9 research outputs found
Womenâs Perception of Quality of Maternity Services: A Longitudinal Survey in Nepal
Background: In the context of maternity service, the motherâs assessment of quality is central because emotional, cultural and respectful supports are vital during labour and the delivery process. This study compared client-perceived quality of maternity services between birth centres, public and private hospitals in a central hills district of Nepal. Methods: A cohort of 701 pregnant women of 5 months or more gestational age were recruited and interviewed, followed by another interview within 45 days of delivery. Perception of quality was measured by a 20-item scale with three sub-scales: health facility, health care delivery, and interpersonal aspects. Perceived quality scores were analysed by ANOVA with post-hoc comparisons and multiple linear regression.Results: Within the health facility sub-scale, birth centre was rated lowest on items âadequacy of medical equipmentâ, âhealth staff suited to womenâs healthâ and âadequacy of health staffâ, whereas public hospital was rated the lowest with respect to âadequacy of roomâ, âadequacy of waterâ, âenvironment cleanâ, âprivacyâ and âadequacy of informationâ. Mean scores of total quality and sub-scales health facility and health care delivery for women attending private hospital were higher (pâ<â0.001) than those using birth centre or public hospital. Mean score of the sub-scale interpersonal aspects for public hospital users was lower (pâ<â0.001) than those delivered at private hospital and birth centre. However, perception on interpersonal aspects by women using public hospital improved significantly after delivery (p<â0.001). Conclusions: Overall, perception of quality differed significantly by types of health facility used for delivery. They rated lowest the supplies and equipment in birth centres and the amenities and interpersonal aspects in the public hospital. Accordingly, attention to these aspects is needed to improve the quality
Lawson criterion for ignition exceeded in an inertial fusion experiment
For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37Â MJ of fusion for 1.92Â MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion