Specific diversity, structure and carbon stock of urban plant formations in southern Benin

The sustainable management of urban green spaces requires the monitoring of the structural parameters of theirs trees. This study, which was carried out in the cities of Abomey-Calavi, Allada and Cotonou in southern Benin, aimed to describe the dendrometric parameters and the rate of carbon stored by urban trees. The inventory of trees planted in two types of urban forests (greened public spaces and shade rows) was performed using the roving survey method at the level of each city. Then, presence and absence data of all trees, as well as diameter at breast height (DBH) >= 10 cm and height >= 2 m were measured. These data were analyzed using R 4.0.5 software. The calculated dendrometric parameters were subjected to variance tests to assess their significance. The different counts allowed us to identify 5128 individual trees. The density per hectare varied from 36.7 to 83.1 between cities and from 40.5 to 80.4 between types of green spaces. Basal area varied from 2.25 to 11.4 m²/ha within cities. In all three cities in the study, trees had an aggregative spatial distribution, but with low numbers of individuals per site. All of the trees studied have a carbon sequestration rate of 689 t/ha. It is therefore necessary to take precautions for the strengthening and preservation of urban trees and their diversity for a more sustainable urban ecological balance. Keywords: Benin, Biomass, Carbon storage, Tree structure, Urban forest

Midwifery 2030: A woman's pathway to health. What does this mean?

© 2015 The Authors. The 2014 State of the World's Midwifery report included a new framework for the provision of woman-centred sexual, reproductive, maternal, newborn and adolescent health care, known as the Midwifery2030 Pathway. The Pathway was designed to apply in all settings (high-, middle- and low-income countries, and in any type of health system). In this paper, we describe the process of developing the Midwifery2030 Pathway and explain the meaning of its different components, with a view to assisting countries with its implementation.The Pathway was developed by a process of consultation with an international group of midwifery experts. It considers four stages of a woman's reproductive life: (1) pre-pregnancy, (2) pregnancy, (3) labour and birth, and (4) postnatal, and describes the care that women and adolescents need at each stage. Underpinning these four stages are ten foundations, which describe the systems, services, workforce and information that need to be in place in order to turn the Pathway from a vision into a reality. These foundations include: the policy and working environment in which the midwifery workforce operates, the effective coverage of sexual, reproductive, maternal, newborn and adolescent services (i.e. going beyond availability and ensuring accessibility, acceptability and high quality), financing mechanisms, collaboration between different sectors and different levels of the health system, a focus on primary care nested within a functional referral system when needed, pre- and in-service education for the workforce, effective regulation of midwifery and strengthened leadership from professional associations. Strengthening of all of these foundations will enable countries to turn the Pathway from a vision into reality

A technical framework for costing health workforce retention schemes in remote and rural areas

<p>Abstract</p> <p>Background</p> <p>Increasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health. However, information about the costs of such policy interventions often appears incomplete, fragmented or missing, despite its importance for the sound selection, planning, implementation and evaluation of these policies. This lack of a systematic approach to costing poses a serious challenge for strong health policy decisions.</p> <p>Methods</p> <p>This paper proposes a framework for carrying out a costing analysis of interventions to increase the availability of health workers in rural and remote areas with the aim to help policy decision makers. It also underlines the importance of identifying key sources of financing and of assessing financial sustainability.</p> <p>The paper reviews the evidence on costing interventions to improve health workforce recruitment and retention in remote and rural areas, provides guidance to undertake a costing evaluation of such interventions and investigates the role and importance of costing to inform the broader assessment of how to improve health workforce planning and management.</p> <p>Results</p> <p>We show that while the debate on the effectiveness of policies and strategies to improve health workforce retention is gaining impetus and attention, there is still a significant lack of knowledge and evidence about the associated costs. To address the concerns stemming from this situation, key elements of a framework to undertake a cost analysis are proposed and discussed.</p> <p>Conclusions</p> <p>These key elements should help policy makers gain insight into the costs of policy interventions, to clearly identify and understand their financing sources and mechanisms, and to ensure their sustainability.</p

Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P\ua0 64 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF 6445%

DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR&nbsp;=&nbsp;2.05, 95%CI&nbsp;=&nbsp;1.39–3.02, p&nbsp;&lt;&nbsp;0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR&nbsp;=&nbsp;0.42, 95%CI&nbsp;=&nbsp;0.18–0.99, p&nbsp;=&nbsp;0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon

Investir dans les ressources humaines pour la santé en Afrique subsaharienne francophone

Cette introduction présente les articles qui composent ce numéro hors-série sur l'investissement dans les ressources humaines de la santé en Afrique francophone. Il situe d'abord la question des ressources humaines dans la problématique de la poursuite des objectifs de développement durable adoptés par l'Assemblée générale des Nations-Unies en 2015. Il présente ensuite le projet Muskoka, lancé par le gouvernement français et mis en ½uvre en collaboration avec l'Organisation mondiale de la santé et l'UNICEF, dans le cadre duquel des études ont été effectuées sur la qualité de la formation des personnels de santé, ainsi que sur les thèmes du recrutement et de la fidélisation dans neuf pays d'Afrique francophone. Les articles de ce numéro hors-série sont brièvement présentés ainsi que les principales leçons qu'ils dégagent quant à la formulation et à la mise en ½uvre d'interventions sur les thèmes étudiés