List of Titles

Quick View

Training a Fit-For-Purpose Rural Health Workforce for Low- and Middle-Income Countries (LMICs): How Do Drivers and Enablers of Rural Practice Intention Differ Between Learners From LMICs and High Income Countries?

- Karen Johnston, Monsie Guingona, Salwa Elsanousi, Jabu Mbokazi, Charlie Labarda, Fortunato L. Cristobal, Shambhu Upadhyay 6, Abu-Bakr Othman, Torres Woolley, Balkrishna Acharya, John C. Hogenbirk, Sarangan Ketheesan1, Jonathan C. Craig, Andre-Jacques Neusy, Sarah Larkins

Authors: Karen Johnston , Monsie Guingona , Salwa Elsanousi , Jabu Mbokazi , Charlie Labarda , Fortunato L. Cristobal , Shambhu Upadhyay 6 , Abu-Bakr Othman , Torres Woolley , Balkrishna Acharya , John C. Hogenbirk , Sarangan Ketheesan1 , Jonathan C. Craig , Andre-Jacques Neusy , Sarah Larkins
Date: 2020
Language: English
Type: Journal article
Identifier: http://hdl.handle.net/11260/3954 , vital:43976
Full Text:

Quick View

The Role of Biomarkers in the Management of Stroke in Eastern Cape Province

- Collin Asongapha Forka

Authors: Collin Asongapha Forka
Date: 2015
Language: English
Type: Masters
Identifier: http://hdl.handle.net/11260/2846 , vital:42964
Description: ABSTRACT Stroke is defined as rapidly developed clinical signs of focal (or global) disturbance of the cerebral function, lasting more than 24 hours with no apparent cause other than a vascular origin. A biomarker is defined as “a physiological characteristic that can be objectively measured and evaluated as an indicator of normal biological or pathogenic process as well as pharmacological responses to a therapeutic interventions. The aim of this study was to investigate the role of biomarkers in defining inflammation, endogenous oxidants/antioxidant status (oxidative stress imbalance) and traditional cardiovascular risk factors. This case (stroke types and subtypes) – control (healthy) study (matched for gender and age) was conducted between December 2012 and June 2015. Mthatha Hospital complex served as the study setting. Nelson Mandela Academic Hospital (NMAH) is a tertiary facility that provides health care to South African population, majority of whom dwell in rural areas around the hospital. Student t-test and ANOVA served to compare means between 2 groups and across >3 groups. Chi – square test was used to compare proportions between 2 groups. Multivariate (multiple linear regression, binary logistic regression, and discriminant functions) analyses were used to identify the most important risk factors of all strokes and fibrinogen to discriminate stroke types and subtypes. ROC method obtained specific ethnic cut–off points of biomarkers that associated independently with all strokes. In total 67 participants were examined: 37 cases of strokes (11 ischemic, 26 haemorrhagic, 11 lacunar ischemic, 13 intra-cerebral hematomas and 8 haemorrhagic brain ischaemia) versus 28 controls. Low socio – economic status (OR=10.3 95%CI 3.3- 32.9 p<0.0001), physical inactivity (OR=13 95% CI 3.3-51.6 p<0.0001), rural residence(OR=6.5 95% CI 1.6-26.5 p=0.004), RDW(OR=3.7 95% CI 1.3-10.9 p=0.016), D – dimer (OR=17.4 95% CI 2.9-104 p=0.002), Fibrinogen (OR=35.1 95% CI 3.5-356.5 p=0.003), and BMI(OR=1.387 95% CI 0.985-2 p=0.06) were the most independent risk factors of all strokes. RDW, Platelets, D-dimer, and Neutrophils were the most discriminant of absence of strokes, ischaemic and haemorrhagic types of stroke. Only Fibrinogen and BNP were the most discriminant of stroke subtypes in low socio–economic status. Meanwhile, Platelets, Neutrophils, and CRP were the most discriminant of stroke subtypes in high socio – economic status. The cut-off points of RDW>14%, Fibrinogen>3.5 g/L, and D-dimer>0.5g/mL separated efficiently all stroke types and controls. Independent variations (R2 = 48%) of Fibrinogen in all participants were explained by increase in CRP (Beta = 0.315; P = 0.003), Platelets (Beta = 0.280; P = 0.004), BMI (Beta = 0.268; P = 0.006), and Monocytes (Beta = 0.241; P = 0.014).iii In conclusion, increased levels of Biomarkers of inflammation, thrombosis, hypercoagulability, but opposite variations of innate immunity (increase in monocytes, decrease or increase in neutrophils), overweight/Obesity, low socio-economic status, physical inactivity, and rural residence were the major risk factors of all strokes. Biomarkers of inflammation have superior performance to diagnose all strokes and to discriminate stroke types and to predict the severity of stroke subtypes than the few traditional cardiovascular risk factors. Education, adequate diet, exercise, reduction of poverty, other measures of secondary prevention, applied research, and integration of chemical pathology in the management of strokes are needed in personalised medicine with cheap tools (RDW, platelets and Fibrinogen) in absence of neuro – imaging in the poorest Eastern Cape province of South Africa.
Full Text:

Quick View

The Interrelationship between oral literature and museum studies

- Enongene Mirabeau Sone

Authors: Enongene Mirabeau Sone
Date: 2016
Subjects: folklore; interrelationship; museum studies; oral literature
Language: English
Type: Journal Article
Identifier: http://hdl.handle.net/11260/2696 , vital:42324
Description: Oral literature and museums are intimately related to each other. While the former is an academic discipline, the latter is an institution. This article examines the historical background of the study of oral literature and the historical development of the museum so that the relationship between the two can be easily appreciated. The article argues that oral literature, as a form of folklore, can help to create good museums and that the museum, on the other hand, can contribute to the study of oral literature. This interrelationship, once appreciated by both oral literature scholars (folklorists) and museologists (museum scholars), will be of tremendous benefit to the study of oral literature as an academic discipline and to the development of more thematic museums, especially in Africa where oral literature is a dynamic aspect of societal life.
Full Text:

Quick View

The Folktale and Social Values in Traditional Africa

- Enongene Mirabeau Sone

Authors: Enongene Mirabeau Sone
Date: 2018
Subjects: folktales; social values; Africa; positive change; ethical behaviour
Language: English
Type: Journal Article
Identifier: http://hdl.handle.net/11260/2704 , vital:42325
Description: Africans, like people elsewhere in the world, have a set of values which they consider worthwhile and necessary for the preservation and wellbeing of their culture. In this way, it may be said that societal values are embodied in and communicated by its system of education and that the education that a society offers its youth reflects the sum total of what is held dear in that society. In many African societies, an important aspect of traditional education is concerned with teaching oral literature using folktales, riddles and proverbs which aim at moulding character and providing children with moral values like honesty, integrity, courage and solidarity. This paper examines the relevance of folktales to the promotion of social values in Africa by demonstrating how folktales can open a window of understanding to a community’s social norms, values, thoughts, concepts and ideas with a view to drawing implications for positive change. It is predicated on the assumption that African folktales, with a particular focus on Cameroon, promote social and ethical values, provide human understanding, facilitate the elimination of anti-social behaviour and help with social identity construction. The point is that folktales, as a form of oral literature, draw their material from the realities of society and hence reflect people’s values and worldview. As a result, folktales are often used as a vehicle for transmitting and preserving shared values and collective experience. The paper concludes by observing that despite the preponderance of modern means of entertainment in Africa, storytelling persists. Contemporary African folktales are imaginatively refined for the purpose of injecting new meanings, ideas and values, based on society’s contemporary experiences and relations.
Full Text:

Quick View

THE EFFECT OF DIET ON THE PATTERN OF GASTROOESOPHAGEAL REFLUX IN THE RURAL SETTING OF THE EASTERN CAPE

- NDEBIA EUGENE JAMOT

Authors: NDEBIA EUGENE JAMOT
Date: 2015
Language: English
Type: PhD Manuscript
Identifier: http://hdl.handle.net/11260/2051 , vital:40807
Description: Gastro-oesophageal reflux is the return of stomach contents back up into the oesophagus. Excessive reflux of acid content into the oesophagus can cause oesophageal disorders such as heartburn, gastro-oesophageal reflux disease and oesophagitis. The prevalence of oesophageal disorders appears to be high in North America, Europe, japan and China while epidemiology data from Africa, South America and Middle East are unknown. More data is required in Africa because population diversity in reflux symptoms may exist and it is important that standard reference ranges of reflux profiles are established for African countries. The aims of this study was to establish a data base of gastro-oesophageal reflux pattern in the Eastern Cape rural area, to compare our findings with similar western studies and to establish the effect diet, H. pylori infection, gender, weight and age on the observed reflux pattern. The reflux pattern was evaluated in healthy subjects for 24h using the newer technique involving the recording of eosophageal intraluminal impedance and pH simultaneously. The technique gives quantitative data on the frequency, nature, type, and duration, and correlates them to the pH of the reflux. The diet survey was done using the usual pattern diet questionnaire, the body mass index (BMI) was calculated and the quantification of H. pylori antibodies IgG was determined in the serum of each participant using an ELISA kit. In total, 77 participants including 48 females and 29 males were included in the study. The mean age was 35 (range 18 - 60) years for females and 37 (range 18 - 54) for males. The mean BMI was 29 (range 19 - 42) for females and 23 (range 18- ii 30) for males. The total number of refluxes recorded in 24h in this population was presented as median, 25th, 75th and 95th percentile corresponding to 49, 29, 65 and 97, respectively. Of these, 37 % were acidic, 43 % were weakly acidic and 20 % were non-acidic. In term of reflux composition 12 % were liquid, 24 % were gas (belches) and 64 % were mixed (gas and liquid). The oesophageal bolus clearance time was 18 s while the acidity of the reflux was completely neutralised 30 s after a reflux. The oesophageal bolus exposure time was 14 min/day and while acid exposure time was 15 min/day. More refluxes were found in upright position compared to supine position. They were a higher number of refluxes and a predominance of non-acid reflux in the present study compared to western countries. We found that most refluxes were postprandial and some parameters of the pattern of gastro-oesophageal reflux were significantly influenced by the traditional diet. Higher carbohydrate, protein and fat in the meal were associated with a high frequency of refluxes most of which were acidic and weakly acidic while higher fruit and vegetable consumption was associated with fewer refluxes. An increased number of non-acid refluxes were observed in high carbohydrate maize based diet. Nearly all participants of the present study were positive for H. pylori and those with a higher concentration of H. pylori IgG in the serum had less oesophageal acid exposure. Females, older and overweight participants presented with an increased frequency of reflux. This study provides normal references values for the pattern of Gastrooesophageal reflux in the rural population of South Africa. The observed pattern of reflux is positively influenced by the traditional diet which is mainly carbohydrate maize based and also by BMI, weight and gender
Full Text:

Quick View

Showing items 1 - 20 of 172