Multiple dorsal carpometacarpal joint dislocation: case report

Carpometacarpal joint dislocation extending from the second to fifth metacarpal is a rare injury. It usually follows high energy trauma but may be seen in low energy trauma. The diagnosis can easily be missed because of severe swelling of the hand at presentation and overlapping of the bones on radiograph of the wrist and hand. The dorsal dislocation is the commonest pattern of injury. We present a case of right dorsal carpometacarpal joint dislocation. The diagnosis was made with radiograph of the right wrist. It was managed with closed reduction and percutaneous K-wire fixation under image intensifier control. He had intensive physiotherapy and functional assessment was done using quick DASH score at regular interval on follow up. On the last follow up, 2 years later, the quick DASH score was 9.1%. The right hand was pain-free. A high index of suspicion and meticulous hand examination is important to avoid missed diagnosis of a carpometacarpal joint dislocation. Prompt reduction and fixation followed by intensive physiotherapy are necessary to achieve excellent hand function

Geriatric trauma - epidemiology and outcome at Cedarcrest Hospitals, Abuja, Nigeria

Background: Trauma is a major public health problem with huge economic and social implications. Old age and co-morbidities generally affect the outcome of traumatic injuries in elderly patients, and the impact of trauma on elderly patients has generally been overlooked. Objective: To describe the epidemiology and outcome of trauma on elderly patients. Design: This was a retrospective study that was conducted at Cedarcrest Hospitals, Abuja, Nigeria. Method: Data were collected from the electronic medical records for all patients aged 65 years and above who visited the emergency department as a result of traumatic injuries. Results: A total of 82 patients were recruited for the study. The prevalence of geriatric trauma was 4.9%, and fall was the commonest mechanism of injury (67.1%). Ninety eight point eight percent had a revised trauma score of 12 while the injury severity score ranged from 1 to 15. Conclusion: Geriatric trauma is relatively common in our environment and efforts should be made to prevent falls in the elderly

A comparison of prevalence of unethical tendering practices at national and subnational levels in Nigeria

Nigeria has recently renewed efforts towards stamping out corruption in every area of its national life. Given that construction procurement is particularly prone to corrupt practices, this study investigated the prevalence of unethical tendering practices in the Nigerian public sector. In particular, a comparison to bare the similarities or differences in the prevalence of unethical tendering practices at national and subnational levels is scarcely available in literature. This study’s objective was to determine and compare the prevalence of unethical tendering practices at the national and subnational levels in Nigeria. The data analysis was based on 120 acceptably filled questionnaires obtained from contractor, client and consultant organisations previously involved in public sector projects. The unethical tendering practices were analysed using prevalence indices and Mann–Whitney U tests. Findings include that the three most prevalent unethical tendering practices are contractor-based, namely: (1) competitors offer bribes to gain access to confidential tendering information (C1); (2) competitors overstate their capacity, experience and qualifications to secure construction contracts (C2); (3) the same owner(s) use different firms to tender for the same project (C3), in descending order of prevalence. No significant difference exists between unethical tendering practices in federal and state government projects. The findings of the study will help the Nigerian government and other stakeholders to better understand unethical practices at the tender stage of construction procurement in the public sector and to evolve better strategies for dealing with them. The study contributes to existing knowledge by separately identifying the prevalent unethical tendering practices in the Nigerian context and comparing unethical tendering practices at national and subnational levels within a country

Improving Nigerian health policymakers’ capacity to access and utilize policy relevant evidence: outcome of information and communication technology training workshop

Information and communication technology (ICT) tools are known to facilitate communication and processing of information and sharing of knowledge by electronic means. In Nigeria, the lack of adequate capacity on the use of ICT by health sector policymakers constitutes a major impediment to the uptake of research evidence into the policymaking process. The objective of this study was to improve the knowledge and capacity of policymakers to access and utilize policy relevant evidence. A modified "before and after" intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point likert scale according to the degree of adequacy; 1 = grossly inadequate, 4 = very adequate was employed. This study was conducted in Ebonyi State, south-eastern Nigeria and the participants were career health policy makers. A two-day intensive ICT training workshop was organized for policymakers who had 52 participants in attendance. Topics covered included: (i). intersectoral partnership/collaboration; (ii). Engaging ICT in evidence-informed policy making; use of ICT for evidence synthesis; (iv) capacity development on the use of computer, internet and other ICT. The pre-workshop mean of knowledge and capacity for use of ICT ranged from 2.19-3.05, while the post-workshop mean ranged from 2.67-3.67 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 8.3%-39.1%. Findings of this study suggest that policymakers' ICT competence relevant to evidence-informed policymaking can be enhanced through training workshop

On logistic regression versus support vectors machine using vaccination dataset

The performance of two classification techniques, logistic regression and Support Vector Machines (SVMs), in assessing vaccination data is investigated in this study. The model was trained based on leave-out-one cross validation to obtain an accurate result. Simulated with ten thousand replications, a life data set was used to establish a better model. The findings from the simulation revealed that the logistic regression model slightly outperformed the SVM while the life data shows that the tuned SVM outperformed both the logistic and the SVM. This demonstrates the practical utility of advanced approaches such as SVMs in difficult categorization scenarios such as vaccination prediction. The study emphasizes the superiority of the customized SVM model in this setting, as well as the potential of machine learning approaches to increase comprehension of complicated healthcare scenarios and guide data-driven decision-making for influencing vaccination plans and public health. The study recommends the use of logistic regression if the data point is high

Detection of Lassa Virus, Mali

To determine whether Lassa virus was circulating in southern Mali, we tested samples from small mammals from 3 villages, including Soromba, where in 2009 a British citizen probably contracted a lethal Lassa virus infection. We report the isolation and genetic characterization of Lassa virus from an area previously unknown for Lassa fever

Construção das identidades de jovens de origem imigrante em Europa: resultados dum projeto Europeu

Este artigo descreve e analisa alguns dos elementos que influenciam a construção das identidades dos jovens de origem imigrante na Europa. Os resultados derivam dum projeto de investigação europeu intitulado “Rumo à construção social duma juventude europeia: a experiência de inclusão e exclusão na esfera pública dos jovens migrantes de segunda geração”1, desenvolvido entre 2006 e 2009 em nove cidades localizadas em cinco países: Espanha (Madrid e Barcelona), Itália (Génova e Roma), Portugal (Lisboa e Porto), França (Metz), Alemanha (Berlim) e Holanda (Utrecht). A primeira parte analisa os dados quantitativos recolhidos nos contextos de estudo, comparando os jovens descendentes de imigrantes com os jovens autóctones, focando a questão da identidade como um assunto central no processo de inclusão dos jovens imigrantes. A segunda parte aborda alguns dos marcadores identitários presentes nos jovens descendentes de imigrantes em Portugal, à luz de dados etnográficos recolhidos especificamente para o caso dos jovens na Área Metropolitana de Lisboa focando as questões de identidade, género e discriminação

Can Racial Identity Be Promotive of Academic Efficacy?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/89953/1/oyserman__harrison__bybee__2001.pd

The metrics and correlates of physician migration from Africa

<p>Abstract</p> <p>Background</p> <p>Physician migration from poor to rich countries is considered an important contributor to the growing health workforce crisis in the developing world. This is particularly true for Africa. The perceived magnitude of such migration for each source country might, however, depend on the choice of metrics used in the analysis. This study examined the influence of choice of migration metrics on the rankings of African countries that suffered the most physician migration, and investigated the correlates of physician migration.</p> <p>Methods</p> <p>Ranking and correlational analyses were conducted on African physician migration data adjusted for bilateral net flows, and supplemented with developmental, economic and health system data. The setting was the 53 African birth countries of African-born physicians working in nine wealthier destination countries. Three metrics of physician migration were used: total number of physician émigrés; emigration fraction defined as the proportion of the potential physician pool working in destination countries; and physician migration density defined as the number of physician émigrés per 1000 population of the African source country.</p> <p>Results</p> <p>Rankings based on any of the migration metrics differed substantially from those based on the other two metrics. Although the emigration fraction and physician migration density metrics gave proportionality to the migration crisis, only the latter was consistently associated with source countries' workforce capacity, health, health spending, economic and development characteristics. As such, higher physician migration density was seen among African countries with relatively higher health workforce capacity (0.401 ≤ <it>r </it>≤ 0.694, <it>p </it>≤ 0.011), health status, health spending, and development.</p> <p>Conclusion</p> <p>The perceived magnitude of physician migration is sensitive to the choice of metrics. Complementing the emigration fraction, the physician migration density is a metric which gives a different but proportionate picture of which African countries stand to lose relatively more of its physicians with unchecked migration. The nature of health policies geared at health-worker migration can be expected to depend on the choice of migration metrics.</p