低频重复经颅磁刺激联合镜像神经元训练系统对卒中后慢性完全性失语的效果研究

目的 观察低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合镜像神经元训练系统(mirror neuron training system,MNTS)对卒中后慢性完全性失语患者的临床效果.方法 前瞻性连续纳入2018年1月-2020年1月于南京医...     

小鼠胚胎神经干细胞在猫全脑缺血再灌注损伤模型中的存活、迁移及分化

目的 观察小鼠神经干细胞在猫全脑缺血再灌注损伤模型中的存活、迁移及分化。方法 参照四血管阻塞法建立猫全脑缺血再灌注损伤模型,将原代培养的小鼠神经干细胞移植入模型动物脑中。一个月后,以免疫荧光技术检测移植干细胞的存活、迁移及分化情况。结果 缺血再灌注损伤模型制作成功7例,成功率70%;免疫荧光法检测小鼠神经干细胞移植到猫前脑后一个月仍有大量存活,部分细胞分化为神经元或神经胶质细胞,并向脑组织中迁移。结论 小鼠神经干细胞在猫全脑缺血再灌注损伤模型中能够存活、迁移并分化。     

Utilization of communities of practice for ongoing learning and knowledge dissemination: Making the case for the Global Alliance for Nursing and Midwifery (GANM)

With the growing connectivity among countries and healthcare practitioners, nurses and midwives in low resource settings are connecting digitally to access information through online platforms. Ninety eight percent of adults online report visiting a social network in the past month, and spend almost two hours per day engaged with social media. In an increasingly interconnected world, innovative strategies are needed to translate knowledge into practice. The Global Alliance for Nursing and Midwifery (GANM), part of the Pan American Health Organization (PAHO)/World Health Organization (WHO) Collaborating Center (CC) at the Johns Hopkins University School of Nursing (JHSON) leverages its Knowledge Gateway to facilitate translating knowledge into practice in order to achieve the Sustainable Development Goals (SDGs). This paper explores the concepts of knowledge dissemination, communities of practice, and makes the case for further using the GANM as an exemplary model to build the capacity of nurses and midwives globally.     

Working ‘off the record’: polio eradication and state immunity in Chad

The reappearance of polio in Chad generates anxieties about governance as well as public health. Since Chad was declared polio-free in 2003, at least 180 cases of paralytic polio have been linked to importations of wild poliovirus from Nigeria. In efforts to eradicate polio through house-to-house vaccination campaigns, international agencies have aggressively implicated political leaders, placing those authorities in a bind. On the one hand, governments are required to demonstrate compliance in the form of universal vaccination. On the other hand, the legitimacy of political leaders and of local authorities in particular depends upon their ability to show compassion for their populations and to be responsive to individual circumstances and concerns about the drops. This article looks at how the obligation of the African state to adopt global public health policy as its own becomes problematic when the goals and protocols of international agencies rely on the assumption that the state controls its population. Under pressure to render account to international agencies, state officials deploy high-level politicians to enforce vaccination mandates at critical moments, create administrative forms to record campaign progress that conceal difficulties in vaccinating children, and use statistics to portray the campaigns as success stories. Local authorities, who feel the bind most acutely, grant exceptions to the mandate of universal vaccination to certain subjects and work with local vaccinators and supervisors to keep cases of unvaccinated children ‘off the record’. These efforts allow the vaccination campaigns to be carried out without incident even as they work against the goal of polio eradication.     

Coordination of a complex welfare system case: rehabilitation entity in Finland

The main purpose of this article is to analyse the institutional and political structures of the Finnish rehabilitation entity and the governmental efforts to improve the governance of the rehabilitation policy. Rehabilitation in Finland is a complex welfare system which has undergone several coordination attempts during the last two decades. The centrality of the coordination of this welfare system is obvious. Based on the content analysis of three Government's rehabilitation reports from 1994 to 2002 and their background papers, this article provides two main findings. First, the rehabilitation entity seems to be based on different funding strategies, different governing and different coordination models between the rehabilitation subsystems. Second, the governance discourse in the reports seems to be unchanging with a predominantly hierarchical mode. The article concludes with a discussion on the challenges to coordinate this kind of a complex welfare system as an entity and also how to overcome those challenges. Copyright © 2010 John Wiley & Sons, Ltd.     

Data and product needs for influenza immunization programs in low- and middle-income countries: Rationale and main conclusions of the WHO preferred product characteristics for next-generation influenza vaccines

In 2017, WHO convened a working group of global experts to develop the Preferred Product Characteristics (PPC) for Next-Generation Influenza Vaccines. PPCs are intended to encourage innovation in vaccine development. They describe WHO preferences for parameters of vaccines, in particular their indications, target groups, implementation strategies, and clinical data needed for assessment of safety and efficacy. PPCs are shaped by the global unmet public health need in a priority disease area for which WHO encourages vaccine development. These preferences reflect WHO’s mandate to promote the development of vaccines with high public health impact and suitability in Low- and Middle-Income Countries (LMIC). The target audience is all entities intending to develop or to achieve widespread adoption of a specific influenza vaccine product in these settings. The working group determined that existing influenza vaccines are not well suited for LMIC use. While many developed country manufactures and research funders prioritize influenza vaccine products for use in adults and the elderly, most LMICs do not have sufficiently strong health systems to deliver vaccines to these groups. Policy makers from LMICs are expected to place higher value on vaccines indicated for prevention of severe illness, however the clinical development of influenza vaccines focuses on demonstrating prevention of any influenza illness. Many influenza vaccine products do not meet WHO standards for programmatic suitability of vaccines, which introduces challenges when vaccines are used in low-resource settings. And finally, current vaccines do not integrate well with routine immunization programs in LMICs, given age of vaccine licensure, arbitrary expiration dates timed for temperate country markets, and the need for year-round immunization in countries with prolonged influenza seasonality. While all interested parties should refer to the full PPC document for details, in this article we highlight data needs for new influenza vaccines to better demonstrate the value proposition in LMICs.     

Improved word comprehension in Global aphasia using a modified semantic feature analysis treatment

Limited research has investigated treatment of single word comprehension in people with aphasia, despite numerous studies examining treatment of naming deficits. This study employed a single case experimental design to examine efficacy of a modified semantic feature analysis (SFA) therapy in improving word comprehension in an individual with Global aphasia, who presented with a semantically based comprehension impairment. Ten treatment sessions were conducted over a period of two weeks. Following therapy, the participant demonstrated improved comprehension of treatment items and generalisation to control items, measured by performance on a spoken word picture matching task. Improvements were also observed on other language assessments (e.g. subtests of WAB-R; PALPA subtest 47) and were largely maintained over a period of 12 weeks without further therapy. This study provides support for the efficacy of a modified SFA therapy in remediating single word comprehension in individuals with aphasia with a semantically based comprehension deficit.     

Health aid and governance in developing countries

Despite anecdotal evidence that the quality of governance in recipient countries affects the allocation of international health aid, there is no quantitative evidence on the magnitude of this effect, or on which dimensions of governance influence donor decisions. We measure health‐aid flows over 1995–2006 for 109 aid recipients, matching aid data with measures of different dimensions of governance and a range of country‐specific economic and health characteristics. Everything else being equal, countries with more political rights receive significantly more aid, but so do countries with higher corruption levels. The dependence of aid on political rights, even when we control for other governance indicators, suggests that health aid is sometimes used as an incentive to reward political reforms. Copyright © 2010 John Wiley & Sons, Ltd.