1,176 research outputs found

    Quality of care for children with acute malnutrition at health center level in Uganda: a cross sectional study in West Nile region during the refugee crisis

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    Background: Arua district, in Uganda, hosts some of the largest refugee camps in the country. The estimated prevalence of moderate and severe acute malnutrition in children is higher than the national estimates (10.4 and 5.6% respectively, compared to 3.6 and 1.3%). This study aimed at assessing the quality of care provided to children with acute malnutrition at out-patient level in such a setting. Methods: Six facilities with the highest number of children with malnutrition were selected. The main tool used was the National Nutrition Service Delivery Assessment Tool, assessing 10 key areas of service delivery and assigned a score as either poor, fair, good or excellent. Health outcomes, quality of case management and data quality were assessed from the health management information system and from the official nutrition registers. Results: All facilities except two scored either poor or fair under all the 10 assessment areas. Overall, 33/60 (55%) areas scored as poor, 25/60 (41%) as fair, 2/60 (3.3%) as good, and none as excellent. Main gaps identified included: lack of trained staff; disorganised patient flow; poor case management; stock out of essential supplies including ready-to-use therapeutic foods; weak community linkage. A sample coverage of 45.4% (1020/2248) of total children admitted in the district during the 2016 financial year were included. The overall mean cure rate was 52.9% while the default rate was 38.3%. There was great heterogeneity across health facilities in health outcomes, quality of case management, and data quality. Conclusion: This study suggests that quality of care provided to children with malnutrition at health center level is substandard with unacceptable low cure rates. It is essential to identify effective approaches to enhance adherence to national guidelines, provision of essential nutritional commodities, regular monitoring of services and better linkage with the community through village health teams

    Giulia Veronica Varisco

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    The headword explains the biography and the contribution of the author Giulia Varisco to the children's literatur

    The hidden burden of measles in Ethiopia: how distance to hospital shapes the disease mortality rate

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    Abstract Background A sequence of annual measles epidemics has been observed from January 2013 to April 2017 in the South West Shoa Zone of the Oromia Region, Ethiopia. We aimed at estimating the burden of disease in the affected area, taking into account inequalities in access to health care due to travel distances from the nearest hospital. Methods We developed a dynamic transmission model calibrated on the time series of hospitalized measles cases. The model provided estimates of disease transmissibility and incidence at a population level. Model estimates were combined with a spatial analysis to quantify the hidden burden of disease and to identify spatial heterogeneities characterizing the effectiveness of the public health system in detecting severe measles infections and preventing deaths. Results A total of 1819 case patients and 36 deaths were recorded at the hospital. The mean age was 6.0 years (range, 0–65). The estimated reproduction number was 16.5 (95% credible interval (CI) 14.5–18.3) with a cumulative disease incidence of 2.34% (95% CI 2.06–2.66). Three thousand eight hundred twenty-one (95% CI 1969–5671) severe cases, including 2337 (95% CI 716–4009) measles-related deaths, were estimated in the Woliso hospital’s catchment area (521,771 inhabitants). The case fatality rate was found to remarkably increase with travel distance from the nearest hospital: ranging from 0.6% to more than 19% at 20 km. Accordingly, hospital treatment prevented 1049 (95% CI 757–1342) deaths in the area. Conclusions Spatial heterogeneity in the access to health care can dramatically affect the burden of measles disease in low-income settings. In sub-Saharan Africa, passive surveillance based on hospital admitted cases might miss up to 60% of severe cases and 98% of related deaths

    Ytterbium Disilicate/Monosilicate Multilayer Environmental Barrier Coatings: Influence of Atmospheric Plasma Spray Parameters on Composition and Microstructure

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    first_pagesettingsOrder Article Reprints Open AccessArticle Ytterbium Disilicate/Monosilicate Multilayer Environmental Barrier Coatings: Influence of Atmospheric Plasma Spray Parameters on Composition and Microstructure by Giulia Di Iorio,Laura Paglia *ORCID,Giulia PedrizzettiORCID,Virgilio GenovaORCID,Francesco MarraORCID,Cecilia BartuliORCID andGiovanni PulciORCID INSTM Reference Laboratory for Materials and Surface Engineering, Sapienza University of Rome, Eudossiana 18, 00184 Rome, Italy * Author to whom correspondence should be addressed. Coatings 2023, 13(9), 1602; https://doi.org/10.3390/coatings13091602 Original submission received: 10 August 2023 / Revised: 31 August 2023 / Accepted: 11 September 2023 / Published: 13 September 2023 Downloadkeyboard_arrow_down Browse Figures Review Reports Versions Notes Abstract SiC/SiC ceramic matrix composites (SiCf/SiC CMCs) are regarded as the new materials for the hot-section components of aircraft gas turbine engines, since they have one-third of the density of metallic superalloys, a higher temperature capability, good mechanical strength, and excellent thermal shock resistance. However, high-temperature water-vapor-rich combustion gases can induce severe surface recession phenomena in SiC/SiC leading to component failure. For this reason, it is necessary to design protective coatings, i.e., environmental barrier coatings (EBCs), able to protect the SiC/SiC surface in combustion environments. In the present work, ytterbium monosilicate (Yb2SiO5), stable when exposed to water vapor at high temperatures, and ytterbium disilicate (Yb2Si2O7), characterized by a thermal expansion coefficient closer to that of the substrate, were selected for a multilayer EBC system. EBCs were processed using the atmospheric plasma spray (APS) technique. A set of deposition parameters were tested, varying the power of the torch, and the composition and microstructure of the deposited coatings were studied in terms of porosity, crack density, and post-deposition phase retention by performing SEM, EDS, and XRD analysis. The results allow for the definition of the influence of deposition parameters on the final properties of multilayer EBC coatings

    Scrivere senza anestesia. La chiarezza di Giulia Niccolai

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    Il saggio colloca storicamente la narratrice e poetessa Giulia Niccolai nel canone del Novecento letterario italiano discutendone poetica e cifre stilistiche. L'ampia analisi proposta tocca tutte le opere dell'autrice evidenziandone i legami intertestuali, anche tra poesia e narrativa, e i progressivi sviluppi in un arco cronologico esteso, tra anni Sessanta e primi anni Duemila. Lo studio coglie anche l'importanza dei riferimenti alle arti visive, in particolare alla fotografia, che Giulia Niccolai ha praticato in prima persona negli anni della Neoavanguardia, e alla pittura americana.The essay places the narrator and poet Giulia Niccolai in the canonical twentieth century Italian literary discussing her poetics and stylistic figures. The wide analysis proposed touches all the works of the author highlighting the intertextual links, also between poetry and narrative, and the progressive developments in an extended chronological period, between the Sixties and early Twenties. The study also captures the importance of references to the visual arts, especially photography, which Giulia Niccolai has practiced in the years of the Neo-avant-garde, and to American painting

    BDC-Decomposition for global influence analysis

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    In biochemical networks, the steady-state input-output influence is the sign of the output steady-state variation due to a persistent positive input perturbation; if the sign does not depend on the value of the strictly positive system parameters, the influence is structural. As recently shown for small perturbations, when the linearized system approximation is valid, steady-state input-output influences can be structurally assessed, for biochemical networks with m unknown parameters, by means of a vertex algorithm with complexity 2m. This letter shows that the structural input-output influence of a biochemical network is a global property, which does not require any small-perturbation assumption. It also shows that, using a new algorithm, the complexity can be reduced down to 2m-n , where n is the system order, thus drastically reducing the computation time. Finally, when the uncertain parameters belong to known intervals, non-conservative bounds are given for the steady-state ratio between output and input, allowing for sensitivity analysis.Accepted Author ManuscriptTeam Tamas Keviczk

    Effect of a Low-Dose/High-Frequency Training on Real-Life Neonatal Resuscitation in a Low-Resource Setting

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    Background: As intrapartum-related events represent a quarter of all neonatal deaths, education on neonatal resuscitation is a critical priority. Objective: To assess the impact of a low-dose/high-frequency neonatal resuscitation training on clinical practice of midwives in a low-resource setting. Methods: Eight months after a modified Neonatal Resuscitation Program (NRP) course, we implemented a low-dose/high-frequency training for midwives at Beira Central Hospital, Mozambique. The training lasted 6 months and included weekly practice sessions. Fifty consecutive resuscitations after the low-dose/high-frequency training were compared with those registered before (n = 50) and after (n = 50) participation in the adapted NRP course using video recording. Results: All 150 neonates received the initial steps; 103 required bag-mask ventilation and 41 required chest compressions. The scores for initial steps, bag-mask ventilation and chest compressions improved after the course (p < 0.0001, p = 0.005 and p = 0.03) and did not change after the low-dose/high-frequency training (p = 0.34, p = 0.99 and p = 0.30). The low-dose/high-frequency training decreased the total time of the procedure (p < 0.0001) and anticipated start time of airway suctioning and tactile stimulation (p = 0.003 and p < 0.0001), but had no effect on the time of initiation of bag-mask ventilation (p = 0.30). Conclusions: In a low- income setting, a low-dose/high-frequency training after participation in an adapted NRP course contributed to improving the initiation and times of some procedures. However, many aspects of neonatal resuscitation remained poor. Low-dose/high-frequency training should focus on improving the prevention of thermal loss, face mask ventilation and heart rate assessment

    Luoghi di danza

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    Writer, journalist, theater and film critic, Marco Ramperti is one of the few that deals with dance in the Italian press of the fascist period. For the newspaper «La Stampa», between 1926 and 1928, he edits the column Luoghi di danza (dance venues), dedicated to ballroom and modern dances. The article investigates the performative nature of Ramperti’s writing, dominated by “staging” devices of the subject matter, as well as by an intrusive presence of the body, first of all that of the author. What emerges is an unprecedented image of the dance in the Twenties, at the same time catalysing the most alienating - and Pirandellian - aspects of modernity, but also a place where genuinely experiencing themselves and the others
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