ICT enabled monitoring fosters greater accountability and improves WASH services in communities

UNICEF has been supporting the Ministry of Water Resources in the development & rolling-out of WASH Information Management System (WASHIMS) across Nigeria. WASHIMS is an user friendly tool for building, organizing and processing sector data for informed decision making. It has evolved from a stand-alone system in 2013 to an on-line web-based platform that now includes features for real time tracking. From only 12 Local Government Areas (LGA) using WASHIMS in 2013, presently there are 70 LGAs regularly operating it. Up-to-date data on the WASH situation is available for over 22,000 communities compared to only 2,600 in 2013. The introduction of real-time tracking of water point functionality has contributed to an increase in functionality from 56% to 71%, with one LGA reporting 98% functionality over 1 year. The widespread use of WASHIMS across the 70 LGAs has renewed interest among all sector players with potential for rapid scale-up across Nigeria

Comparative study of oral PGE 1 and intracervical PGE2 gel for pre-induction cervical ripening in prelabour rupture of membranes >37 weeks gestational age

Background: Active induction of labour in prelabour rupture of membranes resulted in a lower risk of maternal and fetal sepsis as compared to conservative management. Pre-induction cervical ripening helps in successful induction of labour.in this study we have compared the efficacy of low dose 25 mcg oral misoprostol versus intracervical PGE2 gel for cervical ripening in term PROM patients.Methods: Women with pregnancies between 37 and 41 weeks gestational age presenting with PROM at term and a Bishop score of 4 or less were randomly assigned to receive either a 25-mcg oral misoprostol every 4-hourly interval or 3 applications of intracervical PGE2 gel at a 6-hour interval for effective cervical ripening. Oxytocin was initiated if labor had not started after 6 hours of last effective dose of prostaglandin.Results: Fifty-three women (75.73%) (n = 70) in the oral misoprostol group with 2 doses, 4 hours apart had successful cervical ripening within 8 hours in comparison to sixty-two women (88.58%) (n = 70) in the intracervical PGE2 gel group with 2 doses, 6 hrs apart approximately 12 hrs for successful ripening. (p = 0.021). Oral misoprostol group needed shorter mean duration interval for the Bishop score 6 than intracervical PGE2 gel group, 7.84±3.64 hours and 9.39±4.20 hours respectively (p = 0.022). Similarly, the mean time duration interval from ruptured membranes to vaginal delivery in oral misoprostol was shorter i.e. 12.60±3.78 hours versus 14.66±4.08 hours (p = 0.005).Conclusions: Low dose 25 mcg oral misoprostol is a safe, efficacious and better tolerated alternative to intracervical PGE2 gel for pre-induction cervical ripening in especially in PROM patients at term

Smart-phone drives performance and enhances WASH services delivery in communities in Nigeria

The deployment of mobile technology has helped to transform data/evidence gathering in programme management and tracking results under the “Federal Government of Nigeria – UNICEF” Water, Sanitation & Hygiene (WASH) programme in Nigeria. UNICEF has demonstrated the use of smartphonebased real-time reporting to incite improved programme performance management and accountability. Smart-reporting involved Local Government Area (LGA) level coordinated planning, implementation, monitoring and reporting of results by field facilitators using mobile-app supported templates and online tools. This system, within the short time has improved the quality of planning and target setting; fostered greater accountability amongst team members; improved performance of staff and effective use of financial resources and other logistics and demonstrated greater attainment of results. The results so far clearly demonstrate the viability of the Smart-reporting system to improve accountability, advance the management and delivery of WASH programme results with potential for wider scale-up across the country

Spontaneous broad ligament haematoma following a normal vaginal delivery: a case report

Broad ligament haematoma is a rare complication following a normal vaginal delivery. We report one such case of a woman who developed this complication within 3 hrs of normal vaginal delivery. She is G2P1L1, 38 wks GA, in active labour. Pt was allowed for spontaneous progression of labour, following which she delivered vaginally. Within 3 hrs patient looked clinically very pale with vitals being deranged and complains of inability to void urine, severe perineal pain. On basis of clinical examination and transabdominal ultrasound features a diagnosis of right sided broad ligament haematoma was made. Based on patients haemodynamic instability surgical management in the form of obstetric hysterectomy was done

The role of the Maternity Liaison Officer in provision of primary health care: A values-based service model

Background: A policy directive of the New South Wales government focused on ensuring that all ethnic groups within the community have appropriate and equitable access to services led to the introduction of the maternity liaison officer (MLO) program in the late 1990s. The role of the MLO is to work alongside health professionals to provide education, social support and counselling to pregnant refugee and migrant women of culturally and linguistically diverse backgrounds (CALD). Methods: We reviewed reports and policy documents from 2008 to examine the attributes of this hospital-based service model and share insights into how the MLOs deliver care to meet the needs of mothers and babies. Findings: Maternity liaison officers have readily assumed the responsibility of maintaining current knowledge and building competency in improving the health and wellbeing of refugee and migrant women and newborns. They act as important bridge between women and the health system enabling vulnerable women to competently navigate their maternity journey, gynaecological care and the care of newborn infants in a culturally sensitive and appropriate manner. Discussion and conclusion: This service model offers an acceptable way to support the delivery of maternity care to women and include those from refugee and CALD- backgrounds. Investment in the rigorous evaluation of this service is needed to provide strong evidence to optimise service delivery and guide future decision making

Field effect transistors for terahertz detection - silicon versus III–V material issue

International audienceResonant frequencies of the two-dimensional plasma in FETs reach the THz range for nanometer transistor channels. Non-linear properties of the electron plasma are responsible for detection of THz radiation with FETs. Resonant excitation of plasma waves with sub-THz and THz radiation was demonstrated for short gate transistors at cryogenic temperatures. At room temperature, plasma oscillations are usually over-damped, but the FETs can still operate as efficient broadband THz detectors. The paper presents the main theoretical and experimental results on detection with FETs stressing their possible THz imaging applications. We discuss advantages and disadvantages of application of III-V GaAs and GaN HEMTs and silicon MOSFETs

Knowledge of Patients with Mechanical Valve Prostheses Concerning Chronic Oral Anticoagulant Therapy

Adherence to chronic Oral Anticoagulant Therapy (OAT) is directly related to patients' understanding of the therapy. This study verified the knowledge of patients with mechanical valve prostheses concerning OAT. This is a contemporary cross-sectional study, the sample is composed of patients with mechanical valve prostheses (MVP) in outpatient follow-up. A 10-question instrument was used; answers were ‘know' (1 point), ‘know partially' (half point), or ‘do not know' (zero). Patients were grouped according to the result obtained: ≤ 4 points was considered insufficient knowledge; > 4 ≤ 8 equated to moderate knowledge; and > 8 was considered appropriate knowledge. Of the 110 patients, 61.8% presented moderate knowledge, 40.9% were not able to name at least one factor that may alter the INR (International Normalized Ratio) and 37.3% were not able to report their INR target range. The majority of patients presented moderate knowledge concerning the treatment. Strategies to improve knowledge on the topic should be implemented to minimize risks.El objetivo de este estudio fue verificar el conocimiento de pacientes con prótesis valvular sobre la terapia de anticoagulación oral. La adhesión a la terapia de anticoagulación oral crónica está directamente relacionada al entendimiento del paciente sobre esta terapia. Se trata de un estudio transversal contemporáneo, en el cual se incluyeron pacientes de ambulatorio con prótesis valvular mecánica (PVM). Se aplicó un cuestionario con 10 preguntas; las respuestas fueron "sabe" (1 punto), "sabe parcialmente" (medio punto), "no sabe" (cero puntos). Los pacientes fueron agrupados según la puntuación obtenida: ≤ 4 puntos, conocimiento insuficiente; > 4 ≤ 8 puntos, conocimiento regular; > 8 puntos, conocimiento adecuado. De los 110 pacientes incluidos, el 61,8% demostró conocimiento regular, 40,9% no supieron citar un factor que altera el REI (razón estandarizada internacional) y 37,3% no supieron informar su REI objetivo. Se concluyó que la mayoría de los pacientes demostró conocimiento regular sobre el tratamiento. Se recomienda implantar estrategias para mejorar el conocimiento y minimizar los riesgos de la terapia.A adesão à terapia com anticoagulação oral crônica está diretamente relacionada ao entendimento dos pacientes sobre essa terapia. O objetivo deste estudo foi verificar o conhecimento dos pacientes, com prótese valvar mecânica, sobre terapia de anticoagulação oral. Como método, usou-se o estudo transversal contemporâneo. Incluem-se pacientes com prótese valvar mecânica (PVM) em acompanhamento ambulatorial. Aplicou-se instrumento com 10 questões. As respostas eram sabe (um ponto), sabe parcialmente (meio ponto), ou não sabe (zero). Os pacientes foram agrupados conforme a pontuação obtida. Considerou-se ≤4 pontos conhecimento insuficiente, >4 ≤8 conhecimento regular e >8 conhecimento adequado. Os resultados mostram que, dos 110 pacientes, 61,8% apresentaram conhecimento regular, 40,9% não souberam citar ao menos um fator que alterasse a razão normatizada internacional (RNI) e 37,3% não souberam informar o seu RNI alvo. Conclui-se que a maioria dos pacientes apresentou conhecimento regular sobre o tratamento. Estratégias devem ser implementadas para melhorar o conhecimento e, consequentemente, minimizar os riscos dessa terapêutica

Induced Pluripotent Stem Cell-Derived Retinal Pigmented Epithelium: A Comparative Study Between Cell Lines and Differentiation Methods

PurposeThe application of induced pluripotent stem cell-derived retinal pigmented epithelium (iPSC-RPE) in patients with retinal degenerative disease is making headway toward the clinic, with clinical trials already underway. Multiple groups have developed methods for RPE differentiation from pluripotent cells, but previous studies have shown variability in iPSC propensity to differentiate into RPE.MethodsThis study provides a comparison between 2 different methods for RPE differentiation: (1) a commonly used spontaneous continuously adherent culture (SCAC) protocol and (2) a more rapid, directed differentiation using growth factors. Integration-free iPSC lines were differentiated to RPE, which were characterized with respect to global gene expression, expression of RPE markers, and cellular function.ResultsWe found that all 5 iPSC lines (iPSC-1, iPSC-2, iPSC-3, iPSC-4, and iPSC-12) generated RPE using the directed differentiation protocol; however, 2 of the 5 iPSC lines (iPSC-4 and iPSC-12) did not yield RPE using the SCAC method. Both methods can yield bona fide RPE that expresses signature RPE genes and carry out RPE functions, and are similar, but not identical to fetal RPE. No differences between methods were detected in transcript levels, protein localization, or functional analyses between iPSC-1-RPE, iPSC-2-RPE, and iPSC-3-RPE. Directed iPSC-3-RPE showed enhanced transcript levels of RPE65 compared to directed iPSC-2-RPE and increased BEST1 expression and pigment epithelium-derived factor (PEDF) secretion compared to directed iPSC-1-RPE. In addition, SCAC iPSC-3-RPE secreted more PEDF than SCAC iPSC-1-RPE.ConclusionsThe directed protocol is a more reliable method for differentiating RPE from various pluripotent sources and some iPSC lines are more amenable to RPE differentiation