Introduction: Home delivery is still a health problem in Kolda (Senegal). The aim of this work is to study the factors associated with the place of delivery in a situation of free care delivery. Method: A descriptive ...Introduction: Home delivery is still a health problem in Kolda (Senegal). The aim of this work is to study the factors associated with the place of delivery in a situation of free care delivery. Method: A descriptive and analytical cross-sectional study was carried out. Sampling was in two-stage clusters. The study focused on women who gave birth in the last 12months. The data were collected during an individual interview at home. The collection focused on knowledge, attitudes and practices about delivery. Logistic regression was used to explore the determinants of childbirth at the level of health facility. Results: The average age was 25.4 ± 6.5 years. Among the interviewed women, education was reported in 35% of the women and 55% of women estimate that the closest health facility is within 5 km to their home. The time to get to the nearest health facility is less than 15 minutes for 39% of the interviewed women. The prevalence of home delivery was 43.5%. Home delivery was related to the remoteness of the health facility (2.43 [1.75 - 3.37]) but also to incomplete antenatal care (2.52 [1.59 - 4.00]). Support groups highlighted difficulties of access to health facilities because of remoteness. Interviews revealed a lack of involvement of husbands in seeking care for women. Cultural barriers are still there. Conclusions: Despite the gratuity of delivery, the remoteness of health structures and socio-cultural factors are still barriers to access to care for pregnant women. These aspects must be taken into account in health policies. Multi-lateral interventions should be implemented to provide solutions for this health problem.展开更多
Introduction: Cleft lip, palate and alveolar (CLPA) are congenital malformations of the face due to a defect in the fusion of embryonic buds during the first weeks of embryogenesis. These malformations affect the uppe...Introduction: Cleft lip, palate and alveolar (CLPA) are congenital malformations of the face due to a defect in the fusion of embryonic buds during the first weeks of embryogenesis. These malformations affect the upper lip, the alveolar bone and the palate. The incidence in Africa ranges from 1/2000 to 1/500 births. Their multidisciplinary management is long and costly. Thus, the help provided by humanitarian organisations during free care campaigns is welcome. Materials and Methods: This is a retrospective descriptive study conducted from August 2014 to July 2016 in the Maxillofacial Surgery and Stomatology Department of the Treichville University Hospital in Abidjan, Côte d’Ivoire. The objective was to describe the epidemiological, clinical and therapeutic aspects of CLPA during a humanitarian campaign for free care. Results: 51 cases of CLPA were operated on. Males were involved in 54.9% of the cases, i.e. a sex ratio of 1.2. The average age of the patients at the time of the operation was 3.44 years with extremes of 3 months and 52 years. Patients with low socioeconomic status represented 84.3% of the cases. Cleft lips (31.4%) and cleft palates (33.33%) predominated. For cleft lips, unilateral forms were the most frequent (73.5%) and the left side was most often affected (59.2%). The most common surgical techniques used were MILLARD cheiloplasty for cleft lips (79.36%) and Dorrance pushback for cleft palates (78.05%). The postoperative course was simple in the majority of cases (80.47%). Patients and/or parents were satisfied with the postoperative results in over 90% of cases. Discussion: Cleft lip and palate are common. Their management by humanitarian missions through mass campaigns allows us to receive a large number of patients affected by this pathology who are treated with a high satisfaction rate. Conclusion: The characteristics of cleft lip and palate in this study are in many respects identical to those described in the literature, but with some differences specific to Africa, notably the absence of antenatal diagnosis and the advanced age at the time of treatment.展开更多
<strong>Aim:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Despite recent advances in the...<strong>Aim:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Despite recent advances in the treatment of ovarian cancer, recurrence of the disease is still frequent. This study evaluated whether multiple lines of chemotherapy have impact on overall survival (OS), progression free survival (PFS) or on treatment free intervals (TFIs) after serial chemotherapy lines in recurrent settings.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods: </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">A total of 189 patients with ovarian cancer (including fallopian tube and primary peritoneal cancer), who were treated in Kuopio University Hospital in Finland during 2009-2014, were enrolled. The medical files of these patients were retrospectively reviewed.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><b><span style="font-family:""> </span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Median OS and PFS were significantly higher at the time of the first relapse compared to subsequent relapses (p < 0.001). TFIs shortened significantly after the first relapse (p < 0.001). The differences in TFIs were also seen when comparing </span><span style="font-family:Verdana;">platinum sensitive, semi-sensitive and platinum resistant patients. The total</span> <span style="font-family:Verdana;">amount of TFI times during the whole follow-up time was significantly re</span><span style="font-family:Verdana;">duced in those patients that received at least one form of aggressive care at </span><span style="font-family:Verdana;">the end </span><span style="font-family:Verdana;">of life (p = 0.004). </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Ovarian cancer patients received often mul</span><span style="font-family:Verdana;">tiple lines of chemotherapy. TFIs after subsequent chemotherapy lines de</span><span style="font-family:Verdana;">creased during the disease course. More efforts should be taken to avoid unne</span><span style="font-family:Verdana;">cessary and ineffective treatments especially in recurrent phase of the disease.</span></span></span></span>展开更多
目的基于安德森模型了解厦门市居民选择免陪照护服务的影响因素,为干预提供参考依据。方法采用便利抽样法,选取2023年4月至7月厦门市6个辖区的694名常住居民作为研究对象,采用一般资料调查表、日常生活活动能力量表(activity of daily l...目的基于安德森模型了解厦门市居民选择免陪照护服务的影响因素,为干预提供参考依据。方法采用便利抽样法,选取2023年4月至7月厦门市6个辖区的694名常住居民作为研究对象,采用一般资料调查表、日常生活活动能力量表(activity of daily living scale,ADL)、简明健康状况量表(12-Item short form health survey,SF-12)进行问卷调查。引入安德森模型作为框架,并通过单因素和Logistic回归分析厦门市居民选择免陪照护服务的影响因素。结果694名居民均完成研究。选择免陪照护服务就医的有433例(62.39%)。Logistic回归分析结果显示,5个先决因素(年龄、婚姻状况、文化程度、工作状况、住院期间陪护任务承担主体),4个促能因素(个人平均月收入、子女数、主要照护者、免陪照护付费意愿),1个需求因素(最近一年就医次数)是厦门市居民选择免陪照护服务的影响因素(均P<0.05)。结论厦门市居民选择免陪照护服务就医意愿较高但仍有提升空间,建议应根据影响因素采取针对性干预方案,以便提升居民免陪照护就医意愿。展开更多
文摘Introduction: Home delivery is still a health problem in Kolda (Senegal). The aim of this work is to study the factors associated with the place of delivery in a situation of free care delivery. Method: A descriptive and analytical cross-sectional study was carried out. Sampling was in two-stage clusters. The study focused on women who gave birth in the last 12months. The data were collected during an individual interview at home. The collection focused on knowledge, attitudes and practices about delivery. Logistic regression was used to explore the determinants of childbirth at the level of health facility. Results: The average age was 25.4 ± 6.5 years. Among the interviewed women, education was reported in 35% of the women and 55% of women estimate that the closest health facility is within 5 km to their home. The time to get to the nearest health facility is less than 15 minutes for 39% of the interviewed women. The prevalence of home delivery was 43.5%. Home delivery was related to the remoteness of the health facility (2.43 [1.75 - 3.37]) but also to incomplete antenatal care (2.52 [1.59 - 4.00]). Support groups highlighted difficulties of access to health facilities because of remoteness. Interviews revealed a lack of involvement of husbands in seeking care for women. Cultural barriers are still there. Conclusions: Despite the gratuity of delivery, the remoteness of health structures and socio-cultural factors are still barriers to access to care for pregnant women. These aspects must be taken into account in health policies. Multi-lateral interventions should be implemented to provide solutions for this health problem.
文摘Introduction: Cleft lip, palate and alveolar (CLPA) are congenital malformations of the face due to a defect in the fusion of embryonic buds during the first weeks of embryogenesis. These malformations affect the upper lip, the alveolar bone and the palate. The incidence in Africa ranges from 1/2000 to 1/500 births. Their multidisciplinary management is long and costly. Thus, the help provided by humanitarian organisations during free care campaigns is welcome. Materials and Methods: This is a retrospective descriptive study conducted from August 2014 to July 2016 in the Maxillofacial Surgery and Stomatology Department of the Treichville University Hospital in Abidjan, Côte d’Ivoire. The objective was to describe the epidemiological, clinical and therapeutic aspects of CLPA during a humanitarian campaign for free care. Results: 51 cases of CLPA were operated on. Males were involved in 54.9% of the cases, i.e. a sex ratio of 1.2. The average age of the patients at the time of the operation was 3.44 years with extremes of 3 months and 52 years. Patients with low socioeconomic status represented 84.3% of the cases. Cleft lips (31.4%) and cleft palates (33.33%) predominated. For cleft lips, unilateral forms were the most frequent (73.5%) and the left side was most often affected (59.2%). The most common surgical techniques used were MILLARD cheiloplasty for cleft lips (79.36%) and Dorrance pushback for cleft palates (78.05%). The postoperative course was simple in the majority of cases (80.47%). Patients and/or parents were satisfied with the postoperative results in over 90% of cases. Discussion: Cleft lip and palate are common. Their management by humanitarian missions through mass campaigns allows us to receive a large number of patients affected by this pathology who are treated with a high satisfaction rate. Conclusion: The characteristics of cleft lip and palate in this study are in many respects identical to those described in the literature, but with some differences specific to Africa, notably the absence of antenatal diagnosis and the advanced age at the time of treatment.
文摘<strong>Aim:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Despite recent advances in the treatment of ovarian cancer, recurrence of the disease is still frequent. This study evaluated whether multiple lines of chemotherapy have impact on overall survival (OS), progression free survival (PFS) or on treatment free intervals (TFIs) after serial chemotherapy lines in recurrent settings.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods: </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">A total of 189 patients with ovarian cancer (including fallopian tube and primary peritoneal cancer), who were treated in Kuopio University Hospital in Finland during 2009-2014, were enrolled. The medical files of these patients were retrospectively reviewed.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><b><span style="font-family:""> </span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Median OS and PFS were significantly higher at the time of the first relapse compared to subsequent relapses (p < 0.001). TFIs shortened significantly after the first relapse (p < 0.001). The differences in TFIs were also seen when comparing </span><span style="font-family:Verdana;">platinum sensitive, semi-sensitive and platinum resistant patients. The total</span> <span style="font-family:Verdana;">amount of TFI times during the whole follow-up time was significantly re</span><span style="font-family:Verdana;">duced in those patients that received at least one form of aggressive care at </span><span style="font-family:Verdana;">the end </span><span style="font-family:Verdana;">of life (p = 0.004). </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Ovarian cancer patients received often mul</span><span style="font-family:Verdana;">tiple lines of chemotherapy. TFIs after subsequent chemotherapy lines de</span><span style="font-family:Verdana;">creased during the disease course. More efforts should be taken to avoid unne</span><span style="font-family:Verdana;">cessary and ineffective treatments especially in recurrent phase of the disease.</span></span></span></span>
文摘目的基于安德森模型了解厦门市居民选择免陪照护服务的影响因素,为干预提供参考依据。方法采用便利抽样法,选取2023年4月至7月厦门市6个辖区的694名常住居民作为研究对象,采用一般资料调查表、日常生活活动能力量表(activity of daily living scale,ADL)、简明健康状况量表(12-Item short form health survey,SF-12)进行问卷调查。引入安德森模型作为框架,并通过单因素和Logistic回归分析厦门市居民选择免陪照护服务的影响因素。结果694名居民均完成研究。选择免陪照护服务就医的有433例(62.39%)。Logistic回归分析结果显示,5个先决因素(年龄、婚姻状况、文化程度、工作状况、住院期间陪护任务承担主体),4个促能因素(个人平均月收入、子女数、主要照护者、免陪照护付费意愿),1个需求因素(最近一年就医次数)是厦门市居民选择免陪照护服务的影响因素(均P<0.05)。结论厦门市居民选择免陪照护服务就医意愿较高但仍有提升空间,建议应根据影响因素采取针对性干预方案,以便提升居民免陪照护就医意愿。
