Service providers’ perception of the quality of emergency obsteric care provided and factors indentified which affect the provision of quality care

The aim of the study was to investigate health workers’ perception of the quality of, and factors which impact provision of quality emergency obstetric care.MethodsThis exploratory, descriptive qualitative study was conducted at Mwanza district hospital in Malawi. Qualitative data was obtained through 14 individual in-depth interviews with the health workers involved in the management of women who experienced major obstetric complications.ResultsThe health workers’ overall perception of the quality of emergency obstetric care provided was poor. The poor quality of care was identified as related to client related factors and facility/staff factors. Client factors which emerged as contributing to poor quality care were; the client delay in seeking care: reliance on TBAs, reliance on traditional medications, and lack of awareness regarding signs of an obstetric emergency. Facility/staff themes which emerged as contributing to the poor care were; inadequate resources, inadequate staffing, poor teamwork, and inadequate knowledge/supervision.ConclusionThe findings of this study reveal that health care workers rate the quality of emergency obstetric care they provide as poor. They were able to identify structure and process factors which contribute to this overall poorquality emergency obstetric care provided. These were attributed to health care system problems and client problems. Only through addressing thecontributing factors will true improvement of management of obstetric emergencies occur

Species Richness Affects Grassland Yield and Yield Stability Across Seasons, Sites and Years

The benefits of biodiversity (specifically species richness) are proposed to include both greater yield and greater stability of yield in a variable environment (Sanderson et al., 2004). Experimental evidence showing yield benefits is inconsistent (White et al., 2004). There is relatively little experimental data showing the effects of species richness on yield stability. The objective of this study was to measure the yield from mixtures with up to 12 species, and to measure the variability of yield between 2 sites, between spring and summer, and in 2 successive years

Flight Test Results for Uniquely Tailored Propulsion-Airframe Aeroacoustic Chevrons: Shockcell Noise

Azimuthally varying chevrons (AVC) which have been uniquely tailored to account for the asymmetric propulsion-airframe aeroacoustic interactions have recently shown significant reductions in jet-related community noise at low-speed take-off conditions in scale model tests of coaxial nozzles with high bypass ratio. There were indications that such AVCs may also provide shockcell noise reductions at high cruise speeds. This paper describes the flight test results when one such AVC concept, namely, the T-fan chevrons with enhanced mixing near the pylon, was tested at full-scale on a modern large twin-jet aircraft (777-300ER) with focus on shockcell noise at mid-cruise conditions. Shockcell noise is part of the interior cabin noise at cruise conditions and its reduction is useful from the viewpoint of passenger comfort. Noise reduction at the source, in the exhaust jet, especially, at low frequencies, is beneficial from the perspective of reduced fuselage sidewall acoustic lining. Results are shown in terms of unsteady pressure spectra both on the exterior surface of the fuselage at several axial stations and also microphone arrays placed inside the fuselage aft of the engine. The benefits of T-fan chevrons, with and without conventional chevrons on the core nozzle, are shown for several engine operating conditions at cruise involving supersonic fan stream and subsonic or supersonic core stream. The T-fan AVC alone provides up to 5 dB low-frequency noise reduction on the fuselage exterior skin and up to 2 dB reduction inside the cabin. Addition of core chevrons appears to increase the higher frequency noise. This flight test result with the previous model test observation that the T-fan AVCs have hardly any cruise thrust coefficient loss (< 0.05%) make them viable candidates for reducing interior cabin noise in high bypass ratio engines

Gesundheit am seidenen Faden: Innenansichten zu den Herausforderungen der Gesundheitsförderung in der IT-Industrie

Dieses Arbeitspapier enthält einen Zwischenbericht aus der Empirie des vom ISF München bearbeiteten Teilprojekts im Rahmen von DiWa-IT

Humanized childbirth awareness-raising program among Tanzanian midwives and nurses: A mixed-methods study

Background In 2014, the WHO released a statement advocating greater respect for women in their report, “The prevention and elimination of disrespect and abuse during facility-based childbirth”. To address this issue, the Japan International Cooperation Agency established humanized childbirth care. However, this concept remains new in Tanzania. Objective To evaluate the acceptability of the humanized childbirth concept by Tanzanian nurses and midwives. Design Convergent mixed-methods design. Setting Continuing education held at Tanzania\u27s capital city of Dar es Salaam. Participants The inclusion criteria were as follows: (1) registered nurses and midwives; (2) can comprehend English; (3) interested in humanized childbirth, (4) experienced in providing maternal and infant care or midwifery, and (5) attended the two-day program on humanized childbirth. Methods The program was evaluated quantitatively and qualitatively. The valid and reliable 23-item Women-Centered Care English version (WCC23E) questionnaire was used. Open-ended questions elicited the participants’ opinions about the program. Results The entire program was completed by 104 participants (average age, 40.9 years; SD, 9.13). Based on the quantitative data, the mean WCC23E post-test scores showed a significant increase compared with the mean WCC23E pre-test scores, indicating improvement in awareness. The qualitative data revealed three categories: “Gaining knowledge of humanized childbirth as a general dictionary term”, “Accepting and assimilating the concept of humanized childbirth in consideration of their practice”, and “Manifesting their voices of barriers and challenges towards humanized childbirth”. Conclusion The humanized childbirth awareness-raising program was useful for nurses and midwives in terms of favorably changing their perceptions of women-centered care