Hospital Care for Newborn Babies: Quality Assessment, A Systematic Review

Context: Neonatal mortality rate is declining globally. The aim of the present study is to identify relevant indicators for assessing newborn care in hospitals by a systematic review. Evidence Acquisition: A search on electronic data base and manual searches of personal files for studies on quality indicators of newborn care were carried out. Searching 9 bibliographic databases, we found 85 articles of which 22 exactly related ones were selected and studied. Hand search yielded 1 record were also searched and 2 records were included. Results: A list of 87 structure, process and outcome indicators was formulated from the articles. Also 26 excess measures were identified in gray literature. After removing duplicates, and categorizing in 3 domains, 18 measures were input, 41 process and 34 outcome measures. Conclusions: These 93 indicators provide a framework for assessing how well the hospitals are providing neonatal care. These measures should be discussed in each context expert panels to address nationally applicable indices of neonatal care and may be adapted for local health settings.

Impact of cost sharing on utilization of primary health care Services: providers versus household perspectives

This study is set to match and compare results of the analysis of impacts of cost sharing on households with those on health-care providers in two selected districts in Tanzania. The setting is intended to establish and compare concurrently the impact of cost sharing on health-care utilization as viewed from both the providers and beneficiary households. The findings of the study indicate that quality of primary health care has improved as a result of the introduction of cost sharing. Attendance and hence utilization in health facilities has also increased. Mortality rate, at least for one district has not worsened. By implication then, cost sharing appears to have a positive impact on the provision of primary health care, except for a few cases that fail to consult because of the fees. An appropriately managed exemption facility is likely to eliminate the negative impact.

Effect of foliar application of Cu, Zn, and Mn on yield and quality indicators of winter wheat grain

Micronutrients are part of many crucial physiological plant processes. The combined application of N and micronutrients helps in obtaining grain yield with beneficial technological and consumer properties. The main micronutrients needed by cereals include Cu, Mn, and Zn. The subject of this study was to determine yield, quality indicators (protein content and composition, gluten content, grain bulk density, Zeleny sedimentation index, and grain hardness), as well as mineral content (Cu, Zn, Mn, Fe) in winter wheat grain ( Triticum aestivum L.) fertilized by foliar micronutrient application. A field experiment was carried out at the Educational and Experimental Station in Tomaszkowo, Poland. The application of mineral fertilizers (NPK) supplemented with Cu increased Cu content (13.0%) and ω, α/β, and γ (18.7%, 4.9%, and 3.4%, respectively) gliadins in wheat grain. Foliar Zn fertilization combined with NPK increased Cu content (14.9%) as well as high (HMW) and low molecular weight (LMW) glutenins (38.8% and 6.7%, respectively). Zinc fertilization significantly reduced monomeric gliadin content and increased polymeric glutenin content in grain, which contributed in reducing the gliadin:glutenin ratio (0.77). Mineral fertilizers supplemented with Mn increased Fe content in wheat grain (14.3%). It also significantly increased protein (3.8%) and gluten (4.4%) content, Zeleny sedimentation index (12.4%), and grain hardness (18.5%). Foliar Mn fertilization increased the content of ω, α/β, and γ gliadin fractions (19.9%, 9.5%, and 2.1%, respectively), as well as HMW and LMW glutenins (18.9% and 4.5%, respectively). Mineral NPK fertilization, combined with micronutrients (Cu + Zn + Mn), increased Cu and Zn content in grain (22.6% and 17.7%, respectively). The content of ω, α/β, and γ gliadins increased (20.3%, 10.5%, and 12.1%, respectively) as well as HMW glutenins (7.9%).

The Prevalence of Depression among patients and its detection by Primary Health Care Workers at Matawale Health Centre (Zomba)

Background Little information is available on the prevalence of depression in Malawi in primary health care settings and yet there is increased number of cases of depression presenting at tertiary level in severe form. Aim The aim of the study was to determine the prevalence of depression among patients and its detection by health care workers at a primary health care clinic in Zomba. Methods A cross-sectional survey was done among patients attending outpatient department at Matawale Health Centre, in Zomba from 1st July 2009 through to 31st July 2009. A total of 350 adults were randomly selected using systematic sampling. The “Self Reporting Questionnaire”, a questionnaire measuring social demographic factors and the Structured Clinical Interview for DSM-IV Axis I disorders Non-Patient Version (SCID-NP) were administered verbally to the participants. Findings The prevalence of depression among the patients attending the outpatients department was found to be 30.3% while detection rate of depression by clinician was 0%. Conclusion The results revealed the magnitude of depression which is prevalent in the primary health care clinic that goes undiagnosed and unmanaged. It is therefore recommended that primary health care providers do thorough assessments to address common mental disorders especially depression and they should be educated to recognise and manage depression appropriately at primary care level.

Incorporation of the Health Care System in the West

A reflection is made, from an interpretative perspective, on the historical evolution of health care in the West. It starts from the moment that this became a way to intervene the sick and an instrument for healing diseases, focusing on original documents and written sources which account for results of historical research, which range from XV century until today. To do this, it tries to understand the health care as an ideographic body of knowledge consisting of five pieces of a puzzle composed by: the state policy of hospitals accumulation implemented in Spain, the accumulation of medical practices in what is currently Germany, the hospital wards in England, the nosological rationality in France, and the US sanitizing machine; all these movements as producers of closely linked health care developments, that are nothing more than collective actions regulated by social norms around health.