International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Child’s risk attributes at birth and infant mortality disparities in Nigeria

Births in avoidable high-risk contexts defined by the interplay of sub-optimal childbearing age, short spacing, and first and high birth order incur elevated risks of childhood death. However, the extent of disparities in risks of dying in infancy vis-à-vis the continuum of non-high-risk and (un)avoidable high-risk attributes at birth as determined by mother‘s age at childbirth, child spacing, and birth order characteristics is yet to be adequately explored in Nigeria as elsewhere. To fill this gap, chi-square association test and Cox‘s proportional hazards regression were used to analyze data of 31,260 nationally representative children aged 0-59 months drawn from 2013 Nigeria Demographic and Health Survey. Disparities in infant mortality risks were mainly examined across the spectrum of birth-related risk attributes at birth broadly categorized as no extra high-risk, unavoidable firstorder risk and combined avoidable high-risk. The risks of dying in infancy differed significantly by risk attributes to the extent dictated by other confounders. Also, infant mortality risks varied significantly by all moderating factors excluding religion, water source, toilet type and place of delivery. Interventions targeted at reducing avoidable high-risk fertility rate and strengthening health system to provide life-saving care to most-at-risk children would engender rapid improvement in infant survival.Les naissances dans des contextes à risque élevé évitables, définies par l'interaction d'un âge de procréation sous-optimal, d'un espacement réduit, et du premier rang de naissance élevé, entraînaient des risques élevés de mortalité infantile. Toutefois, l'ampleur des disparités en matière de risque de décès dans la petite enfance par rapport au continuum d'attributs à haut risque non haut risque et (in) évitables haut risques à la naissance, déterminée par l'âge de la mère à la naissance, l'espacement des naissances et le rang de naissance les caractéristiques n‘a pas encore été explorée de manière adéquate au Nigeria comme ailleurs. Pour combler cette lacune, le test d‘association du khi-deux et la régression des hasards proportionnels de Cox ont été utilisés pour analyser les données de 31 260 enfants représentatifs au niveau national, âgés de 0 à 59 mois tirés de l‘enquête démographique et de santé réalisée en 2013 au Nigéria. Les disparités dans les risques de mortalité infantile ont été principalement examinées à travers le spectre d'attributs de risque liés à la naissance, généralement classées dans la catégorie comme pas de haut risque supplémentaire, à très haut risque, risque inévitable de premier ordre et le haut évitable combiné. Les risques de mourir dans la petite enfance différaient considérablement par les attributs de risque dans la mesure dictée par d'autres facteurs de confusion. En outre, les risques de mortalité infantile variaient de manière significative en fonction de tous les facteurs modérateurs, à l'exclusion de la religion, de la source d'eau, du type de toilette et du lieu de livraison. Les interventions visant à réduire le taux de fécondité évitable à haut risque et à renforcer le système de santé afin de fournir des soins vitaux aux enfants les plus exposés, engendreraient une amélioration rapide de la survie des nourrissons.Keywords: Infant Mortality, High-Risk Birth, Fertility Behaviour, Disparities, NigeriaAfr J Reprod Health 2019; 23[3]:120-13

Correction: Linkages between men's wealth status and the ideal number of children: A trend and multilevel analysis of survey data in Nigeria.

[This corrects the article DOI: 10.1371/journal.pgph.0001036.]

Linkages between men's wealth status and the ideal number of children: A trend and multilevel analysis of survey data in Nigeria.

Most African societies practice a patriarchal family system that endows a man with authority and dominance in the family and society with a defined role of being the breadwinner of the home. A man is expected to have a great influence in determining the ideal number of children in the family and take a domineering role in decision-making, especially those related to household resource allocation. Therefore, this study examines the relationship between men's wealth status and an ideal number of children. The study used secondary data from the National Demographic Health Survey (NDHS) from 2003 to 2018. The objectives were achieved using descriptive and inferential statistics, including frequency, mean, ANOVA, and multilevel analysis techniques. Wealth status significantly influenced the ideal number of children considering the crude and adjusted regression analysis. After adjusting for individual-level and contextual factors, the odd ratio of ideal number of children was significantly lower among men in the richest categories of the wealth index. Moreover, men with two wives and above, uneducated men, Northern residents, men living in high community family norms, low community family planning, high community poverty, and low community level of education desired a high number of children. The analyses suggest the need for a consideration of community structures to provide lucrative employment for men and would experience an appreciable fertility decline in line with the objectives and targets stated in Nigeria's population policies and programmes

The key organizational factors in healthcare waste management practices of Libyan public hospitals

From MDPI via Jisc Publications RouterHistory: accepted 2021-11-10, pub-electronic 2021-11-19Publication status: PublishedThis study aims to investigate factors contributing to healthcare waste management practices among Libyan public hospitals. The organizational culture and structure are proposed to have their effect upon hospital organizational units in charge of healthcare waste production by a theoretical review to develop two main hypotheses. Hence, this study used the stratified random sampling technique to select respondents such as top management officials, heads of departments, and administrators who work in all the hospitals located in the south of Libya, from whom data was collected. The data for the study was gathered via a survey questionnaire from Libyan public hospitals in the country’s southern region. A total of 210 questionnaires were distributed and 171 usable responses were received, yielding a 70% response rate. Though the findings of the study show some inconsistency, the two dimensions of the culture examined in this study are found to have a positive relationship and significant influence on the management practices of health waste. Besides, it shows the positive relationship between organizational structure and healthcare waste management practices (HWMP). However, the findings of this study suggested that nurses and cleaners’ practices should critically consider structure dimensions such as formalization as well as moderating variables such as hospital location and type of services supplied on the interactions to improve the management of healthcare waste in Libya’s public hospitals.13pubpub2