Autologous blood donations and transfusions among patients undergoing elective orthopaedic, gynaecologic and elective caesarean section at a Tertiary Hospital in North Central Nigeria

Introduction: Allogeneic donor blood is becoming increasingly costly, scarce and associated with multiple risks; there is need for more conservative transfusion strategies, one of which may be adoption of Autologous Blood Donation and Transfusions (ABDT). Despite increased acceptance of ABDT by clinicians and patients in most developed world, awareness in this part of the world is still low.Materials and methods: this is a cross sectional survey of knowledge and acceptance of ABDT by patients scheduled for elective orthopaedic, gynaecologic and elective caesarean section surgeries using structured interviewer administered questionnaire on socio-demographics, clinical presentations, knowledge of blood donations and transfusions, and acceptance of ABDT. The study population comprised of 171 subjects.Results: Gynaecologic/obstetric patients were 120 (70.2%) while 51 (29.8%) of the subjects were Orthopaedic patients. Majority (43.95%) were within the age range 31-45 years, 38.6% were less than 31 years while 17.5% were older than 45 years. Females constituted the larger proportion (77.2%). Twenty one (12.3%) subjects had donated blood in the past, 45 (26.3%) had previous blood transfusions and 30 (17.5%) had knowledge of ABDT. Eight one (47.4%) of all subjects accepted ABDT for the scheduled surgeries while 123 (71.9%) subjects accepted to be voluntary blood donors after surgery. Pre-deposit is the commonest form of ABDT preferred by the subjects (66%), followed by Haemodilution (28%) and Cell salvage (6%). A significant number of the subjects who accepted ABDT were ready to become voluntary blood donors after surgery (90.1%).Conclusion: Acceptance rate as high as 47.4% was recorded in this study despite low awareness. This is higher than what was reported by most authors’ locally but similar to the findings from Europe and Asia. Pre-deposit form was the commonest ABDT acceptable to these patients.  Improving awareness on ABDT will boost voluntary blood donations and improve blood transfusion safety

Critical barriers to environmental management system implementation in the Nigerian construction industry

This is an accepted manuscript of an article published by Springer in Environmental Management, available online: https://doi.org/10.1007/s00267-021-01473-y The accepted version of the publication may differ from the final published version.The impact of different hazardous substances of the construction industry being released to the environment is alarming. This constitutes an adverse effect on the quality of life of construction workers and the populace at large. To reduce this menace, Environmental Management System (EMS) was put in place. Meanwhile, the implementation of EMS in the Nigerian construction industry (NCI) is not certain. This study, therefore, investigated the barriers to EMS implementation in the NCI to group them into a smaller form, i.e., fewer numbers. A questionnaire survey was developed and administered to construction professionals in Nigeria using a purposive sampling technique. The retrieved 106 copies of the questionnaires were subjected to both descriptive and inferential statistics such as mean score, standard deviation, analysis of variance test, post hoc test and exploratory factor analysis. An exploratory factor analysis was conducted three times to identify the critical barriers to EMS implementation in the NCI. The study findings reveal three main categories of barriers affecting EMS implementation, namely; (1) knowledge barrier; (2) process barrier; and (3) culture and management barrier. The study concluded that the three factors indicate the major cardinal barriers that could describe the impediment of EMS in the NCI. It was recommended that the training of construction professionals is important to enhance improvement culture in the NCI