Sustainable Health Development Goals (SHDG): breaking down the walls

The world's governments failed to achieve the Health for All 2000 goals from the Alma Ata Declaration of 1978. Although a lot of milestones have been covered since 2000, the world's governing authorities are unlikely to achieve the current Millennium Development Goals (MDGs) which expire by the end of this year. The inability to achieve these goals may be linked to the multiplicity of health-related directives and fragmentation of health systems in many countries. However, with the proposed 17 sustainability development goals, health has only one universal aim: to ensure healthy lives and promote wellbeing for all at all ages. Accomplishing this will require a focus on health systems (system-thinking), commonization of services and full integration of services with total dismantling of vertical programs across the world.Pan African Medical Journal 2015; 2

Key performance indicators for successful simulation projects

There are many factors that may contribute to the successful delivery of a simulation project. To provide a structured approach to assessing the impact various factors have on project success, we propose a top-down framework whereby 15 Key Performance Indicators (KPI) are developed that represent the level of successfulness of simulation projects from various perspectives. They are linked to a set of Critical Success Factors (CSF) as reported in the simulation literature. A single measure called Project’s Success Measure (PSM), which represents the project’s total success level, is proposed. The framework is tested against 9 simulation exemplar cases in healthcare and this provides support for its reliability. The results suggest that responsiveness to the customer’s needs and expectations, when compared with other factors, holds the strongest association with the overall success of simulation projects. The findings highlight some patterns about the significance of individual CSFs, and how the KPIs are used to identify problem areas in simulation projects

Premarital sex and condom use among trainee healthcare workers: an exploratory study of selected healthcare training institutions in Enugu State, Nigeria

Introduction: to assess the prevalence and causes of premarital sex and condom use among trainee healthcare workers in selected healthcare institutions in Enugu State, Nigeria; and to proffer solution to challenges identified. Methods: we used a mixed study approach with qualitative and quantitative components. Informed consent was obtained from participants and data collected using self-administered structured questionnaires. Epi info® was used for data analysis. Results: a total of 362 respondents (309 unmarried) from four healthcare training institutions participated in the study. Among unmarried respondents, 141(45.8%) were sexually active. Premarital sex was more common among Pentecostals and sexual activity increased with age (r=0.78; p <0.05). Premarital sexual activity was more common among males and trainee nurses (p <0.005). Although knowledge of condom use was high, actual use was poor (20.1%), with lowest rates among females, Catholics and age-group 30-35 years. Breakages, high failure rates and reduced sexual satisfaction were cited as major factors responsible for poor use. Use of non-specific terms such as "casual sex" and "casual or regular sex partners" hindered consistent, correct condom use. Conclusion: there is a significant gap between knowledge of and actual use of condoms, despite high premarital sexual activity amongst healthcare workers. Furthermore, non-specific terminologies hinders appropriate condom usage. We propose the term: Committed Spousal Partner (CSP) defined as "a sexual partner who commits to fidelity (one sexual partner per time) and whose current HIV status is known through medical testing and is properly documented" in place of all non-specific terminology

Hepatitis B in Sub-Saharan Africa

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The potential for modification in cloning and vitrification technology to enhance genetic progress in beef cattle in Northern Australia

AbstractRecent advances in embryology and related research offer considerable possibilities to accelerate genetic improvement in cattle breeding. Such progress includes optimization and standardization of laboratory embryo production (in vitro fertilization – IVF), introduction of a highly efficient method for cryopreservation (vitrification), and dramatic improvement in the efficiency of somatic cell nuclear transfer (cloning) in terms of required effort, cost, and overall outcome. Handmade cloning (HMC), a simplified version of somatic cell nuclear transfer, offers the potential for relatively easy and low-cost production of clones. A potentially modified method of vitrification used at a centrally located laboratory facility could result in cloned offspring that are economically competitive with elite animals produced by more traditional means. Apart from routine legal and intellectual property issues, the main obstacle that hampers rapid uptake of these technologies by the beef cattle industry is a lack of confidence from scientific and commercial sources. Once stakeholder support is increased, the combined application of these methods makes a rapid advance toward desirable traits (rapid growth, high-quality beef, optimized reproductive performance) a realistic goal. The potential impact of these technologies on genetic advancement in beef cattle herds in which improvement of stock is sought, such as in northern Australia, is hard to overestimate

An Investigation into the Use of Net-Conferencing Groupware in Simulation Modelling

Simulation modellers are major users of software tools. Advances in computing such as collaborative working tools and distributed technologies have created new possibilities for innovation in simulation modelling. Collectively, we address these as Collaborative Support for Simulation Modelling (CSSM). To contribute to CSSM, we consider the problem of whether or not it is possible to support human-to-human collaboration in simulation modelling through the use of commonly available groupware technology. The paper reviews aspects of human-to-human collaboration in the simulation modelling process and introduces an example of commonly available groupware technology, the net-conferencing groupware tool NetMeeting^R. Results of a survey into the perceived use of NetMeeting^R in simulation and some resulting applications of the net-conferencing tool that have emerged are presented

Spatial dependency between task positive and task negative networks

Functional neuroimaging reveals both relative increases (task-positive) and decreases (task-negative) in neural activation with many tasks. There are strong spatial similarities between many frequently reported task-negative brain networks, which are often termed the default mode network. The default mode network is typically assumed to be a spatially-fixed network; however, when defined by task-induced deactivation, its spatial distribution it varies depending on what specific task is being performed. Many studies have revealed a strong temporal relationship between task-positive and task-negative networks that are important for efficient cognitive functioning and here. Here, using data from four different cognitive tasks taken from two independent datasets, we test the hypothesis that there is also a fundamental spatial relationship between them. Specifically, it is hypothesized that the distance between task positive and negative-voxels is preserved despite different spatial patterns of activation and deactivation being evoked by different cognitive tasks. Here, we show that there is lower variability in the distance between task-positive and task-negative voxels across four different sensory, motor and cognitive tasks than would be expected by chance - implying that deactivation patterns are spatially dependent on activation patterns (and vice versa) and that both are modulated by specific task demands. We propose that this spatial relationship may be the macroscopic analogue of microscopic neuronal organization reported in sensory cortical systems, and we speculate why this spatial organization may be important for efficient sensorimotor and cognitive functioning.Comment: 16 pages, 4 figure

Hepatic encephalopathy : novel insights into classification, pathophysiology and therapy

Hepatic encephalopathy (HE) is a frequent and serious complication of both chronic liver disease and acute liver failure. HE manifests as a wide spectrum of neuropsychiatric abnormalities, from subclinical changes (mild cognitive impairment) to marked disorientation, confusion and coma. The clinical and economic burden of HE is considerable, and it contributes greatly to impaired quality of life, morbidity and mortality. This review will critically discuss the latest classification of HE, as well as the pathogenesis and pathophysiological pathways underlying the neurological decline in patients with end-stage liver disease. In addition, management strategies, diagnostic approaches, currently available therapeutic options and novel treatment strategies are discussed

Density and Velocity Fields from the PSCz Survey

We present the results for the predicted density and peculiar velocity fields and the dipole from the PSCz survey of 15,000 IRAS galaxies over 84% of the sky. We find a significant component to the dipole arising between 6000 and 15,000 km/s, but no significant component from greater distances. The misalignment with the CMB is 20 degrees. The most remarkable feature of the PSCz model velocity field is a coherent large-scale flow along the baseline connecting Perseus-Pisces, the Local Supercluster, Great Attractor and the Shapley Concentration. We have measured the parameter beta using the amplitude of the dipole, bulk flow and point by point comparisons between the individual velocities of galaxies in the MarkIII and SFI datasets, and the large-scale clustering distortion in redshift space.All our results are consistent with beta = 0.6 +- 0.1.Comment: 8 pages, 8 figures. To appear in 'Towards an Understanding of Cosmic Flows', Victoria, July 1999, eds Courteau,S., Strauss,M., Willick,J. PAS