Enjeux,défis,opportunités et stratégie durable d’implantation de l’imagerie hybride TEMP/TDM dans un pays à ressources médicales limitées,la Côte d’Ivoire

From HO Anger's analogic gamma camera to digital camera, developed countries are at the time of hybrid cameras SPECT/CT and PET/CT. Sub-Saharan black Africa in the image of Côte d’Ivoire, a country with limited medical resources shows an important delay in the evolution of the health system in general and particularly in medical imaging equipment. The purpose of this paper was to approach the issues, challenges and sustainable strategy for the implementation of hybrid imaging SPECT/CT in a developing country where the rate of morbidity and mortality remains high due to infectious but also cancer diseases because of the inadequacy of the health technical platform. To address these challenges, Côte d’Ivoire like many countries in sub-Saharan Africa with limited medical resources must design, test and develop clinical strategies adapted to developing countries. Health authorities of this country must develop a policy for sustainable financing of medical imaging, including the training of the adequate health personnel according to a model of corporate leadership. In this perspective, Côte d’Ivoire must have a SPECT/CT instead of a simple gamma camera. This would allow to optimize its diagnostic health system in oncology, bone and joint disease and in many other medical disciplines. And especially since the SPECT/CT is a high-performance device that has largely demonstrated its diagnostic efficiency and that can be used as SPECT alone or as isolated CT. In addition, this country should take over digital imaging in the context of cooperation with some countries of Africa and Europe ahead in the field of modern medical imaging, seeking assistance from international organizations (IAEA, RAD-AID, WHO,…). Finally this country should implement methods of assessment, types of performance indicators to guide planning for future projects of its system.     

Ecological profile of a Sahelian wetland: Toward understanding the need for national wetland policies

The composition and complex interrelationships among the components of a Sahelian wetland community in Nigeria are described. The hydrology of the wetland is perceived to be the major determinant of the ecological integrity of the area. Ongoing ecological changes started by periodic meteorological droughts and sustained by the effects of large-scale hydro-agricultural projects are described along with their impacts on wildlife habitats and other valuable wetland resources. Establishing national wetland policies that recognize present and potential future values of various wetland types is recommended as an important step toward sustainable conservation of wetland resources in countries of the Sahel.     

Arthropod-borne diseases: vector control in the genomics era

Diseases that are transmitted by arthropods cause severe morbidity and mortality throughout the world. The burden of many of these diseases is borne largely by developing countries. Advances in vector genomics offer new promise for the control of arthropod vectors of disease. Radical changes in vector-biology research are required if scientists are to exploit genomic data and implement changes in public health.     

Designing water-saving-ecological check dam sites by a system optimization model in a region of the loess plateau,Northwest China

Check dams are the most widespread structures for successfully retaining water and checking erosion on the semiarid portions of China's Loess Plateau. However, in the process of check dam planning and construction, difficulties in identifying the weights of influential factors, balancing all factors and making decisions are common problems that seriously restrict rapid socioeconomic development. With the goals of determining potential check dam construction sites and holistically maximizing a projected check dam array's water resource, ecosystem and socioeconomic benefits (taking into account the water shortage and ecological fragility in semiarid areas), a water-saving-ecological check dam site optimization model (WCSOM) was developed. The WCSOM, with newly added water-saving factors, was applied to the selection of check dam sites in the Sijiagou Basin. The model showed that the ecological and the water-saving factors were the top two weights, accounting for 59.88% of the total weight. The top three influencing elements were conservation of water sources, flood prevention capacity and check dam control area, which were part of the ecological, socioeconomic and economic factors, respectively, accounting for 37.77% of the total weight. The scores of larger-scale check dam sites in the basin were generally higher, while the scores of smaller-scale sites were generally lower. The use of the WCSOM in watershed planning will allow a more efficient use of water and soil resources and greatly alleviate water crises in this semiarid area. The WCSOM can be further applied in other regions by adjusting the criterion and index hierarchies, and it can provide technical support for both the planning and rapid development of a check dam system.     

Global health inequalities and the need for solidarity: a view from the Global South

Although the world has experienced remarkable progress in health care since the last half of the 20th century, global health inequalities still persist. In some poor countries life expectancy is between 37‐40 years lower than in rich countries; furthermore, maternal and infant mortality is high and there is lack of access to basic preventive and life‐saving medicines, as well a high prevalence of neglected diseases, HIV/AIDS, tuberculosis, and malaria. Moreover, globalization has made the world more connected than before such that health challenges today are no longer limited within national or regional boundaries, making all persons equally vulnerable. Because of this, diseases in the most affluent countries are closely connected with diseases in the poorest countries. In this paper, we argue that, because of global health inequalities, in a situation of equal vulnerability, there is need for global solidarity not only as a means of reducing health inequalities, but also as a way of putting up a united force against global health challenges. We argue for an African approach to solidarity in which the humanity of a person is not determined by his/her being human or rational capacity, but by his/her capacity to live a virtuous life. According to this view of solidarity, because no one is self‐sufficient, no individual can survive alone. If we are to collectively flourish in a world where no individual, nation or region has all the health resources or protection needed for survival, we must engage in solidarity where we remain compassionate and available to one another at all times.     

Bacillus anthracis Diversity and Geographic Potential across Nigeria,Cameroon and Chad: Further Support of a Novel West African Lineage

Zoonoses, diseases affecting both humans and animals, can exert tremendous pressures on human and veterinary health systems, particularly in resource limited countries. Anthrax is one such zoonosis of concern and is a disease requiring greater public health attention in Nigeria. Here we describe the genetic diversity of Bacillus anthracis in Nigeria and compare it to Chad, Cameroon and a broader global dataset based on the multiple locus variable number tandem repeat (MLVA-25) genetic typing system. Nigerian B. anthracis isolates had identical MLVA genotypes and could only be resolved by measuring highly mutable single nucleotide repeats (SNRs). The Nigerian MLVA genotype was identical or highly genetically similar to those in the neighboring countries, confirming the strains belong to this unique West African lineage. Interestingly, sequence data from a Nigerian isolate shares the anthrose deficient genotypes previously described for strains in this region, which may be associated with vaccine evasion. Strains in this study were isolated over six decades, indicating a high level of temporal strain stability regionally. Ecological niche models were used to predict the geographic distribution of the pathogen for all three countries. We describe a west-east habitat corridor through northern Nigeria extending into Chad and Cameroon. Ecological niche models and genetic results show B. anthracis to be ecologically established in Nigeria. These findings expand our understanding of the global B. anthracis population structure and can guide regional anthrax surveillance and control planning.     

From Nuremberg to the ethics committees in human experimentation

During the Nuremberg trials, the accusation prompted the creation of an ad hoc committee to advise on human experiments carried out on prisoners during wartime in the USA. Precisely a charge that had been brought against Karl Brandt and his colleagues. This committee was the forerunner of the Independent Committees, to which the Declaration of Helsinki assigned a role in analysing the ethics of research projects in humans. From 1980 onwards, in industrialised countries, the legislation regarding clinical trials began to incorporate similar structures, IRBs in the United States of America, Ethics Committees elsewhere, and the 'Committee for the Protection of Persons" in France. However, at that time, in spite of the misleading words, we went from ethics to law, from rules of conduct intended for researchers to legal regulations organising relations between sponsors, investigators and persons participating in biomedical research, which is not the same thing.     

Friedrich Welwitsch, 1806-72 A centennial memoir

The main events in the life of Friedrich Welwitsch are discussed and his achievements evaluated.
SUMMARY A hundred years ago Friedrich Welwitsch, the naturalist-explorer whose name is commemorated in the monotypic genus Welwitschia , died in London. The collection he made in Angola was acclaimed, even 20 years after his death, as the best ever to have come out of tropical Africa, and to this day it remains of unique value.
As well as a contentious spirit Welwitsch had an inflexible devotion to any task he undertook. The Portuguese Government did not clearly comprehend the nature of the investigation it should have invited Welwitsch to carry out in Angola or the character of the man himself. The consequent misunderstanding, discord and severance between Welwitsch and the Government sprang partly from their divergence of purpose and partly from an earlier pattern set between Welwitsch and his father.
But, disappointed as it was with Welwitsch's achievement, the Portuguese Government recognized the scientific value of his collections and successfully contested his attempt to bequeath the best part of them to the British Museum. An action in the English High Court between the King of Portugal and the executors of Welwitsch's will followed, and became tangled with extraneous animosities between the British Museum and Kew before it was finally settled in a compromise.
Welwitsch's life, and especially his quarrel with the Portuguese Government, foreshadowed many disputes of a now unfortunately familiar kind between governments and the scientists they employ. And the nature of his achievement, both its success and its failure, provokes thought on problems of contemporary importance to the advancement of developing countries.     

The Claude Bernard Distinguished Lecture. In pursuit of meaningful learning

The Bernard Distinguished Lecturers are individuals who have a history of experience and expertise in teaching that impacts multiple levels of health science education. Dr. Joel Michael more than meets these criteria. Joel earned a BS in biology from CalTech and a PhD in physiology from MIT following which he vigorously pursued his fascination with the mammalian central nervous system under continuous National Institutes of Health funding for a 15-yr period. At the same time, he became increasingly involved in teaching physiology, with the computer being his bridge between laboratory science and classroom teaching. Soon after incorporating computers into his laboratory, he began developing computer-based learning resources for his students. Observing students using these resources to solve problems led to an interest in the learning process itself. This in turn led to a research and development program, funded by the Office of Naval Research (ONR), that applied artificial intelligence to develop smart computer tutors. The impact of problem solving on student learning became the defining theme of National Science Foundation (NSF)-supported research in health science education that gradually moved all of Dr. Michael's academic efforts from neurophysiology to physiology education by the early 1980's. More recently, Joel has been instrumental in developing and maintaining the Physiology Education Research Consortium, a group of physiology teachers from around the nation who collaborate on diverse projects designed to enhance learning of the life sciences. In addition to research in education and learning science, Dr. Michael has devoted much of his time to helping physiology teachers adopt modern approaches to helping students learn. He has organized and presented faculty development workshops at many national and international venues. The topics for these workshops have included computer-based education, active learning, problem-based learning, and the use of general models in teaching physiology.     

Stressful life events preceding the acute onset of schizophrenia: A cross-national study from the World Health Organization

This study reports on the findings from a WHO sponsored cross-national investigation of life events and schizophrenia. Data are presented from a series of 386 acutely ill schizophrenic patients selected from nine field research centers located in developing and developed countries (Aarhus, Denmark; Agra, India; Cali, Colombia; Chandigarh, India; Honolulu, USA; Ibadan, Nigeria; Nagasaki, Japan; Prague, Czechoslovakia; Rochester, USA). On a methodological level, the study demonstrates that life event methodologies originating in the developed countries can be adapted for international studies and may be used to collect reasonably reliable and comparable cross-cultural data on psychosocial factors affecting the course of schizophrenic disorders. Substantive findings replicate the results of prior studies which conclude that socioenvironmental stressors may precipitate schizophrenic attacks and such events tend to cluster in the two to three week period immediately preceding illness onset.The paper was prepared by these authors on behalf of the collaborating investigators listed on page 196.     

Sustainable biodiversity conservation in the Niger Delta: a practical approach to conservation site selection

The rich biodiversity repository of the Niger Delta region of Nigeria is under severe threat from diverse sources such as deforestation, inadequate farming practices, invasive alien species, urbanization and oil and gas exploration and development activities. This biodiversity “hot spot” is the second most sensitive environment in Africa. The over 70 Protected Areas (PAs) here have lost substantial portions of their area which translates to loss of biodiversity. The need to select representative sites within each of the ecological zones of the region for effective and sustainable biodiversity conservation is, therefore, essential. Vital site criteria that have ecological, socio-economic and cultural dimensions were selected and assessed through a combination of relevant scientific information, indigenous traditional knowledge and participatory rural appraisal (PRA) to yield Key Biodiversity Areas (KBAs).They are significantly different from the site selection criteria and principles used in the UK and to a large extent adopt the critical factors that underscore biodiversity conservation in a largely primary production based economy such as in much of the developing world. The three sites selected for biodiversity conservation through this process yielded not only community buy-in but also participatory action and ownership, which are critical for the sustainability of the biodiversity conservation efforts. Shell Nigeria and World Wide Fund (WWF) representatives are already concluding plans to commence effective conservation projects in the selected sites. This approach is hereby advocated for consideration and adoption for the preservation of the remaining stock of the unique biodiversity in developing countries.     

Biotechnology to improve health in developing countries -- a review

The growing health disparities between the developing and the developed world call for urgent action from the scientific community. Science and technology have in the past played a vital role in improving public health. Today, with the tremendous potential of genomics and other advances in the life sciences, the contribution of science to improve public health and reduce global health disparities is more pertinent than ever before. Yet the benefits of modern medicine still have not reached millions of people in developing countries. It is crucial to recognize that science and technology can be used very effectively in partnership with public health practices in developing countries and can enhance their efficacy. The fight to improve global health needs, in addition to effective public health measures, requires rapid and efficient diagnostic tools; new vaccines and drugs, efficient delivery methods and novel approaches to therapeutics; and low-cost restoration of water, soil and other natural resources. In 2002, the University of Toronto published a report on the "Top 10 Biotechnologies for Improving Health in Developing Countries". Here we review these new and emerging biotechnologies and explore how they can be used to support the goals of developing countries in improving health.     

Biotechnology and sustainable development in sub-Saharan Africa

Whether development is defined by the long-standing economic parameter of per capita gross national product (GNP) or by the newly introduced Human Development Index (HDI), which is not based exclusively on per capita GNP, the countries of sub-Saharan Africa rank at or near the bottom of the developing world. Agriculture and agro-based processing are the mainstays of the economies of the majority of these countries. Because of this, and also because many of the diseases endemic in these countries are communicable, the application of modern biotechnology (including genetic engineering, tissue culture and monoclonal antibody technology) and related biotechnologies could play an important part in creating sustainable development in the region. There is, therefore, an urgent need to train more of the region's indigenous citizens, and to equip more laboratories, in modern biotechnology. It is suggested that, in order to accelerate the harnessing of the fruits of biotechnology, more countries in the region should affiliate with the International Centre for Genetic Engineering and Biotechnology (ICGEB). It is further suggested that a regional equivalent of the ICGEB be built and the services of non-governmental biotechnology organizations used.The author is with Nnamdi Azikiwe University, P. M. B. 5025, Awka, Nigeria. Address correspondence to P. M. B. 1457, Enugu, Nigeria     

Navigation in Marine Protected Areas: National and International Law

Abstract

World fish resources, fishing methods, and processing operations in the seafood industry are described. The fishery situation in developing countries (LDCs) is discussed, with particular reference to artisanal and other local fisheries, and examples are cited to illustrate the structure of the industry. Technology transfer from developed countries to LDCs is discussed and recommendations are presented for future technology transfer programs. It is concluded that an integrated complex of small projects with defined, attainable objectives and immediate impact on income and food supply of the LDC populations is likely to be more successful than large‐scale programs with little immediate payoff. A case study of fisheries in two developing countries, Thailand and Peru, and extensive tabulation of statistical data on catches, value of catch, and unit value of fish species groups for selected countries, with a discussion of the significance of the data, are presented in an appendix.     

Genomic medicine and developing countries: creating a room of their own

The notion that developing countries must wait for the developed world to make advances in science and technology that they later import at great cost is being challenged. We have previously argued that developing countries can harness human genetic variation to benefit their populations and economies. Based on our empirical studies of large-scale population genotyping projects in Mexico, India and Thailand, we describe how these resources are being adopted to improve public health and create knowledge-based economies. A significant additional benefit is building the capacity for scientific research and internalizing advances in technology, whatever their source.     

Human birthweight evolution across contrasting environments

We explore from both theoretical and empirical perspectives the hypothesis that a significant part of the worldwide variability in human birthweight results from adaptive responses to local selective pressures. We first developed an agent-based model to simulate the process of evolutionary selection on life history strategy, and then we performed a comparative analysis across 89 countries worldwide. The model illustrates that optimal birthweight depends on which fitness-reducing risk locally predominates (somatic diseases, parasitic diseases or adverse environmental conditions). When fitness variations between individuals mainly result from somatic diseases (e.g. industrialized countries), or conversely from infectious and parasitic diseases (e.g. developing countries), selection is expected to favour individuals producing larger children. Conversely, when environmental risks increase in relative importance, selective pressures for producing children with high birthweight are reduced. The comparative analysis supports these theoretical expectations, in particular the finding that birthweight is higher than predicted in highly parasitized countries.     

Disease Risk Assessment in African Great Apes Using Geographic Information Systems

This unique study illustrates the potential application of Geographic Information Systems (GIS) to generate hypotheses regarding which African great ape populations, including bonobos (Pan paniscus), chimpanzees (Pan troglodytes), and gorillas (Gorilla gorilla and Gorilla beringei), are at increased risk from human diseases. Human demographic data and core human health indicator data for the African great ape range countries were obtained. Human population density and percent annual human population growth rate were used as combined indicators of environmental stress/vulnerability (as a proxy measure of human–great ape contact), and infant mortality rate (IMR) and healthy life expectancy (HALE) were used as separate indicators of disease burden among the human populations living in the great ape range countries. Cut-off values were determined and, using GIS, these indicators were analyzed to create maps of critical areas (countries) with both environmental stress and high burden of human diseases. When using IMR as the indicator of disease burden, the great ape range countries identified as critical areas included Benin, Guinea-Bissau, Ivory Coast, Liberia, Nigeria, and Tanzania. Cameroon and Uganda were also identified as critical areas when using HALE as the indicator of disease burden; however, Benin was excluded. Validation of these results would allow for targeted interventions thereby maximizing the use of limited resources. Improvements in public health infrastructure in these critical areas would benefit the human populations that have unmet health needs as well as these endangered species.     

基于ISO 14046的工业产品水足迹评价研究——以电缆为例

水足迹国际标准(ISO 14046)于2014年发布,基于生命周期评价(LCA)的思想,水足迹被定义为量化与水相关潜在环境影响的指标。在ISO14046的原则、要求和方法学框架基础上,介绍了工业产品水足迹的计算和评价方法,并以铜电缆和铝合金电缆为例进行研究,分别评价了两类电缆生命周期过程产生的与水相关环境影响。与水足迹网络(WFN)的方法侧重于计算生产产品所需要的水资源总量不同,ISO的方法更关注于产品全生命周期过程的环境影响评价。案例研究表明:铜电缆生命周期全过程耗水量与铝合金电缆相比少24.8%,水短缺足迹相比则少97.9%。这是因为铜电缆生产地江苏的水压力指数(WSI)小于铝合金电缆生产地河北的WSI。由此,在江苏地区生产电缆使用的水资源对当地水环境压力造成的影响远小于在河北地区生产电缆造成的影响。采用科学合理的水足迹评价方法,量化工业产品全生命周期带来的环境影响,能为我国实现工业布局的合理规划和水资源的可持续利用提供科学依据。     

Male fertility attitudes: a neglected dimension in Nigerian fertility research

A sample of 202 male Nigerians enrolled in colleges and graduate schools in the state of Kansas were surveyed to determine their perceptions of population problems in Nigeria; attitudes toward family planning, divorce, and male children; and attitudes toward family size. A major limitation of Nigerian-based fertility research has been the neglect of the role of men in couples' reproductive behavior. The majority of Nigerian students surveyed in this study did not think overpopulation is an impending crisis in Nigeria: 40% thought there are just enough people and 13% indicated there are not enough people. 53% supported the concept of a government population policy, but 67% felt the government should not interfere with family size decisions. Although 84% endorsed the idea that family planning services and information should be available, 69% felt women should not practice family planning without the consent of their husbands. 43% believed a man should divorce his wife if the woman is infertile, unable to produce a male child, or unable to bear the number of children demanded by her husband; in addition, 35% indicated a man should marry a second wife or continue to have children if the couple has 5 daughters and no son. In terms of the value of children, 62% stated that children are wealth or better than wealth, whereas 38% claimed that children use up wealth. Duration of stay in the US was inversely correlated with the number of children considered too many, and the number of male children already born was an important determinant of future family size expectations. In general, it appears that level of education and exposure to US standards do not have a major impact on fertility values among Nigerians, particularly the desire for male children. Educated Nigerian men are an important target for population education, however, because they dominate and control many of the structural, behavioral, and cultural dimensions of fertility behavior.