PROTOCOL: Water, sanitation and hygiene for reducing childhood mortality in low‐ and middle‐income countries

Respiratory tract infections and diarrhoea are the two biggest killers of children in low income contexts. They are closely related to access to, and use of improved water, sanitation and hygiene (WASH). However, there is no high quality systematic review that quantifies the effect of WASH improvements on childhood mortality. Existing systematic reviews of WASH improvements measure effects on morbidity, under the (often implicit) assumption that morbidity is closely correlated with mortality. This is at least partly because the impact evaluations on which they are based are only designed to detect changes in morbidity with statistical precision, whereas mortality is a relatively rare outcome. The proposed review will address this evidence synthesis gap, using the greater statistical power of meta-analysis to pool findings across studies

Survival Following Resection for Soft Tissue Sarcomas

A retrospective study was carried out at the Jos University Teaching Hospital in order to determine the mean survival time (MST) at 10 years for 60 patients with histologically confirmed soft tissue sarcomas at different sites. There were 42 males to 18 females with a mean age of presentation of (28 ± SD 2) years. Forty-six per cent were predominantly high grade extremity lesions, 32 per cent were predominantly low grade trunk lesions and 12 per cent were high/intermediate grade sarcomas of the head and neck. Forty per cent were in stage T3, N0, M0, G3, 33 per cent T2, N0, M0, G1, and 8 per cent were in T2, N0, M0, G2 stage. Local resection was performed in 48 per cent, amputation in 35 per cent and craniectomy/ laparatomy plus resection in 7 per cent respectively. All patients with low grade sarcomas were still alive and free of disease (AFD) at a maximum period of 10 years. For intermediate grade lesions, Kaposi's sarcoma carried the lowest mean survival time (MST) of 1 year, fibroblastic fibrosarcoma 2 years and undifferentiated sarcoma 3 years. The average MST for all high grade lesions was 2 years. Upper extremity lesions carried the worst prognosis with a MST of 1½ years, head, neck, retroperitoneal, abdominal wall sarcoma 2 years and visceral and lower extremity sarcomas 3 years respectively. It was concluded that MST was probably more related to histological grade than site of lesions. Key words: Soft tissue sarcoma, resection, survival Résumé Une étude rétrospective a été effectuée à l'Hôpital Universitaire de Jos pour déterminer le Temps de Survie Moyenne (TSM) au cours de 10 ans, de 60 malades avec des sarcomes tissulaires mous déjà confirmés histologiquement, et localisés à différents emplacements du corps. L'étude a porté sur 42 hommes et 18 femmes âges en moyenne de 28 ±2 ans qui avait présenté des symptômes lors du diagnostic médical. Quarante-six pour cent (46%) des lésions étaient au stade grave, et principalement localisées sur des membres inférieurs et supérieurs, tandis que 32% se situaient au niveau du tronc et elles étaient d'importance relativement moindre. Enfin 12% des lésions étaient des affections de catégories de moyenne à grave et elles étaient localisées sur la tête et le cou. Quarante pour cent (40%) de cas étaient au stade T3, N0, M0, G3; 33 % - au stade T2, N0, M0, G1, et 8% - au stade T2, N0, M0, G2. L'incision locale a été pratiquée dans 48% de cas, l'amputation dans 35%, et la craniotomie / laparotomie suivie d'incision en 7% de cas, respectivement. Tous les malades avec des sarcomes mineurs étaient encore vivants et sans signes de la maladie pour une période maximale de 10 ans. Un TMS d'une année était enregistré pour des lésions de catégorie moyenne de sarcome de Kaposi. Les fibrosarcomes fibroblastiques donnaient lieu à une survie de 2 ans tandis que les sarcomes d'origine imprécise donnaient lieu à 3 ans de survie. Le temps moyen de survie pour toutes les lésions graves était de 2 ans. Les lésions des membres supérieurs donnaient lieu à de pires pronostics avec un TMS de 1½ ans. Aussi une survie de 3 ans était enregistrée chez les personnes avec des lésions situées sur la tête, le cou, de même que dans le cas des sarcomes des parois rétropéritonéale et abdominale, Un temps de survie de 3 ans a été observé pour les malades avec des sarcomes viscéraux et ceux des membres inférieures. Une conclusion donc se dégage de cette étude que le temps moyen de survie est probablement plus lié à la catégorie histologique que l'emplacement des lésions. Mots clés: sarcome mou de tissu, incision, survie (Discovery and Innovation: 2002 14 (3-4): 215-220

Examining the hand hygiene beliefs and practices of nursing students and the effectiveness of their handwashing behaviour

Aims and objectives To examine the hand hygiene beliefs and practices of Turkish nursing students and the effectiveness of their handwashing. Background Handwashing is the most important part of preventing cross-infection, but there is a considerable amount of evidence that shows that the handwashing technique of nurses and nursing students is not always very effective. Design/Methods This research was carried out in two stages and is type of descriptive, analytical and observational. the study comprised 563 students from a Faculty of Nursing. Besides evaluating the nursing students' sociodemographic data, we assessed their beliefs and hand hygiene practices using a Hand Hygiene Beliefs Scale (HHBS) and Hand Hygiene Practices Inventory (HHPI) and also used with "Derma LiteCheck" device to assess how effectively they washed their hands. the STROBE checklist was used. Results the handwashing frequency of the female students was significantly higher. the scores on both the HHBS and the HHPI were significantly higher among the female students compared to the males. the dirtiest areas of the hand were determined as nails (nail beds, beneath the nails), skin between the fingers and fingertips. Conclusions the results of our study indicate that although student nurses have positive perceptions about hand hygiene and appear to have developed good habits, the effectiveness of their handwashing is poor. Relevance to clinical practice It is of great importance that UV light and florescent gel are made readily available both at nursing schools and in hospitals and other health institutions since these elements are useful in providing immediate visual feedback for a full assessment of handwashing behaviour.Ege University Scientific Research Projects FundEge University [2018-HEF003]This research was supported by Ege University Scientific Research Projects Fund (Project acceptance number: 2018-HEF003)