Mrs. Kadiato Kamara: an expert dyer in Sierra Leone / Loretta Reinhardt, Assistant Professor, Erindale College, University of Toronto --

v.66:no.2(1976)

Assessment of the severity of Ebola virus disease in Sierra Leone in 2014–2015

The current Ebola virus disease (EVD) epidemic in West Africa is unprecedented in scale, and Sierra Leone is the most severely affected country. The case fatality risk (CFR) and hospitalization fatality risk (HFR) were used to characterize the severity of infections in confirmed and probable EVD cases in Sierra Leone. Proportional hazards regression models were used to investigate factors associated with the risk of death in EVD cases. In total, there were 17 318 EVD cases reported in Sierra Leone from 23 May 2014 to 31 January 2015. Of the probable and confirmed EVD cases with a reported final outcome, a total of 2536 deaths and 886 recoveries were reported. CFR and HFR estimates were 74·2% [95% credibility interval (CrI) 72·6–75·5] and 68·9% (95% CrI 66·2–71·6), respectively. Risks of death were higher in the youngest (0–4 years) and oldest (≥60 years) age groups, and in the calendar month of October 2014. Sex and occupational status did not significantly affect the mortality of EVD. The CFR and HFR estimates of EVD were very high in Sierra Leone.

Studies on the condition factor of the Sierra Leone mangrove oyster (Crassostrea tulipa)

Sierra Leone is a tropical country where water temperatures are high throughout the year. Consequently the local oysters tend to spawn the year round, with one or two spawning peaks. The condition of such tropical oysters may not be as high as those oyesters in temperate countries since the stored glycogen is regularly utilized to form gonads. A high condition factor value indicates that the oysters have accumulated glycogen and or gonads, whereas a low condition factor value indicates that the oysters have spawned and are in the process of accumulating glycogen, which may later be utilized for gonad development. In oyster culture, condition factor studies may be supported by plankton and oyster spat settlement studies in the culture area. These studies give an indication of when oyster larvae and spat settlement are at their peak values. In Sierra Leone studies of the plankton and spat settlement are undertaken every week throughout the year. Conditions factor is obtained from the ratio weight of dry (oyster) meat x 1000/internal volume. Detailed condition factor values are shown in relation to salinity at two stations. Condition factor declines with reducing salinity, which principally occurs during the rainy season. The best times to collect spat are May to June and September to October

De l’applicabilité du droit international des droits de l’homme dans l’ordre juridique interne

De nos jours, les particuliers peuvent se prévaloir, devant les autorités judiciaires nationales, du droit international des droits de l’homme d’origine conventionnelle, à condition qu’il soit admis que celui-ci est partie intégrante du droit positif national. Les conventions internationales de sauvegarde des droits fondamentaux imprègnent l’ordre juridique interne soit par le biais de compléments internes d’ordre législatif ou réglementaire (logique dualiste), soit du seul fait de leur ratification suivie de leur publication officielle (logique moniste). En l’absence d’une réglementation internationale uniforme des critères de l’applicabilité directe, la difficulté d’identifier les traités de protection des droits de l’homme directement applicables dans l’ordre interne demeure réelle, notamment dans les Etats qui adhèrent à la conception moniste de l’ordre juridique. De façon décisive, la doctrine et la jurisprudence ont consacré deux critères d’identification des clauses conventionnelles autoexécutoires (self-executing), à savoir le critère subjectif du destinataire de la norme internationale et le critère objectif du degré de normativité juridique de celle-ci. La difficulté de la tâche n’en est pas pour autant annihilée comme en atteste, dans le cadre de l’affaire Hissène Habré, la vive controverse sur le caractère prétendument self-executing de la Convention contre la torture. 

Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development.

Remarkable gains have been made in global health in the past 25 years, but progress has not been uniform. Mortality and morbidity from common conditions needing surgery have grown in the world’s poorest regions, both in real terms and relative to other health gains. At the same time, development of safe, essential, life-saving surgical and anaesthesia care in low-income and middle-income countries (LMICs) has stagnated or regressed. In the absence of surgical care, case-fatality rates are high for common, easily treatable conditions including appendicitis, hernia, fractures, obstructed labour, congenital anomalies, and breast and cervical cancer. In 2015, many LMICs are facing a multifaceted burden of infectious disease, maternal disease, neonatal disease, non-communicable diseases, and injuries. Surgical and anaesthesia care are essential for the treatment of many of these conditions and represent an integral component of a functional, responsive, and resilient health system. In view of the large projected increase in the incidence of cancer, road traffic injuries, and cardiovascular and metabolic diseases in LMICs, the need for surgical services in these regions will continue to rise substantially from now until 2030. Reduction of death and disability hinges on access to surgical and anaesthesia care, which should be available, affordable, timely, and safe to ensure good coverage, uptake, and outcomes. Despite growing need, the development and delivery of surgical and anaesthesia care in LMICs has been nearly absent from the global health discourse. Little has been written about the human and economic effect of surgical conditions, the state of surgical care, or the potential strategies for scale-up of surgical services in LMICs. To begin to address these crucial gaps in knowledge, policy, and action, the Lancet Commission on Global Surgery was launched in January, 2014. The Commission brought together an international, multi- disciplinary team of 25 commissioners, supported by advisors and collaborators in more than 110 countries and six continents. We formed four working groups that focused on thedomains of health-care delivery and management; work-force, training, and education; economics and finance; and information management. Our Commission has five key messages, a set of indicators and recommendations to improve access to safe, affordable surgical and anaesthesia care in LMICs, and a template for a national surgical plan.

A gazdasági kamarák szolgáltatásainak szerepe a vállalkozásfejlesztésben - BOKIK esettanulmány

Hazánk uniós csatlakozását megelőzően nagy hangsúlyt kapott a politikai és az üzleti szint közti úgynevezett köztes (mezo) szféra tevékenységének vizsgálata, melynek szereplői a gazdasági kamarák is. Az empirikus felmérés készítésének kettős magyarázata van: egyrészt ismét előtérbe kerültek e szervezetek, mert az állam gazdasági szerepvállalásának csökkentéséhez szükség lenne a gazdasággal összefüggő közfeladatok egy részének, a köztestületi formában működő gazdasági kamarák által történő ellátására. Másrészt a gazdasági kamarák stratégiája („ha a kamara nem lehet mindenkié, akkor legyen rang az odatartozás”) magában foglalja a személyes törődés igényét is, tehát folyamatosan vizsgálni kell, hogy a tagok milyen szolgáltatásokat vesznek igénybe, és ez alapján szükséges-e változtatni, fejleszteni ezeket. A felmérés eredményeképpen egy új, komplexebb szolgáltatási rendszer kerülhet kialakításra, mely alapján a kamarának lehetősége nyílik személyre szabottabb szolgáltatások kialakítására.