Medical Education in Decentralized Settings: How Medical Students Contribute to Health Care in 10 Sub-Saharan African Countries
- Talib, Zohray, van Schalkwyk, Susan, Cooper , I, Pattanaik , Swaha, Turay , Khadija, Sagay, Atiene S, Baingana , Rhona, Baird , Sarah, Gaede , Bernhard, Iputo, Jehu, Kibore , Minnie, Manongi , Rachel, Matsika , Antony, Mogodi , Mpho, Ramucesse , Jeremais, Ross, Heather, Simuyeba, Moses, Haile-Mariam, Damen
- Authors: Talib, Zohray , van Schalkwyk, Susan , Cooper , I , Pattanaik , Swaha , Turay , Khadija , Sagay, Atiene S , Baingana , Rhona , Baird , Sarah , Gaede , Bernhard , Iputo, Jehu , Kibore , Minnie , Manongi , Rachel , Matsika , Antony , Mogodi , Mpho , Ramucesse , Jeremais , Ross, Heather , Simuyeba, Moses , Haile-Mariam, Damen
- Date: 10-2017
- Subjects: Sub Sahara Africa Medical Education Health Care Medical Students Computer File
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5786 , vital:44644 , https://doi:10.1097/ACM.0000000000002003
- Description: Purpose: African medical schools are expanding, straining resources at tertiary health facilities. Decentralizing clinical training can alleviate this tension. This study assessed the impact of decentralized training and contribution of undergraduate medical students at health facilities. Method: Participants were from 11 Medical Education Partnership Initiative-funded medical schools in 10 African countries. Each school identified two clinical training sites-one rural and the other either peri-urban or urban. Qualitative and quantitative data collection tools were used to gather information about the sites, student activities, and staff perspectives between March 2015 and February 2016. Interviews with site staff were analyzed using a collaborative directed approach to content analysis, and frequencies were generated to describe site characteristics and student experiences. Results: The clinical sites varied in level of care but were similar in scope of clinical services and types of clinical and nonclinical student activities. Staff indicated that students have a positive effect on job satisfaction and workload. Respondents reported that students improved the work environment, institutional reputation, and introduced evidence-based approaches. Students also contributed to perceived improvements in quality of care, patient experience, and community outreach. Staff highlighted the need for resources to support students. Conclusions: Students were seen as valuable resources for health facilities. They strengthened health care quality by supporting overburdened staff and by bringing rigor and accountability into the work environment. As medical schools expand, especially in low-resource settings, mobilizing new and existing resources for decentralized clinical training could transform health facilities into vibrant service and learning environments.
- Full Text:
- Date Issued: 10-2017
- Authors: Talib, Zohray , van Schalkwyk, Susan , Cooper , I , Pattanaik , Swaha , Turay , Khadija , Sagay, Atiene S , Baingana , Rhona , Baird , Sarah , Gaede , Bernhard , Iputo, Jehu , Kibore , Minnie , Manongi , Rachel , Matsika , Antony , Mogodi , Mpho , Ramucesse , Jeremais , Ross, Heather , Simuyeba, Moses , Haile-Mariam, Damen
- Date: 10-2017
- Subjects: Sub Sahara Africa Medical Education Health Care Medical Students Computer File
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5786 , vital:44644 , https://doi:10.1097/ACM.0000000000002003
- Description: Purpose: African medical schools are expanding, straining resources at tertiary health facilities. Decentralizing clinical training can alleviate this tension. This study assessed the impact of decentralized training and contribution of undergraduate medical students at health facilities. Method: Participants were from 11 Medical Education Partnership Initiative-funded medical schools in 10 African countries. Each school identified two clinical training sites-one rural and the other either peri-urban or urban. Qualitative and quantitative data collection tools were used to gather information about the sites, student activities, and staff perspectives between March 2015 and February 2016. Interviews with site staff were analyzed using a collaborative directed approach to content analysis, and frequencies were generated to describe site characteristics and student experiences. Results: The clinical sites varied in level of care but were similar in scope of clinical services and types of clinical and nonclinical student activities. Staff indicated that students have a positive effect on job satisfaction and workload. Respondents reported that students improved the work environment, institutional reputation, and introduced evidence-based approaches. Students also contributed to perceived improvements in quality of care, patient experience, and community outreach. Staff highlighted the need for resources to support students. Conclusions: Students were seen as valuable resources for health facilities. They strengthened health care quality by supporting overburdened staff and by bringing rigor and accountability into the work environment. As medical schools expand, especially in low-resource settings, mobilizing new and existing resources for decentralized clinical training could transform health facilities into vibrant service and learning environments.
- Full Text:
- Date Issued: 10-2017
Addressing constraints in promoting wild edible plants’ utilization in household nutrition: case of the Congo Basin forest area
- Ngome, Precillia Ijang Tata, Shackleton, Charlie M, Degrande, Anne, Tieguhong, Julius Chupezi
- Authors: Ngome, Precillia Ijang Tata , Shackleton, Charlie M , Degrande, Anne , Tieguhong, Julius Chupezi
- Date: 2017
- Language: English
- Type: article , text
- Identifier: http://hdl.handle.net/10962/60822 , vital:27836 , DOI 10.1186/s40066-017-0097-5
- Description: It is worth raising the question, why are wild edible plants (WEPs) which are rich in diverse nutrients and widely abundant underutilized despite the increasing rate of undernourishment in poor regions? One reason is that their culinary uses are not quantified and standardized in nutrition surveys, and therefore, they are not properly included in household diet intensification and diversification across regions and cultures. Active steps are needed to bridge this gap. This paper outlines the constraints to including WEPs in nutritional surveys as the lack of standard ways of food identification of diverse WEPs, lack of specific food categorization and therefore difficult dissemination across regions and cultures. As a way forward, a functional categorization of 11 subgroups for WEPs is introduced and discussed. In labeling these sub-food groups, the paper advocates that more WEPs food items and culinary uses should be enlisted during household nutrition surveys. Food researchers could then capitalize these enlisted species and disseminate them to promote diverse food use of WEPs in other regions where they exist but are not utilized as food.
- Full Text:
- Date Issued: 2017
- Authors: Ngome, Precillia Ijang Tata , Shackleton, Charlie M , Degrande, Anne , Tieguhong, Julius Chupezi
- Date: 2017
- Language: English
- Type: article , text
- Identifier: http://hdl.handle.net/10962/60822 , vital:27836 , DOI 10.1186/s40066-017-0097-5
- Description: It is worth raising the question, why are wild edible plants (WEPs) which are rich in diverse nutrients and widely abundant underutilized despite the increasing rate of undernourishment in poor regions? One reason is that their culinary uses are not quantified and standardized in nutrition surveys, and therefore, they are not properly included in household diet intensification and diversification across regions and cultures. Active steps are needed to bridge this gap. This paper outlines the constraints to including WEPs in nutritional surveys as the lack of standard ways of food identification of diverse WEPs, lack of specific food categorization and therefore difficult dissemination across regions and cultures. As a way forward, a functional categorization of 11 subgroups for WEPs is introduced and discussed. In labeling these sub-food groups, the paper advocates that more WEPs food items and culinary uses should be enlisted during household nutrition surveys. Food researchers could then capitalize these enlisted species and disseminate them to promote diverse food use of WEPs in other regions where they exist but are not utilized as food.
- Full Text:
- Date Issued: 2017
Customary management as TURFs: social challenges and opportunities
- Authors: Aswani, Shankar
- Date: 2017
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/145403 , vital:38435 , DOI: 10.5343/bms.2015.1084
- Description: There is a growing interest in working with customary management (CM) systems to effectively manage benthic resources and small-scale fisheries. The underlying notion is that CM institution as territorial use rights in fisheries (TURFs) can be sufficiently adaptive and dynamic to create the local incentives that are necessary for promoting sustainable fishing practices and marine conservation more generally in a given region. This paper reviews the social opportunities and challenges of working with CM systems as a form of TURF, particularly in Oceania. A key conclusion is that policy makers and managers not only need to recognize natural interconnectivity in any one marine space, but also consider the social interconnectivity of stakeholders that covers customary TURFs. Only by recognizing and working with the existing social networks that overlay any given marine territory can the operational principles of CM (as reviewed in this paper) be effectively deployed for achieving some kind of bioeconomic efficiency and creating an equitable rights-based fisheries management system.
- Full Text:
- Date Issued: 2017
- Authors: Aswani, Shankar
- Date: 2017
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/145403 , vital:38435 , DOI: 10.5343/bms.2015.1084
- Description: There is a growing interest in working with customary management (CM) systems to effectively manage benthic resources and small-scale fisheries. The underlying notion is that CM institution as territorial use rights in fisheries (TURFs) can be sufficiently adaptive and dynamic to create the local incentives that are necessary for promoting sustainable fishing practices and marine conservation more generally in a given region. This paper reviews the social opportunities and challenges of working with CM systems as a form of TURF, particularly in Oceania. A key conclusion is that policy makers and managers not only need to recognize natural interconnectivity in any one marine space, but also consider the social interconnectivity of stakeholders that covers customary TURFs. Only by recognizing and working with the existing social networks that overlay any given marine territory can the operational principles of CM (as reviewed in this paper) be effectively deployed for achieving some kind of bioeconomic efficiency and creating an equitable rights-based fisheries management system.
- Full Text:
- Date Issued: 2017
Situating Africa: an alter-geopolitics of knowledge, or Chapungu rises
- Authors: Simbao, Ruth K
- Date: 2017
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/146112 , vital:38496 , https://0-doi.org.wam.seals.ac.za/10.1162/AFAR_a_00340
- Description: This journal issue marks the beginning of a new partnership with African Arts as Rhodes University in Grahamstown, South Africa, joins the editorial consortium. As the National Research Foundation Chair in Geopolitics and the Arts of Africa, I will work with collaborators based largely on the African continent to produce one issue of African Arts per year. This first issue has grown out of conversations with artists, curators, and writers based in Uganda, Zimbabwe, and South Africa at a publishing workshop organized by Rhodes University, as well as an institutional collaboration with Makerere University in Uganda. It also includes a dialogue with colleagues in Tanzania, Zambia, Nigeria, Egypt, South Africa, Benin, the Democratic Republic of Congo, Zimbabwe, the US, Uganda, and Angola/Portugal. A core goal of our work is to significantly increase the participation of authors based on the African continent as a way of strengthening our discipline with a scholarly approach that takes seriously an alter-geopolitics of knowledge as a decolonial concept (Koopman 2011; Mignolo 2002).
- Full Text:
- Date Issued: 2017
- Authors: Simbao, Ruth K
- Date: 2017
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/146112 , vital:38496 , https://0-doi.org.wam.seals.ac.za/10.1162/AFAR_a_00340
- Description: This journal issue marks the beginning of a new partnership with African Arts as Rhodes University in Grahamstown, South Africa, joins the editorial consortium. As the National Research Foundation Chair in Geopolitics and the Arts of Africa, I will work with collaborators based largely on the African continent to produce one issue of African Arts per year. This first issue has grown out of conversations with artists, curators, and writers based in Uganda, Zimbabwe, and South Africa at a publishing workshop organized by Rhodes University, as well as an institutional collaboration with Makerere University in Uganda. It also includes a dialogue with colleagues in Tanzania, Zambia, Nigeria, Egypt, South Africa, Benin, the Democratic Republic of Congo, Zimbabwe, the US, Uganda, and Angola/Portugal. A core goal of our work is to significantly increase the participation of authors based on the African continent as a way of strengthening our discipline with a scholarly approach that takes seriously an alter-geopolitics of knowledge as a decolonial concept (Koopman 2011; Mignolo 2002).
- Full Text:
- Date Issued: 2017
Determination of species and instars of the larvae of the Afrotropical species of Thanatophilus Leach, 1817 (Coleoptera, Silphidae)
- Daniel, Claire A, Midgley, John M, Villet, Martin H
- Authors: Daniel, Claire A , Midgley, John M , Villet, Martin H
- Date: 2017
- Language: English
- Type: article , text
- Identifier: http://hdl.handle.net/10962/59682 , vital:27638 , doi: 10.3897/afrinvertebr.58.12966
- Description: Thanatophilus micans and T. mutilatus have significance for forensic entomology. Their larvae are therefore described and a key is provided for identifying the larvae of Afrotropical Silphidae based on morphological characters. It is shown that seven common species of Thanatophilus can be distinguished by a 360 bp mtDNA sequence from the cytochrome oxidase I gene.
- Full Text:
- Date Issued: 2017
- Authors: Daniel, Claire A , Midgley, John M , Villet, Martin H
- Date: 2017
- Language: English
- Type: article , text
- Identifier: http://hdl.handle.net/10962/59682 , vital:27638 , doi: 10.3897/afrinvertebr.58.12966
- Description: Thanatophilus micans and T. mutilatus have significance for forensic entomology. Their larvae are therefore described and a key is provided for identifying the larvae of Afrotropical Silphidae based on morphological characters. It is shown that seven common species of Thanatophilus can be distinguished by a 360 bp mtDNA sequence from the cytochrome oxidase I gene.
- Full Text:
- Date Issued: 2017
Phototransferred thermoluminescence of α-Al2O3: C: experimental results and empirical models
- Chithambo, Makaiko L, Seneza, Cleophace, Kalita, Jitumani M
- Authors: Chithambo, Makaiko L , Seneza, Cleophace , Kalita, Jitumani M
- Date: 2017
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/115681 , vital:34215 , https://doi.org/10.1016/j.radmeas.2017.08.009
- Description: The thermoluminescence glow curve of α-Al2O3:C consists of a prominent apparently-single peak and a number of weaker intensity secondary peaks. Phototransferred thermoluminescence (PTTL) from secondary glow peaks in α-Al2O3:C is reported. For completeness and to aid discussion, complementary results for the main peak are included. The problem studied is one of phototransferred thermoluminescence for a system of multiple acceptors and multiple donors. A TL glow curve recorded at 5 °C/s following irradiation to 0.5 Gy shows the main peak (labelled II) at 240 °C and two secondary peaks at 86 °C (peak I) and 360 °C (peak III). Peak I is reproduced under phototransfer after any preheating between 100 and 500 °C. Peak II is also reproduced as a PTTL peak after preheating to any temperature up to 800 °C. For the latter, the duration of preheating matters because if the sample is preheated at 800 °C for say, 6 min, PTTL is obtained but not when this is extended to say, 15 min. No PTTL was observed from peak III at all. A study of the time dependence of the PTTL intensity from peak III, following preheating that removes peaks I and II, shows that its electron trap acts as an acceptor when the duration of illumination to stimulate electrons from deep traps is brief but that when the illumination time is extended, the electron trap for peak III loses some of its trapped electrons to the shallower traps thus acting as a donor trap.
- Full Text: false
- Date Issued: 2017
- Authors: Chithambo, Makaiko L , Seneza, Cleophace , Kalita, Jitumani M
- Date: 2017
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/115681 , vital:34215 , https://doi.org/10.1016/j.radmeas.2017.08.009
- Description: The thermoluminescence glow curve of α-Al2O3:C consists of a prominent apparently-single peak and a number of weaker intensity secondary peaks. Phototransferred thermoluminescence (PTTL) from secondary glow peaks in α-Al2O3:C is reported. For completeness and to aid discussion, complementary results for the main peak are included. The problem studied is one of phototransferred thermoluminescence for a system of multiple acceptors and multiple donors. A TL glow curve recorded at 5 °C/s following irradiation to 0.5 Gy shows the main peak (labelled II) at 240 °C and two secondary peaks at 86 °C (peak I) and 360 °C (peak III). Peak I is reproduced under phototransfer after any preheating between 100 and 500 °C. Peak II is also reproduced as a PTTL peak after preheating to any temperature up to 800 °C. For the latter, the duration of preheating matters because if the sample is preheated at 800 °C for say, 6 min, PTTL is obtained but not when this is extended to say, 15 min. No PTTL was observed from peak III at all. A study of the time dependence of the PTTL intensity from peak III, following preheating that removes peaks I and II, shows that its electron trap acts as an acceptor when the duration of illumination to stimulate electrons from deep traps is brief but that when the illumination time is extended, the electron trap for peak III loses some of its trapped electrons to the shallower traps thus acting as a donor trap.
- Full Text: false
- Date Issued: 2017
Central obesity and normal-weight central obesity among adults attending healthcare facilities in Buffalo City Metropolitan Municipality, South Africa: a cross-sectional study
- Owolabi, Eyitayo Omolara, Ter Goon, Daniel, Adeniyi, Oladele Vincent
- Authors: Owolabi, Eyitayo Omolara , Ter Goon, Daniel , Adeniyi, Oladele Vincent
- Date: 2017
- Subjects: Buffalo City Metropolitan Municipality, South Africa Obesity Central obesity, Overall obesity, Waist circumference, Waist-to-hip ratio, Waist-to-height ratio, NICE BMI-WC composite index, Health risk, Abdominal obesity Computer File
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5887 , vital:44664 , https://DOI10.1186/s41043-017-0133-x
- Description: Background Central obesity (CO) confers a significant threat on the cardio-metabolic health of individuals, independently of overall obesity. Disparities in the measures of fat distribution lead to misclassification of individuals who are at risk of cardio-metabolic diseases. This study sought to determine the prevalence and correlates of central obesity and normal-weight central obesity among adults attending selected healthcare facilities in Buffalo City Metropolitan Municipality (BCMM), South Africa, assess their health risk and examine the association between central obesity and cardio-metabolic diseases among adults with normal weight, measured by body mass index (BMI). Methods A cross-sectional survey of 998 adults was carried out at the three largest outpatient clinics in BCMM. Overall and central obesity were assessed using BMI, waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHTR). The WHO STEPwise questionnaire was used for data collection. Blood pressure and blood glucose were measured. Normal-weight central obesity was defined as CO among individuals with normal weight, as assessed by BMI. Health risk levels were assessed using the National Institute for Health and Clinical Excellence (NICE) BMI-WC composite index. Bivariate and multivariate analyses were used to determine the prevalence of CO, normal-weight central obesity and the predictors of CO. Results The mean age of participants was 42.6 (± 16.5) years. The prevalence of CO was 67.0, 58.0 and 71.0% by WC, WHR and WHTR, respectively. The prevalence of normal-weight central obesity was 26.9, 36.9 and 29.5% by WC, WHR and WHTR, respectively. About 41% of the participants had a very high health risk, 13% had increased risk or high risk and 33% had no health risk. Central obesity was significantly associated with hypertension but not associated with diabetes among those with normal weight (by BMI). Female sex, age over 30 years, marriage, secondary or tertiary level of education, non-smoking status, diabetes and hypertension significantly predicted central obesity among the study participants. Conclusion The prevalence of central obesity among the study participants is high, irrespective of the defining criteria. One in three adults of normal weight had central obesity. Body mass index should therefore not be used alone for clinical assessment by healthcare workers in the study setting.
- Full Text:
- Date Issued: 2017
- Authors: Owolabi, Eyitayo Omolara , Ter Goon, Daniel , Adeniyi, Oladele Vincent
- Date: 2017
- Subjects: Buffalo City Metropolitan Municipality, South Africa Obesity Central obesity, Overall obesity, Waist circumference, Waist-to-hip ratio, Waist-to-height ratio, NICE BMI-WC composite index, Health risk, Abdominal obesity Computer File
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5887 , vital:44664 , https://DOI10.1186/s41043-017-0133-x
- Description: Background Central obesity (CO) confers a significant threat on the cardio-metabolic health of individuals, independently of overall obesity. Disparities in the measures of fat distribution lead to misclassification of individuals who are at risk of cardio-metabolic diseases. This study sought to determine the prevalence and correlates of central obesity and normal-weight central obesity among adults attending selected healthcare facilities in Buffalo City Metropolitan Municipality (BCMM), South Africa, assess their health risk and examine the association between central obesity and cardio-metabolic diseases among adults with normal weight, measured by body mass index (BMI). Methods A cross-sectional survey of 998 adults was carried out at the three largest outpatient clinics in BCMM. Overall and central obesity were assessed using BMI, waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHTR). The WHO STEPwise questionnaire was used for data collection. Blood pressure and blood glucose were measured. Normal-weight central obesity was defined as CO among individuals with normal weight, as assessed by BMI. Health risk levels were assessed using the National Institute for Health and Clinical Excellence (NICE) BMI-WC composite index. Bivariate and multivariate analyses were used to determine the prevalence of CO, normal-weight central obesity and the predictors of CO. Results The mean age of participants was 42.6 (± 16.5) years. The prevalence of CO was 67.0, 58.0 and 71.0% by WC, WHR and WHTR, respectively. The prevalence of normal-weight central obesity was 26.9, 36.9 and 29.5% by WC, WHR and WHTR, respectively. About 41% of the participants had a very high health risk, 13% had increased risk or high risk and 33% had no health risk. Central obesity was significantly associated with hypertension but not associated with diabetes among those with normal weight (by BMI). Female sex, age over 30 years, marriage, secondary or tertiary level of education, non-smoking status, diabetes and hypertension significantly predicted central obesity among the study participants. Conclusion The prevalence of central obesity among the study participants is high, irrespective of the defining criteria. One in three adults of normal weight had central obesity. Body mass index should therefore not be used alone for clinical assessment by healthcare workers in the study setting.
- Full Text:
- Date Issued: 2017
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