26 research outputs found
Prevention of unintended pregnancies in Nigeria; the effect of socio-demographic characteristic on the knowledge and use of emergency contraceptives among female university students
Background: The proportion of unintended pregnancy remains high in developing regions due to unmet need for contraception and inconsistent use of modern contraceptives. Practice of emergency contraception is particularly important because of the high rates of unintended pregnancy. The aim was to assess the practice of emergency contraception among female students.Methods: A cross-sectional study was conducted among 5,233 female university students in Nigeria.Results: About 25.4% of the students had ever had sex while 64.3% had heard about emergency contraceptives. About half (49.6%) had good knowledge while 70% thought that emergency contraceptives are effective and easy to access and use. Good knowledge about emergency contraceptives was predicted by dwelling urban or suburban areas (AOR=1.750 and 1.817; P<0.05), being single (AOR=2.597, P=0.001), being in the fourth year (AOR=2.096, P<0.001) and having ever had sex (AOR=1.449, P<0.001). Having ever used emergency contraceptive is predicted by good knowledge (AOR=1.852, P<0.001) and perception that emergency contraceptives are effective (AOR=139.774, P<0.001) and easy to access and use (AOR=8.429, P<0.001).Conclusions: Despite a significant risk of unintended pregnancy among female university students, the usage rate of emergency contraceptive is very low. There is a need to actively promote emergency contraception along with other contraceptive methods with the involvement of health workers and the media.
Organizational Ethics and Employee Level of Productivity in Nigerian Private Universities
Employee level of productivity is one of the many possible outcomes of ethical issues in an organization. An organization with strong ethical beliefs leads to a greater sense of commitment among its employees. The purpose of this research paper was to establish the relationship between organizational ethics and employee level of productivity in higher education institution (private university) in Nigeria. The researcher utilized both explorative and cross-sectional survey research method to gather the needed information. The participants of the study were faculty of Covenant University from the College of Development Studies (CDS) and College of Science and Technology (CST). The population for this study was 390 academic staff of Covenant University out of which a sample of 198 participants were determined using Yard’s formula. The gathered data were analysed with the use of frequency, percentage, standard multiple regression analysis and correlation analysis. The findings of the study revealed that Wasted Time, Leisure, Degree of Gratification, Self-Reliance, Centrality of Work, Hard Work, and Morality are not statistically significant to employee rewards and hours worked. The study recommends that: 1.) Private universities should embark on creating leisure periods for their faculty in order to increase their level of productivity; 2.) Private universities should continue to use reward system and increase promotion as a way of maintaining faculty loyalty. Keywords: Organizational Ethics, Productivity, Employee, Private University, Reward, and Work Hours
A REVIEW OF MOBILE NETWORKS: EVOLUTION FROM 5G TO 6G
The roadmap of 5G and 6G networks represents a significant leap forward in the evolution of mobile communication technology. As the future evolves, the potential of 6G technology to further revolutionize wireless connectivity is an exciting prospect that will continue to drive innovation and research in the field of telecommunications. The vision for 6G networks represents a paradigm shift in wireless communication, aiming to address the evolving demands of the digital era. This paper presents a review of the evolution of the 5G to 6G networks. The review explores the envisioned features, technological advancements, challenges, and future directions of 6G networks. Building upon the foundations of 5G networks, 6G networks are expected to deliver unprecedented data rates, ultra-low latency, seamless connectivity, and intelligent communication. Key technologies shaping the landscape of 6G include terahertz communication, AI-driven networks, quantum communication, and holographic beamforming. However, the deployment of 6G networks is accompanied by various challenges such as spectrum allocation, security, standardization, and regulatory frameworks. By synthesizing current research and industry trends, this review provides insights into the potential trajectory of 6G networks, paving the way for a connected future. Keywords: 6G, 5G, wireless communication, mobile networks, AI-driven networks, MIMO DOI: 10.7176/CEIS/15-1-06 Publication date: April 30th 202
Enhancing the inhibition potential of sodium tungstate towards mitigating the corrosive effect of Acidithiobaccillus thiooxidan on X-52 carbon steel
Microbialcorrosionoftheexternalsurfaceofcarbonsteelpipeswasinvestigatedusingsodiumtungstate,sodium nitrite and zinc nitrite as individual and combined inhibitors. The study involved carbon steel pipes in contact with Acidithiobaccillus thiooxidan. Inhibitor efficiencies were determined and the optimum inhibitor concentration required to effectively limit the corrosive effect of the microbe was 51–52g/L for the best inhibitor. Also, despite the limiting effect of sodium nitrite in its other inhibitor formulations, its presence in the mixture of all three components, improved the performance of the other two chemicals giving the best inhibition efficiency of 85.68%
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Economic burden of the therapeutic management of mental illnesses and its effect on household purchasing power.
Cost or burden of illness studies for mental illnesses has helped define the magnitude of their negative effects on the household, community and national economy. Despite its many benefits, there is a paucity of these studies among Nigerians being managed for mental illnesses. This study was aimed at assessing the economic burden of mental illnesses and its effect on household purchasing power. The study was descriptive cross-sectional in design conducted among 284 out-patients with five categories of mental illnesses at the Neuropsychiatric Hospital, Aro recruited via a systematic sampling technique. Data collection was quantitative using a semi-structured interviewer-administered tool. Participants provided the actual direct costs and estimates of indirect costs incurred during their most recent inpatient admission and their first clinic visit after discharge. Parametric and non-parametric statistical tests were conducted on the direct and estimated indirect costs respectively after testing them for normality using the Q-Q plot with statistical significance determined at p50% earning <US23.1±US15±US$28). There were no statistically significant differences in the mean direct and estimated indirect costs incurred by participants across the categories of mental illnesses. A significantly higher proportion of participants could afford the essential goods (88%) compared to those who could afford luxurious goods (29%) with p<0.001. The mean direct costs incurred by those who could afford the essential and luxurious goods were significantly higher than those who could not following a t-test. The median estimated indirect costs incurred by those who could not afford luxurious goods differed significantly from those who could with the Mann Whitney U-test. Participants with mental illnesses face a high economic burden in managing their condition with the majority unable to afford luxurious goods. Affordability was also associated with incurring more direct costs