Educating Enough Competent Health Professionals: Advancing Educational Innovation at Muhimbili University of Health and Allied Sciences, Tanzania.

Sarah MacFarlane and colleagues share their lessons engaging in educational reform and faculty development with the Muhimbili University of Health and Allied Sciences in Tanzania and the University of California San Francisco

Reflecting on the role of dynamic capabilities in digital government with a focus on developing countries

The ability to reconfigure organisational resources dynamically in order to adapt to changing environments is an important organisational capability. Developing countries in particular have a greater need to reconfigure their government resources. The aim of this study was therefore to conduct a systematic literature review of research into the dynamic capabilities of digital government. The findings suggest that most researchers have focused on the innovative capability compared with adaptive and absorptive capabilities. This means the focus is primarily on new services and infrastructure using ICT, but rarely on scanning the environment to identify new ways to provide existing services, nor on finding new ways to provide new services using ICT. The findings further highlight the absence of research in developing countries, specifically in Africa and Latin America. This research contributes to ICT4D literature in identifying research gaps on how to reconfigure government resources using ICT in developing countries

Neural substrates and functional connectivity associated with sleep-dependent and independent consolidation of new motor skills

La mémoire n’est pas un processus unitaire et est souvent divisée en deux catégories majeures: la mémoire déclarative (pour les faits) et procédurale (pour les habitudes et habiletés motrices). Pour perdurer, une trace mnésique doit passer par la consolidation, un processus par lequel elle devient plus robuste et moins susceptible à l’interférence. Le sommeil est connu comme jouant un rôle clé pour permettre le processus de consolidation, particulièrement pour la mémoire déclarative. Depuis plusieurs années cependant, son rôle est aussi reconnu pour la mémoire procédurale. Il est par contre intéressant de noter que ce ne sont pas tous les types de mémoire procédurale qui requiert le sommeil afin d’être consolidée. Entre autres, le sommeil semble nécessaire pour consolider un apprentissage de séquences motrices (s’apparentant à l’apprentissage du piano), mais pas un apprentissage d’adaptation visuomotrice (tel qu’apprendre à rouler à bicyclette). Parallèlement, l’apprentissage à long terme de ces deux types d’habiletés semble également sous-tendu par des circuits neuronaux distincts; c’est-à-dire un réseau cortico-striatal et cortico-cérébelleux respectivement. Toutefois, l’implication de ces réseaux dans le processus de consolidation comme tel demeure incertain. Le but de cette thèse est donc de mieux comprendre le rôle du sommeil, en contrôlant pour le simple passage du temps, dans la consolidation de ces deux types d’apprentissage, à l’aide de l’imagerie par résonnance magnétique fonctionnelle et d’analyses de connectivité cérébrale. Nos résultats comportementaux supportent l’idée que seul l’apprentissage séquentiel requiert le sommeil pour déclencher le processus de consolidation. Nous suggérons de plus que le putamen est fortement associé à ce processus. En revanche, les performances d’un apprentissage visuomoteur s’améliorent indépendamment du sommeil et sont de plus corrélées à une plus grande activation du cervelet. Finalement, en explorant l’effet du sommeil sur la connectivité cérébrale, nos résultats démontrent qu’en fait, un système cortico-striatal semble être plus intégré suite à la consolidation. C’est-à-dire que l’interaction au sein des régions du système est plus forte lorsque la consolidation a eu lieu, après une nuit de sommeil. En opposition, le simple passage du temps semble nuire à l’intégration de ce réseau cortico-striatal. En somme, nous avons pu élargir les connaissances quant au rôle du sommeil pour la mémoire procédurale, notamment en démontrant que ce ne sont pas tous les types d’apprentissages qui requièrent le sommeil pour amorcer le processus de consolidation. D’ailleurs, nous avons également démontré que cette dissociation de l’effet du sommeil est également reflétée par l’implication de deux réseaux cérébraux distincts. À savoir, un réseau cortico-striatal et un réseau cortico-cérébelleux pour la consolidation respective de l’apprentissage de séquence et d’adaptation visuomotrice. Enfin, nous suggérons que la consolidation durant le sommeil permet de protéger et favoriser une meilleure cohésion au sein du réseau cortico-striatal associé à notre tâche; un phénomène qui, s’il est retrouvé avec d’autres types d’apprentissage, pourrait être considéré comme un nouveau marqueur de la consolidation.Memory in humans is generally divided into two broad categories: declarative (for facts and events) and procedural (for skills and motor abilities). To persist, memories undergo a process referred to as consolidation, where a fresh, initially labile memory trace becomes more robust and stable. Sleep is known to play an important role in declarative memory consolidation, and in the past decade, there has been increasing evidence for a role of sleep in the consolidation of procedural memory as well. Interestingly, however, the beneficial effects of sleep do not seem to be homogenous. Motor sequence learning consolidation, in particular, has been found to be particularly sensitive to sleep effects, while the consolidation of motor adaptation has not. Moreover, neuroimaging research, has demonstrated that the long term retention of these two types of motor abilities rely on different neuronal networks, namely the cortico-striatal and cortico-cerebellar systems, respectively. Yet the implication of these networks in the consolidation of these two types of motor memory remains unclear. The aim of the present doctoral thesis was thus to determine the influence of sleep, while controlling for the simple passage of daytime, on the consolidation of a motor sequence learning task vs. a motor adaptation task. We further aimed to bring new insights into the underlying brain regions involved in consolidating these two forms of motor skills. Consistent with previous research, we found off-line improvements in performance for motor adaptation learning, independent of whether participants had a night of sleep or remained awake during daytime. Furthermore, these improvements were correlated with activity in the cerebellum. In contrast, we found that off-line increases in performance in motor sequence learning were evident after a night of sleep but not over the day; and the putamen was strongly associated with this sleep-dependent consolidation process. Finally, while measuring brain changes in connectivity associated with the latter process, we observed that sleep-dependent consolidation is reflected by an increased level of integration within the cortico-striatal system, but not in other functional networks. Conversely, the simple passage of daytime in the wake state seems to result in decreased cortico-striatal integration. In sum our results highlight that not all motor memories undergo sleep-dependent consolidation. We demonstrated that these different paths to consolidation are also reflected by distinct underlying neuronal systems, namely a cortico-striatal and cortico-cerebellar network associated with the consolidation of motor sequence and motor adaptation learning respectively. Furthermore, we propose that consolidation of motor sequences during sleep protects and favors cohesion within the cortico-striatal system, a phenomenon that, if replicated in other types of memories, may be considered as a new marker of sleep-dependent consolidation

Progress in Global Surgery Comment on “Global Surgery – Informing National Strategies for Scaling Up Surgery in Sub-Saharan Africa”

Abstract Impressive progress has been made in global surgery in the past 10 years, and now serious and evidence-based national strategies are being developed for scaling-up surgical services in sub-Saharan Africa. Key to achieving this goal requires developing a realistic country-based estimate of burden of surgical disease, developing an accurate estimate of existing need, developing methods, rigorously planning and implementing the plan, and scaling-up essential surgical services at the national level

Predicting resurgery in intensive care - a data mining approach

Every day the surgical interventions are associated with medicine, and the area of critical care medicine is no exception. The goal of this work is to assist health professionals in predicting these interventions. Thus, when the Data Mining techniques are well applied it is possible, with the help of medical knowledge, to predict whether a particular patient should or not should be re-operated upon the same problem. In this study, some aspects, such as heart disease and age, and some data classes were built to improve the models created. In addition, several scenarios were created, with the objective can predict the resurgery patients. According the primary objective, the resurgery patients prediction, the metric used was the sensitivity, obtaining an approximate result of 90%.This work has been supported by COMPETE: POCI-01-0145-FEDER-007043 and FCT - Fundacao para a Ciencia e Tecnologia within the Project Scope: UID/CEC/00319/2013." This work is also supported by the Deus ex Machina (DEM): Symbiotic technology for societal efficiency gains - NORTE-01-0145-FEDER-00002

The Impact of urbanization on Food in Security in Amhara Regional State Metropolitan cities

The process of urbanization in developing nations is attended without fast industrialization processes. As a result of this, the urbanization and urban process are accompanied by diverse problems. Hence this paper is aimed at identifying the effect of urbanization on citizens’ food insecurity by monitoring agricultural foodstuff production as a mediating variable.  A quantitative research methodology or approach has been used to depict out urban problems associated with unmanaged urbanization in the Ethiopian, particularly in Amhara regional state.   Structural Equation Modeling was employed to run a mediation analysis by decomposing the direct and indirect effects of one variable on the other. Correlation and regression analyses were executed to measure the direction and magnitude of the effect of the independent variable on the dependent. Regression analysis results indicated the existence of a significant direct effect of urbanization on food insecurity of citizens. The mediation analysis result shows agricultural foodstuff production doesn’t play a mediating role between urbanization and food insecurity. The paper, having traced out the effect of the urbanization on food insecurity, provides possible recommendations. The regional government should be very considerate about the pace of unmanaged, unindustrialized and unemployment induced urbanization. The regional government should address all pushing factors that are dragging farmers into the urban areas. So, it is important to find ways to make farmers beneficial from their farm activities. In this regard, the problem raised by farmers is the inability to settle the debt from fertilizers and improved seeds or at least what they get from selling what they have produced is used to settle their farm debt. Some policy measures such as subsidizing the farmer or extending the repayment period of their debt are then essential to help farmers lead a stable life and lead their families. The government/concerned body need to make a cost-benefit analysis by weighing the pressure from the migration of the farmers and the cost of subsidizing the farmers: compare prevention with curative. Moreover, as a short-term solution, the regional government should identify food unsecured urban households and embrace them in food security packages like urban safety-net programs.  And enhancing the limited income generation capacity of food insecured households

Breves Reflexões sobre Dominação Masculina e Carnivorismo

A história da humanidade é marcada, desde seus primórdios, por traços da exploração do Homem, por meio da subjugação e dispositivos de poder, de violência e de submissão. Esse fato é percebido nas relações entre os gêneros e nas relações do homem com a natureza. O uso da carne na dieta humana também é um traço histórico, que desvela esta dominação e possui conexões ligadas com a sexualidade, especialmente do homem em relação à mulher, de maneira bastante forte. O carnivorismo hoje, apesar de ser amplamente aceito na sociedade, encontra-se ultrapassado porque as possibilidades da alimentação são muito amplas, em razão da modernidade. Além disso, o direito dos animais deve ser considerado, já que anualmente, bilhões deles são abatidos para satisfazer os interesses humanos. Dessa forma, a dieta vegana, o direito dos animais, a ecologia profunda e o moderno conceito da Sustentabilidade surgem na atualidade como alternativas à matança desmedida que ocorre em todo o mundo visando o lucro, e não considerando a vida dos seres e o valor intrínseco que ela possui.