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The International Health Regulations (2005): State of Implementation in Côte D'Ivoire in 2011
Traoré Youssouf,
Coulibaly Amed,
Coulibaly Daouda,
Ekra Kouadio Daniel,
N’Guessan Kouakou Christophe,
Koutouan Mayet Guy Georges,
Agbo Kouadio Serge,
Dagnan N’Cho Simplice
Issue:
Volume 6, Issue 3, May 2018
Pages:
66-74
Received:
25 February 2018
Accepted:
24 March 2018
Published:
12 April 2018
Abstract: Côte d'Ivoire has decided to implement the International Health Regulations (IHR) (2005), which came into effect in June 2007. However, after a period of 5 years without the actual start, several observations have found deficiencies in the application of this legal instrument binding law. In collaboration with the World Health Organization (WHO), actions have been undertaken for its implementation. The purpose of this work was to assess the key minimum core capabilities required to prevent, detect early and respond to public health emergencies. A documentary review on the table took place from 01 to 09 December 2011 at the National Institute of Public Hygiene with all the sectors involved in the implementation of the IHR (2005). For this purpose following a sampling for convenience, An interview grouped by sub-themes made it possible to collect information from the questionnaire developed by WHO. The data collected was analyzed by highlighting the Strengths, Weaknesses, Opportunities and Threats (SWOT) of the 13 components of the IHR. Confidentiality and anonymity have been respected in order to accelerate the implementation of the capacities of this Regulation. In this study with 51 sectors involved, the minimum required such as legislation, coordination and National Focal Point (NFP) communication represented respectively 50%, 73% and 57% regarding the entities rate of involvement in the implementation of the IHR. Human resources and monitoring were not developed (0%) unlike the laboratories (90%), the response to events represented (85%). In addition, other aspects are in the early stages of implementation to various degrees. The assessment of strengths, weaknesses, opportunities and threats revealed significant progress in some technical areas (preparedness, response) and many insufficiencies in the implementation of the IHR (2005). All this shows the degree of involvement of entities in the implementation of the IHR in Côte d’Ivoire. IHR implementation is an investment to ensure the safety and health of global and Ivorian populations.
Abstract: Côte d'Ivoire has decided to implement the International Health Regulations (IHR) (2005), which came into effect in June 2007. However, after a period of 5 years without the actual start, several observations have found deficiencies in the application of this legal instrument binding law. In collaboration with the World Health Organization (WHO), a...
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Impacts of a National Action Plan on Antimicrobial Use in China: A Multi-Center Retrospective Study
Lidao Bao,
Gaowa Sharen,
Sha Li,
Xianhua Ren,
Ruilian Ma
Issue:
Volume 6, Issue 3, May 2018
Pages:
75-81
Received:
10 May 2018
Published:
10 May 2018
Abstract: This study retrospectively analyzed antimicrobial prescription and concomitant economic outcomes in 28 Chinese state-owned hospitals before and after the intervention introduced by the Action Plan. The outcomes of national intervention were evaluated by analyzing statistics collected before and after the Action Plan which came into effect as of July 1, 2011. The fourth quarters of 2010 and 2011 were set as the baseline and intervention periods, respectively. The percentage of patients receiving antimicrobial prescription, the intensity of antimicrobials prescribed, economic indexes related to antimicrobial prescribing, and antimicrobial prophylaxis in clean surgical procedures were investigated, respectively. First, during the intervention period, the percentage of patients receiving antimicrobial treatment dropped to 15.6% and 49.1% in outpatient and inpatient settings, respectively. The intensity of antimicrobial prescribed decreased to 50.29 DDD (defined daily dose) in outpatient setting. The defined daily doses (DDDs) per thousand patients per day decreased to 12914.33 DDDs in outpatient settings. The results were statistically significant as compared to those in the baseline period (P<0.001). Second, the expenses on antimicrobials significantly decreased (P<0.001). Finally, the percentage of patients receiving antimicrobial prophylaxis for clean surgical procedures decreased to 48.94% (P<0.001), while the infection rates did not differ significantly (P=0.581). This multi-center study suggests that the Action Plan launched by China’s government proved effective in state-owned medical institutions in promoting rational antimicrobial prescription.
Abstract: This study retrospectively analyzed antimicrobial prescription and concomitant economic outcomes in 28 Chinese state-owned hospitals before and after the intervention introduced by the Action Plan. The outcomes of national intervention were evaluated by analyzing statistics collected before and after the Action Plan which came into effect as of Jul...
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Uterine Rupture Secondary to Placenta Percreta on Previa: A Case Report of Successful Management by Caesarian Hysterectomy
Dawit Sereke,
Habte Hailemelekot,
Abduselam Hagos,
Elias Teages Adgoy
Issue:
Volume 6, Issue 3, May 2018
Pages:
82-85
Received:
12 April 2018
Accepted:
8 May 2018
Published:
31 May 2018
Abstract: Background: Placenta accreta is a general term used to describe the clinical condition when part of the placenta, or the entire placenta, invades and is inseparable from the uterine wall. Its incidence is growing due to the rising rate of cesarean sections and advanced maternal age on delivery. It is becoming the foremost cause of obstetric hemorrhage leading to significant maternal and fetal morbidity and even mortality. Rarely placenta accreta may lead to spontaneous uterine rupture in the second or third trimester. Case report: A 28-year-old woman gravida 4, para 3, was admitted at the maternity ward of Mendefera regional referral hospital, at a gestational age of 27 weeks due to vaginal bleeding. She had history of 3 time’s caesarian section. At admission her vital sign was stable and her complete blood count was normal, ultrasound showed anterior placentation with partial placenta previa. She was given Dexamethasone 6 gm. IM twice daily for 2 days to enhance lung maturity. At 36 weeks of gestation, she experienced massive vaginal bleeding. A decision was made to perform emergency cesarean section. The possibility of morbidly adherent placenta was considered. Intra-operatively, the placenta was found with engorged blood vessels under the rectus fascia with ruptured uterus and there was adhesion of rectus sheath with part of the uterus. A transverse uterine incision was made at the upper border of the placental attachment to uterus to deliver the fetus. After successful delivery of the fetus, the placenta was found to be densely adhered to the lower uterine segment, penetrating through it and adhered to the posterior wall of the urinary bladder. It was decided to do caesarian hysterectomy with the placenta left in situ. During discharge both the mother and the baby were in good condition. Conclusion: Placenta accreta is a potentially life-threatening obstetric condition that requires a meticulous approach to management. If a multiparous woman with a previous caesarian section is found to have placenta previa, the possibility of placenta accreta should be considered in the diagnosis of the patient. Grayscale ultrasonography is sufficient for the diagnosis of placenta accreta. The recommended management of placenta accreta is planned caesarian hysterectomy.
Abstract: Background: Placenta accreta is a general term used to describe the clinical condition when part of the placenta, or the entire placenta, invades and is inseparable from the uterine wall. Its incidence is growing due to the rising rate of cesarean sections and advanced maternal age on delivery. It is becoming the foremost cause of obstetric hemorrh...
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Literature Review on Tongue Pressure of Healthy Japanese
Keiji Tabuchi,
Kensuke Norikoshi,
Toshio Kobayashi
Issue:
Volume 6, Issue 3, May 2018
Pages:
86-90
Received:
20 June 2018
Published:
21 June 2018
Abstract: The tongue plays an important role in speaking, eating, and drinking while making complicated movements in the oral cavity. By measuring tongue pressure, it is possible to infer the extent of tongue function. In the previous study, there were several papers on tongue pressure which examined subjects by disease, such as symptoms of temporomandibular joint disease, aspiration, but there are few studies on measuring tongue pressure of healthy Japanese. Additionally, there is no study on all age focusing on the relationship between tongue pressure and age and gender. Therefore, the purpose of this study was to reveal the tendency of healthy Japanese tongue pressure through literature review. Japanese medicine abstract society web service and PubMed were used to search the keyword "tongue pressure" in English and Japanese, 58 English papers and 291 Japanese papers were extracted. There were 34 papers including Japanese tongue pressure data. The text and abstract were carefully read and the targets were 12 papers including healthy Japanese tongue pressure data. Data sorted tongue pressure by gender and age. Boys and girls mixed tongue pressure from neonates to three month old was 10-13 kPa, 29-35 kPa for elementary school students, 35 kPa for junior high school students and high school students. Up to high school students, there was no document that measured tongue pressure by gender, respectively. Since the difference between men and women growth begins with middle of elementary school age, it is considered that necessary to measure tongue pressure according to gender. The tongue pressure of women in their twenties to sixtieth was 33-40 kPa, which was the peak of Japanese women’s tongue pressure. Twenties men's tongue pressure is 45 to 55 kPa, which was the peak of Japanese men’s tongue pressure. The maximum tongue pressure in lifetime was found to be 5 to 22 kPa higher for men than for women. However, in women, peak tongue pressure was kept until sixtieth, and the subsequent decrease in tongue pressure was moderate compared to men. In the case of men, the decline in tongue pressure starts in the forties, almost the same tongue pressure as women in the seventies, tongue pressure in men in their octogenarian was inferior to that of the same age women. In literature review, gender and age characteristics and research problems on healthy Japanese tongue pressure were clarified.
Abstract: The tongue plays an important role in speaking, eating, and drinking while making complicated movements in the oral cavity. By measuring tongue pressure, it is possible to infer the extent of tongue function. In the previous study, there were several papers on tongue pressure which examined subjects by disease, such as symptoms of temporomandibular...
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Understanding Parents’ Mistakes in Insulin Doses for Hyperglycaemia Treatment
Wala’a Barifah,
Bill Davey,
Vince Bruno
Issue:
Volume 6, Issue 3, May 2018
Pages:
91-99
Received:
20 June 2018
Published:
21 June 2018
Abstract: This study focuses on how parents make mistakes when administering insulin doses in treating hyperglycemia in their T1D diabetic children. This research employed a qualitative approach, conducting 58 semi-structured, in-depth interviews with 37 Saudi Arabian and Australian parents with T1D children, and 20 combined health professionals and company representatives. A conceptual tree analysis of the interviews was carried out using Atlas software. The initial coding was analyzed into two major themes: Misestimations and misunderstandings of insulin correction doses; and Mistakes in using injection tools and techniques. Each of these themes affords insight into correcting parents’ mistakes in insulin doses through a variety of techniques and technologies for T1D-related insulin delivery. In general, parents had made both corrected and uncorrected mistakes, and surprisingly, many were unfamiliar with the focal meaning of correction doses and how they are estimated or used. Despite significant efforts in diabetes education, the incidence of adverse health outcomes continues. This study shows that parental mistakes in insulin doses for treating hyperglycemia are crucial and involved issues. There are many ways to address these mistakes, and this study seeks to provide recommendations in order improve diabetes care practices.
Abstract: This study focuses on how parents make mistakes when administering insulin doses in treating hyperglycemia in their T1D diabetic children. This research employed a qualitative approach, conducting 58 semi-structured, in-depth interviews with 37 Saudi Arabian and Australian parents with T1D children, and 20 combined health professionals and company ...
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Stress Conditions and Mental Health Status of International Students Studying in Japan
Meixuan Song,
Keiji Tabuchi,
Toshio Kobayashi
Issue:
Volume 6, Issue 3, May 2018
Pages:
100-105
Received:
25 June 2018
Published:
26 June 2018
Abstract: In recent years, as international students studying at universities are increasing in Japan, so maintaining mental health of them living in unfamiliar countries is an important issue. The purpose of this research was to clarify the situation of stress and the condition of mental health among international students. We conducted a self-check question survey for 67 international students who came from 10 countries living in Japan, aged between 20 and 45 (average age was 26.4 years). The contents of the survey were personal attributes, life stress, revised UCLA loneliness scale (20-80 points), and depressed state self-rating scale (CES-D) (0-60 points). For statistical analysis, Pearson correlation analysis with IBM SPSS 22.0 was used. The average years of residence in Japan was 2.07 years. Stressor of daily life were "Japanese language skill shortage" and "various procedures are troublesome". Stressor of economic was "weight of economic burden". Stressor of study were "graduation thesis" and "the field of study and research is difficult". Hereafter, stressor of private expense students was having to do part-time jobs to maintain their lives. When the Japanese language ability was high, the stress on daily life and study was low, but the stress of part-time jobs was higher. It was conceivable that the international students with higher Japanese ability, the demand on work will be also higher. The CES-D score was 15.57 on average and 37.3% with depressed tendency (16 points or more). The positive correlation was found between CES-D and the stressor of daily life (r=0.311, p<0.05), stressor on study (r=0.246, p<0.05), loneliness (r=0.383, p<0.01). In addition, the average score of international students' loneliness scale was 42.72 points. The positive correlation was also found between loneliness and the stressor of daily life (r=0.311, p<0.05). Based on these results is necessary to pay attention to international students' stressors on daily life, study, loneliness, and mental health state. In this research, the actual situation of international student's daily life, economic aspect, and academic stress were clarified. Providing support to maintain their mental health is important to prevent the tendency of depression for international students who living with strong stress and loneliness.
Abstract: In recent years, as international students studying at universities are increasing in Japan, so maintaining mental health of them living in unfamiliar countries is an important issue. The purpose of this research was to clarify the situation of stress and the condition of mental health among international students. We conducted a self-check questio...
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