One year audit of surgical admissions at Gondar university medical college

Background: The new University of Gondar enrolled surgeons for post graduate training in November 2003. A new surgical curriculum was designed in partnership with the Leicester Gondar Link. Admissions to the Department of Surgery over twelve months were subject to audit. The objectives of the audit study were to introduce a new concept, to review the surgical experience of the Department, to support organizational change, to integrate audit into post graduate training, and to measure and improve the quality of the service.Method: Social, medical and administrative data on inpatients was recorded on a discharge summary sheet. The data was coded using a six letter descriptive code and transferred to a computer for presentation on a spread sheet.Results: The results list the social and the demographic distribution of patients; the surgical details including diagnosis, operation and outcome; and administrative data of patient numbers and duration of stay.Conclusion: The discussion is related the objectives of the study. The concept of audit was successfully introduced. Although data was incomplete, trends were apparent. The surgical experience of the Department was documented. The results supported the argument for organizational change including a move to sub-specialization. Audit has become an integral part of the postgraduate curriculum underwriting the monthly morbidity and mortality meetings and providing data for clinical research. The data has provided a baseline mortality rate and exposed quality issues for example, demographic restrictions on access to surgery, and the high mortality rate among patients with head injury

Water Body Temperature Model for Assessing Climate Change Impacts on Thermal Cooling

We develop and test a physically based semi-Lagrangian water body temperature model to apply climatological data and thermal pollution from river-based power plants to historical river flow data in order to better understand climate change impacts on surface water temperature and thermal power plant withdrawal allowances. The model is built for rapid assessment and use in Integrated Assessment Models. We first test the standalone model on a 190km river reach, the Delaware River, where we have detailed flow and temperature data. An R2 of 0.88 is obtained on hourly data for this initial test. Next, we integrate the standalone temperature model into a series of models—rainfall-runoff model, water demand model, water resource management model, and power plant uptake and release model—for the contiguous USA (CONUS), with about 19,000 segments total. With this system in place, we then validate the standalone water temperature model within the system for 16 river stations throughout the CONUS, where we have measured daily temperature data. The model performs reasonably well with a median R2 of 0.88. A variety of climate and emissions scenarios are then applied to the model to test regions of higher vulnerability to river temperature environmental violations, making use of output from two GCMs and six emissions scenarios focusing on projections out to 2050. We find that the two GCMs project significantly different impacts to water temperature, driven largely by the resulting changes in streamflow from the two models. We also find significantly different impacts on the withdrawal allowed by thermal power plants due to environmental regulations. Potential impacts on generation are between +3% and -4% by 2050 for the unconstrained emissions case and +3.5% to -2% for the stringent GHG mitigation policy (where 1% is equivalent to 32 TWh, or about 3 billion USD/year using 2005 electricity prices). We also find that once-through cooling plants are most vulnerable to climate change impacts, with summer impacts ranging from -0.8% to -6% for the unconstrained emissions case and +2.1% to -3.7% for the stringent GHG emissions case

Training the next generation of physician researchers – Vanderbilt Medical Scholars Program

Abstract Background As highlighted in recent reports published by the Physician-Scientist Workforce Working Group at the National Institutes of Health, the percentage of physicians conducting research has declined over the past decade. Various programs have been put in place to support and develop current medical student interest in research to alleviate this shortage, including The Vanderbilt University School of Medicine Medical Scholars Program (MSP). This report outlines the long-term program goals and short-term outcomes on career development of MSP alumni, to shed light on the effectiveness of research training programs during undergraduate medical training to inform similar programs in the United States. Methods MSP alumni were asked to complete an extensive survey assessing demographics, accomplishments, career progress, future career plans, and MSP program evaluation. Results Fifty-five (81%) MSP alumni responded, among whom 12 had completed all clinical training. The demographics of MSP alumni survey respondents are similar to those of all Vanderbilt medical students and medical students at all other Association of American Medical College (AAMC) medical schools. MSP alumni published a mean of 1.9 peer-reviewed manuscripts (95% CI:1.2, 2.5), and 51% presented at national meetings. Fifty-eight percent of respondents reported that MSP participation either changed their career goals or helped to confirm or refine their career goals. Conclusions Results suggest that the MSP program both prepares students for careers in academic medicine and influences their career choices at an early juncture in their training. A longer follow-up period is needed to fully evaluate the long-term outcomes of some participants

National mapping of soil-transmitted helminth and schistosome infections in Ethiopia

Background An accurate understanding of the geographical distributions of both soil-transmitted helminths (STHs; Ascaris lumbricoides, Trichuris trichiura, and the hookworms Necator americanus and Ancylostoma duodenale) and schistosomes (SCH; Schistosoma mansoni and S. haematobium) is pivotal to be able to effectively design and implement mass drug administration (MDA) programmes. The objective of this study was to provide up-to-date data on the distribution of both STH and SCH in Ethiopia to inform the design of the national control program and to be able to efficiently achieve the 75% MDA coverage target set by the WHO. Methods Between 2013 and 2015, we assessed the distributions of STH and SCH infections in a nationwide survey covering 153,238 school-aged children (aged 5–15 years), from 625 woredas (districts), representing all nine Regional States and two City Administrations of Ethiopia. Nationwide disease maps were developed at the woreda level to enable recommendations on the design of the national MDA programme. Results The prevalence of any STH infection across the study population was 21.7%, with A. lumbricoides (12.8%) being the most prevalent STH, followed by hookworms (7.6%) and T. trichiura (5.9%). The prevalence for any SCH was 4.0% in areas where both SCH species were evaluated. Schistosoma mansoni was the most prevalent SCH (3.5 vs 0.3%). STHs were more prevalent in southwest Ethiopia, whereas SCH was found mostly in the west and northeast of the country. The prevalence of moderate-to-heavy intensity infections was 2.0% for STHs and 1.6% for SCH. For STH, a total of 251 woredas were classified as moderately (n = 178) or highly endemic (n = 73), and therefore qualify for an annual and biannual MDA program, respectively. For SCH, 67 woredas were classified as endemic and 8 as highly endemic, and hence they require every two years and annual MDA programme, respectively. Conclusions The results confirm that Ethiopia is endemic for both STHs and SCH, posing a significant public health problem. Following the WHO recommendations on mass drug administration, 18 and 14 million school-aged children are in need of MDA for STHs and SCH, respectively, based on the number of SACs that live on the eligible geographical areas

Metabolic control and bone health in adolescents with type 1 diabetes

<p>Abstract</p> <p>Background</p> <p>Adults with type 1 diabetes (T1D) have decreased bone mineral density (BMD) and increased fracture risk, yet the etiologies remain elusive. Early detection of derangements in bone biomarkers during adolescence could lead to timely recognition. In adolescents with T1D, we evaluated the relationships between metabolic control, BMD, and bone anabolic and turnover markers.</p> <p>Methods</p> <p>Cross-sectional study of 57 adolescent subjects with T1D who had HbA1c consistently ≥ 9% (Poor Control, PC n = 27) or < 9% (Favorable Control, FC n = 30) for two years prior to enrollment. Subjects had T1DM for at least three years and were without diabetes complications, known celiac disease, or other chronic diseases.</p> <p>Results</p> <p>There were no differences between HbA1c groups in BMD, components of the IGF system, or 25-hydroxyvitamin D status. The prevalence of 25-hydroxyvitamin D abnormalities was similar to that seen in the general adolescent population. Few patients met the recommended dietary allowance (RDA) for vitamin D or calcium.</p> <p>Conclusions</p> <p>These data provide no evidence of association between degree of metabolic control and BMD in adolescents with T1D. Adolescents with T1D have a high prevalence of serum 25-hydroxyvitamin D abnormalities. Longitudinal studies are needed to evaluate the predictive value of vitamin D abnormalities on fracture risk.</p

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4 (62.3 (55.1�70.8) million) to 6.4 (58.3 (47.6�70.7) million), but is predicted to remain above the World Health Organization�s Global Nutrition Target of <5 in over half of LMICs by 2025. Prevalence of overweight increased from 5.2 (30 (22.8�38.5) million) in 2000 to 6.0 (55.5 (44.8�67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic. © 2020, The Author(s)

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

Factors associated with acute respiratory infection in children under the age of 5 years: evidence from the 2011 Ethiopia Demographic and Health Survey [Corrigendum]

Gebretsadik A, Worku A, Berhane Y. Pediatric Health, Medicine and Therapeutics. 2015;6:9&ndash;13.On page 9 in the third sentence of the results section &ldquo;(AOR 0.4; 95% CI 0.2&ndash;0.6 and AOR 0.1; 95% CI 0.01&ndash;0.6, respectively)&rdquo; should be &ldquo;(AOR 0.4; 95% CI 0.2&ndash;1.0 and AOR 0.1; 95% CI 0.01&ndash;0.6, respectively)&rdquo;.On page 11 left column, second paragraph P&lt;0.025 should be P&lt;0.25.On page 12, Table 2 note section P&lt;0.005 should be P&lt;0.05.On page 13 reference 7 should have been shown as &ldquo;Prajapati B, Talsania N, Lala MK, Sonalia KN. A study of risk factors of acute respiratory tract infection (ARI) of under five age group in uban and rural communities of Ahmedabad district, Gujarat. Healthline. 2012;3(1):16&ndash;20.&rdquo;Read the original articl