ABSTRACT
Background: Afghanistan has the second lowest health workforce density and the highest level of rural residing population in the Eastern Mediterranean Region. Ongoing insecurity, cultural, socio-economic and regulatory barriers have also contributed to gender and geographic imbalances. Afghanistan has introduced a number of interventions to tackle its health worker shortage and maldistribution.
Aims: This review provides an overview of interventions introduced to address the critical shortage and maldistribution of health workers in rural and remote Afghanistan.
Methods: A review of literature [including published peer-reviewed, grey literature, and national and international technical reports and documents] was conducted.
Results: The attraction and retention of health workforce in rural and remote areas require using a bundle of interventions to overcome these complex multidimensional challenges. Afghanistan expanded training institutions in remote provinces and introduced new cadres of community-based health practitioners. Targeted recruitment and deployment to rural areas, financial incentives and family support were other cited approaches. These interventions have increased the availability of health workers in rural areas, resulting in improved service delivery and health outcomes. Despite these efforts, challenges still persist including: limited female health worker mobility, retention of volunteer community-based health workforce, competition from the private sector and challenges of expanding scopes of practice of new cadres.
Conclusions: Afghanistan made notable progress but must continue its efforts in addressing its critical health worker shortage and maldistribution through the production, deployment and retention of a fit-for-purpose gender-balanced, rural workforce with adequate skill mix. Limited literature inhibits evaluating progress and further studies are needed
Subject(s)
Humans , Male , Female , Medically Underserved Area , Rural Population , Public HealthABSTRACT
Introduction: Fracture of an acrylic resin complete denture base after aging, poses problem for patients, dentists and dental laboratory technicians. This study was performed to determine the effect of thermocycling on the flexural strength of a commercially available, heat-polymerized acrylic denture base material reinforced with glass fibers, carbon fibers, aramid fibers and high (HI) impact resins. Materials and Methods: Forty specimens were made of similar dimension from five groups of materials. Each group had eight specimens. A commercially available heat polymerized P.M.M.A denture base resin was selected as control and PMMA reinforced with glass, carbon, aramid fibres and HI impact resin were compared. All specimens were then subjected to thermocycling before testing. Flexural strength was evaluated with universal testing machine. The results were analyzed with Analysis of Variance (ANOVA) followed by Turkey HSD test. Results: All reinforced specimens and HI impact resins showed better flexural strength than the conventional acrylic resin after thermocycling. Specimens reinforced with glass fibers showed the highest flexural strength, followed by HI impact resin, carbon fibers and aramid fibers. After artificial aging, a significant improvement in the flexural strength of conventional acrylic resin was observed when it was reinforced with glass fibers. Conclusion: Within the limitations of this study, incorporation of 2% by weight of glass fibre in PMMA resin exhibited statistically significant maximum flexural strength followed by high impact resin, carbon, polyaramid reinforced P.M.M.A denture base resin. These can readily be used in the fabrication of dentures subjected to heavy masticatory loads.
ABSTRACT
Aim and Objectives: This study is determined the vertical distance between lingual frenum and incisal edge of mandibular central incisors in dentulous subject and edentulous denture wearer subjects and their variation in different age groups and sex. Materials and Methods: This study involved 120 dentulous subjects (60 men, 60 women) and 20 complete denture wearers. Depending upon the age, the dentulous subjects were divided into three groups. Each group consisted of 40 subjects (20 men, 20 women). Group I consisted of 20-30 yr age, group II 30-4 0yr age and group III consisted of more than 40 yr age. Mandibular impressions of dentulous and denture wearers were made with irreversible hydrocolloid and cast retrieved. The vertical distance between the anterior attachment of lingual frenum and incisal edges of the mandibular central incisors for both the dentulous and edentulous subjects was measured on the casts with the help of dental surveyor. Data were tabulated and stastically analysed. Results: Overall (irrespective of gender) normative range for vertical distance between the anterior attachment of the lingual frenum and mesioincisal edge of mandibular central incisor among dentulous subjects is 9.52-10.24 mm. If we consider gender it is 10.00-11.13 mm for male and 8.82-9.58 mm for female. Conclusion: This study indicated that the distance between the antero-superior most point on the lingual frenum and the mesio-incisal edges of mandibular central incisors can be used as a reliable landmark when the frenum is recorded during function.
ABSTRACT
Pregnancy is a normal physiological event but some pregnancy specific or other medical conditions can cause maternal as well as fetal morbidities and even mortalities. Among them, raised blood pressure during pregnancy adversely affects both maternal and fetal outcomes. In this study, risk factors associated with hypertensive disorders of pregnancy are explored and pregnancy outcomes of hypertensive women with normotensive pregnant women are compared. Case control study. Obstetrics and gynecology department of Jinnah hospital Lahore. 1st October 2011 to 24 February 2012. The case control study of 250 cases [pregnant females with hypertensive disorders] and controls [pregnant females without hypertensive disorder], presented at obstetrics and gynecology department of Jinnah hospital during 1st October 2011 to 24 February 2012 was conducted. SPSS software [16] and MS excel were used for statistical analysis. Mean age for cases and controls was 26.96 +/- 5.29 years and 25.25 +/- 4.60 years, respectively. Age and history of pregnancy was found to be significantly associated with hypertensive disorders of pregnancy. Comparison of neonatal outcome between case group and control group showed that hypertensive pregnant women were at higher risk of having adverse pregnancy outcome. Women with hypertension during pregnancy are at increased risk of having adverse pregnancy outcome as compared to normotensive women and age, history of pregnancy induced hypertension are contributing risk factors for developing hypertension during pregnancy