French good practice guidelines for medical and occupational surveillance of the low back pain risk among workers exposed to manual handling of loads

International audience

Factors associated with institutional delivery in Dangila district, North West Ethiopia: a cross-sectional study.

Introduction: Childbirth in a health institution has been shown to be associated with lower rates of maternal and neonatal mortality. However, about 85% of mothers in Ethiopia deliver at home. Objective: To assess factors associated with institutional delivery service utilization among women who gave birth within one year prior to the study in Dangila district. Methods: A cross-sectional study was conducted from February 01-28, 2015. A total of 763 mothers were interviewed using structured questionnaire. SPSS version 20 was used for analysis. Crude and adjusted Odds ratios were computed for selected variables. A P-value less than 0.05 was considered statistical significant. Results: Only 18.3% of mothers gave birth at health facilities. Knowledge on danger signs [AOR=2.0, 95% CI: (1.1, 3.4)], plan to give birth at health institution [AOR=5.4, 95% CI: (3.0, 9.6)], having ANC follow up during pregnancy [AOR=12.9, 95% CI: (5.0, 33.3)] and time taken to get to a nearby health institution [AOR=5.1, 95% CI: (2.9, 9.1)] were associated with institutional delivery service utilization. Conclusion: Institutional delivery was very low. Knowledge about danger signs, having ANC visits, and time were factors associated with institutional delivery service utilization. Thus,the findings recommend repeated re-enforcement of institutional delivery service utilization through professionals. And also, the findings recommend promotion of institutional delivery service utilization through mass media.

French good practice guidelines for management of the risk of low back pain among workers exposed to manual material handling: Hierarchical strategy of risk assessment of work situations

International audience

Clinical spectrum of ear, nose and throat foreign bodies in North Western Nigeria.

Background: Ear, nose and throat foreign bodies (FBs) are common occurrences particularly among children. This study reviewed the clinical spectrum of ENT FBs, their treatment and outcomes as seen in a tertiary health center in North Western Nigeria. Method: The study was a retrospective chart review of patients that were managed for FB impaction in a tertiary health institution in North Western Nigeria over a four year period. Result: There were 239 patients; M: F: 1.2:1. Majority of FB impaction (46.4%) occurred in children. Majority (68.7%) were otic and FBs. 18.0% of the patients had had failed attempted removal by non ENT specialists. About 25% of these patients developed complications. Majority (62.0%) of these complications occurred in the hand of non-ENT medical personnel. Conclusion: Ear, nose and throat foreign bodies are common in North-Western Nigeria with the highest incidence in children. Removal attempts by untrained health professionals and lack of experience in FB management predisposes to complications. Parental education on close monitoring of their children to avoid such incidences and the need to immediately seek an Otorhinolaryngologist to prevent complications are emphasized.

Stroke in patients with diabetes mellitus: a study from North Western Nigeria.

Background: Stroke is one of the major causes of morbidity and mortality worldwide and apart from being exceedingly harmful in diabetics, stroke is a disabling disorder. The study was undertaken to describe the clinical characteristics, outcome pattern and predictors of mortality in a cohort of diabetic patients presenting with stroke in two tertiary health facilities in North Western Nigeria. Method: Out of all stroke patients seen from June 2007 to February 2011, persons with diabetes mellitus presenting with stroke in the emergency unit of the two tertiary hospitals in Kano were consecutively recruited for the study. Classification of stroke into hemorrhagic and infarctive subtypes was based on brain computerized tomography (CT), brain magnetic resonance imaging (MRI) and World Health Organization (WHO) criteria. Follow-up period was for thirty days. Result: Out of the five hundred and thirty six stroke patients seen during the study period, 85 (15.9%) patients, comprising 48 (56.5%) males, had diabetes. Thirty eight (44.7%) of the identified diabetics were previously undiagnosed. Sixty four (75.3%) had infarctive stroke. One-month case fatality rate was 30.6%. Factors associated with death included male sex, past history of TIA, abnormal respiratory pattern, hemorrhagic stroke, aspiration pneumonitis, and worsening GCS. Aspiration pneumonitis and worsening GCS were independent predictors of one month mortality of stroke in the patients. Conclusion: In DM patients studied, infarctive stroke was more common, case fatality was 30.6%. Male gender, past history of TIA, abnormal respiratory pattern, hemorrhagic stroke, aspiration pneumonitis, and worsening Glasgow Coma Score (GCS) were associated with mortality. Aspiration pneumonitis and worsening GCS were independent predictors of one month mortality of stroke in diabetic patients.

Rectal inflammatory fibroid polyp in a Nigerian: case report & brief review of literature.

Background: Inflammatory fibroid polyps are very unusual gastrointestinal tumours. Furthermore, their occurrence in the rectum is a rarity indeed. Objective: To document this very rare pathologic entity in a patient from our region of Africa and highlight some pertinent clinical and pathologic aspects of the disease. Case report: We present a 59 year old Nigerian who had neither significant previous medical history nor current complaint and had a routine colonoscopy done. The finding in the rectum was of a small polypoidal mass which was excised whole and whose histopathologic findings were consistent with a diagnosis of inflammatory fibroid polyp. Conclusion: A unique case of rectal inflammatory fibroid polyp in a Nigerian is hereby presented. This, to the best of our knowledge, is the first such documented case from our region of the world. Hence, the entity should be considered in the differential diagnosis of colonic polyps from the continent.

Role of cytokines in Trypanosoma brucei-induced anaemia: A review of the literature

Background Anaemia is an important complication of trypanosomiasis. The mechanisms through which trypanosomal infection leads to anaemia are poorly defined. A number of studies have implicated inflammatory cytokines, but these data are limited and inconsistent. In this article, we reviewed the published literature on cytokines associated with Trypanosoma brucei infections and their role in the immunopathology leading to anaemia. Methodology Articles were searched in PubMed through screening of titles and abstracts with no limitation on date of publishing and study design. Articles in English were searched using keywords “African trypanosomiasis”, “sleeping sickness”, “Trypanosoma brucei”, in all possible combinations with “anaemia” and/or “cytokines”. Results Twelve articles examining cytokines and their role in trypanosomeinduced anaemia were identified out of 1095 originally retrieved from PubMed. None of the articles identified were from human-based studies. A total of eight cytokines were implicated, with four cytokines (IFN-γ, IL-10, TNF-α, IL-12) showing an association with anaemia. These articles reported that mice lacking TNF-α were able to control anaemia, and that IFN-γ was linked to severe anaemia given its capacity to suppress erythropoiesis, while IL-10 was shown to regulate IFN-γ and TNF-α, providing a balance that was associated with severity of anaemia. IFN-γ and TNF-α have also been reported to work in concert with other factors such as nitric oxide and iron in order to induce anaemia. Conclusion IFN-γ, IL-10, and TNF-α were the three major cytokines identified to be heavily involved in anaemia caused by Trypanosoma brucei infection. The anti-inflammatory cytokine, IL-10, was shown to counter the effects of proinflammatory cytokines in order to balance the severity of anaemia. The mechanism of anaemia is multifactorial and therefore requires further, more elaborate research. Data from human subjects would also shed more light.

Friendships of High-Achieving African American Adolescents: Relation to Ethnic Identity and Achievement Values

The academic achievement of African American adolescents is a national concern for educators and researchers especially since current reports depict the underachievement of African American students as continuing to lag behind their European American peers. Determining what factors within the school environment that contributes to the achievement gap and how it can be reduced remains an important issue in alleviating disparities seen in educational achievement and attainment. This study examined the relation between characteristics of the close friendships of high-achieving African American adolescents and students’ identity development and motivation in school. Data were collected from 217 high-achieving African American students within 10th to 12th grade from 5 public and private high schools. Each student self-reported on their ethnicity, gender, parents’ education level, grade, FARMs, GPA, perceived teacher support (emotional, academic, and instrumental support), their perception of their ethnic identity, and their perception of their achievement values. Through the use of nomination procedures, students also identified their close friends and responded to questions concerning how supportive (emotional, academic, and instrumental support) they each were. Results from multiple regression analyses showed that the provision of instrumental support from close friends related to the exploration process of the high-achieving students’ ethnic identity. In addition, there was a strong relation between the ethnic identity of close friends and that of the individual. Furthermore, although friend support was not a significant predictor of achievement values, demographic (mother’s education level, grade, and FARMS) and control (teacher support) variables predicted students’ importance and utility of school respectively. These findings add to the literature on age and socioeconomic status as they relate to student’s motivation to achieve. Overall, this study provides some evidence highlighting ways in which close friendships might relate to the self-development of high-achieving African American adolescents. This study provides a starting point for additional ways in which to explore how peer processes relate to the academic behaviors of high-achieving African American adolescents.

‘DEVOTED TO THE INTERESTS OF HIS RACE’: BLACK OFFICEHOLDERS AND THE POLITICAL CULTURE OF FREEDOM IN WILMINGTON, NORTH CAROLINA, 1865-1877

This dissertation examines black officeholding in Wilmington, North Carolina, from emancipation in 1865 through 1876, when Democrats gained control of the state government and brought Reconstruction to an end. It considers the struggle for black office holding in the city, the black men who held office, the dynamic political culture of which they were a part, and their significance in the day-to-day lives of their constituents. Once they were enfranchised, black Wilmingtonians, who constituted a majority of the city’s population, used their voting leverage to negotiate the election of black men to public office. They did so by using Republican factionalism or what the dissertation argues was an alternative partisanship. Ultimately, it was not factional divisions, but voter suppression, gerrymandering, and constitutional revisions that made local government appointive rather than elective, Democrats at the state level chipped away at the political gains black Wilmingtonians had made.

Lições Aprendidas (Lessons Learned) no Exército Português

As Lições Aprendidas em contexto militar permite reduzir o risco operacional e, simultaneamente, aumentar o grau de sucesso das operações. Desde a década de cinquenta, o Exército português demostrou querer aprender com a experiência, nomeadamente com os Franceses na Argélia e Indochina e com os Ingleses no Quénia e Malásia. Na década de sessenta e início dos anos setenta, durante a denominada Guerra de África, acentuou-se esta necessidade. O Exército Português, desde 2012, dispõe de uma capacidade de Lições Aprendidas, constituída por um processo, estrutura e ferramentas, que tem como principal objetivo, precisamente, facilitar o desiderato de se tornar uma organização aprendente. Neste sentido, é pertinente estudar e comparar estes dois sistema, para melhor perceber o fenómeno no passado e evidenciar a capacidade de hoje em dia. Para isso é necessário descreve-los segundo certos parâmetros ou indicadores. Estes indicadores estão evidentes no modelo criado pela Organização Tratado Atlântico Norte para uma capacidade de Lições Aprendidas. Na Investigação foi utilizado uma abordagem Dedutiva, como procedimentos podemos já depreender que foram utilizados o Histórico e Comparativo, as técnicas de recolha de dados foram as Entrevistas e Análise Documental. O estudo proporcionou a materialização do processo, a perceção da estrutura dedicada, das ferramentas, a influência da mentalidade, liderança, e difusão de informação feitas na guerra de África. Na atualidade, muitos dos indicadores de análise estão descritos em diretivas e doutrina de referência, no entanto é pertinente perceber como é que funcionam e criam melhorias hoje em dia. Conclui-se que o modelo criado pela Organização Tratado Atlântico Norte, que valida uma capacidade de Lições Aprendidas nas organizações militares é intemporal, pois depreende-se, que a lógica que a sustenta em tudo se aplica à guerra de África Portuguesa e à atualidade, o que demostra que esta capacidade é fundamental para tornar o Exército Português mais eficaz e eficiente nas suas atividades e missões futuras.

Is there a need for “healthy” chocolate? Systematic literature review

Antecedentes: El chocolate tiene propiedades especiales que ayudan a proteger el cuerpo humano de enfermedades cardiovasculares, incrementa el colesterol HDL y reduce la presión sanguínea. El consumo de chocolate también ayuda a reducir el estrés, eleva el ´animo y reduce el cansancio. El propósito de esta revisión es identificar, seleccionar, organizar y resumir estudios que investiguen el chocolate en relación con la salud, las características sensoriales y las actitudes de las personas. Este artículo es parte de la tesis de maestría: Is there a need for “healthy” chocolate? Systematic literature review and consumer research in Belgium and in Denmark (Es necesario el chocolate “saludable”? Revisión sistemática de la literatura y estudio al consumidor en Bélgica y Dinamarca), presentada por la autora en Junio del 2015 a la Universidad de Aalborg en Copenhague. Métodos: Este estudio presenta tres áreas relacionadas con el chocolate: Chocolate y su relación con la salud; características sensoriales y aceptación del chocolate; y actitudes hacia el chocolate. Una revisión sistemática de la literatura fue realizada para identificar, seleccionar, organizar y resumir estudios que investiguen al chocolate en relación con estas tres áreas. Cuatro bases de datos fueron escogidas: PubMed, Science Direct, Scopus y Web of Science por sus extensiones y porque superponen investigaciones interdisciplinarias.Resultados: Se obtuvieron un total de 2062 hits en las cuatro bases de datos. Un total de sesenta artículos cumplieron los criterios y fueron identificados como relevantes. Los artículos fueron clasificados de acuerdo a las tres áreas incluidas en el estudio. En relación a la salud, se ha indicado en muchos estudios que los polifenoles en el chocolate pueden mejorar la salud, especialmente en enfermedades cardiovasculares. De acuerdo a las características sensoriales y aceptación del chocolate, se ha dicho que la forma del chocolate tiene una influencia en la percepción del mismo. Los polifenoles causan astringencia y amargor al chocolate, haciéndolo no muy apetecido para los consumidores; sin embargo, por razones de salud, los polifenoles deben ser conservados. Acerca de las actitudes hacia el chocolate, hay muchos factores que llevan al deseo incontrolable de consumir chocolate. El chocolate es el alimento más apetecido en Norte América, éste influencia el estado anímico y crea una sensación de saciedad. Conclusión: Con base en esta revisión se puede concluir que un chocolate “saludable” puede ser parte de una dieta saludable, a la gente le gusta disfrutar del chocolate, mujeres más que hombres. La literatura respalda las propiedades saludables que tiene el consumo del chocolate, por esto es necesario trabajar en el desarrollo de productos de chocolate.

Un aporte a la comprensión de las estrategias emergentes en las organizaciones a través del concepto de improvisación y la metáfora musical

Este trabajo se inscribe en uno de los grandes campos de los estudios organizacionales: la estrategia. La perspectiva clásica en este campo promovió la idea de que proyectarse hacia el futuro implica diseñar un plan (una serie de acciones deliberadas). Avances posteriores mostraron que la estrategia podía ser comprendida de otras formas. Sin embargo, la evolución del campo privilegió en alguna medida la mirada clásica estableciendo, por ejemplo, múltiples modelos para ‘formular’ una estrategia, pero dejando en segundo lugar la manera en la que esta puede ‘emerger’. El propósito de esta investigación es, entonces, aportar al actual nivel de comprensión respecto a las estrategias emergentes en las organizaciones. Para hacerlo, se consideró un concepto opuesto —aunque complementario— al de ‘planeación’ y, de hecho, muy cercano en su naturaleza a ese tipo de estrategias: la improvisación. Dado que este se ha nutrido de valiosos aportes del mundo de la música, se acudió al saber propio de este dominio, recurriendo al uso de ‘la metáfora’ como recurso teórico para entenderlo y alcanzar el objetivo propuesto. Los resultados muestran que 1) las estrategias deliberadas y las emergentes coexisten y se complementan, 2) la improvisación está siempre presente en el contexto organizacional, 3) existe una mayor intensidad de la improvisación en el ‘como’ de la estrategia que en el ‘qué’ y, en oposición a la idea convencional al respecto, 4) se requiere cierta preparación para poder improvisar de manera adecuada.

Propiedades psicométricas de los instrumentos para la medición de la actividad física en adultos con discapacidad física relacionada con lesión de médula espinal: una revisión sistemática

Objetivo: Evaluar las propiedades psicométricas de los instrumentos para la medición de la actividad física en adultos de 18-65 años con discapacidad física por lesión de médula espinal. Materiales y métodos: Revisión sistemática. Las bases de datos de Medline, Scopus, Web of Science y 19 revistas especializadas fueron consultadas durante once días entre abril de 2015 y febrero de 2016 para identificar estudios originales de validación, sin límite de tiempo y que estuvieran publicados en español, francés y/o inglés. La calidad metodológica de los instrumentos de medición se evaluó usando las diferentes cajas de propiedades de la lista COSMIN. Resultados: Se identificaron 9229 referencias, de las cuales sólo 12 cumplieron los criterios de inclusión, dando como resultado 13 instrumentos de medición. Se evaluaron seis propiedades psicométricas. La propiedad más común fue la confiabilidad, además se observó que la calidad metodológica de los estudios incluidos no representa los resultados de las propiedades psicométricas de los instrumentos de medición. La calidad metodológica de los instrumentos para la evaluación de la actividad física en población con lesión medular espinal es “baja” para propiedades como consistencia interna, error de medición, sensibilidad, validez de criterio (con excepción del WISCI II que tiene buena validez) y excelente para validez de contenido y fiabilidad. Conclusión: Se ha encontrado que instrumentos empleados hasta el presente en la medición de la actividad física en población con discapacidad física relacionada con lesión de médula espinal han sido creados para otros tipos de discapacidad y otros instrumentos deben ser validados en futuros estudios.

Bisphosphonate-related Osteonecrosis Of The Jaw: A Review Of The Literature.

Bisphosphonates (BPs) are a class of drugs used to treat osteoporosis and malignant bone metastasis. BPs show high binding capacity to the bone matrix, especially in sites of active bone metabolism. The American Society for Bone and Mineral Research defines BRONJ as an area of exposed bone in the maxillofacial region that has not healed within 8 weeks after identification by a healthcare provider in a patient who is receiving or has been exposed to a bisphosphonate and has not had radiation therapy to the craniofacial region. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) can adversely affect quality of life, as it may produce significant morbidity. The American Association of Oral and Maxillofacial Surgeons (AAOMS) considers as vitally important that information on BRONJ be disseminated to other dental and medical specialties. The purpose of this work is to offer a perspective on how dentists should manage patients on BPs, to show the benefits of accurately diagnosing BRONJ, and to present diagnostic aids and treatments strategies for the condition.