Analysis of the Social Experience of Children with Psychomotor Developmental Delay Followed at the Adjamé Child Guidance Center (Southern Côte d'Ivoire)

The research analyzed the social experience of children followed at the Adjamé child guidance center in Côte d'Ivoire for psychomotor developmental delays. This is a major concern given the difficulties in acquiring motor, cognitive, affective, sensory and social skills. Using a deterministic approach, 25 mothers with children with psychomotor developmental disorders were surveyed using a questionnaire on the socio-demographic characteristics of the children and their mothers, the clinical history of the children and the degree of their disorders, their social experience with parents and staff, and the mothers' suggestions. Parents live together and have income-generating activities. In many cases, apart from their parents, the children are in contact with people in the household. They are neither autonomous nor rejected by their peers in social relationships. Instead, they feel rejected by adults who attribute to them a negative social image as snake children, witch children. This plunges the parents into despair and desolation. This is why they suggest raising awareness in order to make the causes of this state of delayed psychomotor development of the child known and to bring about change. In this context, a holistic approach at several levels of intervention: individual, institutional, community and social, is necessary to deal with this discriminating and stigmatizing pathology. It is more than likely that this would contribute to solving the shortage of psychomotricians by increasing the number of these specialists in public facilities in order to optimize the care of children with developmental problems. Keywords: Delayed psychomotor development, social experience, social integration, child morbidity DOI: 10.7176/RHSS/11-20-04 Publication date:October 31st 202

Early reoperation in pediatric surgery at the Teaching Hospital Gabriel Touré.

Introduction: To identify complications requiring early reoperation and to determine associated risk factors in the pediatric surgery of the teaching hospital Gabriel Toure.Materials and Methods: A retrospective study of children 0-15 years old during 4 years (January 2014 to December 2017) presenting with a postoperative complication requiring a reoperation and taken care of during the period of study. Observation of bowels or the liquid stools through the opened wound, the presence of air-fluid levels on an abdominal plain X-ray and the absence of resumption of intestinal transit allowed us to make a decision to re-operate.Results: We have re-intervened on 103 patients because of early postoperative complication out of 4730 cases of pediatric surgery carried out in this hospital during these 4 years. This represented 1.54 % of our total surgical activities. The average age of our patients was a 5.2±2.3 year ranging from 2 months to 15 years. The sex ratio was 0.94. Eighty four (81.55 %) of our patients were admitted and operated on emergently. Peritonitis due to digestive system perforation represented 45.28 % of the indications for reoperation followed by the acute intestinal intussusceptions (10.7 %) and traumatic eviscerations (9.7 %). The average duration before the first intervention was 80±13.6mn. The postoperative evisceration was the 1st cause of reoperation followed by the post-operative peritonitis and then post-operative intestinal obstruction. The average time to reoperation was 6.9 ± 4.2 days.Conclusion: In our hospital risk of reoperation has an association with: indication of first surgery, operating technique, experience of the surgeon, malnutrition and anemia (p<0.05). On the other hand sex, age and the duration of surgery have no effect on early reoperation (p > 0.05)

Revitalizing cultivation and strengthening the seed systems of fonio and Bambara groundnut in Mali through a community biodiversity management approach

Fonio (Digitaria exilis(Kippist)Stapf) and Bambara groundnut (Vigna subterranea(L.)Verdc.) are native crops grown at a small scale in Mali that have potential to support agricultural productivity under climate change. A community biodiversity management approach was explored in this study as a means to reinforce the cultivation of these crops by increasing farmers’ access to intraspecific diversity and developing capacities of community institutions for their management. The research involved six communities in Ségou and Sikasso regions. Multiple varieties of fonio (10–12) and Bambaragroundnut (8–12) were established indiversity fields in each site over 2 years where farmers engaged in experiential learning over the crop cycle. Significant adoption of fonio and Bambara groundnut was detected in several study sites.The precise drivers of adoption cannot be definitively determined but likely include increased seed access and awareness gained through the diversity field fora, seed fairs and community seed banks. No significant yield advantage was detected for any of the varieties in the diversity fields, which showed variable performance by site and year. The number of varieties registered and managed by community seed banks in each site increased from 1–5 varieties of each crop to 11–12 varieties following the interventions. The number of Bambara groundnut varieties cultivated in farmer as light decline in fonio diversity in some communities.The results of this study can inform efforts to strengthen seed systems and cultivation of neglected and underutilized species in Africa

Surgical complications of Pica syndrome: About 3 cases

The Pica syndrome is an eating disorder characterized by an excessive or abnormal desire to consume a non-nourishing substance which can be relatively harmless, or potentially harmful for the health. It is a rare affection secondary to the accumulation of diverse natured foreign bodies inside the digestive tract and more especially at the stomach level. Gastro-intestinal localization is the most frequent, and can remain asymptomatic for a long time. Treatment is surgical. We report 3 cases of digestive complications of Pica syndrome

Performance organisationnelle dans les services de santé au Mali : Approche théorique et perspectives d’améliorations

For several years, the concept of organizational performance in health services has been the subject of much debate in its definition as well as in the determination of measurement indicators. In Mali, the concept of performance in health services is very cumbersome because users complain about the quality of technical platforms, reception methods and the behavior of health personnel. A few studies have been conducted to measure hospital performance in biomedical research in the Malian health sector. However, very little research has shown an interest in hospital performance in management science research. Thus, the purpose of this research is to review the literature on hospital performance in Mali and to propose prospects for improvement using tools from public hospital management. We found at the end of this research that the problem in hospital management comes from health development and that performance is inadequately measured in Mali. Thus, we explored theoretical models of performance, and we found that the Malian health sector is deficient in unidimensional and multidimensional approaches. We then proposed a review of measurement indicators and the integration of Community Health Centers and Reference Health Centers into formal processes for evaluating the performance of health services. We have also found that it is relevant to integrate staff into decision-making processes because they are marginalized in hospital management.     JEL Classification : I18 Paper type: Theoretical Research.Depuis plusieurs années, le concept de la performance organisationnelle dans les services de santé a été l’objet de nombreux débats dans sa définition ainsi que dans la détermination des indicateurs de mesure. Au Mali, le concept de la performance dans les services de santé est très pesant, car les usagers se plaignent de la qualité des plateaux techniques, des modalités d’accueils et des comportements des personnels de santé. Quelques études ont été menées dans la mesure de la performance hospitalière en recherche biomédicale dans le secteur sanitaire malien. Cependant, très peu de recherches ont manifesté un intérêt pour la performance hospitalière dans les recherches en sciences de gestion. Ainsi, l’objet de cette recherche est d’effectuer une revue de la littérature sur la performance hospitalière au Mali et de proposer des perspectives d’améliorations à l’aide d’outils issus du management public hospitalier. Nous avons trouvé à l’issue de cette recherche que la problématique dans la gestion hospitalière est issue du développement sanitaire et que la performance est inadéquatement mesurée au Mali. Ainsi, nous avons exploré les modèles théoriques de la performance, et nous avons trouvé que le secteur sanitaire malien est déficient dans les approches unidimensionnelles et les multidimensionnelles. Nous avons alors proposé une revue des indicateurs de mesure et l’intégration des Centres de Santé Communautaire et des Centres de Santé de Référence dans les processus formels d’évaluation de la performance des services de santé. Nous avons également trouvé qu’il est pertinent d’intégrer les personnels dans les processus de prise de décisions, car ils sont marginalisés dans la gestion hospitalière.     Classification JEL: I18 Type d’article : Article Théorique

Genomic structure and expression of uncoupling protein 2 genes in rainbow trout (Oncorhynchus mykiss)

Background Uncoupling protein 2 (UCP2) belongs to the superfamily of mitochondrial anion carriers that dissociate the respiratory chain from ATP synthesis. It has been determined that UCP2 plays a role in several physiological processes such as energy expenditure, body weight control and fatty acid metabolism in several vertebrate species. We report the first characterization of UCP2 s in rainbow trout (Oncorhynchus mykiss). Results Two UCP2 genes were identified in the rainbow trout genome, UCP2A and UCP2B. These genes are 93% similar in their predicted amino acid sequences and display the same genomic structure as other vertebrates (8 exons and 7 introns) spanning 4.2 kb and 3.2 kb, respectively. UCP2A and UCP2B were widely expressed in all tissues of the study with a predominant level in macrophage-rich tissues and reproductive organs. In fry muscle we observed an increase in UCP2B expression in response to fasting and a decrease after refeeding in agreement with previous studies in human, mouse, rat, and marsupials. The converse expression pattern was observed for UCP2A mRNA which decreased during fasting, suggesting different metabolic roles for UCP2A and UCP2B in rainbow trout muscle. Phylogenetic analysis including other genes from the UCP core family located rainbow trout UCP2A and UCP2B with their orthologs and suggested an early divergence of vertebrate UCPs from a common ancestor gene. Conclusion We characterized two UCP2 genes in rainbow trout with similar genomic structures, amino acid sequences and distribution profiles. These genes appeared to be differentially regulated in response to fasting and refeeding in fry muscle. The genomic organization and phylogeny analysis support the hypothesis of a common ancestry between the vertebrate UCPs

Le développement des ressources humaines de la santé au Mali pour une efficacité de l’aide publique au développement : Revue de la littérature et perspectives d’améliorations

À la suite de la proclamation des objectifs mondiaux, un mouvement international a induit l’injection d’un volume important de flux financiers en faveur du développement du secteur de la santé, car les pays en voie de développement ne disposaient pas des ressources nécessaires afin de les atteindre. Les procédures d’interventions des bailleurs furent harmonisés, les buts étaient orientés vers une couverture sanitaire universelle et un accès équitable aux services de santé. En application aux directives (buts), le Gouvernement du Mali a mis en œuvre une Politique Sectorielle de Santé des Populations développée en plusieurs programmes quinquennaux. Ces initiatives ont été soutenues par le développement des ressources humaines de la santé. Cependant, l’efficacité de l’aide publique au développement est partiellement entravée par les ressources humaines de la santé, car les personnels sont démotivés, insatisfaits et n’adhèrent pas aux politiques publiques. Ces problèmes sont relatifs au fait que les personnels n’ont pas participé aux processus d’élaborations et de mise en œuvre des politiques. Dans cette perspective, cet article a pour but d’effectuer une revue de la littérature sur le développement des ressources humaines au Mali, et de proposer des pistes d’améliorations de l’efficacité de l’aide publique au développement

Proposition d’un modèle explicatif de la performance organisationnelle par les facteurs individuels dans les Centres Hospitaliers Universitaires du Mali

Depuis plusieurs années, la santé des populations constitue une préoccupation majeure du Gouvernement du Mali. Plusieurs dispositions ont été mises en œuvre à cet effet tels que l’accroissement des ressources injectées en santé (matérielles, financières et humaines), l’autonomisation des hôpitaux, le développement des ressources humaines et la modernisation des structures. Malgré ces efforts, les Centres Hospitaliers Universitaires (CHU) de dernière référence font état de performances médiocres car les usagers et les patients se plaignent des modalités d’accueil, de la qualité des plateaux techniques et de l’hôtellerie hospitalière ; et cette sous-performance semble attribuable aux personnels de santé (Sanogo, 2012). Cette recherche a pour but d’effectuer une revue de la littérature sur la performance hospitalière, de décrire les facteurs à l’origine de la sous-performance des CHU ; et de proposer un design de recherche explicatif de la performance hospitalière par le biais des facteurs individuels. À l’issue de cette analyse, nous avons trouvé un modèle structurel à cinq variables (performance, motivation, engagement organisationnel, satisfaction, comportements de citoyenneté) différent du modèle simplifié de Kim (2004). Le modèle structurel proposé induit également l’existence de variables médiatrices interposées entre la satisfaction au travail et la performance