Fever Outpatient Service of General Hospital Applies “1 + 3 + 3” Emergency Management Mode to Deal with COVID-19 Pandemic

Purpose: To discuss the effect of “1 + 3 + 3” emergency management mode to deal with COVID-19 pandemic in fever outpatient service of general hospitals. Method: This paper analyzes and summarizes the problems encountered by fever outpatient service in dealing with the COVID-19 pandemic from three aspects of “One Team”, “Three-Key” Control and “Three Mosts”. Results: The application of “1 + 3 + 3” emergency management mode can effectively boost the orderliness and efficiency of fever outpatient service in dealing with COVID-19 pandemic. Conclusion: The “1 + 3 + 3” emergency management mode provides a new management mode and idea for dealing with COVID-19 pandemic, so the fever outpatient service of general hospitals can better improve the national overall anti-pandemic situation.

An Audit of the Emergency Airway Service in a Regional Hospital in Singapore

Background: Emergency endotracheal intubations (EEI) performed outside of operating theatre (OT) tend to be more challenging and associated with higher risk of complications. In 2011, with the objective of improving patient outcomes, we set up an Emergency Airway Service (EAS) at our 1000-bed regional hospital, with the aim of providing specialized assistance for outside of OT difficult airway management. Method: A retrospective audit of EAS activation from 12/9/2016 and 27/10/2020 was conducted. EAS forms and electronic medical records were reviewed. We collected information on patient characteristics, EAS activation characteristics and its outcomes. Descriptive analysis method was used to present the collected data. Results: There were a total of 275 activations, of which 268 were analysed. Reasons for activation were anticipated difficult intubation (42.2% n = 113), failed intubation attempt (52.6%, n = 141) and advanced intubation equipment required (5.2% n = 14). Intubation was attempted in 261/268 (97.4%) cases by the EAS team. Of these, 255 (97.7%) cases were successful while 6 (2.3%) cases failed intubation. Of the successful intubations by the EAS team, 208/255 (81.5%) were successful on the first attempt. Out of the 6 unsuccessful intubation cases, 1 case required a rescue cricothyroidotomy and 4 cases required an open tracheostomy. Intubation was deemed easy by the EAS team in 170/261 (65.1%) cases. 64/170 (37.6%) cases were intubated with a video laryngoscope (VL). There were 85 cases (32.3%) classified as difficult intubation by the EAS specialist, 13/85 (15.3%) were intubated using only VL, 54/85 (63.5%) cases were intubated using VL with style/bougie. Conclusion: Audit results showed that providing an experienced and well-equipped team of airway specialists round-the-clock to assist in difficult and potentially difficult endotracheal intubations is justifiable and may reduce complications associated with EEI.

Intelligent emergency service system based on wireless sensor and actuator networks

An intelligent emergency service（ IES） system is designed for indoor environments based on a wireless sensor and actuator network（ WSAN） composed of a gateway, sensor nodes, and a multi-robot system（ MRS）. If the MRS receives accident alarm information, the group of robots will navigate to the accident sites and provide corresponding emergency services.According to the characteristics of the MRS, a distributed consensus formation protocol is designed, which can assure that the multiple robots arrive at the accident site in a specified formation. The prototype emergency service system was designed and implemented, and some relevant simulations and experiments were carried out. The results showthat the MRS can successfully provide emergency lighting and failure node replacement services when accidents happen. The effectiveness of the algorithm and the feasibility of the system are verified.

Acute intoxication cases admitted to the emergency department of a university hospital

BACKGROUND: This study aimed to describe the clinical and socio-demographic aspects of acute poisoning in 2010 in Duzce City, Northwest Anatolian Region of Turkey.METHODS: Acute poisoning was due to the intentional ingestion of drugs in young and adult people(≥16), who were treated at the Emergency Service of Duzce University Medical Hospital, Turkey from January 1, 2010 to December 31, 2010. In this retrospective and descriptive study, 95 patients were diagnosed with intoxications and 30 of them intentionally ingested drugs to commit suicide. Records of the patients diagnosed with intoxication were obtained from the Clinical Archive of the hospital. Their diagnoses were established according to the International Statistical Classification of Diseases and Related Health Problems. Codes X60-X84 of this classification were used to classify self-infringed drug injuries and drug poisoning.RESULTS: In this series, 35(36.8%) patients were male and 60 patients(63.2%) female. The male/female ratio was 1.0/1.7. The mean age of the patients was 33.1±14.2 years; 17(17.9%) patients were below 20 years old and 9(9.5%) were older than 50 years. Of these patients, 29(30.5%) were single, 7(7.4%) divorced or separated, and 59(62.1%) married. Their mean time for admission to the emergency service after the incident was 208±180(15–660) minutes. The mean time for admission to the emergency service for patients with food intoxication after the incident was 142±160 minutes, for those with drug intoxication 173±161 minutes, for those with carbon monoxide(CO) intoxication 315±209 minutes, and for those with undefined intoxication 289±166 minutes(P=0.005). Most of the intoxication cases occurred in winter(41.1%, 39 of 95 patients). Admissions to the emergency service were most common in December and April(21 and 16 of 95 patients, respectively). Sixty-five(68.4%) cases were involved in non-deliberate poisoning, whereas 30(31.6%) were involved in deliberate poisoning. Twenty-six of the 95 patients with acute poisonings had mortality risk at admission, however only one died from CO intoxication in the emergency service(1.1%). Suicide attempts were more common in females than in males(21 of 30 patients, 70%, P<0.05). CONCLUSION: In Duzce City of Turkey, most intoxication cases occurred in winter, especially in December. They had non-deliberate poisoning, but deliberate poisoning in suicide attempts was more common in females than in males.

Prototype for Integrating Internet of Things and Emergency Service in an IP Multimedia Subsystem for Wireless Body Area Networks

In recent years, the application of the Internet of Things （IoT） has become an emerging business. The most important concept of next-generation network for providing a common global IT platform is combining seamless networks and networked things, objects or sensors. Also, wireless body area networks （WBANs） are becoming mature with the widespread usage of the IoT. In order to support WBAN, the platform, scenario and emergency service are necessary due to the sensors in WBAN being related to wearer＆#39;s life. The sensors on the body detect a lot of information about bioinformatics and medical signals, such as heartbeat and blood. Thus, the integration of IoT and network communication in daily life is important. However, there is not only a lack of common fabric for integrating IoT with current Internet and but also no emergency call process in the current network communication envi-ronment. To overcome such situations, the prototype of integrating IoT and emergency call process is discussed. A simulated boot-strap platform to provide the discussion of open challenges and solutions for deploying IoT in Internet and the emergency commu-nication system are analyzed by using a service of 3GPP IP multimedia subsystem. Finally, the prototype for supporting WBAN with emergence service is also addressed and the performance results are useful to service providers and network operators that they can estimate their migration to IoT by referring to this experience and experiment results. Furthermore, the queuing model used to achieve the performance of emergency service in IMS and the delay time of the proposed model is analyzed.

Nursing emergency management practice of COVID-19 in a traditional Chinese medicine hospital

Nursing work is an integral part of hospital work.Under the challenge of the COVID-19 epidemic,it is particularly important to establish a timely and efficient nursing management system.The nursing department of our hospital used the theory and method of feedforward control to formulate the emergency plan for epidemic prevention and control and to conduct drills.The plan includes the establishment of the emergency management system for epidemic nursing and key prevention and control positions,rational allocation of human resources,and strengthening personnel training,so as to ensure the efficient operation of nursing epidemic prevention and control work and provide a reference for nursing management mode during the epidemic.

Neonatal Death Rates: Lack of Equal Access to Hospital Obstetric Service and Intensive Therapy

Aim: To identify the association between access to obstetric and neonatal hospital service and neonatal death rates. Method: Quantitative and retrospective research retrieved from Declaration of Live Newly-born Children;Declaration of Death;Investigation Chart on Municipal Child Mortality, between 2000 and 2009, at the Nucleus of Information on Mortality Rates. The population studied comprised 537 neonatal deaths and mothers with residence in the municipality, and investigated by the work team of the Committee for the Investigation of Mother-Child Deaths. Data were analyzed in Epi Info 2002? computer program and the Statistical Package for the Social Sciences? was used. Chi-square Test and Fischer’s Exact Test were applied at p < 0.05. Results: 63.7% of 537 neonates were born in hospitals with maternities and neonatal intensive therapy unit;60.7% weighed ≤1.500 grams;76.7% had a pregnancy age of ≤36 weeks;73% died of asphyxia in the 1st minute and 73.5% died during the perinatal period. Throughout the ten years of analysis, access to hospital obstetric service without NITU reduced death rate from 25% in 2000 to 6.8% in 2009. There was a significant statistical association between place of delivery and maternal socio-demographic variables (maternal age bracket p = 0.028;schooling p = 0.000;family income p = 0.000);occupation p = 0.000) and neonatal variables (race/skin color p = 0.007;type of delivery p = 0.000;weight at birth p = 0.000;pregnancy age p = 0.000 and Apgar Score 1st minute p = 0.000 and Apgar Score 5th minute p = 0.007). Conclusion: Although the municipal government provides obstetric services and specialized neonatal care, this right is not extensive to all;gaps at different levels in mother-child care should be identified to reduce neonatal deaths.

Emergency service results of central venous catheters:Single center,1042 patients,10-year experience

BACKGROUND Central venous catheterization is currently an important procedure in critical care.Central catheterization has important advantages in many clinical situations.It can also lead to different complications such as infection,hemorrhage,and thrombosis.It is important to investigate critically ill patients undergoing catheterization.AIM To evaluate the characteristics,such as hospitalization,demographic characteristics,post-catheterization complications,and mortality relationships,of patients in whom a central venous catheter was placed in the emergency room.METHODS A total of 1042 patients over the age of 18 who presented to the emergency department between January 2005 and December 2015 were analyzed retrospectively.The patients were divided into three groups,jugular,subclavian,and femoral,according to the area where the catheter was inserted.Complications related to catheterization were determined as pneumothorax,guidewire problems,bleeding,catheter site infection,arterial intervention,and sepsis.Considering the treatment follow-up of the patients,three groups were formed as outpatient treatment,hospitalization,and death.RESULTS The mean age of the patients was 60.99±19.85 years;423(40.6%)of them were women.Hospitalization time was 11.89±16.38 d.There was a significant correlation between the inserted catheters with gender(P=0.009)and hospitalization time(P=0.040).Also,blood glucose,blood urea nitrogen,creatinine,and serum potassium values among the biochemical values of the patients who were catheterized were significant.A significant association was observed in the analysis of patients with complications that develop according to the catheter region(P=0.001)and the outcome stage(P=0.001).In receiver operating characteristic curve analysis of hospitalization time and mortality area under curve was 0.575,the 95%confidence interval was 0.496-0.653,the sensitivity was 71%,and the specificity was 89%(P=0.040).CONCLUSION Catheter location and length of stay are important risk factors for catheter-borne infections.Because the risk of infection was lower than other catheters,jugular catheters should be preferred at entry points,and preventive measures should be taken by monitoring patients closely to reduce hospitalization infections.

Perception of the Hospital Nutrition Service by Internal Clients: Example of the Results Obtained in the Area of Production of Pediatric Formulas and Enteral Diets

Aim: Client perception was important to indicate points requiring interventions or adjustments and to permit refinement of the services offered. This study aimed to determine the perception of internal clients regarding the quality of the service after integrating these items into the system of electronic prescription. Methods: We applied a questionnaire elaborated based on the SERVQUAL about the five dimensions of service quality (tangibility, reliability, responsiveness, safety, and empathy) with adaptation of the four-point Likert scale, ranging from “I fully disagree” to “I fully agree”. Results: The instrument was applied to 138 professionals, with a 56% return. Analysis revealed that the strong points were related to tangibility, safety and empathy, while the aspects related to reliability showed a lower score regarding time of delivery, occurrences and waste, and those related to responsiveness showed a lower score regarding service to be provided in a timely manner. The Cronbach Alpha Coefficient indicated that the investigation had a high degree of consistency and that the results could be considered reliable. Conclusion: Application of the adapted SERVQUAL questionnaire revealed that the perception of internal clients about the five quality dimensions after the changes made and provided valuable information for the scoring of aspects that still needed adjustment to improve interventions.

Assessment of Acute Poisoning Cases in Emergency Department of the Provincial General Reference Hospital in Bukavu, DR-Congo

Background: Acute intoxications result from intentionally or accidentally taking a relatively significant amount of a chemical substance which triggers disturbances in the level of psychophysiological functions, the complications of which may lead to mental disorders, physical causalities, and death. Any acute intoxication mostly requires emergency care. Objective: To highlight the prevalence, history, clinical features, emergency treatment, and prediction of acute intoxication cases referred to the emergency services at the Provincial General Reference Hospital in Bukavu, DR-Congo. Methods: A retrospective cross-sectional study was conducted from January 2021 to October 2022 based on an analysis of patients’ medical files. Triage was performed among all-type of patient files recorded in the computerized hospital database Ebale-Sante to sort cases of intoxication. Results: During the observational period, 3966 emergency admissions were counted, of which 321 (8.09%) patients were identified as having acute intoxication. Among these, 100 files that containing sufficient information fit the quality criteria for this study’s analysis. The victims were infants, adolescents and adults aged 1 - 45 years, and 52% were female and 48% were male. Most cases were accidental and, occurred at home, and the victims were driven to the hospital within 2 - 24 hours. The substances consumed included household products, drugs, and herbs. Resuscitation care, antidotes and supportive symptomatic medications ensured that 85% were healed and 10% experienced sequelae;however, 5% died. Conclusion: Acute intoxication occurs in infants mostly accidentally though the ingestion of household products and medicines. Furthermore, suicide cases may occur in traumatized adolescents and discordant couples. People should be informed about how to store hazardous products (e.g.: drugs, household products and pesticides), which should not be available to children, to avoid unintentional poisoning. Special training in clinical toxicology is required to reduce treatment failure.

Nurses’ Experiences in Service Provision a COVID-19 Dedicated Tertiary Public Hospital

Objectives: To assess the nurses’ experiences in service provision a COVID-19 dedicated tertiary public hospital. Materials and Methods: This descriptive cross-sectional study was conducted in one tertiary level public hospital namely Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from January to December 2021. Data were collected through face-to-face interview using a structured questionnaire containing demographic details and experiences faced by the nurses in service provision during COVID-19. Data was analysed by using SPSS (Statistical Package for Social Science) software version 23. Results: The findings revealed that the mean age of the respondents was 32.35 ± 7.248 years, the minimum age was 23 years and maximum age was 58 years. About half of the respondents 52.1% were in 21 - 30 years. The majorities 89% were female. More than half of the respondents 72.6% were Muslim and 63.83% of respondents have completed Diploma in nursing. About 32.2% respondents were living with senior citizen, 33% respondents were infected by COVID-19, 24.23% respondent mentioned nurse-Patient ratio in general ward was 1:7 and 71.08% mentioned nurse-patient ratio in I.C.U/C.C.U. was 1:3 (December 2021). PPE were available among 88.0% respondents and N95 mask were available among 84.0% respondent. About 34.8% respondents got COVID-19 guideline training and 32.4% got donning and doffing training. More than half of the respondents 76% stated that equipment is adequate, 56.38% respondents mention that insufficient of nurses and 53.7% were mentioned insufficient of subordinate staff. About 22.6% respondents faced social stigma and majorities 96.5% respondents mentioned they got proper family support. There was a significant association found between Professional educational qualification and satisfaction of current designation (p value = 0.001 Conclusion: The most important findings of this study was lack of training, insufficient of manpower especially nurses and subordinate staff, high nurse-patient ratio and fear about personal and family safety. The findings of the study will be helpful for the authority in planning for future course of action.

Analyses of Incidents of Institutional Food Service Practice Management for One Year in the Kitchen of a General Hospital, Chubu Region, Japan

This study aimed to assess the incidence of institutional food service practice management errors in the kitchen of a general hospital, Chubu region, Japan. Clarifying the cause of incidents of institutional food service operation can reduce institutional food service practice management errors. This is the first study to analyze incidents at a general hospital kitchen in Japan in English. Data were collected from incident reports over the course of one year, between October 1, 2011 and November 30, 2012. Forty two reports of incidents whose locations were the kitchen were analyzed, for example, incident dates, incident times, workloads, incident contents, incident causes, accident levels, and the presence or absence of negligence. The frequency of incidents for months, for each third of month, for day of week, for time of day, for workload levels of staff member, and for types of incidents were analyzed using chi-square test following Ryan multiple comparison. The incidents were more likely to occur at the start of the business year, during the 11：00 to 12：59 time blocks, and when staffs were busy. Breakdown of incident contents of＂foreign contamination （hair）＂ was 10 reports （24%）. To prevent incidents, new staff should also be trained to acquire skills to avoid making errors during food preparation, ensuring that there is a clear route for communicating changes in the number of hospitalized patients, and building a system that allows for changes to be made to the number of meals to be served and the content of those meals in an accurate and prompt fashion. Furthermore, work uniform should be changed promptly as such contamination can reportedly be improved by having workers wear a work cap.

The 55th anniversary of continuous service of the hospital

The First Affiliated Hospital of Zhejiang UniversitySchool of Medicine, Hangzhou, China was found-ed by the noted scientist Ke-Zhen Zhu in 1947 andNovember 2002 represents the 55th anniversary ofcontinuous service of the hospital. We mark the oc-casion with a brief introduction to the hospital. With 1638 staff members including over 300senior doctors and nurse specialists, the hospitalconsisting of 33 clinical, 23 technical departmentsand 1280 beds deals with around one million outpa-tients, 20 thousand inpatients and 12 thousand oper-ations per year. Located in the hospital are severalimportant national institutes such as Laboratory of In-fectious Diseases, Laboratory of Multi-Organ Trans-plantation, Center of Clinical Pharmacology in addi-

Acute Fevers in the Medical Unit of the Medical-Surgical Emergency Department of the Donka National Hospital

Introduction: Fever is a high core temperature ≥ 37.5°C in the morning and 37.8°C in the evening. It is acute when it evolves from 0 to 20 days. Very common in clinical practice, the etiological diagnosis, particularly in developing and tropical countries, is often a challenge for clinicians due to their diversity and the limited availability of diagnostic tools. There is a wide spectrum of etiological diagnoses including infectious causes and non-infectious causes. The aim of this study was to investigate the etiology of fevers acute at the medical unit in the medico-surgical emergency department of the Donka National Hospital. Methods: This was a descriptive cross-sectional study lasting 03 months (January 01, 2022 to March 31, 2022). We included in this study all patients seen in the medical unit, whose age ≥ 18 years, without distinction of sex, from any origin, with an axillary temperature ≥ 37.5°C in the morning and 37.8°C in the evening, evolving from 0 to 20 days, hospitalized or followed on an outpatient basis, and having given verbal consent. Results: Of a total of 1087 patients seen, 466 had an acute fever. The mean age was 40.04 ± 18.91 years (18 and 96 years). The female sex (58.15%) was predominant with a sex ratio of 0.72. Malaria (50.86%) was the main diagnosis. The treatment consisted of compressed paracetamol (59.01%), arthemether + lumefantrine (50.85%). Conclusion: The incidence of acute fevers is high in the medical unit of the medico-surgical emergency department of the Donka National Hospital. Malaria was the main pathology. Treatment was etiological and symptomatic. This high incidence could be explained by the fact that Guinea is an endemic malaria zone. A study taking into account other etiological factors would be of great interest.

Psychological Complaints at Psychological Emergency Service Associated with Referral to Extended Screening in a Psychology School Clinic

The Psychological Emergency Service(PES)at psychology school clinics is an unscheduled and free psychological service to meet urgent demands.From this service,some patients whose complaints require more time for clinical work are referred to the Extended Screening(ES),a modality composed of six extra appointments.This study aims to analyze the sociodemographic profile of patients seen on PES in a Brazilian Psychology School Clinic,and to identify the demands that motivated referral to the ES,for better qualification of the care offered.This is a descriptive analysis research,carried out based on data from the medical records of 46 patients who went through the PES and were referred to the ES at the institution,between the years 2019 and 2021.Sociodemographic data were collected and,from the session reports,a content analysis of the thematic analysis modality was performed to identify the complaints.The participants’age ranged from 18 to 65 years,with a mean of 32.28 years(sd=10.95).There was a predominance of female participants(71.74%),that completed High School(39.14%)and had an income from one to two Brazilian minimum wages(32.61%).The most frequent complaints were depressive symptoms(56.52%)and difficulties in interpersonal relationships(32.61%).The results obtained,besides allowing the survey of the social and demographic profile of the clientele of the PES at the Psychology School Clinic,and demonstrating its social relevance by providing free psychological care,also show to be of great importance for the definition of more accurate criteria for referral to the ES of patients seen on PES.

Obstetric Emergencies at the Kara University Hospital Maternity Ward: Sociodemographic, Etiological and Prognostic Aspects

Introduction: Obstetric emergencies are common throughout the world and more particularly in developing countries where they are responsible for high maternal-fetal mortality and morbidity. Objective: Study obstetric emergencies in the maternity ward of Kara University Hospital. Method: Retrospective and descriptive study from April 1, 2022 to March 30, 2023, carried out in the Obstetrics and Gynecology Department of Kara University Hospital. Results: Eight hundred and thirty-five (835) obstetric emergencies were recorded out of 2215 admissions, i.e. a frequency of 37.7%. The average age of the patients was 26.7 with a range of 14 and 45 years. They were primigravidas (36.7%) and nulliparous (38.7%), referred (84.7%) and came from rural areas (72%). Emergencies occurred in the 3rd trimester in 74.1% and in parturients (54.1%). Preeclampsia (27%), cessation of progression of labor due to feto-pelvic disproportion (12.4%), postpartum hemorrhage (7.5%) constituted the main obstetric emergencies. In 44.8%, the delivery was carried out vaginally. Magnesium sulfate was the most used drug, i.e. 30.1%;followed by antihypertensive medications in 28.1%. Blood transfusion was performed in 24.3%. The evolution was simple in 90.9%. The maternal fatality rate was 1.6%. The perinatal case fatality rate was 12.3%. Conclusion: Obstetric emergencies are common, dominated by preeclampsia, stopping progress of labor and postpartum hemorrhages. They are responsible for high morbidity and mortality.

Association between Ambient Air Pollution and Hospital Emergency Admissions for Respiratory and Cardiovascular Diseases in Beijing: a Time Series Study

Objective To investigate the association between ambient air pollution and hospital emergency admissions in Beijing. Methods In this study, a semi-parametric generalized additive model （GAM） was used to evaluate the specific influences of air pollutants （PM10, SO2, and NO2） on hospital emergency admissions with different lag structures from 2009 to 2011, the sex and age specific influences of air pollution and the modifying effect of seasons on air pollution to analyze the possible interaction. Results It was found that a 10μg/m3 increase in concentration of PMlo at lag 03 day, SO2 and NO2 at lag 0 day were associated with an increase of 0.88%, 0.76%, and 1.82% respectively in overall emergency admissions. A 10 lag/m3 increase in concentration of PM10, SO2 and NO2 at lag 5 day were associated with an increase of 1.39%, 1.56%, and 1.18% respectively in cardiovascular disease emergency admissions. For lag 02, a 10 μg/m3 increase in concentration of PM10, SO2 and NO2 were associated with 1.72%, 1.34%, and 2.57% increases respectively in respiratory disease emergency admissions. Conclusion This study further confirmed that short-term exposure to ambient air pollution was associated with increased risk of hospital emergency admissions in Beijing.

Availability and Quality of Emergency Obstetric Care, an Alternative Strategy to Reduce Maternal Mortality: Experience of Tongji Hospital, Wuhan, China

The burden of maternal mortality (MM) and morbidity is especially high in Asia.However,China has made significant progress in reducing MM over the past two decades,and hence maternal death rate has declined considerably in last decade,To analyze availability and quality of emergency obstetric care (EmOC) received by women at Tongji Hospital,Wuhan,China,this study retrospectively analyzed various pregnancy-related complications at the hospital from 2000 to 2009.Two baseline periods of equal length were used for the comparison of variables.A total of 11 223 obstetric complications leading to MM were identified on a total of 15 730 hospitalizations,either 71.35％ of all activities.No maternal death was recorded.Mean age of women was 29.31 years with a wide range of 14-52 years.About 96.26％ of women had higher levels of schooling,university degrees and above and received the education of secondary school or college.About 3.74％ received primary education at period two (P2) from 2005 to 2009,which was significantly higher than that of period one (P1) from 2000 to 2004 (P＜0.05) (OR:0.586; 95％ CI:0.442 to 0.776).About 65.69％ were employed as skilled or professional workers at P2,which was significantly higher than that of P1 (P＜0.05).About 34.31％ were unskilled workers at P2,which was significantly higher than that of P1 (P＜0.05).Caesarean section was performed for 9,930 women (88.48％) and the percentage of the procedure increased significantly from 19.25％ at P1 to 69.23％ at P2 (P＜0.05).We were led to conclude that,despite the progress,significant gaps in the performance of maternal health services between rural and urban areas remain.However,MM reduction can be achieved in China.Priorities must include,but not limited to the following:secondary healthcare development,health policy and management,strengthening primary healthcare services.

Evaluating patients' perception of service quality at hospitals in nine Chinese cities by use of the ServQual scale

Objective: To investigate patients' perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQ ual scale method was used in a survey involving patients at out-patient and in-patient facilities in Shanghai, Chongqing, Chengdu, Nanning, Guilin and Laibin of Guangxi, Honghezhou of Yunnan, Wulumuqi of Xinjiang and Zhongshan of Guangdong. The data collected were entered and analyzed using SPSS 20.0. Statistical analyses included descriptive statistics, factor analyses, reliability analyses, product-moment correlations, independent-sample t-tests, One-way ANOVA and regression analyses. Results: The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.979. The Cronbach's α for the reliability analysis was 0.978. All the Pearson correlation coei cients were positive and statistically signii cant. Visitors to out-patient facilities reported more positive perception tacilities on tangibles(t = 4.168, P(t = 1.979, P <han visitors to in-patient f 0.05). Patients of 60 years of age and above reported mor< 0.001) and reliability e positive perception th<an those between 40 and 49 on reliability(F = 3.311, P = 0.010), assurances(F = 2.751, P 0.05) and empathy(F = 4.009, P = 0.003). For the i ve dimensions of the scale, patients in Laibin, Guangxi reported the most positive perceived service quality, followed by patients in Shanghai. On the other hand, patients in Chongqing and Nanning and Guilin of Guangxi reported relatively poor perceptions of service quality. Standardized regression coei cients showed statistically significant(P < 0.001) positive values for all Serv Qual dimensions. Empathy(β = 0.267) and reliability(β uality. = 0.239) most strongly predicted perception of service qConclusions: Chinese patients perceived service quality as satisfactory. Hospitals in various regions of China should enhance their awareness and ability to serve their patients.

Infectious ENT Emergencies: A One-Year Experience at the ENT Department of Mamou Regional Hospital

Introduction: ENT infectious emergencies encompass all infectious pathologies affecting the ear, nose, sinuses, throat, and neck. A good understanding of these emergencies is essential for organizing appropriate care. In Guinea, few studies have described ENT infectious pathologies in rural areas. Objective: To study ENT infectious emergencies in the Otorhinolaryngology department of the Mamou Regional Hospital. Materials and Methods: This is a retrospective and prospective descriptive study, conducted from August 1, 2021, to July 31, 2022. All patients admitted to the ENT department of the Mamou Regional Hospital for an infectious emergency were included. Results: Among the 1854 recorded consultations, 261 cases involved ENT infectious emergencies, representing a prevalence of 14.07%. The most represented age group was 0 to 10 years (31.03%), with a majority of female patients (59%) and a predominantly urban origin (81.61%). Students accounted for 32.18% of the cases. The main reasons for consultation were odynophagia/dysphagia (32.42%) and otalgia (22.94%). The primary etiologies were tonsillitis (28.73%) and otitis (27.20%). Treatments administered included probabilistic antibiotic therapy (38.80%), analgesics (32.03%), and corticosteroid therapy (10.47%). The outcome was favorable in 98.85% of cases, with only 0.38% lost to follow-up. Conclusion: The results of our study confirm the frequency of ENT infectious pathologies. Their management requires joint actions for population awareness, staff training, and services equipment, particularly in rural areas.