Contribution of the World Health Organization/ the special program for research and training in tropical disease (WHO/TDR's) in institution building: lessons from Ethiopia.

BACKGROUND: World Health Organization/Tropical Disease Research (WHO/TDR) has enduring investment in transfers of skills critical to sustaining resilient health research systems through postgraduate training, clinical research and development fellowship (CRDF), bioethics, and grants to neglected tropical disease research. TDR has a long history of partnership with Armauer Hansen Research Institute (AHRI) in Ethiopia. The collaboration started with individuals and lead to institution survival and success. Therefore, the purpose of this study was to explore the impact and lessons learned of TDR initiatives in Ethiopia. METHOD: This study was guided by the 'TDR Impact Pathways'. A total of thirteen in-depth, and five key informant interviews were conducted with individuals who are currently working in Addis Ababa, Gondar, Jimma Universities and AHRI. In addition to the interviews, reports, written communications and publications were reviewed. Interviews were audio recorded, transcribed verbatim, inductively coded, and analyzed thematically. The results were presented following the themes with supportive verbatim quotes. CONCLUSION: TDR's seed grants, training opportunities and technical support catalyzed individual, institutional and national research capacity in Ethiopia. This is a useful indication of how long-term collaboration between individuals could have broader institutional implication as evidenced from the TDR-AHRI complementary partnership.

Upper-Body Strength Endurance and Power Norms in Healthy Collegiate Dancers: A 10-year Prospective Study.

ABSTRACT: Coogan, SM, Hansen-Honeycutt, J, Fauntroy, V, and Ambegaonkar, JP. Upper-body strength endurance and power norms in healthy collegiate dancers: A 10-year prospective study. J Strength Cond Res 35(6): 1599-1603, 2021-Dance is physically demanding and requires dancers to have adequate upper body (UB), core, and lower-body fitness to perform successfully. 50-85% of dancers suffer injury during a performance season. Although a large number of dancer's injuries are to the lower body, several dance genres (e.g., modern, hip hop, and salsa) use UB motions such as partner lifts and holds, which may result in a higher risk for UB injury. Health care practitioners often use baseline physical performance normative values to determine their clients' fitness levels and when planning training programs to prevent or rehabilitate postinjury. Still, little information exists regarding UB fitness norms among collegiate dancers. Thus, our purpose was to determine UB strength endurance and power norms in healthy collegiate dancers. We recorded UB muscular fitness in 214 healthy collegiate dancers (males: n = 26, 174.0 ± 6.7 cm, 71.3 ± 9.2 kg and females: n = 188, 163.0 ± 6.1 cm, 59.3 ± 6.8 kg) prospectively over a 10-year period (2008-2018) in a dance program that emphasizes modern and ballet dance. For UB strength endurance, we recorded the number of push-ups a dancer was able to perform without forcibly straining or losing form for 2 consecutive repetitions. For UB power, dancers sat with legs outstretched, backs flat against a wall, and threw a 3-kg ball horizontally from their chest as far as possible (distance thrown normalized to body height, *BH). The best attempt of 3 trials was used for statistical analyses. We report descriptive statistics, interquartile ranges (IQRs), and percentiles for both outcome measures. Dancers performed 20.4 ± 10.6 (range: 2-70, IQR: 12-24; males: 32.5 ± 14.4; females: 18.4 ± 8.4) push-ups and threw the medicine ball 1.8 ± 0.5 *BH (range: 45-3.9, IQR: 1.4-2.1; females: 1.7 ± 0.5; males: 2.3 ± 0.7). Overall, in this long-term prospective study, we developed UB fitness norms for dancers. The push-up test and medicine ball throw test are simple, low-tech, and inexpensive to test dancers UB fitness. Although dancers' UB muscular fitness was lower than previous reports among traditional sport athletes, these values may not necessarily indicate problems, as subjects were all healthy collegiate-level dancers. Rather, our findings reinforce the need to develop dance-specific norms so that practitioners can use these values to assess dancers' UB fitness and devise interventions appropriately. These results provide baseline UB muscular fitness norms among collegiate modern and ballet dancers, and further support the notion that differing norms are needed for different sports and dance genres. Specifically, future researchers should similarly develop norms across different dance genres for preprofessional and professional dancers and also examine whether these norms can predict dancers' injury risk or performance.

Lower Extremity Horizontal Work But Not Vertical Power Predicts Lower Extremity Injury in Female Collegiate Dancers.

Ambegaonkar, JP, Schock, CS, Caswell, SV, Cortes, N, Hansen-Honeycutt, J, and Wyon, MA. Lower extremity horizontal work but not vertical power predicts lower extremity injury in female collegiate dancers. J Strength Cond Res 32(7): 2018-2024, 2018-Dancers often perform powerful and explosive movements that require adequate lower extremity (LE) activity in horizontal and vertical directions. We examined whether these measures were interrelated and whether they predicted LE injury status in dancers using binary logistic regressions and receiver operator characteristic (ROC) curve analyses. Forty-three collegiate female dancers (18 ± 0.7 years; 162.6 ± 5.9 cm; 59.4 ± 7.1 kg) performed single leg hop (SLH, m) and vertical jump (VJ, cm) tests. Single leg hop and VJ distances were used to calculate SLH norm (as a % of body height) and vertical power (vPower, watts). Lower extremity injuries and dance exposure hours (DEhrs) were recorded for 16 weeks. Dancers had 51 injuries resulting in a 3.7/1,000 DEhr injury incidence rate (95% confidence interval [CI]: 2.7-4.7). Twenty dancers were injured, whereas 23 remained injury free. Injured dancers had significantly lower SLH norm than noninjured dancers (t = 2.7, p = 0.009, 85.2 ± 11.2% vs. 76.8 ± 8.4%, respectively), but vPower was similar (t = 0.6, p = 0.53, injured = 2,632.0 ± 442.9 watts, noninjured = 2,722.7 ± 480.0 watts). SLH norm, but not vPower significantly predicted injury status χ(1,43) = 5.9, p = 0.02. Specifically, an SLH norm cut-off value of 78.2% identified dancers at injury risk (area under the curve = 0.73, SE = 0.08, p = 0.01, 95% CI = 0.57-0.89, sensitivity = 0.75, specificity = 0.70). However, vPower was not able to identify dancers at risk (p = 0.36). vPower had moderate relationships with SLH norm (r = 0.31, p = 0.04). Compared with injured dancers, noninjured dancers had greater SLH norm but similar vPower. Only SLH norm predicted injury status in female collegiate dancers. Thus, the SLH test may possibly predict LE injury risk in dancers. Strength and conditioning coaches can prospectively use baseline SLH test screenings to identify dancers whose SLH is less than 78.2% of their height because these dancers may have increased probability of LE injury risk. Coaches can then include horizontal direction exercises when designing training programs and examine whether these programs reduce LE injury risk in female collegiate dancers.

University students' knowledge and attitudes towards leprosy.

INTRODUCTION: Patients with leprosy may be affected psychologically and socially by the negative attitude of society toward leprosy, caused by widespread ignorance and prevailing stereotypes surrounding the disease. This study aimed to determine the knowledge and attitudes toward leprosy among students at the University of Guadalajara. METHODOLOGY: This descriptive cross-sectional study included 1,300 students over 18 years of age from various Thematic University Centres in Guadalajara. Students' degree subjects included the health sciences, humanities, exact sciences (i.e., chemistry, physics), arts, biological-agricultural sciences, and administration. Students were randomly selected regardless of gender and all students were enrolled in either the first, second, or third year of their undergraduate studies. RESULTS: Overall, students showed an intermediate level of knowledge of leprosy. Results showed that 67% correctly responded that leprosy is an infectious disease, 64% knew of the presence of skin lesions, and 60% knew that a microbe causes the disease. Furthermore, 45% correctly responded that leprosy is a disease associated with poverty and 40% responded that leprosy is disabling. Only 31% stated that leprosy is curable. Negative attitudes were evident regarding the question of employing a leprosy patient (57%) and having a leprosy patient as a spouse or partner (30%). DISCUSSION: The results revealed that there is insufficient knowledge of and poor attitudes toward leprosy among students at the University of Guadalajara. It is necessary to improve current health education measures by using updated educational strategies to reduce the stigma of leprosy and the segregation of leprosy patients and their families.

Behavioral surveillance survey regarding human immunodeficiency virus/acquired immunodeficiency syndrome among high school and junior college students.

BACKGROUND AND AIMS: It is necessary to know the baseline knowledge, attitude, and practices about human immunodeficiency virus/acquired immunodeficiency syndrome among young people and the changes in these with intervention to guide prevention efforts. METHODS: A cross-sectional pre- and post-survey with health education as a method of intervention was carried out in four different randomly selected schools and junior colleges among the Class IX-XII students of both sex. Instrument developed by the World Health Organization (WHO)/UNAIDS in their best practice recommendations was used for data collection. RESULTS: Knowledge about all correct methods was present in 61.23% of the respondents. Knowledge of at least two methods of prevention was present in 70.31% of the respondents. Misconceptions about prevention were that good diet (33.42%), avoiding mosquito bite (49.71%) and avoiding public toilets (65.14%) could help in the prevention. With intervention, there was an improvement in the knowledge. However, the proportion of students with misconceptions did not come down. Correct knowledge about two methods of prevention also did not reach the WHO recommendation of 90%. CONCLUSION: It is very difficult to change the attitude and practices by a single health educational intervention and an ongoing behavior change communication is recommended.

A implantação das diretrizes curriculares nacionais nas escolas de fonoaudiologia no estado da Bahia / The implementation of the national curriculum guidelines in schools of speech in the state of Bahia

Os debates em torno da formação do profissional de saúde ocupam hoje um grande espaço dentro da agenda de discussões da política de saúde brasileira. Na 8ª Conferência Nacional de Saúde (CNS) em 1986, marco histórico da Reforma Sanitária, foram tratadas questões relativas aos trabalhadores em saúde articuladas às questões organizativas e de atribuições ao sistema de saúde como a universalização, a equidade e a democratização. Desde então se aponta para a urgência na adequação da formação profissional voltada para as necessidades colocadas pela realidade social, sobretudo no caso de profissões recentes da área da saúde, como a Fonoaudiologia. Este estudo investigou a incorporação das Diretrizes Curriculares Nacionais (DCN) dos cursos de Fonoaudiologia no Estado da Bahia, a partir da caracterização dos Projetos Político-Pedagógicos e da análise da participação dos atores envolvidos. Teve como desenho o estudo de caso múltiplo com 5 cursos, de caráter exploratório e qualitativo constando de análise documental e entrevistas semi-estruturadas. Procurou-se analisar o contexto sócio-histórico e as possíveis relações entre princípios políticos pedagógicos, diretrizes e implantação das mesmas. Entre os obstáculos identificados destacam-se: enfoque nos aspectos biológicos e curativos, dissociação entre as áreas clinicas e de saúde coletiva, incipiente integração ensino-serviço e baixa capacitação docente. Identificou-se também uma tendência á mudança de valores de modo a aproximar conteúdos e práticas de saúde coletiva com aquelas do campo clínico sob novas perspectivas do cuidado fonoaudiológico. São apresentadas algumas sugestões para a mudança na formação do fonoaudiólogo na graduação.

Conhecimentos e necessidades de aprendizagem de estudantes de fisioterapia sobre a hanseníase / Knowledge and necessities of learning of physioterapys students about leprosy

INTRODUÇÃO: A hanseníase se constitui importante problema de Saúde Pública no Brasil, tendo, no entanto, negligenciada sua importância e valorização na formação das profissões da saúde, mesmo nos países endêmicos. No caso específico do fisioterapeuta, faz-se necessário o ensino da hansenologia nos cursos de graduação no Brasil, para se atuar nas condições de saúde da população diante da problemática da Hanseníase.OBJETIVO: descrever e analisar conhecimentos de estudantes de fisioterapia sobre hanseníase, antes do contato formal na Universidade/Faculdade com a temática. METODOLOGIA: estudo qualitativo, realizado com 51 estudantes de graduação em fisioterapia do quarto ano de escola do interior do estado de São Paulo,em 2004. Na coleta dos dados, utilizou-se questionário auto-aplicado, com questões abertas. A partir da análise qualitativa das respostas realizou-se a categorização das mesmas. RESULTADOS: identificou-se que estudantes do último ano do curso de fisioterapia expressaram desconhecimento e/ou conceitos incompletos ou inadequados, frente a literatura, sobre hanseníase e os seguintes aspectos devem ser enfatizados no ensino da hansenologia: doença hanseníase; preconceito que os doentes vivenciam e como enfrentá-lo; educação em saúde e atuação do fisioterapeuta na hanseníase. Em relação à organização do ensino, identificou-se que Universidades/Faculdades devem construir estratégias para valorizar a hanseníase como um problema de Saúde Pública. CONCLUSÃO: evidenciou-se a necessidade de aprimoramento do ensino da hansenologia no curso de graduação em Fisioterapia, com abordagem do tema desde o início da formação, para que fisioterapeutas possam prestar o cuidado adequado frente a problemática da hanseníase e contribuir com o Programa de Controle da Hanseníase

INTRODUCTION: The Leprosy constitutes a significant problem of Public Health in Brazil, however its importance and valuation in the preparation of the health professions has been neglected, even in the endemic countries. In the specific case of the physiotherapist, the hansenology teaching in the graduation’s course in Brazil becomes necessary, to deal in the future with the health conditions of the population with the Leprosy’s problematic. OBJECTIVE: To describe and analyze the previous knowledge of physiotherapy’s students on leprosy during the professional preparation of the physiotherapist. METHODOLOGY: It is a qualitative study on leprosy knowledge among 51 students of physiotherapy in a Sao Paulo State school, in 2004. For the survey an auto-applied questionnaire with guided questions was used to collect the data. A qualitative analysis was done by categorization. RESULTS: It was identified unfamiliarity and/or inadequate concepts about leprosy and the following aspects must be emphasized in the hansenology teaching: the hansen’s disease; the preconception that the sick people live and how to face it; the health education and the performance of the physiotherapist in leprosy. In relation to the organization of education,it was identified that the Universities/Colleges must construct bigger strategies of motivation, valuing leprosy as a Public Health’s problem. CONCLUSION: It was proven the necessity of the hansenology’s education in the undergraduation courses of physiotherapy, so that the physiotherapists can give adequate assistance to the problematic of leprosy and contribute with the Program of Leprosy Control.

O processo de ensino-aprendizagem da hansenologia na formação profissional de graduandos de fisioterapia / The process of teaching-learning of hansenologia in the profissional formation of physiotherapy students

A hanseníase ainda se constitui em importante problema de Saúde Pública no Brasil havendo, por essa razão, necessidade de sua valorização como tema na formação dos profissionais da saúde, para adquirirem competências e habilidades para sua prevenção, tratamento e reabilitação do paciente. Apesar de essa doença ser apresentada como fenômeno universal ao longo da história, tem-se negligenciado sua importância na formação dos profissionais da área da saúde, o que dificulta seu controle. O objetivo deste estudo foi descrever o processo de ensino-aprendizagem da hansenologia na formação profissional de graduandos de fisioterapia, a partir do relato de experiência apoiada na problematização. Trata-se de um estudo exploratório e descritivo, com cunho qualiquantitativo. Adotou-se a perspectiva da pesquisa ­ação, na qual o pesquisador investigou os conhecimentos sobre hanseníase entre estudantes de fisioterapia e, a partir desse estudo, ofereceu uma formação com base na teoria da problematização de Paulo Freire, na qual a pesquisadora, como professora, e os estudantes, como sujeitos, tiveram um papel ativo na realidade situacional, buscando modificá-la. A pesquisa desenvolveu-se na disciplina de Fisioterapia Preventiva do Curso de Fisioterapia da Fundação Educacional de Fernandópolis com a participação de 51 estudantes no primeiro momento e 63 nos momentos seguintes. Os resultados evidenciaram que os graduandos de fisioterapia apresentavam um nível de compreensão superficial e/ou incompleto sobre a hanseníase e sobre o campo de atuação profissional do fisioterapeuta e, ainda, retratou o preconceito perante a doença. A partir da análise de tais resultados, deu-se o desenvolvimento do programa educativo com base em 4 temas norteadores: hanseníase, preconceito, atuação do fisioterapeuta no contexto da hanseníase e tratamento fisioterápico.(...)

In sickness or in health: TDR's parners. 7. Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

PIP: Mahidol University's Faculty of Tropical Medicine, Bangkok, Thailand, established in 1960, is one of 14 faculties, 5 institutions, 5 centers, and 2 colleges within Mahidol University. It consists of the following departments: Helminthology, Medical Entomology, Microbiology and Immunology, Protozoology, Social and Environmental Medicine, Tropical Hygiene, Tropical Medicine, Tropical Nutrition and Food Science, Tropical Pediatrics, Tropical Pathology, and Tropical Radioisotopes. The UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases (TDR) has been associated with the Faculty since 1977, collaborating mainly upon malaria research, but also in filariasis, leprosy, and schistosomiasis research. Early TDR support was directed at research training and institutional strengthening, although by the early 1980s, the Faculty played an increasingly important role in TDR's research and development program. In recent years, the Faculty has focused upon researching malaria, parasitic and bacterial diseases, nutrition and food sciences, and environmental health. The Faculty's malaria-related research is described. The Faculty also conducts research in many other areas of tropical medicine outside of those of interest to TDR.^ieng

[Vicissitudes of treating leprosy handicaps in Kapolowé, Zaïre]. / Vicissitudes du traitement des handicaps hanséniens à Kapolowé (Zaïre).

In 1990 Kapolowé was, without a doubt, the site of the only surgical centre in Zaire dealing with handicaps which developed in as an after-effect of leprosy. It would be useful to explain the hazards involved in such a venture for reasons which do not pertain to medicine but, rather, to particularly trying socio-political circumstances. The best surgical expertise was thrown out for political reasons. Insecurity and economic hardships practically halted movement and, consequently, the wider application of such expertise. During a mission in 1994, there was a partial resumption of activities. The surgical team was reinstalled and made operational. It had been possible to state that multidrug therapy (MDT) had always ensured that the disabled leprosy patients, living in groups, and treated before 1990 under regular supervision, did not experience serious relapses. That fact corroborates earlier information relating particularly to surgical decompression. Although most of them were able to resume a certain measure of professional activity, social factors must still be borne in mind and the concept of partial permanent disability must be applied.

[The level of knowledge about leprosy among university students]. / Nivel de conocimientos sobre la lepra en estudiantes universitarios.

A survey about leprosy was made in 1,000 students from the University of Guadalajara (Guadalajara, Jalisco, Mexico). There were considered clinical, preventive, social and etiological aspects. The results showed that the patient suffering leprosy is currently marginated. We suggest that this study should be carried out in other universities of Mexico, with purposes to verify the stigmata of this entity.

Articulação docente - assistencial: o caso do programa de controle da hanseníase no Rio de Janeiro / Joint teaching - care: the case of leprosy control program in Rio de Janeiro

O presente trabalho propõe-se a avaliar a articulação ensino-serviço, a partir de um estudo de cado na área específica do programa de controle da hanseníase no Rio de Janeiro...O capítulo de conclusões tenta interpretar as informações e análises efetuadas em todo o trabalho, como fatos científicos coerentes com o modelo de pesquisa sintética adotado. O capítulo de recomendações aponta algumas estratégias a serem levadas a efeito para a melhoria do processo de articulação estudado.