Using Computer and Internet for Medical Literature Searching Among Medical Students in Hadramout University, Yemen

Background: Some researchers have observed that medical students used computer and internet for nonmedical purposes. Is this the case among medical students in a newly established medical college of Hadramout University in Yemen?\ud Objectives: To assess the knowledge and usage of computer and internet among medical students of Hadramout University, find out the medical applications for which they use internet, and the factors that encourage the students to use computer and internet, with an emphasis on gender variations.\ud Methods: In a cross-sectional study, data were collected from 102 randomly selected students from second to sixth year at the academic year 2005/2006 by using structured questionnaire of 23 items. \ud Results: Seventy four students have computer at home (73%), 77 students use internet for general purposes (76.2%) and lesser use internet for educational and research purposes, with significant gender variations. The students opined that accessibility of internet in the college (84.2%) and training about online searching (74.3%) were the most expected factors to improve using of internet for medical research.\ud Conclusion: Incorporating online search of medical literature in curriculum planning is essential to improve the student skills in research

Malaria Control Strategies in The Kilombero Valley, Tanzania

Malaria is major public health problem in Tanzania and increasing trends have been observed in the last two decades. A significant consequence of repeated malaria infections in high transmission areas is anaemia in very young children. The control of malaria in Tanzania includes both preventive and curative strategies. On the preventive side insecticide treated bed nets (ITNs) are a promising tool. ITNs have been shown to be effective in reducing malaria morbidity and mortality in controlled trials. Large-scale implementation of the technology is currently being initiated in many African countries. We report the impact of a large social marketing programme of ITNs on malaria morbidity through a series of studies, in\ud a population of about 55,000 people in Tanzania. The ITNs social marketing programme resulted in a rapid increase in any net ownership (from 58 to 83%) and an increase in ITNs ownership (from 10 to 61%) in children under two years of age within 2 years of implementation. As a result the overall mean haemoglobin levels increased (from 8.0 to 8.9 g/dl) in the study children during the successive surveys. The prevalence of anaemia in the study population decreased from 49% to 26%. Comparison between children with ITNs and those without nets showed that ITNs had a protective efficacy of 63% (95% CI: 38 to 77) on the prevalence of parasitaemia, and 63% (95% CI: 27 to 82) on anaemia (haemoglobin 8 g/dl). These results endorse the wide scale implementation of ITNs in Tanzania. ITNs can only reduce the risk of malaria dis ease but cannot eliminate it. Hence, appropriate effective treatment is required. Chloroquine is a cheap and safe antimalarial and it was until recently the first line drug of choice in the National Malaria Treatment Policy. Resistance to chloroquine has been reported with increasing frequency in Tanzania and has been linked to the increasing admissions with severe disease in hospitals. A comparative randomised, open clinical trial of chloroquine against Co-artem(fixed combination of Artemether +Benflumetol) an alternative new antimalarial, showed seven-day parasitological cure rates of 94% for Co-artemand only 35% for chloroquine. Generally, Co-artemshowed a superior clearance rate, successfully cleared higher parasite densities and suppressed new infections over a longer period of time. Furthermore, Co-artemsuppressed more effectively gametocytes in these children, indicating a potential benefit for reducing malaria transmission. The unacceptably high chloroquine failure rates call for an urgent review of the National Malaria Treatment Guidelines. The decision to change the first line antimalarial and the choice of a new drug depend on a number of factors that include the clinical, epidemiological and social-economical factors, as well as the health infrastructure. Considering all of these dimensions, sulphadoxinepyrimenthamine (SP) was identified as a good interim replacement for chloroquine. Further Phase IV evaluation of Co-artemand other combination therapy regimens are required before considering their inclusion in the national treatment policy. Much work is also needed to identify suitable compounds to be used for home management of malaria, within the national treatment guidelines. Experience gained with these studies gives a description of the different methodologies and tools that can be used to evaluate different components of the National Malaria Control Programme. For example, it was difficult to assess the impact of the ITNs programme using the case-control approach. Repeated cross-sectional assessments were found to be more suitable for assessing the impact of ITNs under programme conditions, especially on malariarelated anaemia in this area of high transmission. Specific indicators for programme evaluation may need to be identified for specific interventions. These may be different from the ones used in randomised controlled trials. The use of molecular markers for monitoring and evaluation of antimalarial intervention programmes illustrate the need to develop and validate novel tools and approaches for programme evaluation. Better malaria control is expected by combining ITNs and an effective antimalarial, especially combination therapy. The evaluation, implementation, and monitoring of all these control activities requires a partnership between researchers, policy makers, health managers, in close collaboration with other stakeholders in the public and private domain, including the beneficiaries - the community.\u

Prevalence and attitudes of smoking among secondary school teachers in Hadramout coastal districts, Yemen

A descriptive KAP study about smoking was conducted in all the ten secondary schools in Hadramout coastal districts during October 2004 – April 2005 and a total of 317 teachers were enrolled in the study (182 male, 135 female teachers). The findings revealed that about 8% of the teachers were smokers; all smokers were males (prevalence 14%). Only 10% of teachers had received training to limit smoking among students, and 27% had educational materials about harmful effects of smoking. The study concluded that low smoking prevalence, good knowledge and attitudes of teachers, especially female teachers, toward smoking may offer a chance for smoking prevention strategies in secondary schools

Malaria Control Strategies in the Kilombero Valley, Tanzania

Malaria is major public health problem in Tanzania and increasing trends have been observed in the last two decades. A significant consequence of repeated malaria infections in high transmission areas is anaemia in very young children. The control of malaria in Tanzania includes both preventive and curative strategies. On the preventive side insecticide treated bed nets (ITNs) are a promising tool. ITNs have been shown to be effective in reducing malaria morbidity and mortality in controlled trials. Large-scale implementation of the technology is currently being initiated in many African countries. We report the impact of a large social marketing programme of ITNs on malaria morbidity through a series of studies, in a population of about 55,000 people in Tanzania. The ITNs social marketing programme resulted in a rapid increase in any net ownership (from 58 to 83%) and an increase in ITNs ownership (from 10 to 61%) in children under two years of age within 2 years of implementation. As a result the overall mean haemoglobin levels increased (from 8.0 to 8.9 g/dl) in the study children during the successive surveys. The prevalence of anaemia in the study population decreased from 49% to 26%. Comparison between children with ITNs and those without nets showed that ITNs had a protective efficacy of 63% (95% CI: 38 to 77) on the prevalence of parasitaemia, and 63% (95% CI: 27 to 82) on anaemia (haemoglobin £ 8 g/dl). These results endorse the wide scale implementation of ITNs in Tanzania. ITNs can only reduce the risk of malaria dis ease but cannot eliminate it. Hence, appropriate effective treatment is required. Chloroquine is a cheap and safe antimalarial and it was until recently the first line drug of choice in the National Malaria Treatment Policy. Resistance to chloroquine has been reported with increasing frequency in Tanzania and has been linked to the increasing admissions with severe disease in hospitals. A comparative randomised, open clinical trial of chloroquine against Co-artemâ (fixed combination of Artemether + Benflumetol) an alternative new antimalarial, showed seven-day parasitological cure rates of 94% for Co-artemâ and only 35% for chloroquine. Generally, Co-artemâ showed a superior clearance rate, successfully cleared higher parasite densities and suppressed new infections over a longer period of time. Furthermore, Co-artemâ suppressed more effectively gametocytes in these children, indicating a potential benefit for reducing malaria transmission. The unacceptably high chloroquine failure rates call for an urgent review of the National Malaria Treatment Guidelines. The decision to change the first line antimalarial and the choice of a new drug depend on a number of factors that include the clinical, epidemiological and social-economical factors, as well as the health infrastructure. Considering all of these dimensions, sulphadoxinepyrimenthamine (SP) was identified as a good interim replacement for chloroquine. Further Phase IV evaluation of Co-artemâ and other combination therapy regimens are required before considering their inclusion in the national treatment policy. Much work is also needed to identify suitable compounds to be used for home management of malaria, within the national treatment guidelines. Experience gained with these studies gives a description of the different methodologies and tools that can be used to evaluate different components of the National Malaria Control Programme. For example, it was difficult to assess the impact of the ITNs programme using the case-control approach. Repeated cross-sectional assessments were found to be more suitable for assessing the impact of ITNs under programme conditions, especially on malariarelated anaemia in this area of high transmission. Specific indicators for programme evaluation may need to be identified for specific interventions. These may be different from the ones used in randomised controlled trials. The use of molecular markers for monitoring and evaluation of antimalarial intervention programmes illustrate the need to develop and validate novel tools and approaches for programme evaluation. Better malaria control is expected by combining ITNs and an effective antimalarial, especially combination therapy. The evaluation, implementation, and monitoring of all these control activities requires a partnership between researchers, policy makers, health managers, in close collaboration with other stakeholders in the public and private domain, including the beneficiaries - the community

Relationship Between Child Survival and Malaria Transmission: An Analysis of the Malaria Transmission Intensity and Mortality Burden Across Africa (MTIMBA) Project Data in Rufiji Demographic Surveillance System, Tanzania.

The precise nature of the relationship between malaria mortality and levels of transmission is unclear. Due to methodological limitations, earlier efforts to assess the linkage have lead to inconclusive results. The malaria transmission intensity and mortality burden across Africa (MTIMBA) project initiated by the INDEPTH Network collected longitudinally entomological data within a number of sites in sub-Saharan Africa to study this relationship. This work linked the MTIMBA entomology database with the routinely collected vital events within the Rufiji Demographic Surveillance System to analyse the transmission-mortality relation in the region. Bayesian Bernoulli spatio-temporal Cox proportional hazards models with village clustering, adjusted for age and insecticide-treated nets (ITNs), were fitted to assess the relation between mortality and malaria transmission measured by entomology inoculation rate (EIR). EIR was predicted at household locations using transmission models and it was incorporated in the model as a covariate with measure of uncertainty. Effects of covariates estimated by the model are reported as hazard ratios (HR) with 95% Bayesian confidence interval (BCI) and spatial and temporal parameters are presented. Separate analysis was carried out for neonates, infants and children 1-4 years of age. No significant relation between all-cause mortality and intensity of malaria transmission was indicated at any age in childhood. However, a strong age effect was shown. Comparing effects of ITN and EIR on mortality at different age categories, a decrease in protective efficacy of ITN was observed (i.e. neonates: HR = 0.65; 95% BCI: 0.39-1.05; infants: HR = 0.72; 95% BCI:0.48-1.07; children 1-4 years: HR = 0.88; 95% BCI: 0.62-1.23) and reduction on the effect of malaria transmission exposure was detected (i.e. neonates: HR = 1.15; 95% BCI:0.95-1.36; infants: HR = 1.13; 95% BCI:0.98-1.25; children 1-4 years: HR = 1.04; 95% BCI:0.89-1.18). A very strong spatial correlation was also observed. These results imply that assessing the malaria transmission-mortality relation involves more than the knowledge on the performance of interventions and control measures. This relation depends on the levels of malaria endemicity and transmission intensity, which varies significantly between different settings. Thus, sub-regions analyses are necessary to validate and assess reproducibility of findings

The Ethics of Decoration in Architecture

اقترن التزيين ومنذ القدم بمختلف الانجازات الانسانية وعدته بعض الطروحات كماليا لا الزاميا قابل للازالة والطرح يمكن الاستغناء عنه، واسيء فهمه كونه مجرد اضافة ووسيلة للتجميل لخصائصه الفنية لاسيما صيغة الحلي الديكورية ، وعلى عكس مفهوم الاخلاق الالزامي المقترن بالاغراض النفعية والقيمية على السواء، ليبرز ذلك التعارض بين المفهومين ضرورة مناقشتهما معا للكشف والتقصي عن الجوانب الاخلاقية للتزيين في النتاج المعماري تحديدا لتقويض تلك الافكار التي عدت التزيين فائضا لا غير،فتوضحت مشكلة البحث بـ "عدم وجود تصور واضح حول المؤشرات الاخلاقية للتزيين في نتاج العمارة "، وبالتالي تحدد هدف البحث بـ "طرح المؤشرات الاخلاقية للتزيين في النتاج المعماري في مستوى المخططات والواجهات"، ووضع البحث فرضيته البحثية متمثلة بـ "تبرز اخلاقيات التزيين في العمارة ضمن المستويين الباطن والظاهر على السواء، في كل من المخططات والواجهات وصولا لتحقيق هيأة الناتج المعماري ككل" ، ولاختبار صحتها اعتمد البحث منهجا استقرائيا ركز على كشف مؤشرات الوظيفة الاخلاقية للتزيين في النتاج المعماري وصولا الى طرح اطار نظري خاص لمؤشرات التزيين الاخلاقية في النتاج المعماري على مستوى المخططات والواجهات معا ،اذ تم التأكد من وقوع التزيين في مستوى المخطط والواجهة على السواء وبما أكد التزامه بالجوانب النفعية الوظيفية البيئية الانشائية الاقتصادية وبما يحقق السلامة والامان ، فضلا عن التزامه بالجوانب الجمالية التعبيرية والرمزية الاتصالية لاسيما التكتونية اذ حددت هيأة النتاج المعماري ككل ووصلت ذروتها اليوم بعد تطورها الى التكتونية الرقمية لانتاج السطوح الرقمية والتي وصفت كجلود لتداخل بنية (الهيكل- القشرة) ومادتهما معا نسجتها عملية التزيين بفضل الامكانات الرقمية لتمثيل السطح الرقمي فضاءا او نسيجا ميتافيزيقيا ومجالا حيا انتقاليا لمختلف القيم الوظيفية والجمالية في العصر الحالي بما اغنى وظيفية المخططات وتعبيرية الواجهات على السواء.The decoration has been associated with various human achievements since ancient times and has been considered by some of theses  as an additional, non-mandatory , can be probability  remove , subtract and dispensable. It is misunderstood as a mere addition and an instrument  for beauty as its artistic characteristics, especially the decorative  jewelry. In contrast to the concept of mandatory  ethics concept  which associated with both for purposes and values aspects, that contrast highlighted the need to discuss them together to investigate the ethical aspects of decorating in architectural output to undermine those ideas, which considered decorating as a surplus only. The research problem was explained by "absence  a clear conception of the ethical indicators of decorating the product of architecture", Thus the goal of the research is that "put the ethical indicators of decoration the architectural output at the level of plans and facades" , so the research put hypothesis as "highlighting the ethics of decoration within both the subcontractor and the apparent levels In each of plans and facades, to achieve architectural output as a whole", it focused on uncovering the ethical indicators of decoration the architectural output, in order to present a special theoretical framework for the indicators of moral decoration at the level of plans and the facades together, It has been confirmed that the decoration at the level of the plans and the facade both, that confirmed its commitment to the functional aspects economic , safety environmental construction, as well as to the aesthetic aspects of expressive and symbolic especially Tectonics, as determined the apperance of architectural output as a whole Today, after its development into digital tectonics for the production of digital surfaces, which were described as skins to overlap the structure (the structure - the skin) and their material together weaving decoration process thanks to the digital potentials to represent the digital surface space or metaphysical fabric and a living space for various functional and aesthetic values in the current era, including richer functional plans and expression facades

Managing Antimicrobial Resistance from Medical and Veterinary Health Sys-tems Perspectives to Achieving Universal Health Coverage in the African Re-gion

Antimicrobial resistance (AMR) is a threat to global health security and may reverse the gains in preventive medicine. This is worsened by the fact that development of resistance out-paces that of new antimicrobials. The factors driving the development of AMR range from health systems to socio-economic and environmental factors. These include poor antimicrobial stewardship, poor access to quality drugs, prescribing antimicrobials without susceptibility laboratory tests, use of antimicrobials in crop, animal production and aquaculture farming. Others are lack of coordinated medical and veterinary health systems strengthening, poor universal health coverage and practice of one health. The burden of the problem is of public health importance especially in Africa where there is high incidence of poverty, high incidence of out-of-pocket health expenditure, lack of basic social amenities and weak health systems with poor collaboration. The impact of AMR includes increased burden on the healthcare system, hospital admission, cost of patient treatment, poor clinical outcomes and impact on food security, among others. In view of the interplay of various systems and factors in the development and emergence of AMR, there is need for multi-sectoral and interdisciplinary approach at global, regional, national and local levels for its prevention and mitigation. Strengthening of health systems from the medical and veterinary perspectives and universal health coverage are critical in the fight against AMR. The relevant stakeholders include political leaders, community leaders, health professionals, academics, and research institutions, federal and state ministries of health, agriculture, education and Nongovernmental organisations among others. Conflict of interest: None declared &nbsp