Investigating Non-Compliance with COVID-19 Vaccination through Hesitancy, Refusal, and Access Limitation: A Community-Based Survey from the Democratic Republic of the Congo

Introduction: Vaccination plays a pivotal role in mitigating the repercussions of the COVID-19 pandemic. However, vaccination campaigns encounter obstacles, especially in developing countries like the Democratic Republic of the Congo (DRC). This study aimed at investigating the roles of vaccine hesitancy, refusal, and access barriers, while identifying individual-level factors associated with non-vaccination in Mbujimayi, DRC. Methods: A community-based cross-sectional survey was conducted in three health districts and included 1496 residents. Attitudes and behaviors related to seeking COVID-19 vaccination were assessed using a standardized questionnaire. Hierarchical logistic regression modeling was used to assess factors potentially affecting non-compliance with vaccination. Results: Among participants (median age = 33, IQR = 23.3, M/F sex ratio = 0.7), 60% displayed misconceptions about COVID-19 or its vaccine, while only 35.2% perceived COVID-19 as a significant health threat. Vaccination coverage was estimated at 49.1% (95% CI: 47.5;52.6), with 71.8% of vaccinated individuals having received one dose. Among the unvaccinated individuals, 50.9% expressed no intention to be vaccinated in the future, citing hesitation (30.4%) or refusal (39.6%) mainly due to side effects or distrust of vaccines. Conversely, 32.7% of the unvaccinated persons expressed access barriers despite willingness to be vaccinated. Misconceptions about COVID-19 and its vaccines were the main drivers of vaccination non-compliance. Conclusion: These findings demonstrate significant vaccine non-compliance driven by hesitancy, refusal, and access barriers. Strategies to enhance vaccination coverage and pandemic preparedness should address misconceptions, sociodemographic barriers, and geographic disparities.

Abdominoplasty, Liposuction and Brazilian Butt Lift (BBL) in Kinshasa in the Democratic Republic of Congo. My Experience in This Aesthetic Plastic Surgery with Black African Women in a Low-Income Country

Background: In low-income African countries, the demand and use of plastic surgery operations including abdominoplasty, liposuction and Brazilian butt lift (BBL) are increasing. The goal of this work is to present my experience and the challenges of this aesthetic plastic surgery among black African women. Material and Methods: A retrospective study was conducted about the abdominoplasties, liposuctions and Brazilian butt lift (BBL) which I operated in public and private hospitals at Kinshasa (Democratic Republic of Congo) in black African women. It covers a period of 13 years, going from December 1, 2010 to December 1, 2023. For this study, I had at least 6 months period (to Juin 1, 2024) to assess the occurrence of early and late postoperative complications. Results: I performed 84 abdominoplasties, 144 liposuctions and 23 Brazilian butt lifts (BBL). The average age at the time of abdominoplasty was 44 years with extremes ranging from 26 to 55 years and a concentration of cases (60.7%) in the age group of 40 to 49 years. The age group of 20 to 29 years old represented the lowest rate of requests for abdominoplasty (4.7%). Patients with a BMI of 30 to 2 were the majority (61.9%), followed by those between 25 to 2 (29.7%). 67.8% of patients were obese (BMI ≥ 30 kg/m2). The average age at the time of liposuction was 41 years with extremes ranging from 21 years to 69 years;and more than half of cases (68%) in the age group between 30 and 49 years. As for Brazilian butt lift (BBL), the average age was 33 years with extremes ranging from 24 to 42 years and a concentration of patients (91.3%) between 20 and 39 years. The immediate postoperative complications of abdominoplasties observed were: seroma in 7% of cases, hematoma and partial infection of the surgical site in 5% of cases. Pathological scars (hypertrophic, keloid) after abdominoplasties were observed in 9% of cases. The most common complication of liposuction was contour deformity. I observed 16 patients (11.1%) with soft-tissue depressions or elevations, skin panniculus or folds. For Brazalian Butt Lift (BBL), complications like asymmetry for 2 patients (8.9%), contour irregularities for 2 patients (8.9%), and excessive fat removal for 6 patients (26%), had observed. I have not recorded any cases of death or pulmonary embolism. Conclusion: I perform aesthetic plastic surgery procedures in black African women with a high socioeconomic standard of living compared to the average of the general population. The renunciation of planned surgery is motivated by the impossibility of paying the cost of the operation as well as by popular and religious perceptions regarding cosmetic surgery. The results of these aesthetic plastic surgery procedures carried out are very satisfactory for them. The challenges to overcome are mainly threefold: the unforeseeable complications of these cosmetic plastic surgery procedures, popular and religious perceptions of cosmetic surgery as well as the poverty of the population.

Diversity and Decentralization in the Democratization Process in Spain

This paper will deal with the history of an important political change in Spain during the transition to democracy between 1976 and 1982： the transformation of a unitary and centralized state to one composed of several political units capable of self-government. The starting point of that process was the confirmation of regional diversity and of the existence of clearly differentiated political sensibilities in some of its territories. The researchers shall rely especially on the legacy of some of the principal actors, and explore the connection between such diversity and the political change that took place.

Regional VS. Global Patterns of Democratization： A Comparative Study

This study analyzes the comparative patterns of democratization between geographic regions and the world. It addresses the question that how some determinants of democracy have different effects among geographical regions. Further, by comparing the similarities and differences in the patterns of democratic diffusion across regions, this study seeks to delineate what changes scholars should adopt in our epistemological approaches and methodological tools, such as the indices of democracy, in an attempt to better understand the policy implications of disparate findings from various empirical studies. As part of a larger research project, this paper focuses its attention on two of the geographical regions Asia and the Middle East.

Polish Media 22 Years After Socio-Political Breakthrough The Road to Professionalization and Democratization

Over two decades have passed by since Poland took the course of democratic changes. In the early 1990s the press sector was re-established as a consequence of de-monopolization and has been taken over by foreigners. The electronle media sector has been restricted for 15 years and foreign companies could only have one third of the ownership. The complexity of Polish media system reflects the long way from communism and governmental media towards free democratized market with some remnants of the previous era. It is hard to predict when it will be shaped in a brand new way and if it is generally possible.

Electoral Authoritarianism in Togo: How Has Foreign Aid Impacted the Democratization Process in Togo From 2005 to 2010?

After four decades of military dictatorship,Togo is still facing a dilemma of whether to break with the past and take a path of democratization or make changes in the continuity.The death of the former President Gnassingbe Eyadema in 2005 was seen by the Togolese community at home and around the world as a window of opportunity or a step toward the emergence of the political liberalization in the country.Unfortunately,with the backing of the Togolese army,Faure Gnassingbe,one of the sons of Eyadema,was enthroned as the country’s new President since 2005.The international economic sanctions on Togo in the aftermath of the death of Eyadema,due to continuing human rights abuses and violations by the authoritarian regime,have accentuated the already acute suffering and poverty of the Togolese population.However,the 2006 Global Political Agreement reached between the traditional political opposition parties and the government paved the way to the normalization of the international cooperation with Togo and hence the lifting of economic sanctions by the international community.Drawing from Solow-Swan growth model and a cross-national causality test of the development-democracy-growth hypothesis of Abbas Pourgerami,this paper investigates the impact of foreign aid on the democratization process since 2005 and argues that foreign aid played a paramount role in consolidating electoral authoritarianism instead of establishing a viable democracy in Togo.

Electoral Governance and Democratization in Francophone Africa:A Critical Appraisal

The exhaustion of dictatorial powers and communist regimes ushered in the third wave of democratization in francophone Africa,through the emergence of democratic institutions essential to the holding of credible elections.This new democratic era,which redefines the stakes of power through peaceful political competition in the form of elections,marked the end,at least symbolically,of a time when a coup or popular insurrection seemed to be the only way to overthrow dictatorial regimes.The election thus appears as an instrument of regulation of political life.Through a constructivist perspective,this research aims to discuss the relationship between electoral governance and democratization in francophone Africa.It shows that even if democracy is taken as a tool of political civilization in francophone Africa,there is no institutional linking.It means that electoral must be the key for the regulation and the credibility of democratization and democracy.

The Impact of Democratization on“FDI”in Tunisia-A Comparison of Pre and Post Revolution Periods

The study examined the impact of democratization on foreign direct investment in Tunisia and has done a comparison of the pre and post revolution periods.The paper has used secondary data for the variables GDP per capita,FDI,Gross Fixed Capital Formation(GFCF),Current health expenditure(%of GDP)for the period 2001-2018.The study aims to provide arguments of the favorable political conditions for FDI,the purpose is to understand;whether,democracy and autocracy attract FDI in the Pre and Post-event of revolution in Tunisia.In addition,this investigation discusses the key elements for path dependency in democratic transitions from autocracy to democracy.The study found that there is a correlation between the adoption of a democratic regime and the FDI evolution.A democratic regime creates the right political circumstances to improve macroeconomic performance.It can stimulate growth if it is conducted in a stable political environment.

Considerations for a Planned Democratizing Data Framework for Valid and Trusted Data

A key requirement of today’s fast changing business outcome and innovation environment is the ability of organizations to adapt dynamically in an effective and efficient manner. Becoming a data-driven decision-making organization plays a crucially important role in addressing such adaptation requirements. The notion of “data democratization” has emerged as a mechanism with which organizations can address data-driven decision-making process issues and cross-pollinate data in ways that uncover actionable insights. We define data democratization as an attitude focused on curiosity, learning, and experimentation for delivering trusted data for trusted insights to a broad range of authorized stakeholders. In this paper, we propose a general indicator framework for data democratization by highlighting success factors that should not be overlooked in today’s data driven economy. In this practice-based research, these enablers are grouped into six broad building blocks: 1) “ethical guidelines, business context and value”, 2) “data leadership and data culture”, 3) “data literacy and business knowledge”, 4) “data wrangling, trustworthy & standardization”, 5) “sustainable data platform, access, & analytical tool”, 6) “intelligent data governance and privacy”. As an attitude, once it is planned and built, data democratization will need to be maintained. The utility of the approach is demonstrated through a case study for a Cameroon based start-up company that has ongoing data analytics projects. Our findings advance the concepts of data democratization and contribute to data free flow with trust.

Contributions of the Measles Follow-Up Vaccination Campaign to Improving the Vaccination Coverage of Children Aged 6 - 59 Months in the Democratic Republic of the Congo in 2019

Background: In accordance with its measles elimination strategic plan 2012-2020, the Democratic Republic of the Congo (DRC) organized a follow-up vaccination campaign against measles from October to December 2019 in 26 provinces. This study aims to establish the contribution of this supplementary vaccination campaign to protecting children against measles. Methods: The survey was carried out in November 2020 among households of the DRC, according to the 2018 revised version of the World Health Organization’s stratified cluster sampling method, using multiple stage sampling. It targeted 280 children aged 6 - 59 months per stratum or province, with 10 children in each of the 28 selected clusters. Data collection using tablets with centralized and real-time data processing was preceded by enumeration to refine the household sampling frame. Clusters and households were selected by random draw. Data collected with CS Pro 7 software were analyzed with SPSS, Epi info 7 and Excel software to determine indicators and make before-after comparisons using the McNemar test, at a precision threshold of 5%. Results: Of the 8535 surveyed children, 89.5% were vaccinatedduring the follow-up campaign and 81.6% were vaccinated before. Only 3.7% had correctly completed campaign vaccination cards. Estimated vaccination coverage increased from 80.8% before the campaign to 92.6% after the campaign (p 0.001). Vaccination coverage after campaign against measles improved in all provinces (p < 0.001) except Bas-Uele and Maniema. Thirteen provinces reached the national coverage target of 95%, compared to five before the campaign. The proportion of zero-dose children dropped significantly after this campaign from 19.2% to 7.4% (p 0.001), and even fell below 1% in six provinces. Conclusion: This measles vaccination campaign improved overall vaccination coverage by 10% and reached more unvaccinated children. Efforts must continue to improve the retention of vaccination card, the adherence of unvaccinated children and the effectiveness of routine vaccination.

The Debate on Democratic Revolution in Japan in the 1920s

Anti-hegemonic movements in Japan had occurred frequently since the early 20th century,and democratic revolution debate in the 1920s was the first significant domestic debate on future development strategy.Various discussions on it from Japanese academia involved state power,absolutism,agrarian revolution,and revolutionary strategy,etc.An analysis of early Japanese scholars’perspectives on the democratic revolution helps to know about the social milieu in Japan at that time,and is of positive significance to comprehend the development process of the current Japanese democratic revolution.

Blood Safety in the Democratic Republic of the Congo: Literature Review

Background: The Democratic Republic of the Congo (DRC) faces severe malaria, postpartum haemorrhage, malnutrition and sickle cell disease that require transfusion. The latter poses immunological, infectious, metabolic and hemodynamic risks to recipients. Objective: To present transfusion safety in the DRC through data from the literature. Methods: This review consists of listing the various articles and abstracts published online and presented in scientific conferences having as a subject of interest transfusion safety in the DRC. Results: The review is dominated by articles from eastern DRC and blood mobilization is around 0.5% of the general population. All screening tests are serological with a proven residual risk. The prevalence of HIV, HBV, HCV and syphilis infections is documented at more than 80% and represents respectively 1.9%, 2.96%, 1.89% and 1.21%. The prevalence of other pathogens, the immunological and haemodynamic risk are very poorly documented (12.5% to 25%). The prevalence of Parvovirus B19 infection is 5.3% and that of bacterial contamination at 1.4%, that of malaria infestations between 0.3% and 28.3%, that of trypanosomiasis at 1.3%, that of babebiosis at 0.17% in blood donors. Allo-immunization represents 47.8%, adverse reactions 3.4%, iron deficiency 63.2, iron deficiency anemia 25.9% and anemia 36.5%. Pediatrics is the biggest user of this blood. Conclusion: The prevalence of HIV, HBV, HCV and Syphilis infections is within the range of sub-Saharan African countries. The serological test is systematic and involves the residual risk, it is necessary to introduce the molecular tests. The prevalence of other pathogens (emerging viruses, bacteria and hemoparasites), the immunological and metabolic risk is poorly documented. The search for these pathogens, irregular antibodies and the determination of ferritin in blood donations is not systematic.

Research on the Role of Democratic Parties in Colleges and Universities in Building Morality and Cultivating People: Taking the General Branch of the Democratic League of Huizhou College as an Example

This article takes the general branch of the Huizhou College of the Democratic League of Huizhou College in recent years as an example. Through literature review, field research, case analysis, and other research methods, it summarized how the Democratic League of Huizhou College made good use of various activity carriers in ideological and political education. It combined discipline construction, scientific research platforms, school-government-enterprise, and other cooperation platforms. From educational methods to subject transformation and integration, and from daily teaching to social practice, it promoted the role of college teachers in the alliance to play the role of cultivating people in the era of college education reform. The aim was to put forward that in educating others, they should first educate themselves, teachers had two-way morality in terms of teacher ethics and professionalism, effectively integrated ideological and political courses into professional teaching and practice, and realized waiting for flowers to bloom in the “context”1 teaching environment like the cultivation effect of salt in water.

Proportion of thyroid cancer and other cancers in the democratic republic of Congo

BACKGROUND Cancer diagnosis is increasing around the world and in the Democratic Republic of the Congo(DRC).The proportion of thyroid cancer has increased over the past three decades.There are very few studies on cancer epidemiology,and in particular on thyroid cancer in the DRC.AIM To establish the most recent proportion of thyroid cancer in the DRC compared to other cancers.METHODS This is a retrospective and descriptive study of 6106 consecutive cancer cases listed in the pathological registers of 4 Laboratories in the city of Kinshasa.This study included all cancer cases recorded in the registers between 2005 and 2019.RESULTS From a sample of 6106 patients,including all cancer types,68.3%cases were female and 31.7%were male.Breast and cervical cancer were the most common types of cancer in women and,prostate and skin cancer were the most common types in men.Thyroid cancer was sixth in proportion in women and eleventh in men compared to all cancers.Papillary carcinoma was the most common of thyroid cancers.Rare cancers such as anaplastic and medullary thyroid carcinomas had a proportion of 7%and 2%,respectively.CONCLUSION Newer diagnostic tools led to a surge in cancer diagnoses in the DRC.Thyroid cancer has more than doubled its proportion over the last several decades in the country.

A Pilot Study about the First Cases of Coronary Angioplasty in Democratic Republic of Congo/Kinshasa: Patient Profile

Background: The objective of this pilot study was to describe clinical profile, electric, echocardiographic and angiographic caracteristics with procedural outcome of congolease patients undergoing coronarography in the first and only one cardiac catheterization center opened in Kinshasa. Methods: An analytical cross-sectional study was carried out over a period from October 2019 (date of establishment of the first coronary angiography unit in DR Congo) to March 2021. We proceeded to a serial sampling of the consecutive cases of all the patients who have an angiographic exploration of coronary arteries. Clinical, ECG and cardiac ultrasound data were collected in all patients. The indications for the coronary angiography examination were set by differents cardiologists on the basis of repolarization troubles in the electrocardiogram, cinetic troubles in echocardiography, positive stress test and chest pain in patients with cardiovascular risq factors. Results: The serie (47 patients) was predominantly male with a sex ratio M/W of 2.6. The average age was 59.8 ± 10.5 years. Arterial hypertension (HBP) was the main risk factor (89.4%);followed by diabetes mellitus (14.9%). Chest pain was the main functional sign with an atypical character in 44.7%. The ECG showed ST segment depression (17%) and T wave inversion (17%), the anterior region being the most affected. Hypokinesia was the most common echocardiographic abnormality (34%), followed by akinesia (10.6%). The anteroseptal and apical territories were affected in 12.8%. Dilated myocardiopathy (DMC) was significantly predominant in the male sex (29.4% vs 7.7%;p = 0.011). With radial puncture as the main approach, coronary angiography was pathological in 44% revealing mono-truncal lesions. The left coronary network was the most affected: the middle inter ventricular artery (12.8%), the proximal interventricular artery (10.6%) and the proximal circonflex artery (10.6%). In multivariate logistic regression analysis, age (for age > 50 years for men and >60 years for women), arterial hypertension and dilated cardiomyopathy emerged as independent determinants of pathological coronary angiography. Transluminal angioplasty was performed in 27.7% of patients. The bypass indication was retained in 4.3% of cases and medical treatment in 68%. Conclusion: Coronary angiography was used to diagnose lesions responsible for ischemic heart disease and to treat 27.7% of patients locally. The young age of patients and limited financial resources encourage the strengthening of preventive measures against cardio vascular risq factors.

The Development of a Law-based Society Contributes to the Legal Protection of Human Rights in China

Over the past 40 years of reform and opening up,the Party and the State have gained a richer and deeper understanding of human rights.In 1997,the 15;Communist Party of China National Congress Report put forward"respect for human rights".In 2004,the idea that"the State respects and protects human rights"was written into

努力构建党内全过程监督体系

长期以来,我们重视自上而下的监督,不够重视自下而上的监督,没有构建起全过程监督体系。造成领导干部特别是“一把手”贪腐问题屡禁不止。要解决这个问题,必须构建并不断完善党内全过程监督体系。全过程监督体系,坚持党中央的集中统一领导,坚持纪委监委专门监督责任,坚持民主监督与集中监督的有机结合,坚持自上而下监督与自下而上监督相结合。当务之急,是要建立健全党内全过程监督制度,进一步明确监督主体、监督对象、监督体制机制。发挥同级党组织相互监督的作用。改进自下而上的民主监督。积极推进对“一把手”和领导班子的监督。加强领导班子成员之间相互监督。加强各级党委对监督工作的领导。强化对干部管理工作的监督,完善干部选举和任用工作监督、“一把手”和领导班子决策监督。加强对党内全过程监督体系构建的领导与管理。

乡村治理如何有为、有效?——全国92个乡村治理典型案例的分析与启示

以农业农村部组织遴选并推广的92个乡村治理创新典型案例为主要分析对象。研究发现:引发乡村治理创新实践的主要原因一是国家战略引导;二是地方为满足制度建设、精神文明建设、法治建设、经济发展而进行创新,解决发展中的逐项难题。文章从完善治理体制、健全治理体系、创新长效机制、聚焦突出问题四个方面展开案例分析。研究发现,乡村治理创新主要表现为:通过党建统领,构建乡村网格化治理模式;通过形成“三治融合”体系,推动乡村治理多主体参与;通过积分制、清单制推动乡村治理实现长效化;通过聚焦乡村主要问题,实现乡村治理变革。基于此,文章认为,实现乡村治理有效有三大机制,即党建引领—全民参与机制、问题导向—实践需求机制、综合创新—长效运行机制。把握三大机制可以帮助各地区因地制宜探索符合本地实际情况的乡村治理有效模式。

基层直接民主制度体系建设:实践价值、内在张力与发展路径

基层治理是全部政治生活的基础,其核心是基层民主。建设基层直接民主制度体系是在基层社会落实党的领导制度体系的具体路径,有助于完善人民当家做主制度体系,推动人民当家做主制度体系的“接地气”发展,促进基层直接民主与基层治理相互贯通,推动基层治理创新和激发基层治理活力。完善基层直接民主制度体系,需要关注基层直接民主制度体系建设面临的内在张力,即基层直接民主制度体系下规范性的民主目标与民主现实之间存在的差距,制度规范与实践运作之间存在的脱节现象,主体功能与程序设计存在需要磨合的环节。构建完善的基层直接民主制度体系,重点在于解决基层民主的制度结构环节不完整、覆盖不全面、关系不顺畅的问题,解决基层民主的理想与现实、原则与制度、稳定与发展之间的张力问题,解决基层民主的观念认知、制度意识和能力提升的实践性问题。走民主和法治之路,直面现代化发展逻辑诱发的基层问题,坚持以人为目的本身,提升基层民主制度的针对性和灵活性,将在更高层次上实现基层直接民主制度体系的完善和发展。