Peri-Urban Growth into Natural Hazard-Prone Areas. Mapping Exposure Transformation of the Built Environment in Nairobi and Nyeri, Kenya from 1948 to Today

Kenya experiences massive urban growth, also into natural hazard-prone areas, exposing settlements and the natural environment to riverine and pluvial floods and other natural hazards. While Nairobi as the capital and principal city has been extensively analysed regarding urban growth and flood hazard in some central parts, awareness of growing peri-urban areas has not been studied as much. The results are of interest to other locations in Kenya and worldwide, too, since the current research and disaster risk practice focus is still too much on megacities and city centres. Therefore, the study compares urban growth into hazard areas in urban rims of Nairobi and Nyeri, Kenya. A change assessment from 1948 to 2020 is conducted by aerial images, declassified satellite images, and recent data. Urban growth rates are 10 to 20-fold, while growth into flood exposed areas ranges from 3 to 100-fold. This study reveals unused opportunities for expanding existing land-use change analysis back to the 1940s in data-scarce environments.

Vulnerability to misinformation and Covid-19 infodemic in French-speaking Belgium (French version)

The main objective of this report is to test the hypothesis that the adoption of an active information-seeking practice related to the health crisis on social networks can be understood as a risk practice in the Covid-19 infodemic. A second objective is to identify the existence of different vulnerability profiles in the infodemic and to understand the information practices associated with these different profiles at risk of misinformation. The approach adopted is therefore firstly a comparative approach between different types of profile. It is not a question of carrying out a longitudinal study representative of the evolution of the French-speaking Belgian population's experience of the crisis. The CoviCom survey is a four-wave questionnaire survey that was conducted in French-speaking Belgium between 30 March 2020 (i.e. 12 days after the entry into force of the first containment in Belgium) and 29 March 2021. In total, the survey collected 10,148 responses to the four waves of the survey (April 2020 containment, May 2020 decontainment, November 2020 second wave epidemic and March 2021 third wave epidemic).

An update on travel and COVID-19: what the practice nurse needs to know

Lockdown and international travel restrictions are once again being eased in many countries, including the UK. However, travellers need to be aware that COVID-19 remains a worldwide risk. Practice nurses have a role to play in supporting UK travellers to make an informed choice about travelling abroad during this ongoing pandemic.

General anaesthesia related mortality in a limited resource settings region: a retrospective study in two teaching hospitals of Butembo

Background General anaesthesia (GA) in developing countries is still a high-risk practice, especially in Africa, accompanied with high morbidity and mortality. No study has yet been conducted in Butembo in the Democratic Republic of the Congo to determine the mortality related to GA practice. The main objective of this study was to assess mortality related to GA in Butembo. Methods This was a retrospective descriptive and analytic study of patients who underwent surgery under GA in the 2 main teaching hospitals of Butembo from January 2011 to December 2015. Data were collected from patients files, anaesthesia registries and were analysed with SPSS 26. Results From a total of 921 patients, 539 (58.5%) were male and 382 (41.5%) female patients. A total of 83 (9.0%) patients died representing an overall perioperative mortality rate of 90 per 1000. Out of the 83 deaths, 38 occurred within 24 h representing GA related mortality of 41 per 1000. There was a global drop in mortality from 2011 to 2015. The risk factors of death were: being a neonate or a senior adult, emergency operation, ASA physical status > 2 and a single deranged vital sign preoperatively, presenting any complication during GA, anaesthesia duration > 120 minutes as well as visceral surgeries/laparotomies. Ketamine was the most employed anaesthetic. Conclusion GA related mortality is very high in Butembo. Improved GA services and outcomes can be obtained by training more anaesthesia providers, proper patients monitoring, improved infrastructure, better equipment and drugs procurement and considering regional anaesthesia whenever possible.

General Anaesthesia Related Mortality in a Limited Resource Settings Region: A Retrospective Study in Two Teaching Hospitals of Butembo

Background: General anaesthesia (GA) in developing countries is still a high-risk practice, especially in Africa, accompanied with high morbidity and mortality. No study has yet been conducted in Butembo to determine the mortality related to GA practice. The main objective of this study was to assess mortality related to GA in Butembo. Methods: This study was a retrospective analytic study of patients who underwent surgery under GA in the 2 main teaching hospitals of Butembo from January 2011 to December 2015. Data were collected from patients file, anaesthesia registries and were analysed with SPSS 26. Results: From a total of 921patients, male and female patients were 539 (58.5%) 382 (41.5%) respectively. A total of 83 (9.0%) patients died. The overall perioperative mortality rate was 90 per 1,000. From the 83 deaths, 38 occurred within 24h representing GA related mortality of 41 per 1,000. There was a global drop in mortality from 2011 to 2015. The risk factors of death were neonate and senior adult age, emergency operation, ASA physical status more than 2 and single deranged vital sign preoperatively. The occurrence of any complication during GA increased the risk of death. Anaesthesia duration more than 120 minutes increased mortality as well as visceral surgeries/laparotomies. Ketamine was the most employed agent. Conclusion: GA related mortality is very high in Butembo. Improved GA services and outcomes can be obtained by training more anaesthesia providers, proper patients monitoring, enhanced the infrastructure, better equipment and drugs procurement.

Factors Influencing Weight Loss Practices in Italian Boxers: A Cluster Analysis

It is common practice in combat sports that athletes rapidly lose body weight before a match, by applying different practices—some safer and others possibly dangerous. The factors behind the choice of practices utilised have not been fully studied. This study aimed to investigate the weight loss strategies used by Italian boxers and to look at the difference between higher and lower risk practice adaptors. A modified version of a validated questionnaire has been sent to 164 amateur (88%) and professional (12%) boxers by email. A heatmap with hierarchical clustering was used to explore the presence of subgroups. Weight loss strategies were used by 88% of the athletes. Two clusters were found, defined by the severity of weight loss behaviours. Professional fighters, high-level athletes and females were more represented in Cluster 2, the one with more severe weight-loss practices. These athletes were characterised by a higher weight loss magnitude and frequency throughout the season and reported being more influenced by physicians and nutritionists, compared with the boxers in Cluster 1. Not all the weight loss practices are used with the same frequency by all boxers. The level of the athlete and the boxing style have an influence on the weight-cutting practices.

Evaluation of the clinical implementation of a large-scale online e-learning program on venous blood specimen collection guideline practices

Background: When performed erroneously, the venous blood specimen collection (VBSC) practice steps patient identification, test request management and test tube labeling are at high risk to jeopardize patient safety. VBSC educational programs with the intention to minimize risk of harm to patients are therefore needed. In this study, we evaluate the efficiency of a large-scale online e-learning program on personnel’s adherence to VBSC practices and their experience of the e-learning program. Methods: An interprofessional team transformed an implemented traditional VBSC education program to an online e-learning program developed to stimulate reflection with focus on the high-risk practice steps. We used questionnaires to evaluate the effect of the e-learning program on personnel’s self-reported adherence to VBSC practices compared to questionnaire surveys before and after introduction of the traditional education program. We used content analysis to evaluate the participants free text experience of the VBSC e-learning program. Results: Adherence to the VBSC guideline high-risk practice steps generally increased following the implementation of a traditional educational program followed by an e-learning program. We however found a negative trend over years regarding participation rates and the practice to always send/sign the request form following the introduction of an electronic request system. The participants were in general content with the VBSC e-learning program. Conclusions: Properly designed e-learning programs on VBSC practices supersedes traditional educational programs in usefulness and functionality. Inclusion of questionnaires in the e-learning program is necessary for follow-up of VBSC participant’s practices and educational program efficiency.