Use Of Protection Means Research Articles

Availability, accessibility, and quality of adolescent Sexual and Reproductive Health (SRH) services in urban health facilities of Rwanda: a survey among social and healthcare providers

BackgroundAdolescents are still getting pregnant and contracting Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs) in Rwanda as elsewhere. Quality and comprehensive SRH services and information for adolescents is valuable for adolescents’ wellbeing. This study aimed at understanding SRH services providers’ viewpoints on accessibility, availability, and quality of SRH services provided to adolescents in selected cities of Rwanda.MethodThe study was a descriptive cross-sectional survey conducted between May 2018 and May 2019 in six selected cities of Rwanda using a mixed-methods approach. A checklist was used to collect data from 159 conveniently selected SRH services providers. The survey tool was validated. SPSS version 20 was used to describe quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically.ResultsQualitatively, health care providers reported that the availability of adolescent SRHS are satisfactory with access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV services, and counselling. However, the accessibility of some services remains limited. According to respondents, some products such as female condoms are less in demand and often expire before they can be distributed. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Religious leaders and family members may hinder adolescents from health-seeking behavior by promoting abstinence and discouraging use of protective means. Quantitatively, we found that 94.3% of health facilities provide information to adolescents on SRH services that were available and 51.6% affirmed delivering services at a low cost. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities.ConclusionSRH services in Rwanda are available for the general population and are not specifically designed for adolescents. These SRH services seem to be fairly accessible to adolescents with insufficient quality as adolescents themselves do not get to be fully involved in service provision among other aspects of quality SRH as stated by the World Health Organization (WHO). Therefore, there is a need to improve the present quality of these services to meet adolescents’ needs in an urban setting.

Radiation-induced cataracts in staff engaged in interventional procedures

Among the radiation effects currently of concern, cataract is the main possibility among interventionalists. Radiation induced eye lens opacities have been found in 1/3rd to half of the operators in interventional suites primarily among interventional cardiologists (ICs) but this may apply to interventional radiologists, electro-physiologists and vascular surgeons as well, who perform similar magnitude of work as ICs. Further, nurses in interventional suites who stay inside for most of the time when radiation beam is ON have been shown to have lens opacities. Data among other category of medical professionals like orthopaedic surgeons, urologists, gastroenterologists and anaesthetists is awaited but lack of use of protective means that is common, tends to indicate that they too may have significant risk. A recent study indicates higher doses to eye lens among urologists, even more than ICs. Most studies so far have shown lens opacities rather than frank cataract, but data from A Bomb survivors indicates that lens opacities have the potential to lead to cataract after several years of latent period. International Commission on Radiological Protection (ICRP) has reduced dose limits for occupational exposure for the eyes from 150 mSv/year to 20 mSv/year and this has been adopted by the European Commission in its BSS and also by the international BSS of IAEA. There is great momentum currently in large part of the world in this area. While the risk is real, the avoidance is also a real possibility.

Diagnóstico serológico de Helicobacter pylori en endoscopistas: Serología en endoscopistas

the Helicobacter pylori entered into the medical world, particularly in the field of the Gastroenterology, revolutionizing it, and changing partially our physiopathological concepts and treatment of the gastroduodenal ulcer. This infestation results in an immune response, that is measured by means of serologic tests, which are very useful in the massive screening studies, mainly in population at risk like those who are institutionalized and the personnel of health, particularly workers of the departments of Gastroenterology. motivated for this, we carry out a prospective study in 38 endoscopists using as controls 38 workers not related with a Gastroenterology department. Thus, we analyzed the presence of antibodies against Helicobacter pylori among the personnel of the departments of Gastroenterology of three hospitals of Havana City. These personnel filled a form designed for this purpose containing following data: age, sex, time of work as endoscopist, use of protection means, and history of gastroduodenal pathology. there were 24 women in each group (63,2%). Whereas the seroprevalence among endoscopists was 39,47%, in the control group, only three people were seropositives (7,89%). We found a positive correlation between the time working as endoscopists and the rate of seropositivity. our study demonstrated that endoscopists have a significantly higher risk than the controls of contracting the infection by the Helicobacter pylori, and that the seropositive endoscopists have sintomatology more frequently than the seronegative endoscopists, although these differences were not statistically significant.