ABSTRACT
BACKGROUND: Maternal mortality in poor countries reflects the under-development in these societies. Global recognition of the burden of maternal mortality and the urgency for a reversal of the trend underpin the Millenium Development Goals (MDGs). OBJECTIVE: To determine risk factors for maternal mortality in institutional births in Nigeria. METHOD: Twenty one health facilities in three states were selected using stratified multi-stage cluster sampling strategy. Information on all delivered mothers and their newborn infants within a three-month period was culled from medical records. RESULTS: A total of 9 208 deliveries were recorded. About one-fifth (20.5%) of women had no antenatal care while 79.5% had at least one antenatal visit during pregnancy. Four-fifths (80.5%) of all deliveries were normal deliveries. Elective and emergency caesarean section rates were 3.1% and 11.5% respectively. There were 79 maternal deaths and 8 526 live births, giving a maternal mortality ratio of 927 maternal deaths per 100 000 live births. No antenatal care, parity, level of education, and mode of delivery were significantly associated with maternal mortality. Low maternal education, high parity, emergency caesarean delivery, and high risk patients risk independently predicted maternal mortality. CONCLUSION: Meeting goal five of the MDGs remains a major challenge in Nigeria. Multi-sectoral approaches and focused political will are needed to revert the high maternal mortality.
Subject(s)
Delivery, Obstetric/statistics & numerical data , Health Knowledge, Attitudes, Practice , Maternal Mortality , Patient Acceptance of Health Care , Adolescent , Adult , Cross-Sectional Studies , Female , Health Services Research , Hospitals, General/statistics & numerical data , Hospitals, Teaching/statistics & numerical data , Humans , Infant, Newborn , Maternal Age , Maternal Health Services/statistics & numerical data , Nigeria/epidemiology , Parity , Pregnancy , Prenatal Care/methods , Prenatal Care/statistics & numerical data , Regression Analysis , Risk Factors , Socioeconomic Factors , Tertiary Care Centers/statistics & numerical data , Young AdultABSTRACT
Background: Every year about 1.2 million people are killed on the world's roads and up to 50 million are injured or disabled as a result of road traffic accidents. The effectiveness of seat belt usage in reducing the severity of the sequelae of road traffic accidents is widely known. The aim of this study was to determine the knowledge, attitude and use of seat belt among commercial drivers in Sokoto Metropolis.Methods: The study design was cross-sectional and descriptive. Pre-tested, structured, interviewer administered questionnaires were used for data collection. Each correct response to the knowledge questions was scored one mark and wrong response or non-response was scored zero.Results: A total of 430 questionnaires were analyzed. The mean knowledge score (%) of the study subjects was high (64.8±17.7). Majority (57.9%) of the respondents had positive attitude towards compulsory use of seat belt. 363 (84.4%) of the respondents reported that they use seat belt when they drive. There were statistically significant associations between age (p<0.0001), ethnicity (p=0.02), education (p=0.001) as well as attendance of driving school (p=0.000002) and the reported use of seat belt.Conclusion: This study has identified high level of knowledge, positive attitude and reported use of seat belt. It is recommended that public awareness of the safety benefits of seat belts and strong enforcement are necessary to achieve optimal use of seat belt
Subject(s)
Attitude , Automobile Driving , Seat BeltsABSTRACT
By means of some aspects of an analysis, the author shows how the fear of being murdered may form part of the secret fantasy of being an exception. This fantasy should offer protection against being helplessly at the mercy of intense feelings which cannot be integrated, and of an intolerable loss of the sense of self, which renders true separation impossible. During the course of development the fantasy gradually assumes its definitive form. One element of this definitive form is that the analysand exists in a state of adulthood as he imagined it as a child. Control and autonomy here seem guaranteed, and dependence, helplessness and ridiculousness have been overcome. For the creation of such a fantasy, the analysand makes 'a great leap forward' at one or more stages of his development. The author indicates how a leap of this kind could be imagined in intrapsychic terms.
Subject(s)
Fantasy , Psychoanalysis , Psychoanalytic Therapy , Adult , Anxiety, Castration/psychology , Depression/psychology , Ego , Humans , Male , Transference, Psychology , Unconscious, PsychologyABSTRACT
Some analysands have great difficulty in facing the fact that they are in analysis, instead clinging grimly to the conviction that they are doing something else. This 'something else' points to the secret fantasy of being an exception, someone who is exceptionally well-loved and occupies an exceptional position with the analyst. On the basis of the secret fantasy of an analysand, the author describes the various possible intrapsychic functions of such a fantasy and attempts to explain why this fantasy has to be defended with such desperate tenacity.
