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Sample records for hospital benin city

  1. Donor blood procurement and utilisation at the University of Benin Teaching Hospital, Benin City.

    PubMed

    Enosolease, M E; Imarengiaye, C O; Awodu, O A

    2004-08-01

    Banked blood is a limited resource in Nigeria. We sought to evaluate factors that may further limit the effective utilisation of donor blood in a tertiary hospital in Benin City. The records of the blood transfusion unit of the hospital were studied to identify the methods of blood procurement and utilisation from January 1, 2000 to December 31, 2002. A total of 11,021 units of blood were received in the blood transfusion unit within this period out of which 1491 (13.5%) donor blood samples were found unfit for transfusion and, hence, discarded. Commercial blood donation accounted for 95.3%, compared to 4.7% from replacement and volunteer donors. Commercial blood donation was a major risk factor for likely disposal of donor blood (chi2 = 74.3, p < 0.0001, OR = 21.1. 95% CI = 7.8-56.7). Expired units of blood with low PCV were discarded for lack of infrastructure to fractionate and store them. Over 0.8million naira (US$6000.00) is wasted annually on discarded units of donor blood mainly from commercial donors. A policy on blood procurement to include subgroup selection of donors and improved funding of blood banking services may enhance efficient and effective utilisation of donor blood.

  2. Helminthiasis in selected children seen at the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria.

    PubMed

    Wagbatsoma, V A; Aisien, M S

    2005-03-01

    Illiteracy, poverty with associated poor environmental sanitation practices have been implicated in the heavy burden of helminthiasis among children. The objective of this cross-sectional survey is to determine the impact of parents' level of education on the intestinal helminthic status of children. All patients, 0-15 years totaling 1030 who visited the communicable disease clinic of the University of Benin Teaching Hospital, Benin City, from October, 2001 to March 2002 were included in this study. However, only 207 of the enlisted patients submitted faecal samples for examination and constituted the study population. Tool for data collection was structured questionnaire that was researcher administered to mother/caregivers after informed consent was obtained. Information sought in the questionnaire included sex and age of the subjects and level of education of their parents. Formol ether concentration method was used for stool examination while intensity was estimated using McMaster counting chamber technique. Of the 207 faecal samples examined 46(22.2% ) had ova of helminths while 161(77.85% ) had none. More school children, 40(19.3% ), than pre-school children, 6(2.9% ) had helminth ova in their faecal samples and the difference was found to be statistically significant (P < 0.05). More females, 28(13.5% ) than males, 18(8.7% ) were infected but the difference was however not statistically significant (P > 0.05). Intestinal helminth ova seen in order of prevalence include A. lumbricoides, 23(11.1% ); hookworm, 12(5.8% ); T. trichiuria, 8(3.8% ); Schistosoma mansoni, 2(1.0% ); Strongyloides stercoralis, 1(0.5% ) while multiple infection was recorded in 11(5.3% ) patients. Intensity of infection was low. The difference between the means for A. lumbricoides, T. trichiuria and multiple infection by age were found to be statistically significant P < 0.001; P < 0.05; P < 0.001, respectively. Mother's level of education more than father's level of education seemed to

  3. Solar retinopathy in Benin City, Nigeria.

    PubMed

    Ukponmwan, C U; Dawodu, O A; Ayanru, J O

    2003-12-01

    The case reports of three patients who were seen at the University of Benin Teaching Hospital Benin City with a diagnosis of solar maculopathy are presented. There was good visual recovery in two of the patients. This report shows the effect on the retina of direct sun gazing. The need to use protective filters is emphasized.

  4. 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

  5. Pattern of Skin Diseases at University of Benin Teaching Hospital, Benin City, Edo State, South-South Nigeria: A 12 Month Prospective Study

    PubMed Central

    Ukonu, B. A.; Eze, E. U

    2012-01-01

    Background and Objective: 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. Materials and Methods: 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. Results: 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. Conclusion: The current pattern of

  6. Adolescent induced abortion in Benin City, Nigeria.

    PubMed

    Omu, A E; Oronsaye, A U; Faal, M K; Asuquo, E E

    1981-12-01

    Induced adolescent abortion is a major cause of maternal and gynecologic death in the University of Benin Teaching Hospital, where 244 out of 349 such cases seen from January 1, 1974 to December 31, 1979 were reviewed. Ignorance and lack of contraceptive facilities were contributory factors. To deal with this problem that has been pervasive throughout Nigeria for the past decade, the authors advocate sex education, systematic dissemination of information for planned and conscientious parenthood as well as free availability of alternative methods of contraception. Interruption of early pregnancy should be an essential component of a national family planning program.

  7. 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.

  8. 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.

  9. 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.

  10. Occupational risk factors associated with lymphoid malignancies in Benin City, Nigeria.

    PubMed

    Omoti, C E; Obieche, J C; Kamdem, A P; Eze, J C

    2012-06-01

    This study is designed to identify the associated occupations most at risk of developing lymphoid malignancies. The medical records of all lymphoid malignancy cases seen in University of Benin Teaching Hospital between July 2001 and June 2010 were retrieved from medical record library. The patient's bio-data, occupational, social and past medical history and pathologic subtypes were extracted. A total of 252 patients records with diagnosis of lymphoid malignancies were reviewed in this study. Farmers (20.6%) and students (38.9%) form the majority of the cases seen and both showed statistically significant association with risk of LM (p<0.0001) This study revealed that agricultural workers and students in Benin City are at higher risk of developing lymphoid malignancies. Although previous studies have implicated agricultural exposure, the same cannot be said about students. It is therefore recommended that a follow up study should be conducted to ascertain the possible environmental, nutritional, social/lifestyle stressors that put students in Benin City at higher risk of lymphoid malignancies.

  11. Etiologic agents of otitis media in Benin city, Nigeria

    PubMed Central

    Osazuwa, Favour; Osazuwa, Emmanuel; Osime, Clement; Igharo, Esohe Amanda; Imade, Paul Erhumwunse; Lofor, Patrick; Momoh, Moses; Omoregie, Richard; Dirisu, John

    2011-01-01

    Background: Otitis Media continues to be a major presentation in the ear, nose and throat clinic. Aim: This study aimed to isolate, characterize and identify the bacteriological and mycological etiologic agents of otitis media in Benin city. Patients and Methods: Ear discharge from 569 (299 males and 270 females) patients diagnosed clinically of otitis media between August 2009 and August 2010 were processed to recover the bacterial and fungal etiologic agents. Susceptibility test was performed on all bacterial isolate. Result: Pseudomonas aeruginosa (28.3%) was the predominant bacteria isolate causing otitis media followed by Staphylococcus aureus (21.0%), Klebsiella sp (8.9%), Proteus sp (8.2%), Alkaligenes spp (4.3%), Streptococcus pneumoniae (3.9%), Escherichia coli (3.0%) and Citrobacter freundi (1.7%). Fungi isolated were Aspergillus niger (9.2%), Candida albicans (5.4%), Candida tropicalis (3.0%), Aspergillus flavus (2.1%) and Candida parasilopsis (1.5%). 413 had a single organism isolated from the middle ear culture while twenty (3.51%) patients had mixed organisms isolated. Infection was highest among 0 - 5 years, and lowest among aged 18 - 23. All bacterial isolates were poorly susceptible to the antibacterial agents. Conclusion: The study uncovers a high frequency of bacteria associated otitis media with the finding of fungi too as a significant etiologic agent. PMID:22540074

  12. Female genital mutilation among Edo people: the complications and pattern of presentation at a pediatric surgery unit, Benin City.

    PubMed

    Osifo, David Osarumwese; Evbuomwan, Iyekoretin

    2009-03-01

    This prospective study on female genital mutilation among Edo people was based on female children and parents who presented on account of it at the University of Benin Teaching Hospital, Benin City, Nigeria, between January 2002 and December 2007. During the period, 51 female children aged 10 days and 18 years presented with complications following genital mutilation. Twenty-nine were brought by their parents for mutilation while 67 parents interviewed believed strongly on female genital mutilation with 47 mothers mutilated. Religio-cultural and superstitious beliefs were the main indications and the type of mutilation ranged from excision of clitoridal tip in 10 (19.6%) children to complete excision of the clitoris, labia minora and inner layer of majora in 7 (13.7%). Complications ranged from clitoridal cyst formation in 21 (41.2%) to life threatening infections with one mortality due to tetanus infection.

  13. Child sexual abuse in Benin City, Edo State, Nigeria: a sociological analysis.

    PubMed

    Omorodion, F I

    1994-01-01

    A study is presented of the reported cases of child rape in Benin City, the capital of Edo State in Nigeria. The conditions that make children, particularly females, more vulnerable to sexual abuse are explored. The organization of family life places children in a dependency cycle that makes rape both inevitable and invisible. Change that is responsive to family needs is more likely to have a positive effect in preventing child rape.

  14. Factors associated with post-cesarean stillbirth in 12 hospitals in Benin: a cross-sectional

    PubMed Central

    Mongbo, Virginie; Ouendo, Edgard-Marius; Agueh, Victoire; Kpozèhouen, Alphonse; Sopoh, Ghislain; Saïzonou, Jacques; Godin, Isabelle

    2016-01-01

    Introduction In spite of free caesarean section applied in Benin since 2009, high rates of stillborn babies continue to be recorded. This study aimed to determine the factors associated with post-caesarean stillborn in Benin. Methods Cross-sectional study that covered all women who have delivered by caesarean from December 2013 to February 2014 in twelve hospitals chosen by simple random selection in each of the twelve departments of Benin. Data collected by chart review have been analyzed using the statistical software Epi info 3.5.1. Univariate analysis and multivariable logistic regression were used to identify factors associated with post-caesarean stillbirth at the significance threshold of 5%. Results There were 66 stillborn per 1,000 births of which 58% died before admission to hospital. The risk factors identified were the reference (p = 0.0011), general anesthesia (p = 0.0371), the low birth weight (p = 0.0001), the retro-placental hematoma (p = 0.0083), and the umbilical cord prolapse (p = 0.0229). Acute fetal distress (p = 0.0308) and anesthesia administered by an anesthetist nurse or midwife (p = 0.0337) were protective factors. Conclusion The majority of cases, in utero death occurred before admission to hospital. Strengthening antenatal refocused consultation, a better access to quality obstetric care and the grant of all obstetric care could reduce stillbirths from caesarean sections in Benin. PMID:28292080

  15. 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.

  16. Pattern of drug use amongst antenatal patients in Benin City, Nigeria.

    PubMed

    Gharoro, E P; Igbafe, A A

    2000-01-01

    Drugs taken by pregnant women could have profound effect on pregnancy outcome for both the mother and fetus. In most developing country regulation of drug is poor, access is unrestricted and abuse of drugs especially antibiotics is rampant. The study was undertaken to determine the pattern and extent of drug consumption amongst pregnant women in Benin City. A cross-sectional study of 1200 pregnant patients at various gestational ages was undertaken, using a structured questionnaire to obtain details of the extent and character of drug use before or during pregnancy. Folic acid was taken by 76.08% of all the pregnant patients, while anti-malarial drugs were taken by 19.75%; 15.83% used the drugs on doctors' prescription and 3.92% without a doctor's prescription. The proportion of the mothers that consumed native herbs was 12.08%. The use of native medication was more prevalent amongst nulliparous mothers (41.82%). Native herb consumption decreased with increase in parity. Both educated and illiterate mothers consumed herbal medications. Less than 1% of the mothers smoke cigarettes. In Benin City drug use in pregnancy is characterized by a pattern of low consumption except folic acid and native herbs. This could be a major setback for any program of drug intervention, as in chemoprophylaxis for malaria in pregnancy. Much resource will be needed for patients' education for successful implementation of any planned program in the community.

  17. 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…

  18. 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…

  19. The low income preschools in Benin City: some health aspects of the children.

    PubMed

    Goyea, H S

    1988-10-01

    Forty-three proprietors of the low-income preschools in Benin City and 353 mothers of children attending such groups were asked to give information pertaining to the common health problems and immunization status of the children. Information was obtained by interviews and self-administered questionnaires. Moreover, 415 children were examined to determine the incidence of head lice, scabies, ringworm and catarrh - conditions which had been found to be common among children in the low-income group. The results revealed that malaria and catarrh were the commonest conditions according to the parents and proprietors while the physical examination established catarrh and ringworm as very common. The immunization status was unsatisfactory. Recommendations are made for the upgrading of these preschool groups for better health and early childhood education.

  20. Sexual networking of market women in Benin City, Edo State, Nigeria.

    PubMed

    Omorodion, F I

    1993-01-01

    The manifestation of acquired immune deficiency syndrome (AIDS) all over the world has increased the need for information on the nature and pattern of sexual networking in Africa, where there is a dearth of such information. In the present study, information on the sexual networking of market women in Benin City, Nigeria, was obtained using a questionnaire instrument. The questionnaire covered the sexual, reproductive, and health behaviors of these women. The data revealed that the levels of both premarital and extramarital sexual networking are high. Such a high degree of sexual networking has exposed a number of these women to sexually transmitted diseases. The manifestation of AIDS in this society will be widespread and devastating to the people and the society because these women are in a polygamous relationship in a society that frowns on the use of contraceptives by couples. In addition, controversies surround the correlation between socioeconomic status (SES) and AIDS, geographical areas of prevalence, and the role of prostitutes in the spread of the disease. For example, studies in Africa show that whereas there is no correlation between SES and AIDS in Kinshasa, the attack rate was higher in educated people in Rwanda and Zambia. Moreover, there are predominantly urban outbreaks in other countries, such as Uganda (Piot & Carael, 1988).

  1. Radiographic anthropometric study of frontal sinus for sex determination in Benin city, South-South Nigeria.

    PubMed

    Eboh, Dennis Erhisenebe O; Ogbeide, Osesogie U; Ivwighren, Theophilus

    2017-01-01

    The frontal sinuses are situated in the frontal bone between the outer and inner plates of the bone. A good knowledge on dimensions is relevant for successful surgery. This study was carried out to determine the dimorphic potential of the frontal sinuses and to ascertain the accuracy in sex determination using the logistic regression model among Edo people of Nigeria. It was a 7 years retrospective study on the Edo, utilizing posterior-anterior radiographs of frontal sinuses in University of Benin Teaching Hospital. The right and left frontal sinus heights and widths were measured in centimeter. The data were analyzed using independent samples t-test and logistic regression with the aid of Statistical Package for the Social Sciences version 20. P ≤0.05 was considered statistically significant. All dimensions were higher in males than in females, wherein the the left side height and width were statistically significant (P < 0.05). Left side frontal sinus width gave the highest accuracy of 60% in sex determination using logit regression. The dimorphic nature of the left dimensions has implications for human identification.

  2. 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

  3. [Implementation of the 5S quality control management scheme to the Ouidah hospital zone in Benin].

    PubMed

    Nana, W F; Drabo, M K; Capo Chichi, J; Agueh, V

    2015-02-01

    Delivery of quality care remains a major challenge for all heathcare institutions. The 5S quality control scheme was applied in the Ouidah hospital zone in Benin starting in 2012. The objective of the present survey was to evaluate its impact in 2013. This was a descriptive and analytic survey of the Ouidha hospital zone. Three techniques – interview, observation, review – were used to collect data from the healthcare staff, hospital users, and documents describing the strategy of the implementation. Implementation of the 5S strategy was considered, on average, to be "satisfactory" with scores of 56% for context, 61% for inputs, and 51% for processes. The internal and external users judged care delivery "very satisfactory" with a score of 79%. Although the results appear satisfactory, the future hospital policy must strengthen the quality insurance process, ensure the availability of management tools, and provide training and further motivation for the "5S" management teams. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  4. 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

  5. Knowledge, attitudes and experiences of sex trafficking by young women in Benin City, South-South Nigeria.

    PubMed

    Okonofua, F E; Ogbomwan, S M; Alutu, A N; Kufre, Okop; Eghosa, Aghahowa

    2004-09-01

    Benin City, the headquarters of Edo State, is known to have one of the highest rates of international sex trafficking of young women in Nigeria. This study was designed to determine the knowledge, attitudes and experiences of young women in Benin City, towards international sex trafficking. A random household sample of 1456 women aged 15-25 years was interviewed with a structured questionnaire that elicited information on women's experiences of, and attitudes towards international sex trafficking. The results indicate that 97.4% of the women have heard of international sex trafficking; 70% had female relatives who lived in the receiving countries of Italy, Spain, and the Netherlands; while 44.0% knew of someone who was currently engaged in sex work abroad. Up to 32% of the women reported that they had been approached by someone offering to assist them to travel abroad. Women of poorer socio-economic status (being out-of-school, unemployed, parents uneducated and unemployed) were more likely to report having been offered assistance to travel abroad. Up to 81.5% of the women supported the notion that sex trafficking should be stopped, while 18.5% felt it should be allowed to continue. The perception that sex trafficking leads to wealth creation and economic gains for women was the most common reason proffered by those wanting the practice to continue. By contrast, the fear of adverse health consequences and the need to maintain social and religious morals were the reasons given by those wanting the practice to discontinue. These results suggest that programs that promote the economic well being of women, and social advocacy focusing on harm reduction will be most helpful in reducing the rate of sex trafficking in Benin City.

  6. 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.

  7. Pathogenic features of clinically significant coagulase-negative staphylococci in hospital and community infections in Benin.

    PubMed

    Nanoukon, Chimène; Argemi, Xavier; Sogbo, Frédéric; Orekan, Jeanne; Keller, Daniel; Affolabi, Dissou; Schramm, Frédéric; Riegel, Philippe; Baba-Moussa, Lamine; Prévost, Gilles

    2017-01-01

    In West Africa, very little consideration has been given to coagulase negative Staphylococci (CNS). Herein, we describe the features contributing to the pathogenicity of 99 clinically-significant independent CNS isolates associated with infections encountered at the National Teaching Hospital Center of Cotonou (Benin). The pathogenic potentials of nosocomial strains were compared with community strains. S. haemolyticus (44%), S. epidermidis (22%) and S. hominis (7%) were the most frequently isolated while bacteremia (66.7%) and urinary tract infections (24.2%) were the most commonly encountered infections. Most strains were resistant to multiple antibiotics, including penicillin (92%), fosfomycin (81%), methicillin (74%) and trimethoprim-sulfamethoxazole (72%). The most frequently isolated species were also the most frequently resistant to methicillin: S. hominis (100%), S. haemolyticus (93%) and S. epidermidis (67%). Screening of toxic functions or toxin presence revealed hemolytic potential in 25% of strains in over 50% of human erythrocytes in 1h. Twenty-six percent of strains exhibited protease activity with low (5%), moderate (10%) and high activity (11%), while 25% of strains displayed esterase activity. Three percent of strain supernatants were able to lyse 100% of human polymorphonuclear cells after 30min. Polymerase chain reaction and latex agglutination methods revealed staphylococcal enterotoxin C gene expression in 9% of S. epidermidis. A majority of hospital-associated CNS strains (68%) had at least one important virulence feature, compared with only 32% for community-acquired strains. The present investigation confirms that these microorganisms can be virulent, at least in some individual cases, possibly through genetic transfer from S. aureus.

  8. Influence of smoking on respiratory symptoms and lung function indices in sawmill workers in Benin City, Nigeria.

    PubMed

    Ugheoke, A J; Ebomoyi, M I; Iyawe, V I

    2006-01-01

    The study was done to assess the influence of smoking on respiratory symptoms and respiratory function in sawmill workers in Benin City. 150 sawmill workers who were all males and aged between 18 and 50 years, and had been in continuous employment in sawmill factories for a minimum of one year were studied. They were selected by a two-stage random sampling process from sawmills in Benin City. These were compared to 150 age and sex matched controls in order to determine the effect of sawdust exposure on the respiratory system. Questionnaire was used to elicit morbidity patterns and anthropometric measurements were also made. Respiratory rates, Peak Expiratory Flow Rates and Blood Pressures were measured in both groups. Respiratory symptoms were more common among sawmill workers compared to the controls. Smoking by some of these workers further aggravated their respiratory symptoms. Although blood pressure was similar in both groups, Respiratory rates were higher and Peak Flow Rates were lower in the sawmill workers compared to the controls (20.83 +/- 2.02 cycles/minute and 516.72 +/- 38.48 L/minute for the sawmill workers; 15.45 +/- 1.23 cycles/minute and 575.37 +/- 27.34 L/minute for the controls, respectively). Less than 5% of the sawmill workers wore protective devices/clothing, and health and safety standards were neither practiced nor enforced. The findings suggest that respiratory symptoms especially sputum production and chest pain are common in sawmill workers. Respiratory function is compromised in these workers.

  9. Association between Periodontal Status, Oral Hygiene Status and Tooth Wear among Adult Male Population in Benin City, Nigeria

    PubMed Central

    Umoh, AO; Azodo, CC

    2013-01-01

    Background: The association between periodontal status, oral hygiene status and severity of tooth wear lesion varies from community to community and also from occupation to occupation. Aim: To determine the association between periodontal status, oral hygiene status and tooth wear among the adult male population in Benin City, Nigeria. Subjects and Methods: This study was conducted among 65 male drivers, aged 25-64 years, with a mean age of 48.6 (9.1) years in an organized private motor park in Benin City between November 2011 and January 2012. The data collected through interview and clinical oral examination were age, educational status, driving experience, oral hygiene status, periodontal status and severity of tooth wear. Results: In this study, 13.8% (9/65) and 1.5% (1/65) of the participants had 4-5 mm and ≥6 mm periodontal pockets, respectively. A total of 15.4% (10/65) of the participants had poor oral hygiene status and 58.5% (38/65) of the participants had tooth wear lesion, with 15.8% (9/65) being severe tooth wear lesions (score 3). Participants with poorer oral hygiene and more severe tooth wear lesions significantly exhibited poorer periodontal status. There also existed a significant association between oral hygiene status and the severity of tooth wear lesion among the participants in this study. Conclusion: Data from this study revealed a statistically significant association between periodontal status, oral hygiene status and severity of tooth wear lesion among the participants. PMID:23919180

  10. Establishing in-hospital geriatrics services in Africa: Insights from the University of Benin Teaching Hospital geriatrics project.

    PubMed

    Akoria, Obehi Aituaje

    2016-01-01

    Unawareness of the peculiar healthcare needs of the elderly and resource constraints may be some reasons why until recently, Nigerian hospitals have not been equipped with the human and infrastructural resources required to meet older adults' special healthcare needs. There is paucity of specialized health services for the elderly in Africa. Nigeria, with a population of over 170 million, did not have any healthcare facility with dedicated services for the elderly until 2012. The University of Benin Teaching Hospital (UBTH) in Nigeria was established in 1973 and created its geriatrics unit in October 2013. A prepared environment and trained interdisciplinary teams are pivotal in providing effective healthcare services for the elderly. The ongoing UBTH geriatrics project aims to provide specialized interdisciplinary health services to older adults and to provide training and continuing professional development in geriatrics for healthcare staff. In developing our inpatient services, we adopted the acute care for elders (ACE) model and worked in tandem with the "ABCs" of implementing ACE units. In the face of limited resources, it was possible to establish a functional geriatrics unit with a trained interdisciplinary team. Family participation is central in our practice. Since October 2013, residents and house officers in internal medicine have been undertaking 4- and 12-weekly rotations, respectively. There is also a robust academic program, which includes once-weekly geriatric pharmacotherapy seminars, once-weekly interdisciplinary seminars, and 2-weekly journal club meetings alternating with seminars on geriatric assessment tools. It is possible to establish geriatric services and achieve best practices in resource-limited settings by investing on improving available human resources and infrastructure. We also make recommendations for setting up similar services in other parts of Africa.

  11. Establishing in-hospital geriatrics services in Africa: Insights from the University of Benin Teaching Hospital geriatrics project

    PubMed Central

    Akoria, Obehi Aituaje

    2016-01-01

    Background: Unawareness of the peculiar healthcare needs of the elderly and resource constraints may be some reasons why until recently, Nigerian hospitals have not been equipped with the human and infrastructural resources required to meet older adults’ special healthcare needs. There is paucity of specialized health services for the elderly in Africa. Nigeria, with a population of over 170 million, did not have any healthcare facility with dedicated services for the elderly until 2012. The University of Benin Teaching Hospital (UBTH) in Nigeria was established in 1973 and created its geriatrics unit in October 2013. A prepared environment and trained interdisciplinary teams are pivotal in providing effective healthcare services for the elderly. The ongoing UBTH geriatrics project aims to provide specialized interdisciplinary health services to older adults and to provide training and continuing professional development in geriatrics for healthcare staff. In developing our inpatient services, we adopted the acute care for elders (ACE) model and worked in tandem with the “ABCs” of implementing ACE units. Results: In the face of limited resources, it was possible to establish a functional geriatrics unit with a trained interdisciplinary team. Family participation is central in our practice. Since October 2013, residents and house officers in internal medicine have been undertaking 4- and 12-weekly rotations, respectively. There is also a robust academic program, which includes once-weekly geriatric pharmacotherapy seminars, once-weekly interdisciplinary seminars, and 2-weekly journal club meetings alternating with seminars on geriatric assessment tools. Conclusions: It is possible to establish geriatric services and achieve best practices in resource-limited settings by investing on improving available human resources and infrastructure. We also make recommendations for setting up similar services in other parts of Africa. PMID:27549420

  12. Food contamination in fast food restaurants in Benin City, Edo State, Nigeria: Implications for food hygiene and safety.

    PubMed

    Isara, A R; Isah, E C; Lofor, P V O; Ojide, C K

    2010-08-01

    To determine the prevalence of food contamination in the fast food restaurants operating in Benin City, Edo State, Nigeria. Three hundred and fifty food handlers were selected by means of a systematic sampling method and interviewed using a semi-structured researcher-administered questionnaire. One hundred and sixty-eight samples of ready-to-eat food and 45 stool samples were collected and analysed in the laboratory for the presence of bacteria (excluding anaerobic bacteria). More than half of the respondents (n=184, 52.6%) had no training in food hygiene and safety. Only 149 (42.6%) respondents knew that micro-organisms can contaminate food. The prevalence of food contamination in the fast food restaurants was found to be 37.5%. Bacillus cereus and Staphylococcus aureus were the most commonly isolated bacteria, while salad, meat pie and fried rice were the most commonly contaminated foods. There is need for the relevant local authorities to ensure that the food sold to consumers in fast food restaurants is safe, wholesome and fit for human consumption in order to prevent outbreaks of food-borne illnesses. Also, there should be regular training/retraining and health education of these food handlers in all aspects of food hygiene and safety. Copyright 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  13. Clergy as collaborators in the delivery of mental health care: an exploratory survey from Benin City, Nigeria.

    PubMed

    James, Bawo O; Igbinomwanhia, Nosa G; Omoaregba, Joyce O

    2014-08-01

    The paucity of skilled manpower in sub-Saharan Africa limits the delivery of effective interventions for the mentally ill. Individuals with mental disorders and their caregivers frequently consult clergy when mental symptoms cause distress. There is an urgent need for collaboration with nonprofessionals in order to improve mental health care delivery and close the widening treatment gap. Using a cross-sectional descriptive method, we explored clergy's (Christian and Muslim) aetiological attributions for common mental illness (schizophrenia and depression) from Benin City, Nigeria, as well as their willingness to collaborate with mainstream mental health services. We observed that a majority of clergy surveyed were able to correctly identify mental illnesses depicted in vignettes, embraced a multifactorial model of disease causation, and expressed willingness to collaborate with mental health care workers to deliver care. Clergy with a longer duration of formal education, prior mental health training, and Catholic/Protestant denomination expressed a greater willingness to collaborate. Educational interventions are urgently required to facilitate this partnership. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  14. 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.

  15. 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

  16. Characteristics of neonatal near miss in hospitals in Benin, Burkina Faso and Morocco in 2012-2013.

    PubMed

    Ronsmans, Carine; Cresswell, Jenny A; Goufodji, Sourou; Agbla, Schadrac; Ganaba, Rasmané; Assarag, Bouchra; Tonouhéoua, Oscar; Diallo, Cheick; Meski, Fatima-Zahra; Filippi, Véronique

    2016-04-01

    The objective of this study is to explore the usefulness of neonatal near miss in low- and middle-income countries by examining the incidence of neonatal near miss and pre-discharge neonatal deaths across various obstetric risk categories in 17 hospitals in Benin, Burkina Faso and Morocco. Data were collected on all maternal deaths, maternal near miss, neonatal near miss (based on organ-dysfunction markers), Caesarean sections, stillbirths, neonatal deaths before discharge and non-cephalic presentations, and on a sample of births not falling in any of the above categories. The burden of stillbirth, pre-discharge neonatal death or neonatal near miss ranged from 23 to 129 per 1000 births in Moroccan and Beninese hospitals, respectively. Perinatal deaths (range 17-89 per 1000 births) were more common than neonatal near miss (range 6-43 per 1000 live births), and between a fifth and a third of women who had suffered a maternal near miss lost their baby. Pre-discharge neonatal deaths and neonatal near miss had a similar distribution of markers of organ dysfunction, but unlike pre-discharge neonatal deaths most neonatal near miss (63%, 81% and 71% in Benin, Burkina Faso and Morocco, respectively) occurred among babies who were not considered premature, low birthweight or with a low 5-min Apgar score as defined by WHO's pragmatic markers of severe neonatal morbidity. Whether the measurement of neonatal near miss adds useful insights into the quality of perinatal or newborn care in settings where facility-based intrapartum and early newborn mortality is very high is uncertain. Perhaps the greatest advantage of adding near miss is the shift in focus from failure to success so that lessons can be learned on how to save lives even when clinical conditions are life-threatening. © 2016 John Wiley & Sons Ltd.

  17. 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.

  18. 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.

  19. [Clinical and radio-anatomical aspects of traumatic brain injuries after road crash at one hospital, Benin].

    PubMed

    Fatigba, Olatoundji Holden; Mensah, Emile; Salako, Alexandre Allode; Babio, Rokiatou; Mensa Savi De Tove, Kofi; Gandaho, Prosper

    2011-11-01

    Traumatic brain injuries (TBI) represent one major cause of death worldwide. The young people are most concerned and road crash is the first etiology. To establish the frequency, clinical, and radio-anatomical sides of TBI after road crash. It was descriptive study performed from January 1, 2008 to June 30, 2009 in Borgou Departmental Hospital, Benin. It concerned patients admitted in ours unit four traumatic brain injuries after road crash. 274 patients answered the criteria of inclusion. They was 22, 2% of the hospitalizations in surgery unit. The mean age was 29.56 years. The age bracket most concerned was the 21- 30 years [35.8%]. The sex ratio M/F was 5.85. The initial loss of consciousness was the clinical sign more observed [89.8%]. The neurological deficits were observed in 9.8% of the cases. The severe TBI (GCS ² 8) accounted for 27.7% of the patients. Among the 110 patients [41.1%] received skull X-ray, 66 patients [50.9%] presented a vault's lesion. The cerebral scanner produced among 38 patients [13.9%] objectified lesions of the vault in 21 [55.3%] patients. The intracranial injuries were dominated by the cerebral contusions [31.6%]. Mortality was 17.5%. Among death, the 21-30 years old was 37.5%. TBI admitted in CHD-Borgou are major problem. Preventives measure concerning all users may be applied.

  20. 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.

  1. 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 Central

    Okojie, P. W.; Isah, E. C.

    2014-01-01

    Objective. To determine the sanitary conditions of vending sites as well as food handling practices of street food vendors in Benin City, Nigeria. Methodology. 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. Results. 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). Conclusion. This study showed that street food vending sites in Benin City were sanitary and that food vendors had good food handling practices. PMID:25258630

  2. 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.

  3. Hospital Waste Management in Nonteaching Hospitals of Lucknow City, India

    PubMed Central

    Manar, Manish Kumar; Sahu, Krishna Kumar; Singh, Shivendra Kumar

    2014-01-01

    Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW) management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices. PMID:25657950

  4. The attitudes of clergy in Benin City, Nigeria towards persons with mental illness.

    PubMed

    Igbinomwanhia, N G; James, B O; Omoaregba, J O

    2013-05-01

    The clergy in sub-Saharan Africa play a major role in the care and pathways to orthodox mental health services of the mentally ill. Their attitudes concerning mental illnesses would influence community mental health intervention efforts. This study aimed to determine the attitudes of clergy towards persons with mental illness. A cross-sectional survey of clergy (n = 107) of the Christian and Muslim faiths was conducted, using a socio-demographic questionnaire and the 40- item Community Attitudes towards Mental Illness (CAMI) scale. Stigmatizing attitudes were evident among members of the clergy surveyed. Most (71.1%) believed the mentally ill were different from other persons, while 68.2% were of the opinion that the mentally ill should be controlled like children. Over 80% of respondents were not comfortable with the idea of the mentally ill living in their vicinity and wanted mental health hospitals situated out of residential areas. Almost half of respondents (45.8%) were uncomfortable with women who were once mentally ill baby-sitting and 63.2% agreed that our mental hospitals seem more like prisons than where the mentally ill can be cared for. Negative attitudes towards the mentally ill were widespread among the clergy sampled. Mental health professionals need to take proactive steps to improve the mental health knowledge of the clergy which may facilitate their roles in the pathway to mental health care.

  5. KNOWLEDGE, ATTITUDE AND CONTROL PRACTICES OF SICKLE CELL DISEASE AMONG YOUTH CORPS MEMBERS IN BENIN CITY, NIGERIA

    PubMed Central

    Adewoyin, A.S.; Alagbe, A.E.; Adedokun, B.O.; Idubor, N.T.

    2015-01-01

    Background: Sickle cell disease (SCD) is a major public health problem in Nigeria. Carrier prevalence is about 25% and it affects about 2 - 3% of the Nigerian population. The disease runs a chronic course, characterized by recurrent ill-health, progressive organ damage and shortened life-span. There is a need for SCD control through public education and other preventive measures. Objective: This study aimed at assessing the level of knowledge regarding SCD among a cross-section of new tertiary graduates in Nigeria, as well as factors influencing their knowledge. It also describes their attitudes and patterns of control practices engaged by the respondents regarding SCD. Method: This was an analytic, cross-sectional study among 370 new tertiary graduates (youth corps members) in Benin City, Nigeria. Bio-data, data on knowledge, their attitude and control practices of sickle cell disease were obtained using a structured questionnaire. Association between the mean level of knowledge and other variables such as age, gender, course of study, etc were tested using one way analysis of variance. Results: Most of the study participants were aged 22 - 29 years. A large proportion (63.5%) of the respondents was females. Only 17.8% of the respondents had a good knowledge of SCD despite high level of awareness (98.4%). Those who studied courses related to medical sciences had significantly higher mean knowledge score. About 94.6% of the respondents knew their SCD carrier status and 80.8% were willing to avoid carrier marriages. Only 38.1% will accept prenatal diagnosis/selective abortion if locally available. Conclusion: Most participants demonstrated moderate level of public health knowledge regarding SCD in Nigeria. Considering the relative lack of prenatal diagnostic services, low acceptability of selective abortion among the respondents, sub-optimal care of affected persons and poor access to haemopoeitic stem cell transplantation (HSCT) in our environment, stronger efforts

  6. Knowledge and Use of Zinc Supplementation in the Management of Childhood Diarrhoea among Health Care Workers in Public Primary Health Facilities in Benin-City, Nigeria

    PubMed Central

    Omuemu, Vivian O.; Ofuani, Ifeanyi J.; Kubeyinje, Itse C.

    2012-01-01

    Zinc supplementation reduces the severity, duration and recurrence of childhood acute diarrhoea. These beneficial effects of zinc in the treatment of diarrhoea led to the inclusion of a 10-14 days treatment regimen by the WHO/UNICEF. This study assessed the level of knowledge and use of zinc supplementation in the management of childhood diarrhoea among health care workers in public primary health facilities in Benin-City, Nigeria. Methodology: This cross-sectional study was carried out among the total population of health care providers in public primary health facilities in Benin-City. Data collection was done using a pre-tested, structured, self-administered questionnaire and data was analyzed using SPSS version 15.0. Results: A total of 168 health care workers participated in the study. Two-thirds of them were aware of zinc supplementation but specific knowledge of zinc supplementation in the management of childhood acute diarrhoea was poor. Thirty-five percent of them prescribed zinc when managing childhood diarrhoea and only 10% of these do so for every case of childhood diarrhoea. About 84.6% of them prescribed the correct dose of zinc while less than half of them prescribe it for the correct duration. All but one of them prescribed zinc in addition to ORS in line with the WHO guideline. Discussion: The study revealed a gap in the knowledge and practice of use of zinc supplementation in the management of childhood diarrhoea. It is recommended that nationwide campaigns should be embarked on to promote the use of zinc supplementation in the clinical management of childhood diarrhoea. PMID:22980153

  7. 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

  8. 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.

  9. Benin: country profile.

    PubMed

    Gabriel, A

    1987-10-01

    Since 1972, Benin has had an official Marxist-Leninist ideology; however, centralized state control contributed to economic stagnation and a search for capital investment. A special section of the World Bank is advising the Government of Benin on public sector reform and privatization, and an agreement with the International Monetary Fund seems likely. At present, 65% of Benin's labor force is engaged in subsistence agriculture, most of which is collectivized, and the gross national product per capita is US$260. The main cash crops are seed cotton and palm oil kernels used in soap and margarine. While women occupy key trade positions in the south of Benin, they are very oppressed in the north. Benin has a population of 4 million. The infant mortality rate is 115/1000 lives births and life expectancy is 43 years. Only 21% of the population has access to clean water. 40% of men, compared to just 17% of women, are literate.

  10. 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

  11. Hathaway v. Worcester City Hospital. 22 Mar 1973.

    PubMed

    1973-01-01

    The arguments and findings in the case of Robbie Mae Hathaway, Plaintiff, Appellant, versus Worcester City Hospital et al., (Worcester, Massachusetts), Defendants, Appellees, are presented. The case was heard January 3, 1973 by the United States Court of Appeals, First Circuit, and was decided March 22, 1973. Hathaway's action challenged the city hospital policy barring the use of facilities in connection with consensual sterilization. The appellant, Hathaway, had 12 pregnancies resulting in 8 live children and maintained that her life would be jeopardized by future pregnancies. She challenged as unconstitutional the policy of the Worcester City Hospital barring the use of its facilities in connection with any consensual sterilization. Appellee administrator specifically refused appellant's request that the hospital allow her physicians to perform a tubal ligation at the time of the delivery of her 8th child in April 1971. Despite further requests, the operation was not performed after the delivery. In the interim, the instant suit was filed in the district court seeking declaratory and injunctive relief and damages. Th district court twice dismissed the complaint. The Assistant solicitor's opinion, on which the hospital's policy is based, was that the legality of sterilization procedures was "highly doubtful" in view of the Massachusetts statutes concerning birth control assistance. The U.S. Court of Appeals, First Circuit, reverses and remands for entry of an order declaring the Worceste City Hospital's policy against the use of its facilities in conjunction with sterilization operations unconstitutional and enjoining the individual appellees from enforcing the policy in the future.

  12. "Sculpture of a Benin Queen."

    ERIC Educational Resources Information Center

    Guip, David

    1987-01-01

    Offers an art lesson for grades K-3 based on an early 19th century sculpture of the head of a Benin Queen. Presents background on the relevance of Queen Mother's position in Benin culture. Discusses importance of regalia and scarification associated with Benin heads. Includes suggestions for classroom activities. (BR)

  13. Variations in asthma hospitalizations and deaths in New York City.

    PubMed

    Carr, W; Zeitel, L; Weiss, K

    1992-01-01

    Recent reports have identified New York City as having asthma mortality rates that are substantially higher than expected based on US rates. This study investigates the problems of asthma morbidity and mortality in New York City. Data on asthma hospitalizations (1982 to 1986) and deaths (1982 to 1987) among persons aged 0 to 34 years were studied. Descriptive and multivariate techniques were used to examine differences in rates among subgroups and across geographic areas. The average annual hospitalization rate was 39.2 per 10,000; the mortality rate was 1.2 per 100,000. Hospitalization and death rates among Blacks and Hispanics were 3 to 5.5 times those of Whites. Large geographic variations in hospitalizations and mortality occurred. Asthma hospitalization and mortality rates were highly correlated (r = .67), with the highest rates concentrated in the city's poorest neighborhoods. Household income, percentage of population Black, and percentage of population Hispanic were significant predictors of area hospitalization rates (adjusted R2 = .75). These findings provide a basis for focusing investigations of the causes of variations in asthma outcomes and targeting interventions to reduce the disproportionate morbidity and mortality borne by poor and minority populations.

  14. [Problems with pregnancy, delivery and puerperium in teenage girls hospitalized in a city hospital].

    PubMed

    Kukulski, P; Kwaśniewski, S; Szymański, J

    1993-08-01

    At the paper the problems of girls hospitalized at the Gynaecological and Obstetrician ward of the hospital situated on the border of city agglomeration were described. The data regards as pregnancy, delivery and puerperium and they were collected in last two years.

  15. Acute Surgical Unit at Auckland City Hospital: a descriptive analysis.

    PubMed

    Hsee, Li; Devaud, Marcelo; Middelberg, Lisa; Jones, Wayne; Civil, Ian

    2012-09-01

    Lack of timely assessment and access to acute operating rooms is a worldwide problem and also exists in New Zealand hospitals. To address these issues, an Acute Surgical Unit (ASU) was set up at Auckland City Hospital (ACH) in January 2009. This service has evolved and been modified to address the specific needs of acute surgical patients of ACH. Despite initial challenges inherent to setting up a new service, the Unit has been in steady operation and enhanced its performance over time. This paper is a descriptive analysis of the design of the ACH ASU and discusses some of the indications for streamlining acute surgical services at a large tertiary metropolitan hospital in New Zealand. Performance of the ASU has shown benefits for acute patients and the Hospital. The acute surgical rotation has also been beneficial for surgical training.

  16. Smoking policy and cessation in an inner-city hospital.

    PubMed

    Montner, P; Bennett, G; Brown, C; Green, S

    1996-01-01

    Hospital policies regarding cigarette smoking can affect the smoking habits of employees, patients, and visitors. Successful smoking policy development and impact have been reported in a number of hospitals. These reports have been from financially secure or university hospitals. This article reports on the policy experience at Interfaith Medical Center, a public hospital serving an economically disadvantaged black inner-city community. Policy implementation and smoking cessation efforts were directed by a broad-based hospital committee. An employee survey demonstrated support for a policy restricting but not banning smoking (89% of nonsmokers, and 80.2% of smokers). Among smoking employees, 87.6% wanted to quit. A policy restricting smoking to designated areas in the cafeteria and coffee shop was enacted. Health fairs and smokeout contests were enthusiastically received and resulted in short-term cessation verified by exhaled carbon monoxide levels. Assemblies where ex-smokers were given "Hall of Fame" certificates, "stop smoking" art contests, and a "stop smoking hotline" generated further cessation activity. The department of medicine, in cooperation with the National Heart, Lung, and Blood Institute's Smoking Education Program, set up a training program for residents on how to help patients quit. Overall, the smoking prevalence, attitudes, and enthusiasm to quit were similar to previous reports in financially secure hospitals. Unfortunately, lack of resources and staff turnover led to dissolution of the program. Institutional stability and a funding source are critical for the long-term success of hospital smoking cessation programs.

  17. Smoking policy and cessation in an inner-city hospital.

    PubMed Central

    Montner, P.; Bennett, G.; Brown, C.; Green, S.

    1996-01-01

    Hospital policies regarding cigarette smoking can affect the smoking habits of employees, patients, and visitors. Successful smoking policy development and impact have been reported in a number of hospitals. These reports have been from financially secure or university hospitals. This article reports on the policy experience at Interfaith Medical Center, a public hospital serving an economically disadvantaged black inner-city community. Policy implementation and smoking cessation efforts were directed by a broad-based hospital committee. An employee survey demonstrated support for a policy restricting but not banning smoking (89% of nonsmokers, and 80.2% of smokers). Among smoking employees, 87.6% wanted to quit. A policy restricting smoking to designated areas in the cafeteria and coffee shop was enacted. Health fairs and smokeout contests were enthusiastically received and resulted in short-term cessation verified by exhaled carbon monoxide levels. Assemblies where ex-smokers were given "Hall of Fame" certificates, "stop smoking" art contests, and a "stop smoking hotline" generated further cessation activity. The department of medicine, in cooperation with the National Heart, Lung, and Blood Institute's Smoking Education Program, set up a training program for residents on how to help patients quit. Overall, the smoking prevalence, attitudes, and enthusiasm to quit were similar to previous reports in financially secure hospitals. Unfortunately, lack of resources and staff turnover led to dissolution of the program. Institutional stability and a funding source are critical for the long-term success of hospital smoking cessation programs. PMID:8583492

  18. Main Neurosurgical Pathologies in Benin Republic

    PubMed Central

    Gandaho, Hugues Jean Thierry; Soumaila, Madougou; Hoinsou-Hans, Isaac; Djrolo, Gautier M. M.; Zevounou, Audrey A. S.; Adeleye, Amos O.

    2016-01-01

    Background: Benin republic is a very low-income French-speaking country in West Africa The development of Neurosurgery in the Republic of Benin took off with the arrival of the first Beninese neurosurgeons in the year 2003. Aims: This study aims to evaluate patients’ attendance in a public neurosurgical center, and appreciate populations’ affordability to a new specialty. Settings and Design: In the year 2004, the Benin Armed Forces established the first Department of Neurosurgery in the Nation's Military Teaching Hospital. From the public authorities, that was a proof of motivation to develop this specialty in the Benin Republic. Materials and Methods: A retrospective cross-sectional survey (September 2003 to December 2009) of the total neurosurgical patient population managed in a public pioneer hospital in a developing country. Statistical Analysis Used: Data were captured and analyzed with the SPSS software (SPSS Inc., Chicago, IL, USA) and presented in descriptive statistics such as frequencies and proportions. Results: 2908 new patients, civilians, and militaries were registered. The surgical treatment was offered adult (86%) as well as pediatric (14%) patients. Spinal degenerative diseases (52.1%) were the most common pathology; neurotraumatology emergency cases (8.4%) appeared low in representation. Three-quarters of patients experienced financial difficulties to procure the required radiologic investigations and although 609 (20.94%) benefited from surgery, most patients could not pay for the surgical operations as well as the perioperative care. Conclusions: In spite of the great constraints of this country's privately-funded health-care delivery system on the affordability of neurosurgical treatment for the average Beninese, this study demonstrates a globally increasing attendance of the department. PMID:28163504

  19. Political Dynamics in Benin,

    DTIC Science & Technology

    1984-04-01

    Popular Revolution was formed, and Marxist-Leninist slogans were introduced. Relations with Lybia , the Soviet Union and other East European countries were...Revolution", Dahomey established diplomatic relations with the People’s Republic of China, Lybia and North Korea and the new regime received the...country. The influence of Lybia and the Eastern bloc countries within the government of Benin appear to be minimal. Toward the end of 1980 Khadaffi gave a

  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 Central

    Igbinosa, Etinosa O.; Beshiru, Abeni; Akporehe, Lucy U.; Oviasogie, Faith E.; Igbinosa, Owen O.

    2016-01-01

    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. PMID:27669285

  1. 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.

  2. Distribution of ABO and Rh-D blood groups in the Benin area of Niger-Delta: Implication for regional blood transfusion.

    PubMed

    Enosolease, Mathew Ebose; Bazuaye, Godwin Nosa

    2008-01-01

    ABO and Rhesus (Rh) blood group antigens are hereditary characters and are useful in population genetic studies, in resolving medico-legal issues and more importantly in compatibility test in blood transfusion practice. Data on frequency distribution of ABO and Rh-D in Niger-Delta region of Nigeria are not available; hence we made an attempt to retrospectively analyze the records on the blood donors, transfusion recipients and patients attending antenatal care or some other medical interventions. Over a twenty-year period between 1986 and 2005, a total of 160,431 blood samples were grouped for ABO and Rh-D at the blood bank of the University of Benin Teaching Hospital, Benin City, Nigeria. Blood group distribution among these samples showed phenotypes A, B, AB and O as 23.72%, 20.09%, 2.97% and 53.22%, respectively. The Rh-D negative phenotype was found among 6.01% of the samples tested.

  3. 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.

  4. HIV-1 seroprevalence in an inner-city public hospital.

    PubMed Central

    Nagachinta, T.; Brown, C. P.; Cheng, F.; Temple, W.; Kerndt, P. R.; Janssen, R. S.

    1994-01-01

    In a hospital-based seroprevalence survey for human immunodeficiency virus type 1 (HIV-1) infection, a stratified sampling method based on age and gender was used to collect 5429 blood samples at an inner-city hospital. Sentinel Hospital Surveillance System (SHSS) criteria developed by the Centers for Disease Control and Prevention were used to classify patient diagnoses into two categories by the likelihood of being associated with HIV-1 infection. The two categories were those with high likelihood of association with HIV-1 (SHSS-ineligible) and those with low likelihood of association with HIV-1 infection (SHSS-eligible). Of the 5429 blood samples, 4262 were SHSS-eligible and 1167 were SHSS-ineligible. After personal identifies were removed, specimens were tested by ELISA and confirmed by Western blot analysis. The overall prevalence rate of HIV-1 infection was 0.98%. The seroprevalence rate was almost 2.6 times higher in high-association patients compared with low-association patients (1.89% versus 0.73%, P < .001). Results from this study indicate a high unsuspected HIV-1 seroprevalence rate in a subpopulation (SHSS-eligible) considered to have diagnoses with low likelihood of association with HIV-1 infection. These patients may better approximate HIV-1 seroprevalence in the general population of the area served by the hospital than would a sample of all patients. Monitoring HIV-1 seroprevalence in the SHSS-eligible group will be a useful measure for community serosurveillance for HIV-1 infection. PMID:8046762

  5. Environmental triggers of hospital admissions for school-age children with asthma in two British cities.

    PubMed

    Julious, Steven A; Jain, Ritika; Mason, Suzanne

    2012-10-01

    Research has reported seasonal peaks in asthma in school age asthmatic children. The study aimed to assess if hospital admissions could be predicted from the possible environmental triggers using data from two British cities: Aberdeen and Doncaster. However, there were no consistent patterns across the two cities with no clear evidence that hospital admissions could be predicted from environmental data.

  6. 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

  7. 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.

  8. 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

  9. Definition of the Catchment Area for a Small Rural Hospital Near a Large City

    PubMed Central

    Hogg, William E.

    1984-01-01

    Practicing physicians, hospital directors, members of the hospital's board of directors and government health care planners can benefit from an accurate description of a hospital catchment area. The sociodemographic and geographic characteristics of the catchment area of Wakefield, PQ.'s 31-bed Gatineau Memorial Hospital (GMH) were studied. A randomized, door-to-door survey was conducted among permanent residents in the catchment area. The response rate was 96.1%. We found language to be an important and complex determinant of hospital utilization patterns. Orientation towards the city also affected the pattern of hospital use; those who lived between Wakefield and Ottawa-Hull were more likely to use a city hospital, as were those who had recently moved to the area, or who commuted to work in the city. ImagesFig. 1Fig. 2 PMID:21279011

  10. Two New York City hospitals' surgical response to the September 11, 2001, terrorist attack in New York City.

    PubMed

    Cushman, James G; Pachter, H Leon; Beaton, Howard L

    2003-01-01

    We describe the surgical response of two affiliated hospitals during the day of, and week following, the September 11th, 2001 terrorist attack at the World Trade Center in New York City. The city of New York has 18 state designated regional trauma centers that receive major trauma victims. The southern half of Manhattan is served by a burn center, two regional trauma centers, and a community hospital that is an affiliate of one of the regional trauma centers. This report accounts for the surgical response by a regional trauma center (Hospital A, located 2.5 miles from the World Trade Center) and its affiliate hospital (Hospital B, located 5 city blocks from the World Trade Center) on September 11th when two commercial jets crashed into the Twin Towers at the World Trade Center mall. Hospital A maintained a concurrent log of patients received during the first 5 hours, the first day, and the first week after the disaster which was kept by the Surgical Triage Officer. The trauma registry completed and verified this data by September 18th. Hospital B collected its data by hand counting and verification by chart review. Both hospitals, A and B, had established disaster plans that were implemented. Nine hundred eleven patients were received by two affiliated hospitals from the World Trade Center attack. Seven hundred seventy six patients (85%) were walking wounded, sustaining mild inhalation and eye irritant injuries. One hundred thirty five (15%) were admitted with 18 (13%) of these undergoing surgery. Twenty two of the 23 transfers were from the community hospital to specialized orthopedic or burn centers. Of the 109 patients admitted to Hospital A, 30 were to the surgical service. The mean ISS score of these patients was 12. There were 4 deaths (within minutes of arrival at the hospital) and 6 delayed deaths (day 1-14). Excluding walking wounded and DOAs, the critical mortality rate was 37.5% overall. The September 11th, 2001, terrorist attack in New York City

  11. Staff's attitude regarding hospital waste management in the dental college hospitals of Bangalore city, India

    PubMed Central

    Rudraswamy, Sushma; Sampath, Naganandini; Doggalli, Nagabhushana

    2012-01-01

    Background: Growing urbanization has led to several changes in the healthcare sector. While on one hand, access to healthcare services are being provided to the community, thereby resulting in better health for all, improper management of biomedical waste emanating from these healthcare establishments has also given rise to many environmental and health problems (Acharya 2003). Although awareness in this issue has increased considerably over the last few years, sensitivity to this problem has been limited. Most hospitals are not actively involved in addressing this problem. Materials and methods: The present study was conducted to assess the attitude of waste management among staff of dental hospitals in Bangalore city, by issuing a pre-tested structured questionnaire. Results: While 82.6% of attenders said that it is necessary to segregate waste into different categories at the point of origin, 61.5% of auxiliaries strongly disagreed that segregation of waste at source increases the risk of injury to waste handlers. As many as 33.5% of dentists strongly disagreed that segregation of waste at source increases the risk of injury to waste handlers and 53.6% agreed that segregation of waste at source does not increase the risk of injury to waste handlers. Conclusion: The findings of this study suggest that the staff had good attitude towards waste management among. PMID:23580838

  12. [A survey on nosocomial tuberculosis infection control in hospitals in Osaka City].

    PubMed

    Shimouchi, Akira; Konishi, Shozaburo; Tanaka, Takashi

    2005-12-01

    To ascertain nosocomial tuberculosis (TB) infection control practice in hospitals in Osaka City. A questionnaire was distributed in the orientation meeting and collected at the occasion of medical inspection in all 196 hospitals in Osaka City in 2003. TB patients were diagnosed in about half of hospitals in the past 3 years. Basic TB infection control measures were taken in the majority of hospitals; such as chest X-ray screening for all inpatients, health check for employees, tuberculin skin test (TST) for newly employed staff, and nomination of a person in charge of TB infection control. Control measures were practiced more often in hospitals where TB patients were diagnosed, such as "fiberoptic bronchoscopy is to be conducted last in the working hours to avoid contamination of TB bacilli in a room," "TST (including two-step method) for all newly employed staff," "Staff wear N95 mask when they deal with TB patients/suspects," and the differences were statistically significant. It is necessary in hospitals in Osaka City to strengthen nosocomial TB infection control as TB patients were diagnosed in about half of hospitals in the past 3 years. Low cost infection control measures were undertaken more often among hospitals where TB patients were diagnosed. Introduction of high cost equipment or improvement of facilities should be considered in hospitals of high TB risk. Guidelines formulated based on analysis of the survey should facilitate all hospitals to introduce at least low cost effective tuberculosis infection control measures.

  13. A tale of two cities: hospitalization costs in 1897 and 1997.

    PubMed

    Boonen, Annelies; Severens, Johannes L; van der Linden, Sjef

    2004-01-01

    To compare the hospitalization day price, and the hospitalization costs 100 years ago with the present situation. Municipal and hospital archives of two cities, Maastricht in The Netherlands and Tongeren in Belgium, were studied systematically for reports of costs. These were compared with the present accounts. Starting from the second part of the nineteenth century, an official day price was calculated each year by averaging the total hospital expenditures by the total number of hospitalization days. Of all expenditures, nutrition accounted for nearly 50% of expenses. Differences with the current situation are striking. Nowadays, the day price is a negotiated tariff. Management and salaries make up more than 70% of the present expenditures. Hospitalization day prices have been used for approximately 150 years to determine hospitalization costs. Since then, the total hospital expenditures and the relative cost components have changed considerably. Compared with the spending power of people, the cost of one day in the hospital increased substantially.

  14. Costs of near-miss obstetric complications for women and their families in Benin and Ghana.

    PubMed

    Borghi, J; Hanson, K; Acquah, C Adjei; Ekanmian, G; Filippi, V; Ronsmans, C; Brugha, R; Browne, E; Alihonou, Eusebe

    2003-12-01

    This paper estimates the total cost to women and their families associated with a spontaneous vaginal delivery and five types of 'near-miss' obstetric complication in Benin and Ghana, and assesses affordability in relation to household cash expenditure. A retrospective evaluation of costs was carried out among 121 mothers in three hospitals in Ghana. A prospective evaluation of costs was undertaken among 420 pregnant women in two hospitals in Benin. Information was collected on the cost of travel to the facilities and of direct medical and non-medical costs incurred during their stay in hospital. In Benin, costs ranged from an average of 15 US dollars for a spontaneous delivery to 256 US dollars for a near-miss complication caused by dystocia. In Ghana, average costs ranged from 18 US dollars for a spontaneous vaginal delivery to 115 US dollars for a near-miss complication caused by haemorrhage. Medical costs accounted for the largest share of total costs, mainly drugs and medical supplies in Ghana and costs of the delivery and any surgical intervention in Benin. Payments associated with a spontaneous vaginal delivery amounted to at least 2% of annual household cash expenditure in both countries. In the case of severe obstetric complications, costs incurred reached a high of 34% of annual household cash expenditure in Benin. The economic burden of hospital-based delivery care in Ghana and Benin is likely to deter or delay women's use of health services. Should a woman develop severe obstetric complications while in labour, the relatively high costs of hospital care could have a potentially catastrophic impact on the household budget.

  15. 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.

  16. A study of New York City obstetrics units demonstrates the potential for reducing hospital inpatient capacity.

    PubMed

    Green, Linda V; Liu, Nan

    2015-04-01

    Hospitals are under significant pressure from payers to reduce costs. The single largest fixed cost for a hospital is inpatient beds, yet there is significant variation in hospital capacity utilization. We study bed capacity in New York City hospital obstetrics units and find that while many hospitals have an insufficient number of beds to provide timely access to care, overall there is significant excess capacity. Our findings, coupled with current demographic and clinical practice trends, indicate that a large fraction of obstetrics units nationwide could likely reduce their bed capacity while assuring timely access to care, resulting in large savings in capital and staffing costs. Given emerging health care delivery and payment models that will likely decrease demand for other types of hospital beds, our study suggests that data-based methodologies should be used by hospitals and policy makers to identify opportunities for reducing excess bed capacity in other inpatient units as well. © The Author(s) 2015.

  17. New ad campaign for St. Mark's Hospital in Salt Lake City: nursing is a calling, not just a career.

    PubMed

    2006-01-01

    A recent advertising campaign for St. Mark's Hospital in Salt Lake City focuses on the hospital's compassion and impeccable nurse care. The effort illustrates that nursing is not just a career, but a calling.

  18. [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.

  19. Hospital morbidity in a medium-sized city: differentials between men and women

    PubMed Central

    de Arruda, Guilherme Oliveira; Molena-Fernandes, Carlos Alexandre; Mathias, Thais Aidar de Freitas; Marcon, Sonia Silva

    2014-01-01

    Objective characterize the hospital morbidity of adults living in the city of Maringá, PR, Brazil, between 2000 and 2011, focusing on the differential between men and women. Method this descriptive study was developed based on data from the Hospital Information System of the Unified Health System in order to investigate the association between groups of hospitalization causes and the average length of hospitalization per gender, in three-year periods. Results the main groups of hospitalization causes for men were: mental disorders, lesions and circulatory diseases; and, among women: tumors, circulatory and genitourinary diseases. Mental disorders and lesions, tumors, circulatory and genitourinary diseases were significantly associated with the female and male genders across the study period. Although not significant, the mean length of hospitalization dropped across the four three-year periods, and only showed a significant difference between men and women in the second triennium. Conclusion differences in the hospital morbidity profile between men and women underline the need for specific health and nursing actions, especially in primary health care, with a view to reducing hospitalizations due to the main groups of causes in the city. PMID:24553699

  20. Delayed discharges from Oxford city hospitals: who and why?

    PubMed

    Carter, Nicholas D; Wade, Derick T

    2002-05-01

    To determine the extent and characteristics of discharge delays of younger patients from acute hospital beds in Oxford, England. Three-month prospective analysis of patients deemed to have delayed discharge. The primary measure was the number of days from the patient being no longer in need of acute medical inpatient care to eventual discharge. Additional assessments included demographic data, primary diagnosis, Motricity Index, Short Orientation-Memory-Concentration Test (SOMC), Barthel Index and contextual data. The major acute hospitals serving the county of Oxfordshire (560,000 people). Fifty patients aged 18-70 years identified by referrals, delayed discharge lists and ward visits whose discharge from hospital had been delayed. The mean (standard deviation, SD) delay period was 36.1 (26.8) days. The mean prevalence and incidence of discharge delays for each three-day period was 19.7 (SD 1.7) and one (SD 1.7) respectively. Most (88%, n = 44) had a primary neurological diagnosis. Twenty-four (48%) patients had Motricity Index scores of less than 50% in one or more limbs and 16 (32%) in two or more limbs. Twenty-six (52%) patients had cognitive impairment (SOMC <18/28). Thirty-nine (78%) patients had a Barthel Index score of less than 15/20 and 24 (48%) of less than 10/20. The period of discharge delay did not correlate with SOMC, Motricity or Barthel Index scores. Only nine had appropriate accommodation available. Patients whose discharge is delayed were common; most had a neurological disability and cognitive impairment; and accommodation was unsuitable or absent for most. Reorganizing services to give patients access to specialized disability services might both improve the care of these patients and increase the efficiency of the health service.

  1. Risk and outcome of aspiration pneumonia in a city hospital.

    PubMed Central

    Jones, J.

    1993-01-01

    Because aspiration pneumonia contributes significantly to morbidity and mortality in hospitalized patients, this study was undertaken to identify risk factors for morbidity and mortality associated with aspiration pneumonia. Patients with a discharge diagnosis of aspiration pneumonia in 1985 and 1990 were studied. Factors associated with death from aspiration pneumonia were: altered mental status, cerebrovascular accident, endotracheal intubation, tachycardia, and hypoxemia. Fever, cough, and unilateral infiltrates on chest radiograph were associated with survival. Attention to proper positioning of comatose patients, aggressive treatment of gastroesophageal reflux, and strict attention to endotracheal tubes and tracheostomies should decrease the morbidity and mortality associated with aspiration pneumonia. PMID:8350375

  2. 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,…

  3. 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,…

  4. 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…

  5. Etiology and outcome of chronic renal failure in hospitalized children in Ho Chi Minh City, Vietnam.

    PubMed

    Mong Hiep, Tran Thi; Janssen, Françoise; Ismaili, Khalid; Khai Minh, Dang; Vuong Kiet, Doan; Robert, Annie

    2008-06-01

    The aim of this study was to investigate the etiology and treatment modalities and to determine mortality risks in hospitalized children with chronic renal failure (CRF) in Ho Chi Minh City, Vietnam. We reviewed the records of 310 children with CRF hospitalized in Ho Chi Minh City from January 2001 to December 2005. The average annual number cases was 4.8 per million child population native to Ho Chi Minh City. Median age was 14 years; 85% of patients were in end-stage renal failure. Associated illnesses were anemia (96%), hypertension (74%), and cardiopulmonary diseases (39%). Causes of included glomerulonephritis (30%) and congenital/hereditary anomalies (20%), but in 50% of children, the etiology was unavailable. Seventy-three percent of cases with end-stage renal failure did not benefit from renal replacement therapy. During hospitalization, 47 patients (15%) died. Mortality risks were higher in young children (1-4 years), in boys, and in patients with acquired pathologies. Severe metabolic acidosis was the main predictive factor of mortality by multivariate regression analysis. Our data shows a poor outcome due to late referral and limited facilities for renal replacement therapy in children with CRF hospitalized in Ho Chi Minh City.

  6. 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…

  7. 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

  8. Hospital waste management system - a case study of a south Indian city.

    PubMed

    Hanumantha Rao, P

    2009-06-01

    It is more than 5 years since the prescribed deadline, 30 December 2002, for all categories of towns covered by the Biomedical Waste Management (BMW) Rules 1998 elapsed. Various reports indicate that the implementation of the BMW Rules is not satisfactory even in the large towns and cities in India. Few studies have looked at the ;macro system' of the biomedical waste management in India. In this context the present study describes the role of the important stakeholders who comprise the 'macrosystem' namely the pollution control board, common waste management facilities, municipal corporation, state government (Directorate of Medical Education and Health Systems Development Project), professional agencies such as the India Medical Association and non-governmental organizations, in the implementation of BMW rules in a capital city of a state in south India. Brief descriptions of the ;micro-system' (i.e. biomedical waste management practices within a hospital) of six hospitals of different types in the study city are also presented.

  9. [Fungemia in hospitals of the city of Buenos Aires, Argentina].

    PubMed

    López Moral, Laura; Tiraboschi, Iris Nora; Schijman, Mariela; Bianchi, Mario; Guelfand, Liliana; Cataldi, Silvana

    2012-01-01

    The incidence of fungi like pathogens in hospitals varies by regions. Our goal was not only to record the incidence and etiology of fungaemia, but also the change during the 4 years analysed, to determine the time of detection in automated blood culture and by lysis-centrifugation, and finally to assess the gender, age and underlying disease of the patients with fungaemia. An observational multicentre study of fungaemia was conducted in hospitals in the Mycology Network of Buenos Aires. A total of 190,920 blood cultures were processed: 182,050 automated blood culture and 8,870 lysis-centrifugation. Fungi were recovered in 1,020 episodes. The overall incidence of fungaemia was 1.72/1,000 admissions; 683 episodes were due to Candida (68%), and 325 (32%) to other fungi: 214 Cryptococcus, 105 Histoplasma, 7 Rhodotorula, 5 Trichosporon, 2 Pichia, 2 Acremonium, one Saccharomyces and one Fusarium. The incidence of candidaemia was 1.15/1,000 admissions with a wide variation between centres (0.35 to 2.65). Most Candida isolates (97%) were detected in the first 2 days of incubation. Candida albicans was recovered in 43% of the episodes. In fungaemia other than candidaemia, the predominant fungi were Cryptococcus and Histoplasma capsulatum. The incidence remained stable during the study period. Fungaemia by Candida were predominant. C. albicans was involved in less than a half of the episodes. The recovery of Cryptoccocus and H. capsulatum is strongly associated with HIV patients. Copyright © 2011 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  10. Comparative Investigation of Health Literacy Level of Cardiovascular Patients Hospitalized in Private and Educational Hospitals of Kerman City, Iran

    PubMed Central

    Malekzadeh, Sajedeh; Azami, Mohammad; Mirzaei, Moghadameh; Motamedi, Fatemeh

    2016-01-01

    Introduction: literacy involves a complex set of abilities to understand and use symbolic systems of a culture for personal development and social development in a diverse set of skills required as an adult to exercise behavior are considered in society Objectives: The aim of this study was to evaluate Comparative investigation of health literacy level of cardiovascular patients hospitalized in private and public educational hospitals of Kerman city Methods: This study used survey methods, analytical and cross-sectional manner. Data was collected through questionnaires distributed among 200 patients of cardiovascular-hospitalization took place in the city of Kerman. To analyze the data in the description of the mean, standard deviation and frequency distribution tables and the level of analysis to determine the relationship between gender and marital status of health literacy test or nonparametric test Mann-Whitney T-Test and, for the relationship between group employment and residence, a one-way analysis of variance or Kruskal-Wallis test, to evaluate the relationship between age and income, Pearson and Spearman correlation to investigate the relationship between level of education and health literacy of SPPS software version 21 was used. Results: The results showed that 10% of patients at educational hospitals in Kerman adequate health literacy, and 48% of patients in private hospitals had adequate health literacy. As a result, there is a significant difference of health literacy between the two types of hospital (p-value <0/0001). Conclusions: The results showed that most patients had inadequate and border health literacy have been. Health plans, preparation of simple educational system and understanding, spending more time and have a discussion with the lower speed In connection with the patient’s doctor and medical staff, Including ways to help patients with low health literacy and improve their health literacy is. PMID:27041812

  11. The impact of heat, cold, and heat waves on hospital admissions in eight cities in Korea.

    PubMed

    Son, Ji-Young; Bell, Michelle L; Lee, Jong-Tae

    2014-11-01

    Although the impact of temperature on mortality is well documented, relatively fewer studies have evaluated the associations of temperature with morbidity outcomes such as hospital admissions, and most studies were conducted in North America or Europe. We evaluated weather and hospital admissions including specific causes (allergic disease, asthma, selected respiratory disease, and cardiovascular disease) in eight major cities in Korea from 2003 to 2008. We also explored potential effect modification by individual characteristics such as sex and age. We used hierarchical modeling to first estimate city-specific associations between heat, cold, or heat waves and hospitalizations, and then estimated overall effects. Stratified analyses were performed by cause of hospitalization, sex, and age (0-14, 15-64, 65-74, and ≥75 years). Cardiovascular hospitalizations were significantly associated with high temperature, whereas hospitalizations for allergic disease, asthma, and selected respiratory disease were significantly associated with low temperature. The overall heat effect for cardiovascular hospitalization was a 4.5% (95% confidence interval 0.7, 8.5%) increase in risk comparing hospitalizations at 25 to 15 °C. For cold effect, the overall increase in risk of hospitalizations comparing 2 with 15 °C was 50.5 (13.7, 99.2%), 43.6 (8.9, 89.5%), and 53.6% (9.8, 114.9%) for allergic disease, asthma, and selected respiratory disease, respectively. We did not find statistically significant effects of heat waves compared with nonheat wave days. Our results suggest susceptible populations such as women and younger persons. Our findings provide suggestive evidence that both high and low ambient temperatures are associated with the risk of hospital admissions, particularly in women or younger person, in Korea.

  12. 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.

  13. [Nutritional status in hospitalized patients in a public hospital in Mexico City].

    PubMed

    Fuchs, V; Mostkoff, D; Salmeán, G Gutiérrez; Amancio, O

    2008-01-01

    To determine the frequency of malnutrition among hospitalized patients and to relate nutrition status with body mass index, fasting time, adequacy intake of protein and energy during hospitalization and length of stay. METHODS (STUDY POPULATION, SUBJECTS, INTERVENTION): We evaluated weight loss in the last 6 months prior to admission, body mass index (BMI), ideal and usual body weight percentages, days of hospitalization, energy and protein intake adequacy, fasting days and cause in hospitalized patients at different wards at Hospital General de Mexico. Patients were divided into groups according to their nutritional status (at risk/with malnutrition or normal) and data was assessed descriptively and comparatively by t-tests to determine mean differences. We assessed 561 hospitalized patients. We found different frequencies of malnutrition according to various indicators: 21.17% according to BMI, 38.07% and 19.57% by percentages of habitual and ideal weights--respectively-- and a weight loss in 69.57% of the patients. Mean daily energy intake was found to be of 1,061+/-432.7 kcal, while mean protein intake was 42.1 + 22.7 g, representing only the 69.4% and 54.9% of the energy and protein requirements. We found statically significant differences among malnourished and normal patients in relation to BMI (p < 0.001), length of stay (p < 0.05), energy adequacy (p < 0.001) and protein intake (p < 0.05). Malnutrition is common in hospitalized patients. An important factor in hospital malnutrition is the lack of compliance in the patient's requirements, preventing a fast recovery and increasing their length of stay. Thus, it is important to make changes and improvements in the institutional health system so that there is trained personnel in order to provide and adequate nutrition care attention to the critically ill patient, improving their condition and general prognosis.

  14. 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…

  15. 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.

  16. Hospital distribution in a metropolitan city: assessment by a geographic information system grid modelling approach.

    PubMed

    Lee, Kwang-Soo; Moon, Kyeong-Jun

    2014-05-01

    Grid models were used to assess urban hospital distribution in Seoul, the capital of South Korea. A geographical information system (GIS) based analytical model was developed and applied to assess the situation in a metropolitan area with a population exceeding 10 million. Secondary data for this analysis were obtained from multiple sources: the Korean Statistical Information Service, the Korean Hospital Association and the Statistical Geographical Information System. A grid of cells measuring 1 × 1 km was superimposed on the city map and a set of variables related to population, economy, mobility and housing were identified and measured for each cell. Socio-demographic variables were included to reflect the characteristics of each area. Analytical models were then developed using GIS software with the number of hospitals as the dependent variable. Applying multiple linear regression and geographically weighted regression models, three factors (highway and major arterial road areas; number of subway entrances; and row house areas) were statistically significant in explaining the variance of hospital distribution for each cell. The overall results show that GIS is a useful tool for analysing and understanding location strategies. This approach appears a useful source of information for decision-makers concerned with the distribution of hospitals and other health care centres in a city.

  17. 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.

  18. Developing a Collaborative Research Environment for a Study of Coastal Groundwater Hydraulics: Benin, West Africa

    NASA Astrophysics Data System (ADS)

    Silliman, S. E.; Boukari, M.; Yalo, N.

    2011-12-01

    The city of Cotonou, Benin, has a population between 1.5 and 2 million people served by groundwater wells. Recent evidence suggests that salinity is increasing in a series of wells which border a salt-water lake. Modeling and field characterization of this complex groundwater system is targeted at providing the national water agency in Benin with assessment of multiple management strategies to reduce the impact of saline inflows from the lake. Research efforts have evolved through development of collaboration among colleagues from the Universite d'Abomey-Calavi (Benin) and the University of Notre Dame (USA): participants have included faculty and students (undergraduate and graduate) from both institutions. The combined research team has provided the ability to: (i) identify funding opportunities through multiple funding sources, (ii) establish long-term monitoring in the lake and groundwater systems through field measurements by Benin partners, (iii) introduce new tools (numerical and instrumentation) through professional contacts and suppliers in the U.S., (iv) establish site security (for long-term installation of equipment) through local knowledge of customs and cultural requirements, and (v) interpret data and management strategies from multiple viewpoints. The project has provided for collection of high-quality data that have provided opportunities to improve both the conceptual model of the local hydrogeology and the field strategies used to characterize both parameters and boundary conditions impacting flow to the water-supply wells.

  19. Health services research in a quick and dirty world: the New York City hospital occupancy crisis.

    PubMed Central

    Myers, L P; Fox, K S; Vladeck, B C

    1990-01-01

    In 1987/1988, New York City experienced an unexpected health care crisis: a severe and prolonged communitywide shortage of inpatient hospital beds. A rapid rise in hospital occupancy rates dramatically ended a long-term decline in hospital utilization and left health care providers and policymakers baffled about both cause and remedy. This article describes the course of a short-term, intensive, midcrisis study that unraveled the reasons for the high occupancy rates. As a case study for a research effort that successfully yielded valid and timely results, this article illuminates the research design and methodological decisions that lay behind the findings and discusses the implications of those decisions. Key to the success of the study were a mandate to diagnose the crisis, a statewide patient discharge data base, our previous hands-on experience with that data base, active support for the study from the community of health care providers, and strong results. PMID:2254088

  20. Experience of delivering women with HIV in an inner city London hospital 1994-2004.

    PubMed

    Parisaei, Maryam; Anderson, J; Erskine, K J; Gann, S

    2007-08-01

    The objective of this study was to compare deliveries in women with HIV at Homerton University Hospital with those in the general antenatal hospital population. The study was a retrospective case-note review of deliveries from 1994 to 2004 at an Inner City London Hospital, UK (Homerton University Hospital). In all, 113 deliveries were studied in 98 women with HIV. Compared with the general antenatal population, women with HIV were more likely to be from African backgrounds, describe inadequate housing and be without the support of a partner or family; 79.8% of deliveries in women with HIV were by caesarean section in comparison with 22.4% in the overall hospital population. A majority of women with HIV received antiretroviral therapy in pregnancy. Intercurrent medical and antenatal complications were uncommon and in a majority the postpartum periods were uncomplicated. A significantly higher proportion of women with HIV infection described a previous history of depression than in the general hospital population. There were two instances of vertical transmission of HIV. In conclusion, our observations suggest that with appropriate monitoring and management strategies, successful pregnancy outcomes can be achieved in a complex HIV-positive patient population.

  1. [Health anthropology and hospital archiving. The Museum of Pathological Anatomy of the City Hospital of Trieste].

    PubMed

    Braulin, F

    2001-10-01

    The preparations found in the Trieste Hospital Museum of Pathological Anatomy fit into the context of a medical semiotics which has its origins in the anatomical clinical method. The study of the practices involved in the museum preparation leads back to its purely diagnostic function inasmuch as it convalidates or contradicts the suppositions that, from the symptomatological case history, made from the study of the lesions and the diseased organ. This whole investigative process corresponds to a break in the field of scientific knowledge which marks the birth of a new approach to diagnosis and a new form of nosology, made possible by the great number of sick people and deaths available in a modern hospital. The Museum is permeated with empiricism, morphologism and localisation, and its exhibits fluctuate between macroscopic and microscopic anatomy, between organic and cellular pathology. In the exhibits of infectious and contagious diseases, one can see traces of the revolution brought about by bacteriology and laboratory techniques; in the considerable collection of malignant tumours, one can detect an oncological awareness which relates explicitly to a nosology based on the work of Virchow. The preparations which refer to pathologies that cannot be reduced simply to localisation illustrate an increasing awareness of functional medicine and clinical biochemistry. The Museum has the task of showing and teaching in order to train the hospital doctor. The Museum--through pathological anatomy--directed the community towards a knowledge of healthcare methods destined to change the morbidity and mortality rates due to a certain disease, in relation to those diseases typical of the times.

  2. Public information campaign on aflatoxin contamination of maize grains in market stores in Benin, Ghana and Togo.

    PubMed

    James, B; Adda, C; Cardwell, K; Annang, D; Hell, K; Korie, S; Edorh, M; Gbeassor, F; Nagatey, K; Houenou, G

    2007-11-01

    Rotary International with the International Institute of Tropical Agriculture (IITA) conducted an information campaign from 2000 to 2004 to increase public awareness of aflatoxin in Benin, Ghana and Togo. Key informant interviews with 2416 respondents showed poor baseline knowledge of aflatoxin and its health risks. The campaign included monitoring of aflatoxin contamination in maize grains from market stores in 38 cities and towns. Aflatoxin concentration in contaminated samples ranged from 24 to 117.5 ng g(-1) in Benin, from 0.4 to 490.6 ng g(-1) in Ghana, and from 0.7 to 108.8 ng g(-1) in Togo. The campaign significantly increased public awareness that populations were exposed to high levels of aflatoxin. The number of maize traders who were informed about the toxin increased 10.3 and 3.2 times in Togo and Benin, respectively; at least 33% more traders believed the information in each of Benin and Togo; 11.4 and 28.4% more consumers sorted out and discarded bad grains in Benin and Ghana, respectively. This paper concludes that sustained public education can help reduce aflatoxin contamination.

  3. 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

  4. 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.

  5. Biological aging and social characteristics: gerontology, the Baltimore city hospitals, and the National Institutes of Health.

    PubMed

    Park, Hyung Wook

    2013-01-01

    The intramural gerontological research program in the National Institutes of Health underwent a substantial growth after its creation within the precincts of the Baltimore City Hospitals in 1940. This paper analyzes its development and the associated problems of its early years. Gerontologists aimed at improving the social and economic life of the elderly through scientific research. With this aim in mind, they conducted various investigations using the indigent aged patients of the Baltimore City Hospitals. Yet the scientists of aging, who hoped to eliminate negative social factors that might bias their research and heighten the confusion between pathology and aging per se, eventually stopped using these patients in the hospital as human subjects. Instead they sought educated affluent subjects in order to eliminate the impact of poverty. By doing so, however, they introduced a new source of social bias to their work, especially within the novel project begun in 1958, the Baltimore Longitudinal Study of Aging. This article thus examines the context of the development of gerontologists' research by analyzing their agenda, institutional environment, and research subjects in the 1940s and the 1950s.

  6. Curitiba acute ischemic stroke protocol: a university hospital and EMS initiative in a large Brazilian city.

    PubMed

    Lange, Marcos Christiano; Zétola, Viviane Flumignan; Parolin, Monica F; Zamproni, Laura N; Fernandes, Artur F; Piovesan, Elcio Juliato; Nóvak, Edison Matos; Werneck, Lineu César

    2011-06-01

    Few healthcare centers in Brazil perform thrombolytic therapy for acute ischemic stroke (AIS) patients. The aim of this study was to describe an interinstitutional protocol for the rapid identification and thrombolytic treatment of AIS patients at a public health hospital in a large Brazilian city. Emergency medical services (EMS) personnel evaluated 433 patients with possible stroke during a six-month period. After a standard checklist, patients with suspected AIS and symptoms onset of less than two hours were evaluated at our University Hospital (UH). Sixty-five (15%) patients met the checklist criteria and had a symptom onset of less than two hours, but only 50 (11%) patients were evaluated at the UH. Among them, 35 (70%) patients had ischemic stroke, 10 (20%) had hemorrhagic stroke, and 5 (10%) had other diagnoses. Of the 35 ischemic stroke patients, 15 (43%) underwent IV thrombolysis. The present study demonstrated that trained EMS workers could help to improve the rate of thrombolytic treatment in large Brazilian cities. Permanent training programs for EMS and hospital staff, with quality control and correct identification of AIS patients, should be implemented to increase appropriate thrombolytic therapy rates in Brazil.

  7. Increasing Prevalence of Electronic Cigarette Use Among Smokers Hospitalized in 5 US Cities, 2010–2013

    PubMed Central

    Harrington, Kathleen F.; Richter, Kimber; Fellows, Jeffrey L.; Sherman, Scott E.; Grossman, Ellie; Chang, Yuchiao; Tindle, Hilary A.; Ylioja, Thomas

    2015-01-01

    Introduction: Little is known about the pattern of electronic cigarette (e-cigarette) use over time or among smokers with medical comorbidity. Methods: We assessed current cigarette smokers’ use of e-cigarettes during the 30 days before admission to 9 hospitals in 5 geographically dispersed US cities: Birmingham, AL; Boston, MA; Kansas City, KS; New York, NY; and Portland, OR. Each hospital was conducting a randomized controlled trial as part of the NIH-sponsored Consortium of Hospitals Advancing Research on Tobacco (CHART). We conducted a pooled analysis using multiple logistic regression to examine changes in e-cigarette use over time and to identify correlates of e-cigarette use. Results: Among 4,660 smokers hospitalized between July 2010 and December 2013 (mean age 57 years, 57% male, 71% white, 56% some college, average 14 cigarettes/day), 14% reported using an e-cigarette during the 30 days before admission. The prevalence of e-cigarette use increased from 1.1% in 2010 to 10.3% in 2011, 10.2% in 2012, and 18.4% in 2013; the increase was statistically significant (p < .0001) after adjustment for age, sex, education, and CHART study. Younger, better educated, and heavier smokers were more likely to use e-cigarettes. Smokers who were Hispanic, non-Hispanic black, and who had Medicaid or no insurance were less likely to use e-cigarettes. E-cigarette use also varied by CHART project and by geographic region. Conclusions: E-cigarette use increased substantially from 2010 to 2013 among a large sample of hospitalized adult cigarette smokers. E-cigarette use was more common among heavier smokers and among those who were younger, white, and who had higher socioeconomic status. PMID:25168031

  8. 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.

  9. Implementing hospital-based communication-and-resolution programs: lessons learned in New York City.

    PubMed

    Mello, Michelle M; Senecal, Susan K; Kuznetsov, Yelena; Cohn, Janet S

    2014-01-01

    In 2010 five New York City hospitals implemented a communication-and-resolution program (CRP) in general surgery. The program's goals were to improve reporting of serious adverse events to risk management, support clinical staff in discussing these events with patients, rapidly investigate why injuries occurred, communicate to patients what was discovered, and offer apologies and compensation when the standard of care was not met. We report the hospitals' experiences with implementing the CRP over a twenty-two-month period. We found that all five hospitals improved disclosure and surveillance of adverse events but were not able to fully implement the program's compensation component. These experiences suggest that strong support from top leadership at the hospital and insurer levels, and adequate staff resources, are critical for the success of CRPs. Hospitals considering adopting a CRP should ensure that their organizations can tolerate risk, their leaders are willing to reinforce CRP implementation, and resources are in place to educate clinical staff about how the program can benefit them.

  10. 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

  11. The Occupational Structure of New York City Municipal Hospitals. Health Services Mobility Study. Text and Appendixes. Research Report Number 2.

    ERIC Educational Resources Information Center

    Gilpatrick, Eleanor, G.; Corliss, Paul K.

    This two volume report is the first of a five-part study to determine ways and means of facilitating horizontal and vertical mobility within New York City's Health Services Administration and selected private hospitals. It seeks to answer two questions: (1) Does the structure of the municipal hospital system permit the efficient planning,…

  12. The Occupational Structure of New York City Municipal Hospitals. Health Services Mobility Study. Text and Appendixes. Research Report Number 2.

    ERIC Educational Resources Information Center

    Gilpatrick, Eleanor, G.; Corliss, Paul K.

    This two volume report is the first of a five-part study to determine ways and means of facilitating horizontal and vertical mobility within New York City's Health Services Administration and selected private hospitals. It seeks to answer two questions: (1) Does the structure of the municipal hospital system permit the efficient planning,…

  13. "The City of the Hospital": On Teaching Medical Students to Write.

    PubMed

    Hellerstein, David J

    2015-12-01

    "The City of the Hospital" is a creative nonfiction writing workshop for medical students, which the author has conducted annually since 2002. Part of the required preclinical Narrative Medicine curriculum at the Columbia University College of Physicians and Surgeons, this six-week intensive workshop includes close readings of literary works and in-class assignments that are then edited by fellow class members and rewritten for final submission. Over the years, students have produced a wide range of compelling essays and stories, and they describe the class as having an effect that lasts throughout their further medical training. This special section includes selected works from class members.

  14. [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

  15. Challenges of nurses' deployment to other New York City hospitals in the aftermath of Hurricane Sandy.

    PubMed

    VanDevanter, Nancy; Kovner, Christine T; Raveis, Victoria H; McCollum, Meriel; Keller, Ronald

    2014-08-01

    On October 29, 2012, a 12-ft storm surge generated by Hurricane Sandy necessitated evacuation and temporary closure of three New York City hospitals including NYU Langone Medical Center (NYULMC). NYULMC nurses participated in the evacuation, and 71 % were subsequently deployed to area hospitals to address patient surge for periods from a few days up to 2 months when NYULMC reopened. This mixed methods study explored nurses' experience in the immediate disaster and the subsequent deployment. More than 50 % of deployed nurse participants reported the experience to be extremely or very stressful. Deployed nurses encountered practice challenges related to working in an unfamiliar environment, limited orientation, legal concerns about clinical assignments. They experienced psychosocial challenges associated with the intense experience of the evacuation, uncertainty about future employment, and the increased demands of managing the deployment. Findings provide data to inform national and regional policies to support nurses in future deployments.

  16. Costs of treating diarrhoea in a children's hospital in Mexico City.

    PubMed Central

    Phillips, M.; Kumate-Rodríguez, J.; Mota-Hernández, F.

    1989-01-01

    The treatment received by children aged under 5 years with diarrhoea was studied in the Hospital Infantil de México (Federico Goméz), Mexico City. The costs of treatment were calculated and estimates were made of how these had changed since the establishment of an oral rehydration unit in the hospital in 1985. The results indicate that drug treatment of outpatients was generally appropriate and inexpensive. In contrast, the cost of drugs for inpatients was considerably higher. The seriousness of the cases justified much of this additional expense for inpatients, but there is evidence that the costs could be reduced further without jeopardizing the quality of the care. Diagnostic tests were relatively expensive, frequently failed to identify diarrhoeal etiology, and their results correlated poorly with the treatment prescribed. The oral rehydration unit resulted in significant savings by causing a 25% fall in the number of inpatients with diarrhoea. PMID:2766450

  17. Installation of a water disinfection system in a Mexico City hospital.

    PubMed

    Juárez Mendoza, J; Martínez Rosales, G; Díaz Sánchez, J; Brust Mascher, E; Brust Carmona, H

    1992-01-01

    With a view to evaluating a small-scale water disinfection system based on production and application of oxidizing gases, the level of equivalent residual chlorine and the degree of contamination by fecal and total coliform bacteria was assessed at various points in the drinking water system of a Mexico City hospital before and after installation of the disinfection equipment. Tests done in May and June 1989, prior to installation of the equipment, showed that residual chlorine concentrations were lower than the national standard in most of the samples and that a sizable portion of these samples were also contaminated with fecal and total coliform concentrations exceeding national standards. After installation of the disinfection system at the main inflow to the hospital's drinking water supply in August 1989, the equivalent residual chlorine concentrations were found adequate and no coliform bacteria were detected. These results indicate that the oxidant mixture generated by the newly installed system was effectively disinfecting the water.

  18. 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

  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. Breastfeeding among inner-city women: from intention before delivery to breastfeeding at hospital discharge.

    PubMed

    Hundalani, Shilpa G; Irigoyen, Matilde; Braitman, Leonard E; Matam, Ramesh; Mandakovic-Falconi, Stefan

    2013-02-01

    This study assessed the degree to which women's intention to breastfeed prior to delivery translates to actual breastfeeding at hospital discharge and to investigate predictors of breastfeeding in a minority inner-city population. We conducted a retrospective cohort study of consecutive mother-infant dyads born July-September 2010 and discharged from the nursery at an academic community hospital in Philadelphia. The demographics of the 578 women who participated included a mean age of 25.3 years (SD 6.1), 61% African American and 18% Latina, 85% covered by Medicaid, and a mean postpartum hospital stay of 2.3 days. Overall, 60% expressed an intention to breastfeed prior to delivery (exclusively or with formula), but only 50% were breastfeeding at discharge. Of those who intended to breastfeed (exclusively or with formula), 75% were breastfeeding at discharge. Of those who intended to breastfeed exclusively, 40% were doing so at discharge. Of those who intended to bottle feed, 11% were breastfeeding at discharge. In multivariable analysis, older mothers and those with lower parity were more likely to breastfeed at discharge and also to breastfeed exclusively, controlling for ethnicity, parity, insurance, pregravida body mass index, score on the Edinburgh Postpartum Depression Scale, type of delivery, infant birth weight and gestational age. In a minority inner-city population, only three in four women who intended to breastfeed prior to delivery were breastfeeding at hospital discharge. However, one in 10 women previously not intending to breastfeed did so. Strategies are needed to promote and strengthen women's intention to breastfeed and to help women's breastfeeding outcomes meet their intentions.

  1. [North-South cooperation on transfusion and hematology teaching: A Benin experience].

    PubMed

    Lafia, E; Anani, L; Glitho, S; Bankole, C; Fachinan, H; Py, J-Y; Domenech, J; Martenot, B; Colombat, P; Chobli, M; Zohoun, I

    2015-06-01

    Hematologic diseases are a significant part of health disorders in Benin. As an example, anemia is the second cause of hospitalization, measuring up to 7.9% all over the country (National Plan of Sanitary Development, 2009-2018). By contrast, there is only one active hematologist in the country. Thanks to two partnerships, on one hand between the health sciences faculty in Cotonou (Benin) and the medicine one in Tours (France), and on the other hand between the Beninese Blood Transfusion National Agency and the French Blood Establishment, a first blood transfusion and hematology formation was held in Cotonou on December 2014. Among other benefits, was created an hematology-transfusion network in order to facilitate relations between Beninese hospital doctors, with the support of the two French partner institutions. The article describes this progress.

  2. Lack of hospital preparedness for chemical terrorism in a major US city: 1996-2000.

    PubMed

    Keim, Mark E; Pesik, Nicki; Twum-Danso, Nana A Y

    2003-01-01

    The [US] Nunn-Lugar-Domenici Defense Against Weapons of Mass Destruction (WMD) Act (the WMD Act of 1996) heralded a new wave of spending by the federal government on counter-terrorism efforts. Between 1996 and 2000, the United States of America (US) federal government allocated large sums of funding to the States for bioterrorism preparedness. Distribution of these funds between institutions involved in first-responder care (e.g., fire and safety departments) and hospitals was uneven. It is unknown whether these additional funds had an impact on the level of hospital preparedness for managing mass casualties involving hazardous materials at the local level, including potential terrorist attacks with chemical agents. (1) To compare 1996 and 2000 measures of preparedness among hospitals of a major US metropolitan area for dealing with hazardous material casualties, including terrorism that involved the use of weapons of mass destruction; and (2) To provide guidance for the improvement of emergency preparedness and response in US hospitals. In July 1996 and again in July 2000,21 hospitals in one major US city were surveyed by questionnaire. A survey was used to assess the amounts of antidote stocks held available for treatment of casualties caused by toxic chemical agents and institutional response capabilities including the number of showers for decontaminating patients, the level of worker protection, and the number of staff trained to decontaminate patients. Hospital preparedness for treating and decontaminating patients exposed to toxic chemical agents was inadequate in 1996 and in 2000. From 1996 to 2000, there was no statistically significant change in the lack of hospital preparedness for stocking of nerve agent and cyanide antidotes. Capacity for decontamination of patients, which included appropriate hazardous material infrastructure and trained staff, generally was unimproved from 1996 to 2000 with the exception of an increase of nearly 30% in hospitals with

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

    PubMed Central

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

    2016-01-01

    Objective: 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). Methods: 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=Z2P (1-P)/d2 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. Results: 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

  4. 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

  5. Remaking hospital space: The health care practices of injection drug users in New York City

    PubMed Central

    Szott, Kelly

    2014-01-01

    Background Medical care has long been depicted by social scientists as a field of social control, as well as a branch of Foucauldian disciplinary power. This report focuses attention on the hospital, a highly regulated place in the United States, and examines how injection drug users (IDUs) negotiate the medical social control and institutionalized disciplinary power they encounter in this place. Methods Twenty-eight qualitative interviews were conducted in New York City with low-income people who inject drugs on a regular basis. Interview questions focused on their health and drug use and interactions with health care providers. Results A variety of practices were employed to avoid, defy and subvert medical power. Study participants reported leaving the hospital when they felt ready rather than waiting to be discharged, actively seeking the type of care they wanted and ignoring medical advice. Conclusion The hospital is not a site of total control in the narratives of IDUs, but rather a space to seek a self-determined amount and type of care. These results can re-orient providers of health care services towards understanding the productivity of the relationship between IDUs and the hospital. PMID:24418630

  6. 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).

  7. Environmental and health-related risk factors for Mycobacterium ulcerans disease (Buruli ulcer) in Benin.

    PubMed

    Nackers, Fabienne; Johnson, Roch C; Glynn, Judith R; Zinsou, Claude; Tonglet, René; Portaels, Françoise

    2007-11-01

    We conducted a case-control study to investigate the association between Buruli ulcer (BU) and environmental- and health-related behaviors in southern Benin. Hospital BU cases (N = 324) and sex- and age-matched neighborhood controls (N = 1,173) answered a questionnaire. Regular use of soap for washing, treating injuries with soap or antibiotic powder, and frequent contact with flowing water appeared protective against BU.

  8. Building a Vision for Education in Benin

    ERIC Educational Resources Information Center

    Ahanhanzo, Joseph; Odushin, David E.; Bibi-Adelakoun, Alice

    2006-01-01

    For the first time in Benin, the education sector has built its own vision. In the past, there were general policy laws, which provided a framework for education policy. The current building experience, arising in a particular context, is the result of a political decision to include in one document all the replies to the questions raised by the…

  9. Building a Vision for Education in Benin

    ERIC Educational Resources Information Center

    Ahanhanzo, Joseph; Odushin, David E.; Bibi-Adelakoun, Alice

    2006-01-01

    For the first time in Benin, the education sector has built its own vision. In the past, there were general policy laws, which provided a framework for education policy. The current building experience, arising in a particular context, is the result of a political decision to include in one document all the replies to the questions raised by the…

  10. Particulate matter and out-of-hospital coronary deaths in eight Italian cities.

    PubMed

    Serinelli, Maria; Vigotti, Maria Angela; Stafoggia, Massimo; Berti, Giovanna; Bisanti, Luigi; Mallone, Sandra; Pacelli, Barbara; Tessari, Roberta; Forastiere, Francesco

    2010-05-01

    We evaluated the association between PM(10) concentration and out-of-hospital coronary deaths in eight Italian cities during 1997-2004. 16 989 subjects aged >35 years who died out-of-hospital from coronary causes were studied and hospital admissions in the previous 2 years identified. We studied the effect of the mean of current and previous day PM(10) values (lag 0-1). A city-specific case-crossover analysis was applied using a time-stratified approach considering as confounders weather, holidays, influenza epidemics, and summer decrease in population. The pooled percentage increase (95% CI) in mortality per 10 microg/m(3) increase in PM(10) was estimated. A statistically significant increase in out-of-hospital coronary deaths was related to a 10 microg/m(3) increase in PM(10): 1.46% (95% CI 0.50 to 2.43). Although no statistically significant effect modification by age was found, the effect was stronger among subjects aged >65 years (1.60%, 0.59 to 2.63), particularly those aged 65-74 (3.01%, 0.74 to 5.34). People in the lowest socio-economic category (3.34%, 1.28 to 5.45) had a stronger effect than those in the highest category. No clear effect modification was seen for gender, season or any specific comorbidity. An indication of negative effect modification was seen for previous admission for cardiac dysrhythmias. Subjects without hospital admissions in the previous 2 years were slightly more affected by PM(10) effects (1.91%, 0.28 to 3.47) than those with at least one previous hospital admission (1.44%, 0.09 to 2.82). Our results show that short term exposure to PM(10) is associated with coronary mortality especially among the elderly and socio-economically disadvantaged. No clear effect modification by previous hospitalisations was detected except for cardiac dysrhythmias, possibly due to protective treatment.

  11. Reshaping inpatient care: efficiency and quality in New York City hospitals.

    PubMed

    Rogut, L

    1996-11-01

    Between 1992 and 1995, the United Hospital Fund engaged two groups of New York City hospitals in collective efforts to address crucial issues of length of stay and patient-centered care; the three-year, $1.1-million Length of Stay Initiative, which supported projects in seven New York City hospitals to identify and change practices that unnecessarily prolong inpatient stays; and the two-year, $700,000 Patient-Centered Care Consortium, through which 15 hospitals surveyed patients and received grants and technical support to design, implement, and evaluate improvements in meeting patients' expressed needs for more personalized care. Specific strategies and interventions developed and tested through the Length of Stay Initiative included continuous quality improvement programs to reduce delays and prevent duplication of diagnostic tests; clinical pathways to reduce unnecessary and inefficient variations in the treatment of common conditions and diseases; and a variety of other techniques, such as work redesign, diagnostic-specific clustering of patients, interdisciplinary design teams, and interdisciplinary rounds. Activities undertaken by the hospitals participating in the Patient-Centered Care Consortium included an initial survey of 3,423 patients and subsequent focus groups, individual interviews, and additional surveys to better understand the nature and causes of problems with care and to target, design, and test small-scale improvements. Among the first products to the consortium were patient education and information programs; daily treatment plans; improvements in the coordination of care and in teamwork among health care professionals; redesigned interpreter services, and improved methods of providing emotional support. Through their projects in the Length of Stay Initiative and Patient-Centered Care Consortium the participating hospitals learned some important lessons about what it takes to increase efficiency, improve the quality of patient care, and

  12. 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.

  13. 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

  14. 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

  15. [Air pollution and urgent hospital admissions in nine Italian cities. Results of the EpiAir Project].

    PubMed

    Colais, Paola; Serinelli, Maria; Faustini, Annunziata; Stafoggia, Massimo; Randi, Giorgia; Tessari, Roberta; Chiusolo, Monica; Pacelli, Barbara; Mallone, Sandra; Vigotti, Maria Angela; Cernigliaro, Achille; Galassi, Claudia; Berti, Giovanna; Forastiere, Francesco

    2009-01-01

    the relationship between air pollution and hospital admissions has been well studied. In this study, the results of the Italian EpiAir Project are reported on the effect of air pollution on hospital admissions in 9 Italian cities during 2001-2005. The association between particulate matter (PM10) and gases (NO2 and O3) and hospital admissions for cardiac, cerebrovascular, respiratory conditions, pulmonary embolism and diabetes has been evaluated. The study population consists of 701,902 hospital admissions of subjects residents in nine Italian cities and hospitalized in the city in the period 2001- 2005. We used a case-crossover approach and the statistical analysis considered the relevant temporal and meteorological factors for confounding adjustment. The results for ozone refer to the warm semester. The analysis of the association between air pollution and admissions was conducted for each city, and the city-specific estimates were meta-analyzed to obtain pooled results. we found an immediate effect of PM10 and NO2 (lag 0) for cardiac diseases as a group and for specific conditions (coronary syndrome and heart failure). No effect of ozone was observed. For cerebrovascular diseases we did not observe a positive effect of the three pollutants. An effect of NO2 on pulmonary embolism was detected. The association between air pollutants and hospitalization for respiratory diseases (respiratory infections, COPD and asthma) showed different lags for the three pollutants: the effect of PM10 was immediate at lag 0-1 while the effects of NO2 and ozone were prolonged at lag 0-5. The strongest association was between NO2 and asthma admissions, especially in children. No effects on diabetes were found. the main results of the present study confirm the deleterious short term impact of air pollution on cardiovascular and respiratory morbidity in Italian cities.

  16. Mediating medical malpractice lawsuits against hospitals: New York City's Pilot Project.

    PubMed

    Hyman, Chris Stern; Schechter, Clyde B

    2006-01-01

    The New York City Health and Hospitals Corporation participated in a feasibility study to measure the participants' satisfaction with mediation of medical malpractice lawsuits. Twenty-nine cases were referred to the study, twenty-four agreed to mediation, and nineteen were mediated. Satisfaction data indicate that the plaintiffs and their attorneys and the defendant's attorney were satisfied with the process whether or not settlement was reached. The mean length of a mediation was 2.34 hours. Of the cases mediated, thirteen settled, with a median payment of 111,000 dollars. The defendant's and plaintiffs' attorneys estimated spending approximately one-tenth the amount of time preparing their case for mediation that they would have spent preparing for trial.

  17. 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

  18. 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.

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

    SciTech Connect

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

    2013-07-03

    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 a 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.

  20. The Epidemiology of Hospital-Referred Head Injury in Ardabil City

    PubMed Central

    Farzaneh, Esmaeil; Abbasi, Vahid; Kahnamouei-aghdam, Fariba; Molaei, Behnam; Iziy, Elham; Ojaghi, Habib

    2017-01-01

    Background and Purpose. Trauma is the leading cause of death for youth in developing countries. Given the prevalence of head trauma (HT) in society and its complication and burden, the epidemiologic study of head trauma is necessary and is the main aim of this study. Materials and Methods. This retrospective population-based survey describes the epidemiology of head injury in a defined population in Ardabil city. It includes all 204 patients with head injury referred to the University Hospital of Ardabil, Iran, during 2013-2014. Data were collected by a checklist and analyzed by statistical methods in SPSS.19. Significance level p < 0.05 was considered. Results. Of all registered cases, 146 (71.6%) were male and the rest of them were female. Most of HT patients lived in Ardabil city (60.8%). The mean age of patients was 22.6 ± 25.9 and most of victims were young. 24.5% of traumatic patients have injuries in severe to critical level (grade 3-4). The most cause of trauma was accidents (41.7%). Most of injuries occurred in night (55.9%) and in summer season (42.2%). Causes were traffic accident in 41.7%. Conclusion. Results showed that the leading cause of head trauma especially in the warm seasons is accidents and so, designing programs to reduce road accidents can dramatically reduce the rate of trauma in the future in Ardabil province. PMID:28255457

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

    NASA Astrophysics Data System (ADS)

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

    2013-07-01

    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 a closed-end cup system with CR-39 (Lantrack®) polycarbonate as detector material. The indoor radon concentrations were found to be between 75 and 170 Bq m-3, below the USEPA-recommended indoor radon action level for working places of 400 Bq m-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.

  2. 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.

  3. Multidrug resistant Acinetobacter baumannii: a descriptive study in a city hospital

    PubMed Central

    2010-01-01

    Background Multidrug resistant Acinetobacter baumannii, (MRAB) is an important cause of hospital acquired infection. The purpose of this study is to determine the risk factors for MRAB in a city hospital patient population. Methods This study is a retrospective review of a city hospital epidemiology data base and includes 247 isolates of Acinetobacter baumannii (AB) from 164 patients. Multidrug resistant Acinetobacter baumannii was defined as resistance to more than three classes of antibiotics. Using the non-MRAB isolates as the control group, the risk factors for the acquisition of MRAB were determined. Results Of the 247 AB isolates 72% (177) were multidrug resistant. Fifty-eight percent (143/247) of isolates were highly resistant (resistant to imipenem, amikacin, and ampicillin-sulbactam). Of the 37 patients who died with Acinetobacter colonization/infection, 32 (86%) patients had the organism recovered from the respiratory tract. The factors which were found to be significantly associated (p ≤ 0.05) with multidrug resistance include the recovery of AB from multiple sites, mechanical ventilation, previous antibiotic exposure, and the presence of neurologic impairment. Multidrug resistant Acinetobacter was associated with significant mortality when compared with sensitive strains (p ≤ 0.01). When surgical patients (N = 75) were considered separately, mechanical ventilation and multiple isolates remained the factors significantly associated with the development of multidrug resistant Acinetobacter. Among surgical patients 46/75 (61%) grew a multidrug resistant strain of AB and 37/75 (40%) were resistant to all commonly used antibiotics including aminoglycosides, cephalosporins, carbepenems, extended spectrum penicillins, and quinolones. Thirty-five percent of the surgical patients had AB cultured from multiple sites and 57% of the Acinetobacter isolates were associated with a co-infecting organism, usually a Staphylococcus or Pseudomonas. As in medical

  4. [Clinical and epidemiologic characteristics of acute diarrhea in adults at a hospital from Cordoba city].

    PubMed

    Polo Friz, H; Toloza, S; Acosta, H; Toloza, C; Unsain, F; Marconetto, G; Massanet, P; Canova, S; Celli, J; Abdala, O; Gandini, B

    1997-01-01

    The purpose of this work was to assess the clinical and epidemiologic presentation features of adult acute diarrhea in a general hospital form Córdoba City. All the patients older than 14 years old who assisted to the Hospital Nacional de Clínicas Central Guard for acute diarrhea, during the periods: A (15-12-89 to 15-03-90), B (15-12-93 to 15-03-94) and C (15-12-94 to 15-03-95), were included. 594 patients were studied: 337 female (56.7%) and 257 male, 143 in the period A, 250 in B and 201 in C. The means +/- SD age was 34.6 +/- 13.3 and stool loose per day at admission 7.3 +/- 4.7. Eighty six percent of patients presented liquid consistent stool, 89.6% abdominal pain, 44.7% vomiting and 18.8% bloody stools. The rate of patients who consulted Central Guard referring acute diarrhea increased from period A (2.4%) to B (3.61%); p = 0.002 and decreased form B to C (2.85%); p = 0.01. The mean (+/- SD) days transcurred from the beginning of diarrhea episode till consultation was 3.5 +/- 2.7; 2.7 +/- 2.3 y 2.9 +/- 3.5 in the periods A, B and C respectively, statistically significant difference between A and B, p < 0.01. Thirty six percent, 21.1% and 23.1% of patients presented mucus with their stools in the periods A, B and C (p = 0.01), and high temperature 61.1%, 48.1% and 48.5% respectively (p = 0.04). Twenty seven percent of stools samples cultures became positive in the periods A, 17.6% in B and 11.5% in C, statistically significant difference between A and C; p = 0.008. The results show that in a general hospital from Córdoba City the adult acute diarrhea is a frequent cause of consult. In the last years there were modifications in its clinical an epidemiologic presentation features.

  5. Uncertainties Regarding Aquifer Development in Coastal Benin

    NASA Astrophysics Data System (ADS)

    Silliman, S. E.; Boukari, M.

    2001-05-01

    From a hydrogeologic point of view, Benin is quite similar to a number of central-western African nations in that it is underlain by a thick sequence of coastal sediments along its southern border and these sediments grade into igneous and metamorphic rocks further north in the country. Cotonou, Benin, is the primary industrial center for Benin and is located along the southern coast. At present, Cotonou enjoys a high quality water supply based on groundwater extraction and treatment (primarily to reduce hardness) Two significant threats to this supply are represented in the potential for salt-water intrusion from Lake Nokoue (and the Atlantic) and for biological / chemical contamination derived from development within the recharge area for the well field. The encroachment is made particularly serious due to poor waste disposal practices in this region. Unfortunately, lack of knowledge of the distribution of sediments in the subsurface, particularly lack of knowledge regarding the continuity of confining layers, leads to substantial uncertainty in the potential impact of these two threats. Initial field characterization and numerical studies are presented that demonstrate the degree of uncertainty in the risk to the water supply resulting from this lack of knowledge of the geology. Uncertainty also occurs due to an uncertain rates and locations of production in the future. It is argued that incorporation of uncertainty, and identification of data needs to reduce this uncertainty, are critical to proper long-term management of this critical resource.

  6. [Investigation on Entamoeba histolytica infection in diarrhea patients from general hospitals in Shanghai City].

    PubMed

    Zhang, Xiao-ping; He, Yan-yan; Wang, Zhen-yu; Zhang, Yao-guang; Zhu, Qian; Jiang, Shou-fu; Li, Ying; Cheng, Yu-ping; Yin, Ming-min

    2015-12-01

    To understand the status of Entamoeba histolytica infection in diarrhea patients in general hospitals, so as to provide the evidences for the prevention and control of the disease. The diarrhea patients in intestinal disease clinics of 3 general hospitals in Shanghai City were chosen as the investigation objectives, and their fecal and blood samples were collected, and then were detected by the normal saline direct smear method and iodine solution staining, immunochromatographic method and ELISA respectively to understand the infection status of E. histolytica, and the characteristics of the infected persons were analyzed. RESULTS Totally 1 015 fecal samples were detected, and among which 36 positive ones were detected by parasitological examinations, with a general positive rate of 3.55%. There were no statistically significant differences among the positive rates of patients from the three hospitals (P > 0.05), nor between or among those of the patients with different sexes, ages, occupations and education levels (all P > 0.05). The positive rate of E. histolytica in bloody purulent stools was higher than those in loose stools and watery stools (both P < 0.01). The peak period of infection was from July to September. Among the 36 infected people detected by parasitological examination, 88.90% of them complained about abdominal pain, and the red blood cells and leucocyte cells were found in the stool samples of 75.00% and 22.23% of the cases, respectively. The positive rates of E. histolytica were 8.18% (83/1 015) and 7.12% (48/675) respectively when detected by the immunochromatographic method and ELISA. Summer and autumn are the high risk seasons for E. histolytica infection, and the surveillance should be strengthened in this period. The positive rate of E. histolytica in samples of bloody purulent stools is high, and the combined application of several detection methods can increase the detection rate.

  7. 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

  8. Active use of cocaine: an independent risk factor for recurrent diabetic ketoacidosis in a city hospital.

    PubMed

    Nyenwe, Ebenezer A; Loganathan, Raghu S; Blum, Steve; Ezuteh, Donald O; Erani, David M; Wan, Jim Y; Palace, Marcia R; Kitabchi, Abbas E

    2007-01-01

    To identify the risk factors for recurrent diabetic ketoacidosis (DKA) in a city hospital. We performed a retrospective analysis of sequential adult admissions for DKA at Bronx Lebanon Hospital Center in New York between July 1, 2001, and June 30, 2004. The patients were divided into cohorts, which were compared with use of analysis of variance and X2 tests. Multivariate logistic regression analysis was performed where indicated. In 168 patients (96 men and 72 women), 219 episodes of DKA occurred. The mean age (+/- SD) of the overall study group was 38.6 +/- 14.8 years. Fifty-four patients (32%) had type 2 diabetes, and 44 patients (26%) had new-onset diabetes. The recurrence rate of DKA was 169% in cocaine users and 39% in nonusers (P<0.0001). Active use of cocaine, noncompliance, and Hispanic ethnicity emerged as independent risk factors for recurrent DKA-odds ratio (OR) = 4.38, P = 0.001; OR = 1.96, P = 0.05; and OR = 0.40, P = 0.005, respectively. The commonest precipitants of DKA were noncompliance (44%) and infection (26%). Noncompliance was associated with use of cocaine, use of cannabis, and cigarette smoking (P = 0.008, 0.04, and 0.01, respectively). In 91 of the hospital admissions for DKA (42%), the patients were active smokers. Active use of cocaine is an independent risk factor for recurrent DKA, as are noncompliance and Hispanic ethnicity. Of these 3 factors, cocaine showed the strongest association with DKA. Therefore, toxicology screening in patients with recurrent DKA may be prudent and worthwhile.

  9. [A pioneer in occupational therapy at mental hospitals in local cities (approaches at Shichiyama Hospital at the beginning of Taisho Era)].

    PubMed

    Honda, Yoshiharu; Suzuki, Hideo; Honda, Hideharu; Irisawa, Satoshi

    2009-01-01

    Occupational therapy at mental hospitals in Japan began in 1901, when Shuzo Kure created two sewing rooms in the female section of Sugamo Hospital and allowed patients to sew pillowcases and hospital gowns for use at the hospital. In 1904, Sugamo Hospital added a work section, and occupational therapy became an official part of the hospital. In addition, Kure stated in The Complete Book of Japanese Internal Medicine (Nihon Naika Zensho), published in 1916, that occupational therapy had also become popular at other mental hospitals; however, he did not refer to specifics, such as information on what kind of occupational therapy was being carried out at which hospital. Shichiyama Hospital is a private facility located in Kumatori-cho, Sennan-gun, Osaka. In 1599, some 200 years before Philippe Pinel released lunatics from their chains, Sanai Honda established Soshindo at Jokenji Temple for the treatment of mental disorders using Chinese herbal remedies. Treatment using these remedies was practiced until the 1950's. Evidence suggests that Chinese herbal remedies were being used in combination with occupational therapy, such as farm work and raising poultry, from the end of the Meiji Era. Plans of the hospital in 1913 included descriptions of a farm, and entertainment and recreational areas for patients, confirming this evidence. It also supported Kure's statement about occupational therapy having become popular at mental hospitals at the beginning of the Taisho Era. In Summary, occupational therapy was practiced at mental hospitals in local cities at the beginning of the Taisho Era, and such occupational therapy in this period was significantly influenced by Shuzo Kure; therefore, I pay my respects to this great pioneer of psychiatric medicine.

  10. Periodontal Health among Non-Hospitalized Chronic Psychiatric Patients in Mangaluru City-India

    PubMed Central

    Singh, Rashmi; Kota, Keshava Pai

    2016-01-01

    Introduction A substantial section of society constituting the mentally ill and psychiatric patients deserve special attention. Evidence has suggested that psychological factors have contributed to an increase in the susceptibility to periodontal disease. Aim The aim of the study was to evaluate the gingival and periodontal health of chronically non-hospitalized psychiatric patients in Mangaluru city, India. Materials and Methods Forty one psychiatric patients having chronic psychiatric illness and on neuroleptic medications for a minimum of 2 years were included in the study. The control group consisted of 41 healthy dental patients who were selected to match the study group by age and gender, and for both groups 20 teeth excluding the third molars should be present. Demographic characteristics, dental examination including gingival index and periodontal health according to the community periodontal index were recorded for each patient in both the groups. Results In the psychiatric patient group (Group A) 47.1% subjects were suffering from schizophrenia and 17.6% subjects were having mood disorder. Gingivitis varied from mild to severe among the patients of both the groups. Bleeding on probing (CPI 1) was recorded in 23.5% in Group A and 14.6% in Group B. Dental calculus (CPI 2) in 38.2% in Group A and 58.5% in Group B of the subjects, 20.6% with at least one 4mm to 5mm pocket (CPI 3), and 17.6% with at least one 6mm pocket (CPI 4). Conclusion The present study underlines a considerable need for prevention and treatment of periodontal disease among chronic psychiatric patients in Mangaluru city. Every effort should be made to increase the awareness of this cohort regarding the importance of oral hygiene practices and on the early diagnosis of periodontal problems. PMID:27656561

  11. [Air pollution and urgent hospital admissions in 25 Italian cities: results from the EpiAir2 project].

    PubMed

    Scarinzi, Cecilia; Alessandrini, Ester Rita; Chiusolo, Monica; Galassi, Claudia; Baldini, Marco; Serinelli, Maria; Pandolfi, Paolo; Bruni, Antonella; Biggeri, Annibale; De Togni, Aldo; Carreras, Giulia; Casella, Claudia; Canova, Cristina; Randi, Giorgia; Ranzi, Andrea; Morassuto, Caterina; Cernigliaro, Achille; Giannini, Simone; Lauriola, Paolo; Minichilli, Fabrizio; Gherardi, Bianca; Zauli-Sajani, Stefano; Stafoggia, Massimo; Casale, Patrizia; Gianicolo, Emilio Antonio Luca; Piovesan, Cinzia; Tominz, Riccardo; Porcaro, Loredana; Cadum, Ennio

    2013-01-01

    to evaluate the relationship between air pollution and hospital admissions in 25 Italian cities that took part in the EpiAir (Epidemiological surveillance of air pollution effects among Italian cities) project. study of time series with case-crossover methodology, with adjustment for meteorological and time-dependent variables. The association air pollution hospitalisation was analyzed in each of the 25 cities involved in the study; the overall estimates of effect were obtained subsequently by means of a meta-analysis. The pollutants considered were PM10, PM2.5 (in 13 cities only), NO2 and ozone (O3); this last pollutant restricted to the summer season (April-September). the study has analyzed 2,246,448 urgent hospital admissions for non-accidental diseases in 25 Italian cities during the period 2006- 2010; 10 out of 25 cities took part also in the first phase of the project (2001-2005). urgent hospital admissions for cardiac, cerebrovascular and respiratory diseases, for all age groups, were considered. The respiratory hospital admissions were analysed also for the 0-14-year subgroup. Percentage increases risk of hospitalization associated with increments of 10 µg/m(3) and interquartile range (IQR) of the concentration of each pollutant were calculated. reported results were related to an increment of 10 µg/m(3) of air pollutant. The percent increase for PM10 for cardiac causes was 0.34% at lag 0 (95%CI 0.04-0.63), for respiratory causes 0.75% at lag 0-5 (95%CI 0.25-1.25). For PM2.5, the percent increase for respiratory causes was 1.23% at lag 0- 5 (95%CI 0.58-1.88). For NO2, the percent increase for cardiac causes was 0.57% at lag 0 (95%CI 0.13-1.02); 1.29% at lag 0-5 (95%CI 0.52-2.06) for respiratory causes. Ozone (O3) did not turned out to be positively associated neither with cardiac nor with respiratory causes as noted in the previous period (2001-2005). the results of the study confirm an association between PM10, PM2.5, and NO2 on hospital admissions

  12. 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.

  13. Statistics on deliveries of mothers with epilepsy at Yokohama City University Hospital.

    PubMed

    Endo, Seiji; Hagimoto, Hiroshi; Yamazawa, Hiroshi; Kajihara, Satoshi; Kubota, Shinji; Kamijo, Atsushi; Nakajima, Kaori; Furusho, Ryo; Miyauchi, Toshiro; Endo, Masaya

    2004-01-01

    To survey and summarize the treatment of pregnant women with epilepsy and to obtain data for the improvement of daily treatment regimens. We reviewed medical records of 36 deliveries of 25 mothers with epilepsy at Yokohama City University Hospital from September 1991 to December 2000 and statistically compared the differences in drug-taking profiles, complications during pregnancy, types of delivery, and complications at delivery between the epilepsy group and a control group (656 total deliveries after 22 weeks except for epilepsy cases in 1991 and 1992 at Yokohama City University Hospital). Of the 25 mothers with epilepsy, three with idiopathic generalized epilepsy, 12 were symptomatic for partial epilepsy. Their mean age at delivery was 29.0 years. The mean age at onset of epilepsy was 13.9 years. Of the 36 pregnancies, 30 (83.3%) cases continued antiepileptic drug (AED) taking throughout the pregnancies; 23 (63.9%) cases received monotherapy. Phenobarbital was the most frequently used drug in monotherapies. Seven (19.4%) cases received polytherapy. Seven (19.4%) patients experienced epileptic seizures during pregnancy. One case showed a low serum AED level. No statistically significant difference was found in complications during pregnancy, types of delivery, or complications at delivery, excluding abnormal rotation in the birth canal. Congenital malformation (cleft lip with palate) was observed in one (2.9%) case. The mother was 39 years old at delivery and had myoma uteri. Onset of epilepsy was at 14 years. She had been taking three kinds of AEDs: 1,400 mg/day of sodium valproate (VPA), 1.5 mg/day of clonazepam (CZP), and 200 mg/day of zonisamide (ZNS). Serum concentrations at pregnancy week 10 were 85.3 microg/ml VPA, 18.1 microg/L CZP, and 10.5 microg/ml ZNS. She also had been taking folic acid, 5 mg/day, but the serum concentration was not measured. The method of treatment and the management of pregnancy were left to the discretion of each doctor. However

  14. Abusive head trauma at a tertiary care children's hospital in Mexico City. A preliminary study.

    PubMed

    Díaz-Olavarrieta, Claudia; García-Piña, Corina A; Loredo-Abdala, Arturo; Paz, Francisco; Garcia, Sandra G; Schilmann, Astrid

    2011-11-01

    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. This is a cross-sectional descriptive study of infants and children under 5, who suffered head trauma and were admitted to the National Pediatrics Institute in Mexico City, a tertiary care referral center. We reviewed medical records and extracted data on clinical and neurological signs and symptoms, fundus, radiological (long bones, thorax, CAT scan), and laboratory tests. We administered a standardized questionnaire assessing child abuse and neglect to the parents of the children included in the study. One hundred and twenty children, under 5 presenting with head trauma, were recruited, 13 (11%) were considered abusive head trauma (AbHT) and 107 (89%) were diagnosed as accidental head injury (AcHI). The AbHT group comprised younger infants (mean age 8 months) and the AcHI group included toddlers about an average of 25 months. To account for this significant age difference, we performed a comparison of age matched cases. The children in the AbHT were more likely to be female, the result of the first unintended pregnancy and the children of younger mothers (17-19). Mothers in this group had attended fewer than 5 prenatal care visits and fathers had a history of alcohol abuse. Five (38%) of the 13 AbHT children did not survive their injuries and overall showed greater neurological and respiratory compromise, increased prothrombin time (PT), and lower hematocrit values. The most common intracranial injuries suffered by children in the AbHT group were subdural/epidural hematoma and parenchymal/subarachnoid hemorrhage. Retinal hemorrhage was the most frequent ocular injury. In a tertiary care children's hospital, 11% of the children presenting with head trauma, were considered of abusive origin. Unintended pregnancy among

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

    PubMed

    Mishra, Rashmi; Kashif, Muhammad; 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.

  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. 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.

  18. [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)

  19. 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.

  20. Management of healthcare waste in circumstances of limited resources: a case study in the hospitals of Nablus city, Palestine.

    PubMed

    Al-Khatib, Issam A; Al-Qaroot, Yousef S; Ali-Shtayeh, Mohammad S

    2009-06-01

    The objectives of this study were the assessment of healthcare waste management and the characterization of healthcare waste material generated in the hospitals in Nablus city, Palestine, and furthermore, to estimate the prevalence of hepatitis B among the cleaning personnel working in these hospitals. The medical waste generation rate in kg per bed per day was between 0.59 and 0.93 kg bed(-1) day(-1). The waste generation rate in the healthcare facilities of Nablus city hospitals was similar to some other developing countries; however, the percentage of medical wastes in the total waste stream was comparatively high. The density of medical waste at the four hospitals studied ranged between 144.9 and 188.4 kg m(-3) with a mean value of 166.7 kg m(-3). The waste segregation and handling practices were very poor. Other alternatives for waste treatment rather than incineration such as a locally made autoclave integrated with a shredder should be evaluated and implemented. The system of healthcare waste management in Nablus city is in need of immediate improvement and attention. Formulating rules and guidelines for medical waste and developing strategies for overcoming the obstacles related to waste management should be considered as an urgent matter.

  1. A rapid HIV testing program for labor and delivery in an inner-city teaching hospital.

    PubMed

    Aaron, Erika; Levine, Amy B; Monahan, Keri; Biondo, Charles P

    2006-01-01

    Although perinatal HIV prophylaxis is probably the most successful HIV prevention intervention to date, between 280 and 370 HIV-positive infants are born in the United States each year. A major reason for continuing vertical transmission is that some HIV-infected women are not aware of their positive HIV serostatus before delivery. A rapid HIV testing program was developed and implemented in a labor and delivery suite at an inner-city teaching hospital in a nonresearch setting. Between April 2002 and June 2005, 259 rapid HIV tests were performed. For the first 19 months of the study, the expedited enzyme-linked immunosorbent assay (ELISA) was performed in 62 patients. For the remainder of the study, the OraQuick rapid HIV-1 antibody test was performed in 197 patients. Turnaround times for the ELISA and OraQuick test were 262 minutes and 143 minutes, respectively, a significant difference (P = .002). Four women had positive test results. Voluntary rapid HIV testing is a feasible strategy for detection of HIV seropositivity in pregnant patients who present in a labor and delivery suite with unknown serostatus. This provides an opportunity to administer antiretroviral prophylaxis and to incorporate other obstetric interventions to decrease vertical HIV transmission.

  2. 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.

  3. 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.

  4. Metformin associated lactic acidosis in Auckland City Hospital 2005 to 2009

    PubMed Central

    Haloob, Imad; de Zoysa, Janak R

    2016-01-01

    AIM: To determine the incidence, clinical characteristics and outcomes of patients with metformin associated lactic acidosis (MALA). METHODS: Auckland City Hospital drains a population of just over 400000 people. All cases presenting with metabolic acidosis between July 2005 and July 2009 were identified using clinical coding. A retrospective case notes review identified patients with MALA. Prescribing data for metformin was obtained from the national pharmaceutical prescribing scheme. RESULTS: There were 42 cases of metabolic lactic acidosis over 1718000 patient years. There were 51000 patient years of metformin prescribed to patients over the study period. There were thirty two cases of lactic acidosis due to sepsis, seven in patients treated with metformin. Ten cases of MALA were identified. The incidence of MALA was estimated at 19.46 per 100000 patient year exposure to metformin. The relative risk of lactic acidosis in patients on metformin was 13.53 (95%CI: 7.88-21.66) compared to the general population. The mean age of patients with MALA was 63 years, range 40-83 years. A baseline estimated glomerular filtration rate was obtained in all patients and ranged from 23-130 mL/min per 1.73 m2. Only two patients had chronic kidney disease G4. Three patients required treatment with haemodialysis. Two patients died. CONCLUSION: Lactic acidosis is an uncommon but significant complication of use of metformin which carries a high risk of morbidity. PMID:27458565

  5. 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

  6. The Green Lane and Auckland City Hospital cardiac resynchronisation therapy experience.

    PubMed

    Martin, Andrew; Sinclair, Susan; Lever, Nigel; Stewart, Jim

    2013-11-01

    To evaluate the outcome of cardiac resynchronisation therapy (CRT) in Auckland since its inception in 2000. Outcome measures were periprocedural events including procedure duration, fluoroscopic time, procedure success, complications, and echocardiographic markers of response. Retrospective review of those undergoing CRT implantation at Green Lane and Auckland City Hospitals. 159 CRT procedures were performed on 139 patients between 2000 and April 2011. Of all procedures: 63% had new device implants, and 23% were upgraded from a pacemaker or defibrillator to CRT. Mean age 62 years, 77% male, mean left ventricular ejection fraction (LVEF) 25%, mean QRS duration 175 ms, 91% LBBB, 36% ischaemic cardiomyopathy. Mean procedure time 147 min and fluoroscopy time 30 min. Eight patients had significant periprocedural complications (6%), 17 experienced lead displacement (12%), and 15 (11%) had unsuccessful procedures. 46% of patients had complete echocardiographic data, of these LVEF improved by >5% in 52%, and decreased by >5% in 6% over a 16-month follow-up. Our service performs well with respect to complication rate, though less well when failure of implantation and lead dislodgement are considered. Where complete echocardiographic data was present 52% of our patients derived significant improvement in LVEF.

  7. 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

  8. 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.

  9. Hepatitis E virus (HEV) in sewage from treatment plants of Messina University Hospital and of Messina City Council.

    PubMed

    La Fauci, V; Sindoni, D; Grillo, O C; Calimeri, S; Lo Giudice, D; Squeri, R

    2010-03-01

    Samples of sewage from treatment plants at the "G. Martino" University Hospital of Messina (AOU) and that of Messina City Council were analysed to detect the hepatits E virus. Samples were taken on sewage entering and exiting the treatment plants on a monthly basis over a one-year period from both the hospital plant (24 samples) and the municipal plant (22 samples). All sewage samples were pretreated by ultrafiltraton and concentration and finally processed by the PCR method to amplify gene material. A total of three samples tested positive: two (8.33%) entering the AOU treatment plant and one (4.5%) entering the municipal plant while no cases of HEV were detected in samples of treated sewage. These findings confirm the presence of the virus in the city of Messina and showed that the two treatment plants to be working efficiently when tested.

  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

    2017-08-29

    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. Causes of Hospitalization among Children Ages Zero to Nine Years Old in the City of São Paulo, Brazil

    PubMed Central

    Ferrer, Ana Paula Scoleze; Sucupira, Ana Cecília Silveira Lins; Grisi, Sandra Josefina Ferraz Ellero

    2010-01-01

    INTRODUCTION: The profile of child morbidity is an important parameter for defining and altering health policies. Studies about infant mortality are more numerous than those on morbidity, especially related to hospital admissions. The objective of this study is to describe the causes of admission in the public health system for children from zero to nine years of age in the city of São Paulo during the years 2002 to 2006 and compare these results to those from the national data. METHOD: Through a cross-sectional study, data were obtained from the Hospital Information System, which is available in the Information System of the Unified Health System - DATASUS. RESULTS: Within the period, 16% of the total admissions corresponded to children from zero to nine years of age, with most of the children being younger than one year of age. In the city of São Paulo, the admission coefficient increased 11%, and in Brazil, it decreased 14%. Respiratory diseases were the main causes of hospitalization. In São Paulo, the second most frequent causes of admission were diseases that originated during the perinatal period (15.9%), and in Brazil, the second most frequent cause of admission was infectious-parasitic diseases (21.7%). Admissions for perinatal diseases increased 32% in São Paulo and 6% in Brazil. While hospitalizations for diarrhea decreased in Brazil, an increase was recorded in the city of São Paulo for children under five years old. CONCLUSIONS: The findings of this study show a paradoxical increase in the number of hospitalizations during an expansion of primary attention, indicating that the rise was not associated with a significant improvement in the quality of service. PMID:20126344

  12. 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.

  13. 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.

  14. Measuring emergency department crowding in an inner city hospital in The Netherlands

    PubMed Central

    2013-01-01

    Background Overcrowding in the emergency department (ED) is an increasing problem worldwide. In The Netherlands overcrowding is not a major issue, although some urban hospitals struggle with increased throughput. In 2004, Weiss et al. created the NEDOCS tool (National Emergency Department Over Crowding Study), a web-based instrument to measure objective overcrowding with scores between 0 (not busy at all) to above 181 (disaster). In this study we tried to validate the accuracy of the NEDOCS tool by comparing this with the subjective feelings of the ED nurse and emergency physician (EP) in an inner city hospital in The Netherlands. Methods In a 4-week period, data of a total of 147 time samplings were collected. The subjective feelings of being overcrowded and feeling rushed by the ED nurse and EP were scored on a survey using a 6-point Likert scale on answering the question of how busy they would say the ED is right now. NEDOCS tool scores were calculated, and these were compared with the subjective feelings using the kappa statistic assessing linear weights according to Cohen’s method. Results Of all the time samplings, approximately 80% of the surveys were completed. The ED was rated as overcrowded 9% of the time by the ED nurses and 11% of the time by the EPs. The median NEDOCS score was 37 (0 to 120) and scored as overcrowded in 3%. There was a good intrarater agreement for the ED nurse and EP for the feeling of overcrowding and feeling of being rushed (κ = 0.79 and 0.73, respectively); the interrater agreement was moderate (κ = 0.53 and 0.43, respectively). The agreement between the NEDOCS and the subjective variables was moderate (κ = 0.50 and 0.53, respectively). A composite variable was created as the average of both the scores of feeling overcrowded of the nurse and the EP and the score of the EP of feeling rushed. The agreement between this and the NEDOCS was κ = 0.53. Conclusions The NEDOCS tool is a reasonably good tool to quantify the subjective

  15. [Frequency of musculoskeletal pathology among elderly patients and its treatment at a Private Hospital in Mexico City].

    PubMed

    Espinosa-Mendoza, R L; Soto-Padilla, M; Gómez-Garcia, F

    2015-01-01

    The elderly represent a growing sector of the Mexican population and they are expected to outgrow the number of youths in the coming years. Musculoskeletal conditions are a major cause of disability among the elders; they affect up to 80%. In Mexico City 36% of the population uses private health care services. To contribute with epidemiologic data about the frequency of musculoskeletal conditions and their hospital-based treatment in patients ages 65 and over admitted to a private hospital in Mexico City. Male and female patients ages 65 and over, admitted for a musculoskeletal illness. 390 patients were studied; 276 females and 114 males. The age group 65-69 years was predominant. The predominating musculoskeletal conditions included fractures, which represented 29.4%, and gonarthrosis, 23.30%. Patients were treated surgically accounted for 91.02%. Among the elderly, chronic conditions are more frequent than acute ones; however, fractures are the most frequent diagnosis. There are no studies in Mexico analyzing the frequency of both, traumatic or degenerative conditions, and their treatment in elderly patients admitted to a private hospital. These results will therefore provide epidemiologic information about our population.

  16. 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.

  17. Offshore Benin, a classic passive margin

    SciTech Connect

    Mathalone, J.M.P. )

    1991-03-01

    Offshore Benin comprises a narrow east-west continental shelf, some 30 km wide. A sharp shelf break running parallel to the coast borders the shelf, whereupon water depths rapidly increase to over 7000 ft. The area lies within the Dahomey Embayment, one of a series of Cretaceous and younger basins lining the coast of Africa that owe their inception to the Late Mesozoic break-up of the Gondwanaland Continent. The basin extends some 100 km inland, but sedimentary section is thin onshore compared to a maximum of 20,000 ft of sediment offshore. Initial sedimentation in this basin was of Neocomian alluvial and lacustrine clastics. These were deposited in east-west-trending narrow half-grabens associated with the initial break up of the South American and African continents. They are covered unconformably by more extensive Albian and Cenomanian transgressive clastics and shallow marine Turonian sandstones which are the main reservoir at Seme, Benin's only oilfield. The Senonian section offshore comprises passive margin deep sea clastic sediments prograding southwards. Very large proximal deep sea channels up to 2500 ft thick are developed in this interval. These channels are associated with excellent petroleum source rocks, averaging 4-5% oil-prone organic carbon, and form the main exploration target in the area when configured in a trap morphology. Seismic data quality is excellent in the region allowing detailed examination of the relationships between the rifted section and later units. In addition, these data illustrate clearly both internal and external morphology of the Senonian proximal deep sea channels.

  18. Ambient Particulate Matter Concentrations and Hospitalization for Stroke in 26 Chinese Cities: A Case-Crossover Study.

    PubMed

    Liu, Hui; Tian, Yaohua; Xu, Yan; Zhang, Jun

    2017-08-01

    Little is known about the short-term health impacts of particulate matter (PM) on stroke in China. We, therefore, conducted a time-stratified case-crossover study to examine the association between ambient PM and hospital admissions for stroke in 26 Chinese cities. We identified hospital admissions for stroke by using electronic hospitalization summary reports from January 1, 2014 through December, 31 2015. We applied conditional logistic regression to explore the association between PM and hospital admissions for stroke. We also assessed the effect modification of stroke risk by geographical region, sex, and age. Hospital admissions for ischemic (n=278 980) and hemorrhagic (69 399) strokes were examined separately. For ischemic stroke, both PM2.5 and PM10 had the strongest effect at lag 3 days, with an interquartile range increase in PM2.5 (47.5 μg/m(3)) and PM10 (76.9 μg/m(3)) significantly associated with a 1.0% (95% confidence interval, 0.7%-1.4%) and 0.8% (95% confidence interval, 0.3%-1.3%) increase in admissions for ischemic stroke, respectively. In northern China where PM pollution is more severe, the risk estimates for both PM2.5 and PM10 were larger than those in southern China in all lag structures. An interquartile range increase in PM2.5 and PM10 in northern China corresponded to a 1.0% (95% confidence interval, 0.7%-1.4%) and 0.7% (95% confidence interval, 0.3%-1.2%) increase in ischemic stroke admissions at lag 3 days, respectively. For hemorrhagic stroke, no significant association was observed with PM in the 26 cities. This study suggests that short-term elevations in PM may increase the risk of ischemic but not hemorrhagic stroke. The associations of PM with ischemic stroke are stronger in northern China than in the south. © 2017 American Heart Association, Inc.

  19. Source to sink tracking of selected human pharmaceuticals from two Oslo city hospitals and a wastewater treatment works.

    PubMed

    Thomas, Kevin V; Dye, Christian; Schlabach, Martin; Langford, Katherine H

    2007-12-01

    The occurrence of twenty pharmaceutical compounds was quantitatively determined in effluents from two major Oslo city hospitals, Rikshospitalet and Ullevål, along with influent, sludge and final effluent from the city's VEAS wastewater treatment works (WTW). Composite hospital effluents were collected over a twelve week period and were showed to contain paracetamol, metoprolol, diclofenac, ibuprofen, 17beta-Estradiol, estriol, estrone, oxytetracycline, tetracycline, doxycycline, chlorotetracycline, demeclocycline, trimethoprim, ciprofloxacin, sulfamethoxazole, cyclophosphamide and ifosfamide. Three pharmaceuticals were not detected above the limit of detection; cefuroxime, 17alpha-ethinylestradiol and meclocycline. Composite influent, sludge and effluent samples were collected from VEAS WTW over a seven week period. The influent into VEAS WTW contained all of the same selected substances detected in the hospital effluents, except for oxytetracycline, chlorotetracycline, demeclocycline, cyclophosphamide and ifosfamide. The percentage of pharmaceuticals entering the works from the hospitals was <10% for all of the selected compounds. VEAS sludge samples contained a different profile of substances reflecting their physico-chemical properties. Hydrophobic antibiotics, such as oxytetracycline, tetracycline and ciprofloxacin, were detected in all of the collected sludge samples. Their absence in the collected influent samples suggests that they enter the works bound to effluent particles, with the dissolved fraction observed in the hospital effluents partitioning onto particulate matter within the sewerage network. The final effluent from VEAS WTW contained reduced concentrations of many pharmaceuticals, including paracetamol, ibuprofen and sulfamethoxazole. For other compounds, such as metoprolol, diclofenac and trimethoprim, there were often higher concentrations in the effluent than the influent. These effluent concentrations represent median inputs varying from low

  20. 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

  1. Serratia marcescens: Biochemical, Serological, and Epidemiological Characteristics and Antibiotic Susceptibility of Strains Isolated at Boston City Hospital

    PubMed Central

    Wilfert, James N.; Barrett, Fred F.; Ewing, W. H.; Finland, Maxwell; Kass, Edward H.

    1970-01-01

    The biochemical, serological, and epidemiological characteristics of 95 strains of Serratia marcescens isolated at the Boston City Hospital were examined. Several strains were shown to be endemic, and the majority of isolates were cultured from urine or respiratory secretions. Serratia species were highly resistant to polymyxin B and the cephalosporins, and various proportions were also resistant to other antibiotics including kanamycin, but all of the isolates were sensitive to gentamicin. The appearance of resistance to kanamycin and nalidixic acid among endemic strains was demonstrated. The nosocomial nature of Serratia infections, particularly those involving the urinary tract, was confirmed. Many clinical bacteriology laboratories currently fail to identify the nonpigmented strains. PMID:4314379

  2. Serratia marcescens: biochemical, serological, and epidemiological characteristics and antibiotic susceptibility of strains isolated at Boston City Hospital.

    PubMed

    Wilfert, J N; Barrett, F F; Ewing, W H; Finland, M; Kass, E H

    1970-02-01

    The biochemical, serological, and epidemiological characteristics of 95 strains of Serratia marcescens isolated at the Boston City Hospital were examined. Several strains were shown to be endemic, and the majority of isolates were cultured from urine or respiratory secretions. Serratia species were highly resistant to polymyxin B and the cephalosporins, and various proportions were also resistant to other antibiotics including kanamycin, but all of the isolates were sensitive to gentamicin. The appearance of resistance to kanamycin and nalidixic acid among endemic strains was demonstrated. The nosocomial nature of Serratia infections, particularly those involving the urinary tract, was confirmed. Many clinical bacteriology laboratories currently fail to identify the nonpigmented strains.

  3. Attitudes of Terminally Ill Patients toward Death and Dying in Nigeria

    ERIC Educational Resources Information Center

    Olokor, Christiana O.

    2011-01-01

    The purpose of this study was to analyze the attitudes of terminally ill patients toward death and dying. Four hospitals in Nigeria were randomly selected: University College Hospital, Ibadan; University of Benin Teaching Hospital, Benin City; the Lagos University Teaching Hospital, Lagos; and Igbinedion Specialist Hospital, Okada, Benin City.…

  4. Occult cancer in patients with deep-vein thrombosis in a general hospital at Mexico City: A pilot study.

    PubMed

    Ramírez-Serrano Torres, Christian O; Román-Guzmán, Edgardo; Ortiz-Mendoza, Carlos-Manuel

    2017-01-01

    We aimed to explore the frequency of occult cancer in patients with deep-vein thrombosis (DVT) at a general hospital in Mexico City. From March 2012 to February 2015, all patients with primary DVT of lower extremities attended in the emergency department of our hospital were studied. Initially, all patients were evaluated with clinical history, physical examination, basic laboratories, abdominal ultrasound, chest X-ray, and duplex venous ultrasonography. In a case-by-case approach, if necessary, computed tomography, endoscopy, colonoscopy, and tumor markers were done. From 182 patients with primary DVT, 30 (16.5%) presented occult cancer: Thirteen males and 17 females, with an average age of 61 years. In males, prostate cancer prevailed (6/13, 46%); meanwhile, in females, pelvic gynecologic cancers predominated (7/17, 41%). Our results suggest that in Mexican patients with primary DVT, occult cancer is frequent.

  5. Occult cancer in patients with deep-vein thrombosis in a general hospital at Mexico City: A pilot study

    PubMed Central

    Ramírez-Serrano Torres, Christian O; Román-Guzmán, Edgardo; Ortiz-Mendoza, Carlos-Manuel

    2017-01-01

    Background: We aimed to explore the frequency of occult cancer in patients with deep-vein thrombosis (DVT) at a general hospital in Mexico City. Materials and Methods: From March 2012 to February 2015, all patients with primary DVT of lower extremities attended in the emergency department of our hospital were studied. Initially, all patients were evaluated with clinical history, physical examination, basic laboratories, abdominal ultrasound, chest X-ray, and duplex venous ultrasonography. In a case-by-case approach, if necessary, computed tomography, endoscopy, colonoscopy, and tumor markers were done. Results: From 182 patients with primary DVT, 30 (16.5%) presented occult cancer: Thirteen males and 17 females, with an average age of 61 years. In males, prostate cancer prevailed (6/13, 46%); meanwhile, in females, pelvic gynecologic cancers predominated (7/17, 41%). Conclusion: Our results suggest that in Mexican patients with primary DVT, occult cancer is frequent. PMID:28616050

  6. Factors Associated With Outpatient Visit Attendance After Discharge From Inpatient Psychiatric Units in a New York City Hospital.

    PubMed

    Humensky, Jennifer L; Fattal, Omar; Feit, Rachel; Mills, Sarah D; Lewis-Fernández, Roberto

    2017-06-01

    A class action lawsuit in New York (Koskinas v. Cuomo) established the right of psychiatric inpatients to receive discharge planning, including arranging outpatient treatment. The attendance rate of the initial outpatient appointment after discharge from inpatient treatment in one city hospital was examined to determine whether rates varied by inpatient unit type. The authors performed retrospective chart review of 1,884 discharges to outpatient care. Multivariate regression models were used to examine the odds of attending the initial appointment. Eighty-four percent of patients attended the initial appointment. Higher odds of attendance were associated with case management, living in a shelter or being homeless, general medical comorbidity, and inpatient treatment in a co-occurring disorders unit. Lower odds were associated with being non-Latino black. Inpatient treatment in a Latino unit had no significant effect. Hospital characteristics, patient population, and availability of local outpatient services may influence continuity of care.

  7. 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

  8. 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

  9. Cases of hydatidosis in patients referred to Governmental hospitals for cyst removal in Sana'a City, Republic of Yemen.

    PubMed

    Al-Shibani, Latifa A N; Al-Eryani, Samira M A; Azazy, Ahmed A; Al-Mekhlafi, Abdulsalam M

    2012-03-01

    Hydatidosis is a parasitic infestation caused by Echinococcus granulosus. This disease is endemic in many countries including Yemen. The present review article aims to have a glimpse at the present status of hydatidosis in Yemen. This is the first descriptive study, investigating recorded cases of hydatidosis from the five main governmental hospitals in the capital Sana'a city, over a longer period starting from 2001 and ending in 2008. A total of 796 medical records of patients referred to the five main governmental hospitals in Sana'a city for cyst removal, were studied. Of these cases 482 were females and 314 were males. Their mean age was 30.0 ± 16.9 years. Information regarding the location of the cyst in the body, age, sex and residence of each patient was recorded. A higher infection rate was found in females than males (60.6% and 39.4%, respectively). Single organ involvement was observed in 98.6% cases, among which, the most frequent localizations were the liver (60.8%) followed by the lung (24.7%). Cases of hydatidosis appeared to increase during the period 2001-2008, with the lowest number (n=26) and the highest number (n=140) recorded in 2001 and 2007, respectively. We conclude that the risk of hydatidosis is still high in Yemen, where street or stray dogs move freely down town and the population should be aware about the role of dogs in the transmission of this disease. Hospital records provide a useful indication of infection expressed as annual rate of hospital cases. Finally, the collaboration of Public Health Authorities, the Veterinary Medical Authorities and the Environmental Affairs Authorities is a must to control this disease.

  10. 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.

  11. The definition of life: a survey of obstetricians and neonatologists in New York City hospitals regarding extremely premature births.

    PubMed

    Ramsay, Sharon M; Santella, Regina M

    2011-05-01

    Among obstetricians and neonatologists in administrative roles in New York City hospitals, a survey was initiated to compare the physicians' definitions of live birth and fetal death, the gestational age at which they consider infants viable, and the resuscitation practices of the neonatologists. The target survey population was 34 neonatologists, and 39 obstetricians representing 41 of the City's 43 maternity hospitals. A telephone survey was used to gather qualitative data from the physicians regarding their definitions of live birth, fetal death, and viability, and their practices regarding extremely premature births. Surveys were completed for 58 physicians, a response rate of 79% (94% for neonatologists and 67% for obstetricians). Physicians' definitions of live birth and fetal death varied, with almost a third (29%) of physicians including gestational age as part of their live birth criteria. Most of the physicians (90%) consider infants born at ≥23 weeks gestation viable. Most neonatologists (97%) said they always resuscitate infants born at ≥23 weeks gestation, and most (94%) said they would never resuscitate infants born at <20 weeks gestation. For infants born at 20-22 weeks gestation, there were differences in resuscitation practices. There is a gap between clinical practices and reporting requirements for live birth and fetal death. Whereas reporting requirements are based on definitions of live birth and fetal death, physicians make resuscitation and other clinical decisions regarding extremely premature infants based on definitions of viability.

  12. Prevalence of Non-Tuberculous Mycobacteria in Hospital Waters of Major Cities of Khuzestan Province, Iran

    PubMed Central

    Khosravi, Azar Dokht; Hashemi Shahraki, Abdolrazagh; Hashemzadeh, Mohammad; Sheini Mehrabzadeh, Rasa; Teimoori, Ali

    2016-01-01

    Non-tuberculous mycobacteria (NTM) are among the emerging pathogens in immunocompromised individuals including hospitalized patients. So, it is important to consider hospitals water supplies as a source for infection. The aim of this study was to determine the prevalence of NTM in the hospital aquatic systems of Khuzestan, South west of Iran. In total, 258 hospital water samples were collected and examined. After initial sample processing, sediment of each sample were inoculated into two Lowenstein-Jensen medium. The positive cultures were studied with phenotypic tests including growth rate, colony morphology, and pigmentation, with subsequent PCR- restriction enzyme analysis (PRA) and rpoB gene sequence analysis. Mycobacterial strains were isolated from 77 samples (29.8%), comprising 52 (70.1%) rapid growing, and 25 (32.4%) slow growing mycobacteria. Based on the overall results, M. fortuitum (44.1%) was the most common mycobacterial species in hospital water samples, followed by M. gordonae (n = 13, 16.8%) and M. senegalense (n = 5, 7.7%). In conclusion, current study demonstrated the NTM strains as one of the major parts of hospital water supplies with probable potential source for nosocomial infections. This finding also help to shed light on to the dynamics of the distribution and diversity of NTM in the water system of hospitals in the region of study. PMID:27148491

  13. [Introduction of hospital information system and anesthesia information management system into the perianesthetic practice at Osaka City University Hospital].

    PubMed

    Shimizu, Motoko; Tanaka, Katsuaki; Hagiwara, Chie; Ikenaga, Kazutake; Yoshioka, Miwako; Asada, Akira

    2011-06-01

    Recently, the hospital information systems (HIS) and anesthesia information management systems (AIMS) have been rapidly improved and have been introduced into the clinical practice in Japan drastically; however, few reports have detailed their influences on clinical practice. We here report our experience. We introduced HIS (EGMAIN-EX, Fujitsu Co., Ltd.) in our preoperative evaluation clinic and in the postoperative care unit. AIMS (ORSYS, Philips Electronics Japan) was introduced almost only to the intraoperative management. It became easy for us to acquire patient's information and to share it with the medical staffs in the other departments. However, we had to invest large human resources for the introduction and maintenance of the HIS and the AIMS. Though AIMS is more useful in anesthetic management than HIS, it seems to be more suitable for coordination with the medical staffs in the other departments to use HIS for perioperative management than to use AIMS.

  14. Estimating the hospitalization burden associated with influenza and respiratory syncytial virus in New York City, 2003–2011

    PubMed Central

    Goldstein, Edward; Greene, Sharon K; Olson, Donald R; Hanage, William P; Lipsitch, Marc

    2015-01-01

    Background Hospitalization burden associated with influenza and respiratory syncytial virus (RSV) is uncertain due to ambiguity in the inference methodologies employed for its estimation. Objectives Utilization of a new method to quantitate the above burden. Methods Weekly hospitalization rates for several principal diagnoses from 2003 to 2011 in New York City by age group were regressed linearly against incidence proxies for the major influenza subtypes and RSV adjusting for temporal trends and seasonal baselines. Results Average annual rates of influenza-associated respiratory hospitalizations per 100 000 were estimated to be 129 [95% CI (79, 179)] for age <1, 36·3 (21·6, 51·4) for ages 1–4, 10·6 (7·5, 13·7) for ages 5–17, 25·6 (21·3, 29·8) for ages 18–49, 65·5 (54·0, 76·9) for ages 50–64, 125 (105, 147) for ages 65–74, and 288 (244, 331) for ages ≥75. Additionally, influenza had a significant contribution to hospitalization rates with a principal diagnosis of septicemia for ages 5–17 [0·76 (0·1, 1·4)], 18–49 [1·02 (0·3, 1·7)], 50–64 [4·0 (1·7, 6·3)], 65–74 [8·8 (2·2, 15·6)], and ≥75 [38·7 (25·7, 52·9)]. RSV had a significant contribution to the rates of respiratory hospitalizations for age <1 [1900 (1740, 2060)], ages 1–4 [117 (70, 167)], and ≥75 [175 (44, 312)] [including chronic lower respiratory disease, 90 (43, 140)] as well as pneumonia & influenza hospitalizations for ages 18–49 [6·2 (1·1, 11·3)] and circulatory hospitalizations for ages ≥75 [199 (13, 375)]. Conclusions The high burden of RSV hospitalizations among young children and seniors age ≥75 suggests the need for additional control measures such as vaccination to mitigate the impact of annual RSV epidemics. Our estimates for influenza-associated hospitalizations provide further evidence of the burden of morbidity associated with influenza, supporting current guidelines regarding influenza vaccination and antiviral treatment. PMID

  15. Estimating the hospitalization burden associated with influenza and respiratory syncytial virus in New York City, 2003-2011.

    PubMed

    Goldstein, Edward; Greene, Sharon K; Olson, Donald R; Hanage, William P; Lipsitch, Marc

    2015-09-01

    Hospitalization burden associated with influenza and respiratory syncytial virus (RSV) is uncertain due to ambiguity in the inference methodologies employed for its estimation. Utilization of a new method to quantitate the above burden. Weekly hospitalization rates for several principal diagnoses from 2003 to 2011 in New York City by age group were regressed linearly against incidence proxies for the major influenza subtypes and RSV adjusting for temporal trends and seasonal baselines. Average annual rates of influenza-associated respiratory hospitalizations per 100 000 were estimated to be 129 [95% CI (79, 179)] for age <1, 36·3 (21·6, 51·4) for ages 1-4, 10·6 (7·5, 13·7) for ages 5-17, 25·6 (21·3, 29·8) for ages 18-49, 65·5 (54·0, 76·9) for ages 50-64, 125 (105, 147) for ages 65-74, and 288 (244, 331) for ages ≥75. Additionally, influenza had a significant contribution to hospitalization rates with a principal diagnosis of septicemia for ages 5-17 [0·76 (0·1, 1·4)], 18-49 [1·02 (0·3, 1·7)], 50-64 [4·0 (1·7, 6·3)], 65-74 [8·8 (2·2, 15·6)], and ≥75 [38·7 (25·7, 52·9)]. RSV had a significant contribution to the rates of respiratory hospitalizations for age <1 [1900 (1740, 2060)], ages 1-4 [117 (70, 167)], and ≥75 [175 (44, 312)] [including chronic lower respiratory disease, 90 (43, 140)] as well as pneumonia & influenza hospitalizations for ages 18-49 [6·2 (1·1, 11·3)] and circulatory hospitalizations for ages ≥75 [199 (13, 375)]. The high burden of RSV hospitalizations among young children and seniors age ≥75 suggests the need for additional control measures such as vaccination to mitigate the impact of annual RSV epidemics. Our estimates for influenza-associated hospitalizations provide further evidence of the burden of morbidity associated with influenza, supporting current guidelines regarding influenza vaccination and antiviral treatment. © 2015 The Authors. Influenza and Other Respiratory Viruses Published by John

  16. [Use of agricultural insecticides in Benin].

    PubMed

    Akogbeto, M C; Djouaka, R; Noukpo, H

    2005-12-01

    The use of insecticides in households and in agriculture has been incriminated in the emergence of insecticide resistance in insect vectors. For farming staff, the emergence of vector resistance is due to indoors spray of insecticides using aerosols and other low quality products in rural and urban settings against mosquitoes. On the other hand, public health specialists believe that the phenomenon of resistance could be due to massive use of insecticides in agriculture for field pests control. In Turkey, the implication of agricultural use of pesticides in the selection of vector resistance is clearly established. This study was framed to identify potential practices favouring the emergence of insecticide resistance in the Republic of Benin. Interviews and focus group discussions were organized with cotton, rice and vegetables farmers. The final aim of these surveys was to point out practices likely to favour the emergence of resistance. The research is conducted in 3 cotton fields, 2 rice fields and 2 vegetable plantations. After filling and signing concerned forms, farmers are subjected to quantitative and qualitative questionnaires to generate data on: insecticides being used, the various doses applied for pests eradication, the frequency of treatments, the cost of treatments (cost/hectare/year) the origin of insecticides, the place of purchase, safety precautions and related health hazards. The results of this study have shown that the use of insecticides in agriculture is a clear fact. During treatments, insecticide residues get in contact with mosquito breeding sites where they diffuse into water and exercise a selection pressure on larvae. This partially explains the high levels of resistance recorded in with strains of Anopheles gambiae collected in agricultural settings under insecticides pressure. Pyrethroids and more specifically deltamethrin and cyfluthrin are the insecticides mainly used in studied localities. Bedrooms of farmers are used as storage

  17. Patterns of asthma death and near-death in an inner-city tertiary care teaching hospital.

    PubMed

    Corn, B; Hamrung, G; Ellis, A; Kalb, T; Sperber, K

    1995-01-01

    Although the pathophysiology of asthma is increasingly understood, asthma deaths continue to increase, especially among non-Caucasians in inner-city urban areas including East Harlem, which has the highest mortality rate in the United States. The cause for this increase is uncertain, but several factors, including poor access to appropriate medical management, the overuse of beta agonists, environmental precipitants, or more severe disease, have been proposed as contributing factors. The Mount Sinai Hospital is a 1300-bed, tertiary care university hospital located at the juncture of East Harlem, an inner-city, predominantly Hispanic and African-American neighborhood, and Carnegie Hill, an affluent, predominantly Caucasian residential area. We examined asthma deaths (13) and near-deaths (20) at the Mount Sinai Hospital from 1986 to 1992 to determine risk factors and compared them to an age- and demographically matched control group. All of the information was based on retrospective patient chart reviews, and the parameters considered included ethnicity, insurance status, poverty level, and medications including the use of beta agonists. All of the asthma deaths and near-deaths except 1 occurred in low-income African-American and Hispanic patients (x = 16.9) However, steroid and beta-agonist usage were comparable in the adverse outcome group compared to the control group. Our results confirm that adverse outcome asthma in East Harlem occurred predominantly among non-Caucasians of low socioeconomic status. We conclude that ethnicity and socioeconomic status play an important role in asthma death and near-death at our institution.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Prevalence and incidence of pressure injuries in pediatric hospitals in the city of São Paulo, SP, Brazil.

    PubMed

    Pellegrino, Donata Maria de Souza; Chacon, Julieta Maria Ferreira; Blanes, Leila; Ferreira, Lydia Masako

    2017-07-12

    To identify the incidence and prevalence of pressure injuries (PIs) in children admitted to hospitals in the city of São Paulo, and assess the association between sociodemographic and clinical characteristics with hospital-acquired pressure injuries (HAPIs). A total of 543 children were evaluated, and their sociodemographic and clinical data were recorded. Student's t, Wilcoxon, chi-square, and Fisher's exact tests were used to assess associations between risk factors and the occurrence of HAPIs. The proportion comparison test was used to assess the difference between the prevalence assessments performed at 2 different time points. The mean prevalence was 7.1% and the mean incidence was 21.8%. Stage 1 PIs totaled 55% of the occurrences, followed by deep tissue injury, stage 2 PIs, and unstageable PIs. Twenty-five percent of PIs were associated with the use of medical devices. The sociodemographic characteristics significantly associated with HAPIs were white skin color and the absence of a parent or guardian as the patient's companion, whereas the clinical characteristics most significantly associated with HAPIs were hospitalization time greater than 30 days, enteral nutrition pathway, a chronic illness of the central nervous system, vasomotor medication, and mechanical ventilation (p < 0.05). The prevalence of PIs among pediatric patients admitted to hospitals in São Paulo was similar to, and the incidence was higher than the reported international rates. Patients not accompanied by a parent, hospitalized for longer periods and in critical condition were those most affected by PIs. Copyright © 2017 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  19. [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.

  20. Pollen exposure and hospitalization due to asthma exacerbations: daily time series in a European city

    NASA Astrophysics Data System (ADS)

    Osborne, Nicholas J.; Alcock, Ian; Wheeler, Benedict W.; Hajat, Shakoor; Sarran, Christophe; Clewlow, Yolanda; McInnes, Rachel N.; Hemming, Deborah; White, Mathew; Vardoulakis, Sotiris; Fleming, Lora E.

    2017-05-01

    Exposure to pollen can contribute to increased hospital admissions for asthma exacerbation. This study applied an ecological time series analysis to examine associations between atmospheric concentrations of different pollen types and the risk of hospitalization for asthma in London from 2005 to 2011. The analysis examined short-term associations between daily pollen counts and hospital admissions in the presence of seasonal and long-term patterns, and allowed for time lags between exposure and admission. Models were adjusted for temperature, precipitation, humidity, day of week, and air pollutants. Analyses revealed an association between daily counts (continuous) of grass pollen and adult hospital admissions for asthma in London, with a 4-5-day lag. When grass pollen concentrations were categorized into Met Office pollen `alert' levels, `very high' days (vs. `low') were associated with increased admissions 2-5 days later, peaking at an incidence rate ratio of 1.46 (95%, CI 1.20-1.78) at 3 days. Increased admissions were also associated with `high' versus `low' pollen days at a 3-day lag. Results from tree pollen models were inconclusive and likely to have been affected by the shorter pollen seasons and consequent limited number of observation days with higher tree pollen concentrations. Future reductions in asthma hospitalizations may be achieved by better understanding of environmental risks, informing improved alert systems and supporting patients to take preventive measures.

  1. Antibiotic Resistance and Biofilm Production in Staphylococcus epidermidis Strains, Isolated from a Tertiary Care Hospital in Mexico City

    PubMed Central

    Cabrera-Contreras, Roberto; Morelos-Ramírez, Rubén; Galicia-Camacho, Ada Nelly; Meléndez-Herrada, Enrique

    2013-01-01

    Staphylococcus epidermidis strains isolated from nosocomial infections represent a serious problem worldwide. In various Mexican states several reports have shown isolates from hospitals with antibiotic resistance to methicillin. In Mexico City, there is scarce information on staphylococcal infections in hospitals. Here, our research findings are shown in a four-year period study (2006–2010) for Staphylococcus epidermidis strains. Susceptibility and/or resistance to antibiotics in SE strains were assessed by phenotypic and molecular methods as mecA gene by PCR, as well as the correlation with biofilm production for these isolates and the relationship to the infection site. Out of a total of 161 (66%) negative biofilm SE strains, just 103 (64%) SE strains were confirmed as MRSE by PCR to mecA gene. From 84 (34%) positive biofilm SE strains, 76 (91%) were confirmed as MRSE by PCR to mecA gene. Higher percentages of resistance to antibiotics and higher number of resistance markers were found in biofilm-forming clinical strains (9 to 14) than non-biofilm-forming SE strains (3 to 8). These research findings represent a guide to establish infection control programs for this hospital. PMID:23724338

  2. 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.

  3. Sustaining malaria prevention in Benin: local production of bednets.

    PubMed

    Rashed, S; Johnson, H; Dongier, P; Gbaguidi, C C; Laleye, S; Tchobo, S; Gyorkos, T W; Maclean, J D; Moreau, R

    1997-03-01

    Through a Benin-Canada participatory research initiative which included both Benin and Canadian non-governmental organizations, a local capacity to produce and market bednets for the prevention of malaria was developed. The development process began following a community-based assessment of local needs and skills. All materials for the manufacture and distribution of the bednets were obtained locally with the exception of the netting which was imported from Canada. The sustainability of the enterprise is enhanced by the community's recognition of the importance of malaria and the culturally acceptable practice of bednet use.

  4. 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

  5. Handheld sun photometer measurements in Southwestern Africa: results from Benin and Ivory Coast.

    NASA Astrophysics Data System (ADS)

    Leon, Jean-François; Akpo, Aristide; Bedou, Mohamadou; Bodjrenou, Marleine; Djossou, Julien; Konaté, Ismael; Yoboué, Véronique; Liousse, Cathy

    2017-04-01

    The atmosphere of the Gulf of Guinea and adjacent countries is influenced by a large amount of aerosol particles advected from the African continent. This place is one of the hot-spot of aerosol optical depth (AOD) in the world. However AOD in situ observations remains scarce in this area. We present in this paper new measurements of the AOD at 4 sites in southwestern Africa: Cotonou (6.37°N, 2.43°W) and Savè (8.1°N, 2.4°E) cities in Benin, and Abidjan (5.34°N, 3.99°W) city and Lamto (6.22°N, 5.03°W) observatory in Côte d'Ivoire. We use a lightweight handheld sun photometer measuring the solar irradiance at 465, 540 and 619 nm operated manually once per day. Measurements are performed without cloud cover in the field of view. Possible remaining cloud contamination is removed by checking the AOD variability during the measurement sequence. A total of 708 daily observations have been acquired in 2015. The AOD time series in Benin and Ivory Coast highlight a seasonal cycle with a maximum during the dry season (December-Mars) and a minimum during the wet season (May-September). The Angström exponent derived from the spectral AOD measurements enables to attribute the maximum AOD to the presence of large desert dust particles advected by the Harmattan wind during the dry season. We have found an excellent agreement (overall correlation coefficient R=0.85) between our data set and the MODIS (Moderate Imaging Spectroradiometer) aerosol products.

  6. Air pollution and hospital admissions for asthma in a tropical city: Kaohsiung, Taiwan

    SciTech Connect

    Shang-Shyue Tsai; Meng-Hsuan Cheng; Hui-Fen Chiu; Trong-Neng Wu; Chun-Yuh Yang

    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 associated 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.

  7. Association between PM10 and respiratory hospital admissions in different seasons in heavily polluted Lanzhou City.

    PubMed

    An, Xingqin; Yan, Tao; Mi, Shengquan; Sun, Zhaobin; Hou, Qing

    2015-01-01

    Exposure-response relationship between particulate matter less than 10 μm in diameter (PM10) and human health in different seasons from 2001 to 2005 was examined based on hospital admissions data of respiratory system diseases from four major hospitals in Lanzhou, China. To quantify associations of respiratory system diseases with multiple air pollutants and meteorological conditions, a semiparametric generalized additive model was used in the authors' study by implementing daily ambient sulfur dioxide, nitrogen dioxide, and PM10 data collected from the Lanzhou Environmental Monitoring Station and daily meteorological data from Lanzhou Meteorological Bureau. Results showed that daily averaged PM10 increased per interquartile range the hospital admissions number of respiratory diseases by 3.3% in spring, 1.4% in summer, 3.6% in autumn, and 4.0% in winter from a single-pollutant model, or 3.1%, 1.4%, 3.0%, and 4.0% from a multi-pollutant model, respectively. The effect of PM10 on respiratory hospital admissions was lowest in summer and highest in winter. The relative risks of PM10 on female or the elderly (≥ 65 yrs.) were higher, showing a stronger association of PM10 with respiratory diseases in female and elderly groups than in males and people younger than 65.

  8. [Overview of hospital mortality at the National Institute of Neurology and Neurosurgery of Mexico City].

    PubMed

    Velásquez-Pérez, Leora; Núñez-Santes, Agustín; Contreras-Cortés, Guadalupe Araceli

    2009-01-01

    Knowing the mortality of the population that goes to medical care, allows to the hospitals institutions and the government to make decisions on the services of health and the conditions of attention. Our objective was to describe the frequency and trend of the main causes of neurological hospital mortality for the period 2002-2007 in the National Institute of Neurology andNeurosurgery "Manuel Velasco Suárez". The data was obtained from hospital discharge registers and medical records. Rates of hospital mortality and the tendency were calculated during the period of study. The overall mortality rate was 4.9 per each 100 discharges. The leading causes of death were cerebrovascular diseases and brain tumors and there was a tendency for increased mortality in cases associated with human immunodeficiency virus (HIV) for men p = 0.004 and p = 0.05 for women with epilepsy, and with a status of epileptic condition. The cerebrovascular diseases and brain tumors tend to hold the first places. The mortality for neurological complications resulting from the diseases caused by the HIV is increasing. It is necessary to promote programs to prevent cardiovascular and HIV infection risk factors, to decrease the mortality rates from these diseases.

  9. Carbapenem-Resistant Klebsiella pneumoniae Infection in Three New York City Hospitals Trended Downwards From 2006 to 2014

    PubMed Central

    Liu, Jianfang; Furuya, E. Yoko; Larson, Elaine L.

    2016-01-01

    Background. Carbapenem-resistant Klebsiella pneumoniae (CRKP) infection is a rising public health threat since its first outbreaks in New York City (NYC) in the early 2000s. We investigated annual trends of CRKP infection in hospital-acquired infections (HAIs) and community-onset infections (COIs) treated in 3 NYC hospitals from 2006 to 2014. Methods. We extracted K pneumoniae infection data including carbapenem susceptibility and anatomical sites, compared clinical characteristics between CRKP and carbapenem-susceptible K pneumoniae infections, and determined CRKP infection proportions in total K pneumoniae infections in HAI and COI to identify statistically significant trends from 2006 to 2014 using the Cochran-Armitage trend test. Results. Carbapenem-resistant K pneumoniae contributed 17.3% (601 of 3477) of hospital-acquired K pneumoniae infection compared with 7.7% (149 of 1926) in COI from 2006 to 2014. Carbapenem-resistant K pneumoniae proportions in HAI and COI were positively correlated over time (r = 0.83, P < .01), and there were downward annual trends of CRKP proportions from 2006 to 2014 in both HAI and COI (25.8% to 10.5% in HAI, P < .001; 13.6% to 3.1% in COI, P < .001). By anatomical site, significant downward annual trends were present only in urinary tract infection (P < .001 for both HAI and COI) from 2006 to 2014. Conclusions. Annual trends of CRKP proportions from 2006 to 2014 were downward in both HAI and COI, and HAI and COI were positively correlated. Efforts to reduce and prevent CRKP infections in both hospital and community settings were successful and warrant continuation. PMID:27942542

  10. 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.

  11. Attributable risks of emergency hospital visits due to air pollutants in China: A multi-city study.

    PubMed

    Chen, Gongbo; Zhang, Yongming; Zhang, Wenyi; Li, Shanshan; Williams, Gail; Marks, Guy B; Jalaludin, Bin; Abramson, Michael J; Luo, Fengming; Yang, Dong; Su, Xin; Lin, Qichang; Liu, Laiyu; Lin, Jiangtao; Guo, Yuming

    2017-09-01

    Air pollution is associated with risks of mortality in China, but the evidence is still limited for morbidity. This study aims to examine overall effects of ambient air pollutants on emergency hospital visits (EHVs) at the national level in China and calculate corresponding attributable risks. We collected daily data for EHVs from 33 largest hospitals in China between Oct 2013 and Dec 2014, as well as daily measurements of particulate matter (PM10 and PM2.5: particles with aerodynamic diameter < 10 μm and 2.5 μm, respectively), nitrogen dioxide (NO2) and sulphur dioxide (SO2) from 31 cities where the hospitals were located. Firstly, quasi-Poisson regression with a constrained distributed lag model (CDLM) was employed to examine city-specific associations of EHVs with each pollutant. Then, the effects at the national scale were pooled with a random-effect meta-analysis. Daily EHVs was significantly associated with a 10 μg/m3 increase in PM2.5 at lag 0-2 days [cumulative relative risk (RR) and 95% confidence intervals (CI): 1.006 (1.002, 1.009)], PM10 at lag 0-1 days [1.004 (1.002, 1.006)], NO2 at lag 0-1 days [1.015 (1.010, 1.019)] and SO2 at lag 0-2 days [1.022 (1.014, 1.030)]. The effect estimates were not modified by sex, but stronger effects were observed among children than adults. Overall, 3.34% of EHVs may result from exposure to ambient PM2.5, 3.96% to PM10, 5.90% to NO2 and 5.38% to SO2. Exposure to outdoor air pollution has acute effects on EHVs. Effective measures to control air pollution levels in China could potentially reduce demands for emergency hospital services. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. [Genotyping of Cryptococcus neoformans/Cryptococcus gattii complex clinical isolates from Hospital "Dr. Julio C. Perrando", Resistencia city (Chaco, Argentina)].

    PubMed

    Cattana, Maria E; Tracogna, Maria F; Fernández, Mariana S; Carol Rey, Mariana C; Sosa, Maria A; Giusiano, Gustavo E

    2013-01-01

    Cryptococcosis is a fungal infection caused by yeast species of Cryptococcus genus, particularly Cryptococcus neoformans/Cryptococcus gattii species complex. The knowledge of the cryptococcosis casuistic in northeastern Argentina is scarce and there is no information about the molecular types circulating in this area. The aim of this study was to genotyping C. neoformans/C. gattii complex clinical isolates obtained at Hospital "Dr. Julio C. Perrando", Resistencia city (Chaco, Argentina), in order to determine species, variety and molecular type. During two years and one month 26 clinical isolates were studied. Using conventional and molecular methods one isolate was identified as C. gattii VGI type, and 25 isolates as C. neoformans var. grubii; 23 of these belonged to VNI type and two belonged to VNII type. This data is a contribution to the knowledge of cryptococcosis epidemiology in Argentina and the first report about C. neoformans/ C. gattii complex molecular types from clinical isolates in northeastern Argentina.

  13. Annual economic burden of hepatitis B virus-related diseases among hospitalized patients in twelve cities in China.

    PubMed

    Zhang, S; Ma, Q; Liang, S; Xiao, H; Zhuang, G; Zou, Y; Tan, H; Liu, J; Zhang, Y; Zhang, L; Feng, X; Xue, L; Hu, D; Cui, F; Liang, X

    2016-03-01

    A nationwide survey of hepatitis B virus (HBV)-associated economic burden has not previously been performed in China. The purpose of this study was to examine the direct, indirect, and intangible costs of HBV-related diseases within the span of one year. A random sample was taken from specialty and general hospitals across 12 cities in six provinces of China. Intangible costs were estimated based on willingness to pay or open-ended answers provided by patients. The results showed that 27 hospitals were enrolled, with a sample population of 4726 patients (77.7% response rate). The average annual costs were $4454.0 (direct), $924.3 (indirect), and $6611.10 (intangible), corresponding to 37.3%, 7.7%, and 55.1% of the total costs, respectively. The direct medical fees were substantially greater than the non-medical fees. Annual indirect costs were divided into outpatient ($112.9) and inpatient ($811.40) loss of income. The intangible costs of chronic HBV were notably higher than either the direct or indirect costs, consistent with the social stigma in China. The comparison amongst individual cities for the average ratio of direct to indirect costs revealed that the sizes of ratios were negatively correlated with the socioeconomic status of the regions. This study suggested that as a whole in China, the HBV-related diseases caused a heavy financial burden which was positively associated with disease severity. Although the intangible costs coincided with a high prevalence of discrimination against CHB patients in Chinese society, our study may serve as future reference for detailed exploration.

  14. The effect of radiology services outsourcing on patients' satisfaction in Tehran city hospitals.

    PubMed

    Mousavi, H; Khodamoradi, F; Rostami Zarinabadi, C H; 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 individual and

  15. [Frequency and antimicrobial resistance of Acinetobacter species in a university hospital of Buenos Aires City].

    PubMed

    Rodríguez, Carlos Hernán; Nastro, Marcela; Dabos, Laura; Vay, Carlos; Famiglietti, Angela

    2014-01-01

    Two-hundred Acinetobacter isolates belonging to 200 patients admitted to Hospital de Clínicas José de San Martín during the period March 2013-June 2014 were analyzed. The identification was performed by mass spectrometry and was confirmed by molecular methods. Susceptibility to antimicrobials was studied by the Vitek-2 system. A 94% correlation of both identification methods was found. Multidrug resistant Acinetobacter baumannii was the predominant genomic species (92.6%) in hospital-acquired infections, whereas Acinetobacter pitti and Acinetobacter nosocomialis accounted for 3.5% and 0.5% of the isolates recovered, respectively. In community-acquired infections a major predominance of the different genomic species was observed. Acinetobacter johnsonii and A. baumannii are the most frequent species, accounting for 45.9% of the isolates recovered. Resistance to carbapenems and minocycline was only observed in A. baumannii. Mass spectrophotometry was an effective tool for the identification of the different genomic species.

  16. Maximizing appropriate antibiotic prophylaxis for surgical patients: an update from LDS Hospital, Salt Lake City.

    PubMed

    Burke, J P

    2001-09-01

    Errors in antimicrobial prophylaxis for surgical patients remain one of the most frequent types of medication errors in hospitals. Failure to administer the first dose of antimicrobial prophylaxis within the 2-h window of time before incision is associated with 2- to 6-fold increases in rates of surgical site infection. Optimal use of antimicrobial prophylaxis includes proper case selection; use of appropriate agents; proper dosing, route of administration, timing, and duration; and intraoperative dosing when appropriate. Effective use of antimicrobial prophylaxis also requires monitoring of and feedback on patterns of use. Programs to improve antimicrobial prophylaxis should be multidisciplinary and should aim to improve use of medications, not simply to change physician practice patterns. The LDS Hospital experience demonstrates the clinical and financial benefits of such a program and also shows the pitfalls of and great difficulties associated with changing systems of care.

  17. Outcomes of Patients With Cocaine Induced Chest Pain in An Inner City Hospital

    PubMed Central

    Atoui, Moustapha; Fida, Nadia; Nayudu, Suresh Kumar; Glandt, Mariela; Chilimuri, Sridhar

    2011-01-01

    Background Cocaine induced chest pain is a major reason for admission in Safety Net Hospitals in the United States. The majority of patients admitted undergo extensive work-up leading to enormous economic burden. We hypothesize that in individuals with low risk, cocaine does not further increase adverse cardiovascular outcomes. Methods We conducted a retrospective chart review of all patients admitted with chest pain to our hospital between 07/01/09 and 06/30/10. We excluded patients with modifiable risk factors for coronary artery disease (CAD). The study population was divided into cocaine and non-cocaine group based on urine drug screen. We analyzed data including demographic, laboratory, cardiac testing, detection of CAD, length of stay and mortality rates. Results A total of 426 individuals matched our inclusion and exclusion criteria and were considered to have no known modifiable cardiac risk factors; 54 in cocaine group and 372 in non-cocaine group. Based on physician discretion, 41(76%) in the cocaine group and 239(64%) in the non-cocaine group underwent various modalities of cardiac testing. Cardiac testing was positive in 6(2.5%) patients in non-cocaine group and none in the cocaine group (p=0.597). There was no significant difference between length of stay and in-hospital mortality between the two groups. Conclusions In individuals at low risk for CAD, cocaine use resulted in higher rate of cardiac testing. However, there is no difference in prevalence of CAD and in-hospital mortality between the two groups. We conclude that cocaine does not increase adverse outcomes in patients with low risk for CAD.

  18. [Optimization of hospital services extended to residents in a big industrial city].

    PubMed

    Gaĭdarov, G M; Kitsul, I S; Kulesh, D V

    2003-01-01

    Scientific approaches to optimizing the hospital medical care with respect to 3 healthcare levels (regional, municipal and departmental) are presented in the paper. An appropriate model of patient-care facilities aimed at solving the issues of intersectoral involvement of such regional, municipal and departmental institutions in implementing the Territorial Program of State Guarantees in Rendering the Free-Of-Charge Medical Care To Population is suggested.

  19. 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

  20. Using Social Media to Perform Local Influenza Surveillance in an Inner-City Hospital: A Retrospective Observational Study.

    PubMed

    Broniatowski, David Andre; Dredze, Mark; Paul, Michael J; Dugas, Andrea

    2015-01-01

    Public health officials and policy makers in the United States expend significant resources at the national, state, county, and city levels to measure the rate of influenza infection. These individuals rely on influenza infection rate information to make important decisions during the course of an influenza season driving vaccination campaigns, clinical guidelines, and medical staffing. Web and social media data sources have emerged as attractive alternatives to supplement existing practices. While traditional surveillance methods take 1-2 weeks, and significant labor, to produce an infection estimate in each locale, web and social media data are available in near real-time for a broad range of locations. The objective of this study was to analyze the efficacy of flu surveillance from combining data from the websites Google Flu Trends and HealthTweets at the local level. We considered both emergency department influenza-like illness cases and laboratory-confirmed influenza cases for a single hospital in the City of Baltimore. This was a retrospective observational study comparing estimates of influenza activity of Google Flu Trends and Twitter to actual counts of individuals with laboratory-confirmed influenza, and counts of individuals presenting to the emergency department with influenza-like illness cases. Data were collected from November 20, 2011 through March 16, 2014. Each parameter was evaluated on the municipal, regional, and national scale. We examined the utility of social media data for tracking actual influenza infection at the municipal, state, and national levels. Specifically, we compared the efficacy of Twitter and Google Flu Trends data. We found that municipal-level Twitter data was more effective than regional and national data when tracking actual influenza infection rates in a Baltimore inner-city hospital. When combined, national-level Twitter and Google Flu Trends data outperformed each data source individually. In addition, influenza

  1. 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…

  2. Campus Planning in Nigeria. Case Study: University of Benin.

    ERIC Educational Resources Information Center

    Bennet, Bob

    A case study of the University of Benin in Nigeria illustrates campus planning in the development of a university. Eight aspects of university planning are considered: (1) the functions of a university (students, staff, facility capacity); (2) residential accommodation for students and staff; (3) commercial facilities (shopping); (4) environment…

  3. 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…

  4. A Complexity Theory Analysis of Educational Reform in Benin.

    ERIC Educational Resources Information Center

    David-Gnahoui, Emmanuel

    Benin is breaking new ground through a profound reform of its primary school system. The innovation in the system is the revolutionary approach as regards educational practice. The main focus has shifted, in the objectives of the curriculum, from what to teach to whom to empower. This paper analyzes the Reforme de l'ecole de qualite fondamentale…

  5. Performance of Implementing Guideline Driven Cervical Cancer Screening Measures in an Inner City Hospital System

    PubMed Central

    Wieland, Daryl L.; Reimers, Laura L.; Wu, Eijean; Nathan, Lisa M.; Gruenberg, Tammy; Abadi, Maria; Einstein, Mark H.

    2013-01-01

    Objective In 2006, the American Society for Colposcopy and Cervical Pathology (ASCCP) updated evidence based guidelines recommending screening intervals for women with abnormal cervical cytology. In our low-income inner city population, we sought to improve performance by uniformly applying the guidelines to all patients. We report the prospective performance of a comprehensive tracking, evidence-based algorithmically driven call-back and appointment scheduling system for cervical cancer screening in a resource-limited inner city population. Materials and Methods Outreach efforts were formalized with algorithm-based protocols for triage to colposcopy, with universal adherence to evidence-based guidelines. During implementation from August 2006 through July 2008, we prospectively tracked performance using the electronic medical record with administrative and pathology reports to determine performance variables such as the total number of Pap tests, colposcopy visits, and the distribution of abnormal cytology and histology results, including all CIN 2,3 diagnoses. Results 86,257 gynecologic visits and 41,527 Pap tests were performed system-wide during this period of widespread and uniform implementation of standard cervical cancer screening guidelines. The number of Pap tests performed per month varied little. The incidence of CIN 1 significantly decreased from 117/171 (68.4%) the first tracked month to 52/95 (54.7%) the last tracked month (p=0.04). The monthly incidence rate of CIN 2,3, including incident cervical cancers did not change. The total number of colposcopy visits declined, resulting in a 50% decrease in costs related to colposcopy services and approximately a 12% decrease in costs related to excisional biopsies. Conclusions Adherence to cervical cancer screening guidelines reduced the number of unnecessary colposcopies without increasing numbers of potentially missed CIN 2,3 lesions, including cervical cancer. Uniform implementation of administrative

  6. 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.

  7. Non-insertive Acupuncture and Neonatal Abstinence Syndrome: A Case Series From an Inner-city Safety Net Hospital

    PubMed Central

    White, Laura F.; Spellman, Lisa W.; Broderick, Maria; Highfield, Ellen Silver; Sommers, Elizabeth; Gardiner, Paula

    2012-01-01

    Objective: We report on the safety of non-insertive acupuncture (NIA) in 54 newborns diagnosed with neonatal abstinence syndrome (NAS) in a busy inner-city hospital. Methods: For this case series, a retrospective chart review was conducted. Data on participant demographics, number of NIA treatments, provider referrals, and outcomes of interest (sleeping, feeding, and adverse events) were collected. Results: Of the 54 newborns receiving NIA, 86% were non-Hispanic white; 87% were on Medicaid, and gestational age ranged from 33.2 to 42.1 weeks. Out of 54 chart reviews, a total of 92 NIA sessions were documented ranging from 1 to 6 sessions per infant. Of the total number of treatments (n = 92), 73% were requested by a physician. Chart reviews reported that restless infants calmed down during NIA, babies slept through or fell asleep immediately following NIA, and better feeding was noted following NIA. There were no adverse events noted in the medical records. Conclusions: This retrospective chart review shows potential for the use of NIA as an adjunctive treatment in newborns with NAS symptoms during hospitalization. More research is necessary to study whether the incorporation of NIA can result in positive outcomes in newborns withdrawing from narcotics. PMID:24078899

  8. A prospective multi-center observational study of children hospitalized with diarrhea in Ho Chi Minh City, Vietnam.

    PubMed

    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

    2015-05-01

    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.

  9. Clinical profile of dengue in patients consulting a tertiary hospital in the city of Cali, Colombia, 2013.

    PubMed

    Matta, Lorena; Barbosa, Mario M; Morales-Plaza, Cristhian D

    2016-03-03

    Dengue virus infection is amongst the most important arboviral diseases in the country and has become a major global public health concern.  To describe the clinical profile of patients with dengue virus infection hospitalized in a tertiary hospital in the city of Cali, Colombia. We also describe the trend analysis of the number of cases by epidemiological weeks in 2013.  We conducted a retrospective study of admitted patients suspected to have dengue infection in the Rafael Uribe Uribe Clinic in the year 2013. Patients with serological confirmation of dengue infection were classified according to the World Health Organization classification. Subsequently, the clinical parameters of the patients with dengue were described.  Of the 1,173 patients with suspected dengue, 287 (24.5%) were confirmed serologically; 152 (53%) were women and 135 (47%) males; 40.1% had no warning signs, 3.8% had warning signs and 25.1% had severe manifestations. The most common symptoms were fever (287;100%), myalgia (223;78%), and headache (183:64%). Hemorrhagic manifestations were recorded in 100 (34.8%) patients; 4 (1.4%) had neurological manifestations. Three deaths (0.7%) were reported, two of which were associated with sickle cell disease.  The severe form of the infection and mortality from dengue reported during the outbreak was more frequent in the pediatric population. It is suggested to implement strategies to ensure specific attention to patients with comorbidities such as sickle cell disease.

  10. Evacuation and deprivation: the wartime experience of the Devon and Exeter City Mental Hospitals.

    PubMed

    Pearce, David

    2011-09-01

    In Exeter, the need for space to treat casualties in World War II led to a significant reduction in capacity at one psychiatric hospital and the closure of another. In spite of this, inpatient stays were longer than in peacetime, partly due to relatives who had to weigh up the advantages and disadvantages of having their unwell kin returned to them. In the latter years of the war, admissions from the Devon catchment area were higher than in peacetime. Having more patients who stayed longer was largely compensated for by utilizing free space as opposed to reducing admissions, leading to overcrowding and a restricted inpatient regime.

  11. Spatio-temporal ozone variation in a case-crossover analysis of childhood asthma hospital visits in New York City.

    PubMed

    Shmool, Jessie Loving Carr; Kinnee, Ellen; Sheffield, Perry Elizabeth; Clougherty, Jane Ellen

    2016-05-01

    Childhood asthma morbidity has been associated with short-term air pollution exposure. To date, most investigations have used time-series models, and it is not well understood how exposure misclassification arising from unmeasured spatial variation may impact epidemiological effect estimates. Here, we develop case-crossover models integrating temporal and spatial individual-level exposure information, toward reducing exposure misclassification in estimating associations between air pollution and child asthma exacerbations in New York City (NYC). Air pollution data included: (a) highly spatially-resolved intra-urban concentration surfaces for ozone and co-pollutants (nitrogen dioxide and fine particulate matter) from the New York City Community Air Survey (NYCCAS), and (b) daily regulatory monitoring data. Case data included citywide hospital records for years 2005-2011 warm-season (June-August) asthma hospitalizations (n=2353) and Emergency Department (ED) visits (n=11,719) among children aged 5-17 years. Case residential locations were geocoded using a multi-step process to maximize positional accuracy and precision in near-residence exposure estimates. We used conditional logistic regression to model associations between ozone and child asthma exacerbations for lag days 0-6, adjusting for co-pollutant and temperature exposures. To evaluate the effect of increased exposure specificity through spatial air pollution information, we sequentially incorporated spatial variation into daily exposure estimates for ozone, temperature, and co-pollutants. Percent excess risk per 10ppb ozone exposure in spatio-temporal models were significant on lag days 1 through 5, ranging from 6.5 (95% CI: 0.2-13.1) to 13.0 (6.0-20.6) for inpatient hospitalizations, and from 2.9 (95% CI: 0.1-5.7) to 9.4 (6.3-12.7) for ED visits, with strongest associations consistently observed on lag day 2. Spatio-temporal excess risk estimates were consistently but not statistically significantly higher

  12. Risk Factors for Neonatal Sepsis in Public Hospitals of Mekelle City, North Ethiopia, 2015: Unmatched Case Control Study.

    PubMed

    Gebremedhin, Destaalem; Berhe, Haftu; Gebrekirstos, Kahsu

    2016-01-01

    Neonatal sepsis is a leading cause of neonatal morbidity and mortality, particularly in the developing countries. Delays in the identification and treatment of neonatal sepsis are among the main contributors to the high mortality. The aim of this study was to determine the risk factors of neonatal sepsis in public hospitals of Mekelle City, Tigray Region, North Ethiopia, 2015. A hospital based case control study was done in public hospitals of Mekelle City, Tigray region. Cases were neonates who had sepsis with their index mothers and controls were neonates who hadn't had sepsis with their index mothers. Hematologic findings were used to diagnose sepsis once the neonates were being clinically suspected. Cases and controls were selected using the systematic sampling technique. Data were entered using Epi info version 7 and then analyzed using SPSS window 20. The binary logistic regression model was used to test the association between dependent and independent variables and multivariable logistic regression was used to identify the associated risk factors to neonatal sepsis. A total of 78 cases and 156 controls were included in this study. More than three quarters (76.8%) of cases had early onset sepsis. The multivariable logistic regression analysis showed that the possible risk factors of neonatal sepsis in this study were; history of maternal urinary tract infection or sexually transmitted infection [AOR = 5. 23; 95% CI (1.82, 15.04)], prolonged rupture of membrane [AOR = 7. 43; 95% CI (2.04, 27.1)], Place of delivery; health center delivery [AOR = 5. 7; 95% CI (1.71, 19.03)], intrapartum fever [AOR = 6. 1 95% CI (1.29, 28.31)], APGAR score <7 at 5th minute [AOR = 68. 9; 95% CI (3.63, 1308)] and not crying immediately at birth [AOR = 124. 0; 95% CI (6.5, 2379)]. Both maternal and neonatal factors had contributed to the risk of neonatal sepsis. Strengthening of the existing risk based prevention strategies as well as improvement of institutional delivery practices

  13. Spatio-temporal ozone variation in a case-crossover analysis of childhood asthma hospital visits in New York City

    PubMed Central

    Shmoola, Jessie Loving Carr; Kinneea, Ellen; Sheffieldb, Perry Elizabeth; Cloughertya, Jane Ellen

    2017-01-01

    Background Childhood asthma morbidity has been associated with short-term air pollution exposure. To date, most investigations have used time-series models, and it is not well understood how exposure misclassification arising from unmeasured spatial variation may impact epidemiological effect estimates. Here, we develop case-crossover models integrating temporal and spatial individual-level exposure information, toward reducing exposure misclassification in estimating associations between air pollution and child asthma exacerbations in New York City (NYC). Methods Air pollution data included: a) highly spatially-resolved intra-urban concentration surfaces for ozone and co-pollutants (nitrogen dioxide and fine particulate matter) from the New York City Community Air Survey (NYCCAS), and b) daily regulatory monitoring data. Case data included citywide hospital records for years 2005–2011 warm-season (June – August) asthma hospitalizations (n = 2,353) and Emergency Department (ED) visits (n = 11,719) among children aged 5 to 17 years. Case residential locations were geocoded using a multi-step process to maximize positional accuracy and precision in near-residence exposure estimates. We used conditional logistic regression to model associations between ozone and child asthma exacerbations for lag days 0 to 6, adjusting for co-pollutant and temperature exposures. To evaluate the effect of increased exposure specificity through spatial air pollution information, we sequentially incorporated spatial variation into daily exposure estimates for ozone, temperature, and co-pollutants. Results Percent excess risk per 10 ppb ozone exposure in spatio-temporal models were significant on lag days 1 through 5, ranging from 6.5 (95% CI: 0.2 – 13.1) to 13.0 (6.0 – 20.6) for inpatient hospitalizations, and from 2.9 (95% CI: 0.1 – 5.7) to 9.4 (6.3 – 12.7) for ED visits, with strongest associations consistently observed on lag day 2. Spatio-temporal excess risk estimates

  14. Evaluating a decade of exposures to blood and body fluids in an inner-city teaching hospital.

    PubMed

    Treakle, Amy M; Schultz, Maureen; Giannakos, George P; Joyce, Patrick C; Gordin, Fred M

    2011-09-01

    To analyze a decade of hospital staff and student exposures to blood and body fluids (BBF) and to identify risk factors relevant to prevention strategies. Retrospective review of a 1999-2008 data set of BBF exposures. The data, maintained by occupational health staff, detailed the type of exposure, the setting in which the exposure occurred, and the occupational group of the BBF-exposed personnel. Washington DC Veterans Affairs Medical Center (VA-DC), an inner-city tertiary care hospital. All healthcare workers and staff at the VA-DC. Review of database. A review of 10 years of data revealed 564 occupational exposures to BBF, of which 66% were caused by needlesticks and 20% were caused by sharp objects. Exposures occurred most often in the acute care setting (which accounted for 39% of exposures) and the operating room (which accounted for 22%). There was a mean of 4.9 exposures per 10,000 acute care patient-days, 0.5 exposures per 10,000 long-term care patient-days, and 0.35 exposures per 10,000 outpatient visits. Housestaff accounted for the highest number of all exposures (196 [35%]). There were, on average, 15.2 exposures per 100 housestaff full-time equivalents. An average of only 1 exposure per year occurred in the hemodialysis center.  Occupational exposures to BBF remain common, but rates vary widely by setting and occupational group. Overall rates are steady across a decade, despite the use of various antiexposure devices and provider education programs. Targeting occupational groups and hospital settings that have been shown to have the highest risk rates should become foundational to future preventative strategies.

  15. Amenagement et politique linguistques: La politique des langues au Benin (Language Management and Language Policy: The Politics of Language in Benin).

    ERIC Educational Resources Information Center

    Halaoui, Nazam

    2001-01-01

    Distinguishing between language management and language policy, examines the politics of language in Benin from independence to the present. Describes the politics of language in Dahomey, the early policies of Benin, and the Republican politics of language, arising from the national constitutional convention and striving to address the needs of…

  16. Laparoscopic management of pancreatic pseudocysts: experience at a general hospital in Mexico City.

    PubMed

    Crisanto-Campos, B A; Arce-Liévano, E; Cárdenas-Lailson, L E; Romero-Loera, L S; Rojano-Rodríguez, M E; Gallardo-Ramírez, M A; Cabral-Oliver, J; Moreno-Portillo, M

    2015-01-01

    Invasive management of pancreatic pseudocysts (PP) is currently indicated in those patients with symptoms or complications. Treatment options are classified as surgical (open and laparoscopic) and non-surgical (endoscopic and radiologic). To describe the morbidity, mortality, and efficacy in terms of technical and clinical success of the laparoscopic surgical approach in the treatment of patients with PP in the last 3 years at our hospital center. We included patients with PP treated with laparoscopic surgery within the time frame of January 2012 and December 2014. The morbidity and mortality associated with the procedure were determined, together with the postoperative results in terms of effectiveness and recurrence. A total of 38 patients were diagnosed with PP within the last 3 years, but only 20 of them had invasive treatment. Laparoscopic surgery was performed on 17 of those patients (mean pseudocyst diameter of 15.3, primary drainage success rate of 94.1%, complication rate of 5.9%, and a 40-month follow-up). The results obtained with the laparoscopic technique used at our hospital center showed that this approach is feasible, efficacious, and safe. Thus, performed by skilled surgeons, it should be considered a treatment option for patients with PP. Copyright © 2015 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  17. E. coli outbreak in a neonate intensive care unit in a general hospital in Mexico City.

    PubMed

    Carrillo-Casas, Erika Margarita; Suástegui-Urquijo, Zaydy; Arroyo-Escalante, Sara; Morales-Espinosa, Rosario; Moncada-Barrón, David; Hernández-Delgado, Lorena; Méndez-Sánchez, José Luis; Delgado-Sapién, Gabriela; Navarro-Ocaña, Armando; Manjarrez-Hernández, Ángel; Xicohtencatl-Cortes, Juan; Hernández-Castro, Rigoberto

    2013-05-01

    Nosocomial infections are a major cause of morbidity and mortality among neonates admitted to neonatal intensive care units (NICUs). The aim of this paper was to describe an outbreak of Escherichia coli among infants admitted to the NICU of the General Hospital "Dr. Manuel Gea Gonzalez" in May of 2008. The isolated E. coli strains were identified using standard biochemical methods. The susceptibilities of these strains were analysed by determining their minimal inhibitory concentrations. Following this, their molecular relationships to each other were assessed by pulsed field gel electrophoresis (PFGE) analysis and corroborated by serology. Twelve E. coli strains were isolated from blood, urine, or indwelling catheter samples from five cases of preterm infants within a 3-day period. Patients were admitted to the NICU of the general hospital and, during the outbreak, developed sepsis caused by E. coli. For four of the patients, the average age was 23 days, while one patient was a 3-month-old infant. Prior to sepsis, the infants had received assisted ventilation and hyperalimentation through a central venous catheter. Two profiles were observed by PFGE; profile A was identified as the outbreak's cause and an outcome of cross-infection, while profile B showed genetic differences but serologically it was identified as part of the same serotype. We conclude that E. coli colonised the patients through horizontal transmission. A focal source of the microorganism in this outbreak was not identified, but cross-transmission through handling was the most probable route.

  18. Hepatitis B vaccination program at a New York City hospital: seroprevalence, seroconversion, and declination.

    PubMed

    Louther, J; Feldman, J; Rivera, P; Villa, N; DeHovitz, J; Sepkowitz, K A

    1998-08-01

    Despite implementation of hepatitis B vaccination programs, 2 problems have prevented full vaccine-induced protection of health care workers (HCWs). About 10% to 12% of vaccinated HCWs do not develop antibody, and many HCWs continue to decline vaccination. To determine the effectiveness of our hepatitis B vaccine program, we studied rates of postvaccination seroconversion and vaccine declination. Employee health service records were used to determine demographic features, hepatitis B surface antibody serostatus at baseline, serologic response to vaccine, and declination or acceptance of vaccine. About 26% of HCWs were seropositive at baseline, including those vaccinated before employment. Higher seroprevalence rates were seen among those born outside the United States, nurses, and laboratory workers. Seroconversion occurred in only 79% of HCWs who completed a 3-vaccine series. Increasing age was the only significant risk for failure to convert. Declination rates overall were about 45% and were lowest in HCWs who have jobs that included potential exposure to blood. Hepatitis B seroprevalence among HCWs at our hospital is higher than in many other urban hospitals in the United States; over postvaccination seroconversion rate is substantially lower; and our declination rate of 45% resembles other published series. Declination of vaccine and failure to respond to vaccine continue to thwart achievement of full control of this preventable occupational infection.

  19. Morbidity following Mexico City's 1985 earthquakes: clinical and epidemiologic findings from hospitals and emergency units.

    PubMed

    Sánchez-Carrillo, C I

    1989-01-01

    Medical records of 822 inpatients and outpatients cared for by the Department of the Federal District medical services during the 1985 Mexico City earthquakes were reviewed. Record incompleteness varied between 92.8 percent and 14.0 percent for the various study variables. No gender differences were detected among the groups; more than 70.0 percent of the patients were ages 15 to 64 years. Multiple traumatic injuries were frequent for inpatients across age groups, while simple contusions were more frequent among outpatients. Multiple head traumas, thorax-abdomen multiple traumas, and simple fractures of an arm or leg were more frequently recorded for inpatients than for outpatients. Head wounds with contusions; simple contusion of the thorax-abdomen, arms, and legs; and psychological trauma were more frequently recorded for outpatients. Although a great many records were incomplete, the data may reflect what actually happened to these patients, given the similarity of the findings with other reports of disasters. Improved record keeping during emergencies is needed to standardize the quantity and the reliability of the data so that statistical and medical care requirements are soundly based. The use of standard questionnaires for data collection is stressed to facilitate the management of clinical and epidemiologic activities. Longitudinal studies are needed to determine patterns of physical injuries, psychological trauma, and survival.

  20. Morbidity following Mexico City's 1985 earthquakes: clinical and epidemiologic findings from hospitals and emergency units.

    PubMed Central

    Sánchez-Carrillo, C I

    1989-01-01

    Medical records of 822 inpatients and outpatients cared for by the Department of the Federal District medical services during the 1985 Mexico City earthquakes were reviewed. Record incompleteness varied between 92.8 percent and 14.0 percent for the various study variables. No gender differences were detected among the groups; more than 70.0 percent of the patients were ages 15 to 64 years. Multiple traumatic injuries were frequent for inpatients across age groups, while simple contusions were more frequent among outpatients. Multiple head traumas, thorax-abdomen multiple traumas, and simple fractures of an arm or leg were more frequently recorded for inpatients than for outpatients. Head wounds with contusions; simple contusion of the thorax-abdomen, arms, and legs; and psychological trauma were more frequently recorded for outpatients. Although a great many records were incomplete, the data may reflect what actually happened to these patients, given the similarity of the findings with other reports of disasters. Improved record keeping during emergencies is needed to standardize the quantity and the reliability of the data so that statistical and medical care requirements are soundly based. The use of standard questionnaires for data collection is stressed to facilitate the management of clinical and epidemiologic activities. Longitudinal studies are needed to determine patterns of physical injuries, psychological trauma, and survival. PMID:2508177

  1. [Etiological agents of dermatomycoses isolated in a hospital of Santa Fe City, Argentina].

    PubMed

    Nardin, M E; Pelegri, D G; Manias, V G; Méndez, E de los A

    2006-01-01

    Superficial mycoses are limited to skin, hair, nails and mucous membranes. The most common etiological agents are dermatophytes and yeasts of Candida genus. The aim of this work was to know the etiological agents of dermatomycoses and their clinical presentation. Were analized 2073 samples of skin, hair, nails, and oral mucous membranes obtained from 1817 patients who attended the Microbiology Branch of the Central Laboratory at Dr. J. M. Cullen Hospital, since September 1999 to September 2003. The samples were examined and identified according to the localization and type of lesion. Out of the total samples 55.67% were positive; 63% were recovered from females, and 37% from males. The most common localization was the skin. Trichophyton rubrum was the most frequent dermatophyte, and among yeasts, Candida albicans was the prevalent species. Fourteen non-dermatophytic fungi (Fusarium spp. and Aspergillus spp.) were isolated, and considered emergent pathogens from superficial mycoses.

  2. Imported Malaria over Fifteen Years in an Inner City Teaching Hospital of Washington DC.

    PubMed

    Yeruva, Sri Lakshmi Hyndavi; Sinha, Archana; Sarraf-Yazdy, Mariam; Gajjala, Jhansi

    2016-06-01

    As endemic malaria is not commonly seen in the United States, most of the cases diagnosed and reported are associated with travel to and from the endemic places of malaria. As the number of imported cases of malaria has been increasing since 1973, it is important to look into these cases to study the morbidity and mortality associated with this disease in the United States. In this study, we would like to share our experience in diagnosing and treating these patients at our institution. We did a retrospective chart review of 37 cases with a documented history of imported malaria from 1998 to 2012. Among them, 16 patients had complicated malaria during that study period, with a mean length of hospital stay of 3.5 days. Most common place of travel was Africa, and chemoprophylaxis was taken by only 11% of patients. Travel history plays a critical role in suspecting the diagnosis and in initiating prompt treatment.

  3. [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.

  4. 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

  5. Falling through the cracks? Missed opportunities for earlier HIV diagnosis in a New York City Hospital.

    PubMed

    Nakao, Jolene H; Wiener, Dan E; Newman, David H; Sharp, Victoria L; Egan, Daniel J

    2014-10-01

    Summary Newly diagnosed HIV-positive patients have frequent health care encounters prior to diagnosis representing missed opportunities for diagnosis. This study determines the proportion of patients with new HIV diagnoses with encounters in the 3 years prior to diagnosis. We describe the characteristics of newly diagnosed patients and of "late testers" (CD4 <200 cells/mm(3) at the time of diagnosis). We identified all newly diagnosed with HIV in emergency department, inpatient, and outpatient settings between May 1, 2006, and December 31, 2009. Data abstractors searched hospital records to identify all emergency department, inpatient, and outpatient visits for the 3 years prior to diagnosis. In all, 23,271 HIV tests were performed and 253 persons were newly diagnosed (1.1%); 152 new positives (60.1%) made at least one prior visit. Of patients with CD4 counts available, 104/175 (59.4%) had CD4 <200 cells/mm(3). Patients with at least one prior visit had a median of three. There was no difference in numbers of visits between late testers and non-late testers, although late testers were more likely to have ED visits. Most newly diagnosed HIV-positive patients had multiple encounters prior to diagnosis. Many of these patients presented with CD4 counts below 200 cells/mm(3), indicating true missed opportunities for earlier diagnosis.

  6. The role of echocardiography in Staphylococcus aureus bacteraemia at Auckland City Hospital.

    PubMed

    Gow, Nicholas; Lowe, Boris S; Freeman, Joshua; Roberts, Sally

    2015-06-12

    Current guidelines recommend echocardiography in all episodes of Staphylococcus aureus bacteraemia (SAB). This study aimed to determine whether a very low-risk group of patients with SAB could be found in whom echocardiography was of no incremental diagnostic value for the diagnosis of infective endocarditis. Using the ANZCOSS dataset, we identified 574 eligible episodes of adult SAB at Auckland District Health Board (ADHB) between 2007 and 2012, and retrospectively obtained additional microbiological and clinical data. Prevalence of IE was determined using the modified Duke's criteria for diagnosis of IE. Multivariate logistic regression analysis was used to determine whether risk factors were independently associated with IE, and we also assessed their negative predictive value (NPV). Transthoracic and/or transoesophageal echocardiography was performed in 370 (65%) episodes of SAB. The prevalence of clinically definite and clinically possible IE was 5.6% and 8.5%, respectively. Thirty day all-cause mortality was 11.7%. The factors with the highest NPV when absent in hospital-acquired SAB were non central venous line-associated bacteraemia (100%), persistent bacteraemia (96%), and presence of a prosthetic valve or cardiac rhythm management (CRM) device (95%). When none of these three criteria were present the NPV was 100% (99-100%). A group of very low risk patients was found in our study: central line-associated SAB without prosthetic valves / CRM devices and without persistent bacteraemia. These patients had no episodes of IE and echocardiography is of no incremental diagnostic benefit.

  7. Prevalence of Pneumocystis jirovecii among immunocompromised patients in hospitals of Tehran city, Iran.

    PubMed

    Homayouni, Mohammad Mohsen; Behniafar, Hamed; Mehbod, Amir Sayed Ali; Mohammad-Sadeghi, Mohammad-Javad; Maleki, Bahman

    2017-09-01

    Pneumocystis jirovecii is an opportunistic organism that can cause extreme complications such as Pneumocystis pneumonia in immunocompromised individuals. There is no comprehensive study was conducted Iran to determine the prevalence of this infection in susceptible individuals. In the present study, 160 sera samples were collected from immunocompromised patients, including acquired immunodeficiency syndrome (AIDS) patients, diabetic patients, Hodgkin lymphoma patients and non-Hodgkin lymphoma patients. The specimens were collected from Imam Khomeini and army's 501 hospitals. The specimens were examined using indirect fluorescent antibody test. The results of the study showed that 39.30% specimens were found positive, with different rates in different groups, including 20, 22.50, 37.50, and 77.50% of diabetic patients, non-Hodgkin patients, Hodgkin lymphoma patients, and AIDS patients, respectively. This occurrence is relatively high and can be a potential life-threatening hazard to infected patients in studied groups, on the other hand the organism can be transmitted from infected people to other susceptible individuals.

  8. Diseases associated with HIV infection: study of biopsies and surgical resection specimens at a large general hospital in Mexico City.

    PubMed

    Sánchez-Peña, P; Romero-Guadarrama, Monica B; Aguirre-García, J

    2009-06-01

    The objective of this study was to analyze the type of diseases associated with HIV infection from a survey of the surgical pathology material accessioned at a large general hospital in Mexico City. From the archives of the pathology unit of the General Hospital of Mexico (Ministry of Health), we compiled data on biopsies and surgical specimen from different organs and tissues of HIV-infected patients (HIV/AIDS) received in the period from January 2005 to July 2008. We found a total of 52 cases, 41 men and 11 women. The main affected anatomical organ was the lymphatic nodes in 33 cases (63.4%), 7 corresponded to the digestive tract (13.46), 3 corresponded to bone marrow (5.76%), 3 corresponded to the perianal region (5.76%), 2 cases corresponded to the hard palate (3.84%), and 1 case each corresponded to the following regions: peritoneum, breast, and lung. The most frequent diagnoses were non-Hodgkin's large B-cell lymphoma in 11 cases (21.12%) and its morphological variants, 8 reactive lymphadenopathy cases (15.38%), 5 atypical mycobacterioses (9.61%), 2 nonspecific granulomatous lesions (3.84%), 2 Burkitt's lymphoma (3.84%), 3 Kaposi sarcoma (5.76%), 1 mixed cellularity Hodgkin's lymphoma (1.92%), 1 Kaposiform hemangioendothelioma (1.92%), and 1 with infection by cytomegalovirus + cryptosporidiosis in the duodenum (1.92%). In this series, the most affected organ in patients with HIV/AIDS was the lymphatic nodes. The most common neoplasm was the non-Hodgkin's lymphoma followed by Kaposi sarcoma. Mycobacterioses were the main infectious diseases, followed by mycotic and viral infections.

  9. Lifespan and associated factors of peripheral intravenous Cannula among infants admitted in public hospitals of Mekelle City, Tigray, Ethiopia, 2016.

    PubMed

    Birhane, Eskedar; Kidanu, Kalayou; Kassa, Mekuria; Gerezgiher, Dawit; Tsegay, Lidia; Weldu, Brhanu; Kidane, Genet; Gerensea, Hadgu

    2017-01-01

    Peripheral Intravenous cannula (IV) is the most common vascular access device used to administer medications with the exception of medication or fluid with high or low PH or hyperosmolarity which may cause severe damage to small veins. The insertion of a peripheral intravenous cannula in newborn infants can be difficult. Appropriate veins with sufficient capacity to insert a cannula become less available throughout the hospital stay. Once a peripheral intravenous cannula is inserted, it is desirable that its patency can be maintained as long as possible. This study was aimed to assess the lifespan and associated factors of peripheral intravenous cannula among infants admitted in public hospitals of Mekelle city, Tigray, Ethiopia, 2016. The method used was a prospective cohort study. 178 study subjects were recruited using systematic random sampling technique. The data was collected by structured questionairre and observational checklist. More than half of infants (94) had a short cannula lifespan (below 30 h). Multivariable logistic regression analysis showed that Pediatric intensive care unit (PICU) [AOR = 6.93; 95% CI (1.56,30.71)], clinical experience (3-5 years) [AOR = 0.168; 95% CI (0.060-0.469)], insertion site (arm) [AOR = 0.126;95% CI (0.046-0.349)], reason for removal (dislodgement and complication) [AOR = 8.15; 95% CI (2.49,26.63) [AOR = 10.48;95% CI (3.08,35.65)], medication [AOR = 0.17;95% CI (0.37,0.784)], corticosteroids [0.164; 95% CI (0.034,0.793)] and blood transfusion [AOR = 0.12; 95% CI (0.028-0.509)] were the statistically significant variables associated with the lifespan of a peripheral intravenous cannula. Untimely removal of peripheral intravenous cannulas was higher in infants and demographic. Cannulation and health care factors had significant effects on the lifespan of a peripheral intravenous cannula.

  10. Risky locations for out-of-hospital cardiopulmonary arrest in a typical urban city.

    PubMed

    Moriwaki, Yoshihiro; Tahara, Yoshio; Iwashita, Masayuki; Kosuge, Takayuki; Suzuki, Noriyuki

    2014-10-01

    The aim of this study is to clarify the circumstances including the locations where critical events resulting in out-of-hospital cardiopulmonary arrest (OHCPA) occur. Subjects of this population-based observational case series study were the clinical records of patients with nontraumatic and nonneck-hanging OHCPA. Of all 1546 cases, 10.3% occurred in a public place (shop, restaurant, workplace, stations, public house, sports venue, and bus), 8.3% on the street, 73.4% in a private location (victim's home, the homes of the victims' relatives or friends or cheap bedrooms, where poor homeless people live), and 4.1% in residential institutions. In OHCPA occurring in private locations, the frequency of asystole was higher and the outcome was poorer than in other locations. A total of 181 OHCPA cases (11.7%) took place in the lavatory and 166 (10.7%) in the bathroom; of these, only 7 (3.9% of OHCPA in the lavatory) and none in the bath room achieved good outcomes. The frequencies of shockable initial rhythm occurring in the lavatory and in bath room were 3.7% and 1.1% (lower than in other locations, P = 0.011 and 0.002), and cardiac etiology in OHCPA occurring in these locations were 46.7% and 78.4% (the latter higher than in other locations, P < 0.001). An unignorable population suffered from OHCPA in private locations, particularly in the lavatory and bathroom; their initial rhythm was usually asystole and their outcomes were poor, despite the high frequency of cardiac etiology in the bathroom. We should try to treat OHCPA victims and to prevent occurrence of OHCPA in these risky spaces by considering their specific conditions.

  11. Typhoid Fever in an inner city hospital: a 5-year retrospective review.

    PubMed

    Farmakiotis, Dimitrios; Varughese, Julie; Sue, Paul; Andrews, Phyllis; Brimmage, Mary; Dobroszycki, Joanna; Coyle, Christina M

    2013-01-01

    Typhoid is a leading cause of fever in returning travelers. The prevalence is highest in migrants visiting friends and relatives (VFR travelers) in the Indian subcontinent, where reports of resistance have been of concern. This study is a retrospective analysis of patients with typhoid, seen over a 5-year period, in a tertiary center that serves a large immigrant population. Patients with blood cultures positive for Salmonella Typhi were identified between 2006 and 2010. Charts were reviewed for demographic data, travel history, symptoms and signs, basic laboratory results, susceptibility profiles, treatment, and clinical course. Resistance to nalidixic acid was used as a marker of decreased susceptibility to quinolones. Seventeen patients were identified with S Typhi. The median age was 12 years (range: 2-47 y) and 94% (16 of 17) were hospitalized with a median stay of 7 days; two were admitted to the intensive care unit. Fourteen patients (82%) had a history of recent travel. Twelve were VFR travelers in Bangladesh and Pakistan and two had recently immigrated. In our study, typhoid patients had low eosinophil counts and elevated transaminases. Seventy-six percent (12 of 17) of all isolates were resistant to nalidixic acid, 23.5% (4 of 17) were resistant to ampicillin and co-trimoxazole, and one was resistant to ciprofloxacin. All isolates were susceptible to third-generation cephalosporins. Younger VFR travelers appear to be at greater risk of acquiring infection and developing complications. Absolute eosinopenia and increased liver function test values could be useful early diagnostic clues in a returning traveler with fever, once malaria has been excluded. There was a high rate of decreased susceptibility to fluoroquinolones, confirming that the use of third-generation cephalosporins or macrolides in patients from the Indian subcontinent is most appropriate. Prevention in VFR travelers to South Asia is critical and efforts should be targeted at better education

  12. Straight to test. Results of a pilot study in a hospital serving an inner city population.

    PubMed

    Hammond, T M; Fountain, G; Cuthill, V; Williams, J; Porrett, T R C; Lunniss, P J

    2008-07-01

    The main aims of the study were to determine the frequency with which two-week wait (2ww) referrals for colorectal cancer (CRC) could proceed directly to straight to test (STT), and the potential improvement in time to diagnosis. A telephone interview was attempted in all 2ww referrals not requiring an advocate and under 80 years. Data were assessed according to a test protocol, and where indicated a potential slot for the appropriate investigation was recorded (virtual test). All patients proceeded to clinic, following which differences in time from GP referral to virtual compared with actual requested test, and any discrepancies between virtual and requested tests were analysed. Between 8th January and 16th February 2007, there were 42 2ww referrals. Twenty-one patients were contacted, of whom 14 were suitable for STT: 13 virtual colonoscopies and one CT scan were booked. Following out-patient consultation, eight colonoscopies; three flexible sigmoidoscopies, one barium enema, and two CT scans were actually booked. There was a difference of 15.5 days between the median times of the virtual and actual test. During this 6-week period a total of nine patients were diagnosed with CRC, of whom three were referred via the 2ww pathway, but none were suitable for STT. This 'straight to test' pilot study suggests a potential strategy for reducing the time to diagnosis and therefore first treatment of those identified with CRC, and offers a methodology for individual hospitals to assess their suitability to employ such a strategy.

  13. Factors associated with nosocomial surgical-site infections for craniotomy in Mexico City hospitals.

    PubMed

    Sánchez-Arenas, Rosalinda; Rivera-García, Blanca Elsa; Grijalva-Otero, Israel; Juárez-Cedillo, Teresa; Martínez-García, María del Carmen; Rangel-Frausto, Sigfrido

    2010-01-01

    Nosocomial surgical-site infection (NSSI) after craniotomy is responsible for an increase in deaths and/or disabilities that affect quality of life. It is necessary to identify factors to be included in an index for their control. The aim of this study was to a) identify intrinsic and extrinsic factors associated with NSSI after craniotomy and b) obtain the infection risk attributed to both intrinsic and extrinsic factors as well as to compare their predictive capability with the NNISS (National Nosocomial Infection Surveillance System) index. A case-control study was conducted during a 2-year period in patients who underwent craniotomy in hospitals affiliated with the Instituto Mexicano del Seguro Social. Patients were selected according to the Centers for Disease Control and Prevention criteria for NSSI. During the study period 737 craniotomies were performed, 41 of which presented with NSSI. Intrinsic factors associated with NSSI were the presence of chronic diseases (OR = 2.18) and craniotomy due to nontraumatic causes (OR = 1.87), whereas extrinsic factors were procedures performed during the late shift (OR = 2.6) and another surgery at the same surgical site (OR = 5.2). These factors comprised the index with intrinsic and extrinsic factors. Extrinsic factors were 1.7 times higher than intrinsic factors, in addition to having a larger area under the ROC curve (0.731). The risk obtained with the NNISS index for patients who had one factor was 1.5, whereas that for patients who had two or three factors was 4.7. In the studied population, patients who underwent a craniotomy with extrinsic factors showed a higher association with NSSI.

  14. Epidemiological Factors Associated with Dengue Shock Syndrome and Mortality in Hospitalized Dengue Patients in Ho Chi Minh City, Vietnam

    PubMed Central

    Anders, Katherine L.; Nguyet, Nguyen Minh; Van Vinh Chau, Nguyen; Hung, Nguyen Thanh; Thuy, Tran Thi; Lien, Le Bich; Farrar, Jeremy; Wills, Bridget; Hien, Tran Tinh; Simmons, Cameron P.

    2011-01-01

    Understanding trends in dengue disease burden and risk factors for severe disease can inform health service allocation, clinical management, and planning for vaccines and therapeutics. Dengue admissions at three tertiary hospitals in Ho Chi Minh City, Vietnam, increased between 1996 and 2009, peaking at 22,860 in 2008. Children aged 6–10 years had highest risk of dengue shock syndrome (DSS); however, mortality was highest in younger children and decreased with increasing age (odds ratio [OR] = 0.52, 95% confidence interval [CI] = 0.36–0.75 in 6- to 10- year-old children and OR = 0.27, 95% CI = 0.16–0.44 in 11- to 15-year-old children compared with 1- to 5-year-old children). Males were overrepresented among dengue cases; however, girls had higher risk of DSS (OR = 1.19, 95% CI = 1.14–1.24) and death (OR = 1.57, 95% CI = 1.14–2.17). Young children with dengue had greatest risk of death and should be targeted in dengue vaccine and drug trials. The increased risk of severe outcomes in girls warrants further attention in studies of pathogenesis, health-seeking behavior, and clinical care. PMID:21212214

  15. The burden of bone, native joint and soft tissue infections on orthopaedic emergency referrals in a city hospital.

    PubMed

    Howell, A; Parker, S; Tsitskaris, K; Oddy, M J

    2016-01-01

    Introduction Bone, native joint and soft tissue infections are frequently referred to orthopaedic units although their volume as a proportion of the total emergency workload has not been reported previously. Geographic and socioeconomic variation may influence their presentation. The aim of this study was to quantify the burden of such infections on the orthopaedic department in an inner city hospital, determine patient demographics and associated risk factors, and review our current utilisation of specialist services. Methods All cases involving bone, native joint and soft tissue infections admitted under or referred to the orthopaedic team throughout 2012 were reviewed retrospectively. Prosthetic joint infections were excluded. Results Almost 15% of emergency admissions and referrals were associated with bone, native joint or soft tissue infection or suspected infection. The cohort consisted of 169 patients with a mean age of 43 years (range: 1-91 years). The most common diagnosis was cellulitis/other soft tissue infection and the mean length of stay was 13 days. Two-thirds of patients (n=112, 66%) underwent an operation. Fifteen per cent of patients were carrying at least one blood borne virus, eleven per cent were alcohol dependent, fifteen per cent were using or had been using intravenous drugs and nine per cent were homeless or vulnerably housed. Conclusions This study has shown that a significant number of patients are admitted for orthopaedic care as a result of infection. These patients are relatively young, with multiple complex medical and social co-morbidities, and a long length of stay.

  16. [Operative data of a psychiatric internation unit in a general hospital of health public system in Buenos Aires City].

    PubMed

    Strejilevich, Sergio; Chan, Mónica; Triskier, Fabián; Orgambide, Susana

    2002-01-01

    The epidemiological projections show that the problems of Mental Health were the main health challenge during the last decade. This situation is particularly worring in our region. The poor operative data in relation to the care of the mental disorders prevent the elaboration of plans on the basis of secure data. Records of externation were analized during the period between 1994-1998 in the men Psychiatric Internation Unity in the Psychopatology Service of the Hospital Piñero in Buenos Aires, which is part of the public health service of the city. an average time of internation of 42.8 days was reported (SD 40,3), which was higher than the 11 days reported in institutions of the private health services. An increasing proportional diagnosis of Bipolar Disorder was reported (chi square corresponding to tendencies P<0.01, lineality P<0.001) and a significative decline in the number of diagnosis of Schizophrenia (chi square corresponding to tendencies P<0.05; lineality P<0.05). In this way, the ratio of the diagnosis of Schizophrenia and Bipolar Disorder changed from 7:1 in 1994 to 1,7:1 in 1998. A variation in the diagnostic habits was observed, suggesting that affective disorders were underdiagnosticated. This tendency was corrected latter. Similar remarks made by other services in the same region support this interpretation of the data.

  17. [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

  18. [Pattern of systemic lupus erythematosus in Benin and West African patients].

    PubMed

    Zomalheto, Zavier; Assogba, Michee; Agbodande, Anthelme; Atadokpede, Felix; Gounongbe, Marcelle; Avimadje, Martin

    2014-12-01

    To describe the clinical features, laboratory characteristics and the treatment of systemic lupus erythematosus (SLE) among Benin people and West Africa people. This is a part of a retrospective study which initially concerned patients seen in the rheumatology, dermatology and internal medicine departments of National Hospital University of Cotonou during January 2000 to March 2013 (14 years). Patients included in the study were all older than 16 years and fulfilling at least four of ACR criteria 1997 for Systemic lupus erythematosus. In a second step, we collect the data of the countries of West Africa where the work on the systemic lupus erythematosus have been published through a literature review including all articles published in the local, regional and international journals. Demographic, clinical and outcomes data were analyzed. 33 cases of lupus were diagnosed in 14 years in Cotonou. The sex ratio was 32/1 and means age 28.76 ± 8.01 [16-51]. The mean delay before diagnosis was 15 months [1- 84 months]. Polyarthralgia/ polyarthritis were the most common presentations (94.3 %) followed by systemic manifestations (78.9 %). Nineteen (19) patients achieved serological profiles. The anti- ds DNA were positive in 15 cases, anti- Sm in 10 cases and anti -SSA in 5 cases. Anti - phospholipids and lupus anticoagulant were absent. Treatment modalities were: corticosteroids (n = 21) antimalarials (n=15) , methotrexate (n = 4) , body corticosteroids (n=5), clinical monitoring without treatment (n = 3). Outcome was satisfactory in 25 cases. Eight (8) patients developed complications, 4 cases of death were observed and 8 patients lost to follow. These data are congruent with those published in the countries of West Africa. SLE seems rare in Benin. In general, in West Africa, the diagnosis is difficult because the clinical polymorphism by misdiagnosis and access serological profiles difficulty. However, the disease appears to be well controlled by treatment dominated by

  19. 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.

  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. 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.

  2. A Survey of ICT Competencies among Students in Teacher Preparation Programmes at the University of Benin, Benin City, Nigeria

    ERIC Educational Resources Information Center

    Danner, R. B.; Pessu, C. O. A.

    2013-01-01

    Today's fast-paced world is becoming increasingly characterized by technology driven communication, which has transformed the world into a large global connected community with ever-increasing outreach of information and communication technology (ICT). Technology plays an increasingly important role in people's lives, and it is envisaged that…

  3. A Survey of ICT Competencies among Students in Teacher Preparation Programmes at the University of Benin, Benin City, Nigeria

    ERIC Educational Resources Information Center

    Danner, R. B.; Pessu, C. O. A.

    2013-01-01

    Today's fast-paced world is becoming increasingly characterized by technology driven communication, which has transformed the world into a large global connected community with ever-increasing outreach of information and communication technology (ICT). Technology plays an increasingly important role in people's lives, and it is envisaged that…

  4. 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.…

  5. 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.…

  6. 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.

  7. Epidemiological data of patients hospitalized with burns and other traumas in some cities in the southeast of Brazil from 1991 to 1997.

    PubMed

    De-Souza, D A; Manço, A R X; Marchesan, W G; Greene, L J

    2002-03-01

    This retrospective analysis of burn patients and victims of other forms of trauma from Ribeirão Preto and nearby cities admitted to hospitals in the city of Ribeirão Preto, São Paulo, Brazil, was carried out to determine the frequency of injuries of all types in order to identify the extent of the problem of burns relative to other forms of trauma. Data concerning 921 patients with burns and 60,344 patients with other traumatic injuries hospitalized during the period from 1991 to 1997 are described. Burns corresponded to 1.5% of the total number of traumatic injuries. When data are reported as absolute numbers or as incidence rate of hospitalized burn patients, burns were two times more frequent among men in most age groups. The case fatality ratio due to burns was 8.4% (77 deaths among 921 patients), with a rate of 6.4% for men and 12.2% for women. The case fatality ratio was higher among women than men regardless of the city of residence. The case fatality ratio was 3.2 and 4.4 times greater for men and women burn victims from other towns than for burn victims from Ribeirão Preto, indicating the need for additional equipment and training of medical and paramedical personnel in the initial measures to be taken with burn patients.

  8. Prevalence of nosocomial infections and anti-infective therapy in Benin: results of the first nationwide survey in 2012

    PubMed Central

    2014-01-01

    Background Data on nosocomial infections in hospitals in low-income countries are scarce and often inconsistent. The objectives of this study were to estimate the prevalence of nosocomial infections and antimicrobial drug use in Benin hospitals. Methods All hospitals were invited to participate in the first national point prevalence study conducted between 10–26 October 2012 using the protocol developed by the “Hospitals in Europe Link for Infection Control through Surveillance” (HELICS) project. Infection prevalence rates and the proportion of infected patients and exposure to antimicrobials were assessed. Results Overall, 87% (39/45) of hospitals participated. Of 3130 inpatients surveyed, 972 nosocomial infections were identified among 597 patients, representing an overall prevalence of infected patients of 19.1%. The most frequent infections were related to the urinary tract (48.2%), vascular catheter use (34.7%), and surgical site (24.7%). 64.6% of patients surveyed were treated with antibiotics, including a significant proportion (30%) of non-infected patients and a high proportion of self-medication (40.8%). Resistance of leading nosocomial pathogens to antimicrobials included methicillin-resistance (52.5%) among Staphylococcus aureus, vancomycin resistance among enterococci (67.5%), cefotaxime resistance among Escherichia coli (67.6%), and ceftazidime resistance among Acinetobacter baumannii (100%) and Pseudomonas aeruginosa (68.2%). Conclusions Benin has high nosocomial infection rates and calls for the implementation of new national infection control policies. Patient safety education and training of all individuals involved in healthcare delivery will be critical to highlight awareness of the burden of disease. The high use of antimicrobials needs to be addressed, particularly their indiscriminate use in non-infected patients. PMID:24883183

  9. Louse-borne relapsing fever profile at Felegehiwot referral hospital, Bahir Dar city, Ethiopia: a retrospective study

    PubMed Central

    2014-01-01

    Background Louse- borne relapsing fever is an acute febrile illness caused by Borrelia recurrentis and is transmitted by body lice, Pediculus humanus corporis. The disease has occurred as epidemic in different parts of the country.Therefore, the aim of this retrospective study was conducted to assess the LBRF profile for the last four years. Methods A retrospective study was conducted on patients with LBRF admitted from 2009–2012 at Felegehiwot referral hospital. The diagnosis was based on both clinical and laboratory methods. Patients with strong clinical suspicion of LBRF and positive for Borrelia species in their blood was diagnosed as LBRF cases. Data was collected from all patients with LBRF- like symptoms in their registration book. Data was checked for completeness, coded and analysed using SPSS version 16. P < 0.05 was considered significant for comparison. Results Of the 4559 patients admitted with LBRF- like symptoms, 4178 (91.6%) were males and 381 (8.4%) were females. Most of the patients (74.2%) were within age groups 11–20 years. The majority of patients (94.4%) were from urban residence. The overall prevalence of LBRF was 225 (4.9%) and the highest prevalence 171 (5.1%) was observed in age groups of 11–20 years. The association between seasonal variation and prevalence of LBRF showed that more patients with positive for Borrelia species were recorded in dry 27 (9.7%) than wet 198 (4.6%) seasons (P < 0.001). Finally, a trend in prevalence of LBRF for the last four years showed that the highest numbers of cases were documented in 2010. Conclusion The overall prevalence of LBRF was high and the highest prevalence was observed in young age groups. Moreover, most of the patients with LBRF were from urban dwellers. Therefore, health education should be delivered towards LBRF prevention in the city. PMID:24742342

  10. [Yeast urinary tract infections. Multicentre study in 14 hospitals belonging to the Buenos Aires City Mycology Network].

    PubMed

    Maldonado, Ivana; Arechavala, Alicia; Guelfand, Liliana; Relloso, Silvia; Garbasz, Claudia

    2016-01-01

    Urinary tract infections are a frequent ailment in patients in intensive care units. Candida and other yeasts cause 5-12% of these infections. The value of the finding of any yeast is controversial, and there is no consensus about which parameters are adequate for differentiating urinary infections from colonization or contamination. To analyse the epidemiological characteristics of patients with funguria, to determine potential cut-off points in cultures (to distinguish an infection from other conditions), to identify the prevalent yeast species, and to determine the value of a second urine sample. A multicentre study was conducted in intensive care units of 14 hospitals in the Buenos Aires City Mycology Network. The first and second samples of urine from every patient were cultured. The presence of white cells and yeasts in direct examination, colony counts, and the identification of the isolated species, were evaluated. Yeasts grew in 12.2% of the samples. There was no statistical correlation between the number of white cells and the fungal colony-forming units. Eighty five percent of the patients had indwelling catheters. Funguria was not prevalent in women or in patients over the age of 65. Candida albicans, followed by Candida tropicalis, were the most frequently isolated yeasts. Candida parapsilosis and Candida glabrata appeared less frequently. The same species were isolated in 70% of second samples, and in 23% of the cases the second culture was negative. It was not possible to determine a useful cut-off point for colony counts to help in the diagnosis of urinary infections. As in other publications, C. albicans, followed by C. tropicalis, were the most prevalent species. Copyright © 2015 Asociación Española de Micología. Published by Elsevier Espana. All rights reserved.

  11. Factors associated with the difficulty in hospital acceptance at the scene by emergency medical service personnel: a population-based study in Osaka City, Japan.

    PubMed

    Katayama, Yusuke; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Iwami, Taku; Kawamura, Takashi; Hayashida, Sumito; Yoshiya, Kazuhisa; Ogura, Hiroshi; Shimazu, Takeshi

    2016-10-26

    To investigate the association between the difficulty in hospital acceptance at the scene by emergency medical service (EMS) personnel and prehospital demographic factors and reasons for EMS calls. A retrospective, observational study. Osaka City, Japan. A total of 100 649 patients transported to medical institutions by EMS from January 2013 to December 2013. The definition of difficulty in hospital acceptance at the scene was EMS personnel making ≥5 phone calls to medical institutions until a decision to transport was determined. Multivariable analysis was used to assess the relationship between difficulty in hospital acceptance and prehospital factors and reasons for EMS calls. Multivariable analysis showed the elderly, foreigners, loss of consciousness, holiday/weekend, and night-time to be positively associated with difficulty in hospital acceptance at the scene. As reasons for EMS calls, gas poisoning (adjusted OR 3.281, 95% CI 1.201 to 8.965), trauma by assault (adjusted OR 2.662, 95% CI 2.390 to 2.966), self-induced drug abuse/gas poisoning (adjusted OR 4.527, 95% CI 3.921 to 5.228) and self-induced trauma (adjusted OR 1.708, 95% CI 1.369 to 2.130) were positively associated with the difficulty in hospital acceptance at the scene. Ambulance records in Osaka City showed that certain prehospital factors such as night-time were positively associated with difficulty in hospital acceptance at the scene, and reasons for EMS calls, such as self-induced drug abuse/gas poisoning, were also positive predictors for difficulty in hospital acceptance at the scene. 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/.

  12. Factors associated with the difficulty in hospital acceptance at the scene by emergency medical service personnel: a population-based study in Osaka City, Japan

    PubMed Central

    Katayama, Yusuke; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Iwami, Taku; Kawamura, Takashi; Hayashida, Sumito; Yoshiya, Kazuhisa; Ogura, Hiroshi; Shimazu, Takeshi

    2016-01-01

    Objectives To investigate the association between the difficulty in hospital acceptance at the scene by emergency medical service (EMS) personnel and prehospital demographic factors and reasons for EMS calls. Design A retrospective, observational study. Setting Osaka City, Japan. Participants A total of 100 649 patients transported to medical institutions by EMS from January 2013 to December 2013. Primary outcome measurements The definition of difficulty in hospital acceptance at the scene was EMS personnel making ≥5 phone calls to medical institutions until a decision to transport was determined. Multivariable analysis was used to assess the relationship between difficulty in hospital acceptance and prehospital factors and reasons for EMS calls. Results Multivariable analysis showed the elderly, foreigners, loss of consciousness, holiday/weekend, and night-time to be positively associated with difficulty in hospital acceptance at the scene. As reasons for EMS calls, gas poisoning (adjusted OR 3.281, 95% CI 1.201 to 8.965), trauma by assault (adjusted OR 2.662, 95% CI 2.390 to 2.966), self-induced drug abuse/gas poisoning (adjusted OR 4.527, 95% CI 3.921 to 5.228) and self-induced trauma (adjusted OR 1.708, 95% CI 1.369 to 2.130) were positively associated with the difficulty in hospital acceptance at the scene. Conclusions Ambulance records in Osaka City showed that certain prehospital factors such as night-time were positively associated with difficulty in hospital acceptance at the scene, and reasons for EMS calls, such as self-induced drug abuse/gas poisoning, were also positive predictors for difficulty in hospital acceptance at the scene. PMID:27798040

  13. [Determinants and relationship of homocysteinemia with cardiometabolic risk factors. A study in Benin, West Africa].

    PubMed

    El Mabchour, Asma; Agueh, Victoire; Delisle, Hélène

    2010-11-01

    Elevated circulating homocysteine (Hcy) is considered as an independent cardiovascular disease risk factor. Hyperhomocysteinaemia (HHcy) is influenced by nutritional, genetic, and environmental factors. The purpose of the study was to assess HHcy prevalence in Benin, its association with intakes of B-vitamins (B2, B6, B9, B12), alcohol intake, and socio-economic status (SES), and its links with other factors of cardio-metabolic risk. The cross-sectional study included 541 apparently healthy subjects, aged 25 to 65 years, from three sites: the main city, a small city and a rural area. Hcy was measured with an ELISA test kit. The HHcy cut-off was 12 μmol/L. Dietary intake was assessed with three 24-hour recalls. We used a structured questionnaire to assess alcohol consumption, demographics, and SES according to education and an amenity score as income proxy. Criteria for obesity, hypertension, dyslipidemia and hyperglycemia were primarily those of World Health Organization (WHO) and the International Diabetes Federation. Mean age was 38.1 ± 10.1 years. The prevalence of HHcy was 52.2% in men and 24.7% in women. In multiple linear regression models, Hcy in men was positively associated with alcohol intake, but only alcohol in beer. In women, Hcy was negatively related to vitamin B12 intake. According to multivariate models of cardio-metabolic risk factors, HHcy was associated in women with more than twice the odds of hypertension and with high TC/HDL-c ratio. In men, Hcy was positively and independently associated with diastolic blood pressure and with LDL-cholesterol and total cholesterol in linear regression models. The prevalence of HHcy is high in Benin, when compared with other studies, and it was as expected higher in men than in women. Elevated Hcy was associated with inadequate intake of vitamin B12 in women, whereas alcohol consumption and its negative correlation with B12 intake was also involved in men. Although HHcy was independently associated with

  14. 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

    2017-06-18

    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; ••: ••-••. © 2017 Japan Geriatrics Society.

  15. Train crash disasters and emergency plans of suburban hospitals in the New York City and Washington, DC areas: what went right; what could have been improved.

    PubMed

    1996-06-01

    Two major train crashes in February--one in Northern New Jersey and the other in Silver Spring, MD, near Washington, DC--posed severe challenges to the disaster plans of area hospitals. The first crash involving two commuter trains near Secaucus, NJ, tested the effectiveness of emergency plans at the Jersey City Medical Center, Jersey City, NJ, and the Meadowlands Hospital Medical Center, Secaucus. The incident occurred at approximately 8:40 a.m. and resulted in three deaths and 162 injuries. The Silver Spring crash, which took place a week after the one in New Jersey, occurred in early evening and involved an Amtrak and a commuter train. It resulted in 11 deaths and 26 injuries. Holy Cross Hospital, Silver Spring, was the primary caregiver. In this report, we'll provide details on how the incidents impacted on nearby hospitals and their security staffs; how challenges, anticipated and unanticipated, were met; and what conclusions were reached in follow-up critiques.

  16. Exploring the sustainability of obstetric near-miss case reviews: a qualitative study in the South of Benin.

    PubMed

    Hutchinson, Cindy; Lange, Isabelle; Kanhonou, Lydie; Filippi, Veronique; Borchert, Matthias

    2010-10-01

    near-miss case reviews are one of a number of audit approaches currently being used and evaluated by those with an interest in reducing high rates of maternal mortality in developing countries. Researchers are beginning to take an interest in issues relating to the sustainability of audits. to develop an understanding of the barriers and facilitators to the sustainability of obstetric near-miss case reviews in five hospitals in southern Benin. semi-structured interviews were designed to explore health workers' and policy makers' views and experiences of the sustainability of near-miss case reviews aimed to improve quality of care and reduce maternal mortality. five hospitals in three regions in the south of Benin. two Ministry of Health officials and eight health-care workers involved in a feasibility study conducted in 1998-2001 that introduced near-miss case reviews. framework analysis to identify themes. while all participants believed in the importance and value of audit, all hospitals had stopped performing near-miss case reviews within two years of completing the feasibility study. Ten qualitative interviews identified six themes relating to the sustainability of case reviews: clear advantages in ensuring quality of care, fear of blame and punishment, availability of resources, training, supportive hospital work environment, and broader policy issues. implementing and sustaining audit is a complex intervention that requires careful planning and consideration. It is important to consider both the content and the context in which audit takes place when developing strategies for sustainability. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. 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.

  18. 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

    2016-10-28

    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/.

  19. [Profile of immune and allergic dermatoses among children at the outpatient dermatology clinic in Cotonou (Benin)].

    PubMed

    Adégbidi, H; Degboé, B; Saka, B; Elégbédé, A; Atadokpèdé, F; Koudoukpo, C; Yédomon, H; do-Ango Padonou, F

    2014-01-01

    The aim of this work was to study the profile of immune and allergic dermatoses (IAD) in children consulting at the outpatient dermatology clinic at the National University Hospital in Cotonou (Benin). This retrospective descriptive study examined records of children consulting with this diagnosis over a 10-year period. IAD (902 cases, 37%) were the most common pediatric dermatosis, followed by infectious dermatosis (24%). The sex ratio of children was 0.78. The age groups most strongly affected were those aged 1-30 months (25.39%) and 150-180 months (19.73%). The main IAD were: eczema (47.9%) and prurigo simplex (40.7%). Other IADs included lichen planus (5.1%), toxicoderma (3.8%), urticaria (1.5%), and erythrodermic eczema (1%). The incidence of eczema increased from 13.5% in 2000 to 21.5% in 2009, an increase of 62.2% over 10 years. IADs are common at the Cotonou hospital clinic and are dominated by eczema, the incidence of which has increased significantly over time.

  20. Interventions among male clients of female sex workers in Benin, West Africa: an essential component of targeted HIV preventive interventions

    PubMed Central

    Lowndes, C M; Alary, M; Labbé, A‐C; Gnintoungbè, C; Belleau, M; Mukenge, L; Meda, H; Ndour, M; Anagonou, S; Gbaguidi, A

    2007-01-01

    Objectives To assess the impact of interventions targeted towards female sex workers (FSWs) and their male clients on client HIV/STI prevalence and sexual behaviour. Methods From 1993 to 2006, an HIV/STI preventive intervention focusing on condom promotion and STI care was implemented among FSWs in Cotonou, Benin, and then expanded to cover their male sexual partners in 2000. The interventions were scaled up to five other cities of Benin in 2001–2002. Serial cross‐sectional surveys of HIV/STI prevalence and sexual behaviour were carried out among clients in Cotonou in 1998, 2002 and 2005; and in the five other cities (O/Cotonou) in 2002 and 2005. Results Significant declines in gonorrhoea prevalence among clients of FSWs: Cotonou, from 5.4% in 1998 to 1.6% in 2005; O/Cotonou: from 3.5% in 2002 to 0.59% in 2005. Chlamydia prevalence also declined O/Cotonou, from 4.8% to 1.8%, while HIV prevalence remained stable. Reported condom use by clients with both FSWs and casual non‐FSW partners, but not regular partners, increased significantly. While condom use at last sex with an FSW was similar in Cotonou to O/Cotonou around the time of implementation of the interventions (56% in 1998 vs 49% in 2002, respectively), it had risen to similar levels by 2005 (95% and 96%, respectively). Conclusions These results demonstrate that it is possible to implement preventive and clinical services for clients of FSWs, and suggest that such interventions, integrated with those targeted towards FSWs, can have a significant effect on sexual behaviour and STI prevalence (particularly gonorrhoea) among this population. PMID:17942573

  1. 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.

  2. Profile of the first cases hospitalized due to influenza A (H1N1) in Panama City, Panama. May-June 2009.

    PubMed

    Tulloch, Felicia; Correa, Ricardo; Guerrero, Gladys; Samaniego, Rigoberto; Garcia, Mariana; Pascale, Juan M; Martinez, Alexander; Mendoza, Yaxelis; Victoria, Gerardo; de Lee, Marisol Ng; Marchena, Loyd; de Mosca, Itza Barahona; Armien, Blas

    2009-11-21

    In April 2009, a novel influenza A (H1N1) virus was identified in patients from Mexico and the United States. From 8 May through 25 June 2009, in the Republic of Panama, 467 cases infected with the same virus were identified, 13 of which were hospitalized at the Santo Tomas Hospital in Panama City. Up to the date of this report, no deaths have been reported in Panama. This study presents the first thirteen cases of Influenza A (H1N1) 2009 that were hospitalized in Panama City. The Santo Tomas Hospital (HST), a third-level institution of the Ministry of Health (MINSA) for adult health care (patients above the age of 14), was designated as the reference center for treating these cases. For this purpose, the norms and criteria established by the system were followed and every patient (case) presenting flu-like symptoms was included (fever equal or greater than 38 masculineC (100.4 masculineF), cough, sore throat, rhinorrhea, lethargy in children under the age of one, and respiratory distress). Seventy-six patients were hospitalized as suspected cases for infection with the influenza A H1N1 2009 virus, of which 13 (17.1%) were confirmed as positive. The clinical picture was characterized by fever (100%), cough (92.3%), rhinorrhea (69.2%), malaise (53.8%), headache (53.8%), and only one case presented gastrointestinal symptoms (diarrhoea). The male:female ratio was 1:2.2. The knowledge and technology translation previously acquired through courses to the HST health care providers were the key in controlling the first influenza A (H1N1) 2009 cases.

  3. Demand for care and nosocomial infection rate during the first influenza AH1N1 2009 virus outbreak at a referral hospital in Mexico City.

    PubMed

    Pérez-Padilla, Rogelio; Fernández, Rosario; García-Sancho, Cecilia; Franco-Marina, Francisco; Mondragón, Edgar; Volkow, Patricia

    2011-01-01

    Comparison of routine hospital indicators (consults at the Emergency Room (ER) and hospital admissions) during the 2009 pandemic of the influenza AH1N1 virus at the national referral hospital for respiratory diseases in Mexico City. The outbreak was from April to mid-May 2009 and two control periods were used:2009 (before and after the outbreak),and during April-May from 2007 and 2008. During the outbreak total consultation at the ER increased six times compared with the 2007-2008 control period and 11 times compared with the 2009 control period. Pneumonia- or influenza-related ER consultations increased 23.2 and 15.3%, respectively. The rate of nosocomial infection during the outbreak was 13.6 and that of nosocomial pneumonia was 6 per/100 hospital discharges, a two-fold and three-fold increase compared to the control periods respectively. During the outbreak,mean severity of admitted patients increased,with a rise in in-hospital mortality and nosocomial infections rate, including nosocomial pneumonia.

  4. Evolving pattern of spinal anaesthesia in stable eclamptic patients undergoing caesarean section at University of Benin Teaching Hospital, Benin, Nigeria.

    PubMed

    Afolayan, J M; Nwachukwu, C E; Esangbedo, E S; Omu, P O; Amadasun, F E; Fadare, J O

    2014-01-01

    Eclampsia is still associated with high maternal and perinatal and perinatal morbidity and mortality, especially in resource poor countries with limited access to perinatal and critical care facilities. The ideal method of anaesthesia for caesarean section in eclamptics is not generally agreed upon. Review of the patients' case notes as well as records of the institution's Labour Ward Theatre, Intensive Care Unit and Postnatal Ward was carried out between January 2011 and December 2012. Patients' clinical and demographic data, anaesthetic management methods, maternal and perinatal outcome measures were evaluated and analysed. Ninety-nine cases of eclampsia were reviewed, of which 87 had Caesarean section. After excluding five patients who had intercurrent medical ailments, 82 patients were finally analyzed. Of these, 65 (79.3%) had spinal anaesthesia while 17 (20.7%) had general anaesthesia. Out of the 19 (23.2%) who were transferred to the intensive care unit, 12 (70.6%) had general anaesthesia while 7 (10.8%) had spinal anaesthesia. Of the 17 patients who had general anaesthesia, 10 (58.8%) were ventilated post operatively versus only 2 (3.1%) in spinal anaesthesia. Nine of the 17 general anaesthesia patients (52.9%) versus only 1 of 65 spinal anaesthesia (1.5%) died in ICU. Apgar was two fold better in the spinal anaesthesia group at 5 minutes.There was a higher risk ratio for stillbirths in the general anaesthesia patients. maternal and perinatal survival and well being are better in eclamptics who had spinal anaesthesia for caesarean section compared to those who had general anaesthesia.

  5. Mites associated with stored grain commodities in Benin, West Africa.

    PubMed

    Zannou, Ignace D; Adebo, Habib O; Zannou, Elisabeth; Hell, Kerstin

    2013-12-01

    After insects, mites are the major arthropod pests that inhabit stored agricultural products worldwide. To determine the acarofauna that infests cowpea, maize, paddy rice and sorghum in Benin (West Africa), surveys were conducted in some principal markets (Dantokpa, Glazoue and Parakou) of this country. A total of 555 samples of grains and debris were collected in May and September 2011. More than 56 species belonging to 24 mite families were recorded in the four products. These mite species included predators, parasites, fungivorous, phytophagous and other groups whose feeding habits are not well known. The family Cheyletidae was the most prevalent and the most diverse predatory mite family encountered, in which Cheyletus malaccensis Oudemans was the most abundant species. Several families of mite pests and mites responsible for allergies (Acaridae, Glycyphagidae, Pyroglyphidae, Pyemotidae and Saproglyphidae) were also detected. The three most dominant and frequent species were C. malaccensis, Suidasia nesbitti (Hughes) and Suidasia sp. Statistical analysis showed that densities of these three mite species were higher in Parakou than in Glazoue and Dantokpa, on one hand, and higher in debris than in grains, on the other hand. The densities of S. nesbitti and Suidasia sp. decreased significantly during the dry season, whereas C. malaccensis remained stable throughout the two samplings. Of all grains, sorghum was the least infested with mites. This study shows that in Benin mites are present in stored agricultural products to which they cause serious damage, and may cause various allergies to people.

  6. A tale of two cities: effects of air pollution on hospital admissions in Hong Kong and London compared.

    PubMed

    Wong, Chit-Ming; Atkinson, Richard W; Anderson, H Ross; Hedley, Anthony Johnson; Ma, Stefan; Chau, Patsy Yuen-Kwan; Lam, Tai-Hing

    2002-01-01

    The causal interpretation of reported associations between daily air pollution and daily admissions requires consideration of residual confounding, correlation between pollutants, and effect modification. If results obtained in Hong Kong and London--which differ in climate, lifestyle, and many other respects--were similar, a causal association would be supported. We used identical statistical methods for the analysis in each city. Associations between daily admissions and pollutant levels were estimated using Poisson regression. Nonparametric smoothing methods were used to model seasonality and the nonlinear dependence of admissions on temperature, humidity, and influenza admissions. For respiratory admissions (> or = 65 years of age), significant positive associations were observed with particulate matter < 10 microm in aerodynamic diameter (PM(10), nitrogen dioxide, sulfur dioxide, and ozone in both cities. These associations tended to be stronger at shorter lags in Hong Kong and at longer lags in London. Associations were stronger in the cool season in Hong Kong and in the warm season in London, periods during which levels of humidity are at their lowest in each city. For cardiac admissions (all ages) in both cities, significant positive associations were observed for PM(10), NO(2), and SO(2) with similar lag patterns. Associations tended to be stronger in the cool season. The associations with NO(2) and SO(2) were the most robust in two-pollutant models. Patterns of association for pollutants with ischemic heart disease were similar in the two cities. The associations between O(3) and cardiac admissions were negative in London but positive in Hong Kong. We conclude that air pollution has remarkably similar associations with daily cardiorespiratory admissions in both cities, in spite of considerable differences between cities in social, lifestyle, and environmental factors. The results strengthen the argument that air pollution causes detrimental short

  7. How Does Patient Safety Culture in the Surgical Departments Compare to the Rest of the County Hospitals in Xiaogan City of China?

    PubMed

    Wang, Manli; Tao, Hongbing

    2017-09-26

    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 "organizational learning

  8. Causes, spectrum and effects of surgical child abuse and neglect in a Nigerian city.

    PubMed

    Osifo, O D; Oku, O R

    2009-01-01

    Children are dependent on parents and care givers for the quality of health care services received and in developing countries, where they are not protected against child abuse; many die as a result of denial of appropriate treatment. The objective of this study was to determine the causes, spectrum and effects of abuse and neglect on surgical children. Analysis of cases of surgical child abuse and neglect between January, 1998 and December, 2007 at the University of Benin Teaching Hospital, Benin City, Nigeria, was done. A total of 281 children aged two days and 12 years comprising 113 males and 168 females with male to female ratio 1:1.4, mainly with congenital malformation, suffered surgical child abuse and neglect ranging from delayed presentation, to child abandonment which was perpetuated by ignorance, poverty, superstitious beliefs, customs as well as non availability of free medical services for children. Counselling and home visits in addition to surgeries were done and 198 (70.5%) children were successfully treated with those abandoned happily reunited with their families, while 56 (19.9%) mortality was recorded due to complications of the primary surgical pathology, and this was statistically significant compared with other children with similar lesions but without abuse or neglect during the period (p=0.0102). Whereas 27 (9.6%) among those discharged against medical advice were lost to follow-up, of the 198 children that survived, 22 suffered psychological trauma and were co-managed with psychologists while seven were transferred to orphanage homes. Surgical child abuse/neglect is rampant, hence, it is hoped that these findings will influence policy makers in this sub-region to formulate policies that will protect children against this form of child abuse.

  9. 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.

  10. 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

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

    PubMed Central

    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

    2015-01-01

    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. PMID:26402922

  12. 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.

  13. Introduction of misoprostol for the treatment of incomplete abortion beyond 12 weeks of pregnancy in Benin.

    PubMed

    Adisso, Sosthène; Hounkpatin, Benjamin I B; Komongui, Gounnou D; Sambieni, Olivier; Perrin, René X

    2014-07-01

    Improving the care of women who have undergone a spontaneous or induced abortion is an important step in reducing abortion-related morbidity and mortality. Both the International Federation of Gynecology and Obstetrics (FIGO) and the World Health Organization recommend the use of manual vacuum aspiration (MVA) and misoprostol rather than sharp curettage to treat incomplete abortion. MVA was introduced into the public healthcare service in Benin in 2006 and since 2008 misoprostol has been available in 3 large maternity hospitals. The present study opted to use an oral dose of 800 μg and not to limit to pregnancies of up to 12 weeks, but to include women with second trimester abortions. After 5 years, results show that around three-quarters of the women treated with misoprostol at 13-18 weeks of pregnancy required MVA to complete uterine evacuation and approximately one-quarter had severe bleeding, confirming that the indication of misoprostol for incomplete abortion should be limited to pregnancies of up to 12 weeks. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  14. Monitoring water stock variations by gravimetry in Benin

    NASA Astrophysics Data System (ADS)

    Seguis, L.; Galle, S.; Descloitres, M.; Laurent, J.-P.; Grippa, M.; Pfeffer, J.; Luck, B.; Genthon, P.; Hinderer, J.

    2009-04-01

    In Central Benin (wet Soudanian climate), in the frame of the AMMA (African Monsoon Multidisciplinary Analysis) program, an hydrological observatory has been set up since 2000. It is based on embedded catchments from a few to twelve thousand squared kilometers. At the local scale, 3 hillslopes with contrasted vegetation covers were selected in 2005 to study the water redistribution processes. With the aim to close the water budget at this scale, the instrumentation device was composed of instruments which monitored the 1st meter of the vadoze zone (succion, humidetric and temperature probes), the groundwater (piezometers screened at different depths) and a flux station to control evapotranspiration. Seasonal water storage changes can be monitored at this local scale but determination of the water budget at catchment scale is still difficult and needs modelling. A promising method seems to be the monitoring of the gravimetric variations. The GHYRAF French project (Gravity and Hydrology in Africa) started in 2008. It is devoted to the water storage variation assessment in sub-saharian Africa. In this aim it carries detailed comparison between models and multidisciplinary observations (ground and satellite gravity, geodesy, hydrology, meteorology). To perform this intercomparison, the main surface gravity experiment consists in periodic absolute gravity measurements at specific points along a north-south monsoonal gradient of rainfall in West Africa (Tamanrasset (20 mm annual rainfall depth) in southern Algeria, Niamey (500 mm) and a Soudanian site in Central Benin (1200 mm). In Benin, three gravity measurements have been already done on the key periods of the water cycle (July 2008 : on-set of the groundwater recharge, September 2008 : highest water table and wettest state in the vadoze zone, January 2009, low water table and dry state in the vadoze zone). We present here the preliminary comparisons of the water storage variation estimations deduced from the

  15. 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

  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. Isolation and Identification of Pathogenic Filamentous Fungi and Yeasts From Adult House Fly (Diptera: Muscidae) Captured From the Hospital Environments in Ahvaz City, Southwestern Iran.

    PubMed

    Kassiri, Hamid; Zarrin, Majid; Veys-Behbahani, Rahele; Faramarzi, Sama; Kasiri, Ali

    2015-11-01

    Musca domestica L., 1758 is capable of transferring a number of pathogenic viruses, bacteria, fungi, and parasites to animals and humans. The objective of this study was to isolate and identify medically important filamentous fungi and yeasts from adult M. domestica collected from two wards of three hospital environments in Ahvaz city, Khuzestan Province, southwestern Iran. The common house flies were caught by a sterile net. These insects were washed in a solution of 1% sodium hypochlorite for 3 min and twice in sterile distilled water for 1 min. The flies were individually crushed with sterile swabs in sterile test tubes. Then 2 ml of sterile normal saline (0.85%) was added to each tube, and the tube was centrifuged for 5 min. The supernatant was then discarded, and the remaining sediment was inoculated with a sterile swab in the Sabouraud's dextrose agar medium containing chloramphenicol. Isolation and identification of fungi were made by standard mycological methods. In this research, totally 190 M. domestica from hospital environments were captured. In total, 28 fungal species were isolated. The main fungi isolated were Aspergillus spp. (67.4%), Penicillium sp. (11.6%), Mucorales sp. (11%), Candida spp. (10.5%), and Rhodotorula sp. (8.4%). Among the house flies caught at the hospitals, about 80% were found to carry one or more medically important species of fungi. This study has established that common house flies carry pathogenic fungi in the hospital environments of Ahvaz. The control of M. domestica in hospitals is essential in order to control the nosocomial fungal infections in patients.

  18. Benzylpiperizine-based party pills' impact on the Auckland City Hospital Emergency Department Overdose Database (2002-2004) compared with ecstasy (MDMA or methylene dioxymethamphetamine), gamma hydroxybutyrate (GHB), amphetamines, cocaine, and alcohol.

    PubMed

    Theron, Lynn; Jansen, Karl; Miles, Jennifer

    2007-02-16

    To examine the impact of 'party pills' (PP; herbal highs) on the Auckland City Hospital Emergency Department Overdose Database 2002-2004, and to present figures for five other substances in that database. Auckland City Hospital's Emergency Department's overdose database was reviewed for 2002, 2003, and 2004 for 'herbal ingestions' and 'party pills' (PP), ecstasy, methamphetamine, GHB, cocaine, and alcohol. Adverse effects attributed to PP were examined. In 2002, 1 patient presented with PP ingestion; 4 presented in 2003 and 21 in 2004 respectively (p<0.001). Of these 21 patients in 2004, 5 had allegedly ingested PP only and none required medical admission. PP only contributed to 1.58% of the overdose database for 2004. 'Party pills' appeared to have a minor impact on the overdose database at Auckland City Hospital between 2002 and 2004. There was a significant decrease in GHB presentations from 2003 to 2004 (p<0.001), but no significant fall in stimulant overdose presentations.

  19. Coarse Particulate Air Pollution Associated with Increased Risk of Hospital Admissions for Respiratory Diseases in a Tropical City, Kaohsiung, Taiwan.

    PubMed

    Cheng, Meng-Hsuan; Chiu, Hui-Fen; Yang, Chun-Yuh

    2015-10-16

    This study was undertaken to determine whether there was an association between coarse particles (PM₂.₅-₁₀) levels and frequency of hospital admissions for respiratory diseases (RD) in Kaohsiung, Taiwan. Hospital admissions for RD including chronic obstructive pulmonary disease (COPD), asthma, and pneumonia, and ambient air pollution data levels for Kaohsiung were obtained for the period from 2006 to 2010. The relative risk of hospital admissions for RD was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single pollutant model (without adjustment for other pollutants), increased rate of admissions for RD were significantly associated with higher coarse PM levels only on cool days (<25 °C), with a 10 µg/m³ elevation in PM₂.₅-₁₀ concentrations associated with a 3% (95% CI = 1%-5%) rise in COPD admissions, 4% (95% CI = 1%-7%) increase in asthma admissions, and 3% (95% CI = 2%-4%) rise in pneumonia admissions. No significant associations were found between coarse particle levels and the number of hospital admissions for RD on warm days. In the two-pollutant models, PM₂.₅-₁₀ levels remained significantly correlated with higher rate of RD admissions even controlling for sulfur dioxide, nitrogen dioxide, carbon monoxide, or ozone on cool days. This study provides evidence that higher levels of PM₂.₅-₁₀ enhance the risk of hospital admissions for RD on cool days.

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

    PubMed

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

    2008-10-01

    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.

  1. 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

  2. Pseudomonas aeruginosa: study of antibiotic resistance and molecular typing in hospital infection cases in a neonatal intensive care unit from Rio de Janeiro City, Brazil.

    PubMed

    Loureiro, M M; de Moraes, B A; Mendonca, V L F; Quadra, M R R; Pinheiro, G S; Asensi, M D

    2002-04-01

    This study had the objective of to analyze the demographic and bacteriologic data of 32 hospitalized newborns in an neonatal intensive care unit of a public maternity hospital in Rio de Janeiro city, Brazil, seized by Pseudomonas aeruginosa sepsis during a period ranged from July 1997 to July 1999, and to determine the antimicrobial resistance percentage, serotypes and pulsed field gel electrophoresis (PFGE) patterns of 32 strains isolated during this period. The study group presented mean age of 12.5 days, with higher prevalence of hospital infection in males (59.4%) and vaginal delivery (81.2%), than females (40.6%) and cesarean delivery (18.8%), respectively. In this group, 20 (62.5%) patients received antimicrobials before positive blood cultures presentation. A total of 87.5% of the patients were premature, 62.5% presented very low birth weight and 40.6% had asphyxia. We detected high antimicrobial resistance percentage to b-lactams, chloramphenicol, trimethoprim/sulfamethoxazole and tetracycline among the isolated strains. All isolated strains were classified as multi-drug resistant. Most strains presented serotype O11 while PFGE analysis revealed seven distinct clones with isolation predominance of a single clone (75%) isolated from July 1997 to June 1998.

  3. The dilemma of a practice: experiences of abortion in a public maternity hospital in the city of Salvador, Bahia.

    PubMed

    McCallum, Cecilia; Menezes, Greice; Reis, Ana Paula Dos

    2016-01-01

    The article discusses abortion and miscarriage from the perspective of women admitted to a public maternity hospital in Salvador (BA), Brazil. Based on qualitative and quantitative research, it draws on participant observation of everyday hospital life. Taking an ethnographic approach, it addresses the hospital experiences of women who had miscarriages or induced abortions, also presenting the views of health professionals. It argues that the way the institution structures care for abortion and miscarriage involves symbolic processes that profoundly affect women's experiences. The discrimination against women who have had abortions/miscarriages is an integral part of the structure, organization and culture of these institutions, and does not derive solely from the individual actions of healthcare personnel.

  4. Antibiotic use for pneumonia among children under-five at a pediatric hospital in Dhaka city, Bangladesh.

    PubMed

    Rashid, Md Mahbubur; Chisti, Mohammod Jobayer; Akter, Dilruba; Sarkar, Malabika; Chowdhury, Fahmida

    2017-01-01

    Pneumonia has been the leading cause of morbidity and mortality among children under 5 for more than 3 decades, particularly in low-income countries like Bangladesh. The World Health Organization (WHO) developed a pneumonia case management strategy which included the use of antibiotics for both primary and hospital-based care. This study aims to describe antibiotic usage for treating pneumonia in children in a private pediatric teaching hospital in Dhaka, Bangladesh. We conducted this cross-sectional study among children <5 years old who were admitted to a private pediatric hospital in Dhaka with a diagnosis of pneumonia in November 2012. We enrolled 80 children during the study period. Among them, 28 (35.4%) were underweight, 14 (17.7%) were moderately underweight, and 13 (16.5%) were severely under-weight. On the basis of WHO classification (2005), 43 children (54%) had severe pneumonia and 37 (46%) had very severe pneumonia, as diagnosed by the research physician. Among the prescribed antibiotics in the hospital, parenteral ceftriaxone was the most common 40 (50%), followed by cefotaxime plus amikacin 14 (17.5%), cefuroxime 7 (8.8%), ceftazidime plus amikacin 6 (7.5%), ceftriaxone plus amikacin 3 (3.8%), meropenem 2 (2.5%), cefepime 2 (2.5%), and cefotaxime 2 (2.5%). Despite the WHO pneumonia treatment strategy, the inappropriate use of higher-generation cephalosporin and carbapenem was high in the study hospital. The results underscore the noncompliance with the WHO guidelines of antibiotic use and the importance of enforcing regulatory policy of the rational use of antibiotics for treating hospitalized children with pneumonia. Following these guidelines may help prevent increased antimicrobial resistance.

  5. [Comparison of sociocultural attitudes towards epilepsy in Limousin (France), in Togo and in Benin (Africa)].

    PubMed

    Nubukpo, P; Preux, P M; Clement, J P; Houinato, D; Tuillas, M; Aubreton, C; Radji, A; Grunitzky, E K; Avode, G; Tapie, P

    2003-01-01

    Sociocultural attitudes continue to have a negative impact on management of epilepsy in many African countries and in a few advanced countries. The purpose of this study was to compare attitudes toward epilepsy in France and two African nations: Togo and Benin. A total of 305 epileptic patients over 18 years of age were interviewed using the same quantitative questionnaire about their beliefs, knowledge attitudes and practices regarding their disease. There were 77 patients from the Limousin region in France, 129 from the rural canton of Nadoba in Togo and 99 from the coastal province in Benin. The frequency of epileptic seizure during the last two years prior to the study was lower in France than in Togo and Benin. The number of people who believed in supernatural causes of epilepsy was higher in Togo and Benin whereas the number of people attributing the disease to social causes (e.g. death and stress) was higher in France. Few epileptic patients in France thought that the disease was contagious whereas many patients in both Togo and Benin still believed that the disease was contagious and that some foods were forbidden. More patients in France than in Togo and Benin were aware of the relationship of epilepsy with alcohol, drug abuse and cerebral injury. Epileptic patients in France were more likely to consult a physician and use medical drugs for the treatment of epilepsy than their counterparts in Togo and Benin. Epileptic patients in Togo often complained of social exclusion. Although sometimes contradictory, these findings support the idea that sociocultural attitudes should be taken into account in the management of the disease.

  6. Patient's Perception and Expectations of the Quality of Outpatient Services of Imam Khomeini Hospital in Sari City.

    PubMed

    Abedi, Ghassem; Rostami, Farideh; Ziaee, Marzieh; Siamian, Hasan; Nadi, Aliasghar

    2015-08-01

    Out-patient department is the gateway to almost all of the hospital services. Providing method of service in this place has an important role in the general impression of the patient of hospital sanitary and treatment services. This research was done with the purpose of studying the perception and expectations of out-patient service receivers of Imam Khomeini Hospital in Sari. A cross-sectional study was conducted on those patients in the outpatient service department of Imam Khomeini Hospital who at least have the junior high school degree. 200 people were selected as sample size with Morgan's table. Respondents answered the questionnaire two times. Once they expressed their perception of the provided services and once for their expectations. Therefore, the following expectation scores are obtained. To prove the significance of demographic variables with perception and expectations, the T and Tukey's tests and also to compare different groups the variance analysis test are used. The mean of age was 25.68± 9.086 (The youngest participant was 16 and the oldest 67 years old). It was observed from the results of the T test there is no significant difference between sex and residential place. It was clear that in perception part; there was a significant difference, at the level of 0.05 significance, in all groups except for responding and behavior, while, in expectation level, no significance in the age of the dimensions except for access. Results showed that the satisfaction status of patients in Imam Hospital clinic in Sari is good. Many of the existing shortages can be improved by presenting an accurate and organized program. The present study shows that some service dimensions of patients require being promoted, the most important of which include behavior, accessibility and affordability, physical and responsiveness dimensions.

  7. Patient’s Perception and Expectations of the Quality of Outpatient Services of Imam Khomeini Hospital in Sari City

    PubMed Central

    Abedi, Ghassem; Rostami, Farideh; Ziaee, Marzieh; Siamian, Hasan; Nadi, Aliasghar

    2015-01-01

    Background and Purpose: Out-patient department is the gateway to almost all of the hospital services. Providing method of service in this place has an important role in the general impression of the patient of hospital sanitary and treatment services. This research was done with the purpose of studying the perception and expectations of out-patient service receivers of Imam Khomeini Hospital in Sari. Materials and Methodology: A cross-sectional study was conducted on those patients in the outpatient service department of Imam Khomeini Hospital who at least have the junior high school degree. 200 people were selected as sample size with Morgan’s table. Respondents answered the questionnaire two times. Once they expressed their perception of the provided services and once for their expectations. Therefore, the following expectation scores are obtained. To prove the significance of demographic variables with perception and expectations, the T and Tukey’s tests and also to compare different groups the variance analysis test are used. Findings: The mean of age was 25.68± 9.086 (The youngest participant was 16 and the oldest 67 years old). It was observed from the results of the T test there is no significant difference between sex and residential place. It was clear that in perception part; there was a significant difference, at the level of 0.05 significance, in all groups except for responding and behavior, while, in expectation level, no significance in the age of the dimensions except for access. Conclusion: Results showed that the satisfaction status of patients in Imam Hospital clinic in Sari is good. Many of the existing shortages can be improved by presenting an accurate and organized program. The present study shows that some service dimensions of patients require being promoted, the most important of which include behavior, accessibility and affordability, physical and responsiveness dimensions. PMID:26543422

  8. Coarse Particulate Air Pollution Associated with Increased Risk of Hospital Admissions for Respiratory Diseases in a Tropical City, Kaohsiung, Taiwan

    PubMed Central

    Cheng, Meng-Hsuan; Chiu, Hui-Fen; Yang, Chun-Yuh

    2015-01-01

    This study was undertaken to determine whether there was an association between coarse particles (PM2.5–10) levels and frequency of hospital admissions for respiratory diseases (RD) in Kaohsiung, Taiwan. Hospital admissions for RD including chronic obstructive pulmonary disease (COPD), asthma, and pneumonia, and ambient air pollution data levels for Kaohsiung were obtained for the period from 2006 to 2010. The relative risk of hospital admissions for RD was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single pollutant model (without adjustment for other pollutants), increased rate of admissions for RD were significantly associated with higher coarse PM levels only on cool days (<25 °C), with a 10 µg/m3 elevation in PM2.5–10 concentrations associated with a 3% (95% CI = 1%–5%) rise in COPD admissions, 4% (95% CI = 1%–7%) increase in asthma admissions, and 3% (95% CI = 2%–4%) rise in pneumonia admissions. No significant associations were found between coarse particle levels and the number of hospital admissions for RD on warm days. In the two-pollutant models, PM2.5–10 levels remained significantly correlated with higher rate of RD admissions even controlling for sulfur dioxide, nitrogen dioxide, carbon monoxide, or ozone on cool days. This study provides evidence that higher levels of PM2.5–10 enhance the risk of hospital admissions for RD on cool days. PMID:26501308

  9. Changes in injury-related hospital emergency department presentations associated with the imposition of regulatory versus voluntary licensing conditions on licensed venues in two cities.

    PubMed

    Miller, Peter; Curtis, Ashlee; Palmer, Darren; Busija, Lucy; Tindall, Jennifer; Droste, Nicolas; Gillham, Karen; Coomber, Kerri; Wiggers, John

    2014-05-01

    Regulatory and collaborative intervention strategies have been developed to reduce the harms associated with alcohol consumption on licensed venues around the world, but there remains little research evidence regarding their comparative effectiveness. This paper describes concurrent changes in the number of night-time injury-related hospital emergency department presentations in two cities that implemented either a collaborative voluntary approach to reducing harms associated with licensed premises (Geelong) or a regulatory approach (Newcastle). This paper reports findings from Dealing with Alcohol-Related problems in the Night-Time Economy project. Data were drawn from injury-specific International Classification of Disease, 10th Revision codes for injuries (S and T codes) presenting during high-alcohol risk times (midnight--5.59 am, Saturday and Sunday mornings) at the emergency departments in Geelong Hospital and Newcastle (John Hunter Hospital and the Calvary Mater Hospital), before and after the introduction of licensing conditions between the years of 2005 and 2011. Time-series, seasonal autoregressive integrated moving average analyses were conducted on the data obtained from patients' medical records. Significant reductions in injury-related presentations during high-alcohol risk times were found for Newcastle since the imposition of regulatory licensing conditions (344 attendances per year, P < 0.001). None of the interventions deployed in Geelong (e.g. identification scanners, police operations, radio networks or closed-circuit television) were associated with reductions in emergency department presentations. The data suggest that mandatory interventions based on trading hours restrictions were associated with reduced emergency department injury presentations in high-alcohol hours than voluntary interventions. © 2014 Australasian Professional Society on Alcohol and other Drugs.

  10. 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.

  11. 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

  12. Geochemical and isotopic study of the aquifers of the littoral plain of Benin

    NASA Astrophysics Data System (ADS)

    Odeloui, Diane; Celle-Jeanton, Hélène; Huneau, Frédéric; Alasanne, Abdoukarim; Boukari, Moussa; Mama, Daouda; Lavastre, Véronique

    2013-04-01

    The study area is located in the Southern part of the coastal sedimentary basin of Benin. This basin contains four aquifers among which the aquifers of the Quaternary and of the Continental Terminal which are concerned by the present study. These aquifers are intensely used for the drinking water supply of about two million inhabitants in the cities of Cotonou, Porto Novo, Ouidah and their surroundings. At present, a degradation of the quality of groundwaters coming from the aquifers of the Quaternary and of Continental Terminal is observed that is connected to ground occupation and to the intensive pumping, having for consequence the progression of the marine intrusion in these aquifers. The present work aims at studying the hydrogeochemical and isotopic behaviour of these two aquifers. The methodological approach consists in the measurements of the physico-chemical parameters, as well as the stable isotope signature of the groundwater in order to appreciate groundwater quality and origin. Results show that groundwaters of the aquifers of the Quaternary and of the Continental Terminal are highly mineralized and show Na-Cl or Ca-HCO3 water types. The main processes affecting the mineralization of waters are, among others, the mixture with salty and brackish waters from the Atlantic Ocean or from the littoral lagoons, dissolution of carbonate minerals and cationic exchanges. The isotopic study indicates that groundwater is recharged by local rainfalls; some samples of the Quaternary aquifer show a mixture with the sea water, which is in good agreement with the geochemical results. Both aquifers tend to show the same isotopic signature suggesting a relatively good hydraulic continuity within the reservoir and confirming geological investigations made through drillings.

  13. The effects of severe iron-deficiency anaemia on maternal and neonatal outcomes: A case-control study in an inner-city London hospital.

    PubMed

    Luis, J; Fadel, M G; Lau, G Y; Houssein, S; Ravikumar, N; Yoong, W

    2016-05-01

    This case-control study investigates the effects of severe iron-deficiency anaemia in pregnancy on maternal and neonatal outcomes in a relatively deprived inner-city population in a North London hospital. The study group comprised of 106 women with haemoglobin (Hb) < 8 g/dl at any point during pregnancy, while controls were 106 women with Hb > 11 g/dl throughout pregnancy. The study group lost an average of 80 ml more blood at delivery (p = 0.032) and had higher rates of postpartum haemorrhage than the control group (27 vs 12 patients, p = 0.012). However, anaemia did not appear to influence other maternal or neonatal outcomes; these may have been confounded by antenatal intervention with oral haematinics or blood transfusion.

  14. 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.

  15. 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

  16. The Role of Psychiatric Emergency Services in Aiding Community Alternatives to Hospitalization in an Inner-City Population

    PubMed Central

    Bell, Carl C.

    1978-01-01

    In the proper political/economic environment, Crisis Intervention Programs can reduce the recidivism rate of patients who suffer from recurrent intermittent acute psychotic episodes. The author seeks to outline such a program and demonstrate its effectiveness in providing an alternative to brief hospitalization. It is believed that this form of management of the psychiatric emergency aids the practice of community psychiatry and supports the use of day treatment facilities, outpatient clinics, emergency housing, family therapy, and other community support systems. PMID:731721

  17. "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…

  18. "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…

  19. 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.

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

    PubMed Central

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

    2016-01-01

    Introduction 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. Methods 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. Results 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. Conclusion 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. PMID:27800116

  1. Technology transfer from havana hospitals to primary care: yamila de armas, MD. Deputy director, provincial health department, havana city province.

    PubMed

    Giraldo, Gloria

    2009-01-01

    Dr Yamila de Armas has occupied an array of posts since finishing her residency in family medicine in her home province of Cienfuegos in 1992. She has served as a family doctor; polyclinic, municipal and provincial health director; medical school dean; and twice vice minister of public health. But few would doubt her toughest job is the one she has now: deputy director of the Havana City Provincial Health Department, in charge of medical services for the 2.2 million people living in Cuba's complex, sprawling capital. It was here in 2002-2003 that the program was launched to repair, refurbish and expand the country's nearly 500 community polyclinics. Key to the effort was equipping these facilities with a broader range of new and upgraded medical technology. Dr de Armas offers MEDICC Review her reflections on the results five years later.

  2. Performance of implementing guideline-driven cervical cancer screening measures in an inner-city hospital system.

    PubMed

    Wieland, Daryl L; Reimers, Laura L; Wu, Eijean; Nathan, Lisa M; Gruenberg, Tammy; Abadi, Maria; Einstein, Mark H

    2011-10-01

    : In 2006, the American Society for Colposcopy and Cervical Pathology updated evidence-based guidelines recommending screening intervals for women with abnormal cervical cytology diagnosis. In our low-income inner-city population, we sought to improve performance by uniformly applying the guidelines to all patients. We report the prospective performance of a comprehensive tracking, evidence-based algorithmically driven call back, and appointment scheduling system for cervical cancer screening in a resource-limited inner-city population. : Outreach efforts were formalized with algorithm-based protocols for triage to colposcopy, with universal adherence to evidence-based guidelines. During implementation from August 2006 to July 2008, we prospectively tracked performance using the electronic medical record with administrative and pathology reports to determine performance variables such as the total number of Pap tests, colposcopy visits, and the distribution of abnormal cytology and histology results, including all cervical intraepithelial neoplasia 2, 3 diagnoses. : A total of 86,257 gynecologic visits and 41,527 Pap tests were performed system-wide during this period of widespread and uniform implementation of standard cervical cancer screening guidelines. The number of Pap tests performed per month varied little. The incidence of CIN 1 significantly decreased from 117 (68.4%) of 171 during the first tracked month to 52 (54.7%) of 95 during the last tracked month (p = 0.04). The monthly incidence rate of CIN 2, 3, including incident cervical cancers, did not change. The total number of colposcopy visits declined, resulting in a 50% decrease in costs related to colposcopy services and approximately a 12% decrease in costs related to excisional biopsies. : Adherence to cervical cancer screening guidelines reduced the number of unnecessary colposcopies without increasing numbers of potentially missed CIN 2, 3 lesions, including cervical cancer. Uniform implementation

  3. Pre-hospital delay and its associated factors in first-ever stroke registered in communities from three cities in China

    PubMed Central

    Jiang, Bin; Ru, Xiaojuan; Sun, Haixin; Liu, Hongmei; Sun, Dongling; Liu, Yunhai; Huang, Jiuyi; He, Li; Wang, Wenzhi

    2016-01-01

    This study aimed to explore pre-hospital delay and its associated factors in first-ever stroke registered in communities from three cities in China. The rates of delay greater than or equal to 2 hours were calculated and factors associated with delays were determined by non-conditional binary logistic regression, after adjusting for different explanatory factors. Among the 403 cases of stroke with an accurate documented time of prehospital delay, the median time (interquartile range) was 4.00 (1.50–14.00) hours. Among the 544 cases of stroke with an estimated time range of prehospital delay, 24.8% of patients were transferred to the emergency department or hospital within 2 hours, only 16.9% of patients with stroke were aware that the initial symptom represented a stroke, only 18.8% used the emergency medical service and one-third of the stroke cases were not identified by ambulance doctors. In the multivariate analyses, 8 variables or sub-variables were identified. In conclusion, prehospital delay of stroke was common in communities. Thus, intervention measures in communities should focus on education about the early identification of stroke and appropriate emergency medical service (EMS) use, as well as the development of organized stroke care. PMID:27411494

  4. FUNGEMIA CAUSED BY Candida SPECIES IN A CHILDREN'S PUBLIC HOSPITAL IN THE CITY OF SÃO PAULO, BRAZIL: STUDY IN THE PERIOD 2007-2010

    PubMed Central

    Oliveira, Vanessa Kummer Perinazzo; Ruiz, Luciana da Silva; Oliveira, Nélio Alessandro Jesus; Moreira, Débora; Hahn, Rosane Christine; Melo, Analy Salles de Azevedo; Nishikaku, Angela Satie; Paula, Claudete Rodrigues

    2014-01-01

    Candidemia remains a major cause of morbidity and mortality in the health care environment. The epidemiology of Candida infection is changing, mainly in relation to the number of episodes caused by species C. non-albicans. The overall objective of this study was to evaluate the frequency of yeasts of the genus Candida, in a four-year period, isolated from blood of pediatric patients hospitalized in a public hospital of the city of São Paulo, Brazil. In this period, yeasts from blood of 104 patients were isolated and, the identified species of Candida by phenotypic and genotypic methods were: C. albicans (39/104), C. tropicalis (25/104), C. parapsilosis (23/104), Pichia anomala (6/104), C. guilliermondii (5/104), C. krusei (3/104), C. glabrata (2/104) and C. pararugosa (1/104). During the period of the study, a higher frequency of isolates of C. non-albicans (63.55%) (p = 0.0286) was verified. In this study we verified the increase of the non-albicans species throughout the years (mainly in 2009 and 2010). Thus, considering the peculiarities presented by Candida species, a correct identification of species is recommended to lead to a faster diagnosis and an efficient treatment. PMID:25076430

  5. Association between Daily Hospital Outpatient Visits for Accidents and Daily Ambient Air Temperatures in an Industrial City

    PubMed Central

    Chau, Tang-Tat; Wang, Kuo-Ying

    2016-01-01

    An accident is an unwanted hazard to a person. However, accidents occur. In this work, we search for correlations between daily accident rates and environmental factors. To study daily hospital outpatients who were admitted for accidents during a 5-year period, 2007–2011, we analyzed data regarding 168,366 outpatients using univariate regression models; we also used multivariable regression models to account for confounding factors. Our analysis indicates that the number of male outpatients admitted for accidents was approximately 1.31 to 1.47 times the number of female outpatients (P < 0.0001). Of the 12 parameters (regarding air pollution and meteorology) considered, only daily temperature exhibited consistent and significant correlations with the daily number of hospital outpatient visits for accidents throughout the 5-year analysis period. The univariate regression models indicate that older people (greater than 66 years old) had the fewest accidents per 1-degree increase in temperature, followed by young people (0–15 years old). Middle-aged people (16–65 years old) were the group of outpatients that were more prone to accidents, with an increase in accident rates of 0.8–1.2 accidents per degree increase in temperature. The multivariable regression models also reveal that the temperature variation was the dominant factor in determining the daily number of outpatient visits for accidents. Our further multivariable model analysis of temperature with respect to air pollution variables show that, through the increases in emissions and concentrations of CO, photochemical O3 production and NO2 loss in the ambient air, increases in vehicular emissions are associated with increases in temperatures. As such, increases in hospital visits for accidents are related to vehicular emissions and usage. This finding is consistent with clinical experience which shows about 60% to 80% of accidents are related to traffic, followed by accidents occurred in work place. PMID

  6. Association between Daily Hospital Outpatient Visits for Accidents and Daily Ambient Air Temperatures in an Industrial City.

    PubMed

    Chau, Tang-Tat; Wang, Kuo-Ying

    2016-01-01

    An accident is an unwanted hazard to a person. However, accidents occur. In this work, we search for correlations between daily accident rates and environmental factors. To study daily hospital outpatients who were admitted for accidents during a 5-year period, 2007-2011, we analyzed data regarding 168,366 outpatients using univariate regression models; we also used multivariable regression models to account for confounding factors. Our analysis indicates that the number of male outpatients admitted for accidents was approximately 1.31 to 1.47 times the number of female outpatients (P < 0.0001). Of the 12 parameters (regarding air pollution and meteorology) considered, only daily temperature exhibited consistent and significant correlations with the daily number of hospital outpatient visits for accidents throughout the 5-year analysis period. The univariate regression models indicate that older people (greater than 66 years old) had the fewest accidents per 1-degree increase in temperature, followed by young people (0-15 years old). Middle-aged people (16-65 years old) were the group of outpatients that were more prone to accidents, with an increase in accident rates of 0.8-1.2 accidents per degree increase in temperature. The multivariable regression models also reveal that the temperature variation was the dominant factor in determining the daily number of outpatient visits for accidents. Our further multivariable model analysis of temperature with respect to air pollution variables show that, through the increases in emissions and concentrations of CO, photochemical O3 production and NO2 loss in the ambient air, increases in vehicular emissions are associated with increases in temperatures. As such, increases in hospital visits for accidents are related to vehicular emissions and usage. This finding is consistent with clinical experience which shows about 60% to 80% of accidents are related to traffic, followed by accidents occurred in work place.

  7. 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…

  8. The ecological relationship between deprivation, social isolation and rates of hospital admission for acute psychiatric care: a comparison of London and New York City.

    PubMed

    Curtis, Sarah; Copeland, Alison; Fagg, James; Congdon, Peter; Almog, Michael; Fitzpatrick, Justine

    2006-03-01

    We report on comparative analyses of small area variation in rates of acute hospital admissions for psychiatric conditions in Greater London around the year 1998 and in New York City (NYC) in 2000. Based on a theoretical model of the factors likely to influence psychiatric admission rates, and using data from the most recent population censuses and other sources, we examine the association with area indicators designed to measure access to hospital beds, socio-economic deprivation, social fragmentation and ethnic/racial composition. We report results on admissions for men and women aged 15-64 for all psychiatric conditions (excluding self-harm), drug-related substance abuse/addiction, schizophrenia and affective disorders. The units of analysis in NYC were 165 five-digit Zip Code Areas and, in London, 760 electoral wards as defined in 1998. The analysis controls for age and sex composition and, as a proxy for access to care, spatial proximity to hospitals with psychiatric beds. Poisson regression modeling incorporating random effects was used to control for both overdispersion in the counts of admissions and for the effects of spatial autocorrelation. The results for NYC and London showed that local admission rates for all types of condition were positively and significantly associated with deprivation and the association is independent of demographic composition or 'access' to beds. In NYC, social fragmentation showed a significant association with admissions due to affective disorders and schizophrenia, and for drug dependency among females. Racial minority concentration was significantly and positively associated with admissions for schizophrenia. In London, social fragmentation was associated positively with admissions for men and women due to schizophrenia and affective disorders. The variable measuring racial/ethnic minority concentration for London wards showed a negative association with admission rates for drug dependency and for affective disorders. We

  9. Seroprevalence of human immunodeficiency virus in parturients at Boston City Hospital: implications for public health and obstetric practice.

    PubMed

    Donegan, S P; Steger, K A; Recla, L; Hoff, R S; Werner, B G; Rice, P A; Craven, D E

    1992-09-01

    We measured the seroprevalence of human immunodeficiency virus in women seeking reproductive services. Demographic and risk behavior data from women were linked anonymously to human immunodeficiency virus antibody results. The overall human immunodeficiency virus seropositivity rate of cord blood was 22 per 1000. Crude seroprevalence rates were higher for black women versus white women (25/1000 vs 22/1000) but lower for black Americans versus white Americans (21/1000 vs 29/1000). Human immunodeficiency virus infection was significantly higher for those women who acknowledge intravenous drug use (odds ratio 12.9, 95% confidence interval 7.3 to 22.7), were born in Haiti (odds ratio 2.6, 95% confidence interval 1.6 to 4.1), lacked prenatal care (odds ratio 2.2, 95% confidence interval 1.1 to 4.2), or received prenatal care at the hospital clinic versus a neighborhood health center (odds ratio 3.0, 95% confidence interval 1.7 to 5.3). The seroprevalence rates were 18/1000 for women seeking abortion and 16/1000 for women seeking family-planning services. Intravenous drug use and country of origin are major risk factors for human immunodeficiency virus infection in women, which may explain differences in seroprevalence rates in various racial or ethnic groups. Hospital-specific data on human immunodeficiency virus infection may be useful for monitoring the epidemic and allocating resources for education, counseling, testing, and prevention.

  10. Knowledge, attitude, and practice towards blood donation among health care providers in hospitals at Bahir Dar City, Ethiopia.

    PubMed

    Abera, Bayeh; Mohammed, Beyan; Betela, Wendmagegn; Yimam, Reshid; Oljira, Adam; Ahmed, Merhab; Tsega, Wubet; Mulu, Wondemagegn; Yizengaw, Endalew

    2017-06-01

    Like other sub-Saharan Africa, in Ethiopia there is a shortage of adequate and safe blood supplies. Health care providers are potential resource and promoter of voluntary blood donation. This study was conducted to determine the knowledge, attitude and practice towards blood donation among health care providers in Bahir Dar City, Ethiopia. Paper based questionnaire was distributed to 276 health care providers from May 01 to June 30, 2016. Overall, 42.8% had donated blood at least once. Of these, males accounted for 60%. The median age of blood donors was 26 years. Voluntary-unpaid donation was 21.2%. Overall, 75.5% health care providers were knowledgeable. The levels of knowledge were significantly different among different disciplines (One-way ANOVA; F=69.7; P=0.004). Males were more knowledgeable than females (P<0.05). The overall favorable attitude was 78.6%. Previous practice of blood donation determined the odds of favorable attitude to be a future regular voluntary-unpaid blood donor (OR: 5.7, 95% CI: 3.2-10.4). Majority of health care providers had adequate knowledge and favorable attitude. However, voluntary-unpaid donation practice (21.1%) was lower compared to 100% target of voluntary-unpaid donation. There should be motivation packages to enhance voluntary-unpaid blood donation among health care professionals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. 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

  12. [Frequency of cancer in a specialty hospital in Mexico City. Implications for the development of early detection methods].

    PubMed

    Herrera-Torre, Analy; García-Rodríguez, Francisco Mario; García, Rebeca Gil; Jiménez-Villanueva, Xicoténcatl; Hernández-Rubio, Angela; Aboharp-Hasan, Ziad

    2014-01-01

    Antecedentes: el cáncer es la segunda causa de muerte en México. El Hospital Juárez de México es una institución general de alta especialidad, por lo que la frecuencia de pacientes con cáncer atendidos en su Unidad de Oncología es una muestra representativa de la frecuencia de cáncer en el país. Objetivo: conocer la estadística de tumores diagnosticados en un hospital de tercer nivel. Material y métodos: estudio retrospectivo efectuado con base en la revisión de los expedientes guardados en los archivos de Anatomía Patológica de pacientes atendidos entre los años 2006 y 2010. Se registraron todos los casos positivos a cáncer de material obtenido mediante biopsia o pieza quirúrgica. Se agruparon por edad, sexo y sitios anatómicos. Resultados: se identificaron las 10 neoplasias más frecuentes en uno y otro sexo, los grupos de edad, y sexo más afectado. Conclusiones: la información obtenida refleja la realidad del país de población abierta no derechohabiente. En México, las mujeres padecen más cáncer que los hombres; las neoplasias de mama y tracto genital son las más frecuentes. Deben reforzarse los sistemas de detección oportuna para que la identificación de casos tempranos sea mayor en nuestra población.

  13. Socio-economic development with regard to the availability of resources in Benin, West Africa

    NASA Astrophysics Data System (ADS)

    Mbarek, R.; Behle, C.; Doevenspeck, M.; Mulindabigwi, V.; Schopp, M.; Singer, U.; Henrichsmeyer, W.; Janssens, M.; Schug, W.

    2003-04-01

    The socio-economic part within the IMPETUS-Project analyses interdependencies between resource availability and socio-economic development in Benin. The results of various research activities of natural and social sciences are integrated in a modelling system, in order to calculate development scenarios of resource utilisation and food security in Benin for the next two decades. Missing data concerning water usage and economic parameters are collected in field surveys, in co-operation with other disciplines and stakeholders on site, investigating the upper Ouémé-catchment in particular. The demand of water is analysed by water frequency observation, household analysis and interviews with experts and shows the effects of changing socio-economic parameters on demand growth. The analysis of water availability investigates the question, how the gap between water demand and water availability, due to demographic, social and natural conditions, may be closed by improved management systems and improved technical equipment. A further field of interest is to measure the influence of land use systems and rain variability on carbon balance and food security. Rain variability associated with inadequate land use systems has become the most important factor for determining food insecurity and emission of (global )greenhouse gases in Benin. Therefore, farmers in Benin need efficient water management systems, otherwise they are obliged to extend their agricultural areas or to migrate towards less occupied regions. The results of the above mentioned research activities are introduced in the modelling system BenIMPACT (Benin Integrated Modelling System for Policy Analysis, Climate and Technology Change). It consists of an agricultural sector model (spatial, synthetic, non-linear), a tool to calculate water balances and a basic data system, which provides data and results in a mapping tool (BenMap). Establishing BenIMPACT as a decision support system in corresponding institutions

  14. 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.

  15. ANTHROPOMETRIC STUDY OF ISCHIOPUBIC INDEX OF THE ISOKO AND BENIN IN NIGERIA.

    PubMed

    Chris-Ozoko, L E; Ebeye, O A; Ufuoma, T P

    2014-10-01

    The ischiopubic index is calculated by dividing the pubic length by the ischial length and multiplying by 100. It has been said to be one of the parameters affecting the pelvic inlet and this is of interest to obstetricians and anatomic anthropologists. To determine and compare the pubic length, ischial length andischiopubic index among the males and females of Isoko and Bini ethnic groups of Nigeria. A retrospective cross sectional study. University of Benin teaching hospital (UBTH), Irrua Specialist teaching hospital (ISTH) and Eku Baptist Hospital. Four hundred antero-posterior radiographs; two hundred for the Isoko (males 105 and females 95) and two hundred also for the Bini (males 110 and females 90) adult pelvis in the age range of 18 - 65 years were evaluated. Pubic length, ischial length, and ischiopubic index were measured. The mean pubic length, mean ischial length and mean ischiopubic index of Isoko males are respectively (mm) 78.42 ± 3.40, 69.41 ± 5.10, 75.2-97.5, 87.52 ± 1.30. The range and point of demarcation are (mm): 75.2-97.5, < 86.22. For Isoko females, the mean pubic length, mean ischial length and mean ischiopubic index are (mm): 81.20 ± 5.0, 74.30 ± 6.10, 106.21 ± 9.10. The range and demarcation point are (mm): 87-125.10, < 97.11. The mean pubic length, mean ischial length and mean ischiopubic index of Bini males are respectively (mm): 74.32 ± 5.40, 82.71 ± 7.20, 88.72 ± 2.40. The range and point of demarcation are (mm) 70-98,< 86.32. For Bini females they are (mm); 86.48 ± 4.20, 78.61± 7.41, 112.21 ± 7.71. The range and point of demarcation are (mm): 84.1-132.50, < 104.50 respectively. The study showed sexual dimorphism in the ischipubic index of the study population and a significant difference in actual mean values and demarking points between the two population groups studied. This contributes growing database of anthropologically and obstetrically significant data for ethnic groups in Nigeria and could help in identification

  16. Genetic organization of transposase regions surrounding blaKPC carbapenemase genes on plasmids from Klebsiella strains isolated in a New York City hospital.

    PubMed

    Gootz, Thomas D; Lescoe, Mary Kay; Dib-Hajj, Fadia; Dougherty, Brian A; He, Wen; Della-Latta, Phyllis; Huard, Richard C

    2009-05-01

    Carbapenem-resistant Klebsiella strains carrying Klebsiella pneumoniae carbapenemases (KPC) are endemic to New York City and are spreading across the United States and internationally. Recent studies have indicated that the KPC structural gene is located on a 10-kb plasmid-borne element designated Tn4401. Fourteen Klebsiella pneumoniae strains and one Klebsiella oxytoca strain isolated at a New York City hospital in 2005 carrying either bla(KPC-2) or bla(KPC-3) were examined for isoforms of Tn4401. Ten of the Klebsiella strains contained a 100-bp deletion in Tn4401, corresponding to the Tn4401a isoform. The presence of this deletion adjacent to the upstream promoter region of bla(KPC) in Tn4401a resulted in a different -35 promoter sequence of TGGAGA than that of CTGATT present in isoform Tn4401b. Complete sequencing of one plasmid carrying bla(KPC) from each of three nonclonal isolates indicated the presence of genes encoding other types of antibiotic resistance determinants. The 70.6-kb plasmid from K. pneumoniae strain S9 carrying bla(KPC-2) revealed two identical copies of Tn4401b inserted in an inverse fashion, but in this case, one of the elements disrupted a group II self-splicing intron. In K. pneumoniae strain S15, the Tn4401a element carrying bla(KPC-2) was found on both a large 120-kb plasmid and a smaller 24-kb plasmid. Pulsed-field gel electrophoresis results indicate that the isolates studied represent a heterogeneous group composed of unrelated as well as closely related Klebsiella strains. Our results suggest that endemic KPC-positive Klebsiella strains constitute a generally nonclonal population comprised of various alleles of bla(KPC) on several distinct plasmid genetic backgrounds. This study increases our understanding of the genetic composition of the evolving and expanding role of KPC-producing, healthcare-associated, gram-negative pathogens.

  17. Impact of the number of on-scene emergency life-saving technicians and outcomes from out-of-hospital cardiac arrest in Osaka City.

    PubMed

    Kajino, Kentaro; Kitamura, Tetsuhisa; Iwami, Taku; Daya, Mohamud; Ong, Marcus Eng Hock; Nishiyama, Chika; Sakai, Tomohiko; Tanigawa-Sugihara, Kayo; Hayashida, Sumito; Nishiuchi, Tatsuya; Hayashi, Yasuyuki; Hiraide, Atsushi; Shimazu, Takeshi

    2014-01-01

    In Japan, ambulance staffing for cardiac arrest responses consists of a 3-person unit with at least one emergency life-saving technician (ELST). Recently, the number of ELSTs on ambulances has increased since it is believed that this improves the quality of on-scene care leading to better outcomes from out-of-hospital cardiac arrest (OHCA). The objective of this study was to evaluate the association between the number of on-scene ELSTs and OHCA outcome. This was a prospective cohort study of all bystander-witnessed OHCA patients aged ≥ 18 years in Osaka City from January 2005 to December 2007 using on an Utstein-style database. The primary outcome measure was one-month survival with favorable neurological outcome defined as a cerebral performance category ≤ 2. Multivariable logistic regression model were used to assess the contribution of the number of on-scene ELSTs to the outcome after adjusting for confounders. Of the 2408 bystander-witnessed OHCA patients, one ELST group was present in 639 (26.5%), two ELST were present in 1357 (56.4%), and three ELST group in 412 (17.1%). The three ELST group had a significantly higher rate of one-month survival with favorable neurological outcome compared with the one ELST group (8.0% versus 4.5%, adjusted OR 2.26, 95% CI 1.27-4.04), while the two ELST group did not (5.4% versus 4.5%, adjusted OR 1.34, 95% CI 0.82-2.19). Compared with the one on-scene ELST group, the three on-scene ELST group was associated with the improved one-month survival with favorable neurological outcome from OHCA in Osaka City. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. 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

  19. Reshaping Care for Older People: Trends in emergency admissions to hospital during a period of simultaneous interventions in Glasgow City, April 2011-March 2015.

    PubMed

    Levin, Kate A; Crighton, Emilia M

    2016-12-01

    This study describes trends in emergency admissions (EAs) in Glasgow City during a period when interventions were designed and implemented, aimed at shifting the balance from institutional to community-based care. Standardised monthly rates of EAs between April 2011 and March 2015 were calculated, for residents of Glasgow City aged 65 years and over. Multilevel zero-inflated Negative Binomial models for EAs nested by datazone were created, adjusting for sex, 5-year age group, area-level deprivation (SIMD quintile), season, month and month squared. Models were also run for EAs by cause, for three causes: chronic obstructive pulmonary disease (COPD), falls and dementia. The rate of EAs first rose then fell during the study period. When modelled, RRs for month (RR for month 12 relative to month 1 and 95% CI=1.02 (0.99, 1.06)) and month squared (RR=0.999 (0.998, 0.999)) indicated a rise in admissions until February 2012, followed by a fall. Risk of admission was greater for males and increased with increasing age group. The risk of going into hospital for those from SIMD 5 (most affluent) was 0.58 (0.56, 0.59) relative to those from SIMD 1 (most deprived). Socioeconomic inequalities were particularly great for COPD-related admissions, where RR for SIMD 5 was 0.25 (0.23, 0.28) times that of SIMD 1. An interaction term between month and SIMD was not significant for any outcome. For dementia-related EAs there was a suggestion that inequalities may be reducing over time. EAs for those aged 65 years and more reduced during the Change Fund period, with similar relative reductions observed across all deprivation quintiles.

  20. Bacterial and viral pathogen spectra of acute respiratory infections in under-5 children in hospital settings in Dhaka city

    PubMed Central

    Bhuyan, Golam Sarower; Hossain, Mohammad Amir; Sarker, Suprovath Kumar; Rahat, Asifuzzaman; Islam, Md Tarikul; Haque, Tanjina Noor; Begum, Noorjahan; Qadri, Syeda Kashfi; Muraduzzaman, A. K. M.; Islam, Nafisa Nawal; Islam, Mohammad Sazzadul; Sultana, Nusrat; Jony, Manjur Hossain Khan; Khanam, Farhana; Mowla, Golam; Matin, Abdul; Begum, Firoza; Shirin, Tahmina; Ahmed, Dilruba; Saha, Narayan; Qadri, Firdausi

    2017-01-01

    The study aimed to examine for the first time the spectra of viral and bacterial pathogens along with the antibiotic susceptibility of the isolated bacteria in under-5 children with acute respiratory infections (ARIs) in hospital settings of Dhaka, Bangladesh. Nasal swabs were collected from 200 under-five children hospitalized with clinical signs of ARIs. Nasal swabs from 30 asymptomatic children were also collected. Screening of viral pathogens targeted ten respiratory viruses using RT-qPCR. Bacterial pathogens were identified by bacteriological culture methods and antimicrobial susceptibility of the isolates was determined following CLSI guidelines. About 82.5% (n = 165) of specimens were positive for pathogens. Of 165 infected cases, 3% (n = 6) had only single bacterial pathogens, whereas 43.5% (n = 87) cases had only single viral pathogens. The remaining 36% (n = 72) cases had coinfections. In symptomatic cases, human rhinovirus was detected as the predominant virus (31.5%), followed by RSV (31%), HMPV (13%), HBoV (11%), HPIV-3 (10.5%), and adenovirus (7%). Streptococcus pneumoniae was the most frequently isolated bacterial pathogen (9%), whereas Klebsiella pneumaniae, Streptococcus spp., Enterobacter agglomerans, and Haemophilus influenzae were 5.5%, 5%, 2%, and 1.5%, respectively. Of 15 multidrug-resistant bacteria, a Klebsiella pneumoniae isolate and an Enterobacter agglomerans isolate exhibited resistance against more than 10 different antibiotics. Both ARI incidence and predominant pathogen detection rates were higher during post-monsoon and winter, peaking in September. Pathogen detection rates and coinfection incidence in less than 1-year group were significantly higher (P = 0.0034 and 0.049, respectively) than in 1–5 years age group. Pathogen detection rate (43%) in asymptomatic cases was significantly lower compared to symptomatic group (P<0.0001). Human rhinovirus, HPIV-3, adenovirus, Streptococcus pneumonia, and Klebsiella pneumaniae had

  1. Costs and cost-effectiveness of a clinical intervention to increase mammography utilization in an inner city public health hospital.

    PubMed

    Thompson, Beti; Thompson, L Anne; Andersen, M Robyn; Hager, Shelly; Taylor, Victoria; Urban, Nicole

    2002-07-01

    Studies have demonstrated the cost-effectiveness of screening women for breast cancer; however, the cost-effectiveness of strategies to motivate women to receive breast cancer screening has been less well studied. A total of 196 women, aged 50 to 74, who were enrolled in a public health hospital clinic, were noncompliant with mammography screening, and had at least one routine clinic appointment during the study period (15 months) were entered into a randomized, controlled trial of a motivational intervention to increase mammography rates. Costs were captured via a modified Delphi technique, accounting records, sampling of staff time logs, and an estimation of miscellaneous and overhead costs. Summary costs were calculated using Excel spread sheets. Overall, 49% of women who received the intervention had a mammogram within 8 weeks of an index visit compared with 22% of control women. Calculation of the cost-effectiveness of the project showed an additional cost of $151 (1996 U.S.$) for each woman receiving the intervention and $559 for each additional woman motivated to receive a mammogram. Cost tracking and cost-effectiveness analysis can be done when intervening in a clinical setting, thereby allowing clinics to make informed decisions about implementing programs to increase motivation of their patients to receive screening.

  2. Physicians' attitude towards tobacco dependence in a private hospital in the city of São Paulo, Brazil

    PubMed Central

    Julião, Alessandra Maria; Camargo, Ana Luiza Lourenço Simões; Cítero, Vanessa de Albuquerque; Maranhão, Mara Fernandes; Maluf, Alfredo; Paes, Ângela Tavares; Glezer, Milton; Cendoroglo, Miguel; Schvartsman, Cláudio

    2013-01-01

    ABSTRACT Objective: To investigate how often physicians identify and treat tobacco dependence and whether characteristics as gender, age, marital status, medical specialty and smoking status can influence their attitude towards this question. Methods: A cross-sectional study was performed on 515 physicians working in a private hospital in São Paulo, Brazil, using a confidential voluntary questionnaire sent and answered electronically. Results: We found that 89% of physicians who answered the research questionnaire often or always asked their patients about smoking habits, but only 39% often or always treated patients' tobacco dependence. In our sample, 5.8% of individuals were current smokers. Tobacco dependent physicians provided less treatment for smoking dependence compared with those who had never smoked, or were former smokers. Being a clinician was associated with higher probability to treat tobacco dependence. Conclusion: Physicians should not only address patients' smoking habits but also provide treatment whenever tobacco dependence is diagnosed. To understand physicians' attitude towards smoking may help to develop strategies to stimulate patients' treatment. The development of smoking cessation programs meant specifically for physicians may also be a strategy to enhance patients' treatment. PMID:23843054

  3. Reliability of Reported Maternal Smoking: Comparing the Birth Certificate to Maternal Worksheets and Prenatal and Hospital Medical Records, New York City and Vermont, 2009.

    PubMed

    Howland, Renata E; Mulready-Ward, Candace; Madsen, Ann M; Sackoff, Judith; Nyland-Funke, Michael; Bombard, Jennifer M; Tong, Van T

    2015-09-01

    Maternal smoking is captured on the 2003 US Standard Birth Certificate based on self-reported tobacco use before and during pregnancy collected on post-delivery maternal worksheets. Study objectives were to compare smoking reported on the birth certificate to maternal worksheets and prenatal and hospital medical records. The authors analyzed a sample of New York City (NYC) and Vermont women (n = 1,037) with a live birth from January to August 2009 whose responses to the Pregnancy Risk Assessment Monitoring System survey were linked with birth certificates and abstracted medical records and maternal worksheets. We calculated smoking prevalence and agreement (kappa) between sources overall and by maternal and hospital characteristics. Smoking before and during pregnancy was 13.7 and 10.4% using birth certificates, 15.2 and 10.7% using maternal worksheets, 18.1 and 14.1% using medical records, and 20.5 and 15.0% using either maternal worksheets or medical records. Birth certificates had "almost perfect" agreement with maternal worksheets for smoking before and during pregnancy (κ = 0.92 and 0.89) and "substantial" agreement with medical records (κ = 0.70 and 0.74), with variation by education, insurance, and parity. Smoking information on NYC and Vermont birth certificates closely agreed with maternal worksheets but was underestimated compared with medical records, with variation by select maternal characteristics. Opportunities exist to improve birth certificate smoking data, such as reducing the stigma of smoking, and improving the collection, transcription, and source of information.

  4. Reliability of Reported Maternal Smoking: Comparing the Birth Certificate to Maternal Worksheets and Prenatal and Hospital Medical Records, New York City and Vermont, 2009

    PubMed Central

    Mulready-Ward, Candace; Madsen, Ann M.; Sackoff, Judith; Nyland-Funke, Michael; Bombard, Jennifer M.; Tong, Van T.

    2015-01-01

    Maternal smoking is captured on the 2003 US Standard Birth Certificate based on self-reported tobacco use before and during pregnancy collected on post-delivery maternal worksheets. Study objectives were to compare smoking reported on the birth certificate to maternal worksheets and prenatal and hospital medical records. The authors analyzed a sample of New York City (NYC) and Vermont women (n = 1,037) with a live birth from January to August 2009 whose responses to the Pregnancy Risk Assessment Monitoring System survey were linked with birth certificates and abstracted medical records and maternal worksheets. We calculated smoking prevalence and agreement (kappa) between sources overall and by maternal and hospital characteristics. Smoking before and during pregnancy was 13.7 and 10.4 % using birth certificates, 15.2 and 10.7 % using maternal worksheets, 18.1 and 14.1 % using medical records, and 20.5 and 15.0 % using either maternal worksheets or medical records. Birth certificates had “almost perfect” agreement with maternal worksheets for smoking before and during pregnancy (κ = 0.92 and 0.89) and “substantial” agreement with medical records (κ = 0.70 and 0.74), with variation by education, insurance, and parity. Smoking information on NYC and Vermont birth certificates closely agreed with maternal worksheets but was underestimated compared with medical records, with variation by select maternal characteristics. Opportunities exist to improve birth certificate smoking data, such as reducing the stigma of smoking, and improving the collection, transcription, and source of information. PMID:25676044

  5. 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.

  6. Effectiveness of prehospital Magill forceps use for out-of-hospital cardiac arrest due to foreign body airway obstruction in Osaka City.

    PubMed

    Sakai, Tomohiko; Kitamura, Tetsuhisa; Iwami, Taku; Nishiyama, Chika; Tanigawa-Sugihara, Kayo; Hayashida, Sumito; Nishiuchi, Tatsuya; Kajino, Kentaro; Irisawa, Taro; Shiozaki, Tadahiko; Ogura, Hiroshi; Tasaki, Osamu; Kuwagata, Yasuyuki; Hiraide, Atsushi; Shimazu, Takeshi

    2014-09-04

    Although foreign body airway obstruction (FBAO) accounts for many preventable unintentional accidents, little is known about the epidemiology of FBAO patients and the effect of forceps use on those patients. This study aimed to assess characteristics of FBAO patients transported to hospitals by emergency medical service (EMS) personnel, and to verify the relationship between prehospital Magill forceps use and outcomes among out-of-hospital cardiac arrests (OHCA) patients with FBAO. We retrospectively reviewed ambulance records of all patients who suffered FBAO, and were treated by EMS in Osaka City from 2000 through 2007, and assessed the characteristics of those patients. We also performed a multivariate logistic-regression analysis to assess factors associated with neurologically favorable survival among bystander-witnessed OHCA patients with FBAO in larynx or pharynx. A total of 2,354 patients suffered from FBAO during the study period. There was a bimodal distribution by age among infants and old adults. Among them, 466 (19.8%) had an OHCA when EMS arrived at the scene, and 344 were witnessed by bystanders. In the multivariate analysis, Magill forceps use for OHCA with FBAO in larynx or pharynx was an independent predictor of neurologically favorable survival (16.4% [24/146] in the Magill forceps use group versus 4.3% [4/94] in the non-use group; adjusted odds ratio, 3.96 [95% confidence interval, 1.21-13.00], p = 0.023). From this large registry in Osaka, we revealed that prehospital Magill forceps use was associated with the improved outcome of bystander-witnessed OHCA patients with FBAO.

  7. Out-of-hospital cardiac arrests during exercise among urban inhabitants in Japan: Insights from a population-based registry of Osaka City.

    PubMed

    Kiyohara, Kosuke; Sado, Junya; Matsuyama, Tasuku; Nishiyama, Chika; Kobayashi, Daisuke; Kiguchi, Takeyuki; Hayashida, Sumito; Kitamura, Yuri; Sobue, Tomotaka; Nakata, Ken; Iwami, Taku; Kitamura, Tetsuhisa

    2017-08-01

    The patient characteristics, pre-hospital interventions, and outcomes of out-of-hospital cardiac arrests (OHCA) occurring during exercise, have not been sufficiently investigated among the general population. OHCA data from 2009 to 2015 were obtained from the population-based OHCA registry in Osaka City, Japan. Patients who suffered OHCA, which occurred during exercise before the arrival of emergency medical service personnel, were included. The primary endpoint was one-month survival with a favourable neurological outcome after OHCA, defined using the Glasgow-Pittsburgh cerebral performance category scale 1 or 2. During the 7-year study period, 16,278 OHCAs were observed, and 52 (0.3%) occurred during exercise (male, n=41 [79%]; median age, 62 years). These incidents occurred mainly during running activities (n=14), followed by swimming (n=8), dance/social dance (n=6), tennis (n=4), and weight training (n=3). Within these exercise-related OHCAs, 47 (90%) were of cardiac origin, 45 (87%) were bystander-witnessed cardiac arrests, 49 (94%) received bystander-initiated cardiopulmonary resuscitation, and 30 (57%) received public-access defibrillation (PAD). Overall, 56% (29/52) had one-month survival with a favourable neurological outcome after OHCA, which was significantly higher among OHCAs of cardiac origin with PAD (77%, 23/30) than among those of cardiac origin without PAD (35%, 6/17) and among those of non-cardiac origin (0%, 0/5) (p<0.001). In Osaka, OHCAs during exercise represented a small subset of the overall OHCA burden, but occurred during a wide variety of exercise activities. Patients with OHCA of cardiac origin had a good prognosis, and PAD played an important role in improving patient outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Gender-violence against the female nursing staff of a Brazilian hospital in São Paulo City.

    PubMed

    Oliveira, Ane R; D'Oliveira, Ana Flávia P L

    2008-10-01

    To estimate the occurrence of psychological, physical and sexual violence among female nursing staff. This is a cross sectional study, conducted with a sample of 179 professionals (50 nurses and 129 nursing aides / nurse technicians) in a general hospital in the municipality of São Paulo, Southeastern Brazil, 2005-2006. A validated questionnaire was applied in face to face interviews with these professionals, conducted by trained interviewers. Psychological, physical and sexual forms of violence were addressed, involving both male and female aggressors who were classified as: intimate partners, family members and other aggressors such as acquaintances and strangers. A descriptive analysis was undertaken, in which the frequency of the occurrence of the different types of violence was calculated with a 95% confidence interval. The most frequent form of violence was intimate partner violence (63.7%; 95% CI: 55.7;70.4), followed by violence perpetrated by others (45.8%; 95% CI: 38.3;53.4) including patients and people accompanying them, colleagues within the field of health, head nurses, acquaintances and strangers. Family members occupied the third place as aggressors, (41.3%; 95% CI: 34.0;48.9), and the majority of these were fathers, brothers, uncles and cousins. In general, the nursing staff did not seek help frequently when acts of aggression occurred: only 29.7% of those who suffered intimate partner violence; 20.3% whose aggressors were others and 29.3% whose aggressors were family members sought help. Those who did not perceive their experience as a form of violence represented 31.9% of the subjects interviewed. The rates of gender violence among female health professionals were important, particularly with respect to violence committed by intimate partners and family members. However, the proportion of these women who sought help was low, considering the fact that this group has a significant educational level.

  9. Knowledge of heart disease and stroke among cardiology inpatients and outpatients in a Canadian inner-city urban hospital

    PubMed Central

    Gill, Richard; Chow, Chi-Ming

    2010-01-01

    BACKGROUND: Heart disease and stroke are leading causes of death in North America. Nevertheless, in 2003, the Heart and Stroke Foundation of Canada reported that nearly two-thirds of Canadians have misconceptions regarding heart disease and stroke, echoing the results of similar American studies. Good knowledge of these conditions is imperative for cardiac patients who are at greater risk than the general population and should, therefore, be better educated. The present study evaluated the awareness of heart disease and stroke among cardiac patients to assess the efficacy of current education efforts. METHODS: Two hundred fifty-one cardiac inpatients and outpatients at St Michael’s Hospital (Toronto, Ontario) were surveyed in July and August 2004. An unaided questionnaire assessed respondents’ knowledge of cardiovascular risk factors, symptoms of heart attack and stroke, and actions in the event of cardiovascular emergency. Demographic data and relevant medical history were also obtained. RESULTS: Cardiac patients demonstrated relatively adequate knowledge of heart attack warning symptoms. These patients also demonstrated adequate awareness of proper actions during cardiovascular emergencies. However, respondents were not aware of the most important risk factors for cardiovascular disease. Knowledge of stroke symptoms was also extremely poor. Socioeconomic status, and personal history of heart attack and stroke were positively correlated with good knowledge. CONCLUSIONS: Future patient education efforts should address the awareness of the important cardiovascular risk factors and knowledge of cardiovascular warning symptoms (especially for stroke), as well as inform patients of appropriate actions during a cardiovascular emergency. Emphasis should be placed on primary and secondary prevention, and interventions should be directed toward low-income cardiac patients. PMID:21165363

  10. Use of biological based therapy in patients with cardiovascular diseases in a university-hospital in New York City

    PubMed Central

    Chagan, Larisa; Bernstein, Diane; Cheng, Judy WM; Kirschenbaum, Harold L; Rozenfeld, Vitalina; Caliendo, Gina C; Meyer, Joanne; Mehl, Bernard

    2005-01-01

    Background The use of complementary and alternative products including Biological Based Therapy (BBT) has increased among patients with various medical illnesses and conditions. The studies assessing the prevalence of BBT use among patients with cardiovascular diseases are limited. Therefore, an evaluation of BBT in this patient population would be beneficial. This was a survey designed to determine the effects of demographics on the use of Biological Based Therapy (BBT) in patients with cardiovascular diseases. The objective of this study was to determine the effect of the education level on the use of BBT in cardiovascular patients. This survey also assessed the perceptions of users regarding the safety/efficacy of BBT, types of BBT used and potential BBT-drug interactions. Method The survey instrument was designed to assess the findings. Patients were interviewed from February 2001 to December 2002. 198 inpatients with cardiovascular diseases (94 BBT users and 104 non-users) in a university hospital were included in the study. Results Users had a significantly higher level of education than non-users (college graduate: 28 [30%] versus 12 [12%], p = 0.003). Top 10 BBT products used were vitamin E [41(43.6%)], vitamin C [30(31.9%)], multivitamins [24(25.5%)], calcium [19(20.2%)], vitamin B complex [17(18.1%)], fish oil [12(12.8%)], coenzyme Q10 [11(11.7%)], glucosamine [10(10.6%)], magnesium [8(8.5%)] and vitamin D [6(6.4%)]. Sixty percent of users' physicians knew of the BBT use. Compared to non-users, users believed BBT to be safer (p < 0.001) and more effective (p < 0.001) than prescription drugs. Forty-two potential drug-BBT interactions were identified. Conclusion Incidence of use of BBT in cardiovascular patients is high (47.5%), as is the risk of potential drug interaction. Health care providers need to monitor BBT use in patients with cardiovascular diseases. PMID:15745441

  11. Etiology of Sudden Cardiac Arrest in Patients with Epilepsy: Experience of Tertiary Referral Hospital in Sapporo City, Japan

    PubMed Central

    MIYATA, Kei; OCHI, Satoko; ENATSU, Rei; WANIBUCHI, Masahiko; MIKUNI, Nobuhiro; INOUE, Hiroyuki; UEMURA, Shuji; TANNO, Katsuhiko; NARIMATSU, Eichi; MAEKAWA, Kunihiko; USUI, Keiko; MIZOBUCHI, Masahiro

    2016-01-01

    It has been reported that epilepsy patients had higher risk of sudden death than that of the general population. However, in Japan, there is very little literature on the observational research conducted on sudden fatal events in epilepsy. We performed a single-center, retrospective study on all the out-of-hospital cardiac arrest (OHCA) patients treated in our emergency department between 2007 and 2013. Among the OHCA patients, we extracted those with a history of epilepsy and then analyzed the characteristics of the fatal events and the background of epilepsy. From 1,823 OHCA patients, a total of 10 cases were enrolled in our study. The median age was 34 years at the time of the incident [9–52 years; interquartile range (IQR), 24–45]. We determined that half of our cases resulted from external causes of death such as drowning and suffocation and the other half were classified as sudden unexpected death in epilepsy (SUDEP). In addition, asphyxia was implicated as the cause in eight cases. Only the two near-drowning patients were immediately resuscitated, but the remaining eight patients died. The median age of first onset of epilepsy was 12 years (0.5–30; IQR, 3–21), and the median disease duration was 25 years (4–38; IQR, 6–32). Patients with active epilepsy accounted for half of our series and they were undergoing poly anti-epileptic drug therapy. The fatal events related to epilepsy tended to occur in the younger adult by external causes. An appropriate therapeutic intervention and a thorough observation were needed for its prevention. PMID:26948699

  12. Prescription habits for preventative medications among pediatric emergency department physicians at an inner-city teaching hospital.

    PubMed

    Lovinsky, S; Rastogi, D

    2010-11-01

    As asthma presentation is episodic, patients with acute exacerbations often present in the emergency department (ED) where preventative regimen may not always be addressed. Addressing initiation and modification of controller medications in the setting of an acute exacerbation may facilitate improved asthma control and decrease the frequency of ED visits, particularly so for families who receive most of their asthma management in the ED. However, this aspect has not yet been explored. We reviewed a random sample of 363 charts, 10% of the total number of asthmatic children, aged 2-18, seen from January to December 2007 in the pediatric ED of an urban teaching hospital located in Bronx, NY, USA. We quantified the frequency of modification of the preventative regimen and the influence of seasons on this practice. Of these 363 children, 42.4% of patients were not previously on a controller medication. Of these, 9.7% were started on a new controller medication, with a significantly higher percent occurring in the summer months. Of those that were previously on a controller medication, 2.87% were started on a new controller medication and 0.95% had their controller medication dose increased. However, the regimen was not adjusted in 14.3% that had been seen four or more times in the preceding 2 years. Of the total 363 children, 78.5% were discharged from the ED on a short course of oral steroids, and this was not part of their preventative regimen. Only four charts had physician-documented asthma severity classification. We found that the preventative regimen was modified in only 0.9-2% of all asthmatic children seen in an urban ED whereas 78.5% were started on systemic steroids. Asthma severity was evaluated in a very small number of patients. Because modification of preventative regimen requires appropriate asthma severity classification, the inclusion of asthma severity classification as part of routine ED evaluation may encourage physicians to address controller

  13. 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.

  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. 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

  16. [Tetanus in Ho Chi Minh City, Vietnam: epidemiological, clinical and outcome features of 389 cases at the Hospital for Tropical Diseases].

    PubMed

    An, V T; Khue, P M; Yen, L M; Phong, N D; Strobel, M

    2015-12-01

    The objective of this study is to describe the different aspects of tetanus during the past recent years in southern Vietnam: epidemiology, clinical picture, management, and death risk factors. It is a retrospective study concerning 389 cases admitted in 2007 and 2008 at the reference Hospital for Tropical Diseases in Ho Chi Minh City. 93% of all cases were generalized tetanus, and 50% were severe cases. A majority of patients were adult males (medium age 43, M/ F sex-ratio 2.9). Half of them underwent tracheotomy and 39% assisted ventilation. Case fatality rate was 6.4%, the lowest reported rate worldwide in the last ten years. Fatalities resulted mainly from neuro-vegetative disorders, essentially cardiogenic shock (28% of all deaths) [OR = 16.95; p < 0.001], sepsis (24%) [OR = 3.25; (p < 0,114], and acute renal failure (16%) [OR = 7,22; p < 0.004]. Age over 60-year [OR = 4.53; p < 0.0001] and a leukocyte count>12.000/mm(3) [OR = 2.32; p < 0.020] were significantly associated with fatal outcome, contrarily to incubation and extension phase durations, or delayed serum administration. Systematic extension of vaccination to all adult males, and improved access to post exposure sero-immunization at all levels of health centres throughout the country may further reduce tetanus burden in Vietnam.

  17. [SIM and SINASC: social representation of nurses and professional in administrative sectors who work in hospitals in the city of São Paulo].

    PubMed

    Schoeps, Daniela; Almeida, Marcia Furquim de; Raspantini, Priscila Ribeiro; Novaes, Hillegonda Maria Dutilh; Silva, Zilda Pereira da; Lefevre, Fernando

    2013-05-01

    Few studies have analyzed the SINASC (Live Birth Information System) and MIS (Mortality Information System) applying qualitative methodology seeking to understand data production processes and contexts. This article aims to study the social representation of health professionals about Live Birth Certificates (LBC) and perinatal Death Certificates (DC). A total of 24 interviews were conducted with nurses and other professionals of 16 Unified Health System (SUS) and non-SUS hospitals of the city of São Paulo in 2009. Qualitative methodology was adopted along with the Collective Subject Discourse technique. Professionals acknowledged that they are an integral part of the information production process of SINASC and their reports indicate that they incorporate it in their work routine. They also perceive that training activities are a tool to understand the information produced by them and are aware of the utility of LBC information. Although physicians are legally responsible for the DC, other professionals frequently provide some of the information to complete it. The professionals see themselves as participants of the SINASC. Despite providing information to complete the DC, they do not see themselves as participants of the MIS operation.

  18. [Tumors of the heart. 16 years experience in Hospital de Cardiología, del Centro Médico Nacional Siglo XXI in Mexico City].

    PubMed

    Alfaro-Gómez, Felipe; Careaga-Reyna, Guillermo; Valero-Elizondo, Guillermo; Argüero-Sánchez, Rubén

    2003-01-01

    We present incidence of primary cardiac tumors diagnosed from 1987 at the Hospital de Cardiología, Centro Médico Nacional Siglo XXI, in Mexico City. We described primary cardiac tumors based on histopathologic diagnosis, frequency, localization, implantation, implantation site, and recurrence. A total of 51 patient files were selected retrospectively. Patients underwent cardiothoracic surgery with primary cardiac tumor established by clinical and echocardiographic parameters with histopathologic corroboration between 1987 and 2002. Statistical analysis of obtained results show frequency, central tendency and standard deviation. Primary cardiac tumors were benign in 84% and malignant in 16%. Among benign tumors, myxoma was present in 74%, (38 cases) followed by papillary fibroelastoma in 6% (three cases); finally, there were two cases (4%) of fibroma. Malignant tumors belonged to two hemangioendothelioma cases (4%) and there were 6 cases of sarcoma (12%). Main affected gender was female in 61%. All cases were taken to surgical resection. There was recurrence four times (8%) belonging to three myxomas and one sarcoma. Average presentation age was 43 +/- 17 years. Cardiac primary tumors represent 0.16% of surgeries taking place at our service. Concordance was found with previous studies regarding frequency, gender, age, localization, and implant site of cardiac primary tumors with greater recurrence in our series.

  19. Novel porcine-like human G26P[19] rotavirus identified in hospitalized paediatric diarrhoea patients in Ho Chi Minh City, Vietnam.

    PubMed

    My, Phan Vu Tra; Rabaa, Maia A; Donato, Celeste; Cowley, Daniel; Phat, Voong Vinh; Dung, Tran Thi Ngoc; Anh, Pham Hong; Vinh, Ha; Bryant, Juliet E; Kellam, Paul; Thwaites, Guy; Woolhouse, Mark E J; Kirkwood, Carl D; Baker, Stephen

    2014-12-01

    During a hospital-based diarrhoeal disease study conducted in Ho Chi Minh City, Vietnam from 2009 to 2010, we identified four symptomatic children infected with G26P[19] rotavirus (RV)--an atypical variant that has not previously been reported in human gastroenteritis. To determine the genetic structure and investigate the origin of this G26P[19] strain, the whole genome of a representative example was characterized, revealing a novel genome constellation: G26-P[19]-I5-R1-C1-M1-A8-N1-T1-E1-H1. The genome segments were most closely related to porcine (VP7, VP4, VP6 and NSP1) and Wa-like porcine RVs (VP1-3 and NSP2-5). We proposed that this G26P[19] strain was the product of zoonotic transmission coupled with one or more reassortment events occurring in human and/or animal reservoirs. The identification of such strains has potential implications for vaccine efficacy in south-east Asia, and outlines the utility of whole-genome sequencing for studying RV diversity and zoonotic potential during disease surveillance. © 2014 The Authors.

  20. Evidence for the molecular heterogeneity of sickle cell anemia chromosomes bearing the betaS/Benin haplotype.

    PubMed

    Patrinos, George P; Samperi, Piera; Lo Nigro, Luca; Kollia, Panagoula; Schiliro, Gino; Papadakis, Manoussos N

    2005-09-01

    There are at least four distinct African and one Asian chromosomal backgrounds (haplotypes) on which the sickle cell mutation has arisen. Additionally, previous data suggest that the beta(S)/Bantu haplotype is heterogeneous at the molecular level. Here, we report the presence of the (A)gamma -499 T-->A variation in sickle cell anemia chromosomes of Sicilian and North African origin bearing the beta(S)/Benin haplotype. Being absent from North American beta(S)/Benin chromosomes, which were studied previously, this variation is indicative for the molecular heterogeneity of the beta(S)/Benin haplotype.

  1. [Audit of the quality of treatment of "near miss" patients in referral maternities in Southern Benin].

    PubMed

    Saizonou, Jacques; De Brouwere, Vincent; Vangeenderhuysen, Charles; Dramaix-Wilmet, Michèle; Buekens, Pierre; Dujardin, Bruno

    2006-01-01

    Maternal mortality is highly associated with the provision of obstetric care. The provision of safe and timely emergency obstetric care (EOC) for women with severe obstetric complications is one of the main components of safe motherhood programs. In this research the objective was to determine the quality of EOC by examining its availability and its provision in a timely fashion. prospective observational study in qualified facilities providing EOC. two teaching, two regional and three district hospitals in the southern part of Benin, West Africa. The study was conducted from July to October 2003. Data collection tools used were based on the World Health organisation Guidelines for monitoring EOC. The midwives in charge of the survey started observation from the admission room and followed the provision of the care offered to the women admitted with near miss complications until they were discharged from hospital. The information about EOC, its availability, timeliness and patients' follow-up were recorded. The study sample included 557 women; immediate emergency care was given within 30 minutes for 61% of the patients. Surgical care (caesarean section and ectopic pregnancies surgery) was started within 60 minutes for 42% and 45 % of the women. In the near miss cases suffering anaemia, blood was not available for 12% of patients and blood transfusions were started within 60 minutes in 10% of cases. In the case of uterine rupture or pre-rupture, the time for starting caesarean section was 60 minutes for 58% of women. As to haemorrhagic near-miss cases, blood was not available in 44% of cases and if caesarean section was indicated, it was done within 60 minutes in 47% of the cases. Half of the patients with hypertension received treatment within 60 minutes after the decision to do so was taken. In infection cases, 53% of the patients received antibiotics treatment within 60 minutes. Generally, the quality of providing EOC in the facilities of the study was good in

  2. Globalization Viewed from the Periphery: The Dynamics of Teacher Identity in the Republic of Benin.

    ERIC Educational Resources Information Center

    Welmond, Michel

    2002-01-01

    Archival research and interviews with teachers and key informants in Benin schools examined cultural schemata that define teacher identity as vessel and conveyer of special knowledge, civil servant, self-sacrificing parental surrogate, or efficient worker ensuring high test grades. Conflicts among these identities, between teachers and the state,…

  3. 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…

  4. 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…

  5. 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…

  6. Insect fauna associated with Anacardium occidentale (Sapindales: Anacardiaceae) in Benin, West Africa.

    PubMed

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

    2014-01-01

    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.

  7. 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…

  8. Professional Development in Sub-Saharan Africa: What Have We Learned in Benin?

    ERIC Educational Resources Information Center

    Kelani, Raphael R.; Khourey-Bowers, Claudia

    2012-01-01

    This paper explores the effectiveness of a technology education professional development (TEPD) program and factors impeding the implementation of such a program within the context of the Republic of Benin (West Africa). Professional development (PD) programs do not always take into account the specific disciplinary content knowledge and…

  9. 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…

  10. 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…

  11. 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…

  12. An assessment of malaria diagnostic capacity and quality in Ghana and the Republic of Benin.

    PubMed

    Keating, Joseph; Finn, Timothy P; Eisele, Thomas P; Dery, Gilbert; Biney, Ekow; Kêdoté, Marius; Fayomi, Benjamin; Yukich, Joshua O

    2014-10-01

    In malaria-endemic countries, the absence of parasitological confirmation of malaria infection potentially results in overtreatment of non-malaria febrile illness with antimalarial drugs; this may lead to healthcare workers (HCW) missing other treatable illness or wastage of resources. This paper presents results from nationally representative assessments of malaria diagnostic accuracy, quality and capacity in Ghana and the Republic of Benin. Cross-sectional surveys were conducted in December 2012 among a representative sample of health facilities (n=30 per country), using a modified service provision assessment, followed by HCW observations and interviews. To analyze the data we used χ(2) statistics and logistic regression. Malaria microscopy and rapid diagnostic test interpretation was accurate most of the time in both countries. Drugs were generally prescribed in line with positive malaria test results (Ghana: 85.4%, 95% CI: 72.2-98.7; Benin: 83.6%, 95% CI: 68.7-98.4), although some patients with negative malaria test results still received treatment (Ghana: 30.1%, 95% CI: 11.1-49.0; Benin: 37.8%, 95% CI: 22.6-53.0). Diagnostics for malaria are often performed adequately and accurately in Ghana and Benin, although diagnostic coverage within facilities remains incomplete and some individuals who test negative for malaria receive antimalarial drugs. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. 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…

  14. Effects of short-term exposure to air pollution on hospital admissions of young children for acute lower respiratory infections in Ho Chi Minh City, Vietnam.

    PubMed

    Le, Truong Giang; Ngo, Long; Mehta, Sumi; Do, Van Dzung; Thach, T Q; Vu, Xuan Dan; Nguyen, Dinh Tuan; Cohen, Aaron

    2012-06-01

    There is emerging evidence, largely from studies in Europe and North America, that economic deprivation increases the magnitude of morbidity and mortality related to air pollution. Two major reasons why this may be true are that the poor experience higher levels of exposure to air pollution, and they are more vulnerable to its effects--in other words, due to poorer nutrition, less access to medical care, and other factors, they experience more health impact per unit of exposure. The relations among health, air pollution, and poverty are likely to have important implications for public health and social policy, especially in areas such as the developing countries of Asia where air pollution levels are high and many live in poverty. The aims of this study were to estimate the effect of exposure to air pollution on hospital admissions of young children for acute lower respiratory infection (ALRI*) and to explore whether such effects differed between poor children and other children. ALRI, which comprises pneumonia and bronchiolitis, is the largest single cause of mortality among young children worldwide and is responsible for a substantial burden of disease among young children in developing countries. To the best of our knowledge, this is the first study of the health effects of air pollution in Ho Chi Minh City (HCMC), Vietnam. For these reasons, the results of this study have the potential to make an important contribution to the growing literature on the health effects of air pollution in Asia. The study focused on the short-term effects of daily average exposure to air pollutants on hospital admissions of children less than 5 years of age for ALRI, defined as pneumonia or bronchiolitis, in HCMC during 2003, 2004, and 2005. Admissions data were obtained from computerized records of Children's Hospital 1 and Children's Hospital 2 (CH1 and CH2) in HCMC. Nearly all children hospitalized for respiratory illnesses in the city are admitted to one of these two pediatric

  15. Malaria vectors resistance to insecticides in Benin: current trends and mechanisms involved.

    PubMed

    Gnanguenon, Virgile; Agossa, Fiacre R; Badirou, Kefilath; Govoetchan, Renaud; Anagonou, Rodrigue; Oke-Agbo, Fredéric; Azondekon, Roseric; AgbanrinYoussouf, Ramziath; Attolou, Roseline; Tokponnon, Filemon T; Aïkpon, Rock; Ossè, Razaki; Akogbeto, Martin C

    2015-04-12

    Insecticides are widely used to control malaria vectors and have significantly contributed to the reduction of malaria-caused mortality. In addition, the same classes of insecticides were widely introduced and used in agriculture in Benin since 1980s. These factors probably contributed to the selection of insecticide resistance in malaria vector populations reported in several localities in Benin. This insecticide resistance represents a threat to vector control tool and should be monitored. The present study reveals observed insecticide resistance trends in Benin to help for a better management of insecticide resistance. Mosquito larvae were collected in eight sites and reared in laboratory. Bioassays were conducted on the adult mosquitoes upon the four types of insecticide currently used in public health in Benin. Knock-down resistance, insensitive acetylcholinesterase-1 resistance, and metabolic resistance analysis were performed in the mosquito populations based on molecular and biochemical analysis. The data were mapped using Geographical Information Systems (GIS) with Arcgis software. Mortalities observed with Deltamethrin (pyrethroid class) were less than 90% in 5 locations, between 90-97% in 2 locations, and over 98% in one location. Bendiocarb (carbamate class) showed mortalities ranged 90-97% in 2 locations and were over 98% in the others locations. A complete susceptibility to Pirimiphos methyl and Fenitrothion (organophosphate class) was observed in all locations with 98-100% mortalities. Knock-down resistance frequencies were high (0.78-0.96) and similar between Anopheles coluzzii, Anopheles gambiae, Anopheles arabiensis, and Anopheles melas. Insensitive acetylcholinesterase-1 was rare (0.002-0.1) and only detected in Anopheles gambiae in concomitance with Knock-down resistance mutation. The maps showed a large distribution of Deltamethrin resistance, Knock-down mutation and metabolic resistance throughout the country, a suspected resistance to

  16. Drug Use and Attitudes among College Students in Benin City, Nigeria.

    ERIC Educational Resources Information Center

    Pela, Ona A.

    1989-01-01

    Examined pattern of drug use among Nigerian college students, their attitudes toward drug use, and their perception of drug harmfulness to the body and to society. Results from 400 undergraduate students revealed that most frequently used social drugs were caffeine and alcohol. Respondents considered heroin and cocaine to pose greatest dangers to…

  17. Drug Use and Attitudes among College Students in Benin City, Nigeria.

    ERIC Educational Resources Information Center

    Pela, Ona A.

    1989-01-01

    Examined pattern of drug use among Nigerian college students, their attitudes toward drug use, and their perception of drug harmfulness to the body and to society. Results from 400 undergraduate students revealed that most frequently used social drugs were caffeine and alcohol. Respondents considered heroin and cocaine to pose greatest dangers to…

  18. Patterns of Adolescent Psychoactive Substance Use and Abuse in Benin City, Nigeria.

    ERIC Educational Resources Information Center

    Pela, Ona A.

    1989-01-01

    Used unobtrusive methods to collect data on substance use from 320 Nigerian partygoers aged 14 through 25. Found that adolescents tended to use following drugs in decreasing order of frequency: alcohol, cigarettes. stimulants, cannabis, and sedative-hypnotics. Polydrug use, especially of alcohol, stimulants, and cigarettes, was common. (Author/NB)

  19. Patterns of Adolescent Psychoactive Substance Use and Abuse in Benin City, Nigeria.

    ERIC Educational Resources Information Center

    Pela, Ona A.

    1989-01-01

    Used unobtrusive methods to collect data on substance use from 320 Nigerian partygoers aged 14 through 25. Found that adolescents tended to use following drugs in decreasing order of frequency: alcohol, cigarettes. stimulants, cannabis, and sedative-hypnotics. Polydrug use, especially of alcohol, stimulants, and cigarettes, was common. (Author/NB)

  20. Pathogens of medical importance isolated from Phaenicia (Lucilia) sericata (Diptera:Calliphoridae) in Benin City, Nigeria.

    PubMed

    Aigbodion, Felix Iruobe; Egbon, Ikponmwosa Nathaniel; Obuseli, Adaobi Joy

    2013-12-01

    Adult flies of Phaenicia sericata were collected, from three different locations, using sweep net. Sterile vials were used in transferring collected specimens from the sweepnet to the laboratory for further analyses of the microbial content on their external body surfaces. Several bacteria were isolated from their external body surface. A prevalence within the neighborhood of 50% of all bacteria isolated, were Staphylococcus aureus and Lactobacillus species. Escherichia coli was an ubiquitous species across the three locations studied. Corynebacteria dipththeria, Klebsiella sp. and Corynebacteria sp. were the least abundant bacteria 'isolates' of relative abundance of 2.94% each. Aspergillus and Fusarium species were among the isolated fungal species. This study re-emphasizes the need for maintainance of high sanitary standards around human dwellings. The health implications of the isolated bacteria and fungi were discussed.

  1. Management of pericardial effusion by drainage: a survey of 10 years' experience in a city centre general hospital serving a multiracial population

    PubMed Central

    Gibbs, C.; Watson, R.; Singh, S.; Lip, G.

    2000-01-01

    The aim of the study was to determine the aetiology of large and symptomatic pericardial effusions and to review the management and subsequent outcome. A survey was done on a consecutive cases of patients who had undergone percutaneous pericardiocentesis over a 10 year period in a city centre general hospital serving a multiethnic catchment population. In all, 46 patients (24 male, 22 female; age range 16 to 90 years, mean 54 years) underwent a total of 51 pericardial drainage procedures (or attempted pericardiocentesis) between 1989 and 1998. Malignancy (44%), tuberculosis (26%), idiopathic (11%), and post-cardiac surgery (9%) were the most common causes of pericardial effusion. The most common presenting symptoms were breathlessness (90%), chest pain (74%), cough (70%), abdominal pain (61%) (presumed to be related to hepatic congestion), and unexplained fever (28%). In the 12 cases of tuberculous pericarditis, nine occurred in patients of Indo-Asian origin, and three in patients of Afro-Caribbean origin. Fever, night sweats, and weight loss were common among these patients, occurring in over 80% of cases of tuberculous pericarditis. Pulsus paradoxus was the most specific sign (100%) for the presence of echocardiographic features of tamponade, with strongest positive predictive value (100%). Although malignancy remains the most common cause in developed countries, tuberculous disease should be considered in patients from areas where tuberculosis is endemic. Percutaneous pericardiocentesis remains an effective measure for the immediate relief of symptoms in patients with cardiac tamponade, although its diagnostic yield in tuberculous pericarditis is relatively low.


Keywords: tuberculosis; pericardial effusions; percutaneous pericardiocentesis PMID:11085787

  2. [Double-balloon enteroscopy: experience in the Hospital de Especialidades del Centro Médico Nacional Siglo XXI IMSS, Mexico City].

    PubMed

    Blancas Valencia, Juan Manuel; Paz Flores, Víctor Manuel; Yokota, Alejo Miyamoto; Huerta Fosado, Blanca Rosa; Meneses, Luis Fernando; Piccini Larco, Julio Roberto; Mejía Cuan, Luis Alvaro

    2005-01-01

    The methods used for the study of the small bowel are not ideal. Double-balloon enteroscopy is a new alternative with therapeutic potential. Evaluate the utility, efficacy and safety of double-balloon enteroscopy in Mexico. Adult patients seen in the Hospital de Especialidades Centro Médico Nacional Siglo XXI, Mexico City who were being studied for: chronic diarrhea, obscure gastrointestinal hemorrhage, weight-loss and chronic anemia were included in the study. Anterograde (oral) and retrograde (anal) approaches were used and study time, findings and complications were evaluated. Thirty-one enteroscopies were performed, 15 were anterograde, 8 retrograde and 8 were performed via both routes, in 23 patients studied between February and October, 2004; 10 of them were women and 13 men with ages ranging from 25 to 80 years. Fourteen patients were sedated and 9 patients were anesthetized. Study time varied form 55 to 90 minutes. With the anterograde route the ileum was reached in 56.6% of cases, 39.1% the jejunum and only in one patient (4.3%) the whole intestine was explored. With the retrograde route in 62.5% of cases the jejunum was explored and 37.5% the ileum. Four patients with obscure gastrointestinal bleeding and 1 patient with chronic anemia had vascular ecstasies, and in 40% of patients there was no identifiable cause. In 2 patients with intestinal stenosis biopsies revealed intestinal lymphoma in one and ischemic injury in another one. The adverse effects were mild and transitoru. Double-balloon enteroscopy is a safe diagnostic and therapeutic method that is useful in cases of obscure hemorrhage, chronic anemia; small bowel pathology was found in 64.7% of cases.

  3. The spectrum of HIV infection in patients seen at a private hospital in Mexico City: 115 patients seen from 1984 to 1990.

    PubMed

    del Río-Chiriboga, C; Tellez-Gómez, I; Orzechowski-Rallo, A; Alanis-Ortega, A

    1996-01-01

    The objective of this study was to describe the epidemiology and clinical presentation of HIV infection among upper middle class patients in Mexico City. A retrospective review of outpatient and hospital records of all HIV-infected patients was accomplished by one of the authors between 1984 and 1990. A total of 115 patients were seen during the study period, 109 men and 6 women. One hundred and seven patients acquired HIV infection through sexual contact, six patients had HIV infection associated with blood transfusion and two were homosexual men who also had a history of intravenous drug use. The mean age of the patients was 36.2 years (range 13 - 65 years). CDC classification at presentation was predominantly stage IV (65%) with the most common AIDS associated diseases at presentation being wasting syndrome in 30 (42.2%), P. carinii pneumonia in 22 (30.9%), cytomegalovirus infection in 11 (15.5%), Cryptosporidium parvum diarrhea in 7 (9.8%), and Kaposi's sarcoma in 6 (8.4%). CD4+ T-lymphocyte cell counts at the time of HIV diagnosis were available in 87 patients (median = 150 cells/microliters; mean = 224 cells/microliters, SD +/- 219). Zidovudine was used in 37 patients after 1988 when it first became available in Mexico, in six patients the drug had to be discontinued because of serious hematologic toxicity. The average follow-up on zidovudine was 8.5 months. Similar age, gender, age distribution, risk categories and CDC classification at presentation was seen compared to other series reported from Mexico. However, the spectrum of opportunistic infections found were similar to that seen in the United States.

  4. 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

  5. DNA-adducts in subjects exposed to urban air pollution by benzene and polycyclic aromatic hydrocarbons (PAHs) in Cotonou, Benin.

    PubMed

    Ayi-Fanou, Lucie; Avogbe, Patrice H; Fayomi, Benjamin; Keith, Gerard; Hountondji, Codjo; Creppy, Edmond E; Autrup, Herman; Rihn, Bertrand Henri; Sanni, Ambaliou

    2011-02-01

    Air pollution effect on humans represents a major public health problem. Exposure to genotoxic compounds in the ambient air is evaluated using different biomarkers. In the present study we assessed DNA-adducts levels in apparently healthy people living and working in the city of Cotonou (Benin) in which exposure to air pollutants such as benzene and polycyclic aromatic hydrocarbons (PAHs) mainly benzo(a)pyrene has been evidenced. Rural inhabitants were enrolled as control group. Taxi-motorbike drivers, street food vendors, and gasoline salesmen were recruited in Cotonou whereas suburban residents were recruited in Godomey, 12 km from Cotonou. We found that taxi-motorbike drivers, roadside residents, street vendors, taxi-motor-bike drivers and gasoline sellers had significantly higher levels of DNA-adducts than suburban and village inhabitants (P < 0.001; post hoc, LSD). Means values were 24.6 ± 6.4, 23.78 ± 6.9, 34.7 ± 9.8, and 37.2 ± 8.1 in the exposed groups versus 2.1 ± 0.6 and 3.1 ± 0.8 adducts/10(8) nucleotides, in the two control groups, respectively. We did not find any significant difference within the high exposure groups and inside low exposure subgroups (namely suburban residents and villagers) because the mean individual exposure values to both PAHs and benzene were similar among subjects exposed in the city of Cotonou and those in suburban and village areas. However, there is significant interindividual variations in adducts levels that may reflect variation of genetic susceptibility factors. Ranges of adduct level/10(8) nucleotides were: 1-69, 1-76, 3-169, 4-124, 0-9, 0-8 adducts/10(8) for taxi-motorbike drivers, roadside residents, street vendors, gasoline sellers, suburban and village inhabitants, respectively. Our study demonstrated a clear-cut elevated level of DNA adducts in city residents than in none exposed people (or very low exposure levels people) and designate these city residents groups as people at risks for the chronic diseases

  6. [Socio-cultural aspects of epilepsy in a rural community in northern Benin in 2011].

    PubMed

    Adoukonou, T; Tognon-Tchegnonsi, F; Gnonlonfoun, D; Djidonou, A; Sego-Sounon, D; Gandaho, P; Houinato, D

    2015-03-01

    Despite the development of knowledge in diagnosis and therapeutic of epilepsy it remains to be cause of rejection and stigma. We aimed to study the knowledge, attitude and practice toward epilepsy and the stigma in a rural community. The cross-sectional study was carried out from 1st to 31st March 2011 in a rural community (Tourou) at Parakou in the northern Benin. It was a door-to-door survey and included 1 031 adults older than 15 years. The diagnosis of epilepsy was based on International League Against Epilepsy. The specific questionnaire was used and comprised 16 items which explored knowledge, attitude and practice toward epilepsy. Another questionnaire was developed to study stigma among epileptics. The associated factors to the misconception toward epilepsy have been studied. All adults have heard about epilepsy and knew the generalized tonic-clonic form of epilepsy and knew someone with epilepsy. Hereditary (98%) and witchcraft (97.9%) and social problems (65.9%) were mentioned as the most cause of epilepsy. Epilepsy was cited as contagious disease by 90.6% of respondents and the associated factors were the sex (p=0.005) and occupational status (0.024). The saliva (98.1%) and witness of the place of seizure (97.8%) were the frequently mentioned modes of transmission. 65% of all mentioned that epileptics can not get marriage and the main associated factors to this belief were the advanced age (p=0.008) and occupational status (0.004). 64.4% believed that children with epilepsy shouldn't be attend to school, age (0.004), ethnicity (0.047) and occupational status were the associated factors with this misconception. Despite 99.4% considered epilepsy as treatable disease only 12.7% would have referred epileptics to the hospital. All the seven epileptics considered themselves as victims of stigma and rejected by their family and the community. The misconceptions associated to the epilepsy can explain the stigma and the therapeutic gap in this rural community.

  7. Monitoring gravity and water storage changes in northern Benin

    NASA Astrophysics Data System (ADS)

    Hector, B.; Hinderer, J.; Boy, J.; Calvo, M.; Séguis, L.; Descloitres, M.; Cohard, J.; Rosat, S.; Riccardi, U.; Galle, S.

    2013-12-01

    The humid sudanian zone of West-Africa undergoes a monsoon climate, implying a strong seasonality in water storage changes (WSC). The GHYRAF (Gravity and Hydrology in Africa) project aims at monitoring both these local and non-local hydrological contributions with the main gravity sensors available today (FG5 absolute gravimeter, superconducting gravimeter -SG- and CG5 micro-gravimeter). The study area is located in hard-rock basement context in Djougou, northern Benin, and is also part of the long-term observing system AMMA-Catch, and thus under intense hydro-meteorological monitoring (rainfall, soil moisture, water table, evapotranspiration, ...). Gravity-derived WSC are compared to hydrological data and to physically-based or conceptual hydrological models calibrated on these data. This presentation shows the results and limitations of each gravimeter in the context of WSC retrieval. This site was first measured with a FG5 absolute gravimeter four times a year from 2008 to 2013. This can be considered as a high sampling rate, given the remote location and the complexity of FG5 carriage and installation. It allowed to derive an average specific yield for the local aquifer, and preliminary estimates of seasonal WSC (up to 120 nm/s2 - 270mm). Yet the lack of continuity in the data avoids further investigations. The SG-060 superconducting gravimeter has been installed in 2010 in order to monitor gravity response to WSC in a continuous way. A strong drift is present (230nm/s2/yr), and FG5 data together with a-priori information on WSC are needed for estimating its effect. Also, frequent power-failures lead to some significant gaps and offsets during which fast WSC may occur (e.g. rain), yielding to a challenging correction for these events. The retrieval of inter-annual WSC suffers from these strong and limiting instrumental effects. At higher frequencies, up to a few days, continuous gravity monitoring may help to quantify evapotranspiration (ET), a poorly

  8. Genetic population study of Y-chromosome markers in Benin and Ivory Coast ethnic groups.

    PubMed

    Fortes-Lima, Cesar; Brucato, Nicolas; Croze, Myriam; Bellis, Gil; Schiavinato, Stephanie; Massougbodji, Achille; Migot-Nabias, Florence; Dugoujon, Jean-Michel

    2015-11-01

    Ninety-six single nucleotide polymorphisms (SNPs) and seventeen short tandem repeat (STRs) were investigated on the Y-chromosome of 288 unrelated healthy individuals from populations in Benin (Bariba, Yoruba, and Fon) and the Ivory Coast (Ahizi and Yacouba). We performed a multidimensional scaling analysis based on FST and RST genetic distances using a large extensive database of sub-Saharan African populations. There is more genetic homogeneity in Ivory Coast populations compared with populations from Benin. Notably, the Beninese Yoruba are significantly differentiated from neighbouring groups, but also from the Yoruba from Nigeria (FST>0.05; P<0.01). The Y-chromosome dataset presented here provides new valuable data to understand the complex genetic diversity and human male demographic events in West Africa. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Guide to Choosing a Hospital

    MedlinePlus

    ... you visit Hospital Compare, finding information about the quality of hospitals is just a few steps away: • Click on “Find and Compare Hospitals,” and decide if you want to look for hospitals by the hospital name, or by ZIP Code, City, State or Territory, or County. • Select General Search, ...

  10. Frequency of cancer in children residing in Mexico City and treated in the hospitals of the Instituto Mexicano del Seguro Social (1996–2001)

    PubMed Central

    Juárez-Ocaña, Servando; González-Miranda, Guadalupe; Mejía-Aranguré, Juan Manuel; Rendón-Macías, Mario Enrique; Martínez-García, María del Carmen; Fajardo-Gutiérrez, Arturo

    2004-01-01

    Background The objective of this article is to present the frequency of cancer in Mexican children who were treated in the hospitals of the Instituto Mexicano del Seguro Social in Mexico City (IMSS-MC) in the period 1996–2001. Methods The Registry of Cancer in Children, started in 1996 in the IMSS-MC, is an on-going, prospective register. The data from 1996 through 2001 were analyzed and the different types of cancer were grouped according to the International Classification for Cancer in Children (ICCC). From this analysis, the general and specific frequencies by age and by sex were obtained for the different groups of neoplasms. Also, the frequency of the stage of the disease that had been diagnosed in cases of children with solid tumors was obtained. Results A total of 1,702 new cases of children with cancer were registered, with the male/female ratio at 1.1/1. Leukemias had the highest frequency with 784 cases (46.1%) and, of these, acute lymphoblastic leukemias were the most prevalent with 614 cases (78.3%). Thereafter, in descending order of frequency, were tumors of the central nervous system (CNST) with 197 cases (11.6%), lymphomas with 194 cases (11.4%), germinal cell tumors with 110 cases (6.5%), and bone tumors with 97 cases (5.7%). The highest frequency of cancer was found in the group of one to four year-olds that had 627 cases (36.8%). In all the age groups, leukemias were the most frequent. In the present work, the frequency of Hodgkin's disease (~4%) was found to be lower than that (~10%) in previous studies and the frequency of tumors of the sympathetic nervous system was low (2.3%). Of those cases of solid tumors for which the stage of the disease had been determined, 66.9% were diagnosed as being Stage III or IV. Conclusions The principal cancers in the children treated in the IMSS-MC were leukemias, CNST, and lymphomas, consistent with those reported by developed countries. A 2.5-fold reduction in the frequency of Hodgkin's disease was found

  11. Frequency of cancer in children residing in Mexico City and treated in the hospitals of the Instituto Mexicano del Seguro Social (1996-2001).

    PubMed

    Juárez-Ocaña, Servando; González-Miranda, Guadalupe; Mejía-Aranguré, Juan Manuel; Rendón-Macías, Mario Enrique; Martínez-García, María del Carmen; Fajardo-Gutiérrez, Arturo

    2004-08-13

    The objective of this article is to present the frequency of cancer in Mexican children who were treated in the hospitals of the Instituto Mexicano del Seguro Social in Mexico City (IMSS-MC) in the period 1996-2001. The Registry of Cancer in Children, started in 1996 in the IMSS-MC, is an on-going, prospective register. The data from 1996 through 2001 were analyzed and the different types of cancer were grouped according to the International Classification for Cancer in Children (ICCC). From this analysis, the general and specific frequencies by age and by sex were obtained for the different groups of neoplasms. Also, the frequency of the stage of the disease that had been diagnosed in cases of children with solid tumors was obtained. A total of 1,702 new cases of children with cancer were registered, with the male/female ratio at 1.1/1. Leukemias had the highest frequency with 784 cases (46.1%) and, of these, acute lymphoblastic leukemias were the most prevalent with 614 cases (78.3%). Thereafter, in descending order of frequency, were tumors of the central nervous system (CNST) with 197 cases (11.6%), lymphomas with 194 cases (11.4%), germinal cell tumors with 110 cases (6.5%), and bone tumors with 97 cases (5.7%). The highest frequency of cancer was found in the group of one to four year-olds that had 627 cases (36.8%). In all the age groups, leukemias were the most frequent. In the present work, the frequency of Hodgkin's disease (~4%) was found to be lower than that (~10%) in previous studies and the frequency of tumors of the sympathetic nervous system was low (2.3%). Of those cases of solid tumors for which the stage of the disease had been determined, 66.9% were diagnosed as being Stage III or IV. The principal cancers in the children treated in the IMSS-MC were leukemias, CNST, and lymphomas, consistent with those reported by developed countries. A 2.5-fold reduction in the frequency of Hodgkin's disease was found. Of the children, the stage of whose

  12. 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.

  13. 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.

  14. First isolation and molecular characterization of foot-and-mouth disease virus in Benin.

    PubMed

    Gorna, Kamila; Houndjè, Evelyne; Romey, Aurore; Relmy, Anthony; Blaise-Boisseau, Sandra; Kpodékon, Marc; Saegerman, Claude; Moutou, François; Zientara, Stephan; Bakkali Kassimi, Labib

    2014-06-25

    Foot-and-mouth disease (FMD) is a highly contagious viral disease of cloven-hoofed animals. It is one of the most economically devastating diseases affecting livestock animals. In West Africa, where constant circulation of FMD virus (FMDV) is assumed, very few studies on the characterization of circulating strains have been published. This study describes the first isolation and characterization of FMDV in Benin. FMDV was isolated from 42 samples. Antigen Capture Elisa (Ag-ELISA) and VP1 coding sequence analysis revealed 33 strains of serotype O and 9 strains of serotype A. Phylogenetic analysis of the VP1 sequence revealed two different groups of type O isolates and one group of A isolates. VP1 sequence comparison with the sequences available in the GenBank database revealed a close relationship of the Benin isolates with topotype O of West Africa and with African topotype A of genotype VI. Knowledge of the recent strains circulating in Benin should contribute to better selection of vaccine strains and enable the updating of molecular epidemiology data available for West Africa in general.

  15. Natural Interactions between S. haematobium and S. guineensis in the Republic of Benin

    PubMed Central

    Moné, Hélène; Minguez, Stéphanie; Ibikounlé, Moudachirou; Allienne, Jean-François; Massougbodji, Achille; Mouahid, Gabriel

    2012-01-01

    Schistosomiasis is a parasitic disease which affects millions of people around the world, particularly in Africa. In this continent, different species are able to interbreed, like Schistosoma haematobium and Schistosoma guineensis, two schistosome species infecting humans. The Republic of Benin is known to harbor S. haematobium, but its geographical situation in between Nigeria, Mali, and Burkina Faso, where S. guineensis was found, raises the question about the possible presence of S. haematobium/S. guineensis hybrids in this country. We conducted morphological analyses on schistosome eggs and molecular analyses on schistosome larvae (high resolution melting (HRM) analysis and gene sequencing) in order to detect any natural interaction between these two species of schistosomes. The morphological results showed the presence of three egg morphotypes (S. haematobium, S. guineensis, and intermediate). Three genotypes were detected by ITS2 rDNA HRM analysis: S. haematobium, S. guineensis, and hybrid, and their percentages confirmed the results of the morphological analysis. However, sequencing of the CO1 mtDNA gene showed that all the samples from Benin belonged to S. haematobium. Our results provide the first evidence of introgression of S. guineensis genes in S. haematobium in Benin. PMID:22645454

  16. Inheritance of the Bantu/Benin haplotype causes less severe hemolytic and oxidative stress in sickle cell anemia patients treated with hydroxycarbamide.

    PubMed

    Okumura, Jéssika V; Silva, Danilo G H; Torres, Lidiane S; Belini-Junior, Edis; Barberino, Willian M; Oliveira, Renan G; Carrocini, Gisele C S; Gelaleti, Gabriela B; Lobo, Clarisse L C; Bonini-Domingos, Claudia R

    2016-07-01

    Beta S-globin gene cluster haplotypes (β(S)-haplotypes) can modulate the response to hydroxycarbamide (HC) treatment in sickle cell anemia (SCA) patients. In Brazil, the most common haplotypes are Bantu and Benin, and both confer a poor prognosis for patients when untreated with HC. We evaluated oxidative and hemolytic biomarkers in 48 SCA patients undergoing HC treatment separated in three subgroups: Bantu/Bantu, Bantu/Benin and Benin/Benin haplotype. On the basis of reduced haptoglobin (HP) levels, patients with Bantu/Bantu haplotypes had 3.0% higher hemolysis degree when compared with those with Bantu/Benin haplotypes (P=0.01). The Benin/Benin patients had 53.6% greater lipid peroxidation index than the Bantu/Bantu patients (P=0.01) because of evaluated thiobarbituric acid reactive species levels. The Bantu/Benin subgroup had intermediate levels of hemolytic and oxidative stress markers compared with the homozygous subgroups. Through strict inclusion criteria adopted, as well as consolidated and well-described hemolytic and the oxidative parameters evaluated, we suggest a haplotype-interaction response to HC treatment mediated by a 'balance' between the genetic factors of each haplotype studied.

  17. [Anxiety and depression among the epileptics in general population in Benin (Western Africa)].

    PubMed

    Nubukpo, P; Houinato, D; Preux, P-M; Avodé, G; Clément, J-P

    2004-01-01

    In order to assess prevalence of depression and anxiety among epileptic patients and to compare it to a control population, a matched case-control survey was performed in 196 persons above 18 Year old (98 epileptics and 98 controls matched according to sex, age 10 and social environment) in Republic of Benin (West Africa), using Goldberg's Depression and Anxiety scale. Two main investigators helped by 5 sociology students were trained on a questionnaire by a psychiatrist skilled with public health matters. People taking part in the survey are epileptic patients who already used health services. Inclusions took place within 17 communes of four departments (Mono, Zou, Ouémé, Atlantique) located in Southern part of Benin. The questionnaire used an Identity sheet and the Goldberg Depression Scale. Results are shown as mean standard deviations, for quantitative values, and percents for qualitative ones. Comparisons of proportions in qualitative variables are carried out using c2 test or Fisher's exact test. Comparisons of means rates between subject's groups are carried out with a Student t test or variance analysis. The correlations between two quantitative variables were assessed by linear correlation coefficient. Significance threshold chosen for the whole set of statistics analysis is 0.05. The majority of interviewed epileptic patients is young (average 32.6 11.5 Years old). A male predominance exists (sex ratio 1.28). 93% of interviewed persons live within their family, are married or cohabit (controls: 98.2%; cases: 87.9%); 57.4% are married (controls: 70%; cases: 44%). The most represented professional categories are craftsmen and shopkeepers (29.2%) as well as farmers (19.5%). Most of recruited patients live in an urban setting (55.4%) and 63.6% of interviewed persons had been living in the area of survey for over 10 Years. The most represented religion within the sample is Christian religion (67.7%), Animists (23.3%) and Muslims (5.8%). 97% of epileptic

  18. [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.

  19. 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

  20. 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…

  1. 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…

  2. 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

  3. Decline in the prevalence of HIV and sexually transmitted infections among female sex workers in Benin over 15 years of targeted interventions.

    PubMed

    Béhanzin, Luc; Diabaté, Souleymane; Minani, Isaac; Boily, Marie-Claude; Labbé, Annie-Claude; Ahoussinou, Clément; Anagonou, Séverin; Zannou, Djimon M; Lowndes, Catherine M; Alary, Michel

    2013-05-01

    An HIV-preventive intervention targeting the sex work milieu and involving fully integrated components of structural interventions, communication for behavioral change and care for sexually transmitted infections (STIs), was implemented in Benin by a Canadian project from 1992 to 2006. It first covered Cotonou before being extended to other main cities from 2000. At the project end, the Beninese authorities took over the intervention, but structural interventions were interrupted and other intervention components were implemented separately. We estimated time trends in HIV/STI prevalence among female sex workers (FSWs) from 1993 to 2008 and assessed the impact of the change in intervention model on trends. Six integrated biological and behavioral surveys were carried out among FSWs. Time trend analysis controlled for potential sociodemographic confounders using log-binomial regression. In Cotonou, from 1993 to 2008, there was a significant decrease in HIV (53.3%-30.4%), gonorrhea (43.2%-6.4%), and chlamydia (9.4%-2.8%) prevalence (all adjusted P = 0.0001). The decrease in HIV and gonorrhea prevalence was also significant in the other cities between 2002 and 2008. In 2002, gonorrhea prevalence was lower in Cotonou than elsewhere (prevalence ratio = 0.53, 95% confidence interval: 0.32 to 0.88). From 2005 to 2008, there was an increase in gonorrhea prevalence (prevalence ratio = 1.76, 95% confidence interval: 1.17 to 2.65) in all cities combined. Our results suggest a significant impact of this targeted preventive intervention on HIV/STI prevalence among FSWs. The recent increase in gonorrhea prevalence could be related to the lack of integration of the intervention components.

  4. Decline in the prevalence of HIV and sexually transmitted infections among female sex workers in Benin over 15 years of targeted interventions

    PubMed Central

    BÉHANZIN, Luc; DIABATÉ, Souleymane; MINANI, Isaac; BOILY, Marie-Claude; LABBÉ, Annie-Claude; AHOUSSINOU, Clément; ANAGONOU, Séverin; ZANNOU, Djimon Marcel; LOWNDES, Catherine M; ALARY, Michel

    2013-01-01

    Background An HIV preventive intervention targeting the sex work milieu and involving fully integrated components of structural interventions (SI), communication for behavioural change and care for sexually transmitted infections (STI), was implemented in Benin by a Canadian project from 1992 to 2006. It first covered Cotonou before being extended to other main cities from 2000. At the project end, the Beninese authorities took over the intervention, but SI were interrupted and other intervention components were implemented separately. We estimated time trends in HIV/STI prevalence among female sex workers (FSW) from 1993 to 2008 and assessed the impact of the change in intervention model on trends. Methods Six integrated biological and behavioural surveys were carried out among FSW. Time trend analysis controlled for potential socio-demographic confounders using log-binomial regression. Results In Cotonou, from 1993 to 2008, there was a significant decrease in HIV (53.3 to 30.4%), gonorrhea (43.2 to 6.4%) and chlamydia (9.4 to 2.8%) prevalence (all adjusted-p=0.0001). The decrease in HIV and gonorrhea prevalence was also significant in the other cities between 2002 and 2008. In 2002, gonorrhea prevalence was lower in Cotonou than elsewhere (prevalence ratio [PR]=0.53; 95% confidence interval [95%CI]: 0.32–0.88). From 2005 to 2008, there was an increase in gonorrhea prevalence (PR=1.76; 95%CI: 1.17–2.65) in all cities combined. Conclusion Our results suggest a significant impact of this targeted preventive intervention on HIV/STI prevalence among FSW. The recent increase in gonorrhea prevalence could be related to the lack of integration of the intervention components. PMID:23337368

  5. 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)

  6. 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)

  7. Suicidal Behaviour and Related Risk Factors among School-Aged Youth in the Republic of Benin

    PubMed Central

    Randall, Jason R.; Doku, David; Wilson, Michael L.; Peltzer, Karl

    2014-01-01

    Introduction Research on factors associated with suicidal ideation and suicide attempts has been conducted largely in developed countries. Research on West African countries in particular is lacking. Methods Data were obtained from the Global School-based Health Survey conducted in Benin in 2009. This was a cross-sectional study of three grades, spanning Junior and Senior High, which sampled a total of 2,690 adolescents. Data on the occurrence of demographic, psycho-social and socio-environmental risk factors were tested using multinomial logistic regression for their association with suicidal ideation and suicide attempts. Results The survey indicated that 23.2% had thought about suicide and 28.3% had made a suicide attempt in the previous year. Anxiety, loneliness, being bullied, alcohol misuse, illicit drug use, and lack of parental support were independently related to the ideation outcomes, suicidal ideation without planning and suicidal ideation with planning. Multinomial regression analysis, using one suicide attempt and multiple suicide attempts as outcomes, revealed that female sex, anxiety, loneliness, being physically attacked, and illicit drug use were associated these outcomes. Discussion The prevalence of suicide attempts reported in the survey is relatively high. It is possible that there are cultural factors that could explain this finding. Our research indicates that many factors are related to the occurrence of suicidal ideation and suicide attempts among youth in Benin. Illicit drug use and violence in particular are associated with a high rate of suicide attempts in Benin. Measures to address these issues may reduce the risk of self-inflicted violence. PMID:24505443

  8. Psychometric Properties of the Participation Scale among Former Buruli Ulcer Patients in Ghana and Benin

    PubMed Central

    de Zeeuw, Janine; Douwstra, Marlies; Omansen, Till F.; Sopoh, Ghislain E.; Johnson, Christian; Phillips, Richard O.; Alferink, Marike; Saunderson, Paul; Van der Werf, Tjip S.; Dijkstra, Pieter U.; Stienstra, Ymkje

    2014-01-01

    Background Buruli ulcer is a stigmatising disease treated with antibiotics and wound care, and sometimes surgical intervention is necessary. Permanent limitations in daily activities are a common long term consequence. It is unknown to what extent patients perceive problems in participation in social activities. The psychometric properties of the Participation Scale used in other disabling diseases, such as leprosy, was assessed for use in former Buruli ulcer patients. Methods Former Buruli ulcer patients in Ghana and Benin, their relatives, and healthy community controls were interviewed using the Participation Scale, Buruli Ulcer Functional Limitation Score, and the Explanatory Model Interview Catalogue to measure stigma. The Participation Scale was tested for the following psychometric properties: discrimination, floor and ceiling effects, internal consistency, inter-item correlation, item-total correlation and construct validity. Results In total 386 participants (143 former Buruli ulcer patients with their relatives (137) and 106 community controls) were included in the study. The Participation Scale displayed good discrimination between former Buruli ulcer patients and healthy community controls. No floor and ceiling effects were found. Internal consistency (Cronbach's alpha) was 0.88. In Ghana, mean inter-item correlation of 0.29 and item-total correlations ranging from 0.10 to 0.69 were found while in Benin, a mean inter-item correlation of 0.28 was reported with item-total correlations ranging from −0.08 to 0.79. With respect to construct validity, 4 out of 6 hypotheses were not rejected, though correlations between various constructs differed between countries. Conclusion The results indicate the Participation Scale has acceptable psychometric properties and can be used for Buruli ulcer patients in Ghana and Benin. Future studies can use this Participation Scale to evaluate the long term restrictions in participation in daily social activities of former

  9. 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.

  10. 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.

  11. Swampy area transformations by exploitation of Raphia hookeri (Arecaceae) in southern Benin (West Africa)

    SciTech Connect

    Profizi, J.

    1988-03-01

    The Raphia palms in the southern part of Benin are confined to freshwater swamps, where the natural vegetation consists of a forest rich in Dicotyledons. Human activity has transformed this forest into a raphiale where Raphia hookeri has become the main arborescent species. The influence of this transformation on the vegetation results in a more regular distribution of Raphis hookeri trunks and a gradual disappearing of clumps of ramets. By now, the future of Raphis hookeri species is almost ensured except in situations of over-exploitation.

  12. 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

  13. Improvements in Patient Acceptance by Hospitals Following the Introduction of a Smartphone App for the Emergency Medical Service System: A Population-Based Before-and-After Observational Study in Osaka City, Japan

    PubMed Central

    Katayama, Yusuke; Kiyohara, Kosuke; Iwami, Taku; Kawamura, Takashi; Izawa, Junichi; Gibo, Koichiro; Komukai, Sho; Hayashida, Sumito; Kiguchi, Takeyuki; Ohnishi, Mitsuo; Ogura, Hiroshi

    2017-01-01

    Background Recently, the number of ambulance dispatches has been increasing in Japan, and it is therefore difficult for hospitals to accept emergency patients smoothly and appropriately because of the limited hospital capacity. To facilitate the process of requesting patient transport and hospital acceptance, an emergency information system using information technology (IT) has been built and introduced in various communities. However, its effectiveness has not been thoroughly revealed. We introduced a smartphone app system in 2013 that enables emergency medical service (EMS) personnel to share information among themselves regarding on-scene ambulances and the hospital situation. Objective The aim of this study was to assess the effects of introducing this smartphone app on the EMS system in Osaka City, Japan. Methods This retrospective study analyzed the population-based ambulance records of Osaka Municipal Fire Department. The study period was 6 years, from January 1, 2010 to December 31, 2015. We enrolled emergency patients for whom on-scene EMS personnel conducted hospital selection. The main endpoint was the difficulty experienced in gaining hospital acceptance at the scene. The definition of difficulty was making ≥5 phone calls by EMS personnel at the scene to hospitals until a decision to transport was determined. The smartphone app was introduced in January 2013, and we compared the patients treated from 2010 to 2012 (control group) with those treated from 2013 to 2015 (smartphone app group) using an interrupted time-series analysis to assess the effects of introducing this smartphone app. Results A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 emergency patients in the control group (50.00%, 300,313/600,526) from 2010 to 2012 and 300,395 emergency patients in the smartphone app group (50.00%, 300,395/600,526) from 2013 to 2015. The rate of difficulty in hospital acceptance

  14. Improvements in Patient Acceptance by Hospitals Following the Introduction of a Smartphone App for the Emergency Medical Service System: A Population-Based Before-and-After Observational Study in Osaka City, Japan.

    PubMed

    Katayama, Yusuke; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Iwami, Taku; Kawamura, Takashi; Izawa, Junichi; Gibo, Koichiro; Komukai, Sho; Hayashida, Sumito; Kiguchi, Takeyuki; Ohnishi, Mitsuo; Ogura, Hiroshi; Shimazu, Takeshi

    2017-09-11

    Recently, the number of ambulance dispatches has been increasing in Japan, and it is therefore difficult for hospitals to accept emergency patients smoothly and appropriately because of the limited hospital capacity. To facilitate the process of requesting patient transport and hospital acceptance, an emergency information system using information technology (IT) has been built and introduced in various communities. However, its effectiveness has not been thoroughly revealed. We introduced a smartphone app system in 2013 that enables emergency medical service (EMS) personnel to share information among themselves regarding on-scene ambulances and the hospital situation. The aim of this study was to assess the effects of introducing this smartphone app on the EMS system in Osaka City, Japan. This retrospective study analyzed the population-based ambulance records of Osaka Municipal Fire Department. The study period was 6 years, from January 1, 2010 to December 31, 2015. We enrolled emergency patients for whom on-scene EMS personnel conducted hospital selection. The main endpoint was the difficulty experienced in gaining hospital acceptance at the scene. The definition of difficulty was making ≥5 phone calls by EMS personnel at the scene to hospitals until a decision to transport was determined. The smartphone app was introduced in January 2013, and we compared the patients treated from 2010 to 2012 (control group) with those treated from 2013 to 2015 (smartphone app group) using an interrupted time-series analysis to assess the effects of introducing this smartphone app. A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 emergency patients in the control group (50.00%, 300,313/600,526) from 2010 to 2012 and 300,395 emergency patients in the smartphone app group (50.00%, 300,395/600,526) from 2013 to 2015. The rate of difficulty in hospital acceptance was 14.19% (42,585/300,131) in the

  15. Short-term effects of fine particulate air pollution on hospital admissions for cardiovascular diseases: a case-crossover study in a tropical city.

    PubMed

    Chang, Chih-Ching; Chen, Pei-Shih; Yang, Chun-Yuh

    2015-01-01

    This study was undertaken to determine whether there was an association between fine particles (PM2.5) levels and hospital admissions for cardiovascular diseases (CVD) in Kaohsiung, Taiwan. Hospital admissions for CVD (including ischemic heart disease [IHD], stroke, congestive heart failure [CHF], and arrhythmias) and ambient air pollution data for Kaohsiung were obtained for the period from 2006-2010. The relative risk of hospital admissions for CVD was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), elevated number of admissions for CVD were significantly associated with higher PM2.5 levels only on cool days (<25°C), with an interquartile range rise associated with a 47% (95% CI = 39-56%), 48% (95% CI = 40-56%), 47% (95% CI = 34-61%), and 51% (95% CI = 34-70%) increase in IHD, stroke, CHF, and arrhythmias admissions, respectively. No significant associations between PM2.5 and hospital admissions for CVD were observed on warm days. In the two-pollutant models, PM2.5 levels remained significant even controlling for sulfur dioxide, nitrogen dioxide, carbon monoxide, or ozone on cool days. This study provides evidence that higher levels of PM2.5 enhance the risk of hospital admissions for CVD in Kaohsiung, Taiwan.

  16. Short-term effects of gaseous pollutants and particulate matter on daily hospital admissions for cardio-cerebrovascular disease in Lanzhou: evidence from a heavily polluted city in China.

    PubMed

    Zheng, Shan; Wang, Minzhen; Wang, Shigong; Tao, Yan; Shang, Kezheng

    2013-01-28

    Panel studies show a consistent association between increase in the cardiovascular hospitalizations with air pollutants in economically developed regions, but little evidence in less developed inland areas. In this study, a time-series analysis was used to examine the specific effects of major air pollutants [particulate matter less than 10 microns in diameter (PM(10)), sulfur dioxide (SO(2)), and nitrogen dioxides (NO(2))] on daily hospital admissions for cardio-cerebrovascular diseases in Lanzhou, a heavily polluted city in China. We examined the effects of air pollutants for stratified groups by age and gender, and conducted the modifying effect of seasons on air pollutants to test the possible interaction. The significant associations were found between PM(10), SO(2) and NO(2) and cardiac disease admissions, SO(2) and NO(2) were found to be associated with the cerebrovascular disease admissions. The elderly was associated more strongly with gaseous pollutants than younger. The modifying effect of seasons on air pollutants also existed. The significant effect of gaseous pollutants (SO(2) and NO(2)) was found on daily hospital admissions even after adjustment for other pollutants except for SO(2) on cardiac diseases. In a word, this study provides the evidence for the detrimental short-term health effects of urban gaseous pollutants on cardio-cerebrovascular diseases in Lanzhou.

  17. Short-Term Effects of Gaseous Pollutants and Particulate Matter on Daily Hospital Admissions for Cardio-Cerebrovascular Disease in Lanzhou: Evidence from a Heavily Polluted City in China

    PubMed Central

    Zheng, Shan; Wang, Minzhen; Wang, Shigong; Tao, Yan; Shang, Kezheng

    2013-01-01

    Panel studies show a consistent association between increase in the cardiovascular hospitalizations with air pollutants in economically developed regions, but little evidence in less developed inland areas. In this study, a time-series analysis was used to examine the specific effects of major air pollutants [particulate matter less than 10 microns in diameter (PM10), sulfur dioxide (SO2), and nitrogen dioxides (NO2)] on daily hospital admissions for cardio-cerebrovascular diseases in Lanzhou, a heavily polluted city in China. We examined the effects of air pollutants for stratified groups by age and gender, and conducted the modifying effect of seasons on air pollutants to test the possible interaction. The significant associations were found between PM10, SO2 and NO2 and cardiac disease admissions, SO2 and NO2 were found to be associated with the cerebrovascular disease admissions. The elderly was associated more strongly with gaseous pollutants than younger. The modifying effect of seasons on air pollutants also existed. The significant effect of gaseous pollutants (SO2 and NO2) was found on daily hospital admissions even after adjustment for other pollutants except for SO2 on cardiac diseases. In a word, this study provides the evidence for the detrimental short-term health effects of urban gaseous pollutants on cardio-cerebrovascular diseases in Lanzhou. PMID:23358231

  18. 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…

  19. Psychosocial issues in people with epilepsy in Togo and Benin (West Africa) I. Anxiety and depression measured using Goldberg's scale.

    PubMed

    Nubukpo, P; Preux, P M; Houinato, D; Radji, A; Grunitzky, E K; Avodé, G; Clément, J P

    2004-10-01

    This study in Togo and Benin, West Africa, was aimed at measuring depression and anxiety among people with epilepsy (PWE). This cross-sectional study of 281 adult PWE in Togo and 215 in Benin matched with the same number of controls without epilepsy used Goldberg's anxiety and depression scale. The statistical tests used for comparisons were chi(2) tests, Fisher's exact test, analysis of variance, and Fisher's PLSD test when necessary. PWE in Togo and Benin had significantly higher (P<0.0001) average depression scores (4.4+/-2.1, 4.7+/-2.7) than controls (0.5+/-0.9, 1.4+/-2.4). They also had significantly higher (P<0.0001) average anxiety scores (5.3+/-2.0, 6.2+/-2.1) than controls (2.5+/-1.6, 1.6+/-2.0). In consideration of the thresholds of the scale, the prevalence of possible major anxiety and depression among PWE was also very high compared with controls (P<0.0001). High anxiety and depression scores were, in general, positively correlated with a higher frequency of seizures and lack of treatment. Results confirmed the existence of anxiety and depression among PWE in Togo and Benin.

  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. 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…

  2. 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

    2017-01-07

    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.

  3. 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…

  4. 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…

  5. 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…

  6. 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…

  7. 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…

  8. 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…

  9. 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…

  10. 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

  11. Diversity of the neglected and underutilized crop species of importance in Benin.

    PubMed

    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.

  12. Natural enemies of the maize cob borer, Mussidia nigrivenella (Lepidoptera: Pyralidae) in Benin, West Africa.

    PubMed

    Sétamou, M; Schulthess, F; Goergen, G; Poehling, H-M; Borgemeister, C

    2002-08-01

    Mussidia nigrivenella Ragonot is a pest of maize cobs in West Africa. It significantly reduces maize yields and grain quality, with quantitative losses of 2-25%at harvest, and up to 10-15% indirect losses due to an increase in storage pest infestation levels. Infestation by M. nigrivenella also significantly increased the susceptibility of maize to Aspergillus flavus infection and subsequent aflatoxin contamination. Surveys conducted in different agro-ecological zones of Benin on cultivated and wild host plants during 1994-1997 revealed one egg parasitoid, three larval parasitoids and one pupal parasitoid attacking M. nigrivenella. Egg parasitism was scarce on all host plants sampled and in all four agro-ecological zones. Parasitism by larval and pupal parasitoids was usually less than 10%, and varied with host plant species. Both larval and pupal parasitoids were rare or absent in cultivated maize fields. The solitary chalcidid pupal parasitoid, Antrocephalus crassipes Masi, was the predominant species, contributing approximately 53% of the observed mortality. Logistic regression analysis indicated that this parasitoid was more prevalent on fruits of Gardenia spp. (Rubiaceae) than on the other host plant species including maize used by M. nigrivenella, and was most abundant between February and September. The differences in parasitoid diversity and parasitism between Benin and other regions suggest that there are opportunities for biological control through introduction of exotic parasitoids or using the 'new association' approach, which uses natural enemies of closely related host species that occupy similar ecological niches to the target pest.

  13. [Perceptions of parental participation by health professionals in childhood malaria control in Benin].

    PubMed

    Houéto, David; d'Hoore, William; Deccache, Alain

    2008-01-01

    The aim of this study was to explore and document the perceptions of health professionals regarding parental participation in the fight against child malaria, specifically with regard to fever management, in Benin (West Africa). The findings indicate that community participation in Malaria control in general, and in the case of children in particular, is essential due to the contributing factors surrounding the disease. This form of participation is different from the one recommended and practiced within the structure of the National Health system. Deep-seated, thorough reform of health care program planning is necessary in order to contribute to the improvement of the population's participation in this process. The concept of health promotion was used to frame and shed light on the analysis of the proposed recommendations. Parents' participation, one that integrates their perceptions and depictions of child fever, is not currently a reality in Benin; the study revealed that the participants seek out and request the development of skills necessary that could enable them to better contribute to the fight against malaria.

  14. 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.

  15. Career Education Program: Geneva Area City Schools. [Grade 3 Units: Money and Banking, Weather, The Hospital Emergency Room, and Let's Go to Town].

    ERIC Educational Resources Information Center

    Geneva Area City Schools, OH.

    Four curriculum units for the third grade level focus on: (1) weather station jobs and the weather prediction system; (2) hospital emergency room workers and the room's function; (3) bank workers and the banking industry; and (4) various urban workers. Behavioral objectives linking the units focus on increasing students' awareness of and…

  16. Is Walk Score associated with hospital admissions from chronic diseases? Evidence from a cross-sectional study in a high socioeconomic status Australian city-state

    PubMed Central

    Mazumdar, Soumya; Learnihan, Vincent; Cochrane, Thomas; Phung, Hai; O'Connor, Bridget; Davey, Rachel

    2016-01-01

    Objectives To explore patterns of non-communicable diseases (NCDs) in the Australian Capital Territory (ACT).To ascertain the effect of the neighbourhood built environmental features and especially walkability on health outcomes, specifically for hospital admissions from NCDs. Design A cross-sectional analysis of public hospital episode data (2007–2013). Setting Hospitalisations from the ACT, Australia at very small geographic areas. Participants Secondary data on 75 290 unique hospital episodes representing 39 851 patients who were admitted to ACT hospitals from 2007 to 2013. No restrictions on age, sex or ethnicity. Main exposure measures Geographic Information System derived or compatible measures of general practitioner access, neighbourhood socioeconomic status, alcohol access, exposure to traffic and Walk Score walkability. Main outcome measures Hospitalisations of circulatory diseases, specific endocrine, nutritional and metabolic diseases, respiratory diseases and specific cancers. Results Geographic clusters with significant high and low risks of NCDs were found that displayed an overall geographic pattern of high risk in the outlying suburbs of the territory. Significant relationships between neighbourhood walkability as measured by Walk Score and the likelihood of hospitalisation with a primary diagnosis of myocardial infarction (heart attack) were found. A possible relationship was also found with the likelihood of being hospitalised with 4 major lifestyle-related cancers. Conclusions Our research augments the growing literature underscoring the relationships between the built environment and health outcomes. In addition, it supports the importance of walkable neighbourhoods, as measured by Walk Score, for improved health. PMID:27932340

  17. The Organization of Hospital Services for Casualties due to the Bombing of Cities, Based on Experience Gained in Barcelona—with Special Reference to the Classification of Casualties

    PubMed Central

    Trueta, J.

    1939-01-01

    (1) Difference between modern “total population” war and old-fashioned war. Difference between bombing of (a) military objectives and (b) civilian population. (a) The heavy bomb, e.g. 750 lb., with large fragments, upward throw, great destruction of buildings. (b) The light bomb with finger nail fragments, horizontal throw, great velocity.There is in addition the incendiary bomb, little used in Barcelona because the buildings are built of stone and concrete. (2) Aerial bombing of a town produces injuries needing more immediate hospitalization than most front-line wounds. At the same time it is possible in a town to organize rapid collection of patients and their immediate transfer to hospital. (3) Experience shows that it is most desirable to make this transfer of patients to hospital a primary consideration. On arrival they are “sorted” and minor injuries are given First Aid treatment and sent home, others are fully examined, classified, and dispatched to the theatres on a priority list, to nearby wards for resuscitation, to wards for rest, or sent on to plaster rooms for splintage, or to a neurosurgical centre. (4) First-aid posts in a town should be in hospitals and treat superficial injuries, &c., after primary sorting in the hospital reception room. (5) First-aid posts in outlying areas should carry out the same function for the same type of cases; all the more seriously wounded, including those with tiny penetrating wounds, should be dispatched without first aid treatment direct to hospital. (6) Hospital arrangements, for circulation of ambulances, for sorting, undressing of patients, docketing of valuables, &c. (7) Classification must be carried out by surgeons of experience and judgment. They must regard not only a standard priority list but the particular clinical picture and prognosis in each case. (8) The surgeon will furthermore draft the cases with regard to the special abilities of the surgical units available, e.g. chest, abdomen, or limbs

  18. Short-Term Effects of Coarse Particulate Matter on Hospital Admissions for Cardiovascular Diseases: A Case-Crossover Study in a Tropical City.

    PubMed

    Chen, Ying-Chen; Weng, Yi-Hao; Chiu, Ya-Wen; Yang, Chun-Yuh

    2015-01-01

    This study was undertaken to determine whether there was an association between coarse particles (PM2.5-10) levels and frequency of hospital admissions for cardiovascular diseases (CVD) in Kaohsiung, Taiwan. Hospital admissions for CVD, including ischemic heart disease (IHD), stroke, congestive heart failure (CHF), and arrhythmias, and ambient air pollution data levels for Kaohsiung were obtained for the period 2006-2010. The relative risk of hospital admissions for CVD was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), increased rates of admissions for CVD were significantly associated with higher coarse PM levels only on cool days (< 25°C), with a 10-μg/m(3) elevation in PM2.5-10 concentrations associated with a 3% (95% CI = 2-4%) rise in IHD admissions, 5% (95% CI = 4-6%) increase in stroke admissions, 3% (95% CI = 1-6%) elevation in CHF admissions, and 3% (95% CI = 0-6%) rise in arrhythmias admissions. No significant associations were found between coarse particle levels and number of hospital admissions for CVD on warm days. In the two-pollutant models, PM2.5-10 levels remained significantly correlated with higher rate of CVD admissions even controlling for sulfur dioxide, nitrogen dioxide, carbon monoxide, or ozone on cool days. Compared to the effect estimate associated with a 10-μg/m(3) increase in PM2.5 levels, effect estimates of frequency of CVD-related admissions associated with a 10-μg/m(3) rise in coarse PM levels were weaker. This study provides evidence that higher levels of PM2.5-10 enhance the risk of hospital admissions for CVD.

  19. Is Walk Score associated with hospital admissions from chronic diseases? Evidence from a cross-sectional study in a high socioeconomic status Australian city-state.

    PubMed

    Mazumdar, Soumya; Learnihan, Vincent; Cochrane, Thomas; Phung, Hai; O'Connor, Bridget; Davey, Rachel

    2016-12-08

    To explore patterns of non-communicable diseases (NCDs) in the Australian Capital Territory (ACT).To ascertain the effect of the neighbourhood built environmental features and especially walkability on health outcomes, specifically for hospital admissions from NCDs. A cross-sectional analysis of public hospital episode data (2007-2013). Hospitalisations from the ACT, Australia at very small geographic areas. Secondary data on 75 290 unique hospital episodes representing 39 851 patients who were admitted to ACT hospitals from 2007 to 2013. No restrictions on age, sex or ethnicity. Geographic Information System derived or compatible measures of general practitioner access, neighbourhood socioeconomic status, alcohol access, exposure to traffic and Walk Score walkability. Hospitalisations of circulatory diseases, specific endocrine, nutritional and metabolic diseases, respiratory diseases and specific cancers. Geographic clusters with significant high and low risks of NCDs were found that displayed an overall geographic pattern of high risk in the outlying suburbs of the territory. Significant relationships between neighbourhood walkability as measured by Walk Score and the likelihood of hospitalisation with a primary diagnosis of myocardial infarction (heart attack) were found. A possible relationship was also found with the likelihood of being hospitalised with 4 major lifestyle-related cancers. Our research augments the growing literature underscoring the relationships between the built environment and health outcomes. In addition, it supports the importance of walkable neighbourhoods, as measured by Walk Score, for improved health. 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/.

  20. 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

  1. 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

  2. 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

  3. Effect of particulate matter air pollution on hospital admissions and medical visits for lung and heart disease in two southeast Idaho cities.

    PubMed

    Ulirsch, Gregory V; Ball, Louise M; Kaye, Wendy; Shy, Carl M; Lee, Carolyn V; Crawford-Brown, Douglas; Symons, Michael; Holloway, Tracey

    2007-08-01

    Few, if any, published time series studies have evaluated the effects of particulate matter air exposures by combining hospital admissions with medical visit data for smaller populations. We investigated the relationship between daily particulate matter (<10 microm in aerometric diameter or PM10) exposures with admissions and medical visits (emergency room, urgent care, and family practice) for respiratory and cardiovascular disease in Pocatello and Chubbuck, Idaho (population about 60,000), from November 1994 through March 2000. Within generalized linear models, time, weather, influenza, and day-of-week effects were controlled. In single-pollutant models, respiratory disease admissions and visits increased (7.1-15.4% per 50 microg/m3 PM10) for each age group analyzed, with the highest increases in two groups, children and especially the elderly. Statistical analyses suggest that the results probably did not occur by chance. Sensitivity analyses did not provide strong evidence that the respiratory disease effect estimates were sensitive to reasonable changes in the final degrees of freedom choice for time and weather effects. No strong evidence of confounding by NO2 and SO2 was found from results of multi-pollutant models. Ozone and carbon monoxide data were not available to include multi-pollutant models, but evidence suggests that they were not a problem. Unexpectedly, evidence of an association between PM10 with cardiovascular disease was not found, possibly due to the lifestyles of the mostly Mormon study population. Successful time series analyses can be performed on smaller populations if diverse, centralized databases are available. Hospitals that offer urgent or other primary care services may be a rich source of data for researchers. Using data that potentially represented a wide-range of disease severity, the findings provide evidence that evaluating only hospital admissions or emergency room visit effects may underestimate the overall morbidity due to

  4. Factors associated with cesarean delivery in public and private hospitals in a city of northeastern Brazil: a cross-sectional study.

    PubMed

    Vieira, Graciete Oliveira; Fernandes, Lorena Gabriel; de Oliveira, Nelson Fernandes; Silva, Luciana Rodrigues; Vieira, Tatiana de Oliveira

    2015-06-05

    To evaluate the prevalence and factors associated with cesarean delivery according to whether care was provided in public or private hospitals in Brazil. This was a cross-sectional study based on a cohort of live births between April 2004 and March 2005. A total of 1,344 mother-child pairs were followed up during the first month of life. The variables analyzed were the socioeconomic and demographic characteristics of the mother and newborn, as well as the healthcare provided during pregnancy and childbirth. Hierarchical analysis was carried out for both prediction models, i.e. healthcare provision either within the Brazilian National Health System (public service) or within the private network. Prevalence and association measurement calculations were carried out. Values were considered significant when pless than or equal to 5.0 %. A total of 1,019 (75,8 %) gave birth in public hospital. The prevalences of cesarean delivery were 29.9 % and 86.2 % in the public and private sectors, respectively. Through hierarchical logistic regression, the risk factors for cesarean delivery presented in the public hospital were maternal age greater than or equal to 20 years (p = 0.003), primiparity (p = 0.004), twinning (p = 0.039), prenatal care provided in the private network (p = 0.004), delivery in hospitals providing high complexity medical care (p = 0.000) and prenatal care with greater than or equal to 6 consultations (p = 0.035). In the private sector, no association was observed between the variables studied and cesarean delivery. The cesarean delivery rates were high in both sectors, although in the private network the rate was almost triple that of the public service. The absence of determinant factors of birth in the private sector drew attention. In planning measures against the growing cesarean rates, it is necessary to take into consideration the environmental determinants as primiparity, twinning and greater maternal age, frequent indications of primary cesarean

  5. 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

  6. The impact of 9/11 on the association of ambient air pollution with daily respiratory hospital admissions in a Canada-US border city, Windsor, Ontario

    PubMed Central

    LUGINAAH, ISAAC; FUNG, KAREN Y.; GOREY, KEVIN M.; KHAN, SHAHEDUL

    2010-01-01

    The 11 September 2001 (9/11) terrorist attacks in the United States resulted in long lines of trucks at the border crossing in Windsor, Ontario. Public concern about the potential impact of these trucks spewing toxic pollutants into the air drew attention to the need to investigate the impact of 9/11 on the daily levels of air pollutants and respiratory hospitalization. In this study, significant increases in respiratory admissions were found one month and 6 months post-9/11. Mean daily respiratory admission was also significantly higher than the same period one year earlier and one year later. SO2 and CO concentration levels were found to be generally higher after 9/11 than one year before and immediately before. Relative risk estimates of respiratory hospitalization after 9/11 showed that SO2 (RR̂ = 1.15 for two-day, RR̂ = 1.18 for three-day, and RR̂ = 1.21 for five-day averages), NO2 (RR̂ = 1.10 for current day), and COH (RR̂ = 1.09 for current day, RR̂ = 1.10 for two-day average) had the most significant effects after 9/11. These results suggest the need for more stringent regulatory efforts in air quality in the region in response to the changing transportation dynamics at this Canada-US border crossing. PMID:21234298

  7. The impact of 9/11 on the association of ambient air pollution with daily respiratory hospital admissions in a Canada-US border city, Windsor, Ontario.

    PubMed

    Luginaah, Isaac; Fung, Karen Y; Gorey, Kevin M; Khan, Shahedul

    2006-08-01

    The 11 September 2001 (9/11) terrorist attacks in the United States resulted in long lines of trucks at the border crossing in Windsor, Ontario. Public concern about the potential impact of these trucks spewing toxic pollutants into the air drew attention to the need to investigate the impact of 9/11 on the daily levels of air pollutants and respiratory hospitalization. In this study, significant increases in respiratory admissions were found one month and 6 months post-9/11. Mean daily respiratory admission was also significantly higher than the same period one year earlier and one year later. SO(2) and CO concentration levels were found to be generally higher after 9/11 than one year before and immediately before. Relative risk estimates of respiratory hospitalization after 9/11 showed that SO(2) (RR̂ = 1.15 for two-day, RR̂ = 1.18 for three-day, and RR̂ = 1.21 for five-day averages), NO(2) (RR̂ = 1.10 for current day), and COH (RR̂ = 1.09 for current day, RR̂ = 1.10 for two-day average) had the most significant effects after 9/11. These results suggest the need for more stringent regulatory efforts in air quality in the region in response to the changing transportation dynamics at this Canada-US border crossing.

  8. Confidentiality and physicians' health. A cross-sectional study of University Hospital Physicians in four European cities (the HOUPE-study).

    PubMed

    Løvseth, Lise Tevik; Aasland, Olaf Gjerløw; Fridner, Ann; Jónsdottir, Lilja Sigrun; Marini, Massimo; Linaker, Olav Morten

    2010-01-01

    To investigate how the subjective burden of confidentiality can act as a stressor that affects physicians' psychological health and wellbeing. Cross-sectional survey data from a sample of university hospital physicians (N=1,956) in four European countries (Sweden, Norway, Iceland and Italy) who participated in the HOUPE (Health and Organization among University hospital Physicians in Europe) study was analysed. About 25% of the participants reported that confidentiality impedes emotional support to a considerable degree. An index of confidentiality as a barrier to seeking support (ICBS) had a negative effect on physicians' health and wellbeing. The effect of ICBS was confirmed and slightly increased when controlled for variables known to buffer the adverse mental and physical effects of stress. Though the physicians in Iceland and in Norway found confidentiality the most challenging, it was the physicians in Italy and Sweden who showed a significant effect of ICBS on their health and wellbeing. Whether confidentiality is a stressor in its own right or an amplifier of stressful situations in medical practice should be further investigated to gain a better understanding of the effect of confidentiality on physicians' coping, stress and health. In addition, there is a need to investigate how physicians can balance coping with the inevitable emotional demands of medical practice and maintaining the ethics of confidentiality in a way that protects both patients' privacy rights and physicians' health and wellbeing.

  9. Help-seeking Behaviors Among Caregivers of Schizophrenia and other Psychotic Patients: A Hospital-based Study in Two Geographically and Culturally Distinct Indian Cities

    PubMed Central

    Naik, Sujit Kumar; Pattanayak, Sanjay; Gupta, Chandra Shekhar; Pattanayak, Raman Deep

    2012-01-01

    Background: India is a country of several diversities and cultures, which may influence the help-seeking behavior of mentally ill patients and families. Only a few Indian studies have focused on help seeking, especially for severe mental disorders. Objective: The study aimed to describe and compare the help-seeking behaviors among caregivers of psychotic patients visiting psychiatric clinics at two distinct cities of India. Materials and Methods: This was a cross-sectional exploratory study of key caregivers (N=50) of patients with a DSM-IV TR diagnosis of schizophrenia and other psychotic disorders, visiting psychiatric out-patient departments of VIMHANS, New Delhi, and CIMS, Bilaspur, Chhattisgarh. After due informed consent was taken, a semi-structured proforma was administered for socio-demographic profile, illness details, causative beliefs, and information on help seeking. Results: Supernatural forces were held responsible by 40% of the Bilaspur sample in contrast to 8% in New Delhi sample. Faith-healers were initial contacts for 56% and 64% of sample, respectively, at New Delhi and Bilaspur. Faith-healers followed by a psychiatrist formed the commonest pathway of care at both centers (32% and 36%, respectively). The sample at New Delhi spent significantly more money (median: $4000 vs. $10) and traveled greater distances (median: 35 km vs. 10 km) for faith-healers during the course of illness. Two-thirds of sample in New Delhi and one-third at Bilaspur were aware of the nearby psychiatrist at the time of initial help seeking; however, only 28% and 12%, respectively, chose psychiatrist as an initial contact. The New Delhi sample reported a fear of medication adverse effects and stigma as perceived disadvantages of psychiatric help. The median time lost at both the centers was 1 month, with a maximum of 8.4 years in New Delhi and 4.9 years in Bilaspur. Of the total, 16% caregivers at New Delhi and 32% at Bilaspur center reported an intention to continue with

  10. 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.

  11. Cognitive impairment and dementia in elderly people living in rural Benin, west Africa.

    PubMed

    Guerchet, Maëlenn; Houinato, Dismand; Paraiso, Moussiliou Noël; von Ahsen, Nicolas; Nubukpo, Philippe; Otto, Markus; Clément, Jean-Pierre; Preux, Pierre-Marie; Dartigues, Jean-François

    2009-01-01

    Dementia is increasing as a priority public health problem because of the ageing of the world population. Our goal was to estimate dementia and cognitive impairment prevalence in an elderly population of rural Benin. In a door-to-door survey, elderly people aged 65 years and above were screened using the Community Screening Interview for Dementia and the Five-Word Test. The prevalence of cognitive impairment was 10.4% and that of dementia was 2.6%. Age, current depressive disorder and absence of the APOE epsilon2 allele were significantly associated with cognitive impairment. Prevalence of dementia and cognitive impairment appears to be lower in this study than in developed countries.

  12. 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.

  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. 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.

  15. Analysis of Hydrological Processes In A Small Catchment In Benin (west Africa)

    NASA Astrophysics Data System (ADS)

    Giertz, S.; Diekkrüger, B.

    The presented study is integrated in the GLOWA IMPETUS project (an integrated ap- proach to the efficient management of scarce water resources in West Africa) which analyses the effects of global change conditions on regional hydrological processes and on the water availability in Benin and Morocco. To examine the hydrological cy- cle and its change at the regional scale, detailed knowledge about the dominant hydro- logical processes dependent on the environmental conditions is necessary. This study provides the analysis of the hydrological processes as well as their simulation at the local scale serving as a basis for the subsequent regionalisation of processes and model parameters. The investigated area is a 30 km2 sized catchment in the sub-humid region of Benin which has been selected as research area for several participating disciplines of the IMPETUS-Project (hydrology, soil degradation, dynamics of vegetation, phys- iological plant ecology). The catchment is characterized by a high spatial variability of the land cover and a high temporal variablility due to land cover changes. Con- sequently all hydrologic measurements are performed on different land use types to analyse their influence on the hydrological processes. The measurements of soil water dynamics, runoff, infiltration and soil physical properties provide detailed information on the generation of model input parameters. A validation of the model output is car- ried out by comparing simulated and measured dynamics of state variables as well as water balance terms. By testing and validating the TOPLATS-model at the local scale in different-sized sub-catchments an evaluation of its applicability to the regional scale and the assessment of the related uncertainties is performed.

  16. 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

  17. Metazoan parasite communities of catfishes (Teleostei: Siluridae) in Benin (West Africa).

    PubMed

    Tossavi, Nounagnon Darius; Gbankoto, Adam; Adité, Alphonse; Ibikounlé, Moudachirou; Grunau, Christoph; Sakiti, Gilbert Nestor

    2014-11-01

    The need for more precise information on the effect of dry season on fish parasite communities in Benin lead us to undergo a focus during this season in one of the major sites of collection fry by fish farmers.Metazoan parasites were then inventoried in 166 specimens of catfishes which constituted of C larias gariepinus, Clarias ebriensis, Synodontis schall, Synodontis nigrita, and Chrysichthys nigrodigitatus (Teleostei: Siluridae). Those fishes were collected from fishermen of Agonlin-Lowé at the side of Oueme River in south Benin from November 2011 to March 2012. In total, 12 parasite species were listed comprising three Monogena (Gyrodactylus sp., Synodontella sp., and Protoancylodiscoides chrysichthes), three Cestoda (Stoeksia pujehuni, Lytocestus sp., and Cestode indeterminate), five Nematoda (Paracamallanus cyathopharynx, Procamallanus laevionchus, Cithariniella petterae, Synodontisia thelastomoides, and nematode indeterminate), and one indeterminated Copepod species. Total infestation rate varied between 83.87 and 100% for the different fish species. This was high but independent of fish sex (χ(2) = 1.669, df = 4, nonsignificant). The highest mean intensity and mean abundance were, respectively, 44 and 13.33. Monogenea and Nematoda have elevated frequency of dominance, and their presence in the host is significantly correlated (r = -0.999; p < 0.05). Clariids were highly infected by Nematoda. Except for P. laevionchus and Proteoancylodiscoides, respectively, in C. gariepinus and in C. nigrodigitatus, the parasites showed clumped distribution. The component community diversity, as measured by the Shannon index (H'), revealed that S. schall had the most parasite diversity.