On Weighted Distributions and Mean Advantage Over Inferiors Functions

In this note, some fundamental results including relationship be-tween weighted distribution functions and mean advantage over inferi-ors functions are established. Ordering of reliability and/or distribution functions via mean advantage over inferiors functions and related func-tions for parent and weighted reliability functions are presented. Some applications and examples are given

Palliative care and prehospital emergency medicine: analysis of a case series.

Palliative care, which is intended to keep patients at home as long as possible, is increasingly proposed for patients who live at home, with their family, or in retirement homes. Although their condition is expected to have a lethal evolution, the patients-or more often their families or entourages-are sometimes confronted with sudden situations of respiratory distress, convulsions, hemorrhage, coma, anxiety, or pain. Prehospital emergency services are therefore often confronted with palliative care situations, situations in which medical teams are not skilled and therefore frequently feel awkward.We conducted a retrospective study about cases of palliative care situations that were managed by prehospital emergency physicians (EPs) over a period of 8 months in 2012, in the urban region of Lausanne in the State of Vaud, Switzerland.The prehospital EPs managed 1586 prehospital emergencies during the study period. We report 4 situations of respiratory distress or neurological disorders in advanced cancer patients, highlighting end-of-life and palliative care situations that may be encountered by prehospital emergency services.The similarity of the cases, the reasons leading to the involvement of prehospital EPs, and the ethical dilemma illustrated by these situations are discussed. These situations highlight the need for more formal education in palliative care for EPs and prehospital emergency teams, and the need to fully communicate the planning and implementation of palliative care with patients and patients' family members

ENTRE INSTABILITÉ ET DÉVELOPPEMENT : Analyse de l'impact de l'endettement par le marché régional des titres publics et la stabilité politique sur la Croissance économique au Mali (2011-2023).

Khalid DEMBELE Cette étude explore la relation complexe entre l'endettement, la croissance économique et la stabilité politique au Mali à travers le marché régional des titres publics de l’UEMOA sur la période de 2011 à 2023. En se servant des bases de  l’UEMOA-Titres de la BCEAO et de la Banque mondiale en appliquant plusieurs méthodes d’estimations : méthode des variables instrumentales et ARDL en raison de la nature des données, pour évaluer les effets de l'endettement à travers les fonds mobilisés sur le marché des titres publics, sur la croissance au Mali. Les résultats indiquent que l'endettement via les titres obligataires peut stimuler la croissance économique, tandis que les instruments de dette à court terme, comme les bons du Trésor, ont tendance à avoir un impact négatif. De plus, la stabilité politique se révèle être un élément clé pour mobiliser des fonds sur le marché régional,  la gestion efficace de la dette et son influence sur la croissance. Ces résultats ont des implications significatifs pour la politique économique, suggérant la nécessité dans le choix de type d’endettement entre les titres obligataires ou bons du trésor et une gestion prudente de la dette  avec un environnement politique stable, et offrent des leçons importantes pour d'autres pays en développemen

Access and use of interventions to prevent and treat malaria among pregnant women in Kenya and Mali: a qualitative study.

BACKGROUND: Coverage of malaria in pregnancy interventions in sub-Saharan Africa is suboptimal. We undertook a systematic examination of the operational, socio-economic and cultural constraints to pregnant women's access to intermittent preventive treatment (IPTp), long-lasting insecticide-treated nets (LLINs) and case management in Kenya and Mali to provide empirical evidence for strategies to improve coverage. METHODS: Focus group discussions (FGDs) were held as part of a programme of research to explore the delivery, access and use of interventions to control malaria in pregnancy. FGDs were held with four sub-groups: non-pregnant women of child bearing age (aged 15-49 years), pregnant women or mothers of children aged <1 year, adolescent women, and men. Content analysis was used to develop themes and sub-themes from the data. RESULTS: Women and men's perceptions of the benefits of antenatal care were generally positive; motivation among women consisted of maintaining a healthy pregnancy, disease prevention in mother and foetus, checking the position of the baby in preparation for delivery, and ensuring admission to a facility in case of complications. Barriers to accessing care related to the quality of the health provider-client interaction, perceived health provider skills and malpractice, drug availability, and cost of services. Pregnant women perceived themselves and their babies at particular risk from malaria, and valued diagnosis and treatment from a health professional, but cost of treatment at health facilities drove women to use herbal remedies or drugs bought from shops. Women lacked information on the safety, efficacy and side effects of antimalarial use in pregnancy. CONCLUSION: Women in these settings appreciated the benefits of antenatal care and yet health services in both countries are losing women to follow-up due to factors that can be improved with greater political will. Antenatal services need to be patient-centred, free-of-charge or highly affordable and accountable to the women they serve

Infections bucco-dentaires en milieu psychiatrique de l’hôpital de Point-G : Observations de 130 cas.

Objectif : Analyser l’influence de la maladie mentale sur l’état de santé bucco-dentaire des patients psychiatriques. Matériels et méthode : Nous avons réalisé une étude prospective, transversale et descriptive basée sur l’observation des lésions bucco-dentaires chez les patients reçus en consultation psychiatrique. Elle s’est déroulée dans le service de Psychiatrie du Centre HospitaloUniversitaire du Point G pendant un mois (de juin à juillet 2014). La population cible était les patients psychiatriques connus suivis et/ou hospitalisés dans le service pendant la période de l'étude. Les données ont été recueillies à partir des dossiers médicaux et un questionnaire et saisies puis analysées avec le logiciel Epi info fr 6.0. Résultats : Pendant la période d’étude, 130 patients ont été retenus selon nos critères d’inclusion, dont 70,0% pour le sexe masculin avec un sex ratio de 2,3. La tranche d’âge 25- 34 ans était la plus représentée, soit 31,50%. . La majorité de nos patients présentaient une abrasion dentaire, soit 90,80% des cas. L’indice CAO/D de notre population était de 5,22. L’halitose et la sècheresse buccale étaient fréquentes chez les patients atteints de psychose chronique, soit respectivement 63,50% et 56,90% des cas. La gingivorragie a été observé chez 61,10% des patients atteints de psychose chronique.Conclusion : Cette étude montre la fréquence élevée de l’infection bucco-dentaire en milieu psychiatrique, d’où l’intérêt d’un partenariat entre professionnels de la santé mentale et ceux de la cavité buccal

Relation entre Maladies Parodontales et Maladies cardiovasculaires : Revue de la littérature

Introduction : La maladie parodontale (MP) est une maladie inflammatoire complexe qui détruit les tissus de soutien de la dent (parodonte) avec une étiologie multifactorielle elle a été liée au diabète, aux obstructions chroniques des voies respiratoires, aux maladies rénales chroniques, aux syndromes métaboliques, à certains types de cancers, la polyarthrite rhumatoïde et aux maladies cardiovasculaires. Les maladies cardiovasculaires (MCV) constituent un ensemble de troubles affectant le cœur et les vaisseaux sanguins, leur cause la plus courante est l’athérosclérose, qui correspond à un remaniement pathologique de la paroi interne des artères de gros et moyen calibres par accumulation de lipides, glucides complexes, éléments sanguins et dépôts calcaires, formant des plaques d’athérosclérose. Ainsi, l’objectif de cette revue de la littérature est de déterminer la relation entre les maladies parodontales et les maladies cardiovasculaires. Matériels et Méthodes : Pour ce travail une stratégie de recherche documentaire électronique a été réalisée dans 2 bases de données dont Pub Med et Google scholar. Ainsi 423 articles traitant la relation entre les maladies parodontales et les maladies cardiovasculaires publiés en anglais ou en français avec texte intégral dans la période allant de 1989 à 2016 ont été sélectionnés. Les titres et résumés des articles retrouvés grâce à la stratégie de recherche ont été passés en revue. Les articles qui n’étaient pas pertinents pour une inclusion ont été écartés dès ce stade. Les données recueillies ont subi une analyse après mise en œuvre des critères d’inclusions : Etudes réalisées chez les humains et rédigées en anglais ou en français et publiés entre 1989 à 2016. Les articles inclus étaient ceux après lecture des titres, des résumés jugés pertinents dont 35 articles traitant la relation entre les maladies parodontales et les Maladies Cardiovasculaires ont été sélectionnés. Résultat : Au total 35 articles traitant la relation entre les maladies parodontales et les Maladies cardiovasculaires ont été sélectionnés compte tenu de leurs cohérence et pertinence. La limite a été la consultation que de 2 bases de données. Les bactériémies associées aux parodontites sont responsables d’une activation de la réponse immuno-inflammatoire favorisant la formation, la maturation et la complication des plaques d’athérome. Il existe un risque accru de MCV chez les patients atteints de parodontite chronique, indépendamment des autres facteurs de risques cardiovasculaires. Le traitement parodontal réduit le niveau d’inflammation systémique et améliore la fonction endothéliale, mais ne modifie pas la dyslipidémie. Conclusion : avec une étiologie infectieuse pour les maladies et divers pour les maladies cardiovasculaires, un lien a été établi entre les deux maladies dans diverses études épidémiologiques et cliniques mais toutes fois reste controverse dans d’autre

Modelling the elimination of river blindness using long-term epidemiological and programmatic data from Mali and Senegal

The onchocerciasis transmission models EPIONCHO and ONCHOSIM have been independently developed and used to explore the feasibility of eliminating onchocerciasis from Africa with mass (annual or biannual) distribution of ivermectin within the timeframes proposed by the World Health Organization (WHO) and endorsed by the 2012 London Declaration on Neglected Tropical Diseases (i.e. by 2020/2025). Based on the findings of our previous model comparison, we implemented technical refinements and tested the projections of EPIONCHO and ONCHOSIM against long-term epidemiological data from two West African transmission foci in Mali and Senegal where the observed prevalence of infection was brought to zero circa 2007–2009 after 15–17 years of mass ivermectin treatment. We simulated these interventions using programmatic information on the frequency and coverage of mass treatments and trained the model projections using longitudinal parasitological data from 27 communities, evaluating the projected outcome of elimination (local parasite extinction) or resurgence. We found that EPIONCHO and ONCHOSIM captured adequately the epidemiological trends during mass treatment but that resurgence, while never predicted by ONCHOSIM, was predicted by EPIONCHO in some communities with the highest (inferred) vector biting rates and associated pre-intervention endemicities. Resurgence can be extremely protracted such that low (microfilarial) prevalence between 1% and 5% can be maintained for 3–5 years before manifesting more prominently. We highlight that post-treatment and post-elimination surveillance protocols must be implemented for long enough and with high enough sensitivity to detect possible residual latent infections potentially indicative of resurgence. We also discuss uncertainty and differences between EPIONCHO and ONCHOSIM projections, the potential importance of vector control in high-transmission settings as a complementary intervention strategy, and the short remaining timeline for African countries to be ready to stop treatment safely and begin surveillance in order to meet the impending 2020/2025 elimination targets

A leaf area index data set acquired in Sahelian rangelands of Gourma in Mali over the 2005–2017 period

The leaf area index of Sahelian rangelands and related variables such as the vegetation cover fraction, the fraction of absorbed photosynthetically active radiation and the clumping index were measured between 2005 and 2017 in the Gourma region of northern Mali. These variables, known as climate essential variables, were derived from the acquisition and the processing of hemispherical photographs taken along 1&thinsp;km linear sampling transects for five contrasted canopies and one millet field. The same sampling protocol was applied in a seasonally inundated Acacia open forest, along a 0.5&thinsp;km transect, by taking photographs of the understorey and the tree canopy. These observations collected over more than a decade, in a remote and not very accessible region, provide a relevant and unique data set that can be used for a better understanding of the Sahelian vegetation response to the current rainfall changes. The collected data can also be used for satellite product evaluation and land surface model development and validation. This paper aims to present the field work that was carried out during 13 successive rainy seasons, the measured vegetation variables, and the associated open database. Finally, a few examples of data use are shown. DOI of the referenced data set: https://doi.org/10.17178/AMMA-CATCH.CE.Veg_Gh.</p

Implementing Preventive Chemotherapy through an Integrated National Neglected Tropical Disease Control Program in Mali

Neglected tropical diseases (NTDs) are a group of chronic infections that affect the poorest group of the populations in the world. There are currently five major NTDs targeted through mass drug treatment in the affected communities. The drug delivery can be integrated to deliver different drug packages as these NTDs often overlap in distribution. Mali is endemic with all five major NTDs. The integrated national NTD control program was implemented through the primary health care system using the community health center workers and the community drug distributors aiming at long-term sustainability. After a pilot start in three regions in 2007 without prior examples to follow on integrated mass drug administration, treatment for the five targeted NTDs was gradually scaled up and reached all endemic districts by 2009, and annual drug coverage in the targeted population has since been maintained at a high level for each of the five NTDs. Around 10 million people received one or more drug treatments each year since 2009. The country is on the way to meet the national objectives of elimination or control of these diseases. The successes and lessons learned in Mali are valuable assets to other countries looking to start similar programs