Vulnerable diseases affecting child mortality in Sierra Leone: emerging health issue

Child mortality in Sierra Leone is the highest ranked in the world. The main causes for child mortality are maternal factors, environmental factors and health factors. Minimal research has been carried out on health factors in Sierra Leone. The objective of this study is to see how maternal and environmental factors have an effect on health factors, which in turn cause child mortality. The data used were from the 2008 Sierra Leone Demographic and Household Survey (SLDHS). The study showed that child mortality had statistically significant factors associated with it: place of residence, birth number, religion and type of toilet facility. Furthermore, the SLDHS had not given much information regarding the cause of diseases affecting children, so we looked only at the effects they had on children. Acute respiratory infections, diarrhoea and measles each had one variable that was statistically significant. As for pneumonia, there were no variables associated with children contracting the disease

Topical Insulin Accelerates Wound Healing in Diabetes by Enhancing the AKT and ERK Pathways: A Double-Blind Placebo-Controlled Clinical Trial

Background: Wound healing is impaired in diabetes mellitus, but the mechanisms involved in this process are virtually unknown. Proteins belonging to the insulin signaling pathway respond to insulin in the skin of rats. Objective: The purpose of this study was to investigate the regulation of the insulin signaling pathway in wound healing and skin repair of normal and diabetic rats, and, in parallel, the effect of a topical insulin cream on wound healing and on the activation of this pathway. Research Design and Methods: We investigated insulin signaling by immunoblotting during wound healing of control and diabetic animals with or without topical insulin. Diabetic patients with ulcers were randomized to receive topical insulin or placebo in a prospective, double-blind and placebo-controlled, randomized clinical trial (NCT 01295177) of wound healing. Results and Conclusions: Expression of IR, IRS-1, IRS-2, SHC, ERK, and AKT are increased in the tissue of healing wounds compared to intact skin, suggesting that the insulin signaling pathway may have an important role in this process. These pathways were attenuated in the wounded skin of diabetic rats, in parallel with an increase in the time of complete wound healing. Upon topical application of insulin cream, the wound healing time of diabetic animals was normalized, followed by a reversal of defective insulin signal transduction. In addition, the treatment also increased expression of other proteins, such as eNOS (also in bone marrow), VEGF, and SDF-1 alpha in wounded skin. In diabetic patients, topical insulin cream markedly improved wound healing, representing an attractive and cost-free method for treating this devastating complication of diabetes.Sao Paulo Research Foundation (FAPESP)Sao Paulo Research Foundation (FAPESP)National Institute of Science and Technology (INCT)National Institute of Science and Technology (INCT)National Council for Scientific and Technological Development (CNPq)National Council for Scientific and Technological Development (CNPq

Protecting Important Sites for Biodiversity Contributes to Meeting Global Conservation Targets

Protected areas (PAs) are a cornerstone of conservation efforts and now cover nearly 13% of the world's land surface, with the world's governments committed to expand this to 17%. However, as biodiversity continues to decline, the effectiveness of PAs in reducing the extinction risk of species remains largely untested. We analyzed PA coverage and trends in species' extinction risk at globally significant sites for conserving birds (10,993 Important Bird Areas, IBAs) and highly threatened vertebrates and conifers (588 Alliance for Zero Extinction sites, AZEs) (referred to collectively hereafter as ‘important sites’). Species occurring in important sites with greater PA coverage experienced smaller increases in extinction risk over recent decades: the increase was half as large for bird species with>50% of the IBAs at which they occur completely covered by PAs, and a third lower for birds, mammals and amphibians restricted to protected AZEs (compared with unprotected or partially protected sites). Globally, half of the important sites for biodiversity conservation remain unprotected (49% of IBAs, 51% of AZEs). While PA coverage of important sites has increased over time, the proportion of PA area covering important sites, as opposed to less important land, has declined (by 0.45–1.14% annually since 1950 for IBAs and 0.79–1.49% annually for AZEs). Thus, while appropriately located PAs may slow the rate at which species are driven towards extinction, recent PA network expansion has under-represented important sites. We conclude that better targeted expansion of PA networks would help to improve biodiversity trends

Differences in the Professional Satisfaction of General Internists in Academically Affiliated Practices in the Greater-Boston Area

Managed care has created more professional constraints for general internists. We surveyed 198 general internists at 12 academically affiliated practices in the greater-Boston area to examine professional satisfaction. Overall, these physicians were moderately satisfied (mean of 59.1 on a 100-point scale). Before adjustment, women had lower overall satisfaction than men, as well as poorer satisfaction with the domains of career concerns and patient access. Gender had no independent effect on satisfaction after adjustment for age, income, percentage of time providing direct patient care, work status, and site. Younger physicians also had lower overall satisfaction, and these differences remained after adjustment. Improvements in professional satisfaction may be required to ensure the continued recruitment of young physicians, particularly women, into general internal medicine

Meeting the hhallenges of globalization while preserving institutional singularity : the case of Quebec CEGEPs

Version pré-publication.Focusing on the case of Quebec general and vocational colleges (collèges d’enseignement general et professionnel – CEGEPs), this chapter will explore how colleges’ responses to global challenges may relate symbiotically with the nature of the higher education system in which they are embedded, and thus preserve their singularity in the global era. CEGEPs interact with organizations across borders and across spatial levels, but their capacity to preserve their singularity relies on institutional initiatives consistent with and supported by the local and provincial contexts. College-university transfer is not an issue in Quebec because it is embedded in the system. CEGEPs however need to respond to the growing knowledge-intensiveness of the economy, and they do so by establishing DEC-BAC dual degrees with local universities and as well as by developing a coherent system of CCTTs that conducts locally-relevant research. CEGEPs have also responded to the global devaluation of diplomas by engaging in international activities that are consistent with Quebec’s knowledge diplomacy, i.e. a province, a region or a country using international education activities to outsource its values, communicate the relevance of its political agenda, and increase its attractiveness (Olds, 2009)