Barriers and opportunities experienced by staff when implementing infection prevention and control guidelines during labour and delivery in healthcare facilities in Nigeria.

BACKGROUND: Infections account for 15% of neonatal deaths and one-tenth of maternal mortality globally. Evidence-based practices to prevent and control infection are essential to reduce newborn and maternal mortality. AIM: To identify the barriers and opportunities experienced by staff when implementing infection prevention and control (IPC) guidelines in maternity wards and delivery units in six health centres in two states in Nigeria. METHODS: A structured survey was undertaken in the maternity ward and delivery unit of six healthcare facilities to assess critical infrastructure and equipment. A survey was completed with the matron to assess staff practices and quality assurance procedures. Data were triangulated with qualitative data from interviews with facility staff. FINDINGS: Usable handwashing facilities - with water, functioning taps and soap available - were present in the delivery units of all six facilities, but were present in only one postnatal ward. All facilities were visibly clean, and staff demonstrated a strong will to comply with protocol. Areas of concern included effectiveness of training, inadequate availability of personal protective equipment, inadequate hand hygiene practices, and outdated procedures to reprocess re-usable medical equipment. CONCLUSION: Safe childbirth and postnatal care require comprehensive adherence to hand hygiene protocols and the use of disposable personal protective equipment. Financial, equipment and human resource constraints are obstacles to effective implementation of IPC in labour and delivery wards in the centres included in this study. Recommended interim measures include the introduction of champions to systematize step-down training and to monitor and provide feedback at facility level.

Training integrate-and-fire neurons with the Informax principle II.

For pt I see J. Phys. A, vol. 35, p. 2379-94 (2002).We develop neuron learning rules using the Informax principle together with the input-output relationship of the integrate-and-fire (IF) model with Poisson inputs. The learning rule is then tested with constant inputs, time-varying inputs and images. For constant inputs, it is found that, under the Informax principle, a network of IF models with initially all positive weights tends to disconnect some connections between neurons. For time-varying inputs and images, we perform signal separation tasks called independent component analysis. Numerical simulations indicate that some number of inhibitory inputs improves the performance of the system in both biological and engineering senses.

Temporal album.

Transient synchronization has been used as a mechanism of recognizing auditory patterns using integrate-and-fire neural networks. We first extend the mechanism to vision tasks and investigate the role of spike dependent learning. We show that such a temporal Hebbian learning rule significantly improves accuracy of detection. We demonstrate how multiple patterns can be identified by a single pattern selective neuron and how a temporal album can be constructed. This principle may lead to multidimensional memories, where the capacity per neuron is considerably increased with accurate detection of spike synchronization.

Balance between four types of synaptic input for the integrate-and-fire model.

We consider the integrate-and-fire model with AMPA, NMDA, GABA(A)and GABA(B)synaptic inputs, with model parameters based upon experimental data. An analytical approach is presented to determine when a post-synaptic balance between excitation and inhibition can be achieved. Secondly, we compare the model behaviour subject to these four types of input, with its behaviour subject to conventional point process inputs. We conclude that point processes are not a good approximation, even away from exact presynaptic balance. Thirdly, numerical simulations are presented which demonstrate that we can treat NMDA and GABA(B)as DC currents. Finally, we conclude that a balanced input is plausible neither pre-synaptically nor post-synaptically for the model and parameters we employed.

A computational model of the analysis of some first-order and second-order motion patterns by simple and complex cells.

Although spatio-temporal gradient schemes are widely used in the computation of image motion, algorithms are ill conditioned for particular classes of input. This paper addresses this problem. Motion is computed as the space-time direction in which the difference in image illuminance from the local mean is conserved. This method can reliably detect motion in first-order and some second-order motion stimuli. Components of the model can be identified with directionally asymmetric and directionally selective simple cells. A stage in which we compute spatial and temporal derivatives of the difference between image illuminance and the local mean illuminance using a truncated Taylor series gives rise to a phase-invariant output reminiscent of the response of complex cells.

Auditory lateralization: an effect of rhythm.

Recall of monaurally presented semantically anomalous sentences, which had either neutral or rhythmic timing, was tested at the right ear, at the left ear, and on transfer from one ear to the other. The component words, being computer stored digitized waveforms, had identical acoustic structure in the two conditions. In the rhythmic condition there was not only an overall advantage in the second half of the experiment but also an asymmetric transfer effect such that this advantage did not appear when the left ear was tested after the right. It is proposed that functional lateralization be viewed as an adaptive, dynamic, organizational factor.