Using Blood Wisely: lessons learnt in establishing a national implementation programme to reduce inappropriate red blood cell transfusion.

Background: Up to 50% of blood is transfused inappropriately despite best evidence. In 2020, Choosing Wisely Canada launched a major national programme, 'Using Blood Wisely', the aim was to engage hospitals to audit their red blood cell transfusion use against national benchmarks and participate in a programme to decrease inappropriate use.

Study Design: Using Blood Wisely is a quality improvement programme including national benchmarks, an audit tool, recommended evidence-based effective interventions and a designation to reward success.

Current state of technical transfusion medicine practice for out-of-hospital blood transfusion in Canada.

Background And Objectives: Canadian out-of-hospital blood transfusion programmes (OHBTPs) are emerging, to improve outcomes of trauma patients by providing pre-hospital transfusion from the scene of injury, given prolonged transport times. Literature is lacking to guide its implementation. Thus, we sought to gather technical transfusion medicine (TM)-specific practices across Canadian OHBTPs.

Organizing a virtual scientific conference: experiences from the Bethune Round Table 2021.

In response to the COVID-19 pandemic, organizations used virtual platforms to host academic meetings. This includes the Canadian Network for International Surgery and the Centre for Global Surgery at the McGill University Health Centre, who were tasked with organizing the Bethune Round Table (BRT), held May 28-31, 2021. With 496 registrants and 300 attendees representing 50 countries, the BRT 2021 was the most trafficked BRT conference in its 20-year history.

Guideline No. 431: Postpartum Hemorrhage and Hemorrhagic Shock.

Objective: This guideline aims to provide evidence for prevention, recognition, and treatment of postpartum hemorrhage including severe hemorrhage leading to hemorrhagic shock.

Target Population: All pregnant patients.

Benefits, Harms, And Costs: Appropriate recognition and treatment of postpartum hemorrhage can prevent serious morbidity while reducing costs to the health care system by minimizing more costly interventions and length of hospital stays.

Identification and mitigation of high-risk pregnancy with the Community Maternal Danger Score Mobile Application in Gboko, Nigeria.

Introduction: Risk analyses within rural regions of Nigeria are not routinely conducted, yet could help inform access to skilled birth care. The objective of this study was to assess and compare the proportion of pregnant women at risk for maternal mortality or morbidity in Benue State, Nigeria by analysing data collected during routine antenatal visits and through the Community Maternal Danger Score (CMDS), a validated risk-analysis tool.

Methods: Two cohorts, comprised of pregnant women presenting to primary healthcare centres within Gboko, Benue State between 2015-2017 and 2020-2021, were included in this study.

Clinical guideline utilization in Uganda: A scoping review and comparison.

Countries such as Uganda often depend on clinical practice guidelines from developed countries, non-profit charities, and international organizations. The sources and organizations that provide most of the guidelines used in Uganda are not well documented. The primary objective of this article was to determine whether a scoping review of scientific, peer-reviewed literature could identify the clinical guidelines actually used in Uganda.

The Kampala Trauma Score: A 20-year track record.

Quantifying the severity of traumatic injury has been foundational for the standardization of outcomes, quality improvement research, and health policy throughout the evolution of trauma care systems. Many injury severity scores are difficult to calculate and implement, especially in low- and middle-income countries (LMICs) where human resources are limited. The Kampala Trauma Score (KTS)-a simplification of the Trauma Injury Severity Score-was developed in 2000 to accommodate these settings.

Assessment and validation of the Community Maternal Danger Score algorithm.

Background: High rates of maternal mortality in low-and-middle-income countries (LMICs) are associated with the lack of skilled birth attendants (SBAs) at delivery. Risk analysis tools may be useful to identify pregnant women who are at risk of mortality in LMICs. We sought to develop and validate a low-cost maternal risk tool, the Community Maternal Danger Score (CMDS), which is designed to identify pregnant women who need an SBA at delivery.

A prospective multi-faceted interventional study of blood bank technologist screening of red blood cell transfusion orders: The START study.

Background: Transfusion of red blood cells (RBC) is a common procedure, which when prescribed inappropriately can result in adverse patient outcomes. This study sought to determine the impact of a multi-faceted intervention on unnecessary RBC transfusions at hospitals with a baseline appropriateness below 90%.

Study Design And Methods: A prospective medical chart audit of RBC transfusions was conducted across 15 hospitals.

Neurosurgery in East Africa: Innovations.

In the last 10 years, considerable work has been done to promote and improve neurosurgical care in East Africa with the development of national training programs, expansion of hospitals and creation of new institutions, and the foundation of epidemiologic and cost-effectiveness research. Many of the results have been accomplished through collaboration with partners from abroad. This article is the third in a series of articles that seek to provide readers with an understanding of the development of neurosurgery in East Africa (Foundations), the challenges that arise in providing neurosurgical care in developing countries (Challenges), and an overview of traditional and novel approaches to overcoming these challenges to improve healthcare in the region (Innovations).

The discovery of fluazaindolizine: A new product for the control of plant parasitic nematodes.

Fluazaindolizine is a new highly effective and selective product for the control of plant parasitic nematodes. Specificity for nematodes coupled with absence of activity against the target sites of commercial nematicides suggests that fluazaindolizine has a novel mode of action. The discovery, structure-activity development and biological properties for this new class of nematicides are presented.

Examining perception and actual knowledge change among learners in a standardized burn course.

Background: Essential Burn Management (EBM) is a burn training program created for East Africa and aims to meet the needs of low- and middle-income countries. The authors present a report on objective testing of change in knowledge, with pre and post tests, and comparison of this testing with the self perception of knowledge gained to explore course utility.

Objective: To evaluate the ability of EBM to improve knowledge in burn care among course participants; and to explore whether participants' self-perception of knowledge gained is comparable with their actual change in knowledge.

Creation of a standardized burn course for Low Income Countries: meeting local needs.

Introduction: Standardized courses for the care of the burn patient have historically been developed in High Income Countries (HIC). These courses do not necessarily reflect the challenges and needs of Low Income Countries (LIC) and some components may not be relevant there (i.e.

Regio- and stereochemical studies on the nitroso-Diels-Alder reaction with 1,2-disubstituted dienes.

The regioselectivity of the nitroso-Diels-Alder reaction between unsymmetrical acyclic dienes and Boc-nitroso (Boc=tert-butoxycarbonyl) reagent or the Wightman chiral chloronitroso reagents has been studied. With the Boc-nitroso reagent, the selectivity is a consequence of steric effects at the C1-position in the diene and electronic effects at the C2-position in the diene. The combination of an unprotected hydroxyethyl side chain at C1 and an electron-withdrawing group at C2 allows complete regioselectivity in favour of the proximal isomer.

INJURY EXPERIENCE IN TANZANIA - NEED FOR INTERVENTION.

Objective: To determine distribution of injuries and factors associated with mortality in six hospitals of Tanzania mainland.

Design: A Cross-Sectional hospital based study.

Setting: Data were collected from casualty departments of Muhimbili Orthopaedic Institute, Morogoro, Mtwara, Kigoma, Musoma regional hospitals and Korogwe district hospital.