Adequate Equipment Research Articles

"Extreme sports" in patients with heart disease: an informative approach to patient counseling

The term "extreme sports" includes a range of sporting activities, predominantly individual, practised outdoors in a wild and non-competitive environment, which have in common the critical role of environmental variables, the importance of qualitative parameters in evaluating performance, the centrality of technological elements and the high perceived risk which, together with the spectacularity, attracts the attention of the media, favoring its popularity. Despite their diversity, these disciplines share specific risks and physiological and pathophysiological aspects. The average age of participants is generally higher than that of traditional and competitive sports, and the prevalence of male subjects implies a higher likelihood of cardiological evaluation whose path has yet to be codified like that of traditional sports. The risk of severe injuries in these sports is not higher than that of traditional sports and non-sporting activities. In contrast, the risk of cardiovascular events is documented only for some sports practised in the mountains, such as mountaineering, skiing and mountain biking, and it does not appear to be higher than that of equivalent physical activities performed at low altitudes. The diagnostic and prognostic criteria for cardiological counseling of enthusiasts are not defined. Environmental exposure to extremes of temperature, altitude, wind and humidity, and dehydration are typical characteristics of these activities, which should be addressed with adequate experience, preparation and equipment to minimize the potential impact on health. Finally, many of these activities are often conducted in "remote areas" compared to the possibility of emergency response, which should be considered in the risk assessment of an acute cardiovascular event. The definition of cardiovascular risk constitutes an open area of research to allow the practice of these sports to an increasing number of participants.

Quality improvement collaborative for improving patient care delivery in Argentine public health sector intensive care units

BackgroundThe demand for healthcare services during the COVID-19 pandemic was excessive for less-resourced settings, with intensive care units (ICUs) taking the heaviest toll.ObjectiveThe aim was to achieve adequate personal protective...

Computed Tomography Analysis of the Anterior Epitympanic Recess and Sinus Tympani Depths Among Filipino Adults at the De La Salle University Medical Center

Objective: To assess the depths of the anterior epitympanic recess (AER) and the sinus tympani (ST) among Filipino adults and to classify the AER and ST according to grade and type, respectively. Methods: Design:Retrospective Review of CT Scans Setting: Tertiary Private Teaching Hospital Participants:Scans of 182 non-pathologic ears from patients aged 18 and above with non-pathologic temporal bones (paranasal sinus, screening sinus, temporal bone, facial and cranial) with 0.62mm cuts seen from CT scans from January 01, 2010 to September 31, 2022 were analyzed. The depths of the AER and ST were measured separately and classified according to AER grade and ST type. Results: The mean depth of the AER (AER-D) was 3.64 mm (SD 1.17). No significant difference was seen between right and left ears. The AER grading of the anterior-posterior depth was found to be Grade 1 (<3mm) in 54 ears (29.7%), Grade 2 (3-5mm) in 106 ears (58.2%), and Grade 3 (>5mm) in 22 ears (12.1%). The mean depth of the sinus tympani (ST-D) was 3.30 mm (SD 0.80). Out of the 182 ears, 121 (66.5%) had Type A, 50 (27.5%) had Type B while 11 (6%) had Type C. Conclusion: Majority of the AER depths measured 3-5mm while most of the sinus tympani were Type A. These hidden recesses should be separately analyzed in preoperative planning for cholesteatoma surgery in order to prepare the adequate equipment to be used and approach towards these areas thereby reducing the risk for residual cholesteatomas and recurrence.

Scientific perspective on rukyatul hilal: A case study of assalam kartasura sukoharjo observatory

In essence, rukyat is looking deeply to see whether the moon has undergone changes to indicate the change of the moon or not. With the advancement of the times, observations no longer only use manual binoculars but are supported by various adequate equipment, making it very easy to carry out observations. . Therefore, it is important for humanity to understand what an observatory is and its uses. This research uses qualitative methods supported by documentation and direct field research at the Assalam observatory in Sukoharjo, Central Java. The results of this research are the contribution of the Assalam Observatory in the implementation of rukyatul hilal in Indonesia. The Assalam Observatory is also the Secretary General of JOPI (Indonesian Planetarium Observatory Network) so its involvement in rukyatul hilal is beyond doubt. So far, the results of observations at the Assalam observatory are at 7-8 degrees every month.

CHALLENGES ENCOUNTERED BY THE POLICE OFFICERS IN CRIME PREVENTION IN TABUK CITY, KALINGA

This study generally determined the challenges encountered by police officers in crime prevention in Tabuk City, Kalinga. The study specifically aimed to determine the specific challenges faced by police officers in effectively preventing crime regarding personal, family, and community relations and resources. Additionally, it sought to investigate the coping mechanisms of police officers to manage the challenges associated with their role in crime prevention. The study used a qualitative-narrative research design, and an interview guide was used to collect the data. The researcher used purposive sampling to select seven participants based on the specific characteristics or criteria relevant to the research questions. Through the use of inductive thematic analysis to analyze the qualitative data, the result revealed that police officers had encountered challenges during the implementation of crime prevention. It includes the impact of duty and personal relationships, threats and attacks, and cultural sensitivity and diversity regarding personal obstacles. Lack of time, high risk and stress, role modeling, and guidance regarding family challenges. Maximum tolerance, community engagement, concealment of criminals, and wrong perception regarding community challenges. Resource challenges require more funds and adequate equipment and vehicles. However, through proactive coping mechanisms, police officers attempted to overcome these obstacles. It concluded that the difficulties encountered by police officers in effectively preventing crime were complex and multifaceted, and they required a holistic approach that prioritized officers' well-being and could better fulfill their mission of promoting public safety. KEYWORDS: Problem encountered, coping mechanism, personal and family challenges, community and resources challenges, police officers

Perceptions of Pre-Service Technical Teachers on the Teaching and Learning Activities in Teacher Instructor Colleges of Uganda

Understanding perceptions about the teaching and learning activities has implications on the way teacher training programs can be improved and influences trainers’ motivation. The aim of the study was to examine pre-service technical teachers’ perceptions of the teaching and learning activities in teacher-instructor colleges in Uganda. The following research questions guided the study; “Is the time allocated for the teaching and learning activities adequate; how is the tutoring conducted; are the pre-service teachers satisfied with the assignments given; do the pre-service teachers trust the teaching and learning process and are the pre-service teachers satisfied with the equipment and materials used for training? The study adopted across sectional survey design. Data was collected from 168 pre-service technical teachers using a researcher-constructed questionnaire. The data gathered was analysed using SPSS and presented as descriptive statistics. The findings revealed that time for teaching and learning; tutoring (organization of training), and assignments given were adequate; pre-service technical teachers trusted the teaching and learning process; however, they observed that the equipment and materials were inadequate for training. It was therefore recommended that the government increase the budget for technical teacher instructor institutions; lobbying for funds through; private partnerships, companies, international donor agencies, tax rebates, fellowships, and research grants to purchase adequate training equipment and engage policy makers to create mechanisms for responding to constant technology advancement for technical teacher instructor training institutions to cope

Influence of Clinician-Related Factors on Adherence to the American Heart Association Guidelines for Acute Coronary Syndrome among Clinicians at Kenya Ports Authority Clinics in Mombasa, Kenya

Purpose: The aim of the study was to assess influence of clinician-related factors on adherence to the American heart association guidelines for acute coronary syndrome among clinicians at Kenya Ports Authority clinics in Mombasa, Kenya. Methodology: A descriptive cross-sectional study involving quantitative methods of data collection was adopted. An interviewer administered questionnaire was used for data collection. The study was carried out in Kenya Ports Authority clinics in Mombasa, Kenya. The target population was 106 clinicians attending to patients who present with Acute Coronary Syndrome at the KPA clinics in Mombasa. A census method was used to determine the study participants. The sample size was made up of a hundred and six participants. The clinicians who consented to participate in the study were included while those who were on sick off, leave or who recently joined the clinic were excluded. Pretesting of the study tool was done at the Kenya Pipeline Clinic Mombasa. Data analysis was done using Statistical Package for Social Sciences version 25 and presented via tables. Findings: The study results showed that at 95% level of confidence (ρ-value = 0.05%), there was a significant association between gender (ᾳ=0.025), work experience (ᾳ=0.016), job cadre (ᾳ=0.014) and training received (ᾳ=0.022) on adherence to the American Heart Association Guidelines for Acute Coronary Syndrome among clinicians at Kenya Ports Authority clinics in Mombasa, Kenya. The association was insignificant between age (ᾳ=0.178), education level (ᾳ=0.439) and specialization (ᾳ=0.489) on adherence to the AHA guidelines. Unique Contribution to Theory, Practice and Policy: The study recommends that the KPA management should increase the medical budget to ensure availability of adequate resources for ACS patient management. These resources include adequate staffing, medication, equipment, and staff training costs. The clinic management should ensure that medications such as aspirin, morphine and nitroglycerine are readily available and accessible at patients care points. The KPA clinic management to formulate a simple algorithm that outlines the steps to be taken when managing ACS patients. The study recommends that the clinics should assess their equipment reqularly for maintenance controls to ensure efficiency. The study further recommends random assessments and post care audits to assess the adherence to ACS guidelines among clinicians. Training associated with adherence to the AHA guidelines and as such, KPA should continue offering training and education on the latest AHA guidelines for ACS to ensure updated guidelines for practice.

Chemotherapy safe handling practices in Ethiopia: A comprehensive multi-center evaluation.

The increasing incidence of cancer and capacity for cancer care in Ethiopia has led to an upsurge in chemotherapy use in the country; however, studies indicate that there is a gap in the safe handling of chemotherapy by healthcare workers. There exists a need to understand if such unsafe practices occur in Ethiopia and, if so, which areas along the chemotherapy life cycle need the most improvement. This study utilized a multi-method design through an online survey administered to health care professionals and evaluative site visits of eight cancer units in Addis Ababa, Ethiopia to understand the current conditions of chemotherapy handling. In addition, a survey was conducted among Ethiopian health care professionals from across the country. Fifty-five percent of survey participants disagreed or strongly disagreed that there are systems in place to identify, prevent, and address chemotherapy hazards in their workplace, and 71% of respondents denied having an active and effective health and safety committee and/or worker health and safety representative where they work. At evaluative site visits, only 30% of health care workers met the minimum guidelines for proper hand hygiene, and 20% of health care workers used adequate Personal Protective Equipment according to guidelines across the chemotherapy lifecycle. Results of this study indicate an urgent need for implementation of evidence-based interventions to improve chemotherapy handling in Ethiopia so that all patients and health care workers are protected from the hazardous toxicities of these drugs.

Medical Events Encountered at a Major International Airport and Health Services Provided.

INTRODUCTION: Travel by airline starts and ends at airports. Thousands of people consisting of passengers, relatives of passengers, and employees gather at airports every day. In this study, medical events (MEs) encountered at Istanbul Atatürk Airport (IAA) and health services provided were analyzed.METHODS: The MEs encountered in IAA between January 1, 2016, and December 31, 2018, and health services provided by the private medical clinic in the airport terminal building were retrospectively analyzed.RESULTS: During the study period, 192,500,930 passengers traveled from the IAA and a total of 11,799 patients were seen at the clinic. There were 4898 (41.5%) male patients. The median age of the 9466 (80.2%) patients whose age was recorded was 34 (28-51) yr. Of 11,799 patients included in the present study, 9228 (78.21%) patients had medical complaints, 1122 (9.5%) patients had trauma complaints, 1180 patients (10%) were transferred to the hospital, and 269 (2.27%) patients required a certificate of preflight fitness. The most common medical complaint was gastrointestinal (1515 patients, 12.84%). The most common trauma was soft tissue injury (345 patients, 2.92%).DISCUSSION: MEs in airports can be as various and also critical as health conditions seen in emergency departments. It is important to provide medical services with an experienced medical team trained in aviation medicine and adequate medical equipment at airports.Ceyhan MA, Demir GG, Cömertpay E, Yıldırımer Y, Kurt NG. Medical events encountered at a major international airport and health services provided. Aerosp Med Hum Perform. 2024; 95(5):259-264.

Physical survey on the health hazards of welding activities on welding operators in Uyo, Nigeria

Background: Welding operators are subjected to several forms of hazards during welding activities. Aim: The study aimed to identify the common practices in welding operations, assess the potential health hazards associated with these practices, and propose recommendations for improving the well-being of welding operators. Methodology: The survey was conducted at different welding workshops in Uyo, Akwa Ibom State, Nigeria. A total of 100 welding operators were observed and interviewed to gather data on their working practices and the health effects they experienced. Results: The findings revealed that the most common welding practices included manual metal arc welding, gas metal arc welding, and gas tungsten arc welding. These practices involved exposure to various hazards such as fumes, gases, noise, and ultraviolet radiation. The survey also found that a significant number of welding operators reported experiencing health issues such as respiratory problems, skin irritation, eye injuries, and hearing loss. These health effects were attributed to the lack of proper ventilation, inadequate personal protective equipment, and poor ergonomic practices in the welding workshops. Conclusion: The findings of this study highlights the importance of addressing the health hazards associated with welding operations to ensure a safer and healthier work environment for improved work conditions and well-being of welding operators. In light of the findings, several recommendations including the implementation of proper ventilation systems, provision of adequate personal protective equipment, regular health screening for welding operators, and training programs on safe welding practices is proposed in order to improve the well-being of welding operators

Shaping The Way to Teach? Exploring the Adoption of Digital Multimodal Texts As Instructional Tools in EFL Teaching Practicum

This research scrutinizes a case study conducted with 15 pre-service English as a Foreign Language (EFL) teachers in a microteaching class at the English Education Department at UIN Walisongo Semarang. The purpose of the study was to examine the forms, implementation, and reflection of digital multimodal instructional media utilized by pre-service teachers. Observations of classrooms and document analysis were employed to acquire data. Pre-service EFL teachers employ digital multimodal instructional media, including PowerPoint presentations, films, and songs, to enhance English language learning. These tools integrate text, images, video, and audio elements to teach language structures, vocabulary, and emotions effectively. Student portfolios showcase diverse educational strategies across different grade levels, using videos, songs, and PowerPoint presentations to engage students and reinforce language skills. Educator reflections underline the significance of digital multimodal media in simplifying complex topics, improving comprehension, and fostering a holistic learning experience. They also stress the importance of adequate equipment and resources for successful multimedia implementation, affirming the value of multimodal approaches in providing impactful and engaging English language education. The study highlights the potential for these digital tools to provide an engaging and interactive learning environment for EFL students. It is recommended that more research investigate ways for optimizing the use of digital multimodal media in diverse EFL teaching scenarios.

Năng lực thực hành chăm sóc của điều dưỡng tại các cơ sở y tế công lập tỉnh Bắc Giang năm 2023 và một số yếu tố liên quan

Clinical nursing care practice is a crucial role in ensuring quality care for patients and contiuously quality improving for healthcare services. Objectives: this study aims to describe the status of clinical nursing care practice and analyse some associated factors among nurses in healthcare facilities in Bac Giang province in 2023. Method: A cross-sectional study was employed among nurses at the clinical departments in 10 healthcare facilities in Bac Giang provinces (including 01 provincial general hospital and 09 districal healthcare centres). A total of 700 nurses were selected in this study. Results: The main findings showed that the clinical nursing care practice reached at 70.9% in general. In which, the proportion of nurses had achieved the standard 6 “Performing clinical care techniques according to the procedures" at the highest rate (90.3%) and the standard 11 "Communicating effectively with patients and their families" at the lowest rate (73.7%). The average score for clinical care practice among nurses ranged from 4.0 to 4.2. The results indicated that participating in training, job satisfaction and satisfaction with the equipment had a significant association with the clincal nursing care practice (p<0.05). Conclusions: Strengthening training and regularly ensuring a working environment with adequate equipment and ensuring job satisfaction is a necessary factor to contribute for improving the clincal nursing care practice at public healthcare facilities in Bac Giang province. Keywords: Nurses, competencies, clincal nursing care practice, health workforce, Vietnam.

Conductas de riesgo asociadas al manejo de plaguicidas químicos por parte de agricultores del norte de Sinaloa, México

The predominant agriculture in the state of Sinaloa is conventional agriculture, which implies intensive use of pesticides and exposure of many farmers to harmful chemicals. Therefore, the objective of this study was to identify those risk behaviors in farmers from northern Sinaloa, Mexico when handling pesticides. Surveys were conducted with farmers from the populations located in Irrigation District 075, including 40 questions related to occupational health and personal hygiene practices. Results show that the majority of farmers (86%) know the health risks to which they are exposed by inadequate handling of pesticides. However, due to economic constraints and lack of knowledge and inspection by authorities, they do not use adequate personal protective equipment and their hygiene practices are inadequate. Consequently, it is essential to develop strategic plans to reduce the risk of intoxication by agrochemicals in rural communities, considering their direct impact on the environment.

La boîte à outils de l’urétéroscopie ou « ce qu’il faut emporter sur une île déserte »

Flexible ureteroscopy is now widely used as the preferred option to surgically treat a urinary stone, due to several technological advancements. Thus, choosing the adequate equipment is challenging, but respect safety concepts. Indeed, placing the safety wire (nitinol, 0,035’’, « stiff ») under rigid cystoscopy is not mandatory but improve safety. Regarding ureteral access sheath (UAS), considerations are similar : UAS facilitates vision, pressure and temperature control but can also be responsible of ureteral injuries at insertion. Suction devices are now undervaluation and could not be discussed. To limit the barotrauma risk, irrigation devices with manual pumps should be used (40cmH20). Choosing a flexible ureteroscope (fURS) is challenging; a special attention has to be given to size, deflexion, working channel position and vision. Thus, using a single fURS is hardly imaginable. Both Holmium:Yttrium-Aluminium-Garnet(Ho:YAG) et Thulium Fiber (TFL) lasers are recommended to treat urinary stones during fURS, with a potential advantage of TFL on thin pulverization. A wide variety of baskets exists and size and shape have to be considered before acquisition. Finally, if ureteral stenting is not mandatory in uncomplicated cases, silicone stents present a lower risk of encrustation and stent-related symptoms compared to polyurethane ones.

Hospital Capital Assets, Community Health, and the Utilization and Cost of Inpatient Care: A Population-Based Study of US Counties.

The provision of high-quality hospital care requires adequate space, buildings, and equipment, although redundant infrastructure could also drive service overprovision. To explore the distribution of physical hospital resources-that is, capital assets-in the United States; its correlation with indicators of community health and nonhealth factors; and the association between hospital capital density and regional hospital utilization and costs. We created a dataset of n=1733 US counties by analyzing the 2019 Medicare Cost Reports; 2019 State Inpatient Database Community Inpatient Statistics; 2020-2021 Area Health Resource File; 2016-2020 American Community Survey; 2022 PLACES; and 2019 CDC WONDER. We first calculated aggregate hospital capital assets and investment at the county level. Next, we examined the correlation between community's medical need (eg, chronic disease prevalence), ability to pay (eg, insurance), and supply factors with 4 metrics of capital availability. Finally, we examined the association between capital assets and hospital utilization/costs, adjusted for confounders. Counties with older and sicker populations generally had less aggregate hospital capital per capita, per hospital day, and per hospital discharge, while counties with higher income or insurance coverage had more hospital capital. In linear regressions controlling for medical need and ability to pay, capital assets were associated with greater hospital utilization and costs, for example, an additional $1000 in capital assets per capita was associated with 73 additional discharges per 100,000 population (95% CI: 45-102) and $19 in spending per bed day (95% CI: 12-26). The level of investment in hospitals is linked to community wealth but not population health needs, and may drive use and costs.

Bridging the gap: understanding Belgian anesthesiologists’ proficiency and training demands in gastric point-of-care ultrasound, a case-based survey

BackgroundPulmonary aspiration syndrome remains a significant complication of general anesthesia, particularly in unfasted patients. Gastric point-of-care ultrasound (POCUS) allows for both qualitative and quantitative assessment of gastric content, providing a safe and reliable method to assess gastric emptying and reduce the risk of aspiration during general anesthesia.MethodsThe survey was distributed to Belgian certified anesthesiologists and trainees between April 2020 and June 2021. Participants received a simulated clinical case of a patient at risk of gastric aspiration, created and approved by two certified anesthesiologists trained to perform gastric POCUS. The objectives of this study were to assess recognition of high-risk clinical situations for gastric aspiration, awareness of the gastric POCUS and its indications, and knowledge of the technical and practical conditions of the procedure among respondents trained in the technique. Furthermore, the study assessed the state of training in gastric POCUS, the desire for education, and the practical availability of ultrasound equipment. The survey used conditional branching to ensure unbiased responses to POCUS-related questions. It included multiple-choice questions, quantitative variables, and 5-point Likert scales. The margin of error was calculated using Daniel’s formula, corrected for a finite population.ResultsThe survey was conducted among 323 anesthesiologists. Only 20.8% (27) recognized the risk of a full stomach based on the patient’s history. Anesthesiologists who recognized the indication for gastric POCUS and were trained in the procedure demonstrated good recall of the practical conditions for performing the procedure and interpreting the results. Only 13.08% (31) of all respondents had received training in gastric POCUS, while 72.57% (172) expressed interest in future training. Furthermore, 80.17% (190) of participants had access to adequate ultrasound equipment and 78.90% (187) supported teaching gastric POCUS to anesthesia trainees.ConclusionsThis survey offers insight into the epidemiology, clinical recognition, knowledge, and utilization of gastric POCUS among Belgian anesthesia professionals. The results emphasize the significance of proper equipment and training to ensure the safe and effective implementation of gastric POCUS in anesthesia practice. Additional efforts should focus on improving training and promoting the integration of gastric POCUS into daily clinical practice.

Impact of a Harmonious Sports Environment on Learning Interest

The study delves into the impact of sports equipment and facilities on students' learning interests within educational environments, with a particular focus on the positive influence observed among physical education (P.E) students. Through a qualitative approach employing the library method, the research explores this influence by dissecting existing literature on related topics, including cooperative learning efficiency in physical education and the motivational dynamics of student-athletes. The findings underscore the vital role played by a harmonious sports environment, marked by sufficient sports equipment and facilities, in fostering physical education, personality development, and lifelong engagement in sports activities. Notably, students with access to such facilities exhibit heightened participation in physical activities, correlating with improved academic performance and enhanced psychological well-being. The study highlights the pivotal role of a supportive sports environment in shaping students' learning interests, boosting academic achievements, and promoting psychological wellness within educational settings. It stresses the necessity of ensuring adequate sports equipment and facilities, coupled with the cultivation of a positive sports culture, to effectively nurture physical education, foster personal growth, and encourage sustained participation in sports activities. Furthermore, the research acknowledges and addresses socioeconomic disparities in sports participation, shedding light on the escalating income inequalities over time, especially among specific demographic groups such as women, middle and high school students, and adults. Moreover, it underscores the potential of group sport participation to mitigate such disparities compared to individual sports, suggesting avenues for fostering more inclusive sporting environments.

The availability, access, challenges and advancements in neurosurgical care in Africa: a mini review.

The availability and accessibility of neurosurgical care across Africa remains limited despite recent advancements. Overall, Africa accounts for 15% of the global neurosurgical disease burden but has access to less than 1% of neurosurgeons globally. While the number of neurosurgeons has increased in recent decades, huge workforce shortages remain, with the region facing the second-largest neurosurgical deficit. Access to adequate facilities and equipment is also lacking. Barriers like poverty, conflicts, and distance from care centres negatively impact patients' ability to access services. However, training programs like the World Federation of Neurosurgical Societies Rabat Training Center have contributed to building local capacity. Use of technologies like neuro-endoscopy is expanding access to more cost-effective interventions for conditions such as hydrocephalus. Undergraduate medical education is also seeing a rise in African students interested in neurosurgery. Despite these advancements, workforce shortfalls, inadequate infrastructure, and challenges posed by geopolitical instability continue to hinder the provision of comprehensive neurosurgical care. Limited research and funding discourage experienced surgeons from practicing in their home countries. Increased international collaboration, support for education, and tackling of structural issues are needed to continue strengthening Africa's neurosurgical capacity and reducing the disease burden. This narrative review aims to provide an overview of the current state of neurosurgery on the continent, highlight achievements, and identify persisting challenges.

Epidemiology of Spinal Trauma and Related Complication.

Traumatic spinal injury is leading cause of mortality and morbidity among the people of productive age group. This study aim to find the cause of spinal injury, site ,and mode of injury, treatment option given so that a preventive measures and create awareness among people of this region. This is a prospective observation study done in Karnali Academy of Health Sciences from December 2021 to January 2023. Performa was filled to collect data. Data were entered in excel sheet and transported to SPSS 16.0 and statistical analysis was done . Out of 117 patients male population had higher incidence of spinal trauma (69.2%) with average age 43.9 years . Fall injury was the commonest mode of injury. 65.8% had injury at the thoracolumbar junction followed by lumbar, thoracic and cervical respectively. Cervical injury patients had higher incidence of neurological deficit. The average duration of trauma to hospital presentation was 10.9±11.2 hours. 19.7 % were operated and 6.8 % of patients were referred to other center. Fall injury being the commonest mode of injury in this art of world, prevention and awareness should be raised about the spinal trauma and its consequences. Adequate equipment with health facilities to the distant hospital may reduce the referral rate and duration of presentation to the hospital which ultimately prevent the further damage to the cord.

Motivación inadecuada de las disposiciones fiscales en el delito de acceso ilícito en Perú

The research work entitled improper motivation inadequate of prosecutors provisions in the crime of illicit access in Peru. Its objective was to analyze the situation of the motivation undue of prosecutors provisions in the crime of illicit access in the Corporate Prosecutor's Office Specialized in Cybercrime of the Center Lima Fiscal District, 2022; in the methodological aspect, in the study carried out the qualitative approach was used, the research method of the case study and phenomenological was applied, the used the basic type in the research and having like design grounded theory; in the same way, the interview was carried out with six participants, who are six trial lawyers from the Center Lima Fiscal District, to later suggest recommendations, in order to provide solutions to the problem raised; be have used the interview as a technique reflected in the interview guide instrument. According to the result obtained, it was demonstrated that the professional inefficiency of the prosecutor, the lack of adequate equipment, are causes that generate the motivation inadequate of the prosecutor provisions in the crime of illicit access in Peru; this inadequate motivation originate also non-compliance with the law; in addition; an emerging subcategory was found, which is the professional profile.