Prise en charge de la douleur post-operatoire immediate en salle de soins post interventionnels

15 à 50 % des opérés font l'expérience des douleurs post opératoires en dépit des traitements analgésiques. Le but de ce travail a été d'évaluer la prise en charge de la douleur post opératoire (DPO)en salle de soins post interventionnels (SPPI). Il s'agit dune étude prospective et descriptive réalisée dans le service d'anesthésie et de réanimation de l'Hôpital Général de Yaoundé, République du Cameroun. Ont été inclus dans cette étude des patients âgés de plus de 15 ans admis en salle de soins post interventionnels et capables d'utiliser les différentes échelles d'évaluation de la douleur (échelle visuelle analogique, échelle numérique, échelle verbale simple). La DPO a été évaluée et les patients ont été traités. Les résultats ont été présentés sous forme de moyennes et de pourcentages. Le test de chi carré a été utilisé pour la comparaison des valeurs. 174 patients ont été recrutés, âgés de 34 ans en moyenne. Le sex ratio a été d'un homme pour 5 femmes. La majorité des interventions chirurgicales a été faite sous anesthésie générale (91 %). L'incidence des DPO a été de 94 %. La fréquence des DPO a été élevée dans les chirurgies orthopédique (13 cas soit 100 %) et gynéco obstétrique (118 cas soit 97,5 %) La Noramidopyrine a été l'antalgique le plus prescrit (73 % des patients). 4 % des patients ont présenté des effets indésirables dus au traitement. La lutte contre la DPO requiert une bonne évaluation de la douleur, des protocoles thérapeutiques adaptés et une surveillance clinique rigoureuse. Clinics in Mother and Child Health Vol. 3(1) 2006: 473-47

PARTICIPATORY RESEARCH DEMONSTRATION AND ITS IMPACT ON THE ADOPTION OF IMPROVED AGRICULTURAL TECHNOLOGIES IN THE SAVANNAS OF WEST AFRICA

Despite continued progress in the development and promotion of improved agricultural technologies, and the gradual process in agricultural research for development (R4D) programmes, adoption rates are relatively low in most parts of sub-Saharan Africa (SSA). Recommendations have, therefore, been made by national and international research institutions and stakeholders for more involvement of the smallholders in evaluating promising agricultural technologies. This study assessed the impact of the participatory research demonstration on the adoption of the technologies promoted by the sub-Saharan Africa Challenge Programme (SSA CP) using the innovation platform (IP) concept. Results showed that 67 and 59% of the IP and non-IP farmers, respectively, reported that researchers and extension personnel decided on the technologies for research or demonstration. Fifty-two and 43% of the IP and non-IP farmers, respectively, perceived research and demonstration to be very useful. The type of technology or demonstration that farmers mostly participated in was crop variety (IP farmers=72.87%; non-IP farmers=70.19%). Following our analyses which are based on the Instrumental Variable (IV) approach, participation in research and demonstrations significantly increased adoption of the demonstrated technologies by 99%. We observed a 100% significant increase in adoption of the demonstrated technologies in the sample of IP participants. The main factors that determined the adoption of the demonstrated technologies included membership to farmer group, and distances to input and output markets.Malgr\ue9 les progr\ue8s continu dans le d\ue9veloppement et la promotion des technologies agricoles am\ue9lior\ue9es, le progr\ue8s graduel dans les programmes de recherche agricole pour le d\ue9veloppement (R4D), les taux d\u2019adoption sont relativement faibles dans la plupart des parties de l\u2019Afrique Sub-Saharienne (SSA). Des recommendations ont \ue9t\ue9, cependant faites par les institutions nationales et internationals de recherches et les parties prenantes pour plus d\u2019implication des petits exploitants agricoles dans l\u2019\ue9valuation des technologies agricoles prometteuses. Cette \ue9tude a evalu\ue9 l\u2019impact de la d\ue9monstration de la recherche participative sur l\u2019adoption des technologies d\ue9velop\ue9es par le programme d\u2019enjeu de l\u2019Afrique Sub-Saharienne (SSA CP) en utilisant le concept de la plate-forme d\u2019innovation (IP). Les r\ue9sultats ont montr\ue9 que 67 et 59% des producteurs de IP et non-IP, respectivement, ont rapport\ue9 que les chercheurs et le personnel de vulgarisation ont le pouvoir de d\ue9cision sur les technologies de recherche et de d\ue9monstration. Cinquante-deux et 43% de producteurs IP et non-IP, respectivement, ont per\ue7u la recherche et la d\ue9monstration comme tr\ue8s utiles. Le type de technologie ou de d\ue9monstration auquel les paysans ont particip\ue9 \ue9tait la vari\ue9t\ue9 de culture, (producteurs IP=72,87%; producteurs non-IP= 70,19%). Selon nos analyses qui sont bas\ue9es sur l\u2019approche de variable instrumentale (IV), la participation \ue0 la recherche et \ue0 la demonstration a sigificativment augment\ue9 l\u2019adoption des technologies d\ue9montr\ue9es par 99%. Nous avions observ\ue9 une augmentation significative de 100% d\u2019adoption de technologies d\ue9montr\ue9es dans l\u2019\ue9chantillon des particpants IP. Les facteurs principaux qui d\ue9terminent l\u2019adoption des technologies d\ue9montr\ue9es comprennent l\u2019appartenance aux groupements de producteurs, et les \ue9carts entre les march\ue9s d\u2019intrant et du produit

The impact of adoption of conservation agriculture on smallholder farmers’ food security in semi-arid zones of southern Africa

BACKGROUND In southern Africa, conservation agriculture (CA) has received a lot of research and promotional support from various organizations in the past decades. Conservation agriculture is largely promoted as one of the few win–win technologies affordable to farmers, in the sense that potentially it improves farmers’ yields (in the long term) at the same time conserving the environment. This is because conservation agriculture reduces nitrogen loss in the soil, promotes water and soil conservation and improves agronomic use efficiency of applied nutrients. However, some concerns have been raised over the feasibility of conservation agriculture on smallholder farms given constraints imposed by the biophysical and institutional realities under which smallholder farmers operate. The main aim of this study is to answer the question whether conservation agriculture is resulting in tangible livelihood outcomes to smallholder farmers. The counterfactual outcome approach was used to estimate ex post impact of conservation agriculture adoption on one of the key livelihood outcomes—food security. RESULTS The study that utilized a data set covering 1623 households in Zimbabwe, Malawi and Mozambique found no significant impact of conservation agriculture adoption on Food Consumption Score of farmers in Zimbabwe and Malawi. Possible reasons for the insignificant of CA impact on food security in Zimbabwe and Malawi could include the small land areas currently devoted to CA, and the failure to implement the full complement of practices necessary to set off the biophysical process that are expected to drive yield increases. In Mozambique, conservation agriculture significantly improved the Food Consumption Score for farmers exposed to the technology. A possible reason for effectiveness of CA in Mozambique could be due to the fact that often CA is being promoted together with other better cropping management practices such as timely weeding and improved seed varieties, which are poorly practiced by the generality of farmers in a country just emerging from a war period. CONCLUSION This paper provides one of the few ex post assessments of the impact of conservation agriculture adoption on household livelihood outcomes—food security. Given the mixed findings, the study suggests that conservation agriculture farmers in the three countries need to be supported to adopt a value chain approach to conservation agriculture. This entails the introduction of commercial or high-value crops in the conservation agriculture programmes, value addition on farmers produce, access to the necessary support services such as markets for seed, fertilizer, herbicides and equipment as well as reliable extension. We believe that under such circumstances conservation agriculture can effectively reduce food insecurity and poverty in the medium to long term

HIV-associated neurocognitive disorders in sub-Saharan Africa: a pilot study in Cameroon

<p>Abstract</p> <p>Background</p> <p>The disease burden of human immunodeficiency virus (HIV) - acquired immunodeficiency syndrome (AIDS) is highest in sub-Saharan Africa but there are few studies on the associated neurocognitive disorders in this region. The objectives of this study were to determine whether Western neuropsychological (NP) methods are appropriate for use in Cameroon, and to evaluate cognitive function in a sample of HIV-infected adults.</p> <p>Methods</p> <p>We used a battery of 19 NP measures in a cross-sectional study with 44 HIV+ adults and 44 demographically matched HIV- controls, to explore the validity of these NP measures in Cameroon, and evaluate the effect of viral infection on seven cognitive ability domains.</p> <p>Results</p> <p>In this pilot study, the global mean z-score on the NP battery showed worse overall cognition in the HIV+ individuals. Significantly lower performance was seen in the HIV+ sample on tests of executive function, speed of information processing, working memory, and psychomotor speed. HIV+ participants with AIDS performed worse than those with less advanced HIV disease.</p> <p>Conclusions</p> <p>Similar to findings in Western cohorts, our results in Cameroon suggest that HIV infection, particularly in advanced stages, is associated with worse performance on standardized, Western neurocognitive tests. The tests used here appear to be promising for studying NeuroAIDS in sub-Saharan Africa.</p