BMC research notes
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Moroccan authorities carry out regular surveys on population and family health (NSFFP 1980, NSPH 1992, SPFH 2004, NSPFH 2011). These surveys constitute valuable resources for monitoring socio-economic and health indicators. They provide an evidence base for health decision makers to help them to optimize health strategies in order to improve the health conditions of the whole population. They also provide updated measures on geographic disparities, socio-economic inequalities and health inequity. The most recent Moroccan population and family health survey (NSPFH 2011) was carried out between November 2010 and March 2011. The final report and the database are not yet accessible, but a preliminary report was released early March 2012. This report does not allow for a complete evaluation of the present health situation in Morocco. A partial equity analysis can, however, be devoted to the comparison of health indicators especially in terms of rural-urban gaps. ⋯ This paper shows that average health indicators improved noticeably during the last two decades but rural-urban disparities are still a challenge for health decision makers. Socio-economic indicators, like illiteracy rate and unemployment, also demonstrate large gender inequalities. This preliminary analysis is designed to assist Moroccan health authorities to evaluate the current health situation in order to adopt cost-effective strategies that improve "health for all" and reduce the gaps between advantaged and disadvantaged populations.
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Randomized Controlled Trial
Development and delivery of patient treatment in the Trondheim Hip Fracture Trial. A new geriatric in-hospital pathway for elderly patients with hip fracture.
Hip fractures are common among frail elderly persons and often have serious consequences on function, mobility and mortality. Traditional treatment of these patients is performed in orthopedic departments without additional geriatric assessment. However, studies have shown that interdisciplinary geriatric treatment may be beneficial compared to traditional treatment. The aim of the present study is to investigate whether treatment of these patients in a Department of Geriatrics (DG) during the entire hospital stay gives additional benefits as compared to conventional treatment in a Department of Orthopaedic Surgery (DOS). ⋯ A new treatment program for old hip fracture patients was developed, introduced and run in the DG, the potential benefits of which being compared with traditional care of hip fracture patients in the DOS in a randomised clinical trial.
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The CanMEDS roles and competencies are being used as the framework to support the development of the Manitoba Practice Assessment Program (MPAP) designed to assess the competence of physicians practicing with a conditional license. Establishing the link between clinical practice and assessment of performance is critical in the development of the MPAP. A first step in establishing this link is to identify activities performed in actual clinical practice as well as the importance of those activities. ⋯ Given that each of the CanMEDS roles is considered at least moderately important, a variety of assessment tools are needed to evaluate competencies across the entire spectrum of roles. The results underscore the importance of incorporating a multifaceted approach when developing a practice assessment program.
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Community Based Interactive Approach-diabetes mellitus (CBIA-DM) is an active self-learning method. This study is aimed at improving type 2 diabetic patients' knowledge, attitude and practice on diabetes self-care by implementing the CBIA-DM strategy. Time series, pre and post quasi-experimental design, Intervention group underwent CBIA-DM, DM-club and Normal-care group acted as control. Data were collected in pre-intervention, immediately, one, three and six months post intervention. Ranging scores for pre and post test questionnaires were: knowledge (0-18) and attitude (9-45); categorizing as rational scales of the scores in good, fair and poor. Practicing in diabetes self-care was assessed using 12 questionnaires, and categorized as adhere and not adhere to DM self-care. Effectiveness of CBIA-DM was evaluated based on the increasing number of participants in good knowledge and attitude levels, and adherence in practicing diabetes self-care. ⋯ CBIA-DM strategy is effective to improve diabetic patients' knowledge, attitude and practice on diabetes self-care. Repeating and improving the strategy program is needed to sustain the impact.
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Splenic injuries at Bugando Medical Centre in northwestern Tanzania: a tertiary hospital experience.
Splenic injuries constitute a continuing diagnostic and therapeutic challenge to the trauma or general surgeons practicing in developing countries where sophisticated imaging facilities are either not available or exorbitantly expensive. The purpose of this review was to describe our own experience in the management of the splenic injuries outlining the aetiological spectrum, injury characteristics and treatment outcome of splenic injuries in our local environment and to identify predictors of outcome among these patients. ⋯ Trauma resulting from road traffic accidents (RTAs) remains the most common cause of splenic injuries in our setting. Most of the splenic injuries were Grade III & IV and splenectomy was performed in majority of the cases. Non-operative management can be adopted in patients with blunt isolated and low grade splenic injuries but operative management is still indispensable in this part of Tanzania. Urgent preventive measures targeting at reducing the occurrence of RTAs is necessary to reduce the incidence of splenic injuries in our centre.