Identification and mitigation of high-risk pregnancy with the Community Maternal Danger Score Mobile Application in Gboko, Nigeria.

Introduction Risk analyses within rural regions of Nigeria are not routinely conducted, yet could help inform access to skilled birth care. The objective of this study was to assess and compare the proportion of pregnant women at risk for maternal mortality or morbidity in Benue State, Nigeria by analysing data collected during routine antenatal visits and through the Community Maternal Danger Score (CMDS), a validated risk-analysis tool. Methods Two cohorts, comprised of pregnant women presenting to primary healthcare centres within Gboko, Benue State between 2015–2017 and 2020–2021, were included in this study. The 2015–2017 cohort had their risk assessed retrospectively through analysis of routinely collected data. Identification of risk was based on their age, parity, and disease status (HIV and diabetes). The 2020–2021 cohort had their risk assessed prospectively using the CMDS. Results Routinely collected data from 2015–2017 demonstrated that up to 14.9% of women in Gboko were at risk for mortality or morbidity. The CMDS reported that up to 21.5% of women were at a similar level of risk; a significant difference of 6.6% (p = 0.006). The CMDS was more efficient in obtaining and assessing this data, and the identification of risk occurred in real-time. Conclusion Routine data collected in Gboko identifies a high proportion of pregnant women at risk for mortality or morbidity. The CMDS is an evidence-based risk analysis tool that expands on this assessment by also estimating individual and community-level risk, which allows for more efficient mitigation and prevention strategies of maternal mortality

All-optical generation and photoassociative probing of sodium Bose-Einstein condensates

We demonsatrate an all optical technique to evaporatively produce sodium Bose-Einstein condensates (BEC). We use a crossed-dipole trap formed from light near 1060 nm, and a simple ramp of the intensity to force evaporation. In addition, we introduce photoassociation as diagnostic of the trap loading process, and show that it can be used to detect the onset of Bose-Einstein condensation. Finally, we demonstrate the straightforward production of multiple traps with condensates using this technique, and that some control over the spinor state of the BEC is achieved by positioning the trap as well.Comment: 8 pages, 10 figure

Sub-Natural-Linewidth Quantum Interference Features Observed in Photoassociation of a Thermal Gas

By driving photoassociation transitions we form electronically excited molecules (Na$_2^*$) from ultra-cold (50-300 $\mu$K) Na atoms. Using a second laser to drive transitions from the excited state to a level in the molecular ground state, we are able to split the photoassociation line and observe features with a width smaller than the natural linewidth of the excited molecular state. The quantum interference which gives rise to this effect is analogous to that which leads to electromagnetically induced transparency in three level atomic $\Lambda$ systems, but here one of the ground states is a pair of free atoms while the other is a bound molecule. The linewidth is limited primarily by the finite temperature of the atoms.Comment: 4 pages, 5 figure

Injury experience in Tanzania - Need for intervention

Objective: To determine distribution of injuries and factors associated with mortality in six hospitals of Tanzania mainland.Design: A Cross - Sectional hospital based study.Setting: Data were collected from casualty departments of Muhimbili Orthopaedic Institute, Morogoro, Mtwara, Kigoma, Musoma regional hospitals and Korogwe district hospital.Subjects: Patients who sustained injuries and attended in six involved hospitals between November 2011 and December 2012.Results: Of the 9316 injury patients seen, 71.7% were males. Majority (55%) were between 18 – 45 years age group. Traffic crashes were the leading cause of injuries and accounted for 47.5% of all injuries. Fractures accounted for 49.2%, and injuries were severe in 1.2% as determined by the Kampala trauma score II (KTS II). Majorities 66.7% were admitted and 2.4% died at the casualty. Factors associated with mortality were; being unemployed (P = 0.000), using ambulances to the hospital (P = 0.000), receiving medical attention within 2 to 10 hours after injury (P = 0.001), road traffic crashes (P = 0.000), 18 - 45 years age group (P = 0.003), low KTS II score (P = 0.000) and sustaining head injury (P = 0.000).Conclusion: Injuries in Tanzania are an important public health problem, predominantly in adult males, mostly due to traffic crashes. It is therefore important to reinforce preventive measures and pre-hospital emergency service is urgently needed

Piloting an Educational Response to Violence in Uganda: Prospects for a New Curriculum

This pilot study assessed Mato-Oput5 (hereafter the curriculum), a new peace education curriculum, for indications of beneficial efficacy, specifically the capacity to reduce negative attitudes towards conflict and violence, and injury and violence rates. A cluster randomisedcontrol design was used. Three of the six purposively selected schools were exposed to the curriculum. Mato-Oput5 is a value-based, formalised curriculum taught by specifically trainedteachers. Its learning areas include conflict, conscience, violence, non-violence, impulse control, anger management, kindness, forgiveness, empathy and reconciliation. The results showed the baseline and post-intervention bio-demographic characteristics of the treatment arms to be comparable, thus suggesting baseline group equivalence and randomisation success. The follow-up loss was 9%. The mean pre- and post-intervention intentional incidentrates of the intervention and control groups were 270/1000 and 370/1000, and 190/1000 and 350/1000, respectively: these differences were not significant. The intervention had no effect onpost-intervention intentional incident rates. There were indications of beneficial efficacy in the curriculum, especially its ability to cause attitude shifts in support of non-violence. Statisticallysignificant behavioural effects were not detected although a downward rate trend was seen in the intervention group

Piloting an Educational Response to Violence in Uganda: Prospects for a New Curriculum

This pilot study assessed Mato-Oput5 (hereafter the curriculum), a new peace education curriculum, for indications of beneficial efficacy, specifically the capacity to reduce negative attitudes towards conflict and violence, and injury and violence rates. A cluster randomised control design was used. Three of the six purposively selected schools were exposed to the curriculum. Mato-Oput5 is a value-based, formalised curriculum taught by specifically trained teachers. Its learning areas include conflict, conscience, violence, non-violence, impulse control, anger management, kindness, forgiveness, empathy and reconciliation. The results showed the baseline and post-intervention bio-demographic characteristics of the treatment arms to be comparable, thus suggesting baseline group equivalence and randomisation success. The follow-up loss was 9%. The mean pre- and post-intervention intentional incident rates of the intervention and control groups were 270/1000 and 370/1000, and 190/1000 and 350/1000, respectively: these differences were not significant. The intervention had no effect on post-intervention intentional incident rates. There were indications of beneficial efficacy in the curriculum, especially its ability to cause attitude shifts in support of non-violence. Statistically significant behavioural effects were not detected although a downward rate trend was seen in the intervention group

Narrow-line magneto-optical cooling and trapping of strongly magnetic atoms

Laser cooling on weak transitions is a useful technique for reaching ultracold temperatures in atoms with multiple valence electrons. However, for strongly magnetic atoms a conventional narrow-line magneto-optical trap (MOT) is destabilized by competition between optical and magnetic forces. We overcome this difficulty in Er by developing an unusual narrow-line MOT that balances optical and magnetic forces using laser light tuned to the blue side of a narrow (8 kHz) transition. The trap population is spin-polarized with temperatures reaching below 2 microkelvin. Our results constitute an alternative method for laser cooling on weak transitions, applicable to rare-earth-metal and metastable alkaline earth elements.Comment: To appear in Phys. Rev. Lett. 4 pages, 5 figure

Kampala Trauma Score (KTS): Is it a new triage tool?

In North America, injury surveillance has generated an accumulation of data regarding trauma events and outcomes through the implementation of trauma registries. Trauma registries have been predominantly instituted in response to the desire to be accredited by the American College of Surgeons (ACS). Committee on Trauma as an ACS Trauma Center1. These registries play a key role in research that determines epidemiological patterns of injury, advances injury prevention actions and finally, measures outcomes2. For example, they have been used extensively in the US to monitor reductions in mortality which has been attributed to the institution of “trauma systems”, coordinated hospital-based systems for the management of injured patients3. As interventions to reduce and prevent injuries are sought, registries allow the calculation of injury rates, identification of causes and measurement of outcomes produced by implementation of interventions4. Trauma registry data is made universally comparable across different strata through the routine use of trauma scores, such as the revised trauma score (RTS) and injury severity score (ISS)

Student self-assessment after Essential Surgical Skills training for final-year medical students at Gulu University, northern Uganda

Background: Medical practice depends on a set of essential clinical and surgical skills, yet inadequate attention is given to training these skills in medical school. This study aimed to evaluate the effect of Essential Surgical Skills® (ESS) training on self-report comfort levels in performing surgical skills among final-year medical students at Gulu University in Gulu, Uganda. Methods: This study analysed 5 years’ worth of pre- and post-course ESS self-evaluation questionnaires completed by final-year medical students attending Gulu University between 2013 and 2017. Pre- and post-course results were compared using Student’s t-test. ESS elements covered over the 5-day course were: surgery fundamentals; respiratory and anaesthesia skills; and skills related to gastrointestinal, obstetric, and orthopaedic surgery. Results: There was a significant improvement in the students’ level of comfort related to all ESS components when pre- and post-course questionnaire responses were compared (P < 0.001). Conclusions: Medical schools should emphasize training of essential clinical and surgical skills because these give medical students the confidence and proficiency needed in clinical practice. Keywords: surgical skills; education; training; medical school; Uganda; Somalia