Benefit-cost analysis of coordinated strategies for control of rabies in Africa.

Previous research suggests that dog mass vaccination campaigns can eliminate rabies locally, resulting in large human and animal life gains. Despite these demonstrated benefits, dog vaccination programs remain scarce on the African continent. We conducted a benefit-cost analysis to demonstrate that engaging into vaccination campaigns is the dominant strategy for most countries even in the absence of coordinated action between them. And quantify how coordinated policy measures across countries in Africa could impact rabies incidence and associated costs. We show that coordinated dog mass vaccination between countries and PEP would lead to the elimination of dog rabies in Africa with total welfare gains of USD 9.5 billion (95% CI: 8.1 - 11.4 billion) between 2024 and 2054 (30 years). Coordinated disease control between African countries can lead to more socially and ecologically equitable outcomes by reducing the number of lost human lives to almost zero and possibly eliminating rabies.

[Hand hygiene--is hand disinfection the best solution?]. / Håndhygiene--er hånddesinfeksjon den beste løsning?

Nosocomial infections have been recognized as a critical problem in modern medicine and are associated with the quality of health care provided in hospitals. On average, 7-10% of hospitalized patients acquire an infection after hospital admission. A substantial proportion of these result from cross-contamination. Transmission of microorganisms by the hands of health care workers is the main cause for spreading. Prevention of bacterial contamination and infection to the patients requires good hand washing or disinfection, and a series of guidelines have been proposed. However, health care workers show poor compliance with such rules. At a time when costs for patient care are increasing and hospitals are threatened by bacterial resistance, prevention of nosocomial infections is an important issue. Thus, many international publications at present discuss the general problems of hand hygiene, still is the most cost effective method in prevention of nosocomial infections. Factors that contribute to poor compliance in hand hygiene have been targeted, and practical solutions in order to improve hand cleansing practices have been suggested. Increased use of the quicker methods of hand disinfection instead of hand washing is one of them.

Soft tissue correction of a single-tooth pontic space: a comparative quantitative volume assessment.

STATEMENT OF PROBLEM: Various augmentation procedures are recommended for the correction of localized alveolar ridge defects. However, no study has quantitatively evaluated the results of these procedures to date. PURPOSE: This study compared 2 soft tissue augmentation surgeries commonly used to alter contours of single-tooth pontic space by quantifying 3-dimensional volume changes with the optical projection Moiré method at 1 and 3.5 months after surgery. MATERIAL AND METHODS: Twenty-four patients required surgery. Each patient had a localized alveolar ridge defect, corresponding to a mesial-distal width of 1 single tooth. The defect of 12 patients was corrected with a subepithelial connective tissue graft; the remaining 12 patients were treated by receiving a free full-thickness gingival graft, which included epithelium and connective tissue with fatty tissue. Six unoperated defects of 6 patients formed the control group. For each defect, an impression was made before treatment, at 1 and 3.5 months after surgery to measure the volume changes on the dental casts with a validated projection Moiré system. Volume change was assessed relative to the preoperative dimension at the buccal and crestal aspects of the single-tooth pontic space. RESULTS: At 3.5 months postsurgery, mean volumetric gain for the connective tissue group with 159 mm(3) (SD +/- 80) was significantly greater (P =.027) than for free full-thickness gingival graft group with 104 mm(3) (SD +/- 31). CONCLUSION: The applied projection Moiré method proved its applicability in assessing 3-dimensional volume changes of pontic spaces with a single-tooth width. Volumetric assessment after 1 and 3.5 months revealed significantly greater volume gain with the subepithelial connective tissue graft in comparison to the free full-thickness gingival graft.

Family planning of Portuguese immigrants and integration in Belgium.

PIP: A substantial immigration of Portuguese and other foreign nationals to Belgium due to a favorable immigration policy guides this investigation to focus on this group in order to study the influence of the acculturation experience on birth-control practices. Choosing a sample of 100 married women within a group of 998 Portuguese immigrants in an urban municipality in Brussels, the study sets out specifically to investigate whether these immigrants adopt attitude patterns of the receiving social group or if they preserve the customs of their original community. The hypothesis held by the study was that the better the woman's integration into Belgian society, the larger her knowledge and acceptance of contraceptives would be. The study found that the majority of interviewed immigrants remained poorly integrated into the Belgian society, and that the transition from a traditional to an industrial society had not included great changes in attitudinal behavior which would facilitate social and cultural integration into the new society. In terms of attitudes toward contraception, negative behavior was observed to be linked not to levels of acculturation, but rather to lack of information. Though the majority of respondents expressed desires for controlled fecundity even when still in Portugal, those who came to Belgium with no previous knowledge or desires admitted to having felt the need for contraceptive practice. The crucial factor in acceptance of modern contraceptive practices is singled out as one of communication. Access to information about contraception is readily available in the Belgian society. The information actually obtained by the women, however, depended on their access to informational channels, the circumstances through which they got in touch with such sources, and their problems with a language barrier when relying on the media through which contraceptive knowledge was made available.^ieng