District Unit Research Articles

Analysis of Economic Vitality and Development Equilibrium of China’s Three Major Urban Agglomerations Based on Nighttime Light Data

Eliminating poverty, reducing inequality, and achieving balanced development are one of the United Nations Sustainable Development Goals. Objectively and accurately measuring regional economic vitality and development equilibrium is a pressing scientific issue that needs to be addressed in order to achieve common prosperity. Nighttime light (NTL) remote sensing data have been proven to be a good proxy variable for socio-economic development, and are widely used due to their advantages of convenient access and wide spatial coverage. Based on multi-source data, this study constructs an Economic Development Index (EDI) that comprehensively reflects regional economic vitality from two aspects, economic quality and development potential, combines the Nighttime Light Development Index (NLDI) as the evaluation indicators to measure the economic vitality and development equilibrium, analyzes the economic vitality and development equilibrium of 300 district and county units in China’s three major urban agglomerations from 2000 to 2020 and their temporal and spatial variation characteristics, and discusses the connotation of EDI and its availability. The results show the following: (1) From 2000 to 2020, the average growth rate of EDI in China’s three major urban agglomerations reached 36.32%, while the average decrease rate of NLDI reached 38.75%; both economic vitality and the development equilibrium have been continuously enhanced. Among them, the Yangtze River Delta (YRD) urban agglomeration experienced the fastest economic growth, while the Guangdong–Hong Kong–Macao Greater Bay Area (GBA) exhibited the strongest economic strength. (2) Both economic vitality and the development equilibrium in these three urban agglomerations exhibited distinct spatial agglomeration characteristics, namely center-surrounding distribution, coastal–inland distribution, and radial belt–pole distribution, respectively. (3) Over the past two decades, the economic development of these three urban agglomerations has progressed towards the pattern of regional coordinated development, pole-driven development and urban–rural integrated development. The research results can provide new research perspectives and scientific support for promoting regional balanced development, achieving sustainable development goals, and reducing inequality.

Gerenciando riscos em salas de vacina: um estudo de segurança em Unidades Básicas de Saúde de Salvador, BA

Introduction: The risks in vaccination rooms imply not only damage to users, but also to vaccination coverage. Objective: to analyze structural conditions and factors that facilitate and hinder risk management in vaccine rooms. Methods: This cross-sectional study was conducted in the vaccination rooms of the Basic Health Units (UBS) of a health district in Salvador, BA. Data collection: form for interview with the responsible professional and on-site observation of these services. The following were analyzed: physical-structural conditions; care for the refrigeration chamber and thermal boxes; Nursing conduct; and training of professionals. Results: 91.3% vaccination rooms were studied. These services operate in exclusive spaces; immunobiologicals stored in refrigerated chambers. Vaccines are packaged and used according to the expiration date. Professional team: one nurse and two nursing technicians were present in 66.6% of the rooms; the hand hygiene practice of the professionals was 76.1%. Nursing team training was observed in 19%, annual training in 14.2%, and participation in scientific events in 19%. Of the 21 vaccine rooms, 5 (23.8%) had adequate risk management practices, 14 (66.6%) had risk management practices requiring adjustment, and 2 (9.6%) had inadequate risk management. Statistical correlation was identified between risk management practices and individual items from the categories analyzed to ratify the good practices in the vaccination room presented here. Conclusion: This study highlights inadequacies in vaccination rooms and the need to review work processes, as well as to incorporate systematic strategies for managing the numerous risks related to these services, to guarantee user safety.

Production and management practices and technologies used for growing potatoes and tomatoes

Purpose. The aim of this study was to assess production and management practices and technologies used by farmers for tomato and potato production, as well as their productivity. Methodology / approach. This research was conducted in Ziway-Dugda and Tiyo districts of Arsi Zone in Oromia National Regional State of Ethiopia during 2022 cropping season. Data were collected from 400 households in 10 kebeles (local administrative unit) of both districts using Kobo toolbox from respondents through face-to-face interview and descriptive analysis using SPSS version 22. Results. The results of the study showed that farmers in the study areas used different pre-harvest practices. These include cultivation tools and methods, planting locations, tomato staking, potato hilling and irrigation practices to successfully grow vegetables and increase land productivity by rotating different crops on their land. Various diseases, weeds and insects have been observed on their farms, which were managed by cultural, agronomic, mechanical and chemical management practices on tomato and potato farms during the last cropping years in the study districts. Thus, majority farmers in the study areas have used insecticides and fungicides on tomato and potato farms; but most of the weeds were removed by hand weeding. Most tomato and potato farmers have determined the type of chemical and its use from their own previous experience, in consultation with salespeople and extension agents in their regions. However, the study results showed that there are unused production and management practices for tomato and potato cultivation by some farmers. There are many production and management practices and technologies used by farmers to improve vegetable productivity in the study areas, although some farmers did not adopt improved production and management technologies, resulting in reduced production, which requires future interventions to increase their capacity through training and technology adoption. Originality / scientific novelty. This study stands out in the field of production and management practices and technologies used by smallholder tomato and potato producers due to its innovative approach and unique contribution to existing knowledge and skills. While previous studies have examined the relationship between production and management practices and technologies in an agricultural context, particularly focusing on state farms, our study focuses on small-scale tomato and potato producers. Through our thorough case study research and interview structure, we not only deepened our understanding of production and management practices in the agricultural sector, but also provided practical recommendations for improving the efficiency and sustainability of small-scale tomato and potato producers on different farms/fields. Practical value / implications. The findings of this study can be used to develop recommendations for policy makers and researchers on how to improve labour productivity in the future Thus, the policy focuses on developing strategies for producers to adopt modern production and management practices and technologies, raising farmers’ awareness of available technologies, improving management practices and increasing crop productivity in the study area.

Scale to measure the attitude of farmers towards district agro-met units (DAMUS) Project

Scale to measure the attitude of farmers towards district agro-met units (DAMUS) Project

Fungsi Satuan Polisi Pamong Praja dalam Penertiban Minuman Beralkohol di Kabupaten Timor Tengah Selatan

Often viewed as drinks that can provide tranquility and warmth to the drinker, especially during the rainy season. Drinking alcoholic beverages has even become a tradition for the people in this district. As a result of this tradition, the circulation of alcoholic beverages without or lacking permits (IP-MB) can easily proliferate. 1.To understand and analyze the implementation of the Function of the Civil Service Police Unit in Regulating Alcoholic Beverages in South Central Timor District. 2. To identify and analyze the Factors Inhibiting the Function of the Civil Service Police Unit in Regulating Alcoholic Beverages in South Central Timor District. This research was conducted within the jurisdiction of the Civil Service Police Unit in South Central Timor District, using the Juridical Empirical method. The aspects studied include the Function of the Civil Service Police Unit in Regulating Alcoholic Beverages and the Inhibiting Factors of the Civil Service Police Unit in Regulating Alcoholic Beverages in South Central Timor District. Data collection involved both Primary and Secondary data. The research findings indicate that the Function of the Civil Service Police Unit in regulating alcoholic beverages is achieved through the implementation of Standard Operational Procedures (SOP), the regulation of permits for alcoholic beverage businesses, and enforcement against violations of alcoholic beverage consumption. Factors inhibiting law enforcement regarding permits for alcoholic beverage businesses include enforcement factors, socialization factors, infrastructure factors, budget constraints, the number of competent officials, and bureaucratic complexities in permit administration.

Towards a liveable city: Measuring the liveability index in Tuban Regency, East Java

A liveable city is an urban planning concept where the city as a public space focuses on the social life and the entire community. Tuban Regency is one of the regencies in East Java that intends to measure the liveability of its city. For the first experiment, the measurement was conducted before and after the pandemic (2020 to 2023). This research tries to measure the liveability index at the regency level. The measurement uses district data units to measure the regency liveability index achievement in more detail. The result shows that the rural area index is higher than the urban in terms of the environment, food security, housing and settlements, and accessibility/transportation.

Spatial-temporal distribution characteristics of etiologically positive pulmonary tuberculosis in Jiangsu Province from 2011 to 2021

Objective: To analyze the spatial-temporal distribution of etiologically positive pulmonary tuberculosis (PTB) at the county (city, district) unit in Jiangsu Province from 2011 to 2021 to provide evidence for the implementation and adjustment of prevention and control strategies of PTB in Jiangsu Province. Methods: The registration data of etiologically positive PTB patients in Jiangsu Province from 2011 to 2021 were collected from the Tuberculosis Management Information System in the China Information System of Disease Control and Prevention. Data on the permanent population were from the statistical yearbook of each county (city, district) in Jiangsu Province. Geoda 1.18.0 software was used to analyze the global and local spatial autocorrelation and explore the spatial clustering. SaTScan 10.1 software was used to analyze the spatial-temporal clusters, and ArcGIS 10.7 software was used to visualize the spatial-temporal clusters. Results: A total of 128 240 etiological positive PTB cases were registered in Jiangsu Province from 2011 to 2021, with an average annual registration rate of 13.99/100 000. The registration rate showed an overall upward trend (trend χ2=63.49, P<0.001) after 2017, and the etiologically positive rate showed an overall upward trend (trend χ2=3 710.86, P<0.001). The annual Moran's I values ranged from 0.107 to 0.343, which showed a spatial clustering distribution. The results of local spatial autocorrelation analysis showed that there were "high-high" clustering areas in Jiangsu Province each year, showing a dynamic distribution, and most of the areas were distributed in the central and southern regions of Jiangsu Province, with the largest number (7) in 2015 and the smallest number (1) in 2011. A total of 4 spatial-temporal clustering areas were explored by spatial-temporal scanning analysis (all P<0.001), among which the first-level clustering area covered 3 counties (cities, districts), namely Changshu, Taicang, and Xiangcheng District of Suzhou, and the clustering time was from 2011 to 2015. The secondary clustering areas covered 24 counties (cities, districts), mainly covering Jiangsu's central and northern regions, such as Huai'an, Suqian, and Yancheng. The third-level clustering areas covered 26 counties (cities, districts); the fourth-level clustering area was the Gaochun District of Nanjing, with the clustering period from 2017 to 2021. Conclusions: From 2011 to 2021, the etiologically positive PTB registration rate at the county (city, district) level in Jiangsu Province had obvious spatial-temporal clustering characteristics. The clustering areas included the northern areas with relatively backward economies and the southern areas with better economic development. Multiple measures should be taken to prevent and control PTB according to the specific situation in different regions.

Factors Associated with Mothers Health Seeking Behavior among Newborn Illness.

Inappropriate, delayed and poor health seeking behavior increases the high risk of morbidity and mortality among newborns, infants and children. Newborns health status depends upon mothers' health seeking behavior. This study aimed to determine the factors associated with mother's health seeking behavior among newborn illness in Rupandehi District, Nepal. Community based cross-sectional study among 372 mothers aged 15-49 years was conducted in Rupandehi district Nepal from May to November 2019. Multistage probability random sampling was used as the sampling technique. Siddharthanagar municipality and Mayadevi rural municipality were selected randomly among 16 local units of Rupandehi district. Two wards from each unit were selected by stratified random sampling using non replacement lottery method. As the sample size was 372, ninety three respondents were selected randomly from each ward. The mean age and standard deviation of mothers was 25.32±4.36 years respectively. Among 372 mothers, 21.24% had poor health seeking behavior. Mothers having more than one child (AOR=0.15; CI: 0.02-0.98), primary and above education (AOR=8.89; CI: 3.15-25.08), visited hospital after 24 hours of newborn illness (AOR=13.59; CI: 1.73-106.7), knew danger signs of newborn (AOR=18.74; CI: 5.65-62.23), practiced exclusive breastfeeding (AOR=8.20; CI: 3.36-20.03) were significantly associated with health seeking behavior. Almost 22 % of mothers had poor health seeking behavior regarding their newborn illness. Number of living child, education of mother, appropriate time for treatment, receive health services when there is dangers signs of newborn and exclusive breast feeding practice were independent factors associated with mother's health seeking behavior. Hence, decision-makers and local administrator should provide specific intervention to newborns' mother regarding family planning, identifying and preventing danger signs of newborn, importance of appropriate time of treatment and exclusive breastfeeding.

A spatial decision support system for multi-dimensional sustainability assessment of river basin districts: the case study of Sarno river, Italy

Effective management of the complex Socio-ecological systems (SES) of the river basin, influenced by a range of social, economic, and environmental variables, requires multi-purpose Spatial Decision Support Systems (SDSSs) to identify and select balanced and sustainable regeneration scenarios. In many cases, the lack of cooperation between administrative institutions and the low level of participation of the stakeholders involved are the main obstacles to effective planning and regeneration practices and call for new forms of governance. However, to address these critical issues, few studies use quantitative approaches to assess the multidimensional resources of river basins in an integrated perspective in terms of their capacity to activate cooperation networks between river-crossed cities. This study aims to suggest a methodological approach combining Multi-Criteria Decision Analysis and Geographic Information Systems to achieve integration in pursuing sustainable regeneration pathways for a river basin district, analysing the case study of the Sarno River, composed of 20 administrative units, in Southern Italy. The specific purpose is to provide decision-makers with an SDSS to evaluate sustainability scenarios based on the multi-dimensional performances of River Basin District Units (RBDU). The results delivered four partial rankings of RBDU related to social, cultural, ecological, and economic scenarios and one overall ranking for an integrated sustainability scenario. Each ranking includes a clustering of municipalities according to three classes: Leader, Link and Follower. The outcome is twofold: to provide decision-makers with recommendations for supporting governance models based on sustainability pathways and to suggest valuable methods and tools for dealing with the spatial misfits, considered as the mismatch between the physical boundaries of a natural system and the management area of an organization.

Perspectives of healthcare workers on integrated management of childhood illness in Pakistan: A phenomenological approach.

In 2019, an estimated 5.2 million deaths were reported among children less than 5years of age. At primary healthcare level, healthcare workers (HCWs) mostly rely on history and clinical findings and less on inadequate diagnostic facilities. To enhance case management skills of HCWs, World Health Organization devised an integrated management of childhood illnesses (IMCI) strategy in 1995, modified to distance learning IMCI in 2014. A qualitative phenomenological study was conducted to explore perceptions of HCWs about standard and distance IMCI. Four focus group discussions were conducted with purposively selected 26 HCWs (IMCI trained) from 26 basic health units of Abbottabad district in Pakistan. Gadamer's philosophical hermeneutics were adopted during the inductive thematic analysis. Five themes that emerged are inexorable health seeking behaviors, IMCI being a comprehensive algorithm for consultation, a tedious protocol, scaling up protocol to specialists and private practitioners, and administrative insufficiency by the department of health. Improvement in case management skills of HCWs was reported as a result of IMCI trainings. It needs administrative support, regulations to control poly-pharmacy and provision of drugs without prescription, and a curb on political and bureaucratic interference.

Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study

BackgroundEpidemiologic studies on the effects of long-term exposure to ozone (O3) have shown inconclusive results. It is unclear whether to O3 has an effect on chronic kidney disease (CKD). We investigated the effects of O3 on mortality and renal outcome in CKD.MethodsWe included 61,073 participants and applied Cox proportional hazards models to examine the effects of ozone on the risk of end-stage renal disease (ESRD) and mortality in a two-pollutants model adjusted for socioeconomic status. We calculated the concentration of ozone exposure one year before enrollment and used inverse distance weighting (IDW) for interpolation, where the exposure was evenly distributed.ResultsIn the single pollutant model, O3 was significantly associated with an increased risk of ESRD and all-cause mortality. Based on the O3 concentration from IDW interpolation, this moving O3 average was significantly associated with an increased risk of ESRD and all-cause mortality. In a two-pollutants model, even after we adjusted for other measured pollutants, nitrogen dioxide did not attenuate the result for O3. The hazard ratio (HR) value for the district-level assessment is 1.025 with a 95% confidence interval (CI) of 1.014–1.035, while for the point-level assessment, the HR value is 1.04 with a 95% CI of 1.035–1.045. The impact of ozone on ESRD, hazard ratio (HR) values are, 1.049(95%CI: 1.044–1.054) at the district unit and 1.04 (95%CI: 1.031–1.05) at the individual address of the exposure assessment. The ozone hazard ratio for all-cause mortality was 1.012 (95% confidence interval: 1.008–1.017) for administrative districts and 1.04 (95% confidence interval: 1.031–1.05) for individual addresses.ConclusionsThis study suggests that long-term ambient O3 increases the risk of ESRD and mortality in CKD. The strategy to decrease O3 emissions will substantially benefit health and the environment.

The outcomes of treatment for homebound adults with complex medical conditions in a hospital-at-home unit in the southern district of Israel

BackgroundA model of hospital-at-home services called the Home Care Unit (“the unit”) has been implemented in the southern region of the Clalit Healthcare Services in Israel. The aim of the present study was to characterize this service model.MethodsA retrospective cross-over study. included homebound patients 65 years of age and above who were treated for at least one month in the framework of the unit, between 2013 and 2020. We compared the hospitalization rate, the number of hospital days, the number of emergency room visits, and the cost of hospitalization for the six-month period prior to admission to the unit, the period of treatment in the unit, and the six-month period following discharge from the unit.ResultsThe study included 623 patients with a mean age of 83.7 ± 9.2 years with a mean Mini-mental State Examination (MMSE) score of 12.0 ± 10.2, a mean Charlson Comorbidity Index (CCI) of 3.7 ± 2.2 and a Barthel Index score of 23.9 ± 25.1. The main indications for admission to the unit were various geriatric syndromes (56.7%), acute functional decline (21.2%), and heart failure (12%). 22.8% died during the treatment period and 63.4% were discharged to ongoing treatment by their family doctor after their condition stabilized. Compared to the six months prior to admission to the unit there was a significant decrease (per patient per month) in the treatment period in the number of days of hospitalization (2.84 ± 4.35 vs. 1.7 ± 3.8 days, p < 0.001) and in the cost of hospitalization (1606 ± 2170 vs. 1066 ± 2082 USD, p < 0.001).ConclusionsTreatment of homebound adults with a high disease burden in the setting of a hospital-at-home unit can significantly reduce the number of hospital days and the cost of hospitalization. This model of service for homebound patients with multiple medical problems maintained a high level of care while reducing costs. The results support the widespread adoption of this service in the community to enable the healthcare system to respond to the growing population of elderly patients with medical complexity.

Healthy eating encouragement and socio-demographic factors associated with cognitive development among pre-schoolers: a cross-sectional evaluation in Nepal.

Cognitive development in pre-schoolers through healthy eating and socio-demographic support is crucial for their later lives. We investigated healthy eating encouragement, socio-demographic factors and their association with cognitive development in pre-schoolers. Quantitative data were collected using a multi-stage random sampling between February and April 2021. Pre-schoolers 36 and 71 months and their primary caregivers were recruited from three local government units of Rupandehi district. We compared healthy eating encouragement, socioeconomic and demographic factors with cognitive development using t-test, one-way analysis of variance and multiple linear regression analysis to identify the predictors of the cognitive development among pre-schoolers. Cognitive development in pre-schoolers is significantly positively associated with age 36-48 months (β = 0.153; 95% CI: 0.12, 13.96), living in a nuclear family (β = 0.121; 95% CI: 0.59, 6.88) and following Buddhism (β = 0.148; 95% CI: 0.88, 14.32). Conversely, children from specific caste/ethnic backgrounds, such as Dalit (β = -0.126; 95% CI: -10.79, -0.68), Janajati (β = -0.237; 95% CI: -6.14, -2.09) and non-Dalit Tarai caste or ethnicity (β = -0.133; 95% CI: -3.46, -0.25) and mothers employed (β = -0.134; 95% CI: -10.62, -1.44) show significantly lower levels of cognitive development. The finding shows that socioeconomic factors have an influence on cognitive development and also stimulate the adoption of healthy eating encouragement practices.

Analysis of microplastics distributed in the environment: Case studies in South Korea

The massive production and extensive distribution of microplastics, stemming from postconsumer plastics, have become problematic for the environment and human health. Various studies have reported the hazardous potential and toxicity of microplastics in living organisms, including animals and humans. As a precautionary measure to protect them from microplastic exposure, significant efforts have been made to analyze the distribution of microplastics in the environment. However, each research group individually examined the microplastic distribution in a specific location. Consequently, there is a lack of information regarding the presence of microplastics in wider district units, such as cities and across the nation. In this study, an overview of various case studies in South Korea is provided by discussing the presence and concentration of microplastics in South Korea and examining the reports and research articles on the analysis of microplastic distributions in different locations in South Korea. The current sampling and analysis methods used for microplastic distribution studies were also summarized, along with their technical challenges. The possible sources of primary and secondary microplastics were also discussed to determine the original plastic types of microplastics derived from industries and households.

Pemberdayaan Perempuan Dalam Upaya Deteksi Dini Kanker Serviks Melalui Metode Reproductive Organ Self Examination (Rose) di Wilayah Kerja UPT Puskesmaskecamatan Sumbawa Unit 1

Cervical cancer is the most common cancer in women, and mostly occurs in developing countries including Indonesia. In 2020, the World Health Organization found that cervical cancer was the seventh most common cause of death in the world, and caused 604,127 events annually. In the United States, cervical cancer cases are estimated at 13,800 cases of invasive cervical cancer and 4,290 deaths from cervical cancer occurred in 2020. For the ASEAN region, the incidence of cervical cancer in Singapore is 25.0 in Chinese, 17.8 in Malays, and Thai at 23.7 per 100,000 population. Every year there are about 90-100 new cases of cervical cancer, and every year about 40,000 people are affected by this disease. Cervical cancer ranks second as many as 36,633 or 9.20% of the total cancer cases in Indonesia in 2020. The purpose of this community service activity is to convey information about cervical cancer and improve early detection skills of cervical cancer with the ROSE method in women of childbearing age in the Working Area of the Puskesmas Sumbawa District Unit I. Reproductive Organ Self Examination (ROSE) is a simple method that can be done by mothers themselves to find out any problems in their reproductive organs. Health education needs to be done to improve mothers' knowledge and attitudes about cervical cancer. This community service activity aims to improve the behavior of mothers in the working area of UPT Puskesmas Sumbawa District Unit 1 in conducting early detection of cervical cancer through the IVA method and the ROSE technique and continued with questions and answers with activity participants. Women of childbearing age (WUS) in the Working Area of UPT Puskesmas Sumbawa District Unit I.

Perkembangan Rumah Sakit Umum Daerah Lubuk Basung (1986-2020)

This thesis examines the development of Lubuk Basung Regional General Hospital from 1986-2020. The purpose of writing this thesis describes the developments and changes that occurred at Lubuk Basung Hospital as the only C-level Health Service unit in Agam district from 1986-2020.To be more focused, this research is focused on the following problem formulations: (1). What is the background of the establishment of Lubuk Basung Hospital?, (2). How is the Development of Health Services at Lubuk Basung Hospital (1986-2020)? The Research Methods used are; Heuristics is the first stage carried out to find sources relevant to research. Source criticism is a form of process carried out by the author to find and filter the truth value of sources, Interpretation is a stage where researchers try to express various ideas of their thoughts obtained through primary or secondary sources, Historiography is the last stage in the Historical method where in this stage the author writes the results of research chronologically and systematically. The results of this study illustrate that the development and changes in the institution of Lubuk Basung Regional General Hospital continue to experience progress from 1986 to 2020. Especially when it started when the Hospital was designated as a Regional General Hospital with type D class and changed to a Regional General Hospital with type C class to its role in providing services for the people of Lubuk Basung which is still standing today

Combat Training of Personnel of the Moscow Military District units in 1934-1940

The author analyzes the indicators reflecting the level of combat training of the units of the Moscow Military District in 1934-1940. There is considered the organization of the training process of units as one of the main components of effective military training. The data collection on the level of training of the Red Army personnel and headquarters commanders in the framework of tactical and marksmanship training is studied. The source base of the work was the office documents stored in the Russian State Military Archive. It is concluded that in the course of implementing the process of combat training of the Moscow Military District units, some progress was made. In particular, individual training of soldiers and small units increased; the results of shooting improved. At the same time, there were constant problems, such as the organization of the training, the shortage of qualified personnel, as well as the level of tactical training.

비도시지역 관리체계 개선 방향에 관한 연구

In 2003, the National Land Planning And Utilization Act was enacted, but the non-urban area management system through the use area system has problems due to the too wide range of restrictions on management areas, small-scale development using loopholes in the existing legal system, and double administrative procedures due to the lifting of conservation areas. To solve this problem, it is necessary to re-establish the permit standards of non-urban areas or incorporate management areas into the vertical use area classification system to clearly distinguish the identity of the management area. In order to prevent waste of administrative power, it is necessary to give special-purpose areas to areas released from preserved mountainous districts and agricultural promotion areas without separate administrative procedures, strengthen diversion requirements for in preserved mountainous districts, and reorganize the management system so that accommodation facilities can only be made possible through planned locations such as district unit planning areas or growth management planning areas. The growth management plan is an auxiliary means for Permission for Development Activities and can designate non-permissible uses, but it cannot relax permitted uses, so it has limitations as a means of inducing location. In the case of planning management areas, most facilities are permitted due to negative use regulations, so it is difficult to induce location through additional relaxations. Therefore local governments and residents will actively establish growth management plans only when restrictions on behavior in existing special-purpose area are strengthened and ease of allowable use through growth management plan. The planned development of non-urban areas is possible only by planting the perception that regional development in non-urban areas is possible only through district unit plans and growth management plans.

IN PATIENTS WITH HAND SEPSIS, DO BEDSIDE DEBRIDEMENT AND OPERATING THEATRE DEBRIDEMENT HAVE SIMILAR CLINICAL OUTCOMES, HOSPITAL COST, AND TIME TO DISCHARGE IN A DISTRICT HOSPITAL SETTING IN SOUTH AFRICA?

In patients with hand sepsis does bedside debridement compared to operating theatre debridement have similar clinical outcomes, hospital cost and time to discharge in a District Hospital setting in South Africa?A case series of 130 adult patients presenting to a district level orthopaedic unit over 1 year with hand sepsis requiring debridement. All included patients were debrided at the bedside (i.e. the emergency room, ward, OPD) under wrist or digital block. Patients excluded from the study included patients with necrotising soft tissue infections that required debridement in theatre. A cost analysis was done based on operating theatre (OT) costs saved as defined by Samuel1 et al. If an average theatre time of 45 min is taken then the cost saved per patient is approximately R1500 and approximately R300000 for the patients included in the case series. This excludes ward and other hospital costs related to a longer hospital admission.The mean time to discharge for the included patients was 24 hours. This study suggests that bedside debridement can be a viable and cost effective option for selected cases of hand sepsis that can avoid the high cost and time associated with operating theatre debridement with similar outcomes.This has implications for the future treatment of hand sepsis in resource constrained settings were operating theatre time is not only very expensive but also very scarce.

The Prevalence of Trachomatous Trichiasis in People Aged 15 Years and Over in Six Evaluation Units of Gaoual, Labé, Dalaba and Beyla Districts, Guinea

ABSTRACT Purpose Trachoma is a public health problem in 42 countries. Inflammation associated with repeated ocular infection with Chlamydia trachomatis can cause the eyelid to scar and turn inwards, resulting in the eyelashes rubbing against the eyeball, known as trachomatous trichiasis (TT). In Guinea, baseline surveys conducted in 2013 reported inflammatory trachoma prevalences below the World Health Organization (WHO) threshold for elimination, but TT prevalences above threshold. Given this epidemiological context and time since baseline survey, TT-only surveys were conducted in selected districts to determine current TT prevalence. The results of this study provide critical data for assessing Guinea’s achievement of trachoma elimination targets. Methods Four health districts, consisting of six evaluation units (EU), were surveyed. In each EU, field teams visited 29 clusters with a minimum 30 households included in each. Participants aged≥15 years were examined by certified graders trained to identify TT and determine whether management had been offered. Results A total of 22,476 people were examined, with 48 TT cases across the six EUs identified. Five of six EUs had an age-and-gender adjusted TT-prevalence unknown to the health system less than 0.2%, whereas one EU, Beyla 2, had an adjusted TT prevalence of 0.24%. Conclusion These TT-only surveys, along with findings from other trachoma interventions, suggest that Guinea is close to achieving elimination of trachoma as a public health problem. This study demonstrates the value of undertaking TT-only surveys in settings where baseline surveys indicated active trachoma prevalences below WHO elimination threshold, but TT prevalences above it.