“Confidence comes with frequent practice”: health professionals’ perceptions of using manual vacuum aspiration after a training program
The aim of this study was to explore health worker’s perception of using manual vacuum aspiration (MVA) 1 year after an educational intervention. The health personnel in Malawi who treat women with incomplete abortions are medical interns, clinical officers and nurses/midwives. The training was designed as a refresher course as health personnel usually are trained how to do MVA during their studies. Altogether, 53 health personnel received the training and filled out questionnaires on knowledge, attitude and practice before the training had started. After 1 year, focus group discussions were arranged with 33 of the previously trained health personnel. There was an almost equal number of nurses, clinical officers and medical interns in the survey and in the focus groups, which included fairly equal numbers of male and female participants and a good age spread among the participants. Even though the participants demonstrated knowledge on the benefits of using MVA prior to the training, most of the health personnel used curettage because of a lack of confidence, broken equipment and high gestational age of the expectant mothers. The training sessions were considered useful, but could have been extended to several days and have included actual patients. Our findings provide important insight on how to proceed in improving post-abortion care in a country where complications of unsafe abortion are common and the health system is low on resources.
This book presents the results of analysis of human capital in Murmansk and Archangelsk regions, republics of Komi and Karelia, and Nenets Autonomous Region. The authors considered migration processes and their trends; some of these were analyzed at municipal level. Having taken in account the importance of life expectancy as a complex indicator of sustainable development, the authors identified the periods of its growth and decline. Age-specific differences were also scrutinized. The relative contributions of major causes of mortality in life expectancy at birth were estimated. The authors described the dynamics of population of small indigenous peoples of the North (Vepsians, Nenets, Komi), the problems associated with their self-identification, census administration, migration, childbirth and life expectancy. The authors analyzed climate change as the new health risk factor, which affects safety of food and drinking water, accessibility of medical services and specific practices of deer-herding. A separate chapter of the book is devoted to current and future trends in working-age population until 2002. Each territory of Barents Sea Region displayed its own peculiar behavior of this indicator. The authors compared selected social, economic and demographic indicators in European part of Russian Arctic with those in foreign countries which belong to Barents Sea Region. This monograph was a product of collaborative efforts of the researchers from Economic Forecasting Institute and Institute of Demography of Higher School of Economics. B. A. Revich, Doctor of Medicine, and B. N. Porfiryev, Corresponding Member of Russian Academy of Sciences, edited this book.
This prototype development explains the challenges encountered during the ISO/IEEE 11073 standard implementation process. The complexity of the standard and the consequent heavy requirements, which have not encouraged software engineers to adopt the standard. The developing complexity evaluation drives us to propose two possible implementation strategies that cover almost all possible use cases and eases handling the standard by non-expert users. The first one is focused on medical devices (MD) and proposes a low-memory and low-processor usage technique. It is based on message patterns that allow simple functions to generate ISO/IEEE 11073 messages and to process them easily. MD act as X73 agent. Second one is focused on more powerful device X73 manager, which do not have the MDs' memory and processor usage constraints. The protocol between Agent and Manager is point-to-point and we can distribute the functionality between devices.
Developed both implementation X73 Agent and Manager will cut developing time for applications based on ISO/EEE 11073.
In the internal medicine wide spectrum the gastroenterology is one of the chapters, less enlightened by the scientific evidence. It does not mean that the practice of the grasntroenterology may ot be improved by the systematic use of the approaches of the evidence based medicine
This article is talking about state management and cultural policy, their nature and content in term of the new tendency - development of postindustrial society. It mentioned here, that at the moment cultural policy is the base of regional political activity and that regions can get strong competitive advantage if they are able to implement cultural policy successfully. All these trends can produce elements of new economic development.