Air Pollution and Season on Childhood Asthma Hospitalization in Cities of Differing Urban Patterns: Big Data Analytics of Government Open Data.

    PubMed

    Kuo, Ching-Yen; Pan, Ren-Hao; Chan, Chin-Kan; Wu, Chiung-Yi; Phan, Dinh-Van; Chan, Chien-Lung

    2018-03-31

    Few studies have assessed the lagged effects of levels of different urban city air pollutants and seasons on asthma hospitalization in children. This study used big data analysis to explore the effects of daily changes in air pollution and season on childhood asthma hospitalization from 2001 to 2010 in Taipei and Kaohsiung City, Taiwan. A time-stratified case-crossover study and conditional logistic regression analysis were employed to identify associations between the risk of hospitalization due to asthma in children and the levels of air pollutants (PM 2.5 , PM 10 , O₃, SO₂, and NO₂) in the days preceding hospitalization. During the study period, 2900 children in Taipei and 1337 in Kaohsiung aged ≤15 years were hospitalized due to asthma for the first time. The results indicated that the levels of air pollutants were significantly associated with the risk of asthma hospitalization in children, and seasonal effects were observed. High levels of air pollution in Kaohsiung had greater effects than in Taipei after adjusting for seasonal variation. The most important factor was O₃ in spring in Taipei. In children aged 0-6 years, asthma was associated with O₃ in Taipei and SO₂ in Kaohsiung, after controlling for the daily mean temperature and relative humidity.

  16. Application of a Time-Stratified Case-Crossover Design to Explore the Effects of Air Pollution and Season on Childhood Asthma Hospitalization in Cities of Differing Urban Patterns: Big Data Analytics of Government Open Data

    PubMed Central

    Chan, Chin-Kan; Wu, Chiung-Yi

    2018-01-01

    Few studies have assessed the lagged effects of levels of different urban city air pollutants and seasons on asthma hospitalization in children. This study used big data analysis to explore the effects of daily changes in air pollution and season on childhood asthma hospitalization from 2001 to 2010 in Taipei and Kaohsiung City, Taiwan. A time-stratified case-crossover study and conditional logistic regression analysis were employed to identify associations between the risk of hospitalization due to asthma in children and the levels of air pollutants (PM2.5, PM10, O3, SO2, and NO2) in the days preceding hospitalization. During the study period, 2900 children in Taipei and 1337 in Kaohsiung aged ≤15 years were hospitalized due to asthma for the first time. The results indicated that the levels of air pollutants were significantly associated with the risk of asthma hospitalization in children, and seasonal effects were observed. High levels of air pollution in Kaohsiung had greater effects than in Taipei after adjusting for seasonal variation. The most important factor was O3 in spring in Taipei. In children aged 0–6 years, asthma was associated with O3 in Taipei and SO2 in Kaohsiung, after controlling for the daily mean temperature and relative humidity. PMID:29614737

  17. Productivity vs. training in primary care: analysis of hospitals and health centers in New York City.

    PubMed

    DeLia, Derek; Cantor, Joel C; Duck, Elaine

    2002-01-01

    This paper examines the indirect costs of primary care residency in terms of ambulatory care site productivity and the influence of graduate medical education (GME) subsidies on the employment of primary care residents. Using a sample of hospitals and health centers in New York City (NYC), we find that most facilities employ significantly more primary care residents relative to nonresident primary care physicians than would be dictated by cost-minimizing behavior in the production of primary care. We also find evidence that New York's GME subsidy encourages the "overemployment" of residents, while the Medicare GME subsidy does not. We conclude that the trade-off between productivity and teaching is more serious in primary care than in inpatient settings, and that facilities heavily involved in ambulatory care teaching will be at a competitive disadvantage if GME subsidies are not targeted specifically for primary care.

  18. Impact of Tactile Stimulation on Neurobehavioral Development of Premature Infants in Assiut City

    ERIC Educational Resources Information Center

    Sayed, Atyat Mohammed Hassan; Youssef, Magda Mohamed E.; Hassanein, Farouk El-Sayed; Mobarak, Amal Ahmed

    2015-01-01

    Objective: To assess impact of tactile stimulation on neurobehavioral development of premature infants in Assiut City. Design: Quasi-experimental research design. Setting: The study was conducted in the Neonatal Intensive Care Unit at Assiut University Children Hospital, Assiut General Hospital, Health Insurance Hospital (ElMabarah Hospital) and…

  19. Credit with Health Education in Benin: A Cluster Randomized Trial Examining Impacts on Knowledge and Behavior.

    PubMed

    Karlan, Dean; Thuysbaert, Bram; Gray, Bobbi

    2017-02-08

    We evaluate whether health education integrated into microcredit lending groups reduces health risks by improving health knowledge and self-reported behaviors among urban and rural borrowers in eastern Benin. In 2007, we randomly assigned 138 villages in the Plateau region of Benin to one of four variations of a group liability credit product, varying lending groups' gender composition and/or inclusion of health education using a 2 × 2 design. Women in villages receiving health education, regardless of gender composition of the groups, showed improved knowledge of malaria and of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), but not of childhood illness danger signs. No significant changes in health behavior were observed except an increase in HIV/AIDS prevention behavior, a result predominantly driven by an increase in respondents' self-reported ability to procure a condom, likely an indicator of increased perceived access rather than improved preventative behavior. Women in villages assigned to mixed-gender groups had significantly lower levels of social capital, compared with villages assigned to female-only groups. This suggests there may be an important trade-off to consider for interventions seeking improved health outcomes and social capital through provision of services to mixed-gender groups. Although bundling health education with microcredit can expand health education coverage and lower service-delivery costs, the approach may not be sufficient to improve health behaviors. © The American Society of Tropical Medicine and Hygiene.

  20. Depression in Teenager Pregnant Women in a Public Hospital in a Northern Mexican City: Prevalence and Correlates

    PubMed Central

    Alvarado-Esquivel, Cosme; Sifuentes-Alvarez, Antonio; Salas-Martinez, Carlos

    2015-01-01

    Background Very little is known about prenatal depression in teenagers in Mexico. We determined the prevalence and correlates of prenatal depression in teenager women attending a public hospital in Durango City, Mexico. Methods We performed a cross-sectional study to assess depression in 181 teenager pregnant women who attended a public hospital for prenatal care. We used a validated Mexican version of the Edinburg postnatal depression scale (EPDS) to screen depression. Women with EPDS scores suggestive of depression were further examined to confirm depression by a psychiatric evaluation using the DSM-IV criteria. Bivariate and multivariate analyses were used to evaluate the prevalence association with socio-demographic, clinical and psychosocial characteristics of the pregnant women. Results Of the 181 teenager pregnant women studied, 61 (33.7%) had EPDS equal to or higher than 8 (range 8 - 23), and 37 of them were confirmed to have prenatal depression by the psychiatric evaluation. The general prevalence of prenatal depression in the teenager pregnant women studied was 20.4%. Of the 37 women with depression, 34 suffered from minor depression and three suffered from major depression. Thus, the prevalence of minor and major depression in the women studied was 18.8% and 1.7%, respectively. Multivariate analysis of the socio-demographic, clinical and psychosocial characteristics of the teenager pregnant women showed that prenatal depression was associated with a previous episode of depression during pregnancy (odds ratio (OR) = 6.12; 95% confidence interval (CI): 1.68 - 22.30; P = 0.006), and borderline associations with big fetal size (OR = 9.9; 95% CI: 0.94 - 104.24; P = 0.05) and family problems (OR = 3.83; 95% CI: 0.99 - 14.84; P = 0.05). Conclusions Results demonstrate that prenatal depression is common in pregnant teenagers in Durango City, Mexico. The history of an episode of depression during pregnancy should alert physicians for further depression episodes

  1. Depression in teenager pregnant women in a public hospital in a northern mexican city: prevalence and correlates.

    PubMed

    Alvarado-Esquivel, Cosme; Sifuentes-Alvarez, Antonio; Salas-Martinez, Carlos

    2015-07-01

    Very little is known about prenatal depression in teenagers in Mexico. We determined the prevalence and correlates of prenatal depression in teenager women attending a public hospital in Durango City, Mexico. We performed a cross-sectional study to assess depression in 181 teenager pregnant women who attended a public hospital for prenatal care. We used a validated Mexican version of the Edinburg postnatal depression scale (EPDS) to screen depression. Women with EPDS scores suggestive of depression were further examined to confirm depression by a psychiatric evaluation using the DSM-IV criteria. Bivariate and multivariate analyses were used to evaluate the prevalence association with socio-demographic, clinical and psychosocial characteristics of the pregnant women. Of the 181 teenager pregnant women studied, 61 (33.7%) had EPDS equal to or higher than 8 (range 8 - 23), and 37 of them were confirmed to have prenatal depression by the psychiatric evaluation. The general prevalence of prenatal depression in the teenager pregnant women studied was 20.4%. Of the 37 women with depression, 34 suffered from minor depression and three suffered from major depression. Thus, the prevalence of minor and major depression in the women studied was 18.8% and 1.7%, respectively. Multivariate analysis of the socio-demographic, clinical and psychosocial characteristics of the teenager pregnant women showed that prenatal depression was associated with a previous episode of depression during pregnancy (odds ratio (OR) = 6.12; 95% confidence interval (CI): 1.68 - 22.30; P = 0.006), and borderline associations with big fetal size (OR = 9.9; 95% CI: 0.94 - 104.24; P = 0.05) and family problems (OR = 3.83; 95% CI: 0.99 - 14.84; P = 0.05). Results demonstrate that prenatal depression is common in pregnant teenagers in Durango City, Mexico. The history of an episode of depression during pregnancy should alert physicians for further depression episodes during pregnancy in teenagers. Further

  2. Dietary exposure to aflatoxin in human male infertility in Benin City, Nigeria.

    PubMed

    Ibeh, I N; Uraih, N; Ogonar, J I

    1994-01-01

    To discover the relationship between aflatoxin levels, if any, in serum of infertile men in comparison with random controls from the community. In a parallel experiment, adult male rats were given an aflatoxin-contaminated diet. 100 adult males, yielding 50 semen samples, from men attending Infertility Clinics at a university teaching hospital and 50 normal men in the same community. The staple foods of the men were assayed for aflatoxin content. The rats were given the aflatoxin-rich diet, and their spermatozoa were examined and their ability to reproduce assessed. A random sampling of semen from 100 adult males comprising 50 samples drawn from infertile men and 50 drawn from normal individuals within the same community revealed the presence of aflatoxins in 20 semen samples from the infertile group (40.0%) and four samples from the fertile group (8.0%). The mean aflatoxin concentrations were 1.660 +/- 0.04 micrograms/mL (infertile men) and 1.041 +/- 0.01 micrograms/mL (fertile men). Infertile men with aflatoxin in their semen showed a higher percentage of spermatozoal abnormality (50.0%) than the fertile men (10.0-15.0%). Dietary exposure of adult male Albino rats to aflatoxin (8.5 micrograms AF1/g of Guinea growers feed for 14 days) produced deleterious effects on the spermatozoa of the affected rats, producing features that resemble those seen in semen of infertile men exposed to aflatoxin.

  3. Bacterial-resistance among outpatients of county hospitals in China: significant geographic distinctions and minor differences between central cities.

    PubMed

    Xiao, Yonghong; Wei, Zeqing; Shen, Ping; Ji, Jinru; Sun, Ziyong; Yu, Hua; Zhang, Tiantuo; Ji, Ping; Ni, Yuxing; Hu, Zhidong; Chu, Yunzhuo; Li, Lanjuan

    2015-06-01

    The purpose of this study was to survey antibacterial resistance in outpatients of Chinese county hospitals. A total of 31 county hospitals were selected and samples continuously collected from August 2010 to August 2011. Drug sensitivity testing was conducted in a central laboratory. A total of 2946 unique isolates were collected, including 634 strains of Escherichia coli, 606 Klebsiella pneumoniae, 476 Staphylococcus aureus, 308 Streptococcus pneumoniae, and 160 Haemophilus influenzae. Extended-spectrum β-lactamases were detected in E. coli (42.3% strains), K. pneumoniae (31.7%), and Proteus mirabilis (39.0%). Ciprofloxacin-resistance was detected in 51.0% of E. coli strains. Salmonella spp. and Shigella spp. were sensitive to most antibacterial agents. Less than 8.0% of Pseudomonas aeruginosa isolates were resistant to carbapenem. For S. aureus strains, 15.3% were resistant to methicillin, and some strains of S. pneumoniae showed resistance to penicillin (1.6%), ceftriaxone (13.0%), and erythromycin (96.4%). β-lactamase was produced by 96.5% of Moraxella catarrhalis strains, and 36.2% of H. influenzae isolates were resistant to ampicillin. Azithromycin-resistant H. influenzae, imipenem-resistant but meropenem-sensitive Proteus, and ceftriaxone- and carbapenem non-sensitive M. catarrhalis were recorded. In conclusion, cephalosporin- and quinolone-resistant strains of E. coli and Klebsiella pneumonia and macrolide-resistant Gram-positive cocci were relatively prominent in county hospitals. The antibacterial resistance profiles of isolates from different geographical locations varied significantly, with proportions in county hospitals lower than those in their tertiary counterparts in the central cities, although the difference is diminishing. Copyright © 2015 The Authors. Published by Elsevier Masson SAS.. All rights reserved.

  4. Assessing knowledge, performance, and efficiency for hospital waste management-a comparison of government and private hospitals in Pakistan.

    PubMed

    Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz; Geng, Yong; Ashraf, Uzma

    2017-04-01

    Proper management of healthcare waste is a critical concern in many countries of the world. Rapid urbanization and population growth rates pose serious challenges to healthcare waste management infrastructure in such countries. This study was aimed at assessing the situation of hospital waste management in a major city of Pakistan. Simple random sampling was used to select 12 government and private hospitals in the city. Field visits, physical measurements, and questionnaire survey method were used for data collection. Information was obtained regarding hospital waste generation, segregation, collection, storage, transportation, and disposal. Data envelopment analysis (DEA) was used to classify the hospitals on the basis of their relative waste management efficiencies. The weighted average total waste generation at the surveyed hospitals was discovered to be 1.53 kg/patient/day of which 75.15% consisted of general waste and the remaining consisted of biomedical waste. Of the total waste, 24.54% came from the public hospital and the remaining came from the private hospitals. DEA showed that seven of the surveyed hospitals had scale or pure technical inefficiencies in their waste management activities. The public hospital was relatively less efficient than most of the private hospitals in these activities. Results of the questionnaire survey showed that none of the surveyed hospitals was carrying out waste management in strict compliance with government regulations. Moreover, hospital staff at all the surveyed hospitals had low level of knowledge regarding safe hospital waste management practices. The current situation should be rectified in order to avoid environmental and epidemiological risks.

  5. Utilization and farmers' knowledge on pigeonpea diversity in Benin, West Africa.

    PubMed

    Ayenan, Mathieu Anatole Tele; Danquah, Agyemang; Ahoton, Léonard Essehou; Ofori, Kwadwo

    2017-06-20

    Understanding factors driving farmers' uses of crop genetic resources is a key component not only to design appropriate conservation strategies but also to promote sustainable production. However, in Benin, limited information is available on farmers' knowledge related to pigeonpea uses and conservation. This study aimed at i) identifying and investigating the different uses of pigeonpea in relation with socio-cultural factors, namely age, gender, ethnic group and respondents' residence, ii) assessing pigeonpea varieties richness at household level and iii) evaluating the extent and distribution of pigeonpea varieties. Three hundred and two farmers were surveyed using structured questionnaire. Direct observation, field visit and focus group discussion were carried out. Association between number of varieties maintained at household level and socio-cultural variables was tested. Mann-Whitney test was used to assess whether the number of varieties held by households headed by men and women were different. Distribution and extent of diversity was assessed through four cells analysis. Farmers in Benin mainly grow pigeonpea for its grains for home consumption. Pigeonpea's stem and leaves are used for medicinal purposes to treat malaria, dizziness, measles, and eye infection. The ethnic group and the locality of residence of farmers influenced on the use of pigeonpea for medicinal purposes (P < 0.01). There was no significant association (P > 0.05) between the number of varieties held by household and the age of the respondent, number of years of experience in pigeonpea cultivation, the size of household, number of family members engaged in agricultural activities and gender. Farmers used criteria including seed colors, seed size, plant height, maturity groups and cooking time to classify their varieties. Varieties with white seed coat color were the most grown while varieties with black, red or mottled seed coat color are being abandoned and deserve to be conserved

  6. Dramatic Decrease in Malaria Transmission after Large-Scale Indoor Residual Spraying with Bendiocarb in Benin, an Area of High Resistance of Anopheles gambiae to Pyrethroids

    PubMed Central

    Akogbeto, Martin; Padonou, Gil Germain; Bankole, Honore Sourou; Gazard, Dorothee Kinde; Gbedjissi, Ghelus Louis

    2011-01-01

    In 2008, the National Malaria Control Program in Benin implemented a vector control intervention based on indoor residual spraying (IRS). Four districts of high resistance of Anopheles gambiae to pyrethroids were sprayed with bendiocarb. More than 350,000 inhabitants have been protected. Entomologic parameters in the control area were compared with those in intervention sites. The study has shown a drastic decrease in the An. gambiae biting rate in the sprayed areas. Results of an enzyme-linked immunosorbent assay were negative for Plasmodium falciparum antigen during the entire period of the intervention. No household members received infected bites (entomologic inoculation rate = 0 during January–July). Parous rates were low in areas covered by IRS because bendiocarb is not conducive to long-term mosquito survival. Bendiocarb was found to be a good alternative insecticide for IRS in Benin, in areas where An. gambiae has developed high resistance to pyrethroids. PMID:21976555

  7. Determination of discretionary salt intake in rural Guatemala and Benin to determine the iodine fortification of salt required to control iodine deficiency disorders: studies using lithium-labeled salt.

    PubMed

    Melse-Boonstra, A; Rozendaal, M; Rexwinkel, H; Gerichhausen, M J; van den Briel, T; Bulux, J; Solomons, N W; West, C E

    1998-09-01

    The use of discretionary salt, which is salt added during cooking and at the table, as a suitable vehicle for iodine intake was assessed by measuring salt consumption using the lithium-marker technique in rural areas of Guatemala and Benin. In both countries, we studied boys aged 6-12 y and their mothers. Subjects used lithium-labeled salt after all unlabeled salt was removed from their households. In Guatemala, 24-h urine samples for 9 mother-son pairs were collected at baseline and on days 7, 8, and 9 during the use of lithium-labeled salt. Total maternal salt intake averaged 5.2 +/- 1.7 g/d (mean +/- SD), of which 77 +/- 24% came from discretionary sources, whereas Guatemalan boys consumed 1.8 +/- 0.6 g salt/d, of which 72 +/- 12% came from discretionary sources. In Benin, urine collection from 13 mother-son pairs took place at baseline and on days 5 and 7. Beninese mothers had a total salt intake of 9.0 +/- 2.9 g/d and their sons had an intake of 5.7 +/- 2.8 g/d; discretionary salt contributed 52 +/- 14% and 50 +/- 13%, respectively, of total salt consumed. Therefore, fortification of household salt appears to be an appropriate method of controlling iodine deficiency in both countries, although fortification of other salt sources could be considered in Benin.

  8. ‘Rowing against the current’: the policy process and effects of removing user fees for caesarean sections in Benin

    PubMed Central

    Cresswell, Jenny A; Makoutodé, Patrick; De Brouwere, Vincent; Witter, Sophie; Filippi, Veronique; Kanhonou, Lydie G; Goufodji, Sourou B; Lange, Isabelle L; Lawin, Lionel; Affo, Fabien; Marchal, Bruno

    2018-01-01

    Background In 2009, the Benin government introduced a user fee exemption policy for caesarean sections. We analyse this policy with regard to how the existing ideas and institutions related to user fees influenced key steps of the policy cycle and draw lessons that could inform the policy dialogue for universal health coverage in the West African region. Methods Following the policy stages model, we analyse the agenda setting, policy formulation and legitimation phase, and assess the implementation fidelity and policy results. We adopted an embedded case study design, using quantitative and qualitative data collected with 13 tools at the national level and in seven hospitals implementing the policy. Results We found that the initial political goal of the policy was not to reduce maternal mortality but to eliminate the detention in hospitals of mothers and newborns who cannot pay the user fees by exempting a comprehensive package of maternal health services. We found that the policy development process suffered from inadequate uptake of evidence and that the policy content and process were not completely in harmony with political and public health goals. The initial policy intention clashed with the neoliberal orientation of the political system, the fee recovery principles institutionalised since the Bamako Initiative and the prevailing ideas in favour of user fees. The policymakers did not take these entrenched factors into account. The resulting tension contributed to a benefit package covering only caesarean sections and to the variable implementation and effectiveness of the policy. Conclusion The influence of organisational culture in the decision-making processes in the health sector is often ignored but must be considered in the design and implementation of any policy aimed at achieving universal health coverage in West African countries. PMID:29564156

  9. Exploring Reasons for Bed Pressures in Winnipeg Acute Care Hospitals

    ERIC Educational Resources Information Center

    Menec, Verena H.; Bruce, Sharon; MacWilliam, Leonard R.

    2005-01-01

    Hospital overcrowding has plagued Winnipeg and other Canadian cities for years. This study explored factors related to overcrowding. Hospital files were used to examine patterns of hospital use from fiscal years 1996/1997 to 1999/2000. Chart reviews were conducted to examine appropriateness of admissions and hospital stays during one pressure…

  10. Association Between Women's Empowerment and Maternal and Child Nutrition in Kalalé District of Northern Benin.

    PubMed

    Alaofè, Halimatou; Zhu, Min; Burney, Jennifer; Naylor, Rosamond; Douglas, Taren

    2017-09-01

    Evidence on effectiveness of women's empowerment (WE) to reduce undernutrition is limited in sub-Sahara Africa, and few studies incorporate multidimensional measures of WE. To examine whether a WE status, in sum and across leadership, decision-making, mobility, economic security, male involvement in housework, and nonfamily group domains, is associated with women and their children nutritional status in Kalalé district of northern Benin. Data were obtained from the 2014 Solar Market Garden baseline study: 767 paired reproductive-age women aged 15 to 49 years and children 6 to 59 months old. Exploratory principal component (cross-validate with confirmatory) factor analysis was first conducted to identify the structure of empowerment. Then, using a new survey-based index, regression analysis was conducted to examine associations between WE measures and maternal dietary diversity score (DDS) and body mass index (BMI), as well as their child's DDS, height-for-age z score (HAZ), weight-for-height z score (WHZ), and weight-for-age z score (WAZ). Positive associations were observed between women's composite empowerment, leadership, maternal DDS and BMI, and female child's DDS. However, opposite signs were found between economic security and child's DDS. Mobility was positively associated with female children's WHZ and male children's HAZ and WAZ, while decision-making was correlated with male child's WHZ and female children's WAZ. Women's empowerment can be associated with undernutrition. Efforts to improve nutrition may benefit from empowerment initiatives that promote women's self-confidence and decision-making in Benin. However, additional qualitative and longitudinal research may enhance understanding of WE in the present area.

  11. Bight of Benin: a Maternal Perspective of Four Beninese Populations and their Genetic Implications on the American Populations of African Ancestry.

    PubMed

    Primativo, Giuseppina; Ottoni, Claudio; Biondi, Gianfranco; Serafino, Sara; Martínez-Labarga, Cristina; Larmuseau, Maarten H D; Scardi, Michele; Decorte, Ronny; Rickards, Olga

    2017-03-01

    The understanding of the first movements of the ancestral populations within the African continent is still unclear, particularly in West Africa, due to several factors that have shaped the African genetic pool across time. To improve the genetic representativeness of the Beninese population and to better understand the patterns of human settlement inside West Africa and the dynamics of peopling of the Democratic Republic of Benin, we analyzed the maternal genetic variation of 193 Beninese individuals belonging to Bariba, Berba, Dendi, and Fon populations. Results support the oral traditions indicating that the western neighbouring populations have been the ancestors of the first Beninese populations, and the extant genetic structure of the Beninese populations is most likely the result of admixture between populations from neighbouring countries and native people. The present findings highlight how the Beninese populations contributed to the gene pool of the extant populations of some American populations of African ancestry. This strengthens the hypothesis that the Bight of Benin was not only an assembly point for the slave trade during the Trans-Atlantic Slave Trade but also an important slave trapping area. © 2017 John Wiley & Sons Ltd/University College London.

  12. Malaria Diagnosis and Hospitalization Trends, Brazil

    PubMed Central

    Roberts, Donald R.; Alecrim, Maria das Gracas C.; Costa, Monica R.F.; Quinnan, Gerald V.

    2007-01-01

    We focused on rates of malaria in the state of Amazonas and city of Manaus, Brazil. Plasmodium vivax accounted for an increased number and rate of hospital admissions, while P. falciparum cases decreased. Our observations on malaria epidemiology suggest that the increased hospitalization rate could be due to increased severity of P. vivax infections. PMID:18258018

  13. Endogenous knowledge of four leafy vegetables used by rural populations in Benin.

    PubMed

    Vihotogbe-Sossa, Carole N A; Akissoe, Noël H; Anihouvi, Victor B; Ahohuendo, Bonaventure C; Ahanchede, Adam; Sanni, Ambaliou; Hounhouigan, D Joseph

    2012-01-01

    Leafy vegetables are sources of diet diversification and could contribute to food and nutritional security in African rural areas. However, in some places, little is known about if, how, and why leafy vegetables are consumed. Processing and preservation methods, food forms, and consumption determinants of four leafy vegetables (Sesamum radiatum, Ceratotheca sesamoïdes, Acmella uliginosa and Justicia tenella), known to contribute to the diet of rural populations in the Center and Northern parts of Benin, were investigated. Three hundred randomly selected households were investigated, using rapid appraisal and quantitative survey methods, descriptive statistics and correspondence analysis. Processing methods to prepare sauces varied depending on sociocultural groups. Cooking of fresh leaves predominated, while sun drying was the usual practice of preserving these leafy vegetables. Consumption frequencies were associated with sociocultural groups, food habits, and availability in living areas.

  14. Disaster Vulnerability of Hospitals: A Nationwide Surveillance in Japan.

    PubMed

    Ochi, Sae; Kato, Shigeaki; Kobayashi, Kenichi; Kanatani, Yasuhiro

    2015-12-01

    Hospital preparedness against disasters is key to achieving disaster mitigation for health. To gain a holistic view of hospitals in Japan, one of the most disaster-prone countries, a nationwide surveillance of hospital preparedness was conducted. A cross-sectional, paper-based interview was conducted that targeted all of the 8701 registered hospitals in Japan. Preparedness was assessed with regard to local hazards, compliance to building code, and preparation of resources such as electricity, water, communication tools, and transportation tools. Answers were obtained from 6122 hospitals (response rate: 70.3%), among which 20.5% were public (national or city-run) hospitals and others were private. Eight percent were the hospitals assigned as disaster-base hospitals and the others were non-disaster-base hospitals. Overall compliance to building code, power generators, water tanks, emergency communication tools, and helicopter platforms was 90%, 84%, 95%, 43%, and 22%, respectively. Major vulnerabilities in logistics in mega-cities and stockpiles required for chronic care emerged from the results of this nationwide surveillance of hospitals in Japan. To conduct further intensive surveillance to meet community health needs, appropriate sampling methods should be established on the basis of this preliminary study. Holistic vulnerability analysis of community hospitals will lead to more robust disaster mitigation at the local level.

  15. Dominant viral pathologies in the extensive and semi-intensive animal breeding and their treatment mode in ethno veterinary medicine in Benin

    PubMed Central

    Kpodékon, T. M.; Ogni, C. A.; Dassou, H.; Dougnon, T. J.; Boko, C.; Koutinhouin, G. B.; Goussanou, J. S. E.; Akoegninou, A.; Youssao, I.

    2015-01-01

    Aim: This study aims to identify the dominant viral animal pathologies and to list the traditional recipes used by the breeders for their treatment. Materials and Methods: The method of data collection was based on a retrospective survey. Thus, 787 breeders and agro-breeders scattered in the eight agro-ecological areas of Benin were interviewed using semi-structured questionnaires. Results: In total, 5 pathologies were reported by breeders. Among those pathologies, foot and mouth disease was reported by all of the breeders of the southern part of Borgou compared with the other areas (p<0.05) and treated by 25 species of medicinal plants. African swine fever was the main pathology reported (22.92%) (p<0.05) in the fishery areas which is controlled by 7 medicinal plants. Pseudorinderpest was more reported (33.78%) (p<0.05) in the cotton area of central Benin and treated by 8 medicinal plants. There is also Newcastle disease that was mostly reported in the Western Atacora and treated by 32 medicinal plants as well as fowl pox which was a more reported in the lands of the bar area and the low-pressure area about 34.48% and 36.17% proportions, respectively, and treated by eight medicinal plants. Conclusion: The breeders in Benin possess rich ethno veterinary knowledge on medicinal plants and their uses in the treatment of livestock. A total of 57 medicinal plants have been inventoried to fight against five major viral diseases as African swine fever, pseudorinderpest and foot and mouth disease. The common plants used to treat viral disease in general were Euphorbia unispina, Euphorbia poissonii, Lannea acida, and Mangifera indica. The most harvested organs on the plants reported in this survey were the barks, the leaves, and the whole plants. To better develop our indigenous resources, it would be important to expand this ethno-pharmacological investigation to other diseases category. PMID:27047056

  16. [Determination of prevalence and etiology of anemia during pregnancy in southern Benin, in conjunction with revision of national management policy].

    PubMed

    Koura, K G; Briand, V; Massougbodji, A; Chippaux, J P; Cot, M; Garcia, A

    2011-02-01

    Anemia during pregnancy is a serious public health problem. Control requires identification of the underlying etiology. The objective of this study carried out in conjunction with revision of the national policy for the protection of pregnant women in Benin was to determine the prevalence and etiology of anemia. From October 2006 to April 2007, 300 pregnant women were examined at two maternities in Ouidah, Benin. Sociodemographic and environmental characteristics, dietary data, behavioral practices, and history of malaria infection during pregnancy were collected. Blood and stool samples were tested for the presence of malaria parasites and intestinal worms respectively. Hemoglobin and ferritinemia levels were also determined. The prevalence of anemia (Hb < 11 g/dL) was 65.7% while that of malaria and intestinal worms was 4.3% and 8% respectively. Iron deficiency was not found. A borderline significant correlation was found between helminthiasis and anemia. No correlation was found between anemia and malaria. These findings indicate that kits progressively introduced by the health system during the study period provided relatively effective care. This study demonstrates a high prevalence of moderate anemia during pregnancy and suggests that it is mainly due to intestinal helminthiasis. These findings underline the importance of preventive antihelminthic treatment during pregnancy.

  17. Acquisition of electroencephalographic data in a large regional hospital - Bringing the brain waves to the computer.

    NASA Technical Reports Server (NTRS)

    Low, M. D.; Baker, M.; Ferguson, R.; Frost, J. D., Jr.

    1972-01-01

    This paper describes a complete electroencephalographic acquisition and transmission system, designed to meet the needs of a large hospital with multiple critical care patient monitoring units. The system provides rapid and prolonged access to a centralized recording and computing area from remote locations within the hospital complex, and from locations in other hospitals and other cities. The system includes quick-on electrode caps, amplifier units and cable transmission for access from within the hospital, and EEG digitization and telephone transmission for access from other hospitals or cities.

  18. Transport accidents among children and adolescents at the emergency service of a teaching hospital in the southern zone of the city of São Paulo☆☆☆

    PubMed Central

    Gorios, Carlos; de Souza, Renata Maia; Gerolla, Viviane; Maso, Bruno; Rodrigues, Cintia Leci; Armond, Jane de Eston

    2014-01-01

    Objective to describe the victim profile and circumstances of transport accidents involving children and adolescents who were attended at a teaching hospital in the southern zone of the city of São Paulo. Methods this was an individual observational case series study among patients up to the age of 19 years who were attended at a hospital in the southern zone of the city of São Paulo, state of São Paulo, Brazil, due to traffic accidents. The files notifying suspected or confirmed cases of violence and accidents (SIVVA files) covering January to December 2012 were analyzed. Results among the 149 cases notified, 64.4% related to males and 35.6% to females. The transport accidents were predominantly among males, irrespective of age. The main injury diagnoses were superficial head trauma (24.8%) followed by multiple non-specified trauma (36.4%), in both sexes. Conclusion transport accidents among children and adolescents occurred more often among males. The main transport accidents among the children and adolescents attended as emergency cases were caused by motor vehicles and motorcycles. Among the accident victims, the largest proportion was attended because of being run over. PMID:26229833

  19. Streptococcal sore throat followup program in a hospital clinic, New York City.

    PubMed Central

    Kaufman, A; Murray, D; Starita, L; Brickner, P W

    1975-01-01

    To improve followup and treatment of patients with streptococcal sore throat at St. Vincent's Hospital and Medical Center, New York City, a simple and inexpensive method was devised for recalling and treating untreated patients with positive throat cultures and culturing household contacts. The program was conducted by a clinic nurse and a secretary, with only occasional assistance from a physician. All services were free for those without Medicaid coverage. The secretary sent notification letters to all patients with positive cultures urging them to return for treatment and emphasizing the need for their contacts to come for screening. The secretary, trained in the throat culturing technique, also performed the laboratory work on the cultures from contacts. The clinic nurse swabbed the throats of all contacts and administered treatment, according to a standing-order protocol, to all with culture-proved streptococcal sore throat. A comparison of initially untreated patients with positive cultures seen 3 months before and 6 months after the program was started revealed that 46 percent returned for treatment after the notification letter was sent; before the program only 21 percent returned for treatment. No attempt had been made to reach household contacts before the program began. The rate of streptococcal sore throat in contacts was 14 percent, and in the clinic patients it was 11 percent during the first 6 months of the program. Images p369-a p371-a PMID:808824

  20. Effects of essential oils from medicinal plants acclimated to Benin on in vitro ruminal fermentation of Andropogon gayanus grass.

    PubMed

    Kouazounde, Jacques B; Jin, Long; Assogba, Fidele M; Ayedoun, Marc A; Wang, Yuxi; Beauchemin, Karen A; McAllister, Tim A; Gbenou, Joachim D

    2015-03-30

    Plants from West Africa commonly used in both human and veterinary medicine contain various secondary metabolites. However, their potential in mitigating ruminal methane production has not been explored. This study examined the effects of seven essential oils (EOs) from plants acclimated to Benin at four dosages (100, 200, 300 and 400 mg L(-1)), on in vitro rumen microbial fermentation and methane production using Andropogon gayanus grass as a substrate. Compared to control, Laurus nobilis (300-400 mg L(-1) ), Citrus aurantifolia (300-400 mg L(-1)) and Ocimum gratissimum (200-400 mg L(-1)) decreased (P < 0.05) methane production (mL g(-1) DM) by 8.1-11.8%, 11.9-17.8% and 7.9-30.6%, respectively. Relative to the control, reductions in methane (mL g(-1) DM) of 11.4%, 13.5% and 14.2% were only observed at 400 mg L(-1) for Eucalyptus citriodora, Ocimum basilicum and Cymbopogon citratus, respectively. These EOs lowered methane without reducing concentrations of total volatile fatty acids or causing a shift from acetate to propionate production. All EOs (except M. piperita) reduced (P < 0.05) apparent dry matter (DM) disappearance of A. gayanus. The current study demonstrated that EOs from plants grown in Benin inhibited in vitro methane production mainly through a reduction in apparent DM digestibility. © 2014 Society of Chemical Industry.

  1. Prevalence of Urinary Tract Infection Among Pregnant Women and its Complications in Their Newborns During the Birth in the Hospitals of Dezful City, Iran, 2012 - 2013.

    PubMed

    Amiri, Marziyeh; Lavasani, Zohreh; Norouzirad, Reza; Najibpour, Reza; Mohamadpour, Masoomeh; Nikpoor, Amin Reza; Raeisi, Mohammad; Zare Marzouni, Hadi

    2015-08-01

    Urinary tract infection (UTI) is the most common disorder caused by bacterial agents in pregnancy, which can lead to important complications in newborn of such mothers in case of inappropriate diagnosis and treatment. The purpose of this study was to study the prevalence of UTI among pregnant women and its complications in their newborns during the birth in the hospitals of Dezful City, Iran, during 2012 - 2013. In this cross-sectional retrospective study, 1132 women admitted to Dr. Ganjavian and Ayatollah Nabavi Hospitals in Dezful City, Iran, during 2012 - 2013 were randomly allocated into the case and control groups and were matched based on their age, numbers of pregnancy, sex and diseases of their children. UTI was the only difference between the two groups. Twenty-two thousand six hundred deliveries occurred within the course of this study. Due to UTI, 5% of deliveries led to hospitalization of mothers (1132 patients).Weight and height of newborn infants of mothers afflicted with UTI (P < 0.001) were significantly lower compared to newborns of healthy women (P < 0.001). There was a significant association between the two groups of pregnant women with UTI in terms of type of delivery (normal and caesarean section) (P < 0.008). The lower incidence of UTI in pregnant women compared to other areas of Iran represents the role of climate and weather in the prevalence of UTI. In addition, the increased number of low-birth-weight infants had a remarkable correlation with UTI, which can influence the health of the next generation.

  2. Prevalence of Urinary Tract Infection Among Pregnant Women and its Complications in Their Newborns During the Birth in the Hospitals of Dezful City, Iran, 2012 - 2013

    PubMed Central

    Amiri, Marziyeh; Lavasani, Zohreh; Norouzirad, Reza; Najibpour, Reza; Mohamadpour, Masoomeh; Nikpoor, Amin Reza; Raeisi, Mohammad; Zare Marzouni, Hadi

    2015-01-01

    Background: Urinary tract infection (UTI) is the most common disorder caused by bacterial agents in pregnancy, which can lead to important complications in newborn of such mothers in case of inappropriate diagnosis and treatment. Objectives: The purpose of this study was to study the prevalence of UTI among pregnant women and its complications in their newborns during the birth in the hospitals of Dezful City, Iran, during 2012 - 2013. Patients and Methods: In this cross-sectional retrospective study, 1132 women admitted to Dr. Ganjavian and Ayatollah Nabavi Hospitals in Dezful City, Iran, during 2012 - 2013 were randomly allocated into the case and control groups and were matched based on their age, numbers of pregnancy, sex and diseases of their children. UTI was the only difference between the two groups. Results: Twenty-two thousand six hundred deliveries occurred within the course of this study. Due to UTI, 5% of deliveries led to hospitalization of mothers (1132 patients).Weight and height of newborn infants of mothers afflicted with UTI (P < 0.001) were significantly lower compared to newborns of healthy women (P < 0.001). There was a significant association between the two groups of pregnant women with UTI in terms of type of delivery (normal and caesarean section) (P < 0.008). Conclusions: The lower incidence of UTI in pregnant women compared to other areas of Iran represents the role of climate and weather in the prevalence of UTI. In addition, the increased number of low-birth-weight infants had a remarkable correlation with UTI, which can influence the health of the next generation. PMID:26430526

  3. Spatial Analysis of the Level of Exposure to Seismic Hazards of Health Facilities in Mexico City, Mexico

    NASA Astrophysics Data System (ADS)

    Moran, S.; Novelo-Casanova, D. A.

    2011-12-01

    Although health facilities are essential infrastructure during disasters and emergencies, they are also usually highly vulnerable installations in the case of the occurrence of large and major earthquakes. Hospitals are one of the most complex critical facilities in modern cities and they are used as first response in emergency situations. The operability of a hospital must be maintained after the occurrence of a local strong earthquake in order to satisfy the need for medical care of the affected population. If a health facility is seriously damaged, it cannot fulfill its function when most is needed. In this case, hospitals become a casualty of the disaster. To identify the level of physical exposure of hospitals to seismic hazards in Mexico City, we analyzed their geographic location with respect to the seismic response of the different type of soils of the city from past earthquakes, mainly from the events that occurred on September 1985 (Ms= 8.0) and April 1989 (Ms= 6.9). Seismic wave amplification in this city is the result of the interaction of the incoming seismic waves with the soft and water saturated clay soils, on which a large part of Mexico City is built. The clay soils are remnants of the lake that existed in the Valley of Mexico and which has been drained gradually to accommodate the growing urban sprawl. Hospital facilities were converted from a simple database of names and locations into a map layer of resources. This resource layer was combined with other map layers showing areas of seismic microzonation in Mexico City. This overlay was then used to identify those hospitals that may be threatened by the occurrence of a large or major seismic event. We analyzed the public and private hospitals considered as main health facilities. Our results indicate that more than 50% of the hospitals are highly exposed to seismic hazards. Besides, in most of these health facilities we identified the lack of preventive measures and preparedness to reduce their

  4. National-level differences in the adoption of environmental health technologies: a cross-border comparison from Benin and Togo.

    PubMed

    Wendland, Kelly J; Pattanayak, Subhrendu K; Sills, Erin O

    2015-03-01

    Environmental health problems such as malaria, respiratory infections, diarrhoea and malnutrition pose very high burdens on the poor rural people in much of the tropics. Recent research on key interventions-the adoption and use of relatively cheap and effective environmental health technologies-has focused primarily on the influence of demand-side household-level drivers. Relatively few studies of the promotion and use of these technologies have considered the role of contextual factors such as governance, the enabling environment and national policies because of the challenges of cross-country comparisons. We exploit a natural experimental setting by comparing household adoption across the Benin-Togo national border that splits the Tamberma Valley in West Africa. Households across the border share the same culture, ethnicity, weather, physiographic features, livelihoods and infrastructure; however, they are located in countries at virtually opposite ends of the institutional spectrum of democratic elections, voice and accountability, effective governance and corruption. Binary choice models and rigorous non-parametric matching estimators confirm that households in Benin are more likely than households in Togo to plant soybeans, build improved cookstoves and purchase mosquito nets, ceteris paribus. Although we cannot identify the exact mechanism for the large and significant national-level differences in technology adoption, our findings suggest that contextual institutional factors can be more important than household characteristics for technology adoption. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  5. 76 FR 40797 - Establishment of Class E Airspace; Lincoln City, OR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-12

    ...This action establishes Class E airspace at Lincoln City, OR, to accommodate aircraft using a new Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Samaritan North Lincoln Hospital Heliport. This action also corrects the name of the city were the Heliport is located. This improves the safety and management of Instrument Flight Rules (IFR) operations.

  6. Security Station and Front Entrance to hospital property, looking northeast ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Security Station and Front Entrance to hospital property, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Security Station & Front Gate, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  7. Medical City introduces new magazine for Dallas community.

    PubMed

    Rees, Tom

    2005-01-01

    Medical City, Dallas, launches a quarterly magazine titled, IN: Mind Body Life, as the final phase in its two-year branding campaign. In search of a unique style, the hospital worked with American Airlines' publishing house, AAP Custom.

  8. Prevalence, risk factors, and genetic diversity of veterinary important tick-borne pathogens in cattle from Rhipicephalus microplus-invaded and non-invaded areas of Benin.

    PubMed

    Adjou Moumouni, Paul Franck; Aplogan, Gilbert Luc; Katahira, Hirotaka; Gao, Yang; Guo, Huanping; Efstratiou, Artemis; Jirapattharasate, Charoonluk; Wang, Guanbo; Liu, Mingming; Ringo, Aaron Edmond; Umemiya-Shirafuji, Rika; Suzuki, Hiroshi; Xuan, Xuenan

    2018-03-01

    Babesiosis, theileriosis, anaplasmosis, and heartwater are tick-borne diseases (TBD) that threaten livestock production in sub-Saharan Africa including Benin. This country has been faced with an invasion of Rhipicephalus microplus, a major vector for babesiosis, theileriosis, and anaplasmosis over the last decade. Yet, data on TBD and the impact of the invasive ticks are lacking, making risk level evaluation and disease control arduous. In this study, epidemiological features of Babesia bovis, B. bigemina, Theileria spp., Anaplasma marginale and Ehrlichia ruminantium infections in Benin cattle were investigated in R. microplus-invaded and non-invaded areas. Detection of pathogens was based on species-specific PCR assays and resulting data were used to identify risk factors. Genetic diversity and phylogenies were then evaluated using several markers. Out of 207 samples examined, 170 (82.1%), 109 (52.7%), 42 (20.3%) 24 (11.6%) and 1 (0.5%) were positive for T. mutans, A. marginale, B. bigemina, B. bovis and E. ruminantium, respectively. Animal gender (for B. bovis), exposure to R. microplus (for B. bigemina and A. marginale), animal age (for B. bigemina and A. marginale) and cattle breed and/or antiprotozoal treatment (for T. mutants) significantly modulated pathogen occurrence. In addition, R. microplus exposure was significantly related to co-infection patterns and cases of clinical theileriosis and/or anaplasmosis were recorded among cattle highly exposed to the tick. In the genetic characterization, Theileria spp. and E. ruminantium sequences were conserved. Babesia spp. and A. marginale, however, showed high sequence polymorphisms that indicate the presence of several strains and may be linked to R. microplus invasion. Taken together, these results ascertain the endemicity of tick-borne infections in Benin and suggest that the characteristics of Babesia spp. and A. marginale infections in R. microplus-invaded and non-invaded areas are different. Copyright

  9. [Factors associated with the strength of organizational culture in a Beninese hospital].

    PubMed

    Sopoh, Ghislain Emmanuel; Kouckodila Nzingoula, Michael Florian; Sossa Jérôme, Charles; Hessou Ahahanzo-Glèlè, Yolaine; Damienne Agueh, Victoire; Tinoaga Ouédraogo, Laurent; Makoutodé, Michel

    Organizational culture, a frequently ignored concept, affects job satisfaction and productivity in organizations. To determine the factors associated with the strength of organizational culture (OC) in Mono / Couffo regional hospital in Lokossa in Benin. This cross-sectional and analytical study involved 121 workers of Mono/Couffo hospital in March 2015. Data on the strength of OC was collected using a questionnaire based on the validated tool proposed by Cameron and Quinn (2006). Logistic regression was performed to explore the nature of the relationship between the independent variables and OC using Odds ratios. 62% of the surveyed subjects had a positive perception of organizational culture. This perception was statistically associated with managerial factors (moral support of workers and type of relationship with the executive staff). The risk of perceiving a low strength of OC was sixfold higher OR = 3.78, 95% CI (1.08 - 13.22) among subjects who felt they did not have moral support from executive staff than in those who perceived this moral support. The risk of perceiving a weak OC was higher among subjects who considered relations with the staff to be uncordial [OR = 14.32, 95% CI (4.35 - 47.11)] compared to those who considered these relations to be cordial. Human resource management factors were more closely associated with the strength of organizational culture. Hospital managers should pay more attention to these factors in their hospitals to promote better institutional performance.

  10. Is chloroquine chemoprophylaxis still effective to prevent low birth weight? Results of a study in Benin

    PubMed Central

    Denoeud, Lise; Fievet, Nadine; Aubouy, Agnès; Ayemonna, Paul; Kiniffo, Richard; Massougbodji, Achille; Cot, Michel

    2007-01-01

    Background In areas of stable transmission, malaria during pregnancy is associated with severe maternal and foetal outcomes, especially low birth weight (LBW). To prevent these complications, weekly chloroquine (CQ) chemoprophylaxis is now being replaced by intermittent preventive treatment with sulfadoxine-pyrimethamine in West Africa. The prevalence of placental malaria and its burden on LBW were assessed in Benin to evaluate the efficacy of weekly CQ chemoprophylaxis, prior to its replacement by intermittent preventive treatment. Methods In two maternity clinics in Ouidah, an observational study was conducted between April 2004 and April 2005. At each delivery, placental blood smears were examined for malaria infection and women were interviewed on their pregnancy history including CQ intake and dosage. CQ was measured in the urine of a sub-sample (n = 166). Multiple logistic and linear regression were used to assess factors associated with LBW and placental malaria. Results Among 1090 singleton live births, prevalence of placental malaria and LBW were 16% and 17% respectively. After adjustment, there was a non-significant association between placental malaria and LBW (adjusted OR = 1.43; P = 0.10). Multiple linear regression showed a positive association between placental malaria and decreased birth weight in primigravidae. More than 98% of the women reported regular chemoprophylaxis and CQ was detectable in 99% of urine samples. Protection from LBW was high in women reporting regular CQ prophylaxis, with a strong duration-effect relationship (test for linear trend: P < 0,001). Conclusion Despite high parasite resistance and limited effect on placental malaria, a CQ chemoprophylaxis taken at adequate doses showed to be still effective in reducing LBW in Benin. PMID:17341298

  11. Addressing diarrhea prevalence in the West African Middle Belt: social and geographic dimensions in a case study for Benin.

    PubMed

    Pande, Saket; Keyzer, Michiel A; Arouna, Aminou; Sonneveld, Ben G J S

    2008-04-23

    In West Africa, the Northern Sahelian zone and the coastal areas are densely populated but the Middle Belt in between is in general sparsely settled. Predictions of climate change foresee more frequent drought in the north and more frequent flooding in the coastal areas, while conditions in the Middle Belt will remain moderate. Consequently, the Middle Belt might become a major area for immigration but there may be constraining factors as well, particularly with respect to water availability. As a case study, the paper looks into the capacity of the Middle Belt zone of Benin, known as the Oueme River Basin (ORB), to reduce diarrhea prevalence. In Benin it links to the Millennium Development Goals on child mortality and environmental sustainability that are currently farthest from realization. However, diarrhea prevalence is only in part due to lack of availability of drinking water from a safe source. Social factors such as hygienic practices and poor sanitation are also at play. Furthermore, we consider these factors to possess the properties of a local public good that suffers from under provision and requires collective action, as individual actions to prevent illness are bound to fail as long as others free ride. Combining data from the Demographic Health Survey with various spatial data sets for Benin, we apply mixed effect logit regression to arrive at a spatially explicit assessment of geographical and social determinants of diarrhea prevalence. Starting from an analysis of these factors separately at national level, we identify relevant proxies at household level, estimate a function with geo-referenced independent variables and apply it to evaluate the costs and impacts of improving access to good water in the basin. First, the study confirms the well established stylized fact on the causes of diarrhea that a household with access to clean water and with good hygienic practices will, irrespective of other conditions, not suffer diarrhea very often. Second

  12. Assessment of noise levels generated by music shops in an urban city in Nigeria.

    PubMed

    Ebare, M N; Omuemu, V O; Isah, E C

    2011-09-01

    To assess the level of noise generated by music shops in an urban city in Nigeria. Cross-sectional, descriptive study. The study involved music shops in three out of eight identified clusters of market areas in Benin City. A semi-structured, researcher-administered questionnaire was also used to collect data from music shop owners. Noise levels generated by speakers in the music shops were measured using a sound level meter, and blood pressure measurements were taken with a mercury sphygmomanometer. Of the 250 music shops studied, more than 90.0% generated noise levels >85 dB, and 54.8% had a continuous pattern of noise. Longer duration of working years was significantly associated with decreased hearing (P = 0.01), shouting when talking (P = 0.04) and high blood pressure (P = 0.003). The position of music dealers in relation to the speakers was significantly associated with shouting when talking (P = 0.000). A significant association was found between higher levels of noise and high blood pressure (P = 0.004). This study found very high levels of noise in music shops, which could be a source of occupational noise exposure among music dealers. Enlightenment campaigns on the hazards of exposure to loud noise and periodic audiometry examinations are recommended for this occupational group. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  13. [Promoting the sustainable management of hospital waste in Kinshasa].

    PubMed

    Kasuku, Wanduma; Bouland, Catherine; De Brouwer, Christophe; Mareschal, Bertrand; Mulaji, Crispin

    2016-11-01

    The management of hospital waste is a high-risk practice in the hospitals of Kinshasa, the largest city of the Democratic Republic of the Congo, from the point of view of public health and the environment. A multi-criteria study carried out in 4 hospitals assessed the situation and put forward solutions. Copyright © 2016. Publié par Elsevier Masson SAS.

  14. Secondhand smoke exposure in hospitality venues in Europe.

    PubMed

    Lopez, Maria J; Nebot, Manel; Albertini, Marco; Birkui, Pierre; Centrich, Francesc; Chudzikova, Monika; Georgouli, Maria; Gorini, Giuseppe; Moshammer, Hanns; Mulcahy, Maurice; Pilali, Maria; Serrahima, Eulalia; Tutka, Piotr; Fernandez, Esteve

    2008-11-01

    Although in the last few years some European countries have implemented smoking bans in hospitality venues, the levels of secondhand smoke (SHS) in this occupational sector could still be extremely high in most countries. The aim of this study was to assess exposure to SHS in hospitality venues in 10 European cities. We included 167 hospitality venues (58 discotheques and pubs, 82 restaurants and cafeterias, and 27 fast-food restaurants) in this cross-sectional study. We carried out fieldwork in 10 European cities: Vienna (Austria), Paris (France), Athens (Greece), Florence and Belluno (Italy), Galway (Ireland), Barcelona (Spain), Warsaw and Lublin (Poland), and Bratislava (Slovak Republic). We measured vapor-phase nicotine as an SHS marker. We analyzed 504 samples and found nicotine in most samples (97.4%). We found the highest median concentrations in discos/pubs [32.99 microg/m(3); interquartile range (IQR), 8.06-66.84 microg/m(3)] and lower median concentrations in restaurants/cafeterias (2.09 microg/m(3); IQR, 0.49-6.73 microg/m(3)) and fast-food restaurants (0.31 microg/m(3); IQR, 0.11-1.30 microg/m(3)) (p < 0.05). We found differences of exposure between countries that may be related to their smoking regulations. Where we sampled smoking and nonsmoking areas, nicotine concentrations were significantly lower in nonsmoking areas. Hospitality venues from European cities without smoking regulations have very high levels of SHS exposure. Monitoring of SHS on a regular basis as well as a total smoking ban in hospitality sector would be needed.

  15. Farmers' perception of termites in agriculture production and their indigenous utilization in Northwest Benin.

    PubMed

    Yêyinou Loko, Laura Estelle; Orobiyi, Azize; Agre, Paterne; Dansi, Alexandre; Tamò, Manuele; Roisin, Yves

    2017-11-21

    Although termites are considered as agricultural pests, they play an important role in maintaining the ecosystem. Therefore, it matters to investigate the farmers' perception of the impacts of the termites on the agriculture and their indigenous utilization. A semi-structured questionnaire was used to interview 94 farmers through 10 villages of Atacora department, in the northwestern region of Benin, to obtain information for the development of successful strategies of termite management and conservation. Their perceptions on the importance and management of termites along with the indigenous nomenclature and utilization of termite mounds were assessed. Termite species identified by farmers were collected and preserved in 80% alcohol for identification. Eight crops were identified by farmers as susceptible to termites with maize, sorghum, and yam as being the most susceptible. According to farmers, the susceptibility to termites of these crops is due to their high-water content and sweet taste. A total of 27 vernacular names of termites were recorded corresponding to 10 species, Amitermes evuncifer, Macrotermes subhyalinus, and Trinervitermes oeconomus being the most damaging termite species. All the names given to termite species had a meaning. The drought was identified by farmers as the main factor favouring termite attacks. Demolition of termite mounds in the fields was the most commonly reported control method. Salt and other pesticides were commonly used by farmers to protect stored farm products. The lack of effective control methods is the main constraint for termite management. In northwestern Benin, farmers reported different purpose utilizations of termite mounds and termites. The study has shown that farmers perceived termites as pests of several agricultural crops and apply various indigenous control practices whose efficiency need to be verified. Utilization of termites and termite mound soil as food and medicinal resources underlines the need for a

  16. Screening for common mental disorders and substance abuse among temporary hired cleaners in Egyptian Governmental Hospitals, Zagazig City, Sharqia Governorate.

    PubMed

    Abbas, R A; Hammam, R A M; El-Gohary, S S; Sabik, L M E; Hunter, M S

    2013-01-01

    Informal employment is common in developing countries, including Egypt. This type of employment may have significant consequences on mental health. To determine the prevalence and risk factors of common mental disorders and substance abuse among temporary hired hospital cleaners. A cross-sectional study was conducted on 242 adult temporary cleaners and 209 permanent cleaners working in 4 governmental hospitals in Zagazig City, Sharqia Governorate, Egypt. All participants were invited to complete a structured questionnaire through a semi-structured interview which included the self-reporting questionnaire 20 items (SRQ-20) and the work stress scale. Assessment of drug use included urine-based screening tests for common substances abused. The prevalence of job stress, common mental disorders and substance abuse, particularly tramadol and cannabis (Bango), was significantly higher in the studied temporary cleaners compared to permanent cleaners. Risk factors associated with increased susceptibility of the temporary cleaners to common mental disorders were family history of substance abuse, high crowding index, history of physical illness, low educational level, and smoking; while being unmarried, male sex, family history of mental disorder, age ≥40 years, smoking, and length of service ≥8 years, were associated with substance abuse among the same group. Temporary hired hospital cleaners suffered from impaired mental health more than permanent cleaners. Therefore, expanding the coverage of current laws and occupational safety and health standards to cover workers in the informal sector especially in developing countries is recommended.

  17. Clinical Outcome, Social Impact and Patient Expectation: a Purposive Sampling Pilot Evaluation of Patients in Benin Seven Years After Surgery.

    PubMed

    White, Michelle C; Randall, Kirsten; Avara, Esther; Mullis, Jenny; Parker, Gary; Shrime, Mark G

    2018-05-01

    Access to affordable and timely surgery is not equitable around the world. Five billion people lack access, and while non-governmental organizations (NGOs) help to meet this need, long-term surgical outcomes, social impact or patient experience is rarely reported. In 2016, Mercy Ships, a surgical NGO, undertook an evaluation of patients who had received surgery seven years earlier with Mercy Ships in 2009 in Benin. Using purposive sampling, patients who had received maxillofacial, plastics or orthopedic surgery were invited to attend a surgical evaluation day. In this pilot study, we used semi-structured interviews and questionnaire responses to assess patient expectation, surgical and social outcome. Our results show that seven years after surgery 35% of patients report surgery-related pain and 18% had sought further care for a clinical complication of their condition. However, 73% of patients report gaining social benefit from surgery, and overall patient satisfaction was 89%, despite 35% of patients saying that they were unclear what to expect after surgery indicating a mismatch of doctor/patient expectations and failure of the consent process. In conclusion, our pilot study shows that NGO surgery in Benin provided positive social impact associated with complication rates comparable to high-income countries when assessed seven years later. Key areas for further study in LMICs are: evaluation and treatment of chronic pain, consent and access to further care.

  18. Direct cost of dengue hospitalization in Zhongshan, China: Associations with demographics, virus types and hospital accreditation.

    PubMed

    Zhang, Jing Hua; Yuan, Juan; Wang, Tao

    2017-08-01

    Zhongshan City of Guangdong Province (China) is a key provincial and national level area for dengue fever prevention and control. The aim of this study is to analyze how the direct hospitalization costs and the length of stay of dengue hospitalization cases vary according to associated factors such as the demographics, virus types and hospital accreditation. This study is based on retrospective census data from the Chinese National Disease Surveillance Reporting System. Totally, the hospital administrative data of 1432 confirmed dengue inpatients during 2013-2014 was obtained. A quantile regression model was applied to analyze how the direct cost of Dengue hospitalization varies with the patient demographics and hospital accreditation across the data distribution. The Length of Stay (LOS) was also examined. The average direct hospitalization cost of a dengue case in this study is US$ 499.64 during 2013, which corresponded to about 3.71% of the gross domestic product per capita in Zhongshan that year. The mean of the Length of Stay (LOS) is 7.2 days. The multivariate quantile regression results suggest that, after controlling potential compounding variables, the median hospitalization costs of male dengue patients were significantly higher than female ones by about US$ 18.23 (p<0.1). The hospitalization cost difference between the pediatric and the adult patients is estimated to be about US$ 75.25 at the median (p<0.01), but it increases sharply among the top 25 percentiles and reaches US$ 329 at the 90th percentile (p<0.01). The difference between the senior (older than 64 years old) and the adult patients increases steadily across percentiles, especially sharply among the top quartiles too. The LOS of the city-level hospitals is significantly shorter than that in the township-level hospitals by one day at the median (p<0.05), but no significant differences in their hospitalization costs. The direct hospitalization costs of dengue cases vary widely according to the

  19. Patient choice modelling: how do patients choose their hospitals?

    PubMed

    Smith, Honora; Currie, Christine; Chaiwuttisak, Pornpimol; Kyprianou, Andreas

    2018-06-01

    As an aid to predicting future hospital admissions, we compare use of the Multinomial Logit and the Utility Maximising Nested Logit models to describe how patients choose their hospitals. The models are fitted to real data from Derbyshire, United Kingdom, which lists the postcodes of more than 200,000 admissions to six different local hospitals. Both elective and emergency admissions are analysed for this mixed urban/rural area. For characteristics that may affect a patient's choice of hospital, we consider the distance of the patient from the hospital, the number of beds at the hospital and the number of car parking spaces available at the hospital, as well as several statistics publicly available on National Health Service (NHS) websites: an average waiting time, the patient survey score for ward cleanliness, the patient safety score and the inpatient survey score for overall care. The Multinomial Logit model is successfully fitted to the data. Results obtained with the Utility Maximising Nested Logit model show that nesting according to city or town may be invalid for these data; in other words, the choice of hospital does not appear to be preceded by choice of city. In all of the analysis carried out, distance appears to be one of the main influences on a patient's choice of hospital rather than statistics available on the Internet.

  20. Prevalence of Methicillin-Resistant Staphylococcus aureus and Other Staphylococcus Species in Raw Meat Samples Intended for Human Consumption in Benin City, Nigeria: Implications for Public Health.

    PubMed

    Igbinosa, Etinosa O; Beshiru, Abeni; Akporehe, Lucy U; Oviasogie, Faith E; Igbinosa, Owen O

    2016-09-24

    The present study was designed to characterize methicillin-resistant staphylococci from raw meat. A total of 126 meat samples were obtained from open markets between February and April, 2015. Antimicrobial susceptibility testing was carried out using the disc diffusion method. Molecular profiling was conducted using 16S rRNA, mecA, nuc, and PVL gene signatures were detected by polymerase chain reaction assay. Fifty isolates of methicillin-resistant Staphylococcus spp. were detected in 26 (52%) pork, 14 (28%) beef and 10 (20%) chicken samples. The staphylococcal isolates were identified through partial 16S ribosomal ribonucleic acid (16S rRNA) nucleotide sequencing, and BLAST analysis of the gene sequence revealed 98%-100% staphylococcal similarity. All isolates from beef and chicken samples amplified the mecA gene, while 100% of the MRSA isolates amplified the PVL gene. The multidrug resistance profile (resistant to ≥1 antimicrobial agent in ≥3 classes of antimicrobial agents) of the staphylococcal isolates showed that 7 isolates were resistant to methicillin, penicillin, clindamycin, chloramphenicol, trimethoprim-sulfamethoxazole, kanamycin, amoxicillin, cloxacillin, erythromycin, vancomycin, and gentamycin. There was a significant regression effect from the multidrug-resistant profile on the number of isolates (p < 0.05) suggesting a consequence of the dissemination of resistant strains within bacterial populations. The findings of the present study indicate that raw meats in the Benin metropolis were possibly contaminated with pathogenic and multi-drug resistant staphylococci strains and therefore could constitute a risk to public health communities.

  1. Cotton Dust Exposure and Respiratory Disorders among Textile Workers at a Textile Company in the Southern Part of Benin.

    PubMed

    Hinson, Antoine Vikkey; Lokossou, Virgil K; Schlünssen, Vivi; Agodokpessi, Gildas; Sigsgaard, Torben; Fayomi, Benjamin

    2016-09-08

    The textile industry sector occupies a prominent place in the economy of Benin. It exposes workers to several occupational risks, including exposure to cotton dust. To assess the effect of exposure to cotton dust on the health of workers, this study was initiated and conducted in a Beninese cotton industry company. The objective of the study was to evaluate the respiratory disorders among the textile workers exposed to cotton dust and the cross-sectional study involved 656 subjects exposed to cotton dust and 113 non-exposed subjects. The methods used are mainly based on a survey using a questionnaire of organic dust designed by the International Commission of Occupational Health (ICOH); and on the measures of lung function parameters (FEV₁ and FVC). The main results of the different analyzes revealed that subjects exposed to cotton dust have more respiratory symptoms than unexposed subjects (36.9% vs. 21.2%). The prevalence of chronic cough, expectorations, dyspnoea, asthma and chronic bronchitis are 16.8%, 9.8%, 17.3%, 2.6%, and 5.9% respectively among the exposed versus 2.6%, 0.8%, 16.8%, 0% and 0.8% among the unexposed subjects. The prevalence of byssinosis is 44.01%.The prevalence of symptoms is dependent on the sector of activity and the age of the subject. These results should encourage medical interventions and technical prevention especially since the textile industry occupies an important place in the Benin's economy.

  2. [The evaluation of the integral water treatment system of a general hospital in Mexico City].

    PubMed

    Juárez-Mendoza, J; Martínez-Rosales, G; Díaz-Sánchez, J; Pérez-Guadarrama, M de L; Brust-Carmona, H

    1990-01-01

    The Mexican Health Office (SSA) promotes the use and progeny of the appropriate technology for the bacteriological quality evaluation and disinfect the water by means of the in situ progeny of the clorus and ozonus gases when needed, for the human consumption in suburban and rural communities. The clorus water disinfecting conventional methods by many reasons are useless, even in urbanized cities. CEDAT has built and design a group of apparatus, called: "Water treatment whole equipment for small communities", and it's build up by: Membrane Filter, Double Chamber Incubator, ultraviolet Light Sterilizer and a clorus and ozonus progenic gas electrolytic cell with CA and CD power box and a Venturi Tube. The electrolytic cell raw material is the sodium chlorine (salt) water mixed. The evaluation of these equipment was made at the Manuel Gea González Medical Doctor General Hospital. During 38 days there was a daily measure of chlorine sewage in six different parts of the hospital. It was used the cellulose membrane filter technic with a 0.45 mm porus and a sowing in M-Endo and M-FC Broth cultivation was in a 37 and 44 centigrade incubation. The first 10 days chlorine sewage was found, the last 28 weren't measurable. Total coliforms in 23 of 42, 7 days samples and excrement coliforms in 5 of 18, 3 days samples, were developed during the 38 days period. The electrolytic cell was settled for the water gas measure up in its way to the reservoir. Afterwards chlorine sewage was measured from 0.2 mg/l to 1 mg/l in all the sample parts. No germ kind was discovered during the 10 days sampling.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. All-Round Marketing Increases Hospital Popularity.

    PubMed

    Ziqi, Tao

    2015-06-01

    Xuzhou Center Hospital is in a competing medical market in Xuzhou city. This hospital has been dedicating to improve the medical skills and provide professional and individualized service to the patients in order to improve the patient's experience and increase the patient's satisfaction. On the other side, this hospital has provided an all-round marketing campaign to build up the social influence and public reputation through public-praise marketing, web marketing, media marketing, and scholar marketing. Besides, this hospital has been cooperating with foreign medical institutions and inviting foreign medical specialists to academic communication. With the combined effects of improving medical service and all-round marketing, the hospital's economic performance has been enhanced significantly and laid a solid foundation for its ambition to become the first-class hospital in Huaihai Economic Zone.

  4. Hartford Hospital surgeons share publicity with robot 'assistants.'.

    PubMed

    Botvin, Judith D

    2004-01-01

    Hartford Hospital, Hartford, Conn. finds some patients gravitate to Boston or New York City for high-tech procedures. Being the first Connecticut hospital with the daVinci Robotic Surgery System, it developed an advertising campaign emphasizing high-tech surgery with the human touch. Hartford also broadcast a robotic prostatectomy on its popular live webcast series.

  5. From local hydrological process analysis to regional hydrological model application in Benin: Concept, results and perspectives

    NASA Astrophysics Data System (ADS)

    Bormann, H.; Faß, T.; Giertz, S.; Junge, B.; Diekkrüger, B.; Reichert, B.; Skowronek, A.

    This paper presents the concept, first results and perspectives of the hydrological sub-project of the IMPETUS-Benin project which is part of the GLOWA program funded by the German ministry of education and research. In addition to the research concept, first results on field hydrology, pedology, hydrogeology and hydrological modelling are presented, focusing on the understanding of the actual hydrological processes. For analysing the processes a 30 km 2 catchment acting as a super test site was chosen which is assumed to be representative for the entire catchment of about 15,000 km 2. First results of the field investigations show that infiltration, runoff generation and soil erosion strongly depend on land cover and land use which again influence the soil properties significantly. A conceptual hydrogeological model has been developed summarising the process knowledge on runoff generation and subsurface hydrological processes. This concept model shows a dominance of fast runoff components (surface runoff and interflow), a groundwater recharge along preferential flow paths, temporary interaction between surface and groundwater and separate groundwater systems on different scales (shallow, temporary groundwater on local scale and permanent, deep groundwater on regional scale). The findings of intensive measurement campaigns on soil hydrology, groundwater dynamics and soil erosion have been integrated into different, scale-dependent hydrological modelling concepts applied at different scales in the target region (upper Ouémé catchment in Benin, about 15,000 km 2). The models have been applied and successfully validated. They will be used for integrated scenario analyses in the forthcoming project phase to assess the impacts of global change on the regional water cycle and on typical problem complexes such as food security in West African countries.

  6. [Place of vulvovaginal candidiasis in the lower genital tract infections and associated risk factors among women in Benin].

    PubMed

    Ogouyèmi-Hounto, A; Adisso, S; Djamal, J; Sanni, R; Amangbegnon, R; Biokou-Bankole, B; Kinde Gazard, D; Massougbodji, A

    2014-06-01

    Determine the place of vulvo-vaginal candidiasis (VVC) in the lower genital infections and seek risk factors among women in Benin. The study was conducted in the laboratory of mycology of Hôpital de la Mère et de l'Enfant Lagune (Homel) from 1st March to 31st July, 2013. It involved all the women who were asked a vaginal swab and gave their consent in written form. After administration of a questionnaire, the vaginal samples were collected with sterile cotton swabs for a test with potassium hydroxide, an estimation of vaginal pH, direct microscopic examination, fresh, and after a Gram stain and culture on Sabouraud-chloramphenicol, ordinary agar and fresh blood agar. One hundred and thirty-one women were included in the study period. Clinical signs were dominated by vaginal discharge (74.8%), followed by vulvar pruritus (51.9%) and dyspareunia (36.6%). Culture on Sabouraud was positive in 51 cases or 38.9%. Candida albicans was isolated in 96.1% of cases, against 3.9% of Candida glabrata. The risk factors involved were: pregnancy, antibiotics, synthetic underclothing and frequent wearing tight pants. In addition of Candida, Gardnerella vaginalis was found in 36.6% of samples with an association with C. albicans in 28.2% of cases. This study showed that vulvovaginal candidiasis is the leading cause of lower genital tract infections in women in Benin with involvement of several risk factors which research is needed to develop appropriate preventive measures. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  7. Hospitals and Health Maintenance Organizations: An Analysis of the Minneapolis-St. Paul Experience

    PubMed Central

    Morrisey, Michael A.; Gibson, Geoffrey; Ashby, Cynthia S.

    1983-01-01

    Minneapolis-St. Paul is recognized as a prime example of health care competition. Policymakers and others have been asked to look to the Twin Cities as a model upon which to base new competitive initiatives in the health care sector. Yet little is known about the impact of Health Maintenance Organizations (HMOs) on other health care providers. This study examines the effects of the area's seven health maintenance organizations on the local hospital community. Three questions are addressed. First, is the situation in the Twin Cities unique? A comparison of case study findings and the available literature together with hospital data from similarly HMO-penetrated markets suggests that the Twin Cities' hospital market is indeed different. Second, what is the nature of hospital-HMO interaction? The flexibility of contracting apparently allows hospitals to affiliate successfully with an HMO under a variety of service and reimbursement agreements. Third, what effect has HMO activity had on community-wide utilization? While HMO enrollees clearly use fewer hospital days and the trend in the community is toward fewer days, attributing the change to HMOs is difficult. A large portion of the differences between HMO and community-wide utilization levels is attributable to differences in population. PMID:10309856

  8. Charity Hospital: from the beginning to either a new beginning or the end.

    PubMed

    Hoover, Eddie L

    2007-05-01

    Through epidemics, wars, hurricanes, pirates and politics, Charity Hospital has served the indigent population of New Orleans and Louisiana since May 10, 1736 as the second oldest continuing public hospital in the country following Bellevue in New York City, which opened six weeks earlier on March 31, 1736. The first Charity facility was financed by the estate of boat builder Jean Louis, whose will recorded, "a sale shall be made of all that remains, which, together with my small lot, I bequeath to serve in perpetuity to the founding of a hospital for the sick of the City of New Orleans...".

  9. Project Return and Babygram Hospital Outreach, 1993-94.

    ERIC Educational Resources Information Center

    Weiler, Jeanne

    Project Return, a dropout recovery program to assist pregnant and parenting teenagers and parents of elementary school children to return to school, was first implemented in 1989-90, and by 1993-94 had expanded to serve 19 sites in New York City. The Babygram Hospital Outreach program, an outgrowth of Project Return, operated in 12 hospitals and…

  10. 75 FR 11580 - Florida Power Corporation, City of Alachua, City of Bushnell, City of Gainesville, City of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-11

    ...- 0096] Florida Power Corporation, City of Alachua, City of Bushnell, City of Gainesville, City of Kissimmee, City of Leesburg, City of New Smyrna Beach and Utilities Commission, City of New Smyrna Beach, City of Ocala, Orlando Utilities Commission and City of Orlando, Seminole Electric Cooperative, Inc...

  11. Secondhand Smoke Exposure in Hospitality Venues in Europe

    PubMed Central

    Lopez, Maria J.; Nebot, Manel; Albertini, Marco; Birkui, Pierre; Centrich, Francesc; Chudzikova, Monika; Georgouli, Maria; Gorini, Giuseppe; Moshammer, Hanns; Mulcahy, Maurice; Pilali, Maria; Serrahima, Eulalia; Tutka, Piotr; Fernandez, Esteve

    2008-01-01

    Background Although in the last few years some European countries have implemented smoking bans in hospitality venues, the levels of secondhand smoke (SHS) in this occupational sector could still be extremely high in most countries. Objective The aim of this study was to assess exposure to SHS in hospitality venues in 10 European cities. Methods We included 167 hospitality venues (58 discotheques and pubs, 82 restaurants and cafeterias, and 27 fast-food restaurants) in this cross-sectional study. We carried out fieldwork in 10 European cities: Vienna (Austria), Paris (France), Athens (Greece), Florence and Belluno (Italy), Galway (Ireland), Barcelona (Spain), Warsaw and Lublin (Poland), and Bratislava (Slovak Republic). We measured vapor-phase nicotine as an SHS marker. Results We analyzed 504 samples and found nicotine in most samples (97.4%). We found the highest median concentrations in discos/pubs [32.99 μg/m3; interquartile range (IQR), 8.06–66.84 μg/m3] and lower median concentrations in restaurants/cafeterias (2.09 μg/m3; IQR, 0.49–6.73 μg/m3) and fast-food restaurants (0.31 μg/m3; IQR, 0.11–1.30 μg/m3) (p < 0.05). We found differences of exposure between countries that may be related to their smoking regulations. Where we sampled smoking and nonsmoking areas, nicotine concentrations were significantly lower in nonsmoking areas. Conclusions Hospitality venues from European cities without smoking regulations have very high levels of SHS exposure. Monitoring of SHS on a regular basis as well as a total smoking ban in hospitality sector would be needed. PMID:19057698

  12. Comparison of two different running models for the shock wave lithotripsy machine in Taipei City Hospital: self-support versus outsourcing cooperation.

    PubMed

    Huang, Chi-Yi; Chen, Shiou-Sheng; Chen, Li-Kuei

    2009-10-01

    To compare two different running models including self-support and outsourcing cooperation for the extracorporeal shock wave lithotripsy (SWL) machine in Taipei City Hospital, we made a retrospective study. Self-support means that the hospital has to buy an SWL machine and get all the payment from SWL. In outsourcing cooperation, the cooperative company provides an SWL machine and shares the payment with the hospital. Between January 2002 and December 2006, we used self-support for the SWL machine, and from January 2007 to December 2008, we used outsourcing cooperation. We used the method of full costing to calculate the cost of SWL, and the break-even point was the lowest number of treatment sessions of SWL to make balance of payments every month. Quality parameters including stone-free rate, retreatment rate, additional procedures and complication rate were evaluated. When outsourcing cooperation was used, there were significantly more treatment sessions of SWL every month than when utilizing self-support (36.3 +/- 5.1 vs. 48.1 +/- 8.4, P = 0.03). The cost of SWL for every treatment session was significantly higher using self-support than with outsourcing cooperation (25027.5 +/- 1789.8 NT$ vs. 21367.4 +/- 201.0 NT$). The break-even point was 28.3 (treatment sessions) for self-support, and 28.4 for outsourcing cooperation, when the hospital got 40% of the payment, which would decrease if the percentage increased. No significant differences were noticed for stone-free rate, retreatment rate, additional procedures and complication rate of SWL between the two running models. Besides, outsourcing cooperation had lower cost (every treatment session), but a greater number of treatment sessions of SWL every month than self-support.

  13. Assessment of Utilization and Cost-Effectiveness of Telemedicine Program in Western Regions of China: A 12-Year Study of 249 Hospitals Across 112 Cities.

    PubMed

    Wang, Ting-Ting; Li, Jin-Mei; Zhu, Cai-Rong; Hong, Zhen; An, Dong-Mei; Yang, Hong-Yu; Ren, Jie-Chuan; Zou, Xue-Mei; Huang, Cheng; Chi, Xiao-Sa; Chen, Jia-Ni; Hong, Zhen; Wang, Wen-Zhi; Xu, Cai-Gang; He, Li; Li, Wei-Min; Zhou, Dong

    2016-11-01

    The imbalance in healthcare between urban and rural areas is still a problem in China. In recent decades, China has aimed to develop telemedicine. We assessed the implementation, utilization, and cost-effectiveness of a large telemedicine program across western China. In 2002-2013, a government-sponsored major telemedicine program was established by West China Hospital of Sichuan University (hub), covering 249 spoke hospitals in 112 cities throughout western China and in 40 medical expertise areas. We analyzed the cross-sectional data from 11,987 consultations conducted at West China Hospital using the telemedicine network over a 12-year period. The types of diseases as well as the diagnosis and treatment changes were assessed. We also performed a cost-savings analysis and a one-way sensitivity analysis. Of the 11,987 teleconsultations, we noted that neoplasms (19.4%), injuries (13.9%), and circulatory diseases (10.3%) were the three most common diagnoses. Teleconsultations resulted in a change of diagnosis in 4,772 (39.8%) patients, and 3,707 (77.7%) of them underwent major diagnosis changes. Moreover, it led to a change of treatment in 6,591 (55.0%) patients, including 3,677 (55.8%) changes not linked to diagnosis changes. The telemedicine network resulted in an estimated net saving of $2,364,525 (if the patients traveled to the hub) or $3,759,014 (if the specialists traveled to the spoke hospitals). The introduction of telemedicine in China, linking highly specialized major hospitals (hub) with hundreds of small rural hospitals (spoke), can greatly improve the quality, efficiency, and cost-effectiveness of healthcare delivery and utilization. This new Internet-based healthcare model should be utilized more widely in developing countries.

  14. Association between Ambient Temperatures and Mental Disorder Hospitalizations in a Subtropical City: A Time-Series Study of Hong Kong Special Administrative Region.

    PubMed

    Chan, Emily Y Y; Lam, Holly C Y; So, Suzanne H W; Goggins, William B; Ho, Janice Y; Liu, Sida; Chung, Phoebe P W

    2018-04-14

    Background : Mental disorders have been found to be positively associated with temperature in cool to cold climatic regions but the association in warmer regions is unclear. This study presented the short-term association between temperatures and mental disorder hospitalizations in a subtropical city with a mean annual temperature over 21 °C. Methods : Using Poisson-generalized additive models and distributed-lagged nonlinear models, daily mental disorder hospitalizations between 2002 and 2011 in Hong Kong were regressed on daily mean temperature, relative humidity, and air pollutants, adjusted for seasonal trend, long-term trend, day-of-week, and holiday. Analyses were stratified by disease class, gender and age-group. Results : 44,600 admissions were included in the analysis. Temperature was positively associated with overall mental-disorder hospitalizations (cumulative relative risk at 28 °C vs. 19.4 °C (interquartile range, lag 0-2 days) = 1.09 (95% confidence interval 1.03, 1.15)), with the strongest effect among the elderly (≥75 years old). Transient mental disorders due to conditions classified elsewhere and episodic mood disorders also showed strong positive associations with temperature. Conclusion : This study found a positive temperature-mental-disorder admissions association in a warm subtropical region and the association was most prominent among older people. With the dual effect of global warming and an aging population, targeted strategies should be designed to lower the disease burden.

  15. Nutritional Characteristics of Forage Grown in South of Benin

    PubMed Central

    Musco, Nadia; Koura, Ivan B.; Tudisco, Raffaella; Awadjihè, Ghislain; Adjolohoun, Sebastien; Cutrignelli, Monica I.; Mollica, Maria Pina; Houinato, Marcel; Infascelli, Federico; Calabrò, Serena

    2016-01-01

    In order to provide recommendations on the most useful forage species to smallholder farmers, eleven grass and eleven legume forages grown in Abomey-Calavi in Republic of Benin were investigated for nutritive value (i.e. chemical composition and energy content) and fermentation characteristics (i.e. gas and volatile fatty acid production, organic matter degradability). The in vitro gas production technique was used, incubating the forages for 120 h under anaerobic condition with buffalo rumen fluid. Compared to legume, tropical grass forages showed lower energy (8.07 vs 10.57 MJ/kg dry matter [DM]) and crude protein level (16.10% vs 19.91% DM) and higher cell wall content (neutral detergent fiber: 63.8% vs 40.45% DM), respectively. In grass forages, the chemical composition showed a quite high crude protein content; the in vitro degradability was slightly lower than the range of tropical pasture. The woody legumes were richer in protein and energy and lower in structural carbohydrates than herbaceous plants, however, their in vitro results are influenced by the presence of complex compounds (i.e. tannins). Significant correlations were found between chemical composition and in vitro fermentation characteristics. The in vitro gas production method appears to be a suitable technique for the evaluation of the nutritive value of forages in developing countries. PMID:26732328

  16. Stress Management and Relaxation Techniques use among underserved inpatients in an inner city hospital.

    PubMed

    Gardiner, Paula; Sadikova, Ekaterina; Filippelli, Amanda C; Mitchell, Suzanne; White, Laura F; Saper, Robert; Kaptchuk, Ted J; Jack, Brian W; Fredman, Lisa

    2015-06-01

    Little is known about the use of Stress Management and Relaxation Techniques (SMART) in racially diverse inpatients. We hope to identify socioeconomic status (SES) factors, health behavior factors, and clinical factors associated with the use of SMART. We conducted a secondary analysis of baseline data from 623 hospitalized patients enrolled in the Re-Engineered Discharge (RED) clinical trial. We assessed socio-demographic characteristics and use of SMART. We used bivariate and multivariate logistic regression to test the association of SMART with socio-demographic characteristics, health behaviors, and clinical factors. A total of 26.6% of participants reported using SMART and 23.6% used mind body techniques. Thirty six percent of work disabled patients, 39% of illicit drug users, and 38% of participants with depressive symptoms used SMART. Patients who both reported illicit drug use and screened positive for depression had significantly increased odds of using SMART [OR=4.94, 95% CI (1.59, 15.13)]. Compared to non-Hispanic whites, non-Hispanic blacks [0.55 (0.34-0.87)] and Hispanic/other race individuals [0.40 (0.20-0.76)] were less likely to use SMART. We found greater utilization of SMART among all racial groups compared to previous national studies. In the inner city inpatient setting, patients with depression, illicit drug use, and work disability reported higher rates of using SMART. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Statement of Facts for 1982 City-Wide Mock Trial Competitions. Vincent Taylor, Plaintiff v. Lance Memorial Hospital for Women, Raymond Miller, M.D., and Dorothy Dillon, R.N., Defendants. No. MT-82.

    ERIC Educational Resources Information Center

    National Inst. for Citizen Education in the Law, Washington, DC.

    Prepared by the District of Columbia Street Law Project for its 11th annual city-wide mock trial competition, this instructional handout provides material for a civil trial over a disputed discriminatory termination of employment. Vincent Taylor claims that the Lance Memorial Hospital for Women fired him on the basis of his sex. The hospital…

  18. Land use scenarios development and impacts assessment on vegetation carbon/nitrogen sequestration in the West African Sudan savanna watershed, Benin

    NASA Astrophysics Data System (ADS)

    Chabi, A.

    2015-12-01

    ackground: Reduced Emissions from Deforestation and Degradation (REDD+), being developed through the United Nations Framework Convention on Climate Change (UNFCCC) requires information on the carbon/nitrogen stocks in the plant biomass for predicting future climate under scenarios development. The development of land use scenarios in West Africa is needed to predict future impacts of change in the environment and the socio-economic status of rural communities. The study aims at developing land use scenario based on mitigation strategy to climate change as an issue of contributing for carbon and nitrogen sequestration, the condition 'food focused' as a scenario based crop production and 'financial investment' as scenario based on an economic development pathway, and to explore the possible future temporal and spatial impacts on vegetation carbon/nitrogen sequestration/emission and socio-economic status of rural communities. Preliminary results: BEN-LUDAS (Benin-Land Use DyNamic Simulator) model, carbon and nitrogen equations, remote sensing and socio-economic data were used to predict the future impacts of each scenario in the environment and human systems. The preliminary results which are under analysis will be presented soon. Conclusion: The proposed BEN-LUDAS models will help to contribute to policy decision making at the local and regional scale and to predict future impacts of change in the environment and socio-economic status of the rural communities. Keywords: Land use scenarios development, BEN-LUDAS, socio-economic status of rural communities, future impacts of change, assessment, West African Sudan savanna watershed, Benin

  19. Auckland City Hospital's Ortho-Geriatric Service: an audit of patients aged over 65 with fractured neck of femur.

    PubMed

    Wimalasena, Bodhi; Harris, Roger

    2016-07-01

    The aims of this audit were to collect the Minimum Data Set outlined by the Australia New Zealand Hip Fracture Registry (ANZHFR), assess patient characteristics, analyse process of care, and evaluate how this compares to NICE guidelines for hip fracture care, as well as to Auckland Hospital data from 2007. Retrospective case record audit of patients with fractured neck of femur aged 65 years and over admitted under Orthopaedics over a 4-month period in 2013. Ninety-one patients were audited; mean age was 83 years, 68% were female. Both inpatient and 30-day mortality was 5%. 120-day mortality was 15%. Seventy-six percent of patients were admitted from ED within the national health target prescribed period of 6 hours. Only one patient was treated non-surgically. Eighty-six percent had surgery within 48 hours of admission. Eighty-two percent of patients had rehabilitation and treatment by Older People's Health. Of those living at home pre-fracture, 76% returned home on discharge. Thirty-seven percent of patients were able to walk unaided prior to hip fracture, but only 1% on discharge. Average overall length of stay was 22 days. Bisphosphonates were prescribed for 56% of patients. Compared to 2007, Auckland City Hospital has demonstrated a significant improvement in the rate of provision of timely surgery for hip fracture patients. Most patients are receiving the guideline recommended fracture-specific surgical interventions. The assessment and treatment of osteoporosis needs further attention.

  20. Using information technology for an improved pharmaceutical care delivery in developing countries. Study case: Benin.

    PubMed

    Edoh, Thierry Oscar; Teege, Gunnar

    2011-10-01

    One of the problems in health care in developing countries is the bad accessibility of medicine in pharmacies for patients. Since this is mainly due to a lack of organization and information, it should be possible to improve the situation by introducing information and communication technology. However, for several reasons, standard solutions are not applicable here. In this paper, we describe a case study in Benin, a West African developing country. We identify the problem and the existing obstacles for applying standard ECommerce solutions. We develop an adapted system approach and describe a practical test which has shown that the approach has the potential of actually improving the pharmaceutical care delivery. Finally, we consider the security aspects of the system and propose an organizational solution for some specific security problems.

  1. Social structure of lions (Panthera leo) is affected by management in Pendjari Biosphere Reserve, Benin.

    PubMed

    Sogbohossou, Etotépé A; Bauer, Hans; Loveridge, Andrew; Funston, Paul J; De Snoo, Geert R; Sinsin, Brice; De Iongh, Hans H

    2014-01-01

    Lion populations have undergone a severe decline in West Africa. As baseline for conservation management, we assessed the group structure of lions in the Pendjari Biosphere Reserve in Benin. This reserve, composed of one National Park and two Hunting Zones, is part of the WAP transboundary complex of protected areas. Overall mean group size was 2.6±1.7 individuals (n = 296), it was significantly higher in the National Park (2.7±1.7, n = 168) than in the Hunting Zones (2.2±1.5, n = 128). Overall adult sex ratio was even, but significantly biased towards females (0.67) in the National Park and towards males (1.67) in the Hunting Zones. Our results suggest that the Pendjari lion population is affected by perturbations, such as trophy hunting.

  2. Quantification of uncertainties related to the regional application of a conceptual hydrological model in Benin (West Africa)

    NASA Astrophysics Data System (ADS)

    Bormann, H.; Diekkrüger, B.

    2003-04-01

    A conceptual model is presented to simulate the water fluxes of regional catchments in Benin (West Africa). The model is applied in the framework of the IMPETUS project (an integrated approach to the efficient management of scarce water resources in West Africa) which aims to assess the effects of environmental and anthropogenic changes on the regional hydrological processes and on the water availability in Benin. In order to assess the effects of decreasing precipitation and increasing human activities on the hydrological processes in the upper Ouémé valley, a scenario analysis is performed to predict possible changes. Therefore a regional hydrological model is proposed which reproduces the recent hydrological processes, and which is able to consider the changes of landscape properties.The study presented aims to check the validity of the conceptual and lumped model under the conditions of the subhumid tree savannah and therefore analyses the importance of possible sources of uncertainty. Main focus is set on the uncertainties caused by input data, model parameters and model structure. As the model simulates the water fluxes at the catchment outlet of the Térou river (3133 km2) in a sufficient quality, first results of a scenario analysis are presented. Changes of interest are the expected future decrease in amount and temporal structure of the precipitation (e.g. minus X percent precipitation during the whole season versus minus X percent precipitation in the end of the rainy season, alternatively), the decrease in soil water storage capacity which is caused by erosion, and the increasing consumption of ground water for drinking water and agricultural purposes. Resuming from the results obtained, the perspectives of lumped and conceptual models are discussed with special regard to available management options of this kind of models. Advantages and disadvantages compared to alternative model approaches (process based, physics based) are discussed.

  3. Nutritional Properties Assessment of Endogenous and Improved Varieties of Maize (Zea mays L.) Grown in Southern Benin.

    PubMed

    Josiane, Semassa Adjobignon; Bienvenu, Anihouvi Victor; Wilfried, Padonou Segla; Adolphe, Adjanohoun; Djima, Aly; Joachin, Gbenou; Lamine, Baba-Moussa

    2017-01-01

    A wide range of maize varieties is used in Benin but information on the nutritional characteristics of these varieties are not well known. This study aims to assess the nutritional composition of maize varieties in use in the southern region of Benin with the purpose of providing consumers accurate information for better choice. Moisture, ash, protein, fiber and fat contents were determined according to Association of Official Analytical Chemists and American Association of Cereal Chemists methods. Sugar and organic acids were assessed using High Performance Liquid Chromatography methods and amino acids profile was established according to Rosen method using glutamic acid. The maize varieties were classified into 5 clusters according to their macro nutrients composition and 4 clusters based on their sugar and organic acids contents. Varieties of group 5 were very rich in protein (14.34 g/100 g), while the highest fat content (7.22 g/100 g) was observed for group 2 varieties. The highest carbohydrate contents obtained were 80.64 g/100 g, 80.11 g/100 g and 79.15 g/100 g for groups 1, 4 and 5 varieties respectively. Moreover the dendrogram gave four homogeneous clusters according to sugars and organic acids composition. Varieties of groups 2, 3 and 4 had almost the same fructose contents ranging between 0.04 and 0.06%; varieties of group 1 contained the highest contents of raffinose, sucrose and glucose; those of group 2 were very rich in propionate and fructose. It is concluded that some of maize varieties investigated contained high level of protein. Furthermore glutamic acid was the predominant amino acid while the least amino acid was methionine. Those varieties, owing to their protein and amino acids contents could have many benefits by providing vital constituents to the body.

  4. Pre-AIDS mortality in the Edinburgh City Hospital HIV cohort.

    PubMed

    Seaman, S R; Brettle, R P; Gore, S M

    1997-11-15

    In this paper, we look at the incidence and predictive factors of pre-AIDS mortality among HIV-infected individuals, and injecting drug users (IDUs) in particular, and compare IDUs with non-IDUs. 627 patients (73 per cent IDUs) of the Edinburgh City Hospital HIV Cohort were enrolled pre-AIDS and followed up until September 1994. Analyses were performed using cumulative hazard and cumulative incidence estimators for a competing risks model, the Cox proportional hazards model and the non-parametric hazard estimator of Fusaro et al. (1993). The effects of age and CD4 T-lymphocyte cell count, progressively depleted during HIV progression, were investigated. 60 deaths occurred in AIDS-free patients during follow-up; 25 were drug-related deaths in IDUs. Pre-AIDS mortality was higher among IDUs than non-IDUs (p = 0.07). The cumulative incidences of pre-AIDS death after five years from enrollment were 11 per cent in IDUs and 6 per cent in non-IDUs; the cumulative AIDS incidences were, respectively, 19 per cent and 32 per cent. After eight years, cumulative pre-AIDS death incidence was 15 per cent among IDUs; cumulative AIDS incidence among IDUs was 35 per cent. Both groups had similar risks of medically-related (non-AIDS)-MRNA-death. Age and CD4 count were both individually predictive of MRNA death (relative risks (RRs); 2.1 per decade of life, p < 0.01; and 1.9 for each 100 cells per 100 microliters lost, p < 0.0001), although when used together age was less significant (RR 1.6, p = 0.07). Neither was statistically significant for drug-related mortality, although hazard may be lower in older individuals and may increase with falling CD4 count. The drug-related mortality was 1.1 per cent: 2.3 per cent in the first two years after enrollment, and 0.4 per cent thereafter. We conclude that older HIV-infected individuals are at greater risk of medically-related death before AIDS. This risk increases as CD4 count declines. Drug-related hazard may be greater in younger

  5. Spatial variation of pneumonia hospitalization risk in Twin Cities metro area, Minnesota.

    PubMed

    Iroh Tam, P Y; Krzyzanowski, B; Oakes, J M; Kne, L; Manson, S

    2017-11-01

    Fine resolution spatial variability in pneumonia hospitalization may identify correlates with socioeconomic, demographic and environmental factors. We performed a retrospective study within the Fairview Health System network of Minnesota. Patients 2 months of age and older hospitalized with pneumonia between 2011 and 2015 were geocoded to their census block group, and pneumonia hospitalization risk was analyzed in relation to socioeconomic, demographic and environmental factors. Spatial analyses were performed using Esri's ArcGIS software, and multivariate Poisson regression was used. Hospital encounters of 17 840 patients were included in the analysis. Multivariate Poisson regression identified several significant associations, including a 40% increased risk of pneumonia hospitalization among census block groups with large, compared with small, populations of ⩾65 years, a 56% increased risk among census block groups in the bottom (first) quartile of median household income compared to the top (fourth) quartile, a 44% higher risk in the fourth quartile of average nitrogen dioxide emissions compared with the first quartile, and a 47% higher risk in the fourth quartile of average annual solar insolation compared to the first quartile. After adjusting for income, moving from the first to the second quartile of the race/ethnic diversity index resulted in a 21% significantly increased risk of pneumonia hospitalization. In conclusion, the risk of pneumonia hospitalization at the census-block level is associated with age, income, race/ethnic diversity index, air quality, and solar insolation, and varies by region-specific factors. Identifying correlates using fine spatial analysis provides opportunities for targeted prevention and control.

  6. Characterisation of Blighia sapida (Sapindaceae) seed oil and defatted cake from Benin.

    PubMed

    Djenontin, Sebastien Tindo; Wotto, Valentin D; Lozano, Paul; Pioch, Daniel; Sohounhloue, Dominique K C

    2009-01-01

    A sample of Blighia sapida seeds collected in Benin has been analysed and the results are compared to the scarcely available literature data. The chemical analysis of seed oil shows a saponification value of 145 and an iodine value of 66, consistent with the high mono-unsaturated fatty acids (FAs) content (63.8 wt%). The most interesting feature is the prominent concentration of eicosenoic acid (48.4 wt%). Arachidic acid being the main component within the saturated group, the C20 FAs fraction accounts for 68.4 wt%, thus making the peculiar composition of this oil. Among the unsaponifiable fraction (2.4 wt%), the major sterol is stigmasterol (54.6 wt%), surprisingly over passing beta-sitosterol. Tocols (338 ppm) contains mainly alpha- and gamma-tocopherol. Regarding the defatted cake, results show the prominent position of starch and a noticeable amount of proteins and fibers (44.2, 22.4, 15.6 wt%, respectively). Seventeen amino acids were identified together with valuable minerals (total ashes 3.5 wt%). Possible uses of oil and defatted cake are discussed.

  7. Storage insects on yam chips and their traditional management in Northern Benin.

    PubMed

    Loko, Y L; Dansi, A; Tamo, M; Bokonon-Ganta, A H; Assogba, P; Dansi, M; Vodouhè, R; Akoegninou, A; Sanni, A

    2013-01-01

    Twenty-five villages of Northern Benin were surveyed to identify the constraints of yam chips production, assess the diversity of storage insects on yam chips, and document farmers' perception of their impacts on the stocks and their traditional management practices. Damages due to storage insects (63.9% of responses) and insufficiency of insect-resistant varieties (16.7% of responses) were the major constraints of yam chips production. Twelve insect pest species were identified among which Dinoderus porcellus Lesne (Coleoptera, Bostrichidae) was by far the most important and the most distributed (97.44% of the samples). Three predators (Teretrius nigrescens Lewis, Xylocoris flavipes Reuter, and Alloeocranum biannulipes Montrouzier & Signoret) and one parasitoid (Dinarmus basalis Rondani) all Coleoptera, Bostrichidae were also identified. The most important traditional practices used to control or prevent insect attack in yam chips were documented and the producers' preference criteria for yam cultivars used to produce chips were identified and prioritized. To further promote the production of yam chips, diversification of insect-resistant yam varieties, conception, and use of health-protective natural insecticides and popularization of modern storage structures were proposed.

  8. How Does Patient Safety Culture in the Surgical Departments Compare to the Rest of the County Hospitals in Xiaogan City of China?

    PubMed Central

    Wang, Manli; Tao, Hongbing

    2017-01-01

    Objectives: Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured surgical settings compared with other units in county hospitals using the HSOPSC. This study aims to assess the strengths and weaknesses of surgical departments compared with all other departments in county hospitals in China with HSOPSC. Design: This research is a cross-sectional study. Methods: In 2015, a Chinese translation of HSOPSC was administered to 1379 staff from sampled departments from 19 county hospitals in Xiaogan City (Hubei Province, China) using a simple random and cluster sampling method. Outcome Measures: The HSOPSC was completed by 1379 participants. The percent positive ratings (PPRs) of 12 dimensions (i.e., teamwork within units, organizational learning and continuous improvement, staffing, non-punitive response to errors, supervisor/ manager expectations and actions promoting patient safety, feedback and communication about errors, communication openness, hospital handoffs and transitions, teamwork across hospital units, hospital management support for patient safety, overall perception of safety, as well as frequency of events reported) and the positive proportion of outcome variables (patient safety grade and number of events reported) between surgical departments and other departments were compared with t-tests and X2 tests, respectively. A multiple regression analysis was conducted, with the outcome dimensions serving as dependent variables and basic characteristics and other dimensions serving as independent variables. Similarly, ordinal logistic regression was used to explore the influencing factors of two categorical outcomes. Results: A total of 56.49% of respondents were from surgical departments. The PPRs for “teamwork within units” and

  9. Disrespect and abuse during childbirth in fourteen hospitals in nine cities of Peru.

    PubMed

    Montesinos-Segura, Reneé; Urrunaga-Pastor, Diego; Mendoza-Chuctaya, Giuston; Taype-Rondan, Alvaro; Helguero-Santin, Luis M; Martinez-Ninanqui, Franklin W; Centeno, Dercy L; Jiménez-Meza, Yanina; Taminche-Canayo, Ruth C; Paucar-Tito, Liz; Villamonte-Calanche, Wilfredo

    2018-02-01

    To assess the prevalence of disrespect and abuse during childbirth and its associated factors in Peru. In an observational cross-sectional study, women were surveyed within 48 hours of live delivery at 14 hospitals located in nine Peruvian cities between April and July 2016. The survey was based on seven categories of disrespect and abuse proposed by Bowser and Hill. To evaluate factors associated with each category, prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated using adjusted Poisson models with robust variances. Among 1528 participants, 1488 (97.4%) had experienced at least one category of disrespect and abuse. Frequency of abandonment of care was increased with cesarean delivery (PR 1.27, 95% CI 1.03-1.57) but decreased in the jungle region (PR 0.27, 0.14-0.53). Discrimination was associated with the jungle region (PR 5.67, 2.32-13.88). Physical abuse was less frequent with cesarean than vaginal delivery (PR 0.23, 0.11-0.49). The prevalences of abandonment of care (PR 0.42, 0.29-0.60), non-consented care (PR 0.70, 0.57-0.85), discrimination (PR 0.40, 0.19-0.85), and non-confidential care (PR 0.71, 0.55-0.93) were decreased among women who had been referred. Nearly all participants reported having experienced at least one category of disrespect and abuse during childbirth care, which was associated with type of delivery, being referred, and geographic region. © 2017 International Federation of Gynecology and Obstetrics.

  10. Mass casualties in the Oklahoma City bombing.

    PubMed

    Teague, David C

    2004-05-01

    The Alfred P. Murrah Federal Building in Oklahoma City was partially destroyed by a terrorist bomb on April 19, 1995. Injuries were sustained by 759 people, 168 of whom died. Fatalities occurred primarily among victims in the collapse zone of the federal building. Only 83 survivors required hospitalization. Twenty-two surviving victims sustained multiple fractures. Most victims arrived at local emergency departments by private vehicle within 2 hours. More severely injured survivors were transported by ambulance. The closer receiving hospitals used emergency department facilities and minor treatment areas. Few survivors were extricated from the bombing site more than 3 hours after the detonation. Mass casualty plans must provide for improved communications, diversion and retriage from facilities nearest the disaster site, and effective coordination of community and hospital resources.

  11. Performance-Based Financing to Strengthen the Health System in Benin: Challenging the Mainstream Approach

    PubMed Central

    Paul, Elisabeth; Lamine Dramé, Mohamed; Kashala, Jean-Pierre; Ekambi Ndema, Armand; Kounnou, Marcel; Codjovi Aïssan, Julien; Gyselinck, Karel

    2018-01-01

    Background: Performance-based financing (PBF) is often proposed as a way to improve health system performance. In Benin, PBF was launched in 2012 through a World Bank-supported project. The Belgian Development Agency (BTC) followed suit through a health system strengthening (HSS) project. This paper analyses and draws lessons from the experience of BTC-supported PBF alternative approach – especially with regards to institutional aspects, the role of demand-side actors, ownership, and cost-effectiveness – and explores the mechanisms at stake so as to better understand how the "PBF package" functions and produces effects Methods: An exploratory, theory-driven evaluation approach was adopted. Causal mechanisms through which PBF is hypothesised to impact on results were singled out and explored. This paper stems from the co-authors’ capitalisation of experiences; mixed methods were used to collect, triangulate and analyse information. Results are structured along Witter et al framework. Results: Influence of context is strong over PBF in Benin; the policy is donor-driven. BTC did not adopt the World Bank’s mainstream PBF model, but developed an alternative approach in line with its HSS support programme, which is grounded on existing domestic institutions. The main features of this approach are described (decentralised governance, peer review verification, counter-verification entrusted to health service users’ platforms), as well as its adaptive process. PBF has contributed to strengthen various aspects of the health system and led to modest progress in utilisation of health services, but noticeable improvements in healthcare quality. Three mechanisms explaining observed outcomes within the context are described: comprehensive HSS at district level; acting on health workers’ motivation through a complex package of incentives; and increased accountability by reinforcing dialogue with demand-side actors. Cost-effectiveness and sustainability issues are also

  12. Incidence of ectopic pregnancy in Benin City, Nigeria.

    PubMed

    Oronsaye, A U; Odiase, G I

    1981-10-01

    A study of 100 consecutive cases of ectopic pregnancy managed over a 21-month period in the University Department of Obstetrics and Gynaecology is reported. The results show that this is a common gynaecological emergency in the community. Although pelvic inflammatory disease appears to be an important aetiological factor, a significant proportion showed no evidence of previous pelvic sepsis. The usual surgical treatment of cases in our unit is, where possible, total salpingectomy rather than salpingo-oophorectomy.

  13. Rotavirus vaccine and health-care utilization for rotavirus gastroenteritis in Tsu City, Japan

    PubMed Central

    Kamiya, Hajime; Suga, Shigeru; Nagao, Mizuho; Ichimi, Ryoji; Fujisawa, Takao; Umemoto, Masakazu; Tanaka, Takaaki; Ito, Hiroaki; Tanaka, Shigeki; Ido, Masaru; Taniguchi, Koki; Ihara, Toshiaki; Nakano, Takashi

    2016-01-01

    Background Rotavirus vaccines were introduced in Japan in November 2011. We evaluated the subsequent reduction of the health-care burden of rotavirus gastroenteritis. Methods We conducted active surveillance for rotavirus gastroenteritis among children under 5 years old before and after the vaccine introduction. We surveyed hospitalization rates for rotavirus gastroenteritis in children in Tsu City, Mie Prefecture, Japan, from 2007 to 2015 and surveyed the number of outpatient visits at a Tsu City clinic from 2010 to 2015. Stool samples were obtained for rotavirus testing and genotype investigation. We assessed rotavirus vaccine coverage for infants living in Tsu City. Results In the pre-vaccine years (2007–2011), hospitalization rates for rotavirus gastroenteritis in children under 5 years old were 5.5, 4.3, 3.1 and 3.9 cases per 1000 person-years, respectively. In the post-vaccine years (2011–2015), the rates were 3.0, 3.5, 0.8 and 0.6 cases per 1000 person-years, respectively. The hospitalization rate decreased significantly in the 2013–2014 and 2014–2015 seasons compared to the average of the seasons before vaccine introduction (P < 0.0001). In one pre-vaccine year (2010–2011), the number of outpatient visits due to the rotavirus infection was 66. In the post-vaccine years (2011–2015), the numbers for each season was 23, 23, 7 and 5, respectively. The most dominant rotavirus genotype shifted from G3P[8] to G1P[8] and to G2P[4]. The coverage of one dose of rotavirus vaccine in Tsu City was 56.5% in 2014. Conclusion After the vaccine introduction, the hospitalization rates and outpatient visits for rotavirus gastroenteritis greatly decreased. PMID:28246579

  14. The use of medicinal plants in self-care in the Agonlin region of Benin.

    PubMed

    Allabi, Aurel Constant; Busia, Kofi; Ekanmian, Vital; Bakiono, Fidèle

    2011-01-07

    To investigate the extent and type of medicinal plants used in self-care by the inhabitants of the Agonlin community in the Republic of Benin. A semi-structured questionnaire was used to interview a total of one thousand mothers. The prevalence rate of the use of herbal medicines in self-care was found to be 51.04%. One hundred and fourteen (114) plant species belonging to 69 families were reported, each with their local names, medicinal use, and parts used. Of all the indications of the identified plants, fever, headache, abdominal pain, and vomiting were the most frequently reported, with malaria treatment recording the highest usage of plant remedies (22%). The plant part most frequently used was the leaves. This study showed that self-care using medicinal plants is a major part of health care in the Agonlin area. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  15. Why 1D electrical resistivity techniques can result in inaccurate siting of boreholes in hard rock aquifers and why electrical resistivity tomography must be preferred: the example of Benin, West Africa

    NASA Astrophysics Data System (ADS)

    Alle, Iboukoun Christian; Descloitres, Marc; Vouillamoz, Jean-Michel; Yalo, Nicaise; Lawson, Fabrice Messan Amen; Adihou, Akonfa Consolas

    2018-03-01

    Hard rock aquifers are of particular importance for supplying people with drinking water in Africa and in the world. Although the common use of one-dimensional (1D) electrical resistivity techniques to locate drilling site, the failure rate of boreholes is usually high. For instance, about 40% of boreholes drilled in hard rock aquifers in Benin are unsuccessful. This study investigates why the current use of 1D techniques (e.g. electrical profiling and electrical sounding) can result in inaccurate siting of boreholes, and checks the interest and the limitations of the use of two-dimensional (2D) Electrical Resistivity Tomography (ERT). Geophysical numerical modeling and comprehensive 1D and 2D resistivity surveys were carried out in hard rock aquifers in Benin. The experiments carried out at 7 sites located in different hard rock groups confirmed the results of the numerical modeling: the current use of 1D techniques can frequently leads to inaccurate siting, and ERT better reveals hydrogeological targets such as thick weathered zone (e.g. stratiform fractured layer and preferential weathering associated with subvertical fractured zone). Moreover, a cost analysis demonstrates that the use of ERT can save money at the scale of a drilling programme if ERT improves the success rate by only 5% as compared to the success rate obtained with 1D techniques. Finally, this study demonstrates, using the example of Benin, that the use of electrical resistivity profiling and sounding for siting boreholes in weathered hard rocks of western Africa should be discarded and replaced by the use of ERT technique, more efficient.

  16. The burden of intentional injuries in Mwanza City, north-western Tanzania: a tertiary hospital survey.

    PubMed

    Chalya, Phillipo L; Gilyoma, Japhet M

    2012-07-01

    Intenionai injuries are an emerging silent epiaemic in developing countries ana contribute significantly to global injury burden. A descriptive prospective study was conducted to establish the prevalence, contributing factors, injury pattern and treatment outcome of intentional injuries at Bugando Medical Centre in Northwestern Tanzania. Data was collected using a pre-tested, coded questionnaire and analyzed using SPSS software version 17.0. A total of 1642 (23.7%) patients with intentional injuries were studied. Of these, 97.7% resulted from interpersonal violence (homicide) and 2.3% were self-inflicted (suicide). Males outnumbered females by a ratio of 2.2:1. Their median age was 24 years. The majority of injuries (53.5%) occurred at home. Criminal violence was the most common reason for intentional injuries accounting for 52.1% of cases. In women, domestic violence was responsible for 64.6% of the admissions. Poverty, lack of education, unemployment and alcohol abuse were the most common contributing factors to intentional injuries. Blunt and sharp objects (48.6%) were the most common weapons used. Gunshot injuries were recorded in 11.6% of cases. The head/neck was commonly affected in 49.2%. Soft tissue injuries (87.3%) were the most frequent type of injuries. The majority (90.1%) of patients were treated surgically. Complication rate was 15.0%.The median hospital stay was 26 days (range 1 day to 114 days). Patients with long bone fractures and those who had complications stayed longer in the hospital (P < 0.001). Mortality rate was 13.3%. The mortality rate was significantly high in patients with severe injuries (Injury Severity Score > 15), severe head injuries and those who needed intensive care unit (ICU) admissions and ventilatory support (P< 0.001). Intentional injuries are an emerging but neglected epidemic in Mwanza City and contribute significantly to high morbidity and mortality. Urgent preventive measures targeting at the root causes of violence such

  17. Comparison of clinical and biochemical variables in type 2 diabetes mellitus patients and their first-degree relatives with metabolic syndrome in Benin City, Nigeria: A cross sectional case controlled study.

    PubMed

    Ogedengbe, S; Ezeani, I U; Aihanuwa, E

    2016-01-01

    Type 2 diabetes mellitus (T2DM) is characterized by a relative insulin deficiency or insulin resistance. It is also associated with a cluster of metabolic abnormalities, including hyper-tension and dyslipidemia. Although there are many studies that have studied the metabolic abnormalities in T2DM patients with metabolic syndrome (MetS), only few of them have assessed the metabolic abnormalities in their first-degree relatives (FDRs) who had MetS. The aim of this study is to compare the clinical and biochemical variables in T2DM subjects and their FDRs without diabetes in Benin City, Nigeria. This is a cross sectional case control study including 124 T2DM patients, 96 FDR of T2DM subjects, and 96 controls recruited using convenience sampling. Data were collected using a questionnaire-administered technique. Variables of interest that were assessed included anthropometric indices like waist circumference (WC), hip circumference (HC), waist:hip ratio (WHR), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum lipid profile, fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), proteinuria, and microalbuminuria. The 1999 World Health Organization (WHO) criteria were used to make a diagnosis of metabolic syndrome. The Chi-square test was used for comparison of proportions. P-value of less than 0.05 was taken as statistically significant. The student t-test was used to compare means and test for significant differences in the anthropometric and the metabolic indices. The prevalence of the MetS in T2DM persons was 87.1%, 16.7% in the FDR group, and 13.5% in the control group according to the WHO criteria. The mean value of HbA1c was significantly higher in T2DM subjects with MetS (p<0.05). The mean values of WC, FPG, total cholesterol, HDL cholesterol, and LDL cholesterol were higher in subjects with MetS in the T2DM group than in persons with MetS in the FDR group though not significant (p>0.05). The mean values of WHR, BMI, SBP

  18. Stress Management and Relaxation Techniques Use among Underserved Inpatients in an Inner City Hospital

    PubMed Central

    Gardiner, Paula; Sadikova, Ekaterina; Filippelli, Amanda C.; Mitchell, Suzanne; White, Laura F.; Saper, Robert; Kaptchuk, Ted J.; Jack, Brian W.; Fredman, Lisa

    2015-01-01

    Objective Little is known about the use of Stress Management and Relaxation Techniques (SMART) in racially diverse inpatients. We hope to identify socioeconomic status (SES) factors, health behavior factors, and clinical factors associated with the use of SMART. Design and Main Outcome Measures We conducted a secondary analysis of baseline data from 623 hospitalized patients enrolled in the Re-Engineered Discharge (RED) clinical trial. We assessed socio-demographic characteristics and use of SMART. We used bivariate and multivariate logistic regression to test the association of SMART with socio-demographic characteristics, health behaviors, and clinical factors. Results A total of 26.6% of participants reported using SMART and 23.6% used mind body techniques. Thirty six percent of work disabled patients, 39% of illicit drug users, and 38% of participants with depressive symptoms used SMART. Patients who both reported illicit drug use and screened positive for depression had significantly increased odds of using SMART [OR=4.94, 95% CI (1.59, 15.13)]. Compared to non-Hispanic whites, non-Hispanic blacks [0.55, (0.34 to 0.87)] and Hispanic/other race individuals [0.40, (0.20 to 0.76)] were less likely to use SMART. Conclusions We found greater utilization of SMART among all racial groups compared to previous national studies. In the inner city inpatient setting, patients with depression, illicit drug use, and work disability reported higher rates of using SMART. PMID:26051576

  19. Social Structure of Lions (Panthera leo) Is Affected by Management in Pendjari Biosphere Reserve, Benin

    PubMed Central

    Sogbohossou, Etotépé A.; Bauer, Hans; Loveridge, Andrew; Funston, Paul J.; De Snoo, Geert R.; Sinsin, Brice; De Iongh, Hans H.

    2014-01-01

    Lion populations have undergone a severe decline in West Africa. As baseline for conservation management, we assessed the group structure of lions in the Pendjari Biosphere Reserve in Benin. This reserve, composed of one National Park and two Hunting Zones, is part of the WAP transboundary complex of protected areas. Overall mean group size was 2.6±1.7 individuals (n = 296), it was significantly higher in the National Park (2.7±1.7, n = 168) than in the Hunting Zones (2.2±1.5, n = 128). Overall adult sex ratio was even, but significantly biased towards females (0.67) in the National Park and towards males (1.67) in the Hunting Zones. Our results suggest that the Pendjari lion population is affected by perturbations, such as trophy hunting. PMID:24416263

  20. Quantifying trade-offs between future yield levels, food availability and forest and woodland conservation in Benin.

    PubMed

    Duku, Confidence; Zwart, Sander J; van Bussel, Lenny G J; Hein, Lars

    2018-01-01

    Meeting the dual objectives of food security and ecosystem protection is a major challenge in sub-Saharan Africa (SSA). To this end agricultural intensification is considered desirable, yet, there remain uncertainties regarding the impact of climate change on opportunities for agricultural intensification and the adequacy of intensification options given the rapid population growth. We quantify trade-offs between levels of yield gap closure, food availability and forest and woodland conservation under different scenarios. Each scenario is made up of a combination of variants of four parameters i.e. (1) climate change based on Representative Concentration Pathways (RCPs); (2) population growth based on Shared Socioeconomic Pathways (SSPs); (3) cropland expansion with varying degrees of deforestation; and (4) different degrees of yield gap closure. We carry out these analyses for three major food crops, i.e. maize, cassava and yam, in Benin. Our analyses show that in most of the scenarios, the required levels of yield gap closures required to maintain the current levels of food availability can be achieved by 2050 by maintaining the average rate of yield increases recorded over the past two and half decades in addition to the current cropping intensity. However, yields will have to increase at a faster rate than has been recorded over the past two and half decades in order to achieve the required levels of yield gap closures by 2100. Our analyses also show that without the stated levels of yield gap closure, the areas under maize, cassava and yam cultivation will have to increase by 95%, 102% and 250% respectively in order to maintain the current levels of per capita food availability. Our study shows that food security outcomes and forest and woodland conservation goals in Benin and likely the larger SSA region are inextricably linked together and require holistic management strategies that considers trade-offs and co-benefits. Copyright © 2017 Elsevier B.V. All

  1. Window Details U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Window Details - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  2. Landscape Plan U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Landscape Plan - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  3. Strong advocacy led to successful implementation of smokefree Mexico City.

    PubMed

    Crosbie, Eric; Sebrié, Ernesto M; Glantz, Stanton A

    2011-01-01

    To describe the approval process and implementation of the 100% smokefree law in Mexico City and a competing federal law between 2007 and 2010. Reviewed smokefree legislation, published newspaper articles and interviewed key informants. Strong efforts by tobacco control advocacy groups and key policymakers in Mexico City in 2008 prompted the approval of a 100% smokefree law following the WHO FCTC. As elsewhere, the tobacco industry utilised the hospitality sector to block smokefree legislation, challenged the City law before the Supreme Court and promoted the passage of a federal law that required designated smoking areas. These tactics disrupted implementation of the City law by causing confusion over which law applied in Mexico City. Despite interference, the City law increased public support for 100% smokefree policies and decreased the social acceptability of smoking. In September 2009, the Supreme Court ruled in favour of the City law, giving it the authority to go beyond the federal law to protect the fundamental right of health for all citizens. Early education and enforcement efforts by tobacco control advocates promoted the City law in 2008 but advocates should still anticipate continuing opposition from the tobacco industry, which will require continued pressure on the government. Advocates should utilise the Supreme Court's ruling to promote 100% smokefree policies outside Mexico City. Strong advocacy for the City law could be used as a model of success throughout Mexico and other Latin American countries.

  4. Strong advocacy led to successful implementation of smokefree Mexico City

    PubMed Central

    Crosbie, Eric; Sebrié, Ernesto M; Glantz, Stanton A

    2011-01-01

    Objective To describe the approval process and implementation of the 100% smokefree law in Mexico City and a competing federal law between 2007 and 2010. Methods Reviewed smokefree legislation, published newspaper articles and interviewed key informants. Results Strong efforts by tobacco control advocacy groups and key policymakers in Mexico City in 2008 prompted the approval of a 100% smokefree law following the WHO FCTC. As elsewhere, the tobacco industry utilised the hospitality sector to block smokefree legislation, challenged the City law before the Supreme Court and promoted the passage of a federal law that required designated smoking areas. These tactics disrupted implementation of the City law by causing confusion over which law applied in Mexico City. Despite interference, the City law increased public support for 100% smokefree policies and decreased the social acceptability of smoking. In September 2009, the Supreme Court ruled in favour of the City law, giving it the authority to go beyond the federal law to protect the fundamental right of health for all citizens. Conclusions Early education and enforcement efforts by tobacco control advocates promoted the City law in 2008 but advocates should still anticipate continuing opposition from the tobacco industry, which will require continued pressure on the government. Advocates should utilise the Supreme Court’s ruling to promote 100% smokefree policies outside Mexico City. Strong advocacy for the City law could be used as a model of success throughout Mexico and other Latin American countries. PMID:21059606

  5. [The determinants of the low case fatality rate of the cholera epidemic in the Littoral department of Benin in 2008].

    PubMed

    Gbary, Akpa Raphaël; Sossou, Roch Aristide; Dossou, Jean-Paul; Mongbo, Virginie; Massougbodji, Achille

    2011-01-01

    The 2008 cholera outbreak in Benin was characterized by a low case fatality rate (0.39 p.100) in the Littoral department, where 502 cases were recorded between July and December. The aim of this study was to identify the key factors associated with the low case fatality rate within the department. The cross-sectional, descriptive and analytical study conducted as part of this research used 404 patient records, focus group discussions with ten former patients, in-depth interviews with 8 health authorities involved in the response and structured face-to-face interviews with 12 health personnel involved in the treatment of patients. The data were analyzed using qualitative and quantitative content analysis based on EPIINFO 3.3.2 and EXCEL 2007 software. The results from several sources were cross-checked through triangulation. The mean age of patients was 23.72 ± 14.8 years. 39.35% patients were admitted with severe dehydration. Oral rehydration, intravenous rehydration and antibiotic therapy were given to 99.5%, 85% and 97.77% of patients, respectively. Only one hospital death was noted. The low case fatality rate was mainly due to the following factors: the high quality of care provided in a center with qualified personnel and available and free of charge treatment kits, protocols based on massive rehydration and appropriate hygiene measures, and patient compliance with the treatment plan. The response was also characterized by good coordination, wide mass and local health promotion, and selective antibiotic prophylaxis, which contributed significantly to reducing the spread of the infection.

  6. The use of antibiotics in cattle in North-East Benin: pharmaceutical inventory and risk practices of cattle breeders.

    PubMed

    Dognon, S R; Antoine-Moussiaux, N; Douny, C; Gustin, P; Moula, N; Scippo, M L; Youssao, A K I

    2018-05-07

    This study's aim is to inventory antibiotics used in cattle in North-East Benin and assess risk practices that could be the cause of both food chain contamination by antibiotic residues and selection of antibiotic-resistant bacteria in animals and humans. A survey was conducted among 98 cattle breeders in the districts of Banikoara, Kandi, Bembereke, and Kalale in North Benin. Semi-structured interviews were conducted, covering breeder status, breeding system, and antibiotic use. Multiple correspondence analysis and hierarchical classification analysis were conducted to establish a breeder typology. Breeders mainly belonged to the Fulani ethnic group (71.4 ± 8.9%) and almost all of them received "no formal education" (96.9 ± 3.4%). Cattle herds were mainly composed of a single breed, the Borgou (76.4 ± 8.1%) or the Fulani Zebu (16.0 ± 7.0%). Some herds were mixed. Antibiotics groups used in cattle breeding were tetracyclines, beta-lactams, sulfonamides, aminoglycosides, and macrolides, used by respectively 100%, 69.4 ± 9.1%, 56.1 ± 9.8%, 44.9 ± 9.8%, and 34.7 ± 9.4% of breeders. These drugs were purchased in local markets (59.0 ± 15.4%) and veterinary pharmacy (41.0 ± 15.4%). They were mainly used against respiratory diseases, lameness, mastitis, omphalitis and neonatal enteritis, and skin diseases. Only 49.0 ± 9.9% of breeders seek veterinary services to treat animals and 92.9 ± 5.1% of them did not respect antibiotic withdrawal times. These practices suggest that both contamination of bovine meat with antibiotic residues and selection of resistant bacteria are to be expected, resulting in adverse health effects on consumers.

  7. Photograph of model projected new hospital building and new landscaping ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photograph of model projected new hospital building and new landscaping for area north of building 500. Model displayed on the mezzanine level of building 500. - Fitzsimons General Hospital, Bounded by East Colfax to south, Peoria Street to west, Denver City/County & Adams County Line to north, & U.S. Route 255 to east, Aurora, Adams County, CO

  8. The benefits of redesigning Benin's vaccine supply chain.

    PubMed

    Brown, Shawn T; Schreiber, Benjamin; Cakouros, Brigid E; Wateska, Angela R; Dicko, Hamadou M; Connor, Diana L; Jaillard, Philippe; Mvundura, Mercy; Norman, Bryan A; Levin, Carol; Rajgopal, Jayant; Avella, Mélanie; Lebrun, Caroline; Claypool, Erin; Paul, Proma; Lee, Bruce Y

    2014-07-07

    New vaccine introductions have put strains on vaccine supply chains around the world. While increasing storage and transportation may be the most straightforward options, it is also important to consider what financial and operational benefits can be incurred. In 2012, suboptimal vaccine coverage and impending vaccine introductions prompted the Republic of Benin's Ministry of Health (MOH) to explore ways to improve their vaccine supply chain. Working alongside the Beninese MOH, we utilized our computational model, HERMES, to explore the impact on cost and vaccine availability of three possible options: (1) consolidating the Commune level to a Health Zone level, (2) removing the Commune level completely, and (3) removing the Commune level and expanding to 12 Department Stores. We also analyzed the impact of adding shipping loops during delivery. At baseline, new vaccine introductions without any changes to the current system increased the logistics cost per dose ($0.23 to $0.26) and dropped the vaccine availability to 71%. While implementing the Commune level removal scenario had the same capital costs as implementing the Health Zone scenario, the Health Zone scenario had lower operating costs. This increased to an overall cost savings of $504,255 when implementing shipping loops. The best redesign option proved to be the synergistic approach of converting to the Health Zone design and using shipping loops (serving ten Health Posts/loop). While a transition to either redesign or only adding shipping loops was beneficial, implementing a redesign option and shipping loops can yield both lower capital expenditures and operating costs. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. First Floor Plan U.S. Veterans Hospital, Jefferson Barracks, Therapeutic ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    First Floor Plan - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  10. Modelling latrine diffusion in Benin: towards a community typology of demand for improved sanitation in developing countries.

    PubMed

    Jenkins, Marion W; Cairncross, Sandy

    2010-03-01

    Latrine diffusion patterns across 502 villages in Benin, West Africa, were analysed to explore factors driving initial and increasing levels of household adoption in low-coverage rural areas of sub-Saharan Africa. Variables explaining adoption related to population density, size, infrastructure/services, non-agricultural occupations, road and urban proximity, and the nearby latrine adoption rate, capturing differences in the physical and social environment, lifestyles and latrine exposure involved in stimulating status/prestige and well-being reasons for latrine adoption. Contagion was most important in explaining adoption initiation. Cluster analysis revealed four distinct village typologies of demand for latrines which provide a framework for tailoring promotional interventions to better match the different sanitation demand characteristics of communities in scaling-up sanitation development and promotion programmes.

  11. Patterns of time series of numbers of emergency hospitalizations in mental hospitals in Moscow and Kazan (common features and differences)

    NASA Astrophysics Data System (ADS)

    Aptikaeva, O. I.; Gamburtsev, A. G.; Martyushov, A. N.

    2012-12-01

    We have investigated the numbers of emergency hospitalizations in mental and drug-treatment hospitals in Kazan in 1996-2006 and in Moscow in 1984-1996. Samples have been analyzed by disease type, sex, age, and place of residence (city or village). This study aims to discover differences and common traits in various structures of series of hospitalizations in these samples and their possible relationships with the changing parameters of the environment. We have found similar structures of series of samples of the same type both in Moscow and in Kazan. In some cases, cyclic structures of series of numbers of hospitalizations and series of changes in solar activity and the rate of rotation of the earth change simultaneously.

  12. Hospital managers' attitude and commitment toward electronic medical records system in Isfahan hospitals 2014.

    PubMed

    Jahanbakhsh, Maryam; Karimi, Saeed; Hassanzadeh, Akbar; Beigi, Maliheh

    2017-01-01

    Electronic medical record system (EMRS) is a valuable system for safe access to the patient's data and increases health care quality. Manpower is one of the requirements for EMRS, among which manager is the most important person in any hospital. Taking into account manager's positive attitude and good commitments, EMRS will be implemented successfully. As such, we decided to assess manager's attitude and commitment toward EMRS in Isfahan hospitals in the year of 2014. This article aimed to determine the hospital managers' attitude and commitment toward the implementation of EMRS. The present article is an applied analytic study. Research society consisted of the managers of all the hospitals in Isfahan that include hospitals affiliated to Isfahan University of Medical Sciences, private, and social security hospitals. This study was done in 2014. Data collection tools included a questionnaire for which reliability and validity were determined. Data were analyzed by means of SPSS 20. Average score for the managers' attitude toward EMRS in the city of Isfahan was 77.5 out of 100 and their average score for commitment was 74.7. Manager's attitude in social security hospitals was more positive than the private and governmental ones (83.3%). In addition, the amount of commitment by the managers in social security hospitals was higher than the same in private and governmental hospitals (86.6%). At present, managers' attitude and commitment in Isfahan hospitals toward EMRS are very high and social security hospitals show more readiness in this respect.

  13. Voting pattern of mental patients in a community state hospital.

    PubMed

    Klein, M M; Grossman, S A

    1967-06-01

    The voting pattern of mental patients in a community-based state hospital was studied. Patients were polled on the New York City mayoralty race. A comparison to the vote of the general population revealed that the hospital sample vote resembled most closely the election results of the hospital district. The results highlight the advantage of community-centered mental health facilities, which undertake the treatment and rehabilitation of mental patients under conditions that maintain ties with family and community.

  14. North and South Elevations U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    North and South Elevations - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  15. Interior, food processing room, looking northeast U.S. Veterans Hospital, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, food processing room, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Kitchen, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  16. The rise of pathophysiologic research in the United States: the role of two Harvard hospitals.

    PubMed

    Tishler, Peter V

    2013-01-01

    Pathophysiologic research, the major approach to understanding and treating disease, was created in the 20th century, and two Harvard-affiliated hospitals, the Peter Bent Brigham Hospital and Boston City Hospital, played a key role in its development. After the Flexner Report of 1910, medical students were assigned clinical clerkships in teaching hospitals. Rockefeller-trained Francis Weld Peabody, who was committed to investigative, pathophysiologic research, was a critical leader in these efforts. At the Brigham, Harvard medical students observed patients closely and asked provocative questions about their diseases. Additionally, physicians returned from World War I with questions concerning the pathophysiology of wartime injuries. At the Boston City Hospital's new Thorndike Memorial Laboratory, Peabody fostered investigative question-based research by physicians. These physicians expanded pathophysiologic investigation from the 1920s. Post-war, Watson and Crick's formulation of the structure of DNA led shortly to modern molecular biology and new research approaches that are being furthered at the Boston Hospitals.

  17. Injuries to rescue workers following the Oklahoma City bombing.

    PubMed

    Dellinger, A M; Waxweiler, R J; Mallonee, S

    1997-06-01

    The objective of this study was to identify and describe physical injuries to rescue workers in the aftermath of the Oklahoma City bombing. Data were obtained from medical records from 16 hospital emergency departments and specialty clinics in the Oklahoma City area, and reported visits to medical providers at the bombing site. Participants were rescue personnel from the Oklahoma City Fire Department, the mutual aid fire stations in the Oklahoma City area, the Federal Emergency Management Agency's Urban Search and Rescue teams, and military personnel stationed near Oklahoma City. All participants were involved in the rescue and recovery operation. The two main outcome measures were (1) the number, types, and rates of injuries; and (2) comparisons of case-finding methods, including medical chart review and telephone interview. The most common injuries were strains and sprains (21.4%), foreign bodies in eyes (14.5%), and laceration/crush/puncture wounds (18.4%). Of the four case-finding mechanisms, telephone interviews following the event identified the largest number of cases (84.5%). Most injuries were minor; some injuries such as chemical burns were preventable. The potential utility of other data collection mechanisms is considered.

  18. Promoting Teen Health and Reducing Risks: A Look at Adolescent Health Services in New York City.

    ERIC Educational Resources Information Center

    Citizens' Committee for Children of New York, NY.

    This study examined data from focus groups with New York City adolescents and interviews with health care providers serving New York City adolescents (hospital based clinics, school based health centers, child health clinics, community health centers, and a multi-service adolescent center) in order to determine how to promote health and reduce…

  19. [Postgraduate training program in neurology at the regional hospitals in Hokkaido area].

    PubMed

    Matsumoto, Akihisa

    2007-11-01

    In the new post graduate training system, the 55% of interns in the Hokkaido area choosed the post graduate training at the general hospitals and 45% of them choosed the medical universities (Hokkaido university, Asahikawa medical university, Sapporo medical university). Furthermore, 23% of interns in Hokkaido area choosed the general hospitals and medical universities in Sapporo city. As to the post graduate training system in neurology, 5 hospitals included the neurology for at least 1 month to 3 months. On the other hand, in one general hospital in Sapporo city, the clinical training of neurology was not included in the post graduate training system. During 2 years of the new post graduate training system, only 25% of the interns could rotate the neurological department. Since the neurology training course is necessary for the post graduate training system, it is suggested to need to support the opportunity to rotate the neurology for the interns.

  20. [Delirium in Patients Over 60 Years of Age in a Tertiary Level Public Hospital in the City of Pereira (Colombia): Under-Diagnosed and Under-Recorded].

    PubMed

    César Sánchez, Julio; Isabel González, Martha; César Gutiérrez, Julio

    2013-06-01

    Delirium is a common disorder in the hospitalized geriatric population and it has a great importance on the clinical outcome of inpatients; however, delirium is not diagnosed properly. To clarify the state of delirium diagnosis and records in a tertiary level public hospital in the city of Pereira. A cross-sectional descriptive study was performed by searching the clinical records of hospitalized patients older than 60 years 2010 and 2011, using the ICD-10 classification as a filter, and verifying the diagnostic criteria of DSM-IV in the clinical records. In the years 2010 and 2011, 5325 patients older than 60 years were hospitalized (19.3%). According to the official statistical records; 0.08% of them were reported with an unspecified diagnosis of delirium (F059). In the clinical records search 455 additional delirium patients were found using the same criteria (40.2%), of which 90.1% had delirium, and only 29.5% were classified with the code F059. The diagnoses and recording of delirium patients over 60 years old patients are underestimated, which is demonstrated by the incongruence of the data obtained from the official records and those obtained from the clinical records. This fact increases the risk and vulnerability of patients with undetected delirium or diagnosed but not reported delirium in hospital statistical sources. Liaison psychiatry is a necessity in third level health institutions, as well as a program of continued education for the health staff about prevention, diagnosis criteria and treatment of delirium. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  1. Cardiovascular Health Issues in Inner City Populations.

    PubMed

    Nayyar, Dhruv; Hwang, Stephen W

    2015-09-01

    Inner city populations in high-income countries carry a disproportionately high burden of cardiovascular disease. Although low individual socioeconomic status has long been associated with higher morbidity and mortality from cardiovascular disease, there is a growing body of evidence that area-level socioeconomic status may also have a major effect on cardiovascular outcomes. A lack of supermarkets, limited green space, and high rates of violent crime in inner city neighbourhoods result in poor dietary intake and low rates of physical activity among residents. The physical and social environments of inner city neighbourhoods may also contribute to high rates of comorbid mental illness in disadvantaged urban populations. Mental illness may lead to the clustering of cardiovascular risk factors through its impact on health behaviours, effects of psychiatric medications, and sequelae of substance abuse. Individuals residing in disadvantaged neighbourhoods experience reduced access to both primary preventive and acute in-hospital cardiovascular care. This may be driven by financial disincentives for caring for patients with low socioeconomic status, as well as system capacity issues in the inner city, and patient-level differences in health-seeking behaviours. Small-scale studies of interventions to improve individual-level health behaviours and access to care in the inner city have demonstrated some success in improving cardiovascular outcomes through the use of mobile clinics, health coaching, and case management approaches. There is a need for further research into community-wide interventions to improve the cardiovascular health of inner city populations. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  2. Five thousand years of tropical lake sediment DNA records from Benin

    NASA Astrophysics Data System (ADS)

    Bremond, L.; Favier, C.; Ficetola, G. F.; Tossou, M. G.; Akouégninou, A.; Gielly, L.; Giguet-Covex, C.; Oslisly, R.; Salzmann, U.

    2017-08-01

    Until now, sedimentary DNA (sedDNA) studies have only focused on cold and temperate regions were DNA is relatively well preserved. Consequently, the tropics, where vegetation is hyperdiverse and natural archives are rare, have been neglected and deserve attention. In this study, we used next-generation sequencing to barcode sedDNA from Lake Sele, localized in the tropical lowlands of Benin (Africa), and compared the taxonomic diversity detected by DNA analyses with pollen assemblages. Plant sedDNA was successfully amplified from 33 of the 34 successfully extracted samples. In total, 43 taxa were identified along the 5000 years spanned by the sediment: 22 taxa were identified at the family level and 21 at the genus level. The plant diversity recovered through sedDNA from Lake Sele showed a specific local signal and limited overlapping with pollen. Introduced plants, grown and cultivated close to the water, such as sweet potato, were also well recorded by sedDNA. It appears, therefore, to be a promising approach to studying past diversity in tropical regions, and could help in tracking the introduction and history of agriculture. This is the first time this method has been used in the field of domestication and dissemination of several specific crops, and the results are very encouraging.

  3. Maternal Anemia in Benin: Prevalence, Risk Factors, and Association with Low Birth Weight

    PubMed Central

    Bodeau-Livinec, Florence; Briand, Valerie; Berger, Jacques; Xiong, Xu; Massougbodji, Achille; Day, Karen P.; Cot, Michel

    2011-01-01

    We studied the prevalence of anemia during pregnancy and its relationship with low birth weight (LBW; birth weight < 2,500 g) in Benin. We analyzed 1,508 observations from a randomized controlled trial conducted from 2005 to 2008 showing equivalence on the risk of LBW between two drugs for Intermittent Preventive Treatment of malaria during pregnancy (IPTp). Despite IPTp, helminth prophylaxis, and iron and folic acid supplementations, the proportions of women with severe anemia (hemoglobin [Hb] concentration < 80 g/L) and anemia (Hb < 110 g/L) were high throughout pregnancy: 3.9% and 64.7% during the second and 3.7% and 64.1% during the third trimester, but 2.5% and 39.6% at the onset of labor, respectively. Compared with women without anemia (Hb ≥ 110 g/L) during the third trimester, women with severe anemia (Hb < 80 g/L) were at higher risk of LBW after adjustment for potential confounding factors (prevalence ratio [PR] = 2.8; 95% confidence interval [1.4–5.6]). PMID:21896797

  4. Smallholders' perceptions of goat farming in southern Benin and opportunities for improvement.

    PubMed

    Dossa, L H; Wollny, C; Gauly, M

    2007-01-01

    To be successful, initiatives to improve smallholder's goat production should directly address the needs and objectives of the keepers while promoting rational use of local genetic resources. This paper identifies the objectives, constraints and needs of goat farmers in southern Benin and discusses their relevance to the development of improvement programmes. Between November and December 2005, structured questionnaires, focus group discussions and participant observation were used to collect information from 38 goat farmers in two selected locations. Goats were kept mainly for sale whenever cash was needed. Traits related to reproduction, to behaviour, to health and to meat production were considered equally important and were ranked very highly by goat keepers. Increased net income per flock through increased number of marketable animals is the derived breeding objective from the trait analysis. Disease outbreaks resulting in high mortality, poor housing, and feed shortages were, in descending order, the most important problems. It was concluded that the development of initiatives to improve management practices is an overriding priority. It will lead to increases in productivity in the short term and foster farmers' participation in the development of long-term improvement strategies, which should include selection and controlled mating.

  5. Storage Insects on Yam Chips and Their Traditional Management in Northern Benin

    PubMed Central

    Loko, Y. L.; Dansi, A.; Tamo, M.; Bokonon-Ganta, A. H.; Assogba, P.; Dansi, M.; Vodouhè, R.; Akoegninou, A.; Sanni, A.

    2013-01-01

    Twenty-five villages of Northern Benin were surveyed to identify the constraints of yam chips production, assess the diversity of storage insects on yam chips, and document farmers' perception of their impacts on the stocks and their traditional management practices. Damages due to storage insects (63.9% of responses) and insufficiency of insect-resistant varieties (16.7% of responses) were the major constraints of yam chips production. Twelve insect pest species were identified among which Dinoderus porcellus Lesne (Coleoptera, Bostrichidae) was by far the most important and the most distributed (97.44% of the samples). Three predators (Teretrius nigrescens Lewis, Xylocoris flavipes Reuter, and Alloeocranum biannulipes Montrouzier & Signoret) and one parasitoid (Dinarmus basalis Rondani) all Coleoptera, Bostrichidae were also identified. The most important traditional practices used to control or prevent insect attack in yam chips were documented and the producers' preference criteria for yam cultivars used to produce chips were identified and prioritized. To further promote the production of yam chips, diversification of insect-resistant yam varieties, conception, and use of health-protective natural insecticides and popularization of modern storage structures were proposed. PMID:23710140

  6. [Philanthropic general hospitals: a new setting for psychiatric admissions].

    PubMed

    Larrobla, Cristina; Botega, Neury José

    2006-12-01

    To understand the process that led Brazilian philanthropic general hospitals to implement psychiatric units and to describe the main characteristics and therapeutic approaches of these services. Ten institutions in three Brazilian states (Minas Gerais, São Paulo e Santa Catarina) were assessed in 2002. Forty-three semi-structured interviews were carried out with health professionals who worked at the hospitals to collect data on service implementation process, therapeutic approaches and current situation. The interviews were audio-recorded and their content was analyzed. There was no mental hospital in the cities where the institutions were located. In five hospitals, psychiatric patients were admitted to general medical wards because there was no psychiatric unit. The therapeutic approach in six hospitals was based on psychopharmacological treatment. Due to lack of resources and more appropriate therapeutic planning, the admission of patients presenting psychomotor agitation increases resistance against psychiatric patients in general hospitals. Financial constraints regarding laboratory testing is still a challenge. There is no exchange between local authorities and hospital administrators of these institutions that are compelled to exceed the allowed number of admissions to meet the demand of neighboring cities. The need for mental health care to local populations combined with individual requests of local authorities and psychiatrists made possible the implementation of psychiatric units in these localities. In spite of the efforts and flexibility of health professional working in these institutions, there are some obstacles to be overcome: resistance of hospital community against psychiatric admissions, financial constraints, limited professional training in mental health and the lack of a therapeutic approach that goes beyond psychopharmacological treatment alone.

  7. Building Sections and Detailed Wall Sections U.S. Veterans Hospital, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Building Sections and Detailed Wall Sections - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  8. Southwest corner, looking north U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Southwest corner, looking north - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  9. North wall, looking southeast U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    North wall, looking southeast - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  10. Basement, bathroom, looking south U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Basement, bathroom, looking south - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  11. Northeast corner, looking southwest U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Northeast corner, looking southwest - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  12. Community-based interventions for the use and conservation of animal genetic resources: the case of indigenous scavenger chicken production in Benin.

    PubMed

    Rodríguez, Luis C; Herrero, Mario; Baltenweck, Isabel

    2011-06-01

    Scavenging chicken production in Africa is important for the livelihood of the poor. In most countries, these low inputs, low output systems employ local breeds making use of the feeding resources available in the household. However, their replacement with introduced exotic breeds with higher productivities represents a risk for their conservation. Here, we present a simulation model to evaluate the impact of community-based interventions aiming to improve the profitability of local chicken breeds and promote their use and conservation. The results indicate that under the current conditions, farmers producing exotic chicken are able to sell more animals in a one year period; however the market price of local chicken makes their production more profitable. Vaccination campaigns significantly reduce the mortality rate of both breeds, having a positive effect on producers' income but its impact on animal off-take is larger for exotic breeds, and the availability of feeding resources is the limiting factor as the flock size increases. The results of the intervention are positive in terms of increasing farmers' income but do not clearly contribute to the conservation of indigenous breeds since after the vaccination campaign, the gap between the profitability of indigenous and exotic breeds is reduced. The simulation model indicates that under the current conditions, the conservation of indigenous chicken breeds in Benin is maintained by the existence of distinct niche markets with consumers able to pay higher prices for indigenous chicken. Policies for the conservation of chicken genetic resources in Benin are discussed.

  13. Energy survey, study and report of hospitals in Michigan: Appendix A: Volume 1, Saint Mary's Hospital Grand Rapids, Michigan: Final report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1988-08-01

    This study is part of a three-phased demonstration project to reduce energy consumption in hospitals through practical life-cycle, cost-effective modifications and alterations. Funds for the demonstration project are provided by the American Hospital Association (AHA), the Department of Energy (DOE), and the Department of Health and Human Services (DHHS). Two hospitals in Michigan were selected for the project, Bay Medical Center in Bay City and St. Mary's Hospital in Ground Rapids. The objectives of this study, which is funded by HHS, are to investigate and analyze energy usage of the facilities and to identify all life-cycle, cost-effective changes required tomore » effect a reduction in energy consumption.« less

  14. Asthma Outcomes at an Inner-City School-Based Health Center.

    ERIC Educational Resources Information Center

    Lurie, Nicole; Bauer, Ellen Jones; Brady, Cynthia

    2001-01-01

    Measured asthma outcomes after initiating an inner-city elementary school health center that emphasized asthma detection and treatment. Pre- and post-intervention comparison of students indicated that: hospitalization rates for asthma decreased; outpatient visits for care in the absence of symptoms doubled; numbers of students seeing an asthma…

  15. Exploring implementation practices in results-based financing: the case of the verification in Benin.

    PubMed

    Antony, Matthieu; Bertone, Maria Paola; Barthes, Olivier

    2017-03-14

    Results-based financing (RBF) has been introduced in many countries across Africa and a growing literature is building around the assessment of their impact. These studies are usually quantitative and often silent on the paths and processes through which results are achieved and on the wider health system effects of RBF. To address this gap, our study aims at exploring the implementation of an RBF pilot in Benin, focusing on the verification of results. The study is based on action research carried out by authors involved in the pilot as part of the agency supporting the RBF implementation in Benin. While our participant observation and operational collaboration with project's stakeholders informed the study, the analysis is mostly based on quantitative and qualitative secondary data, collected throughout the project's implementation and documentation processes. Data include project documents, reports and budgets, RBF data on service outputs and on the outcome of the verification, daily activity timesheets of the technical assistants in the districts, as well as focus groups with Community-based Organizations and informal interviews with technical assistants and district medical officers. Our analysis focuses on the actual practices of quantitative, qualitative and community verification. Results show that the verification processes are complex, costly and time-consuming, and in practice they end up differing from what designed originally. We explore the consequences of this on the operation of the scheme, on its potential to generate the envisaged change. We find, for example, that the time taken up by verification procedures limits the time available for data analysis and feedback to facility staff, thus limiting the potential to improve service delivery. Verification challenges also result in delays in bonus payment, which delink effort and reward. Additionally, the limited integration of the verification activities of district teams with their routine tasks

  16. LANDSCAPE CHANGES IN A LOWLAND IN BENIN: ECOLOGICAL IMPACT ON PESTS AND NATURAL ENEMIES.

    PubMed

    Boucher, A; Silvie, P; Menozzi, P; Adda, C; Auzoux, S; Jean, J; Huat, J

    2015-01-01

    Habitat management involving conservative biological control could be a good crop pest management option in poor African countries. A survey was conducted from August 2013 to July 2014 in a rainfed lowland region near Pélébina, northern Benin, in order to characterize spatiotemporal landscape changes and investigate their influence on the main crop pests and their associated natural enemies. The area was mapped mainly regarding crop fields and fallows. Visual observations were recorded and a database was compiled. Major landscape composition changes were noted between rainy and dry seasons, which affected the presence of both pests and natural enemies. Cereals (rice, maize and sorghum) and cotton were grown in the humid season, and then okra (Abelmoschus esculentus) was the dominant vegetable crop in dry season. These modifications impacted fallow abundance throughout the lowland. Different cotton (e.g. Helicoverpa armigera, Dysdercus sp., Zonocerus variegatus) or rice (e.g. Diopsis longicornis, D. apicalis) pests were observed during dry season in okra crops. Dry season surveys of Poaceae in two types of fallows ('humid', 'dry') revealed the presence of very few stem borers: only 0.04% of stems sampled were infested by stem borers, with a mean of 1.13 larvae per stem. Known cereal stem borer species such as Busseola fusco, Coniesta ignefusalis, Sesamia calamistis were not clearly identified among these larvae because of their diapausing stage and white color. Unexpected pollinators (Hymenoptera Apidae, genus Braunsapis, Ceratina and Xylocopa) and predators (Crabronidae, genus Dasyproctus) were found in the stems. Sweep-net collection of insects in humid fallows allowed us to describe for the first time in Benin seven Diopsidae species (23% of adults bearing Laboulbeniomycetes ectoparasitic fungi). Some of these species were captured in rice fields during rainy season. Parasitoids (adult Chalcidoidae and Ichneumonoidae) were observed during both seasons but their

  17. Interior, rear sunporch, looking north U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, rear sunporch, looking north - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  18. South (front) wall, looking northwest U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    South (front) wall, looking northwest - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  19. Interior, east bedroom, looking southeast U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, east bedroom, looking southeast - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  20. Interior, living room, looking west U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, living room, looking west - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  1. Interior, dining room, looking southeast U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, dining room, looking southeast - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  2. Conflict and Compromise: Catholic and Public Hospital Partnerships

    PubMed Central

    Wall, Barbra Mann

    2010-01-01

    This article analyzes the tensions and uneasy negotiations, based on a case study, that occurred among Catholic sisters, administrators, bishops, physicians, and the Vatican for more than seven years at a hospital in Austin, Texas. Here, the largest health care system in the city, which was Catholic, joined with the local public, tax-supported hospital that provided the majority of reproductive health care services in the region. A clash resulted over whether the hospital could continue providing sterilization and contraceptive services to its primarily poor patients. This article examines the fierce debates that occurred, especially over emergency contraception and attempts to develop creative solutions after a hierarchical crackdown from the Vatican. The end result was a compromise that included the creation of a “hospital within a hospital.” PMID:20067093

  3. Implementation of a decentralized community-based treatment program to improve the management of Buruli ulcer in the Ouinhi district of Benin, West Africa

    PubMed Central

    Amoussouhoui, Arnaud Setondji; Wadagni, Anita Carolle; Johnson, Roch Christian; Aoulou, Paulin; Agbo, Inès Elvire; Houezo, Jean-Gabin; Boyer, Micah; Nichter, Mark

    2018-01-01

    Background Mycobacterium ulcerans infection, commonly known as Buruli ulcer (BU), is a debilitating neglected tropical disease. Its management remains complex and has three main components: antibiotic treatment combining rifampicin and streptomycin for 56 days, wound dressings and skin grafts for large ulcerations, and physical therapy to prevent functional limitations after care. In Benin, BU patient care is being integrated into the government health system. In this paper, we report on an innovative pilot program designed to introduce BU decentralization in Ouinhi district, one of Benin’s most endemic districts previously served by centralized hospital-based care. Methodology/Principal findings We conducted intervention-oriented research implemented in four steps: baseline study, training of health district clinical staff, outreach education, outcome and impact assessments. Study results demonstrated that early BU lesions (71% of all detected cases) could be treated in the community following outreach education, and that most of the afflicted were willing to accept decentralized treatment. Ninety-three percent were successfully treated with antibiotics alone. The impact evaluation found that community confidence in decentralized BU care was greatly enhanced by clinic staff who came to be seen as having expertise in the care of most chronic wounds. Conclusions/Significance This study documents a successful BU outreach and decentralized care program reaching early BU cases not previously treated by a proactive centralized BU program. The pilot program further demonstrates the added value of integrated wound management for NTD control. PMID:29529087

  4. Hospitals' readiness for clinical governance implementation in educational hospitals of yazd, iran.

    PubMed

    Bahrami, Mohammad Amin; Sabahi, Ali Akbar; Montazeralfaraj, Razieh; Shamsi, Farimah; Ardekani, Samaneh Entezarian

    2014-01-01

    Clinical governance is a systematic approach to maintaining and improving the quality of patient care. This study aimed to assess some Iranian educational hospitals' readiness for clinical governance implementation through the organizational climate. It was a cross-sectional study that used the Clinical Governance Climate Questionnaire (CGCQ) in three educational hospitals in Yazd, a city in central Iran, in 2012. A total of 186 personnel contributed to the study. Data were analyzed using SPSS version 16. Descriptive statistics and the Kruskal-Wallis test were used for data analyses. The mean scores of the clinical governance climate in Shahid Sadoughi, Shahid Rahnemoon and Afshar hospitals were 2.63±0.29, 2.58±0.32, and 2.68±0.29. The mean scores of quality improvement planning and change, quality improvement integration and motivation, clinical risk management and climate of blame and punishment, organizational learning, and training and development (T&D) opportunities for learning in the studied hospitals were 2.21±0.49, 2.80±0.40, 2.76±0.40, 2.91±0.54 and 3.06±0.72, respectively. The results of this study showed that the educational hospitals' climate should be more supportive for successful implementation of clinical governance.

  5. Patterns of genetic and morphometric diversity in baobab (Adansonia digitata) populations across different climatic zones of Benin (West Africa).

    PubMed

    Assogbadjo, A E; Kyndt, T; Sinsin, B; Gheysen, G; van Damme, P

    2006-05-01

    Baobab (Adansonia digitata) is a multi-purpose tree used daily by rural African communities. The present study aimed at investigating the level of morphometric and genetic variation and spatial genetic structure within and between threatened baobab populations from the three climatic zones of Benin. A total of 137 individuals from six populations were analysed using morphometric data as well as molecular marker data generated using the AFLP technique. Five primer pairs resulted in a total of 217 scored bands with 78.34 % of them being polymorphic. A two-level AMOVA of 137 individuals from six baobab populations revealed 82.37 % of the total variation within populations and 17.63 % among populations (P < 0.001). Analysis of population structure with allele-frequency based F-statistics revealed a global F(ST) of 0.127 +/- 0.072 (P < 0.001). The mean gene diversity within populations (H(S)) and the average gene diversity between populations (D(ST)) were estimated at 0.309 +/- 0.000 and 0.045 +/- 0.072, respectively. Baobabs in the Sudanian and Sudan-Guinean zones of Benin were short and produced the highest yields of pulp, seeds and kernels, in contrast to the ones in the Guinean zone, which were tall and produced only a small number of fruits with a low pulp, seed and kernel productivity. A statistically significant correlation with the observed patterns of genetic diversity was observed for three morphological characteristics: height of the trees, number of branches and thickness of the capsules. The results indicate some degree of physical isolation of the populations collected in the different climatic zones and suggest a substantial amount of genetic structuring between the analysed populations of baobab. Sampling options of the natural populations are suggested for in or ex situ conservation.

  6. Blackout 2003: preparedness and lessons learned from the perspectives of four hospitals.

    PubMed

    Klein, Kelly R; Rosenthal, Marc S; Klausner, Howard A

    2005-01-01

    The blackout in North America of August 2003 was one of the worst on record. It affected eight US states and parts of Canada for >24 hours. Additionally, two large US cities, Detroit, Michigan and Cleveland, Ohio, suffered from a loss of water pressure and a subsequent ban on the use of public supplies of potable water that lasted four days. A literature review revealed a paucity of literature that describes blackouts and how they may affect the medical community. This paper includes a review of after-action reports from four inner-city, urban hospitals supplemented accounts from the authors' hospital's emergency operations center (EOC). Some of the problems encountered, included: (1)lighting; (2) elevator operations; (3) supplies of water; (4) communication operations; (5) computer failure; (6) lack of adequate supplies of food; (7) mobility to obtain X-ray studies; (8) heating, air condition, and ventilation; (9) staffing; (10) pharmacy; (11) registration of patients; (12) hospital EOC; (13) loss of isolation facilities; (14) inadequate supplies of paper; (15) impaired ability to provide care for non-emergency patients; (16) sanitation; and (17) inadequate emergency power. The blackout of 2003 uncovered problems within the US hospital system, ranging from staffing to generator coverage. This report is a review of the effects that the blackout and water ban of 2003 had on hospitals in a large inner-city area. Also discussed are solutions utilized at the time and recommendations for the future. The blackout of 2003 was an excellent test of disaster/emergency planning, and produced many valuable lessons to be used in future events.

  7. Hospital managers’ attitude and commitment toward electronic medical records system in Isfahan hospitals 2014

    PubMed Central

    Jahanbakhsh, Maryam; Karimi, Saeed; Hassanzadeh, Akbar; Beigi, Maliheh

    2017-01-01

    INTRODUCTION: Electronic medical record system (EMRS) is a valuable system for safe access to the patient's data and increases health care quality. Manpower is one of the requirements for EMRS, among which manager is the most important person in any hospital. Taking into account manager's positive attitude and good commitments, EMRS will be implemented successfully. As such, we decided to assess manager's attitude and commitment toward EMRS in Isfahan hospitals in the year of 2014. AIM: This article aimed to determine the hospital managers’ attitude and commitment toward the implementation of EMRS. MATERIALS AND METHODS: The present article is an applied analytic study. Research society consisted of the managers of all the hospitals in Isfahan that include hospitals affiliated to Isfahan University of Medical Sciences, private, and social security hospitals. This study was done in 2014. Data collection tools included a questionnaire for which reliability and validity were determined. Data were analyzed by means of SPSS 20. RESULTS: Average score for the managers’ attitude toward EMRS in the city of Isfahan was 77.5 out of 100 and their average score for commitment was 74.7. Manager's attitude in social security hospitals was more positive than the private and governmental ones (83.3%). In addition, the amount of commitment by the managers in social security hospitals was higher than the same in private and governmental hospitals (86.6%). CONCLUSION: At present, managers’ attitude and commitment in Isfahan hospitals toward EMRS are very high and social security hospitals show more readiness in this respect. PMID:28584837

  8. Incidence of leukemias in children from El Salvador and Mexico City between 1996 and 2000: Population-based data

    PubMed Central

    Mejía-Aranguré, Juan Manuel; Bonilla, Miguel; Lorenzana, Rodolpho; Juárez-Ocaña, Servando; de Reyes, Gladys; Pérez-Saldivar, María Luisa; González-Miranda, Guadalupe; Bernáldez-Ríos, Roberto; Ortiz-Fernández, Antonio; Ortega-Alvarez, Manuel; Martínez-García, María del Carmen; Fajardo-Gutiérrez, Arturo

    2005-01-01

    Background There are very few studies that report the incidence of acute leukemias in children in Latin America. This work assesses the incidence of acute leukemias, between 1996 and 2000, in children from 0–14 years old who were attended at the Mexican Social Security Institute in Mexico City and in children from 0–11 years old in El Salvador. Methods Design: Population-based data. Hospitals: In San Salvador, El Salvador, Hospital Nacional de Niños "Benjamín Bloom", the only center in El Salvador which attends all children, younger than 12 years, with oncologic disease. The Pediatric Hospital and the General Hospital of the Mexican Social Security Institute in Mexico City, the only centers in Mexico City which attend all those children with acute leukemia who have a right to this service. Diagnosis: All patients were diagnosed by bone marrow smear and were divided into acute lymphoid leukemia (ALL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and unspecified leukemias (UL). The annual incidence rate (AIR) and average annual incidence rate (AAIR) were calculated per million children. Cases were stratified by age and assigned to one of four age strata: 1) <1 year; 2) 1–4 years; 3) 5–9 years, or 4) 10–14 or 10–11 years, for Mexico City and El Salvador, respectively. Results The number of cases was 375 and 238 in El Salvador and Mexico City, respectively. AAIRs in Mexico City were 44.9, 10.6, 2.5, 0.5, and 58.4 per million children for ALL, AML, CML, UL, and total leukemias, respectively. The AAIRs in El Salvador could not be calculated because the fourth age stratum in El Salvador included children only from 0–11 years old. The incidence rates for the Salvadoran group of 0–11 year olds were 34.2, 7.1, 0.6, 0.2, and 43.2 per million children for ALL, AML, CML, UL, and total leukemias, respectively. Conclusion Reported AIRs for each age group in El Salvador were similar to those from other American countries. The AAIR of ALL in

  9. Diabetes Control among Vietnamese Patients in Ho Chi Minh City: An Observational Cross-Sectional Study

    ERIC Educational Resources Information Center

    Yokokawa, Hirohide; Khue, Nguyen Thy; Goto, Aya; Nam, Tran Quang; Trung, Tran The; Khoa, Vo Tuan; Ngoc, Nguyen Thi Boi; Minh, Pham Nghiem; Vinh, Nguyen Quang; Okayama, Akira; Yasumura, Seiji

    2010-01-01

    The objective of this study was to assess the extent of diabetic control and its associated factors among Vietnamese patients with diabetes mellitus (DM). The study was conducted among 652 outpatients who were recruited at a public general hospital (People Hospital 115) and a private clinic (Medic Center) in Ho Chi Minh City, Vietnam. Median age…

  10. Precipitation chemistry and wet deposition in a remote wet savanna site in West Africa: Djougou (Benin)

    NASA Astrophysics Data System (ADS)

    Akpo, A. B.; Galy-Lacaux, C.; Laouali, D.; Delon, C.; Liousse, C.; Adon, M.; Gardrat, E.; Mariscal, A.; Darakpa, C.

    2015-08-01

    In the framework of the IDAF (IGAC/DEBITS/AFrica) international program, this study aims to study the chemical composition of precipitation and associated wet deposition at the rural site of Djougou in Benin, representative of a West and Central African wet savanna. Five hundred and thirty rainfall samples were collected at Djougou, Benin, from July 2005 to December 2009 to provide a unique database. The chemical composition of precipitation was analyzed for inorganic (Ca2+, Mg2+, Na+, NH4+, K+, NO3-, Cl-, SO42-) and organic (HCOO-, CH3COO-, C2H5COO-, C2O42-) ions, using ion chromatography. The 530 collected rain events represent a total of 5706.1 mm of rainfall compared to the measured pluviometry 6138.9 mm, indicating that the collection efficiency is about 93%. The order of total annual loading rates for soluble cations is NH4+ > Ca2+ > Mg2+ > K+. For soluble anions the order of loading is carbonates > HCOO- > NO3- > CH3COO- > SO42- > Cl- > C2O42- > C2H5COO-. In the wet savanna of Djougou, 86% of the measured pH values range between 4.7 and 5.7 with a median pH of 5.19, corresponding to a VWM (Volume Weighed Mean) H+ concentration of 6.46 μeq·L-1. This acidity results from a mixture of mineral and organic acids. The annual sea salt contribution was computed for K+, Mg2+, Ca2+ and SO42- and represents 4.2% of K+, 41% of Mg2+, 1.3% of Ca2+, and 7.4% of SO42-. These results show that K+, Ca2+, SO42-, and Mg2+ were mainly of non-marine origin. The marine contribution is estimated at 9%. The results of the chemical composition of rainwater of Djougou indicates that, except for the carbonates, ammonium has the highest VWM concentration (14.3 μeq·L-1) and nitrate concentration is 8.2 μeq·L-1. The distribution of monthly VWM concentration for all ions is computed and shows the highest values during the dry season, comparing to the wet season. Identified nitrogenous compound sources (NOx and NH3) are domestic animals, natural emissions from savanna soils, biomass

  11. Southeast corner, looking northwest U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Southeast corner, looking northwest - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  12. West wall, looking northeast U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    West wall, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  13. U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  14. Special report. Twin Cities hospital breaks down ambulatory care, overcomes fears of outpatient care.

    PubMed

    1995-01-06

    With payers pushing for shorter hospital stays and outpatient services generating growing shares of hospitals' revenues, experts everywhere are projecting the end of the traditional inpatient-oriented hospital. Those predictions have triggered a scramble by many hospital managers to adapt their organizations and empty beds to the expected predominance of same-day services. One Minnesota facility that surveyed the outpatient trend, however, found that its strategic options weren't limited to becoming a jumbo-sized outpatient clinic, explain David Allen, a partner with The Chancellor Group, Bloomington, Minn., and Daniel Weber, vice president of Fairview Southdale Hospital, Edina, Minn., in this special report. By understanding the multidimensional nature of ambulatory services and focusing its efforts on becoming a regional hub of healthcare services, Fairview Southdale has carved its own niche in a changing provider market.

  15. Ground Floor Plan (Section A) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Ground Floor Plan (Section A) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  16. Ground Floor Plan (Section B) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Ground Floor Plan (Section B) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  17. First Floor Plan (Section A) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    First Floor Plan (Section A) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  18. First Floor Plan (Section B) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    First Floor Plan (Section B) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  19. Second Floor Plan (Section A) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Second Floor Plan (Section A) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  20. Second Floor Plan (Section B) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Second Floor Plan (Section B) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  1. [Day hospital in internal medicine: A chance for ambulatory care].

    PubMed

    Grasland, A; Mortier, E

    2018-04-16

    Internal medicine is an in-hospital speciality. Along with its expertise in rare diseases, it shares with general medicine the global care of patients but its place in the ambulatory shift has yet to be defined. The objective of our work was to evaluate the benefits of an internal medicine day-hospital devoted to general medicine. Named "Centre Vi'TAL" to underline the link between the city and the hospital, this novel activity was implemented in order to respond quickly to general practitioners having difficulties to synthesize their complex patients or facing diagnostic or therapeutic problems. Using preferentially email for communication, the general practitioners can contact an internist who is committed to respond on the same day and take over the patient within 7 days if day-hospital is appropriate for his condition. The other patients are directed either to the emergency department, consultation or full hospitalization. In 14 months, the center has received 213 (144 women, 69 men) patients, mean age 53.6, addressed by 88 general practitioners for 282 day-hospital sessions. Requests included problem diagnoses (n=105), synthesis reviews for complex patients (n=65), and treatment (n=43). In the ambulatory shift advocated by the authorities, this experience shows that internal medicine should engage in the recognition of day-hospital as a place for diagnosis and synthesis reviews connected with the city while leaving the general practitioners coordinator of their patient care. This activity of synthesis in day-hospital is useful for the patients and efficient for our healthcare system. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  2. [From the history of organization of medical care to population in cities of the north-eastern Caucasus in XIX--early XX centuries].

    PubMed

    2013-01-01

    The article deals with becoming of urban health care in the region of the north-eastern Caucasus in XIX--early XX centuries. The characteristics and stages of development of medical care in cities appeared grew from military fortifications and fortresses in the meddle of XIX century are established. The first curative institutions in cities were military hospitals and infirmaries. Later on appeared clinics of philanthropic societies and even later on hospitals functioning on municipality funds and private curative establishments.

  3. Learning Cities as Healthy Green Cities: Building Sustainable Opportunity Cities

    ERIC Educational Resources Information Center

    Kearns, Peter

    2012-01-01

    This paper discusses a new generation of learning cities we have called EcCoWell cities (Economy, Community, Well-being). The paper was prepared for the PASCAL International Exchanges (PIE) and is based on international experiences with PIE and developments in some cities. The paper argues for more holistic and integrated development so that…

  4. [Effects of long-term fluoride in drinking water on risks of hip fracture of the elderly: an ecologic study based on database of hospitalization episodes].

    PubMed

    Park, Eun Young; Hwang, Seung Sik; Kim, Jai Yong; Cho, Soo Hun

    2008-05-01

    Fluoridation of drinking water is known to decrease dental caries, particularly in children. However, the effects of fluoridated water on bone over several decades are still in controversy. To assess the risk of hip fracture related to water fluoridation, we evaluated the hip fracture-related hospitalizations of the elderly between a fluoridated city and non-fluoridated cities in Korea. Cheongju as a fluoridated area and Chungju, Chuncheon, Suwon, Wonju as non-fluoridated areas were chosen for the study. We established a database of hip fracture hospitalization episode based on the claims data submitted to the Health Insurance Review Agency from January 1995 to December 2002. The hip fracture hospitalization episodes that satisfied the conditions were those that occurred in patients over 65 years old, the injuries had a hip fracture code (ICD-9 820, ICD-10 S72) and the patients were hospitalized for at least 7days. A total of 80,558 cases of hip fracture hospitalization episodes were analyzed. The admission rates for hip fracture increased with the age of the men and women in both a fluoridated city and the non-fluoridated cities (p<0.01). The relative risk of hip fracture increased significantly both for men and women as their age increased. However, any difference in the hip fracture admission rates was not consistently observed between the fluoridated city and the nonfluoridated cities. We cannot conclude that fluoridation of drinking water increases the risk of hip fracture in the elderly.

  5. Jobs in Recreation and Hospitality. Job Family Series.

    ERIC Educational Resources Information Center

    Science Research Associates, Inc., Chicago, IL.

    This booklet describes jobs in recreation and hospitality in the following chapter classifications: serving people in cities and communities; helping people enjoy natural resources; helping people enjoy cultural resources; and helping people enjoy trips and travel. For each occupation, duties are outlined and working conditions discussed.…

  6. Traumatic brain injuries in children: A hospital-based study in Nigeria.

    PubMed

    Udoh, David O; Adeyemo, Adebolajo A

    2013-01-01

    Traumatic Brain Injury (TBI) is a significant cause of morbidity and mortality worldwide. Our previous studies showed a high frequency of motor vehicle accidents among neurosurgical patients. However, there is a dearth of data on head injuries in children in Nigeria. To determine the epidemiology of paediatric traumatic brain injuries. This is a prospective analysis of paediatric head trauma at the University of Benin Teaching Hospital, a major referral centre for all traumatic brain injuries in Nigeria between October 2006 and September 2011. We studied the demographic, clinical and radiological data and treatment outcomes. Data was analysed using statistical package for the social sciences (SPSS) 16.0. We managed 127 cases of paediatric head injuries, 65 boys and 62 girls representing 13% of all head injuries managed over the 5-year period. They were aged 3 months to 17 years. The mean age was 7.4 years (median 7 years) with peak incidence occurring at 6-8 years i.e. 31 (24.4%) cases. Motor vehicle accidents resulted in 67.7%, falls 14% and violence 7%. The most frequent computed tomography finding was intracerebral haemorrhage. Mean duration of hospitalization was 18 days (median 11 days). Eleven patients died, mortality correlating well with severity and the presence of intracerebral haematoma. Head injuries in children are due to motor vehicle and motor vehicle-related accidents. Hence, rational priorities for prevention of head injuries in children should include prevention of vehicular, especially pedestrian, accidents in developing countries.

  7. Environmental pollutants and stroke-related hospital admissions.

    PubMed

    Nascimento, Luiz Fernando Costa; Francisco, Juliana B; Patto, Marielle Beatriz R; Antunes, Angélica M

    2012-07-01

    Some effects of environmental pollution on human health are known, especially those affecting the respiratory and cardiovascular systems. The current study aimed to estimate these effects on the production of hospital admissions for stroke. This was an ecological study using hospital admissions data in São José dos Campos, São Paulo State, Brazil, with diagnosis of stroke, from January 1, 2007, to April 30, 2008. The target pollutants were particulate matter, sulfur dioxide, and ozone. Use of a Poisson linear regression model showed that same-day exposure to particulate matter was associated with hospitalization for stroke (RR = 1.013; 95%CI: 1.001-1.025). An increase of 10 µg/m(3) in this pollutant increased the risk of hospitalization by 12% (RR = 1.137; 95%CI: 1.014-1.276). In the multi-pollutant model, it was thus possible to identify particulate matter as associated with hospitalization for stroke in a medium-sized city like São José dos Campos.

  8. Ecotoxicological and Genotoxic Evaluation of Buenos Aires City (Argentina) Hospital Wastewater

    PubMed Central

    Juárez, Ángela Beatriz; Dragani, Valeria; Saenz, Magalí Elizabeth; Moretton, Juan

    2014-01-01

    Hospital wastewater (HWW) constitutes a potential risk to the ecosystems and human health due to the presence of toxic and genotoxic chemical compounds. In the present work we investigated toxicity and genotoxicity of wastewaters from the public hospital of Buenos Aires (Argentina). The effluent from the sewage treatment plant (STP) serving around 10 million inhabitants was also evaluated. The study was carried out between April and September 2012. Toxicity and genotoxicity assessment was performed using the green algae Pseudokirchneriella subcapitata and the Allium cepa test, respectively. Toxicity assay showed that 55% of the samples were toxic to the algae (%I of growth between 23.9 and 54.8). The A. cepa test showed that 40% of the samples were genotoxic. The analysis of chromosome aberrations (CA) and micronucleus (MN) showed no significant differences between days and significant differences between months. The sample from the STP was not genotoxic to A. cepa but toxic to the algae (%I = 41%), showing that sewage treatment was not totally effective. This study highlights the need for environmental control programs and the establishment of advanced and effective effluent treatment plants in the hospitals, which are merely dumping the wastewaters in the municipal sewerage system. PMID:25214834

  9. Hospital Versus Home Death: Results from the Mexican Health and Aging Study

    PubMed Central

    Cárdenas-Turanzas, Marylou; Torres-Vigil, Isabel; Tovalín-Ahumada, Horacio; Nates, Joseph L.

    2013-01-01

    Context Characterizing where people die is needed to inform palliative care programs in Mexico. Objectives To determine whether access to health care influences the place of death of older Mexicans and examine the modifying effects of demographic and clinical characteristics. Methods We analyzed 2001 baseline and 2003 follow-up data from the Mexican Health and Aging Study. Cases included adults who completed the baseline interview and died before the follow-up interview and for whom a proxy interview was obtained in 2003. The main outcome variable was the place of death (hospital vs. home). The predictors of the place of death were identified using logistic regression analysis. Results The study group included 473 deceased patients; 52.9% died at home. Factors associated with hospital death were having spent at least one night in a hospital during the last year of life (odds ratio [OR]: 6.73; 95% confidence interval [CI]: 3.29, 13.78) and dying in a city other than the city of usual residence (OR: 4.68, 95% CI: 2.56, 8.57). Factors associated with home death were not having health care coverage (OR: 2.78, 95% CI: 1.34, 5.88), living in a city of less than 100,000 residents (OR: 2.44, 95% CI: 1.43, 4.17), and older age (OR: 1.03, 95% CI: 1.01, 1.05). Conclusion Older Mexicans with access to health care services were more likely to die in the hospital even after controlling for important clinical and demographic characteristics. Findings from the study may be used to plan the provision of accessible end-of-life hospital and home-based services. PMID:21146354

  10. The impact of a 100% smoke-free law on the health of hospitality workers from the city of Neuquén, Argentina.

    PubMed

    Schoj, Veronica; Alderete, Mariela; Ruiz, Ernesto; Hasdeu, Santiago; Linetzky, Bruno; Ferrante, Daniel

    2010-04-01

    The objective of this study was to evaluate the impact of 100% smoke-free environment legislation on respiratory and sensory irritation symptoms and respiratory function among bar and restaurant workers from the city of Neuquén, Argentina. Pre-ban and post-ban studies without a comparison group in an Argentinean city were conducted. A baseline survey and spirometric measurements were performed with a total of 80 bar and restaurant workers 1 month before (October 2007) and 3 months after (March 2008) the implementation of the new 100% smoke-free legislation. A significant reduction in secondhand smoke exposure was observed after the enactment and enforcement of the new legislation, and an important reduction in respiratory symptoms (from a pre-ban level of 57.5% to a post-ban level of only 28.8%). The reduction of sensory irritation symptoms was even higher. From 86.3% of workers who reported at least one sensory irritation symptom in October 2007, only 37.5% reported the same symptoms in March 2008. Also, data obtained by spirometry showed a significant forced vital capacity increase. Consistent with other studies, 100% smoke-free legislation improved short-term health outcomes in the sample and should be implemented nationwide. Furthermore, undertaking this study has been highly important in promoting 100% smoke-free environment legislation at the workplace as a legitimate right of hospitality workers, and in reducing social acceptance of designated smoking areas in bars and restaurants.

  11. The impact of a 100% smoke-free law on the health of hospitality workers from the city of Neuquén, Argentina

    PubMed Central

    Alderete, Mariela; Ruiz, Ernesto; Hasdeu, Santiago; Linetzky, Bruno; Ferrante, Daniel

    2010-01-01

    Objectives The objective of this study was to evaluate the impact of 100% smoke-free environment legislation on respiratory and sensory irritation symptoms and respiratory function among bar and restaurant workers from the city of Neuquén, Argentina. Methods Pre-ban and post-ban studies without a comparison group in an Argentinean city were conducted. A baseline survey and spirometric measurements were performed with a total of 80 bar and restaurant workers 1 month before (October 2007) and 3 months after (March 2008) the implementation of the new 100% smoke-free legislation. Results A significant reduction in secondhand smoke exposure was observed after the enactment and enforcement of the new legislation, and an important reduction in respiratory symptoms (from a pre-ban level of 57.5% to a post-ban level of only 28.8%). The reduction of sensory irritation symptoms was even higher. From 86.3% of workers who reported at least one sensory irritation symptom in October 2007, only 37.5% reported the same symptoms in March 2008. Also, data obtained by spirometry showed a significant forced vital capacity increase. Conclusions Consistent with other studies, 100% smoke-free legislation improved short-term health outcomes in the sample and should be implemented nationwide. Furthermore, undertaking this study has been highly important in promoting 100% smoke-free environment legislation at the workplace as a legitimate right of hospitality workers, and in reducing social acceptance of designated smoking areas in bars and restaurants. PMID:20378587

  12. Hospital Nuclear Pharmacy Survey: Preliminary Aspects In Brazil

    PubMed Central

    Brasil, Marcelo Pau; de Barros, Marcio Paes; Antunes, Leila Jorge; Santos-Oliveira, Ralph

    2012-01-01

    Radiopharmaceuticals are special drugs that in the composition preserve one or more radionuclides which can be used as diagnostic or therapeutic tools in Nuclear Medicine Units. This study evaluated hospitals and clinics which have nuclear medicines services at the city of Rio de Janeiro from August to November 2010. The data were obtained through a longitudinal research. The results showed that most of the hospitals (>80%) did not have pharmacist and all them (100%) considered that a pharmacist in the nuclear pharmacy is not required. PMID:23493051

  13. [A study of refractive errors in a primary school in Cotonou, Benin].

    PubMed

    Sounouvou, I; Tchabi, S; Doutetien, C; Sonon, F; Yehouessi, L; Bassabi, S K

    2008-10-01

    Determine the epidemiologic aspects and the degree of severity of different refractive errors in primary schoolchildren. A prospective and descriptive study was conducted from 1 December 2005 to 31 March 2006 on schoolchildren ranging from 4 to 16 years of age in a public primary school in Cotonou, Benin. The refraction was evaluated for any visual acuity lower than or equal to 0.7. The study included 1057 schoolchildren. The average age of the study population was 8.5+/-2.6 years with a slight predominance of females (51.8%). The prevalence of refractive error was 10.6% and astigmatism accounted for the most frequent refractive anomaly (91.9%). Myopia and the hyperopia were associated with astigmatism in 29.4% and 16.1% of the cases, respectively. The age bracket from 6 to 11 years accounted for the majority of refractive errors (75.9%), without age and sex being risk factors (p=0.811 and p=0.321, respectively). The average vision of the ametropic eye was 0.61, with a clear predominance of slight refractive errors (89.3%) and particularly of low-level simple astigmatism (45.5%). The relatively low prevalence of refractive error observed does not obviate the need for implementing actions to improve the ocular health of schoolchildren.

  14. High number of diarrhoeal co-infections in travellers to Benin, West Africa.

    PubMed

    Lääveri, Tinja; Pakkanen, Sari H; Antikainen, Jenni; Riutta, Jukka; Mero, Sointu; Kirveskari, Juha; Kantele, Anu

    2014-02-12

    Travellers' diarrhoea (TD) is the most frequent health problem among travellers to the tropics. Using routine techniques, the aetiology mostly remains unresolved, whereas modern molecular methods enable reducing the number of equivocal cases considerably. While many studies address the aetiology of TD in Asian, Central American and North African tourist resorts, only few focus on Western Africa. Stool samples from 45 travellers travelling in Benin, West Africa, were analyzed by a new multiplex qPCR assay for Salmonella, Yersinia, Campylobacter, Vibrio cholerae, Shigella or enteroinvasive (EIEC), enterohaemorrhagic (EHEC), enterotoxigenic (ETEC), enteroaggregative (EAEC), and enteropathogenic Escherichia coli (EPEC). All 18 pre-travel samples proved negative for bacterial pathogens. Of the 39/45 (87%) travellers having had TD, EPEC was detected in post-travel samples in 30 (77%) cases, EAEC in 23 (59%), ETEC in 22 (56%), Shigella or EIEC in 7 (18%), EHEC in two (5%), and Salmonella in one (3%). In 31(79%) of the TD cases two or more bacterial pathogens were identified. Two (8%) samples remained negative: both patients had taken antimicrobials for TD. EPEC, EAEC and ETEC were the most common findings. 79% of the cases had a co-infection. As modern diagnostics reveals in most patients a multitude of pathogens, the role of each pathogen should be re-evaluated.

  15. Biodiversity of aerobic endospore-forming bacterial species occurring in Yanyanku and Ikpiru, fermented seeds of Hibiscus sabdariffa used to produce food condiments in Benin.

    PubMed

    Agbobatinkpo, Pélagie B; Thorsen, Line; Nielsen, Dennis S; Azokpota, Paulin; Akissoe, Noèl; Hounhouigan, Joseph D; Jakobsen, Mogens

    2013-05-15

    Yanyanku and Ikpiru made by the fermentation of Malcavene bean (Hibiscus sabdariffa) are used as functional additives for Parkia biglobosa seed fermentations in Benin. A total of 355 aerobic endospore-forming bacteria (AEFB) isolated from Yanyanku and Ikpiru produced in northern and southern Benin were identified using phenotypic and genotypic methods, including GTG5-PCR, M13-PCR, 16S rRNA, gyrA and gyrB gene sequencing. Generally, the same 5-6 species of the genus Bacillus predominated: Bacillus subtilis (17-41% of isolates), Bacillus cereus (8-39%), Bacillus amyloliquefaciens (9-22%), Bacillus licheniformis (3-26%), Bacillus safensis (8-19%) and Bacillus altitudinis (0-19%). Bacillus aryabhattai, Bacillus flexus, and Bacillus circulans (0-2%), and species of the genera Lysinibacillus (0-14%), Paenibacillus (0-13%), Brevibacillus (0-4%), and Aneurinibacillus (0-3%) occurred sporadically. The diarrheal toxin encoding genes cytK-1, cytK-2, hblA, hblC, and hblD were present in 0%, 91% 15%, 34% and 35% of B. cereus isolates, respectively. 9% of them harbored the emetic toxin genetic determinant, cesB. This study is the first to identify the AEFB of Yanyanku and Ikpiru to species level and perform a safety evaluation based on toxin gene detections. We further suggest, that the gyrA gene can be used for differentiating the closely related species Bacillus pumilus and B. safensis. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. State of malnutrition in hospitals of Ecuador.

    PubMed

    Gallegos Espinosa, Sylvia; Nicolalde Cifuentes, Marcelo; Santana Porbén, Sergio

    2014-08-01

    Hospital malnutrition is a global health problem affecting 30-50% of hospitalized patients. There are no estimates of the size of this problem in Ecuadorian hospitals. Hospital malnutrition might influence the quality of medical assistance provided to hospitalized populations. To estimate the current frequency of malnutrition among patients admitted to Ecuadorian public hospitals. The Ecuadorian Hospital Malnutrition Study was conducted between November 2011 and June 2012 with 5,355 patients (Women: 37.5%; Ages ≥ 60 years: 35.1%; Length of stay ≤ 15 days: 91.2%) admitted to 36 public hospitals located in the prominent cities of 22 out of the 24 provinces of the country. Malnutrition frequency was estimated by means of the Subjective Global Assessment survey. Malnutrition affected 37.1% of the surveyed patients. Malnutrition was dependent upon patient's age and education level; as well as the presence of cancer, sepsis, and chronic organic failure. Hospital areas showed different frequencies of hospital malnutrition. Health condition leading to hospital admission influenced negatively upon nutritional status. Malnutrition frequency increased as length of stay prolonged. Malnutrition currently affects an important proportion of patients hospitalized in public health institutions of Ecuador. Policies and actions are urgently required in order to successfully deal with this health problem and thus to ameliorate its negative impact upon quality of medical care. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  17. Characterization of hospital and community-acquired respiratory syncytial virus in children with severe lower respiratory tract infections in Ho Chi Minh City, Vietnam, 2010

    PubMed Central

    Tuan, Tran Anh; Thanh, Tran Tan; Hai, Nguyen thi Thanh; Tinh, Le Binh Bao; Kim, Le thi Ngoc; Do, Lien Anh Ha; Chinh B'Krong, Nguyen thi Thuy; Tham, Nguyen thi; Hang, Vu thi Ty; Merson, Laura; Farrar, Jeremy; Thuong, Tang Chi; de Jong, Menno D; Schultsz, Constance; van Doorn, H Rogier

    2015-01-01

    Background Human respiratory syncytial virus (RSV) is an important community and nosocomial pathogen in developed countries but data regarding the importance of RSV in developing countries are relatively scarce. Methods During a 1-year surveillance study in 2010, we took serial samples from children admitted to the Emergency Unit of the Respiratory Ward of Children's Hospital 1 in Ho Chi Minh City, Vietnam. RSV was detected within 72 hours of admission to the ward in 26% (376/1439; RSV A: n = 320; RSV B: n = 54; and RSV A and B: n = 2). Among those negative in the first 72 hours after admission, 6·6% (25/377) acquired nosocomial RSV infection during hospitalization (RSV A: n = 22; and RSV B: n = 3). Results Children with nosocomial RSV infection were younger (P = 0·001) and had a longer duration of hospitalization (P < 0·001). The rate of incomplete recovery among children with nosocomial RSV infection was significantly higher than among those without (P < 0·001). Phylogenetic analysis of partial G gene sequences obtained from 79% (316/401) of positive specimens revealed the co-circulation of multiple genotypes with RSV A NA1 being predominant (A NA1: n = 275; A GA5: n = 5; B BA3: n = 3; B BA9: n = 26; and B BA10: n = 7). The RSV A GA5 and RSV B BA3 genotypes have not been reported from Vietnam, previously. Conclusion Besides emphasizing the importance of RSV as a cause of respiratory infection leading to hospitalization in young children and as a nosocomial pathogen, data from this study extend our knowledge on the genetic diversity of RSV circulating in Vietnam. PMID:25702707

  18. The Effect of Reciprocal Peer Counselling in the Enhancement of Self-Concept among Adolescents

    ERIC Educational Resources Information Center

    Egbochuku, E. O.; Obiunu, J. J.

    2006-01-01

    This study investigated the effect of reciprocal peer counselling in the enhancement of self-concept of Nigerian adolescent students. The effect of sex on self-concept was also investigated. Sixty-eight senior secondary school students from three schools (a boys' school, a girls' school, and a co-educational school) in Benin City, Edo State…

  19. Hospital waste management in El-Beheira Governorate, Egypt.

    PubMed

    Abd El-Salam, Magda Magdy

    2010-01-01

    This study investigated the hospital waste management practices used by eight randomly selected hospitals located in Damanhour City of El-Beheira Governorate and determined the total daily generation rate of their wastes. Physico-chemical characteristics of hospital wastes were determined according to standard methods. A survey was conducted using a questionnaire to collect information about the practices related to waste segregation, collection procedures, the type of temporary storage containers, on-site transport and central storage area, treatment of wastes, off-site transport, and final disposal options. This study indicated that the quantity of medical waste generated by these hospitals was 1.249tons/day. Almost two-thirds was waste similar to domestic waste. The remainder (38.9%) was considered to be hazardous waste. The survey results showed that segregation of all wastes was not conducted according to consistent rules and standards where some quantity of medical waste was disposed of with domestic wastes. The most frequently used treatment method for solid medical waste was incineration which is not accepted at the current time due to the risks associated with it. Only one of the hospitals was equipped with an incinerator which is devoid of any air pollution control system. Autoclaving was also used in only one of the selected hospitals. As for the liquid medical waste, the survey results indicated that nearly all of the surveyed hospitals were discharging it in the municipal sewerage system without any treatment. It was concluded that the inadequacies in the current hospital waste management practices in Damanhour City were mainly related to ineffective segregation at the source, inappropriate collection methods, unsafe storage of waste, insufficient financial and human resources for proper management, and poor control of waste disposal. The other issues that need to be considered are a lack of appropriate protective equipment and lack of training and

  20. Preventable Hospitalization Rates and Neighborhood Poverty among New York City Residents, 2008-2013.

    PubMed

    Bocour, Angelica; Tria, Maryellen

    2016-12-01

    Knowing which demographic groups have higher rates of preventable hospitalizations can help identify geographic areas where improvements in primary care access and quality can be made. This study assessed whether preventable hospitalization rates by neighborhood poverty decreased from 2008 to 2013 and whether the gap between very high and low poverty neighborhoods changed. We examined trends in age-adjusted preventable hospitalization rates and rate ratios by neighborhood poverty overall and by sex using JoinPoint regression. Prevention Quality Indicators (PQIs) developed by the Agency for Healthcare Research and Quality were applied to inpatient hospitalization data from the New York State Department of Health's Statewide Planning and Research Cooperative System. PQIs were classified into composites. From 2008 to 2013, preventable hospitalization rates per 100,000 adults across each poverty group decreased. For very high poverty neighborhoods (ZIP codes with ≥30 % of persons living below the federal poverty level (FPL)), there were significant decreases overall (3430.56 to 2543.10, annual percent change [APC] = -5.91 %), for diabetes (676.15 to 500.83, APC = -5.75 %), respiratory (830.78 to 660.29, APC = -4.85 %), circulatory (995.69 to 701.81, APC = -7.24 %), and acute composites (928.18 to 680.17, APC = -5.62 %). The rate ratios also decreased over time; however, in 2013, the rates for very high poverty neighborhoods were two to four times higher than low poverty neighborhoods (ZIP codes with <10 % of persons below the FPL). While preventable hospitalization rates have decreased over time, disparities still exist. These findings underscore the need to ensure adequate access to quality and timely primary care among individuals living in high poverty neighborhoods.

  1. Air pollution and hospital admissions for asthma in a tropical city: Kaohsiung, Taiwan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shang-Shyue Tsai; Meng-Hsuan Cheng; Hui-Fen Chiu

    2006-07-15

    This study was undertaken to determine whether there is an association between air pollutants levels and hospital admissions for asthma in Kaohsiung, Taiwan. Hospital admissions for asthma and ambient air pollution data for Kaohsiung were obtained for the period from 1996 through 2003. The relative risk of hospital admission was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single-pollutant models, on warm days ({>=}25{sup o}C) statistically significant positive associations were found in all pollutants except sulfur dioxide. On cool days ({<=} 25{sup o}C) all pollutants were significantly associatedmore » with asthma admissions. For the two pollutant models, CO and O{sub 3} were significant in combination with each of the other four pollutants on warm days. On cool days NO{sub 2} remained statistically significant in all the two-pollutant models. This study provides evidence that higher levels of ambient pollutants increase the risk of hospital admissions for asthma.« less

  2. New York City's Child Health Clinics: Providing Quality Primary Care to Children in Low-Income and Immigrant Families.

    ERIC Educational Resources Information Center

    Citizens' Committee for Children of New York, NY.

    A study was conducted to determine whether the New York City Health and Hospitals Corporation (HHC) is fulfilling dual public health and primary care missions of its Child Health Clinics, which provide services to 78,000 New York City children every year. Among the services provided by Child Health Clinics are health examinations for school and…

  3. Factors associated with variation in financial condition among voluntary hospitals.

    PubMed Central

    Brecher, C; Nesbitt, S

    1985-01-01

    This article uses multiple regression analysis to identify factors which affect variations in the financial condition of voluntary hospitals in New York State. Six separate ratios are used to measure financial condition and 18 independent variables are considered. The factors affecting financial conditions were found to vary among dimensions of financial health, and different causal relationships were evident among hospitals in New York City than among those in the rest of the state. PMID:4019212

  4. [Emergency eye care in French university hospitals].

    PubMed

    Bourges, J-L

    2018-03-01

    The patient's request for urgent care in ophthalmology (PRUCO) at health care centers is constantly growing. In France, university hospitals are managing 75% of these cases. We sought to quantify PRUCO referred to French university hospital emergency units as well as to approach the structure and the territorial distribution of emergency eye care provided by French university hospitals. We conducted a quick cross-sectional survey sent to the 32 metropolitan and overseas French university hospitals. It inquired for each hospital whether emergency eye care units were available, whether ophthalmologists were on duty or on call overnight and how many PRUCO were managed in 2016. The 32 university hospitals completed the survey. A total of 398650 PRUCO were managed in French university hospitals in 2016. The emergency unit was exclusively dedicated to eye care for 70% of the hospitals, with 47% (15/32) of them employing an ophthalmologist on duty overnight. Every hospital but one had at least one ophthalmologist on call. The city of Paris set aside, university hospitals took care of an annual mean of 9000 PRUCO (min=500; max=32,250). The 32 French university hospitals are actively responding to patient's requests for urgent care in ophthalmology with very heterogeneous patient volumes and organizational systems. Half of them employ ophthalmologists on duty. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  5. Hospital or general practice? Results of two experiments limiting the number of self referrals of patients with injuries to hospitals in The Netherlands.

    PubMed Central

    Sixma, H J; de Bakker, D H

    1996-01-01

    OBJECTIVE: To describe the results of two Dutch experiments aimed at limiting the number of self referrals to accident and emergency (A&E) departments of a newly opened hospital. METHODS: Basic design for both field experiments was a one group test-retest study, with the opening of a new hospital being the experimental factor. Data refer (1) to the number of patient contacts for acute somatic and non-somatic professional help with traumata and intoxications filled in on contact registration forms, and (2) to patient reports based on written questionnaires and interviews by telephone. RESULTS: Both studies show that it is possible to limit the number of self referrals, although it is important to be aware of possible side effects. The solution chosen in one of the cities, with patients visiting the A&E department being sent back to a general practitioner, was highly effective but resulted in a series of complaints from the public. This forced the authorities to abandon their original policy. The model chosen in the other city, with two specialized health centres serving as an alternative for the free A&E department of the new hospital, was somewhat less successful in preventing patients from going directly to a hospital, but was much more acceptable for the public. CONCLUSIONS: Both studies showed that controlling the number of self referrals to the A&E departments of hospitals is possible. However, the more rigid the model, the more difficult it will be to have this model accepted by patients. Based on arguments like cost-effectiveness, a better solution might be not to discourage people from going to the hospital with minor injuries, but to integrate primary health care (PHC) and hospital facilities. PMID:8832346

  6. Are the nation's hospitals facing a capital crisis?

    PubMed

    Johnsson, J

    1990-07-20

    Are hospitals facing a capital crisis? Wall Street is taking a long, hard look at hospitals' bottom lines--and many analysts don't like what they see. Hospitals' increasing reliance on long-term debt, lower debt-service coverage ratios, and weakening performance indicators all signal a potentially volatile situation for some sectors of the field. Which hospitals are at risk? Experts point to hospitals in Southern California and New York. But others say that hospitals in moderate-size cities with 250 beds and $40 million or more in long-term debt are vulnerable. However, 40 percent of the 600 CEOs who responded to our Hamilton/KSA survey agree that the continued erosion of reimbursement will require a government bailout similar to the savings and loan industry. "A great deal depends on public policy," says Darrel Brownell, executive vice-president and chief financial officer, Memorial Health Services, a two-hospital system based in Long Beach, CA. "The government has the ability to maintain the industry in a stable condition, or it has the ability to force it into a bailout situation."

  7. Performance-Based Financing to Strengthen the Health System in Benin: Challenging the Mainstream Approach.

    PubMed

    Paul, Elisabeth; Lamine Dramé, Mohamed; Kashala, Jean-Pierre; Ekambi Ndema, Armand; Kounnou, Marcel; Codjovi Aïssan, Julien; Gyselinck, Karel

    2017-04-15

    Performance-based financing (PBF) is often proposed as a way to improve health system performance. In Benin, PBF was launched in 2012 through a World Bank-supported project. The Belgian Development Agency (BTC) followed suit through a health system strengthening (HSS) project. This paper analyses and draws lessons from the experience of BTC-supported PBF alternative approach - especially with regards to institutional aspects, the role of demand-side actors, ownership, and cost-effectiveness - and explores the mechanisms at stake so as to better understand how the "PBF package" functions and produces effects. An exploratory, theory-driven evaluation approach was adopted. Causal mechanisms through which PBF is hypothesised to impact on results were singled out and explored. This paper stems from the co-authors' capitalisation of experiences; mixed methods were used to collect, triangulate and analyse information. Results are structured along Witter et al framework. Influence of context is strong over PBF in Benin; the policy is donor-driven. BTC did not adopt the World Bank's mainstream PBF model, but developed an alternative approach in line with its HSS support programme, which is grounded on existing domestic institutions. The main features of this approach are described (decentralised governance, peer review verification, counter-verification entrusted to health service users' platforms), as well as its adaptive process. PBF has contributed to strengthen various aspects of the health system and led to modest progress in utilisation of health services, but noticeable improvements in healthcare quality. Three mechanisms explaining observed outcomes within the context are described: comprehensive HSS at district level; acting on health workers' motivation through a complex package of incentives; and increased accountability by reinforcing dialogue with demand-side actors. Cost-effectiveness and sustainability issues are also discussed. BTC's alternative PBF approach

  8. Ameloblastomatous Change in Radicular Cyst of The Jaw in a Nigerian Population.

    PubMed

    Omoregie, F O; Sede, M A; Ojo, A M

    2015-06-01

    To determine the incidence, age, gender, jaw-sites and subtypes of radicular cyst, and to determine the incidence of ameloblastomatous change in radicular cyst in a Nigerian population. A 10-year retrospective analysis of all diagnosed orofacial lesions in the Department of Oral Pathology and Medicine, University of Benin Teaching Hospital, Benin City, Nigeria. From the 785 diagnosed orofacial lesions within the study period; there were 54 (6.9%) cases of radicular cysts of the jaws. The peak age group was the 3(rd) decade (n=23, 42.6%) with a mean age of 31 ± 1.7 years. There were 29 (53.7%) males and 25 (46.3%) females, giving a ratio of 1.2:1. The mandible was the commonest jaw-site (n=32, 59.3%). There were 12 (22.2%) cases of periapical cyst which were significantly associated with anterior maxillary site (n=8, 14.8%) [p=0.001]. Seven (13.0%) cases of cystic ameloblastoma were diagnosed among the radicular cysts, with a predilection of the lesions for 3(rd) and 4(th) decades of life (n=6, 11.1%), and posterior mandible (n=5, 9.3%). This study showed a low incidence of radicular cyst of the jaw among orofacial lesions and a relatively higher incidence of ameloblastomatous change in radicular cyst compared to previous reports. Immuno-histochemical examination is recommended to differentiate radicular cyst with ameloblastomatous-like change from cystic ameloblastoma arising from radicular cyst.

  9. Peer Group Counselling and School Influence on Adolescents' Self-Concept

    ERIC Educational Resources Information Center

    Egbochuku, E. O.; Aihie, N. O.

    2009-01-01

    The study focused on the influence of peer group counselling and school influence on the self-concept of adolescents' in Nigerian secondary schools. Sixty-eight Senior Secondary School II students from three schools--a boys' school, a girls' school and a co-educational school in Benin City participated in the study. A pre-test, post-test control…

  10. Tonal Icons in Bini.

    ERIC Educational Resources Information Center

    Wescott, Roger W.

    1973-01-01

    Bini, a language spoken by a million horticulturists in and around Benin City, Nigeria, belongs genealogically to the Edo branch of the Kwa family of the Niger-Congo phylum. Bini dialects differ in their tonemic inventory, which ranges from four to six tonemes per dialect. But all dialects exhibit two morphotonemes--high and low--which perhaps…

  11. CityGML - Interoperable semantic 3D city models

    NASA Astrophysics Data System (ADS)

    Gröger, Gerhard; Plümer, Lutz

    2012-07-01

    CityGML is the international standard of the Open Geospatial Consortium (OGC) for the representation and exchange of 3D city models. It defines the three-dimensional geometry, topology, semantics and appearance of the most relevant topographic objects in urban or regional contexts. These definitions are provided in different, well-defined Levels-of-Detail (multiresolution model). The focus of CityGML is on the semantical aspects of 3D city models, its structures, taxonomies and aggregations, allowing users to employ virtual 3D city models for advanced analysis and visualization tasks in a variety of application domains such as urban planning, indoor/outdoor pedestrian navigation, environmental simulations, cultural heritage, or facility management. This is in contrast to purely geometrical/graphical models such as KML, VRML, or X3D, which do not provide sufficient semantics. CityGML is based on the Geography Markup Language (GML), which provides a standardized geometry model. Due to this model and its well-defined semantics and structures, CityGML facilitates interoperable data exchange in the context of geo web services and spatial data infrastructures. Since its standardization in 2008, CityGML has become used on a worldwide scale: tools from notable companies in the geospatial field provide CityGML interfaces. Many applications and projects use this standard. CityGML is also having a strong impact on science: numerous approaches use CityGML, particularly its semantics, for disaster management, emergency responses, or energy-related applications as well as for visualizations, or they contribute to CityGML, improving its consistency and validity, or use CityGML, particularly its different Levels-of-Detail, as a source or target for generalizations. This paper gives an overview of CityGML, its underlying concepts, its Levels-of-Detail, how to extend it, its applications, its likely future development, and the role it plays in scientific research. Furthermore, its

  12. Per-Capita Medicare Expenditures, Primary Care Access, Mortality Rates, and the Least Healthy Cities in America.

    PubMed

    Weeks, William B; Weinstein, James N

    2017-01-01

    To determine whether several measures of health care expenditures, access, and outcomes for the 25 recently identified "least healthy cities in America" differed from those in the rest of America. For 2004 and 2013, we obtained publicly available price-, age-, sex-, and race-adjusted hospital service area per-capita Medicare expenditures; age-, sex-, and race-adjusted Medicare mortality rates; and 2 indicators of primary care access: the proportion of enrollees having at least one ambulatory visit to a primary care clinician and the per-capita discharge rate for ambulatory care sensitive conditions. Using population weighting, we used Student t test for expenditure data and the chi-squared test for access and outcomes data to compare results of the 25 least healthy cities in aggregate to the rest of America. In both years examined, the 25 least healthy cities had substantially (about $500 per capita per year) and statistically significantly higher total per-capita Medicare Part A and Part B expenditures than the rest of America: about 4/5 of this difference was due to higher hospital and skilled nursing facility expenditures; physician expenditures were modestly lower in the 25 least healthy cities. While a greater proportion of Medicare beneficiaries in the least healthy cities had a primary care clinician both years, mortality and ambulatory care sensitive condition admission rates were substantially higher in the least healthy cities. Policymakers and health system executives should work together to determine the best asset allocation across determinants of health that maximizes value creation from a community health perspective. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Profile of Dental Caries in Teenagers in Mumbai City Visiting Nair Hospital Dental College.

    PubMed

    Banga, Kulvinder Singh; Rastogi, Sweta; Mistry, Siddhi

    2018-01-01

    Witnessing the alarming rise and pattern of distribution of dental caries worldwide, the need of the hour is to take initiative in preventing the spread further. This survey was conducted to determine the occurrence of dental caries and its associated risk factors in teenagers of Mumbai city who visited Nair Hospital Dental College. The objective of the study was to analyze the current dietary habits, oral hygiene status, and the number of sugar exposures in teenagers by a questionnaire followed by clinical examination which was carried out using International Caries Detection and Assessment System (ICDAS) II to detect the profile of dental caries. The data obtained from the questionnaire and examination were analyzed using Chi-square test. The survey showed that, out of the 300 teenagers examined, 67% visited the dentist only when they were symptomatic. Around 60% consumed sweets 2-3 times/day. A major percentage, 89%, consumed sweets irrespective of meal time and 52% consumed aerated drinks often. Only 16% used appropriate brushing techniques and 93% were not aware if their toothpaste was fluoridated. ICDAS II revealed that a total number of teeth requiring preventive treatment ranged from 8.3% to 14% and total number of teeth requiring definitive treatment ranged from 36% to 48%. It was found that tooth most commonly treated was 36 followed by tooth number 46 showing that the incidence of caries is higher in lower arch. Most of the teenagers had a high rate of sweet consumption in between meals and poor knowledge of brushing techniques, fluoridated toothpaste, interdental aids, and mouthrinses. ICDAS showed a high incidence of caries in teenagers, especially in the lower arch. ICDAS II showed good accuracy in differentiating between noncavitated and cavitated lesions which helps to provide an accurate treatment plan for teenagers so that it prevents the progression of the lesion.

  14. A Field Study in Benin to Investigate the Role of Mosquitoes and Other Flying Insects in the Ecology of Mycobacterium ulcerans.

    PubMed

    Zogo, Barnabas; Djenontin, Armel; Carolan, Kevin; Babonneau, Jeremy; Guegan, Jean-François; Eyangoh, Sara; Marion, Estelle

    2015-01-01

    Buruli ulcer, the third mycobacterial disease after tuberculosis and leprosy, is caused by the environmental mycobacterium M. ulcerans. There is at present no clear understanding of the exact mode(s) of transmission of M. ulcerans. Populations affected by Buruli ulcer are those living close to humid and swampy zones. The disease is associated with the creation or the extension of swampy areas, such as construction of dams or lakes for the development of agriculture. Currently, it is supposed that insects (water bugs and mosquitoes) are host and vector of M. ulcerans. The role of water bugs was clearly demonstrated by several experimental and environmental studies. However, no definitive conclusion can yet be drawn concerning the precise importance of this route of transmission. Concerning the mosquitoes, DNA was detected only in mosquitoes collected in Australia, and their role as host/vector was never studied by experimental approaches. Surprisingly, no specific study was conducted in Africa. In this context, the objective of this study was to investigate the role of mosquitoes (larvae and adults) and other flying insects in ecology of M. ulcerans. This study was conducted in a highly endemic area of Benin. Mosquitoes (adults and larvae) were collected over one year, in Buruli ulcer endemic in Benin. In parallel, to monitor the presence of M. ulcerans in environment, aquatic insects were sampled. QPCR was used to detected M. ulcerans DNA. DNA of M. ulcerans was detected in around 8.7% of aquatic insects but never in mosquitoes (larvae or adults) or in other flying insects. This study suggested that the mosquitoes don't play a pivotal role in the ecology and transmission of M. ulcerans in the studied endemic areas. However, the role of mosquitoes cannot be excluded and, we can reasonably suppose that several routes of transmission of M. ulcerans are possible through the world.

  15. Informing effective smokefree policies in Argentina: air quality monitoring study in 15 cities (2007-2009)

    PubMed Central

    Schoj, Verónica; Sebrié, Ernesto M; Pizarro, María Elizabeth; Hyland, Andrew; Travers, Mark J

    2015-01-01

    Objective To evaluate indoor air pollution in hospitality venues in Argentina. Material and Methods PM2.5 levels were measured in a convenience sample of venues in 15 cities with different legislative contexts following a protocol developed by Roswell Park Cancer Institute. Results 554 samples were collected. Across all 5 smokefree cities the mean PM2.5 level was lower during daytime vs. evening hours, 24 vs. 98 PM2.5 respectively (p=.012). In the three cities evaluated before and after legislation, PM2.5 levels decreased dramatically (p<0.001 each). Overall, PM2.5 levels were 5 times higher in cities with no legislation vs. smokefree cities (p<0.001). In cities with designated smoking areas, PM2.5 levels were not statistically different between smoking and non-smoking areas (p=0.272). Non-smoking areas had significantly higher PM2.5 levels compared to 100% smokefree venues in the same city (twofold higher) (p=0.017). Conclusions Most of the participating cities in this study had significantly lower PM2.5 levels after the implementation of 100% smokefree legislation. Hence, it represents a useful tool to promote 100% smokefree policies in Argentina. PMID:21243186

  16. Patterns of Genetic and Morphometric Diversity in Baobab (Adansonia digitata) Populations Across Different Climatic Zones of Benin (West Africa)

    PubMed Central

    ASSOGBADJO, A. E.; KYNDT, T.; SINSIN, B.; GHEYSEN, G.; VAN DAMME, P.

    2006-01-01

    • Background and Aims Baobab (Adansonia digitata) is a multi-purpose tree used daily by rural African communities. The present study aimed at investigating the level of morphometric and genetic variation and spatial genetic structure within and between threatened baobab populations from the three climatic zones of Benin. • Methods A total of 137 individuals from six populations were analysed using morphometric data as well as molecular marker data generated using the AFLP technique. • Key Results Five primer pairs resulted in a total of 217 scored bands with 78·34 % of them being polymorphic. A two-level AMOVA of 137 individuals from six baobab populations revealed 82·37 % of the total variation within populations and 17·63 % among populations (P < 0·001)· Analysis of population structure with allele-frequency based F-statistics revealed a global FST of 0·127 ± 0·072 (P < 0·001). The mean gene diversity within populations (HS) and the average gene diversity between populations (DST) were estimated at 0·309 ± 0·000 and 0·045 ± 0·072, respectively. Baobabs in the Sudanian and Sudan-Guinean zones of Benin were short and produced the highest yields of pulp, seeds and kernels, in contrast to the ones in the Guinean zone, which were tall and produced only a small number of fruits with a low pulp, seed and kernel productivity. A statistically significant correlation with the observed patterns of genetic diversity was observed for three morphological characteristics: height of the trees, number of branches and thickness of the capsules. • Conclusions The results indicate some degree of physical isolation of the populations collected in the different climatic zones and suggest a substantial amount of genetic structuring between the analysed populations of baobab. Sampling options of the natural populations are suggested for in or ex situ conservation. PMID:16520343

  17. [Long-term psychiatric hospitalizations].

    PubMed

    Plancke, L; Amariei, A

    2017-02-01

    significantly less risk of long-term hospitalization than those of large cities. We found no influence of material and social deprivation in the long-term hospitalizations. Long-term hospitalization in psychiatry only concerns a minority of patients but represents the fifth of the total number of days of full-time hospitalization. The recent patients were significantly less exposed to the risk of having a long-term hospitalization. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. Formation des enseignants dans une perspective d'education permanente au benin

    NASA Astrophysics Data System (ADS)

    Agboton, Sébastien; Moussa, Yaya Mede

    1994-05-01

    The history of teacher training in Benin, which provides evidence of social and cultural change, suggests that a system of lifelong education should be introduced which unites formal, non-formal and informal education, all of which already exist in embryo. The education originally given to every member of society was a continuing progression from initiate to initiator, a lifelong education that involved, among other things, knowledge of agricultural production. This traditional system was disrupted by the reorganization of teacher training after 1945. Recurrent training of teachers remained inadequate because of limited external funding for in-service training, the lack of teachers, the suspension of recruitment and the closure of teacher training colleges. The 1975 reform, through the initiative known as Operation Education and Development, envisaged links between school and social environment, allying intellectual work with production. This meant a radical change in the role of the teacher, who was confronted with technical advance and was obliged to enter a difficult continuing process of self-training. Furthermore, population growth and the restrictions imposed by the World Bank have brought about developments in both lifelong learning and apprenticeship. These two elements are brought together under an initiative known as Production Scolaire Artisanale, designed for out-of-school learners and artisans. The author concludes that the creation of a coherent system of voluntary education would be possible in a society that was itself favourably disposed to education.

  19. Interest of LQAS method in a survey of HTLV-I infection in Benin (West Africa).

    PubMed

    Houinato, Dismand; Preux, Pierre-Marie; Charriere, Bénédicte; Massit, Bruno; Avodé, Gilbert; Denis, François; Dumas, Michel; Boutros-Toni, Fernand; Salamon, Roger

    2002-02-01

    HTLV-I is heterogeneously distributed in Sub-Saharan Africa. Traditional survey methods as cluster sampling could provide information for a country or region of interest. However, they cannot identify small areas with higher prevalences of infection to help in the health policy planning. Identification of such areas could be done by a Lot Quality Assurance Sampling (LQAS) method, which is currently used in industry to identify a poor performance in assembly lines. The LQAS method was used in Atacora (Northern Benin) between March and May 1998 to identify areas with a HTLV-I seroprevalence higher than 4%. Sixty-five subjects were randomly selected in each of 36 communes (lots) of this department. Lots were classified as unacceptable when the sample contained at least one positive subject. The LQAS method identified 25 (69.4 %) communes with a prevalence higher than 4%. Using stratified sampling theory, the overall HTLV-I seroprevalence was 4.5% (95% CI: 3.6-5.4%). These data show the interest of LQAS method application under field conditions to detect clusters of infection.

  20. Assessment of pharmacy information system performance in selected hospitals in isfahan city during 2011.

    PubMed

    Saqaeian Nejad Isfahani, Sakineh; Mirzaeian, Razieh; Habibi, Mahbobe

    2013-01-01

    In supporting a therapeutic approach and medication therapy management, pharmacy information system acts as one of the central pillars of information system. This ensures that medication therapy is being supported and evaluated with an optimal level of safety and quality similar to other treatments and services. This research aims to evaluate the performance of pharmacy information system in three types of teaching, private and social affiliated hospitals. The present study is an applied, descriptive and analytical study which was conducted on the pharmacy information system in use in the selected hospitals. The research population included all the users of pharmacy information systems in the selected hospitals. The research sample is the same as the research population. Researchers collected data using a self-designed checklist developed following the guidelines of the American Society of Health-System Pharmacists, Australia pharmaceutical Society and Therapeutic guidelines of the Drug Commission of the German Medical Association. The checklist validity was assessed by research supervisors and pharmacy information system pharmacists and users. To collect data besides observation, the questionnaires were distributed among pharmacy information system pharmacists and users. Finally, the analysis of the data was performed using the SPSS software. Pharmacy information system was found to be semi-automated in 16 hospitals and automated in 3 ones. Regarding the standards in the guidelines issued by the Society of Pharmacists, the highest rank in observing the input standards belonged to the Social Services associated hospitals with a mean score of 32.75. While teaching hospitals gained the highest score both in processing standards with a mean score of 29.15 and output standards with a mean score of 43.95, and the private hospitals had the lowest mean scores of 23.32, 17.78, 24.25 in input, process and output standards respectively. Based on the findings, the studied

  1. Rapid operation assessment of voluntary HIV counselling and testing services in three cities in China, 2009.

    PubMed

    Ma, W; Ye, S; Xiao, Y; Jin, C; Li, Y; Zhao, L; Cai, Y; Liu, B; Detels, R

    2013-12-01

    To assess the operation of voluntary counselling and testing (VCT) services forhuman immunodeficiency virus (HIV) in three cities in China. A cross-sectional study using mixed methods, including focus group discussions,in-depth interviews, field assessment, archive checking and structured questionnaire interviews, was conducted to assess different aspects of VCT services. Surveys were undertaken in six counties of three China Global Fund AIDS Program (Round Five) cities, including 11 VCT clinics, 38 counsellors, 83 clients and 332 individuals at risk for HIV infection. All counsellors were trained and approved for providing counselling. As there were adequate numbers of clinics and counsellors, VCT services ran smoothly. Clients were generally satisfied with VCT services and considered service operation to be adequate. Problems with the VCT programme included fewer VCT services in general hospitals, lack of a referral mechanism, and long delays between testing and receipt of results. The operation of VCT services in the three cities was generally adequate, but referral services were poor. More attention needs to be paid to HIV testing and counselling in general hospitals, and referral networks need to be strengthened.

  2. Hospitals learn their collective power: an isolation gown success story.

    PubMed

    Kressel, Amy B; McVey, Jennie L; Miller, Joan M; Fish, Lauren L

    2011-02-01

    We describe an investigation and improvement project designed to provide comfortable, affordable, fluid-resistant isolation gowns in response to inadequate compliance with gown use. Infection control and purchasing departments determined number of gowns used, cost/gown, and contract information for our laundry service. We investigated disposable gown options. During a conference call for a multihospital project, we learned that 4 local hospitals all used the same laundry service and that all were dissatisfied with the quality of the reusable gowns. The 4 hospitals resolved to meet with the hospital laundry service to negotiate as a group. In preparation, we both investigated laundry services in neighboring cities and reviewed Centers for Disease Control and Prevention and Occupational Safety and Health Administration isolation gown requirements. Confronted with its major customers acting collectively, the laundry service agreed to identify gowns by age, bring gowns to Occupational Safety and Health Administration compliance, mark grids so gowns could be removed after 75 washes, add 6,000 new gowns, and remove 6,000 old gowns. The cost increase was 3.75¢/gown. After the changeover was complete, reports of fluid leaking through gowns stopped. We saved $187,000 by keeping reusable gowns. When we tried to provide comfortable, affordable, fluid-resistant isolation gowns, we encountered 2 barriers: our city had only 1 hospital laundry service, and disposable gowns were costly. We solved the problem through unusual collaboration: internal (Infection Control and Purchasing) and external (with otherwise competing hospitals). Collaboration and knowledge sharing led to accountability: the hospital to its staff and budget and the laundry service to the hospitals. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  3. High number of diarrhoeal co-infections in travellers to Benin, West Africa

    PubMed Central

    2014-01-01

    Background Travellers’ diarrhoea (TD) is the most frequent health problem among travellers to the tropics. Using routine techniques, the aetiology mostly remains unresolved, whereas modern molecular methods enable reducing the number of equivocal cases considerably. While many studies address the aetiology of TD in Asian, Central American and North African tourist resorts, only few focus on Western Africa. Methods Stool samples from 45 travellers travelling in Benin, West Africa, were analyzed by a new multiplex qPCR assay for Salmonella, Yersinia, Campylobacter, Vibrio cholerae, Shigella or enteroinvasive (EIEC), enterohaemorrhagic (EHEC), enterotoxigenic (ETEC), enteroaggregative (EAEC), and enteropathogenic Escherichia coli (EPEC). Results All 18 pre-travel samples proved negative for bacterial pathogens. Of the 39/45 (87%) travellers having had TD, EPEC was detected in post-travel samples in 30 (77%) cases, EAEC in 23 (59%), ETEC in 22 (56%), Shigella or EIEC in 7 (18%), EHEC in two (5%), and Salmonella in one (3%). In 31(79%) of the TD cases two or more bacterial pathogens were identified. Two (8%) samples remained negative: both patients had taken antimicrobials for TD. Conclusions EPEC, EAEC and ETEC were the most common findings. 79% of the cases had a co-infection. As modern diagnostics reveals in most patients a multitude of pathogens, the role of each pathogen should be re-evaluated. PMID:24521079

  4. Crowdsourced Smart Cities versus Corporate Smart Cities

    NASA Astrophysics Data System (ADS)

    Alizadeh, Tooran

    2018-05-01

    Considering the speedy growth of smart-city promises and practices, there is an urgent need to take a critical approach and offer an integrated vision for an otherwise fragmented and sectoral concept. In particular, the literature warns about a critical deficit around the theorization of the smart city because discussions of relevant smart city theories or frameworks are few and fall short of offering alternative practical resolutions to the dominant discourse. In developing a response to such a deficit, this paper takes up the challenge to broaden theoretical insights into smart cities, by offering a bottom-up understanding of the ‘smart city’ concept with special attention to the potential of passive crowdsourcing based on the ocean of mostly untapped and unutilized available data in the public domain. Crowdsourced smart cities are proposed as an alternative to enable public engagement in smart city debates and decision-making – especially when dealing with global digital corporations.

  5. Why do households invest in sanitation in rural Benin: Health, wealth, or prestige?

    NASA Astrophysics Data System (ADS)

    Gross, Elena; Günther, Isabel

    2014-10-01

    Seventy percent of the rural population in sub-Saharan Africa does not use adequate sanitation facilities. In rural Benin, as much as 95% of the population does not use improved sanitation. By analyzing a representative sample of 2000 rural households, this paper explores why households remain without latrines. Our results show that wealth and latrine prices play the most decisive role for sanitation demand and ownership. At current income levels, sanitation coverage will only increase to 50% if costs for construction are reduced from currently 190 USD to 50 USD per latrine. Our analysis also suggests that previous sanitation campaigns, which were based on prestige and the allure of a modern lifestyle as motives for latrine construction, have had no success in increasing sanitation coverage. Moreover, improved public health, which is the objective of public policies promoting sanitation, will not be effective at low sanitation coverage rates. Fear at night, especially of animals, and personal harassment, are stated as the most important motivational factors for latrine ownership and the intention to build one. We therefore suggest changing the message of sanitation projects and introduce new low-cost technologies into rural markets; otherwise, marketing strategies will continue to fail in increasing sanitation demand.

  6. 'The hospital was just like a home': self, service and the 'McCord Hospital Family'.

    PubMed

    Noble, Vanessa; Parle, Julie

    2014-04-01

    For more than a century, McCord Hospital, a partly private and partly state-subsidised mission hospital has provided affordable health-care services, as well as work and professional training opportunities for thousands of people in Durban, a city on the east coast of South Africa. This article focuses on one important aspect of the hospital's longevity and particular character, or 'organisational culture': the ethos of a 'McCord Family', integral to which were faith and a commitment to service. While recognising that families - including 'hospital families' like that at McCord - are contentious social constructs, with deeply embedded hierarchies and inequalities based on race, class and gender, we also consider however how the notion of 'a McCord family' was experienced and shared in complex ways. Indeed, during the twentieth century, this ethos was avidly promoted by the hospital's founders and managers and by a wide variety of employees and trainees. It also extended to people at a far geographical remove from Durban. Moreover, this ethos became so powerful that many patients felt that it shaped their convalescence experience positively. This article considers how this 'family ethos' was constructed and what made it so attractive to this hospital's staff, trainees and patients. Furthermore, we consider what 'work' it did for this mission hospital, especially in promoting bonds of multi-racial unity in the contexts of segregation and apartheid society. More broadly, it suggests that critical histories of the ways in which individuals, hospitals, faith and 'families' intersect may be of value for the future of hospitals as well as of interest in their past.

  7. Is a healthy city also an age-friendly city?

    PubMed

    Jackisch, Josephine; Zamaro, Gianna; Green, Geoff; Huber, Manfred

    2015-06-01

    Healthy Ageing is an important focus of the European Healthy Cities Network and has been supported by WHO since 2003 as a key strategic topic, since 2010 in cooperation with the Global Network of Age-friendly Cities and Communities. Based on the methodology of realist evaluation, this article synthesizes qualitative evidence from 33 structured case studies (CS) from 32 WHO European Healthy Cities, 72 annual reports from Network cities and 71 quantitative responses to a General Evaluation Questionnaire. City cases are assigned to three clusters containing the eight domains of an age-friendly city proposed by WHO's Global Age-friendly City Guide published in 2007. The analysis of city's practice and efforts in this article takes stock of how cities have developed the institutional prerequisites and processes necessary for implementing age-friendly strategies, programmes and projects. A content analysis of the CS maps activities across age-friendly domains and illustrates how cities contribute to improving the social and physical environments of older people and enhance the health and social services provided by municipalities and their partners. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. The effect of radiology services outsourcing on patients’ satisfaction in Tehran city hospitals

    PubMed Central

    Mousavi, H; Khodamoradi, F; Rostami Zarinabadi, CH; Mozafar Saadati, H; Mohammadi, M; Mahboubi, M; Mousavi, N

    2015-01-01

    Background: To have a developed society we should have healthy, active, and happy individuals and present that extended healthcare services perform an essential function in increasing the society’s health level. Health in a society includes the society’s, and people comfort with the condition and an assuring the situation that they can live healthily. Also, considering the self-governing plan of hospitals from 1995, the hospital authorities should choose a method of presenting services, and, the hospital is ready to present those activities during its own activities from an economic viewpoint. The current study was done while trying to discover the effect of the Outsourcing of the Radiology Unit on the patients’ satisfaction in hospitals of Tehran. Method: The present research was done in a case-evidence and sectional study. Considering the weight of a month’s references to the Radiology Unit, which included around 1200 individuals, the volume of samples for measuring the frequency of the patients’ satisfaction with the means of Morgan table was similar to 291 individuals. To decrease the error percentage in each hospital we questioned 300 individuals. (n+10) were questioned and the gathered information were examined by what means SPSS application variant 21 and were then studied by climagraph – Smirnoph, Du Whitman – Vitney K tests. Findings: the mean of the patients’ satisfaction of turned over and non-turned over Radiology Unit services were 41.46 and 45, respectively (from the maximum score of 60). A meaningful variation was seen among the patients' Satisfaction in the two hospitals from the analytical viewpoint (p-value<0.001) and there was also a significant difference between the patients’ waiting time (p-value<0.001). The research’s findings showed that the outsourcing has a negative influence on the patients’ satisfaction and the duration of their waiting time. Conclusion: Many times, managers do the outsourcing without considering

  9. City face to face with nature

    NASA Astrophysics Data System (ADS)

    Prabowo, Hendro; Dewi, Mahargyantari P.

    2017-11-01

    Within the perspective of environmental psychology, there are some forms of earth destruction such as global warming, deforestation, pollution, and species extinction. These have been caused by the massive growth of population that inevitably means more housingis needed while at the same time, agricultural land for food production has been shrinking. Nisbet, Zelenski, and Murphy (2009) proposed that personal relationships with nature may provide some insight into the way people treat the environment. In other words, disconnection from the natural world may be contributing to our planet's destruction. In addition, Koger and Winter (2011) proposed green urban planning and green buildings as solution not only for overcoming the destruction, but also they are useful to reduce stress. Wilson (1984) pioneered the term "biophilia" to refer to a fundamental hypothesized, genetically based human need and propensity to affiliate with "life and lifelike processes." Studies have shown, for example, that even minimal connection with nature—such as looking at it through a window—can promote the healing of hospitalized patients; can increase health in the workplace; and can reduce the frequency of illness in prisons. In hundreds of other studies, interaction with pets has shown a wide range of benefits forclinical patients—from adults with Alzheimer's disease to children with autism—as well as for people within the general population (Kahn, Severson, & Ruckert, 2009). This paper is an attempt to collect data regarding the efforts of cities today in adapting to nature, such as Barcelona which tried to control the bird population with contraception;Austin city coexists with bats; dozens of cities in the US which conform with bees and honey, and Masdar city that is designed along with its nature.

  10. Beliefs About the Cause of Schizophrenia Among Caregivers in Midwestern Nigeria

    PubMed Central

    Igberase, Osayi; Okogbenin, Esther

    2017-01-01

    Schizophrenia is a devastating illness with a chronic and relapsing course. While Western countries may endorse, biological and psychosocial causes more commonly than supernatural causes, non-western cultures like Nigeria in contrast, tend to endorse supernatural causes. Belief in supernatural causes has been reported to have consequences for treatment seeking behavior. This study aimed to examine the causes of schizophrenia reported by family members of outpatients with schizophrenia in a neuropsychiatric hospital in Midwestern Nigeria. In this study, we recruited a convenient sample of 200 consecutive caregivers of patients visiting the outpatient department of the Psychiatric Hospital, Benin City, Nigeria. These primary caregivers were unpaid relatives who provided support to patients. The patients were service users who fulfilled the diagnostic criteria of the International Classification of Disease [ICD-10; World Health Organization 1993] for schizophrenia and had been on treatment for at least two years. Majority (72.0%) of caregivers endorsed supernatural causes as most important in the etiology of schizophrenia, while 28.0% endorsed natural causes. Every participant without formal education endorsed supernatural attribution. In our study, it was evident that participants embraced multiple causal attributions for schizophrenia. PMID:28748057

  11. Beliefs About the Cause of Schizophrenia Among Caregivers in Midwestern Nigeria.

    PubMed

    Igberase, Osayi; Okogbenin, Esther

    2017-03-22

    Schizophrenia is a devastating illness with a chronic and relapsing course. While Western countries may endorse, biological and psychosocial causes more commonly than supernatural causes, non-western cultures like Nigeria in contrast, tend to endorse supernatural causes. Belief in supernatural causes has been reported to have consequences for treatment seeking behavior. This study aimed to examine the causes of schizophrenia reported by family members of outpatients with schizophrenia in a neuropsychiatric hospital in Midwestern Nigeria. In this study, we recruited a convenient sample of 200 consecutive caregivers of patients visiting the outpatient department of the Psychiatric Hospital, Benin City, Nigeria. These primary caregivers were unpaid relatives who provided support to patients. The patients were service users who fulfilled the diagnostic criteria of the International Classification of Disease [ICD-10; World Health Organization 1993] for schizophrenia and had been on treatment for at least two years. Majority (72.0%) of caregivers endorsed supernatural causes as most important in the etiology of schizophrenia, while 28.0% endorsed natural causes. Every participant without formal education endorsed supernatural attribution. In our study, it was evident that participants embraced multiple causal attributions for schizophrenia.

  12. Exposure to fine particulate matter and hospital admissions due to pneumonia: Effects on the number of hospital admissions and its costs.

    PubMed

    Patto, Nicole Vargas; Nascimento, Luiz Fernando Costa; Mantovani, Katia Cristina C; Vieira, Luciana C P F S; Moreira, Demerval S

    2016-07-01

    Given that respiratory diseases are a major cause of hospitalization in children, the objectives of this study are to estimate the role of exposure to fine particulate matter in hospitalizations due to pneumonia and a possible reduction in the number of these hospitalizations and costs. An ecological time-series study was developed with data on hospitalization for pneumonia among children under 10 years of age living in São José do Rio Preto, state of São Paulo, using PM2.5 concentrations estimated using a mathematical model. We used Poisson regression with a dependent variable (hospitalization) associated with PM2.5 concentrations and adjusted for effective temperature, seasonality and day of the week, with estimates of reductions in the number of hospitalizations and costs. 1,161 children were admitted to hospital between October 1st, 2011, and September 30th, 2013; the average concentration of PM2.5 was 18.7 µg/m3 (≈32 µg/m3 of PM10) and exposure to this pollutant was associated with hospitalization four and five days after exposure. A 10 µg/m3 decrease in concentration would imply 256 less hospital admissions and savings of approximately R$ 220,000 in a medium-sized city.

  13. Observations of biogenic isoprene emissions and atmospheric chemistry components at the Savé super site in Benin, West Africa, during the DACCIWA field campaign.

    NASA Astrophysics Data System (ADS)

    Jambert, Corinne; Pacifico, Federica; Delon, Claire; Lohou, Fabienne; Reinares Martinez, Irene; Brilouet, Pierre-Etienne; Derrien, Solene; Dione, Cheikh; Brosse, Fabien; Gabella, Omar; Pedruzzo Bagazgoitia, Xavier; Durand, Pierre

    2017-04-01

    Tropospheric oxidation of VOCs (Volatile Organic Compounds), including isoprene, in the presence of NOx and sunlight leads to the formation of O3 and Secondary Organic Aerosols (SOA). Changes in NO or VOCs sources will consequently modify their atmospheric concentrations and thus, the rate of O3 production and SOA formation. NOx have also an impact on the abundance of the hydroxyl radical (OH) which determines the lifetime of some pollutants and greenhouse gases. Anthropogenic emissions of pollutants from mega cities located on the Guinean coast in South West Africa are likely to increase in the next decades due to a strong anthropogenic pressure and to land use changes at the regional or continental scale. The consequences on regional air quality and on pollutant deposition onto surfaces may have some harmful effects on human and ecosystem health. Furthermore, the regional climate and water cycle are affected by changes in atmospheric chemistry. When transported northward on the African continent, polluted air masses meet biogenic emissions from rural areas which contributes to increase ozone and SOA production, in high temperature and solar radiation conditions, highly favourable to enhanced photochemistry. During the Dynamics-aerosol-chemistry-cloud interactions in West Africa (DACCIWA) field campaign, we measured the atmospheric chemical composition and the exchanges of trace components in a hinterland area of Benin, at the Savé super-site (8°02'03" N, 2°29'11″ E). The observations, monitored in June and July 2016, in a rural mixed agricultural area, include near surface concentrations of ozone (O3), carbon monoxide (CO), nitrogen oxides (NOx) and isoprene, isoprene fluxes and meteorological parameters. We observed hourly average concentrations of O3 up to 50 ppb, low NOx concentrations (ca. 1 ppb and CO concentrations between 75 and 300 ppb. An 8 m tower was equipped with a Fast Isoprene Sensor and sonic anemometer to measure isoprene concentrations and

  14. Chemical composition and sources of atmospheric aerosols at Djougou (Benin)

    NASA Astrophysics Data System (ADS)

    Ouafo-Leumbe, Marie-Roumy; Galy-Lacaux, Corinne; Liousse, Catherine; Pont, Veronique; Akpo, Aristide; Doumbia, Thierno; Gardrat, Eric; Zouiten, Cyril; Sigha-Nkamdjou, Luc; Ekodeck, Georges Emmanuel

    2017-06-01

    In the framework of the INDAAF (International Network to study Deposition and Atmospheric chemistry in AFrica) program, atmospheric aerosols were collected in PM2.5 and PM10 size fractions at Djougou, Benin, in the West Africa, from November, 2005 to October, 2009. Particulate carbon, ionic species, and trace metals were analyzed. Weekly PM2.5 and PM10 total mass concentrations varied between 0.7 and 47.3 µg m-3 and 1.4-148.3 µg m-3, respectively. We grouped the aerosol chemical compounds into four classes: dust, particulate organic matter (POM), elemental carbon (EC), and ions. We studied the annual variation of each class to determine their contribution in the total aerosol mass concentration and finally to investigate their potential emission sources. On an annual basis, the species presented a well-marked seasonality, with the peak of mass concentration for both sizes registered in dry season, 67 ± 2 to 86 ± 9 versus 14 ± 9 to 34 ± 5% in wet season. These values emphasized the seasonality of the emissions and the relative weak interannual standard deviation indicates the low variability of the seasonality. At the seasonal scale, major contributions to the aerosol chemistry in the dry season are: dust (26-59%), POM (30-59%), EC (5-9%), and ions (3-5%), suggesting a predominance of Sahelian and Saharan dust emissions and biomass burning source in this season. In the wet season, POM is predominant, followed by dust, EC, and ions. These results point out the contribution of surrounded biofuel combustion used for cooking and biogenic emissions during the wet season.

  15. Short-term effects of air pollution on hospital admissions in Korea.

    PubMed

    Son, Ji-Young; Lee, Jong-Tae; Park, Yoon Hyeong; Bell, Michelle L

    2013-07-01

    Numerous studies have identified short-term effects of air pollution on morbidity in North America and Europe. The effects of air pollution may differ by region of the world. Evidence on air pollution and morbidity in Asia is limited. We investigated associations between ambient air pollution and hospital admissions in eight Korean cities for 2003-2008. We applied a two-stage Bayesian hierarchical model to estimate city-specific effects and the overall effects across the cities. We considered lagged effects of pollutants by cause (allergic disease, asthma, selected respiratory disease, and cardiovascular disease), sex, and age (0-14, 15-64, 65-74, and ≥ 75 years). We found evidence of associations between hospital admissions and short-term exposure to air pollution. An interquartile range (IQR) increase in PM10 (30.7 µg/m) was associated with an overall increase of 2.2% (95% posterior interval = 0.5%-3.9%), 2.8% (1.3%-4.4%), 1.7% (0.9%-2.6%), and 0.7% (0.0%-1.4%) in allergic, asthma, selected respiratory, and cardiovascular admissions, respectively. For NO2 (IQR 12.2 ppb), the corresponding figures were 2.3% (0.6%-4.0%), 2.2% (0.3%-4.1%), 2.2% (0.6%-3.7%), and 2.2% (1.1%-3.4%). For O3, we found positive associations for all the studied diagnoses except cardiovascular disease. SO2 was associated with hospital admissions for selected respiratory or cardiovascular causes, whereas O3 was negatively associated with cardiovascular admissions. We found suggestive evidence for stronger associations in younger and older age groups. Associations were similar for men and women. Ambient air pollution was associated with increased risk of hospital admissions in Korea. Results suggest increased susceptibility among the young or the elderly for pollution effects on specific diseases.

  16. Education Cities

    ERIC Educational Resources Information Center

    Shaked, Haim

    2014-01-01

    In recent years, several cities in Israel have labeled themselves "Education Cities," concentrating on education as their central theme. Employing qualitative techniques, this article aims to describe, define, and conceptualize this phenomenon as it is being realized in three such cities. Findings show that Education Cities differ from…

  17. The Association Between Management of the Board of Trustees and Its Effectiveness at Hospitals in Tabriz; 2011 to 2013.

    PubMed

    Masoudi Asl, Irvan; Iezadi, Shabnam; Akhavan Behbahani, Ali; Rahbari Bonab, Maryam

    2015-06-01

    Reforming the structure and improving care and service system, particularly at hospitals, are the main priorities of the health system. The board of trustees of the hospitals is the main proposed strategy in this field. Hospitals with board of trustees were created with the aim of improving accountability to the community and guaranteeing efficient management and attracting public support in running the hospital. The aim of this study was to investigate the association between hospital effectiveness and the board of trustee's management method. This cross-sectional study was conducted in Tabriz City, Iran, during the years 2011 to 2013. To assess the effectiveness of board of trustees' management, two hospitals in Tabriz City were compared. Hospitals selected through purposive typical case sampling method. Two hospitals had equal structure, same doctors, and both were gynecology hospitals of Tabriz City, but one of them was a gynecology hospital managed by the board of trustees and the other was managed by the chairman. The information about the five variables of hospital effectiveness was collected during the years 2011 to 2013 using standard lists and questionnaires, which were available in the hospitals; these variables included quality management, safety, medical equipment management, and patients and staff satisfaction. Then, each variable was weighted through the technique of hierarchical analysis and finally they were analyzed using SPSS 17 and Expert Choice 11. Among the five variables related to the effectiveness, safety showed to have the highest weight and medical equipment management had the lowest weight. According to the statistical analyses, the score of the effectiveness of the hospital with the board of trustees was 33.08 (on the scale of 0 - 100) and the score of the hospital with the chairperson was 29.52. No significant association was found between the effectiveness of hospital and the board of trustees management (P = 0.81). Because there was

  18. A care pathway analysis of tuberculosis patients in benin: Highlights on direct costs and critical stages for an evidence-based decision-making.

    PubMed

    Laokri, Samia; Amoussouhui, Arnaud; Ouendo, Edgard M; Hounnankan, Athanase Cossi; Anagonou, Séverin; Gninafon, Martin; Kassa, Ferdinand; Tawo, Léon; Dujardin, Bruno

    2014-01-01

    Free tuberculosis control fail to protect patients from substantial medical and non-medical expenditure, thus a greater degree of disaggregation of patient cost is needed to fully capture their context and inform policymaking. A retrospective cross-sectional study was conducted on a convenience sample of six health districts of Southern Benin. From August 2008 to February 2009, we recruited all smear-positive pulmonary tuberculosis patients treated under the national strategy in the selected districts. Direct out-of-pocket costs associated with tuberculosis, time delays, and care-seeking pattern were collected from symptom onset to end of treatment. Population description and outcome data were reported for 245 patients of whom 153 completed their care pathway. For them, the median overall direct cost was USD 183 per patient. Payments to traditional healers, self-medication drugs, travel, and food expenditures contributed largely to this cost burden. Patient, provider, and treatment delays were also reported. Pre-diagnosis and intensive treatment stages were the most critical stages, with median expenditure of USD 43 per patient and accounting for 38% and 29% of the overall direct cost, respectively. However, financial barriers differed depending on whether the patient lived in urban or rural areas. This study delivers new evidence about bottlenecks encountered during the TB care pathway. Financial barriers to accessing the free-of-charge tuberculosis control strategy in Benin remain substantial for low-income households. Irregular time delays and hidden costs, often generated by multiple visits to various care providers, impair appropriate patient pathways. Particular attention should be paid to pre-diagnosis and intensive treatment. Cost assessment and combined targeted interventions embodied by a patient-centered approach on the specific critical stages would likely deliver better program outcomes.

  19. Maternal anemia at first antenatal visit: prevalence and risk factors in a malaria-endemic area in Benin.

    PubMed

    Ouédraogo, Smaïla; Koura, Ghislain K; Accrombessi, Manfred M K; Bodeau-Livinec, Florence; Massougbodji, Achille; Cot, Michel

    2012-09-01

    The risk factors for maternal anemia (hemoglobin level less than 110 g/L) were studied in human immunodeficiency virus-negative pregnant women in Benin at the time of first antenatal visit and prior to any prevention. Data for the first 1,005 pregnant women included in a multicentre randomized controlled trial were analyzed. Anemia was common (68.3%), and malaria and helminth infestations were prevalent in 15.2% and 11.1% of the women. A total of 33.3%, 31.3% and 3.6% of the women were iron, folic acid and vitamin B12 deficient, respectively. These parasitic infections and nutrient deficiencies were associated with a high risk of anemia. Twenty-one percent, 15%, 12%, 11% and 7% of anemia were attributable to malnutrition, malaria, iron, folic acid deficiencies, and helminth infestations, respectively. Most anemia was caused by factors that could be prevented by available tools, stressing the need to reinforce their implementation and to evaluate their effectiveness throughout the course of the pregnancy.

  20. Maternal Anemia at First Antenatal Visit: Prevalence and Risk Factors in a Malaria-Endemic Area in Benin

    PubMed Central

    Ouédraogo, Smaïla; Koura, Ghislain K.; Accrombessi, Manfred M. K.; Bodeau-Livinec, Florence; Massougbodji, Achille; Cot, Michel

    2012-01-01

    The risk factors for maternal anemia (hemoglobin level less than 110 g/L) were studied in human immunodeficiency virus–negative pregnant women in Benin at the time of first antenatal visit and prior to any prevention. Data for the first 1,005 pregnant women included in a multicentre randomized controlled trial were analyzed. Anemia was common (68.3%), and malaria and helminth infestations were prevalent in 15.2% and 11.1% of the women. A total of 33.3%, 31.3% and 3.6% of the women were iron, folic acid and vitamin B12 deficient, respectively. These parasitic infections and nutrient deficiencies were associated with a high risk of anemia. Twenty-one percent, 15%, 12%, 11% and 7% of anemia were attributable to malnutrition, malaria, iron, folic acid deficiencies, and helminth infestations, respectively. Most anemia was caused by factors that could be prevented by available tools, stressing the need to reinforce their implementation and to evaluate their effectiveness throughout the course of the pregnancy. PMID:22826498

  1. From “Comprehensive Transportation Hub” to “City New Sitting Room”---Overall the design about Jinan East district comprehensive transportation hub

    NASA Astrophysics Data System (ADS)

    Lv, Jie; Guo, Jianmin; Li, Jin

    2017-08-01

    integrated transport hub or high-speed rail station often talked about, often known as the “city portal” and the title of “city window”, so the comprehensive transportation hub or the high-speed rail station of a city is very important to a region or a provincial. At the same time, it reflects that the managers and users of a city only focus on the comprehensive transportation hub of transportation service function and ignore her cities attributes and functions. Jinan east district comprehensive transportation hub in the beginning of design is given a feature that it has to serve both the traffic and city. We are trying to build a new center for Jinan east new town, the window to welcome people, the city hall of hospitality.

  2. [Measures taken by a university hospital for the prevention and control of the 2009 H1N1 influenza].

    PubMed

    Hayashi, Jun; Murata, Masayuki; Furusyo, Norihiro; Hoshina, Takayuki; Shimono, Nobuyuki

    2010-09-01

    After extensive discussion with the Fukuoka City government of measures for the prevention and control of the 2009 H1N1 influenza pandemic, Kyushu University Hospital organized the infection control teams of 39 hospitals in the Fukuoka City area in preparation for a possible outbreak. A facility was set up at Kyushu University Hospital for the screening of outpatients with fever, and those with influenza and an underlying disease or severe symptoms were admitted to the hospital. 37 (22%) of the 171 outpatients with fever were infected with the new strain of influenza, confirmed by rapid influenza antigen test and PCR: Of these 37 patients, 17 (45.9%) were negative by influenza antigen test. Other 37 patients (5 adults, 32 children) were admitted, all of whom were successfully treated with neuraminidase inhibitors and discharged with no aftereffects.

  3. Costing the supply chain for delivery of ACT and RDTs in the public sector in Benin and Kenya.

    PubMed

    Shretta, Rima; Johnson, Brittany; Smith, Lisa; Doumbia, Seydou; de Savigny, Don; Anupindi, Ravi; Yadav, Prashant

    2015-02-05

    Studies have shown that supply chain costs are a significant proportion of total programme costs. Nevertheless, the costs of delivering specific products are poorly understood and ballpark estimates are often used to inadequately plan for the budgetary implications of supply chain expenses. The purpose of this research was to estimate the country level costs of the public sector supply chain for artemisinin-based combination therapy (ACT) and rapid diagnostic tests (RDTs) from the central to the peripheral levels in Benin and Kenya. A micro-costing approach was used and primary data on the various cost components of the supply chain was collected at the central, intermediate, and facility levels between September and November 2013. Information sources included central warehouse databases, health facility records, transport schedules, and expenditure reports. Data from document reviews and semi-structured interviews were used to identify cost inputs and estimate actual costs. Sampling was purposive to isolate key variables of interest. Survey guides were developed and administered electronically. Data were extracted into Microsoft Excel, and the supply chain cost per unit of ACT and RDT distributed by function and level of system was calculated. In Benin, supply chain costs added USD 0.2011 to the initial acquisition cost of ACT and USD 0.3375 to RDTs (normalized to USD 1). In Kenya, they added USD 0.2443 to the acquisition cost of ACT and USD 0.1895 to RDTs (normalized to USD 1). Total supply chain costs accounted for more than 30% of the initial acquisition cost of the products in some cases and these costs were highly sensitive to product volumes. The major cost drivers were found to be labour, transport, and utilities with health facilities carrying the majority of the cost per unit of product. Accurate cost estimates are needed to ensure adequate resources are available for supply chain activities. Product volumes should be considered when costing supply chain

  4. Influence of exposure differences on city-to-city heterogeneity ...

    EPA Pesticide Factsheets

    Multi-city population-based epidemiological studies have observed heterogeneity between city-specific fine particulate matter (PM2.5)-mortality effect estimates. These studies typically use ambient monitoring data as a surrogate for exposure leading to potential exposure misclassification. The level of exposure misclassification can differ by city affecting the observed health effect estimate. The objective of this analysis is to evaluate whether previously developed residential infiltration-based city clusters can explain city-to-city heterogeneity in PM2.5 mortality risk estimates. In a prior paper 94 cities were clustered based on residential infiltration factors (e.g. home age/size, prevalence of air conditioning (AC)), resulting in 5 clusters. For this analysis, the association between PM2.5 and all-cause mortality was first determined in 77 cities across the United States for 2001–2005. Next, a second stage analysis was conducted evaluating the influence of cluster assignment on heterogeneity in the risk estimates. Associations between a 2-day (lag 0–1 days) moving average of PM2.5 concentrations and non-accidental mortality were determined for each city. Estimated effects ranged from −3.2 to 5.1% with a pooled estimate of 0.33% (95% CI: 0.13, 0.53) increase in mortality per 10 μg/m3 increase in PM2.5. The second stage analysis determined that cluster assignment was marginally significant in explaining the city-to-city heterogeneity. The health effe

  5. Unexpected nerve gas exposure in the city of Matsumoto: report of rescue activity in the first sarin gas terrorism.

    PubMed

    Okudera, H; Morita, H; Iwashita, T; Shibata, T; Otagiri, T; Kobayashi, S; Yanagisawa, N

    1997-09-01

    This report describes the rescue activities and the exposure of rescue and hospital personnel from the first unexpected nerve gas terrorist attack using sarin (isopropyl methylphophonofluoridate) in the city of Matsumoto at midnight on June 27, 1994. The details of the emergency activities in the disaster were studied based on the records from emergency departments of the affiliated hospitals and records from the firehouse. About 600 people, including residents and rescue staff, were exposed to sarin gas. Fifty-eight residents were admitted to hospitals, and 7 died. Among 95 rescuers and the duty doctor from the doctor car, 8 had mild symptoms of poisoning. All the rescue activity took place without gas masks or decontamination procedures. In this case of unexpected mass exposure to sarin gas, the emergency rescue system for a large disaster in Matsumoto city, which had been established for a conflagration or a local earthquake, was effective.

  6. Hydro-gravimetry in West-Africa: First results from the Djougou (Benin) superconducting gravimeter

    NASA Astrophysics Data System (ADS)

    Hector, Basile; Hinderer, Jacques; Séguis, Luc; Boy, Jean-Paul; Calvo, Marta; Descloitres, Marc; Rosat, Séverine; Galle, Sylvie; Riccardi, Umberto

    2014-10-01

    The increasing number of hydro-gravimetry studies proves the rising interest of the hydrology community toward this monitoring method. The accuracy of superconducting gravimeters (SG) potentially allows the retrieval of small water storage changes (WSC) down to a few millimeters of equivalent water thickness. However, the importance of corrections applied to SG data to achieve such a precision in gravity residuals should be recalled. The Djougou permanent gravity station presented in this paper and located in northern Benin, West-Africa, provides a good opportunity to review these considerations. This station is equipped since July 2010 with the superconducting gravimeter SG-060 aimed at deriving WSC at different time-scales, daily to inter-annual. In this area, WSC are (1) part of the control system for evapotranspiration (ET) process, a key variable of the West-African monsoon cycle and (2) the state variable for resource management, a critical issue in storage-poor hard rock basement contexts such as in northern Benin. The potential for deriving WSC from time-lapse gravity data partly depends on environmental features such as topography and the instrument shelter. Therefore, this issue is addressed first, with the background idea that such sensitivity analysis should be undertaken before setting up any new instrument. In Djougou, local topography is quite flat leading to a theoretical straightforward relationship between gravity changes and WSC, close to the standard Bouguer value. However, the shelter plays a significant masking role, which is the principal limitation to the retrieval of fast hydrological processes such as ET following a rain event. Several issues concerning classical gravity corrections are also addressed in the paper. These include gap-filling procedures during rain-events and drift estimates for short time series. Special attention is provided to atmospheric corrections, and different approaches are tested: a simple scalar admittance, a

  7. Pilot assessment of soil-transmitted helminthiasis in the context of transmission assessment surveys for lymphatic filariasis in Benin and Tonga.

    PubMed

    Chu, Brian K; Gass, Katherine; Batcho, Wilfrid; 'Ake, Malakai; Dorkenoo, Améyo M; Adjinacou, Elvire; Mafi, 'Eva; Addiss, David G

    2014-02-01

    Mass drug administration (MDA) for lymphatic filariasis (LF) programs has delivered more than 2 billion treatments of albendazole, in combination with either ivermectin or diethylcarbamazine, to communities co-endemic for soil-transmitted helminthiasis (STH), reducing the prevalence of both diseases. A transmission assessment survey (TAS) is recommended to determine if MDA for LF can be stopped within an evaluation unit (EU) after at least five rounds of annual treatment. The TAS also provides an opportunity to simultaneously assess the impact of these MDAs on STH and to determine the frequency of school-based MDA for STH after community-wide MDA is no longer needed for LF. Pilot studies conducted in Benin and Tonga assessed the feasibility of a coordinated approach. Of the schools (clusters) selected for a TAS in each EU, a subset of 5 schools per STH ecological zone was randomly selected, according to World Health Organization (WHO) guidelines, for the coordinated survey. In Benin, 519 children were sampled in 5 schools and 22 (4.2%) had STH infection (A. lumbricoides, T. trichiura, or hookworm) detected using the Kato-Katz method. All infections were classified as light intensity under WHO criteria. In Tonga, 10 schools were chosen for the coordinated TAS and STH survey covering two ecological zones; 32 of 232 (13.8%) children were infected in Tongatapu and 82 of 320 (25.6%) in Vava'u and Ha'apai. All infections were light-intensity with the exception of one with moderate-intensity T. trichiura. Synchronous assessment of STH with TAS is feasible and provides a well-timed evaluation of infection prevalence to guide ongoing treatment decisions at a time when MDA for LF may be stopped. The coordinated field experiences in both countries also suggest potential time and cost savings. Refinement of a coordinated TAS and STH sampling methodology should be pursued, along with further validation of alternative quantitative diagnostic tests for STH that can be used with

  8. Pilot Assessment of Soil-Transmitted Helminthiasis in the Context of Transmission Assessment Surveys for Lymphatic Filariasis in Benin and Tonga

    PubMed Central

    Chu, Brian K.; Gass, Katherine; Batcho, Wilfrid; 'Ake, Malakai; Dorkenoo, Améyo M.; Adjinacou, Elvire; Mafi, 'Eva; Addiss, David G.

    2014-01-01

    Background Mass drug administration (MDA) for lymphatic filariasis (LF) programs has delivered more than 2 billion treatments of albendazole, in combination with either ivermectin or diethylcarbamazine, to communities co-endemic for soil-transmitted helminthiasis (STH), reducing the prevalence of both diseases. A transmission assessment survey (TAS) is recommended to determine if MDA for LF can be stopped within an evaluation unit (EU) after at least five rounds of annual treatment. The TAS also provides an opportunity to simultaneously assess the impact of these MDAs on STH and to determine the frequency of school-based MDA for STH after community-wide MDA is no longer needed for LF. Methodology/Principal Findings Pilot studies conducted in Benin and Tonga assessed the feasibility of a coordinated approach. Of the schools (clusters) selected for a TAS in each EU, a subset of 5 schools per STH ecological zone was randomly selected, according to World Health Organization (WHO) guidelines, for the coordinated survey. In Benin, 519 children were sampled in 5 schools and 22 (4.2%) had STH infection (A. lumbricoides, T. trichiura, or hookworm) detected using the Kato-Katz method. All infections were classified as light intensity under WHO criteria. In Tonga, 10 schools were chosen for the coordinated TAS and STH survey covering two ecological zones; 32 of 232 (13.8%) children were infected in Tongatapu and 82 of 320 (25.6%) in Vava'u and Ha'apai. All infections were light-intensity with the exception of one with moderate-intensity T. trichiura. Conclusions Synchronous assessment of STH with TAS is feasible and provides a well-timed evaluation of infection prevalence to guide ongoing treatment decisions at a time when MDA for LF may be stopped. The coordinated field experiences in both countries also suggest potential time and cost savings. Refinement of a coordinated TAS and STH sampling methodology should be pursued, along with further validation of alternative

  9. [Evolution in the hospitalization for infectious diseases among non-EU patients in Emilia Romagna].

    PubMed

    Sabbatani, Sergio; Passini, Alessia; Salvioli, Valentina; Chiodo, Francesco

    2005-03-01

    In the Emilia Romagna (ER) area, between 1996 and 2000, a progressive increment in hospitalization for TBC, malaria, AIDS and hepatitis in non-EU patients was observed. This study aims to determine whether this trend was confirmed in 2001 and in which cities the increase was most significant. The Hospital Discharge Cards (HDC) registered in ER for non-EU patients in the relevant period were examined. In 2001, of 20,980 hospitalization cases of non-EU patients, 394 (1.87%) were attributed to infectious diseases, amounting to an increase of 1.77% over 2000. Of the 394 patients 250 (63.45%) were male and 144 (36.55%) female. The most represented age group was 20-39 yrs. Male patients more frequently come from Morocco (54), Senegal (45), Brazil (43), females from Nigeria (36), Morocco (26) and Ghana (14). The towns and cities where hospitalization occurred were, in decreasing order: Modena (24.6%), Bologna (19.3%), Reggio Emilia (12.9%), Ravenna (10.4%), Rimini (8.6%), Parma (8.3%), Piacenza (7.3%), Forli (4.8%), Ferrara and Cesena (both 1.8%). The Hospital Departments primarily involved were: Infectious Diseases with 213 hospitalizations (54%), Pneumology 69 (17.5%), Medicine 44 (11.1%), and Paediatrics 39 (9.9 %). Hospitalization causes were, in order of frequency: TBC with 137 cases (34.8%), malaria 75 cases (19%), AIDS 72 cases (18.3%), viral hepatitis 56 cases (14.2%), septicaemia 22 cases (5.6%) and Salmonella spp. infections 18 cases (4.5%).

  10. 300 Cities - An Exploration in Characterizing US Cities

    DTIC Science & Technology

    2008-06-01

    10 . SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 12. DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release...divided into PMSA’s the entire area becomes a CMSA. Metro areas that are not subdivided are designated MSA’s. [ 10 ] (Page 2) 300 Cities CMU-ISR-08-122...considering the general population. 300 Cities CMU-ISR-08-122 - 10 - CASOS Report Figure 2: City Unique Diversity. Percent of city population composed of

  11. The doctor-patient relationship, defensive medicine and overprescription in Chinese public hospitals: evidence from a cross-sectional survey in Shenzhen city.

    PubMed

    He, Alex Jingwei

    2014-12-01

    Defensive medicine describes physicians' behavioral response to threats from medical malpractice litigation. Previous studies have found widespread practice of defensive medicine that is responsible for the global escalation of health care costs. Defying the traditional explanations, this study, with a case of a Chinese city, reveals that in a country where medical malpractice lawsuits are rare, physicians' self-perceived threats from patients may constitute a major reason for defensive practices. Defensive behaviors in the Chinese context mainly take the form of overprescribing diagnostic tests, procedures and drugs. The existing literature tends to explain this in terms of Chinese doctors' desire to supplement their low incomes. Behind this is a series of misaligned incentives deeply embedded in the Chinese health system. Using a cross-sectional survey of physicians, this study shows that overprescription in Chinese hospitals is driven not only by hard economic incentives, but also by doctors' motive of avoiding disputes with patients. The survey was carried out in Shenzhen City, in December 2013. A sample containing 504 licensed physicians was drawn by random sampling. Descriptive analyses identified significant dissatisfaction with income and workload as well as severe tensions between doctors and patients. Drawing from the literature on defensive medicine, multivariate analysis revealed that physicians' previous experience of medical disputes is significantly associated with defensive behaviors, particularly overprescription. Low income continued to be a critical predictor, reinforcing the target income hypothesis and suggesting the resilience of perverse economic incentives. This study sheds fresh light on China's recent health policy reforms by highlighting the critical impact of the doctor-patient relationship. The effort to contain health care costs must progress on two fronts, mitigating the tensions between doctors and patients while still reforming the

  12. The status of Iranian hospital pharmacies according to age-friendly pharmacies criteria

    PubMed Central

    Bastani, Peivand; Marzaleh, Milad Ahmadi; Dehghani, Mina; Falahatzadeh, Maryam; Rahmati, Elahe; Tahernezhad, Ali

    2017-01-01

    Due to the increasing elderly population and the subsequent increase in their need for medication and more referrals to the pharmacy, this study was conducted to investigate the Iranian hospital pharmacies in terms of age-friendliness criteria. This was a cross-sectional study conducted in 2017. The study population included 3 metropolitan hospital pharmacies selected through clustered sampling, and all their 67 pharmacies were included by census. Data collection tool was a reliable researcher-made checklist (t = 0.85, α = 0.9) Data analysis was performed using Kruskal–Wallis test and Mann–Whitney test through SPSS version 24. The results in these three cities showed that only two pharmacies were in a high level of age-friendly. The relationship between type of pharmacy and the final score of age-friendly situation in these cities showed no significant relationship. There was no significant relationship among the average of the final score of the age-friendly situation in three studied cities. Due to the increasing elderly population and the aging society, readiness of Iranian hospital pharmacies to provide services to the elderly will be one of the most challenging issues in the long term. With proper legislation and policies on health-care systems, especially pharmacies, physical and psychological problems in elderly can be reduced in the future. Furthermore, with advancing toward age-friendly pharmacies, the community can be empower and become ready encountering elderly problems. PMID:29184842

  13. High folate levels are not associated with increased malaria risk but with reduced anaemia rates in the context of high-dosed folate supplements and intermittent preventive treatment against malaria in pregnancy with sulphadoxine-pyrimethamine in Benin.

    PubMed

    Moya-Alvarez, Violeta; Ouédraogo, Smaila; Accrombessi, Manfred; Cot, Michel

    2018-04-23

    To investigate whether high-dosed folate supplements might diminish the efficacy of malaria intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) in a cohort of pregnant women in Benin, where malaria is holoendemic. We followed 318 women during the entire pregnancy and analysed haematological and Plasmodium falciparum indicators in the context of an intermittent preventive treatment trial in Benin. During the follow-up, women received two-dose IPTp (1500/75 mg of SP per dose) at the maternity clinic and 600 mg of albendazole, 200 mg ferrous sulphate and 5 mg folic acid per day for home treatment. High folate levels were not associated with increased malaria risk (adjusted OR (aOR) = 0.51 (95% CI: 0.17; 1.56, P-value = 0.24)), nor with increased P. falciparum density (beta coefficient = -0.26 (95% CI: -0.53; 0.02), P-value = 0.07) in a randomised trial of IPTp in Benin. On the contrary, higher iron levels were statistically associated with increased odds of a positive blood smear (aOR = 1.7 95% CI (1.2; 2.3), P-value < 0.001) and P. falciparum parasite density (beta coefficient = 0.2 95% CI (0.1; 0.3), P-value < 0.001). High folate levels were statistically associated with decreased odds of anaemia (aOR = -0.30 95% CI (0.10; 0.88), P-value = 0.03). High folate levels are not associated with increased malarial risk in a prospective longitudinal cohort in the context of both iron and high-dosed folate supplements and IPTp. They are associated with reduced risk of anaemia, which is particularly important because iron, also given to treat anaemia, might be associated with increased malaria risk. © 2018 John Wiley & Sons Ltd.

  14. Prevalence of mip virulence gene and PCR-base sequence typing of Legionella pneumophila from cooling water systems of two cities in Iran.

    PubMed

    Ahmadrajabi, Roya; Shakibaie, Mohammad Reza; Iranmanesh, Zahra; Mollaei, Hamid Reza; Sobhanipoor, Mohammad Hossein

    2016-07-03

    Legionella pneumophila is the primary respiratory pathogen and mostly transmitted to human through water cooling systems and cause mild to severe pneumonia with high mortality rate especially in elderly both in hospitals and community. However, current Legionella risk assessments may be compromised by uncertainties in Legionella detection methods. Here, we investigated the presence of L. pneumophila mip gene in water samples collected from different hospitals cooling towers, nursing homes and building/hotels water coolants from two geographical locations of Iran (Kerman and Bam cities) during summer season of 2015 by both nested and real-time PCR methods. Analysis of the 128 water samples for presence of the mip gene by nested-PCR revealed, 18 (23%) positive cases in Kerman and 7(14%) in Bam. However, when samples were tested by real-time PCR, we identified 4 more new cases of L. pneumophila in the hospitals as well as nursing homes water systems that were missed by nested-PCR. The highest rate of contamination was detected in water obtained from hospitals cooling towers in both the cities (p≤0.05). Dendrogram analysis and clonal relationship by PCR-base sequence typing (SBT) of the L. pneumophila genomic DNAs in Kerman water samples showed close clonal similarities among the isolates, in contrast, isolates identified from Bam city demonstrated two fingerprint patterns. The clones from hospital water samples were more related to the L. pneumophila serogroup- 1.

  15. Prevalence of mip virulence gene and PCR-base sequence typing of Legionella pneumophila from cooling water systems of two cities in Iran

    PubMed Central

    Ahmadrajabi, Roya; Shakibaie, Mohammad Reza; Iranmanesh, Zahra; Mollaei, Hamid Reza; Sobhanipoor, Mohammad Hossein

    2016-01-01

    ABSTRACT Legionella pneumophila is the primary respiratory pathogen and mostly transmitted to human through water cooling systems and cause mild to severe pneumonia with high mortality rate especially in elderly both in hospitals and community. However, current Legionella risk assessments may be compromised by uncertainties in Legionella detection methods. Here, we investigated the presence of L. pneumophila mip gene in water samples collected from different hospitals cooling towers, nursing homes and building/hotels water coolants from two geographical locations of Iran (Kerman and Bam cities) during summer season of 2015 by both nested and real-time PCR methods. Analysis of the 128 water samples for presence of the mip gene by nested-PCR revealed, 18 (23%) positive cases in Kerman and 7(14%) in Bam. However, when samples were tested by real-time PCR, we identified 4 more new cases of L. pneumophila in the hospitals as well as nursing homes water systems that were missed by nested-PCR. The highest rate of contamination was detected in water obtained from hospitals cooling towers in both the cities (p≤0.05). Dendrogram analysis and clonal relationship by PCR-base sequence typing (SBT) of the L. pneumophila genomic DNAs in Kerman water samples showed close clonal similarities among the isolates, in contrast, isolates identified from Bam city demonstrated two fingerprint patterns. The clones from hospital water samples were more related to the L. pneumophila serogroup- 1. PMID:27028760

  16. Computed tomography of patients with head trauma following road traffic accident in Benin City, Nigeria.

    PubMed

    Eze, K C; Mazeli, F O

    2011-01-01

    The outcome of head trauma as a result of road accident rests with increased use of CT scan and other radiological imaging modalities for prompt diagnosis is important. To find out the time of presentation for CT scan, symptoms for referral for CT scan and pattern of injuries in patients with cranial CT scan following road traffic accidents. Retrospective analysis of cranial computed tomography (CT) films, request cards, duplicate copy of radiology reports, soft copy CT images and case notes of 61 patients who underwent cranial CT scan on account of road traffic accidents. The study CT scans were performed at the radiology department of University Teaching Hospital between 1st January 2002 and 31st December 2004. 51 patients (83.6%) were male while 10 (16.4%) were female with male to female ratio of 5:1. Thirty - eight (62.3%) patients were aged 20-39 years. Forty two patients (68.9%) presented after one week of injury. No patient presented within the first six hours of injury. The symptoms needing referral for CT scan included head injury 30 (49.2%), seizures 10 16.4%), skull fractures 8 (13.1%) and persistent headache 6 (5.6%). A total of 113 lesions were seen as some patients presented with more than one lesion. The findings on CT scan included 10 patients with normal findings , 21 (34.4%) skull fractures , 21 (34.4%) intra-cerebral haemorrhage , 19 (31.2%) brain contusion , 18 (29.5%) paranasal sinus collection,11 (18.0%) cerebral oedema, 10 (16.4%) subdural haematoma and 5 (8.2%) epidural haematoma. Over 80% of the subdural and epidural haematomas were associated with skull fractures. The yield from plain radiography was poor being positive in only 8 (13.1%) while CT scan was positive in 51 (83.61%). Also 75 (about 66%) of the 113 lesions seen on CT scan were treatable surgically. CT scan is an effective imaging modality of patient with road traffic accident and should be promptly requested in symptomatic patients who sustain trauma to the head toward

  17. The Alberta and Xenia tornados: how two hospitals handled hundreds of victims under trying conditions.

    PubMed

    2000-11-01

    Tornadoes rarely hit in areas where there are many hospitals. Two of the worst in recent years caused numerous casualties in a rural area of Canada and in a small city in Ohio, taxing the capabilities of the nearby hospitals involved. This report provides details on how they handled these disasters and what they learned from their experience.

  18. Community-Academic Partnership to Investigate Low Birth Weight Deliveries and Improve Maternal and Infant Outcomes at a Baltimore City Hospital.

    PubMed

    Harvey, Elizabeth M; Strobino, Donna; Sherrod, Leslie; Webb, Mary Catherine; Anderson, Caroline; White, Jennifer Arice; Atlas, Robert

    2017-02-01

    Purpose Mercy Medical Center (MMC), a community hospital in Baltimore Maryland, has undertaken a community initiative to reduce low birth weight (LBW) deliveries by 10 % in 3 years. MMC partnered with a School of Public Health to evaluate characteristics associated with LBW deliveries and formulate collaborations with obstetricians and community services to improve birth outcomes. Description As part of the initiative, a case control study of LBW was undertaken of all newborns weighing <2500 grams during June 2010-June 2011 matched 2:1 with newborns ≥2500 grams (n = 862). Assessment Logistic regression models including maternal characteristics prior to and during pregnancy showed an increased odds of LBW among women with a previous preterm birth (aOR 2.48; 95 % CI: 1.49-4.13), chronic hypertension (aOR: 2.53; 95 % CI: 1.25-5.10), hospitalization during pregnancy (aOR: 2.27; 95 % CI:1.52-3.40), multiple gestation (aOR:12.33; 95 % CI:5.49-27.73) and gestational hypertension (aOR: 2.81; 95 % CI: 1.79-4.41). Given that both maternal pre-existing conditions and those occurring during pregnancy were found to be associated with LBW, one strategy to address pregnant women at risk of LBW infants is to improve the intake and referral system to better triage women to appropriate services in the community. Meetings were held with community organizations and feedback was operationalized into collaboration strategies which can be jointly implemented. Conclusion Education sessions with providers about the referral system are one ongoing strategy to improve birth outcomes in Baltimore City, as well as provision of timely home visits by nurses to high-risk women.

  19. 78 FR 34300 - Safety Zone; Bullhead City Regatta, Bullhead City, AZ

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-07

    ... 1625-AA00 Safety Zone; Bullhead City Regatta, Bullhead City, AZ AGENCY: Coast Guard, DHS. ACTION... navigable waters of the Colorado River in Bullhead City, Arizona for the Bullhead City Regatta on August 10.... The City of Bullhead is sponsoring the Bullhead City Regatta, which is held on the navigable waters of...

  20. 77 FR 36439 - Safety Zone; Bullhead City Regatta; Bullhead City, AZ

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ... 1625-AA00 Safety Zone; Bullhead City Regatta; Bullhead City, AZ AGENCY: Coast Guard, DHS. ACTION... navigable waters of the Colorado River in Bullhead City, Arizona for the Bullhead City Regatta on August 11... The City of Bullhead is sponsoring the Bullhead City Regatta, which is held on the navigable waters of...