Management

This research was conducted to determine the level of professionalism of health care managers. Therefore, the personal and professional differences affecting the levels of professionalism of individuals working in private or public hospitals and working as managers in different fields were investigated and the results obtained were compiled. In the study, 123 individuals from the universe of 218 people were reached and the ones who were reached were asked to complete Swailes questionnaire (2003). Results show that the as the level of education increases, levels of professionalism of also increases. According to our results, choosing the occupation consciously has a positive effect on professionalism level. Also, the time of managerial duty was also founded as a factor contributing to the professionalism level. Lastly, the results showed that the level of professionalism is higher among people who positioned as ‘different levels of management’ than those who have other positions. In the light of these results, it is recommended to increase the education levels of the people who work as managers, to help people choose the profession consciously and to provide support for increasing the level of professionalism in all levels, not only in the time of the managerial duty. In addition, it is important to encourage the activities among people who work in different positions in health institutions to increase their professional professionalism skills equally.

ABSTRACT: Gliomas are the most frequent primary brain tumors. Most gliomas require aggressive combination of therapy with radiotherapy and chemotherapy after maximal surgery. Recurrent glioma is a significant deterioration in an existing neurological deficit. The current study aimed to prospectively assess the clinical characteristics of first and second presentations of patients, the optimal treatment among the available modalities for recurrent glioma and to illustrate the highly selected individuals with recurrent glioma and the determinants of treatment modalities and patients recruited for. Hence a prospective study on 24 patients with recurrent cerebral glioma carried out in the Neurosurgical Teaching Hospital in Baghdad/Capital of Iraq during Feb. 2009 to Feb. 2011. Twenty one patients (87.5%) were exposed to second operation directed at their tumor site, and had mean survival of 50 weeks, while 3 patients (12.5%) had been treated by chemotherapy had survived for a mean of 11 weeks. Reoperation was associated with a mortality rate of (4.1%). Best survival and good outcome was found in those who had good neurological performance and they were relatively young age. Malignant transformation and dedifferentiation was found in (75%) of cases. In conclusion, no curable treatment regarding recurrent glioma is definite, but reoperation is feasible and can be carried with less morbidity and mortality when considering a good selection criteria of the patients, preserving chemotherapy for those who are not amenable for surgery.

Hypertension (high blood pressure) is presently one of the most important risk factors for the development of cardiovascular diseases. Several developed and developing nations including Nigeria have adopted various initiatives to prevent and/or manage hypertension. This article entails the development of guidelinesby means of integrated and collaborative approach involving experts knowledgeable in the field coupled with community actionin rural settings in Delta State Nigeria. Using the Nominal Group Technique meeting, a group of seven key stakeholders knowledgeable in the field were brought together to harmonize their ideas and experiences within a period of three days. The meeting lasted six hours each day.Each round addressing a topic lasted for an hour and 45 minutes.Major concepts addressed were: optimal diagnosis and appropriate medical evaluation for high blood pressure, principles of blood pressure measurement and different steps in blood pressure measurement. Others are management options (routine baseline investigations, pharmacological and non-pharmacological measures) and prevention of high blood pressure as well as community screening programmes. This simple guideline will not only serve as a vade mecum but will also have a strong impact on the health, quality of life and mortality rate among rural communities in Nigeria.

Hypertension is a global health challenge affecting many adults. Cultural perception has been identified to affect disease progression and management. This article describes the experiences of a typical rural community in Delta State Nigeria in terms of their various traditional and cultural practices and the influence these have on the management and prevention of high blood pressure in the community. An ethnographic study was conducted utilizing in-depth interviews method. Ten known hypertensive patients were purposively selected who had blood pressure readings of ≥140/90 mmHg observed on three separate occasions from a previous survey conducted in the same community, and who had also confirmed their use of traditional practices in the management of high blood pressure. The traditional and cultural practices identified were: medicinal plants, sacrifices, scarification and tribal marks. Anti-hypertensive drugs were used alongside with traditional practices and where these traditional practices fail, local diets served as a remedy. These cultural practices such as local foodstuffs and dietary preferences (especially the palm kernel soup, which is a high cholesterol item), may either predispose them to risk factors of certain diseases or promote their health (as do the medicinal plants and some herbal preparations). Models of community based management of hypertension in rural settings is highly recommended. This will help retain and preserve relevant cultural values and serve to maintain community wellbeing.