Current practice of family planning among teachers in public secondary school in Enugu East Senatorial District, Nigeria

Background: The aim of this study is to determine the current practice level of family planning and the associated factors among public secondary school teachers in Enugu East Senatorial District. Method: A cross-sectional study was carried out among public secondary school teachers, aged 18 - 60 years, in Enugu East Senatorial District, using probability proportional to size sampling and systematic random sampling to select 1000 participants. Binary and multiple logistic regression analyses were used to determine association. An odds ratio with a 95% confidence interval (CI) was computed to determine the level of significance. Results: The current practice level of family planning is 26.5%. Respondents with bachelor's in education were 2 times more likely to be a current user of family planning (AOR=2.39; 95% CI: 1.25-4.55). However, respondents in age group 38 years and above were less likely to be a current user of family planning (AOR=0.64; 95% CI: 0.43-0.95), likewise female respondents (AOR=0.66; 95% CI: 0.44-0.98). Additionally, respondents who mentioned radio (AOR=0.64; 95%CI: 0.44-0.93), social media (AOR=0.73; 95% CI: 0.53-0.99) and healthcare (AOR=0.61; 95%CI: 0.43-0.88) as source of information were less likely to be current user of family planning. Whereas partner who encouraged the use of family planning (AOR=2.54; 95% CI: 1.71-3.78) span style="font-family: 'Times New Roman'; font-weight: bold">, partner who allow each other to decide on family planning methods (AOR=4.47; 95% CI: 2.67-7.48) and those who had good knowledge of family planning (AOR=1.96; 95% CI: 1.40- 2.67) were more likely to be current user of family planning. Conclusion: The level of current practice of family planning is low and a significant number of factors predict the current practice of family planning. A family planning educational workshop among teachers is needed to improve teacher's knowledge on family planning to address the issue of adolescent sexual reproduction as teachers are vessels of knowledge impartation to students

Postoperative delirium / 대한마취과학회지

Delirium can be defined as an ‘acute brain dysfunction.’ Compared to dementia, which is a disease that deteriorates the brain function chronically, delirium shows very similar symptoms but is mostly ameliorated when the causative factors are normalized. Due to the heterogeneity in etiologies and symptoms, people including health care workers often mistake delirium for dementia or other psychiatric disorders. Delirium has attracted global interest increasingly and a vast amount of research on its management has been conducted. Experts in the field have constantly suggested that systematic intervention should be implemented through a team-based multicomponent approach aimed to reduce the incidence and duration of delirium. Surgery involves many health care workers with different expertise who are not familiar with delirium. For a team-based approach on the management of delirium, it is vital that all medical personnel concerned have a common understanding of delirium and keep in constant communication. Postoperative delirium is a common complication and exerts an enormous burden on patients, their families, hospitals, and public resources. To alleviate this burden, this article aimed to review general features and the latest evidence-based knowledge of delirium with a focus on postoperative delirium.

The Past, Present and Future of Heart Transplantation

Heart transplantation (HTx) has become standard treatment for selected patients with end-stage heart failure. Improvements in immunosuppressant, donor procurement, surgical techniques, and post-HTx care have resulted in a substantial decrease in acute allograft rejection, which had previously significantly limited survival of HTx recipients. However, limitations to long-term allograft survival exist, including rejection, infection, coronary allograft vasculopathy, and malignancy. Careful balance of immunosuppressive therapy and vigilant surveillance for complications can further improve long-term outcomes of HTx recipients.

Clinical Nutrition Management Status in Convalescent Hospitals Before and After Healthcare Accreditation Process

The increasing elderly population has created an urgent need for well-managed convalescent hospitals, which should provide appropriate clinical nutrition services. The new accreditation policy requiring participation of all convalescent hospitals since 2013 may promote improvement of clinical nutrition services. This study examined whether or not the accreditation policy has increased practice level and dietitians' perception of the importance of clinical nutrition management. Of the 177 convalescent hospitals accredited by January 30, 2014, dietitians from 73 hospitals (41.2%) completed the survey questionnaire. The pre-tested questionnaire surveyed general characteristics of the hospital and dietitians, current status of clinical nutrition management, and changes in the perception and practice levels of various aspects of food and clinical nutrition management. In average, dietitians with more than 5 years of work experience (68.1%) provided food and clinical nutrition services (71.2%). After accreditation, dietitians' perception of the importance and practice level of clinical nutrition service increased (P<0.001). Level of perception, however, was significantly (P<0.001) higher than practice level before and after accreditation. During perception and practice level of initial nutrition assessment, a compulsory accreditation item, notably and significantly (P<0.001) improved after accreditation. The significant difference between perception and practice level disappeared after accreditation. In conclusion, the accreditation process had positive effects on clinical nutrition management in terms of dietitians' perception and practice levels. Making more accreditation items compulsory and providing motivation and professional education to dietitians in convalescent hospitals could lead to additional improvements.

O pensamento clínico contemporâneo: revisitando a técnica / Contemporary clinical thought: revisiting the technique / El pensamiento clínico contemporáneo: revisitando la técnica

Este trabalho é parte de uma apresentação feita em 2012, no II Encontro Internacional André Green, realizado na Asociación Psicoanalítica Argentina. O texto retoma alguns conceitos fundamentais de Green, particularmente os conceitos de pulsão, representação e pulsão de morte. Desenvolvem-se, a partir daí, algumas ideias sobre as reformulações da técnica, interpretação, construção, contratransferência imaginativa e silêncio do analista.

'This article is part of a presentation shown in 2012, during the II International André Green Meeting, which took place at the Asociación Psicoanalítica Argentina. The text considers some of Greens basic concepts, particularly the ideas of drive, representation and death drive. From this, ideas on the reformulations of the technique, interpretation, construction, imaginative countertransference and silence of the analyst are developed.

Este trabajo es parte de una presentación realizada en el II Encuentro Internacional André Green del año 2012, en la Asociación Psicoanalítica Argentina. El texto retoma algunos conceptos fundamentales de Green, en particular los conceptos de pulsión, representación y pulsión de muerte. De ahí se desarrollan algunas ideas sobre las reformulaciones de la técnica, interpretación, construcción, contratransferencia imaginativa y silencio del analista.

A sociedade excitada na clínica / The excited society in clinical practice / La sociedad excitada en la clínica

O comentário, utilizando-se da experiência clínica da autora, tematiza os dilemas vividos pelo analista, perigosamente desafiado, como seu paciente, num embate entre proposições da vida contemporânea, aparentemente excludentes, ou seja: que solução singular encontrar para desenvolver-se enquanto sujeito no confronto com a força, aparentemente invencível, da "sociedade excitada", conforme desvelada por Christoph Türcke.

The commentary, based upon the clinical experience of the author, characterizes the dilemma faced by the psychoanalyst, dangerously challenged, as his patient, in a clash between propositions of contemporary life, apparently excludent, that is: which singular solution can be found in order to promote self-development as subject in the confrontation against the strength, seemingly unbeatable, of the "excited society", as unravelled by Christoph Türcke.

El comentario, basándose en la experiencia clínica de la autora, tematiza los dilemas vividos por el analista, peligrosamente desafiado, como su paciente, en un choque entre proposiciones de la vida contemporánea, aparentemente exclusiva, o sea: que solución singular encontrar para desarrollarse como sujeto de la confrontación con la fuerza, aparentemente invencible, de la "sociedad excitada", como fue dada a conocer por Christoph Türcke.