Episodes of excessive rest alternate with symptom-free intervals, and the cause of the condition is unknown, although Stanford notes nearly half of patients knowledge flu-like symptoms a few days before their first KLS episode When symptoms of KLS are present, they are able to last for times, weeks or even months, causing all normal daily activities to stop, based on the Kleine Levin Syndrome Basis. They can not attend school, care or function for themselves, & most are bedridden and uncommunicative while awake even. In between episodes those diagnosed with KLS appear to be in perfect health with no proof behavioral or physical dysfunction, notes the Foundation. Nonetheless they function daily with the frightful fact that they could become sick again at any moment.We designed this trial to assess whether a multifaceted intervention to promote professional onsite schooling with audits and feedback would reduce the price of cesarean delivery. Secondary goals included evaluation of the effects of this strategy on additional obstetrical interventions and on maternal and neonatal outcomes. Methods Participants and Hospitals We conducted the QUARISMA trial at 32 open public hospitals in Quebec province from April 1, 2008, october 31 to, 2011. To meet the requirements to join the trial, hospitals had been required to have at least 300 deliveries in the entire year before initiation of the study, a rate of cesarean delivery higher than 17 percent ,22 and at the proper time of recruitment, no latest or ongoing quality-improvement applications designed to decrease the rate of cesarean delivery specifically.