Seeking treatment for symptomatic malaria in Papua New Guinea

Background: Malaria places a significant burden on the limited resources of many low income countries. Knowing more about why and where people seek treatment will enable policy makers to better allocate the limited resources. This study aims to better understand what influences treatment-seeking behaviour for malaria in one such low-income country context, Papua New Guinea (PNG). Methods: Two culturally, linguistically and demographically different regions in PNG were selected as study sites. A cross sectional household survey was undertaken in both sites resulting in the collection of data on 928 individuals who reported suffering from malaria in the previous four weeks. A probit model was then used to identify the factors determining whether or not people sought treatment for presumptive malaria. Multinomial logit models also assisted in identifying the factors that determined where people sought treatments. Results: Results in this study build upon findings from other studies. For example, while distance in PNG has previously been seen as the primary factor in influencing whether any sort of treatment will be sought, in this study cultural influences and whether it was the first, second or even third treatment for a particular episode of malaria were also important. In addition, although formal health care facilities were the most popular treatment sources, it was also found that traditional healers were a common choice. In turn, the reasons why participants chose a particular type of treatment differed according to the whether they were seeking an initial or subsequent treatments. Conclusions: Simply bringing health services closer to where people live may not always result in a greater use of formal health care facilities. Policy makers in PNG need to consider within-country variation in treatment-seeking behaviour, the important role of traditional healers and also ensure that the community fully understands the potential implications of not seeking treatment for illnesses such as malaria at a formal health care facility.Carol P Davy, Elisa Sicuri, Maria Ome, Ellie Lawrence-Wood, Peter Siba, Gordon Warvi, Ivo Mueller and Lesong Conte

The role of open abdomen in non-trauma patient : WSES Consensus Paper

The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing. Therefore, the World Society of Emergency Surgery (WSES), Abdominal Compartment Society (WSACS) and the Donegal Research Academy united a worldwide group of experts in an international consensus conference to review and thereafter propose the basis for evidence-directed utilization of OA management in non-trauma emergency surgery and critically ill patients. In addition to utilization recommendations, questions with insufficient evidence urgently requiring future study were identified.Peer reviewe

Indications for Kinesthetic Learning Through Haptic Devices

Haptic technology can provide a sense of touch, either by force feedback or by different vibrations, to give different sensations to the user. It can be used in conjunction with 3D virtual reality or augmented reality environments to give improved perceptions of reality with the additional sensation of touch. This type of haptic enhanced interface can provide a sense of reality in different domains, such as 3D painting, brush-based models, calligraphy, dentistry, or training and learning in different subject fields (Perry et al. 2017; Shenoy and Shenoy 2013). There are a number of studies on the learning effectiveness of haptic systems which report how a greater sense of immersion in a learning environment can promote deep conceptual learning for difficult concepts. Haptic feedback can assist the development of fine motor skill performance in dentistry (Perry et al. 2017) and in other medical areas