Neonatal jaundice and its management: knowledge, attitude and practice of community health workers in Nigeria

BACKGROUND: Neonatal jaundice (NNJ) is still a leading cause of preventable brain damage, physical and mental handicap, and early death among infants in many communities. Greater awareness is needed among all health workers. The objective of the study was to assess the knowledge of primary health care workers about the description, causes, effective treatment, and sequelae of NNJ. METHODS: The setting was a local government area i.e. an administrative district within the south-western part of Nigeria. Community health workers in this area were interviewed by means of a self-administered questionnaire which focused on awareness and knowledge of neonatal jaundice and its causes, treatment and complications. RESULTS: Sixty-six community health workers participated in the survey and male-to-female ratio was 1:5. Their work experience averaged 13.5 (SD 12.7) years. Only 51.5% of the respondents gave a correct definition of NNJ. 75.8 % knew how to examine for this condition while 84.9 % knew at least two of its major causes in our environment. Also, only 54.5 % had adequate knowledge of effective treatment namely, phototherapy and exchange blood transfusion. Rather than referring affected babies to hospitals for proper management, 13.4 %, 10.4 % and 3 % of the participants would treat with ineffective drugs, natural phototherapy and herbal remedies respectively. None of the participants knew any effective means of prevention. CONCLUSION: Primary health care workers may have inadequate knowledge and misconceptions on NNJ which must be addressed concertedly before the impact of the condition on child health and well-being can be significantly reduced. We recommend regular training workshops and seminars for this purpose

Regional disparities in infant mortality in Canada: a reversal of egalitarian trends

<p>Abstract</p> <p>Background</p> <p>Although national health insurance plans and social programs introduced in the 1960s led to reductions in regional disparities in infant mortality in Canada, it is unclear if such patterns prevailed in the 1990s when the health care and related systems were under fiscal duress. This study examined regional patterns of change in infant mortality in Canada in recent decades.</p> <p>Methods</p> <p>We analysed regional changes in crude infant mortality rates and in infant mortality rates among live births with a birth weight ≥ 500 g and ≥ 1,000 g in Canada from 1945 to 2002. Associations between baseline infant mortality rates in the provinces and territories (e.g., in 1985–89) and the change observed in infant mortality rates over the subsequent period (e.g., between 1985–89 and 1995–99) were assessed using Spearman's rank correlation coefficient. Trends in regional disparities were also assessed by calculating period-specific rate ratios between provinces/territories with the highest versus the lowest infant mortality.</p> <p>Results</p> <p>Provincial/territorial infant mortality rates in 1945–49 were not correlated with changes in infant mortality over the next 10 years (rho = 0.01, P = 0.99). However, there was a strong negative correlation between infant mortality rates in 1965–69 and the subsequent decline in infant mortality (rho = - 0.85, P = 0.002). Provinces/territories with higher infant mortality rates in 1965–69 (Northwest Territories 64.7 vs British Columbia 20.7 per 1,000 live births) experienced relatively larger reductions in infant mortality between 1965–69 and 1975–79 (53.7% decline in the Northwest Territories vs a 36.6% decline in British Columbia). This pattern was reversed in the more recent decades. Provinces/territories with higher infant mortality rates ≥ 500 g in 1985–89 experience relatively smaller reductions in infant mortality between 1985–89 and 2000–02 (rho = 0.82, P = 0.004). The infant mortality ≥ 500 g rate ratio (contrasting the province/territory with the highest versus lowest infant mortality) was 3.2 in 1965–69, 2.4 in 1975–79, 2.2 in 1985–89, 3.1 in 1995–99 and 4.1 in 2000–02.</p> <p>Conclusion</p> <p>Fiscal constraints in the 1990s led to a reversal of provincial/territorial patterns of change in infant mortality in Canada and to an increase in regional health disparities.</p

Digital Image Correlation Techniques for NDE and SHM

Monitoring and analyzing the integrity of structures, infrastructure, and machines is essential for economic, operational, and safety reasons. The assessment of structural integrity and dynamic conditions of those systems is important to ensure safe operation and achieve or even extend the design service life. Recent advancements in camera technology, optical sensors, and image processing algorithms have made optically based and noncontact measurement techniques such as photogrammetry and digital image correlation (DIC) appealing methods for nondestructive evaluation (NDE) and structural health monitoring (SHM). Conventional sensors (e.g., accelerometers, strain gages, string potentiometers, LVDTs) provide results only at a discrete number of points. Moreover, these sensors need wiring, can be time-consuming to install, may require additional instrumentations (e.g., power amplifiers, data acquisition), and are difficult to implement on large-sized structures without interfering with their functionality or may require instrumentation having a large number of data channels. On the contrary, optical techniques can provide accurate quantitative information about full-field displacement, strain, geometry, and the dynamics of a structure without contact or interfering with the structure’s functionality. This chapter presents a summary review of the efforts made in both academia and industry to leverage the use of DIC systems for NDE and SHM applications in the fields of civil, aerospace, and energy engineering systems. The chapter also summarizes the feasibility of the approaches and presents possible future directions of the measurement approach