Stunting is a major risk factor for overweight: results from national surveys in 5 Arab countries

We analysed data on overweight and stunting from large national surveys performed between 2001 and 2004 in 5 Arab countries [Djibouti, Libyan Arab Jamahiriya, Morocco, Syrian Arab Republic and Yemen]. Overweight and stunting were defined according to new WHO growth standards. Overweight ranged from 8.9% in Yemen to 20.2% in Syrian Arab Republic. The risk ratio [RR] for overweight in stunted children ranged from 2.14 in Djibouti to 3.85 in Libyan Arab Jamahiriya. RR ranged from 0.76 in mildly stunted children of Yemen to 7.15 in severely stunted children in Libyan Arab Jamahiriya. Etiological fraction in the population ranged from 7.49% to 69.76%

use of body mass index for measurement of fat mass in children is highly dependant on abdominal fat

We examined the relationship between body fat and body mass index [BMI] in a multiethnic population of obese children. BMI z-scores were compared to DEXA measures of whole body composition and regional fat distribution. Fat mass index [FMI] was best predicted by the equation: 1/[[0.159 - 0.013 x percentile of total abdominal fat] - [0.01 x BMI z-score]], where percentile of abdominal fat ranges from 1 to 5. Predicted FMI had high agreement with FMI measured by DEXA. There were no detectable differences in this relation between different ethnic groups. Both BMI and abdominal fat should be used as a proxy to determine adiposity

Libyan national health services the need to move to management-by-objectives

In the last four decades, there has been a substantial horizontal expansion of health services in Libya. This resulted in improvement in morbidity and mortality, in particularly those related to infectious disease. However, measures such as the national performance gap indicator reveal an underperforming health system. In this article, we discuss aspects related to the Libyan health system and its current status including areas of weakness. Overcoming current failures and further improvement are unlikely to occur spontaneously without proper planning. Defining community health problems, identifying unmet needs, surveying resources to meet them, establishing SMART [specific, measurable, achievable, and realistic and time specific] objectives, and projecting administrative action to accomplish the proposed programs, are a must. The health system should rely on newer approaches such as management-by-objectives and risk-management rather than the prevailing crisis-management attitude

French Health Care System ; what can we learn?

All public systems look for the best organizational structure to funnel part of their national income into healthcare services. Appropriate policies may differ widely across country settings. Most healthcare systems fall under one of two broad categories, either Bismark or Beveridge systems. There is no simple ideal model for the organization of health services, but most healthcare systems that follow the Beveridge healthcare model are poor performers. The Libyan Health system is a low responsive, inefficient and underperforming system that lacks goals and/or SMART. [Specific, Measurable, Achievable, Realistic, Time specific] objectives. A look at different organization models in the world would reinforce efforts to reorganize and improve the performance of the Libyan National Healthcare services. The French Health Care System [FHCS] ranked first according to the WHO and the European Health Consumer Powerhouse. The FHCS was described to have a technically efficient, generous healthcare system that provides the best overall health care. This makes the FHCS a practical model of organization having many of the essential aspects of a modern national health service. In this review, we describe the main features of the FHCS, current challenges and future trends with particular attention paid to aspects that could be of importance to the Libyan Healthcare System

Essential concepts in modern health services

Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health, e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints

Human bone marrow-derived mesenchymal stem cells

Mesenchymal stem cells [MSCs] have elicited a great clinical interest, particularly in the areas of regenerative medicine and induction of tolerance in allogeneic transplantation. Previous reports demonstrated the feasibility of transplanting MSCs, which generates new prospects in cellular therapy. Recently, injection of MSCs induced remission of steroid-resistant acute graft-versus-host disease [GVHD]. This review summarizes the knowledge and possible future clinical uses of MSCs