Health care providers' perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia : a systematic literature review of qualitative and quantitative data.

BACKGROUND: Unsafe abortions are a serious public health problem and a major human rights issue. In low-income countries, where restrictive abortion laws are common, safe abortion care is not always available to women in need. Health care providers have an important role in the provision of abortion services. However, the shortage of health care providers in low-income countries is critical and exacerbated by the unwillingness of some health care providers to provide abortion services. The aim of this study was to identify, summarise and synthesise available research addressing health care providers' perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia. METHODS: A systematic literature search of three databases was conducted in November 2014, as well as a manual search of reference lists. The selection criteria included quantitative and qualitative research studies written in English, regardless of the year of publication, exploring health care providers' perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia. The quality of all articles that met the inclusion criteria was assessed. The studies were critically appraised, and thematic analysis was used to synthesise the data. RESULTS: Thirty-six studies, published during 1977 and 2014, including data from 15 different countries, met the inclusion criteria. Nine key themes were identified as influencing the health care providers' attitudes towards induced abortions: 1) human rights, 2) gender, 3) religion, 4) access, 5) unpreparedness, 6) quality of life, 7) ambivalence 8) quality of care and 9) stigma and victimisation. CONCLUSIONS: Health care providers in sub-Saharan Africa and Southeast Asia have moral-, social- and gender-based reservations about induced abortion. These reservations influence attitudes towards induced abortions and subsequently affect the relationship between the health care provider and the pregnant woman who wishes to have an abortion. A values clarification exercise among abortion care providers is needed.

Emergency department triage scales and their components : a systematic review of the scientific evidence

Emergency department (ED) triage is used to identify patients' level of urgency and treat them based on their triage level. The global advancement of triage scales in the past two decades has generated considerable research on the validity and reliability of these scales. This systematic review aims to investigate the scientific evidence for published ED triage scales. The following questions are addressed: 1. Does assessment of individual vital signs or chief complaints affect mortality during the hospital stay or within 30 days after arrival at the ED? 2. What is the level of agreement between clinicians' triage decisions compared to each other or to a gold standard for each scale (reliability)? 3. How valid is each triage scale in predicting hospitalization and hospital mortality? A systematic search of the international literature published from 1966 through March 31, 2009 explored the British Nursing Index, Business Source Premier, CINAHL, Cochrane Library, EMBASE, and PubMed. Inclusion was limited to controlled studies of adult patients (≥15 years) visiting EDs for somatic reasons. Outcome variables were death in ED or hospital and need for hospitalization (validity). Methodological quality and clinical relevance of each study were rated as high, medium, or low. The results from the studies that met the inclusion criteria and quality standards were synthesized applying the internationally developed GRADE system. Each conclusion was then assessed as having strong, moderately strong, limited, or insufficient scientific evidence. If studies were not available, this was also noted. We found ED triage scales to be supported, at best, by limited and often insufficient evidence. The ability of the individual vital signs included in the different scales to predict outcome is seldom, if at all, studied in the ED setting. The scientific evidence to assess interrater agreement (reliability) was limited for one triage scale and insufficient or lacking for all other scales. Two of the scales yielded limited scientific evidence, and one scale yielded insufficient evidence, on which to assess the risk of early death or hospitalization in patients assigned to the two lowest triage levels on a 5-level scale (validity).

A systematic review of triage-related interventions to improve patient flow in emergency departments

Background Overcrowding in emergency departments is a worldwide problem. A systematic literature review was undertaken to scientifically explore which interventions improve patient flow in emergency departments. Methods A systematic literature search for flow processes in emergency departments was followed by assessment of relevance and methodological quality of each individual study fulfilling the inclusion criteria. Studies were excluded if they did not present data on waiting time, length of stay, patients leaving the emergency department without being seen or other flow parameters based on a nonselected material of patients. Only studies with a control group, either in a randomized controlled trial or in an observational study with historical controls, were included. For each intervention, the level of scientific evidence was rated according to the GRADE system, launched by a WHO-supported working group. Results The interventions were grouped into streaming, fast track, team triage, point-of-care testing (performing laboratory analysis in the emergency department), and nurse-requested x-ray. Thirty-three studies, including over 800,000 patients in total, were included. Scientific evidence on the effect of fast track on waiting time, length of stay, and left without being seen was moderately strong. The effect of team triage on left without being seen was relatively strong, but the evidence for all other interventions was limited or insufficient. Conclusions Introducing fast track for patients with less severe symptoms results in shorter waiting time, shorter length of stay, and fewer patients leaving without being seen. Team triage, with a physician in the team, will probably result in shorter waiting time and shorter length of stay and most likely in fewer patients leaving without being seen. There is only limited scientific evidence that streaming of patients into different tracks, performing laboratory analysis in the emergency department or having nurses to request certain x-rays results in shorter waiting time and length of stay.

Clean Code vs Dirty Code : Ett fältexperiment för att förklara hur Clean Code påverkar kodförståelse

Stora och komplexa kodbaser med bristfällig kodförståelse är ett problem som blir allt vanligare bland företag idag. Bristfällig kodförståelse resulterar i längre tidsåtgång vid underhåll och modifiering av koden, vilket för ett företag leder till ökade kostnader. Clean Code anses enligt somliga vara lösningen på detta problem. Clean Code är en samling riktlinjer och principer för hur man skriver kod som är enkel att förstå och underhålla. Ett kunskapsglapp identifierades vad gäller empirisk data som undersöker Clean Codes påverkan på kodförståelse. Studiens frågeställning var: Hur påverkas förståelsen vid modifiering av kod som är refaktoriserad enligt Clean Code principerna för namngivning och att skriva funktioner? För att undersöka hur Clean Code påverkar kodförståelsen utfördes ett fältexperiment tillsammans med företaget CGM Lab Scandinavia i Borlänge, där data om tidsåtgång och upplevd förståelse hos testdeltagare samlades in och analyserades. Studiens resultat visar ingen tydlig förbättring eller försämring av kodförståelsen då endast den upplevda kodförståelsen verkar påverkas. Alla testdeltagare föredrar Clean Code framför Dirty Code även om tidsåtgången inte påverkas. Detta leder fram till slutsatsen att Clean Codes effekter kanske inte är omedelbara då utvecklare inte hunnit anpassa sig till Clean Code, och därför inte kan utnyttja det till fullo. Studien ger en fingervisning om Clean Codes potential att förbättra kodförståelsen.

L1 Use in the EFL-classroom : A Literature Review on Teachers’ Use of the L1 in the EFL-classroom on Upper Secondary Level

Even though English should mainly be used in the EFL-classroom according to the Swedish national curriculum, some recent scholars have argued that a judicious use of the students’ L1 by the teachers in some particular situations may benefit the learning environment there. From this context, this thesis examines what research says about in what particular situations the L1 is used by teachers in upper secondary EFL-classrooms as well as the teachers’ and the students’ attitudes towards this practice. The method used was a systematic literature review, where seven articles from all across the globe were analyzed, compared and synthesized. The results show that the L1 was mainly used by the teachers when managing discipline, when explaining grammar and when teaching vocabulary. However, the articles did not conclude how the L1 could be used strategically by the teachers. Concerning the teachers’ and students’ attitudes, the majority of these were positive towards L1 use by the teacher in the above mentioned situations. However, the teachers were not aware of how the L1 could be used by them in a judicious and a strategic way. Lastly, it can be concluded that more research is needed on how the L1 can be used more strategically by the teachers as well as on the students’ perspective on this.