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MORIARTY, JO, and JABEER BUTT. "Inequalities in quality of life among older people from different ethnic groups." Ageing and Society 24, no. 5 (August 24, 2004): 729–53. http://dx.doi.org/10.1017/s0144686x04002521.
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British research on the quality of life in old age has neglected the increasing ethnic diversity of the older population, and although studies of health and income inequalities have highlighted the contribution played by racism, analyses of the factors influencing the quality of life have rarely considered its effects. This paper discusses inequalities in quality of life among older people from different ethnic groups using data from a cross-sectional survey of 203 White British, Asian, Black Caribbean, Black African and Chinese people aged 55 and more years living in England and Scotland. They were interviewed face-to-face in the language of their choice using a semi-structured schedule. Consistent with the existing literature, the study found differences in health, income and social support among the ethnic groups. The paper suggests, however, that future work should examine disparities in health and income within as well as between minority ethnic groups, and that a greater appreciation is required of the way in which such disparities may be accentuated by variations in health expectations, in the distribution of income within households, and in the willingness to discuss financial difficulties. The cumulative effects of health and material disadvantage and the experience of racism have implications both for future quality of life research and for government policies that aim to raise social inclusion and reduce inequalities.
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Klompas, Michelle, and Eleanor Ross. "Life experiences of people who stutter, and the perceived impact of stuttering on quality of life: personal accounts of South African individuals." Journal of Fluency Disorders 29, no. 4 (January 2004): 275–305. http://dx.doi.org/10.1016/j.jfludis.2004.10.001.
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Adediyan, Aderopo Raphael. "Is Financial Inclusion a Determinant of Life Expectancy? Evidence from West African Region." Studies in Business and Economics 23, no. 1 (July 2021): 22–37. http://dx.doi.org/10.29117/sbe.2020.0119.
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This study is a contribution to the debate on the significance of financial inclusion with much emphasis on its impacts on human life span. The sample used for the analyses consisted of 14 West African countries over the period 2010 and 2018. The study employed a dynamic 2-Step System GMM approach, and under different model specifications, control for public and private health expenditure, food production quality, population, access to electricity, and the number of people practicing open defecation. The estimated results, among others, showed considerable evidence of positive feedback of financial inclusion on human life span. As such, substantial improvement in the access to and use of financial services is key to a high life expectancy in the region.
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Anderson, Joy L. "Evaluation of African American Adolescent Health Status With Gender Comparison." Californian Journal of Health Promotion 4, no. 2 (June 1, 2006): 168–74. http://dx.doi.org/10.32398/cjhp.v4i2.1942.
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The goals of Healthy People 2010 are to increase the quality of life and life expectancy, and eliminate health disparities. There is no clear picture, however, if these goals are being addressed by African American adolescents. This study was conducted to evaluate health status of African American adolescents aged 13-19 in Florida’s Big Bend Region. Healthy People 2010 objectives were consulted for the evaluation. Responses from a convenience sample of 35 participants (63% female, 34% male) who completed a survey comprised of questions based on Likert scale are summarized here. The results show that the African American adolescents are engaging in some physical activity; however, only about half of them reported maintaining a healthy body weight. The majority of the adolescents reported avoiding smoking, but fewer adolescents reported avoiding drinking alcohol. Only a small percentage of the adolescents reported that their friends carried a gun or knife to school within the last 30 days; the percentage increased when the adolescents were asked if their friends got into a fist fight within the last 30 days. The adolescents sampled in this study have only achieved the Healthy People 2010 objectives in one of the health concern areas examined herein. It is also important to note that there are substantial gender-based disparities. In order to meet all Healthy People 2010 objectives, health education and promotion must be increased. Future research should explore different aspects of health status of adolescents in general, and further examine gender disparities and contributing factors.
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Marsh, Sophia E., and Ilse Truter. "Fit for the future? Status of health-related quality of life research in South Africa." International Journal of Technology Assessment in Health Care 36, no. 5 (September 29, 2020): 508–17. http://dx.doi.org/10.1017/s0266462320000690.
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ObjectiveTo provide insights into the attributes of health-related quality of life (HRQoL) research within the context of economic evaluations for a potential national health technology assessment process in South Africa, and make evidence generation recommendations.MethodsA systematic review was conducted in January 2019 using Medline, the Web of Science (WoS) Core Collection and the South African SciELO collection via the WoS Platform, and in the Cochrane Library. No time restrictions were applied. Duplicate records were removed before first- and second-pass screening by two reviewers working independently.ResultsThe review identified 123 publications representing 104 studies since the first-published article appeared in 1996. Only eight studies were randomized controlled trials, most were cross-sectional (n = 54). The EQ-5D, SF-36, and WHOQOL-BREF were the most used HRQoL instruments (n = 35, n = 23, and n = 10, respectively). Instruments were frequently administered in multiple languages, reflecting the cultural groups in which the study was conducted, with the English version of instruments used most often. Studies were predominantly conducted within the public health sector (n = 67), in the Western Cape province (n = 46), in adults (n = 92) and people with HIV (n = 24).ConclusionSouth African specific HRQoL studies have been conducted in a range of settings and populations using mostly generic HRQoL instruments in multiple languages. These studies may provide generalizable, real-world data due to their observational nature. However, more comparative and longitudinal studies should be conducted as this is preferred for economic evaluations and patient, disease, and treatment characteristics should be reported in full.
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Fawale, Michael B., Mayowa O. Owolabi, and Adesola Ogunniyi. "Effects of seizure severity and seizure freedom on the health-related quality of life of an African population of people with epilepsy." Epilepsy & Behavior 32 (March 2014): 9–14. http://dx.doi.org/10.1016/j.yebeh.2013.12.026.
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Maku, Olukayode, Olorunfemi Alimi, and Fidelis Ogwumike. "Transmission Mechanism of Globalization and Its Impact on Human Welfare Development in Sub-Saharan African Countries." Izvestiya Journal of the University of Economics - Varna 65, no. 1 (March 25, 2021): 45–64. http://dx.doi.org/10.36997/ijuev2021.65.1.45.
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The increased intensity of globalization across borders integrated the sub-Saharan African (SSA) countries into the world economy as shown by the increasing degree of trade openness (from 55.4% in 1980–1984 to 65.6% in 2000–2015) and foreign direct investment as a percentage of GDP (from 0.3% in 1980–1984 to 2.85% in 2000–2015). The quality of life of the people in the region improved marginally regarding access to basic needs. However, the effects of globalization on access to basic needs such as water, sanitation, healthcare services have received little attention. Thus, this study investigates the impact of globalization on human welfare in sixteen SSA countries over the period 1980-2015. Using a panel fixed effect approach, the findings revealed that globalization through its various channels (trade openness, capital and financial flows and labour mobility and information technology), improves human welfare indicators in sub-Saharan Africa. However, the low level of good governance in the region deteriorates the development of human wellbeing. Thus, there is a need to improve the quality of overnance to enhance the welfare of the people through global interactions.
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BAJEKAL, MADHAVI, DAVID BLANE, INI GREWAL, SAFFRON KARLSEN, and JAMES NAZROO. "Ethnic differences in influences on quality of life at older ages: a quantitative analysis." Ageing and Society 24, no. 5 (August 24, 2004): 709–28. http://dx.doi.org/10.1017/s0144686x04002533.
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This article sets out to examine ethnic differences in the key influences on quality of life for older people in the context of the increasing health and wealth of British older people generally and the ageing of the post-1945 migrants. It is based on secondary multivariate analysis of the Fourth National Survey of Ethnic Minorities of England and Wales. Respondents aged 45–74 years belonging to four ethnic groups (1,068 white, 514 Caribbean, 581 Indian and East African Asian, and 199 Pakistani) were included in the analysis, which focuses on differences between ethnic groups by age and gender, using the white population as the reference group. Four dimensions (incorporating seven factors) that influence the quality of life were determined among this age group: quality of neighbourhood (availability of local amenities, and problems with crime and the physical environment); social networks and community participation (strength of family networks, and community participation); material conditions (income, wealth and housing conditions) and health. The relative position of the four ethnic groups on the seven factors illustrated two contrasting patterns. For the factors based on conventional indicators of social inequalities – such as material circumstances, health, participation in formal social networks, and quality of the physical environment – the white group ranked highest, the Pakistanis lowest, and the Indian and Caribbean groups ranked second and third. But factors that capture more immediate and subjective elements, such as frequency of family contact and the desirability of the residential neighbourhood, displayed a diametrically opposite rank-order, with the Pakistani group ranked first and the white group fourth. The study highlights the value of examining separately the various influences on quality of life. Contradictory patterns are revealed in key influences that are hidden by global measures. The study also reveals the difficulty of identifying culturally-neutral measures of quality of locality, with ethnic minority groups having a more positive perception of their area than rated by conventional measures of area deprivation such as the Index of Deprivation.
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W.D, Thwala. "Motivators of Construction Workers in the South African Construction Sites: A Case Study." Journal of Economics and Behavioral Studies 4, no. 11 (November 15, 2012): 625–34. http://dx.doi.org/10.22610/jebs.v4i11.363.
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Construction industry involves laborious and hazard work because of its demands it requires energetic and enthusiastic people and this are the attributes that in most cases young people poses. Construction industry stakeholder should shift their attention and prioritize the motivation of its workers since the industry has a way of cubing poverty and uplifting the county’s economy. This study used data from both primary and secondary sources a special focus on leadership and human resource management context. A survey was conducted with managers and employees regarding motivation on construction site were conducted at different parts of Gauteng. Furthermore, employees work because they obtain something that they need from work and that something obtained from work impacts morale, employee motivation, and the quality of life. Workforce motivation affects productivity. Because most of the activities are done under difficult conditions including harsh weather conditions, to make it attractive employees should be motivated to carry out different activities. Motivators should be in place to improve the chances of the industry’s competitiveness both locally and internationally.
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Trafford, Zara, Erna van der Westhuizen, Shona McDonald, Margi Linegar, and Leslie Swartz. "More Than Just Assistive Devices: How a South African Social Enterprise Supports an Environment of Inclusion." International Journal of Environmental Research and Public Health 18, no. 5 (March 6, 2021): 2655. http://dx.doi.org/10.3390/ijerph18052655.
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Appropriate assistive technology has the potential to considerably enhance quality of life, access to health and education, and social and economic participation for people with disabilities. Most disabled people in the world live in low- and middle-income countries where access to assistive devices and other support is severely lacking. There is little evidence that describes contextually relevant approaches to meeting these needs, particularly in African countries. We provide a detailed description of a South African organisation which has manufactured mobility and seating devices for children with disabilities since 1992. The Shonaquip Social Enterprise (SSE) also trains and builds capacity among a wide range of stakeholders (caregivers, health workers, educators, government, and communities) to acknowledge and advocate for the wellbeing of disabled children and adults, and works closely with government to strengthen existing service provisions. Using examples from the SSE, we highlight a number of useful principles to consider when trying to provide for the needs of people with disabilities, particularly in low-resource settings. While access to assistive devices is important, devices have limited capacity to improve participation if the broader environment is overly restrictive and stigmatising. Improved access to devices ought to be situated within a range of broader efforts to increase the inclusion and participation of people with disabilities.
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Musyoka-Kamere, Isabella. "Revisiting African Traditional Education to Promote Peace through Education in Africa." Msingi Journal 1, no. 1 (August 2, 2018): 459–97. http://dx.doi.org/10.33886/mj.v1i1.73.
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African traditional values are the principles, standards and qualities, which Africans traditionally held dear for perpetuation of culture and society. They are the values that guided human action towards a common good. There are certain things that Africans found intrinsically valuable, that gave them a distinct cultural personality and enabled them to contribute to knowledge and history. Some of these include the sense of community life, sacredness of life and respect for authority and elders.These values of African traditional education can be revisited to infuse peace and unity in today‘s fragmenting society. Peace here is taken to mean the non-violent, non-exploitative, cohesive, tolerant and united co-existence between people and respect for the social environment. This paper will document the dominant African cultural values and attempt to assess the contribution of these values to the promotion of peace in modern times. This is a library-based research, which involves a desk review ofarticles, documents and internet sources to draw facts and use the information to provide suggestions for promoting peace. It will try to bring out the salient values of African culture and see how these can be adapted to today‘s world to enhance peaceful co-existence and thus lead to change in public consciousness and habits to improve the quality of life. The findings of the study will highlight viable options for African societies to come out of their cultural quagmire and suggest ways of preserving values that lead to national cohesion and development.
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Raheem, Dele. "The Need for Agro-Allied Industries to Promote Food Security by Value Addition to Indigenous African Food Crops." Outlook on Agriculture 40, no. 4 (December 2011): 343–49. http://dx.doi.org/10.5367/oa.2011.0063.
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Food security is a major concern in developing countries and requires urgent attention and collaborative effort from all stakeholders. As the human population continues to increase, the demand for food becomes far greater than the supply can meet. There is a need to cultivate more indigenous food crops and to diversify into new products by using processing and preservation techniques to ensure that more people have access to good quality, nutritious foods. It is therefore essential that agro-allied industries in African countries receive encouragement to improve the application of technology for processing raw food crops, increasing their shelf life, improving nutritional values and packaging, and maintaining high quality standards. This paper emphasizes the potential benefits for three staple African foods – maize, cassava and sorghum. The application of science to transform the properties of these foods and relevant technologies, such as extrusion cooking, can add value to their use in the immediate future and will help in meeting the Millennium Development Goals.
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Abiola, Olajide O., Oluwaseyi J. Adigun, Olushola J. Ajamu, and Oyeronke T. Williams. "Health seeking behaviour in management of erectile dysfunction among men in an urban African population." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 2 (January 23, 2018): 380. http://dx.doi.org/10.18203/2320-1770.ijrcog20180152.
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Background: Erectile dysfunction (ED) is consistent inability to achieve/maintain penile erection sufficiently enough for satisfactory sexual intercourse. It is a major sexual disorder causing significant distress in men with associated poor quality of life. Despite it being a common sexual disorder, many of the affected people do not seek medical care. The study sought to investigate health seeking behaviour in management of ED among urban dwelling African men.Methods: A cross-sectional descriptive survey method was adopted. The study population comprised of men drawn from an urban setting in Nigeria using a multi-stage sampling technique. Three hypotheses were formulated which were cultural beliefs, financial status and medical access/perception on quality of care will not significantly influence health seeking behaviour for management of ED. Researchers’ designed questionnaire validated by three experts drawn from the relevant fields with reliability co-efficient of 0.77 obtained through split half method by Pearson product moment correlation was used for data collection. The three postulated hypotheses were tested using Person product moment correlation.Results: All the three hypotheses were rejected at 0.05 alpha level of significance because their calculated r-values were greater than their critical values.Conclusions: It was concluded that cultural beliefs, financial status and access to medical facilities/perception of quality of care from such medical facilities influence the health seeking behaviour of men in the management of ED.
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Moon, Heehyul, Sunshine Rote, Hallie Decker, Burton Kelsey, Chelsea Burton, Sharon Moore, and Tewsdaay Babicka. "Resilience and Service Needs Among African American Caregivers of People With Dementia: A Pilot Mixed-Methods Study." Innovation in Aging 4, Supplement_1 (December 1, 2020): 353. http://dx.doi.org/10.1093/geroni/igaa057.1136.
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Abstract African American caregivers face unique challenges and strengths in addressing the needs of dementia care recipients. The purpose of the current study was to explore the roles of the familism and faith and service preferences and needs for African American dementia caregivers. Through collaborative partnerships among the research team, Alzheimer’s’ Association, Area Agency on Aging, and local churches, we obtained focus group and survey data (N=30) from African American dementia caregivers. Most caregivers were female (90%) and older than 51 years and had provided care more than 3 years. CGs showed strong cultural reasons (e.g., faith, duty, paying back) for providing care (range 0-40;M= 34.5; SD= 5.2). Focus groups data, which was audio taped, transcribed, and analyzed by three researchers using content analysis, revealed three major themes related to dementia care experiences and needs. First, caregivers explained positive aspects of caregiving for both the individual caregiver and family (growth in faith, sense of self -efficacy, feeling of gratefulness). Second, caregivers also described negative aspects that pose substantial challenges such as lack of services, lack of balance in life, family conflicts over care, and mistrust based on their previous experiences with existing health care systems. Third, caregivers described their knowledge of dementia and shared their self-care and coping strategies and a need for support group services. The findings show an urgent need to implement culturally responsive services, especially in undeserved areas and populations, for caregivers to maintain or improve their emotional well-being and quality of care as well as family relationships.
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SKARE, THELMA L., ADRIANA B. BORTOLUZZO, CÉLIO R. GONÇALVES, JOSÉ ANTONIO BRAGA da SILVA, ANTONIO CARLOS XIMENES, MANOEL B. BÉRTOLO, SANDRA L. E. RIBEIRO, et al. "Ethnic Influence in Clinical and Functional Measures of Brazilian Patients with Spondyloarthritis." Journal of Rheumatology 39, no. 1 (November 1, 2011): 141–47. http://dx.doi.org/10.3899/jrheum.110372.
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Objective.Spondyloarthritides (SpA) can present different disease spectra according to ethnic background. The Brazilian Registry of Spondyloarthritis (RBE) is a nationwide registry that comprises a large databank on clinical, functional, and treatment data on Brazilian patients with SpA. The aim of our study was to analyze the influence of ethnic background in SpA disease patterns in a large series of Brazilian patients.Methods.A common protocol of investigation was prospectively applied to 1318 SpA patients in 29 centers distributed through the main geographical regions in Brazil. The group comprised whites (65%), African Brazilians (31.3%), and people of mixed origins (3.7%). Clinical and demographic variables and various disease index scores were compiled. Ankylosing spondylitis (AS) was the most frequent disease in the group (65.1%); others were psoriatic arthritis (18.3%), undifferentiated SpA (6.8%), enteropathic arthritis (3.7%), and reactive arthritis (3.4%).Results.White patients were significantly associated with psoriasis (p = 0.002), positive HLA-B27 (p = 0.014), and use of corticosteroids (p < 0.0001). Hip involvement (p = 0.02), axial inflammatory pain (p = 0.04), and radiographic sacroiliitis (p = 0.025) were associated with African Brazilian descent. Sex distribution, family history, and presence of peripheral arthritis, uveitis, dactylitis, urethritis, and inflammatory bowel disease were similar in the 3 groups, as well as age at disease onset, time from first symptom until diagnosis, and use of anti-tumor necrosis factor-α agents (p > 0.05). Schober test and thoracic expansion were similar in the 3 groups, whereas African Brazilians had higher Maastricht Ankylosing Spondylitis Enthesitis Scores (p = 0.005) and decreased lateral lumbar flexion (p = 0.003), while whites had a higher occiput-to-wall distance (p = 0.02). African Brazilians reported a worse patient global assessment of disease (p = 0.011). Other index scores and prevalence of work incapacity were similar in the 3 groups, although African Brazilians had worse performance in the Ankylosing Spondylitis Quality of Life questionnaire (p < 0.001).Conclusion.Ethnic background is associated with distinct clinical aspects of SpA in Brazilian patients. African Brazilian patients with SpA have a poorer quality of life and report worse disease compared to whites.
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Guerchet, Maëlenn, Antoine Gbessemehlan, Caroline Adou, Jean-Pierre Clément, Bébène Ndamba-Bandzouzi, Pascal Mbelesso, and Dismand Houinato. "330 - Depression and Anxiety among Older people in Central Africa: Results of the EPIDEMCA population-based study." International Psychogeriatrics 32, S1 (October 2020): 89. http://dx.doi.org/10.1017/s1041610220002306.
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Introduction:Depression and anxiety are two very common psychiatric disorders in late-life. They are markers of poor quality of life and are strongly associated with death among older people. Yet, few studies on these comorbidities have been conducted in the African population. This study aims to present the epidemiology of depression and anxiety among older people in Central Africa.Method:A cross-sectional population-based study was carried out in Republic of Congo (ROC) and Central African Republic (CAR) between 2011 - 2012 among older people aged ? 65 years (EPIDEMCA study). Data were collected using a standardized questionnaire and participants underwent a brief physical examination. Depression and anxiety symptoms were ascertained using a community version of the Geriatric Mental State (GMS-B3) and the Automated Geriatric Examination for Computer Assisted Taxonomy diagnostic system (AGECAT), probable cases were defined as having a GMS-AGECAT level of 3 or more. Logistic regression models were used to investigate the association between potential risk factors collected and each symptom.Results:Overall 2002 participants were included in the EPIDEMCA study (500 in Brazzaville and 529 in Gamboma in ROC, 500 in Bangui and 473 in Nola (473) in CAR). Median age of the participants was 72 years [interquartile range: 68 – 78 years] and females were mostly represented (61.8%). Prevalence was 38.1% (95% Confidence Interval: 35.9% - 40.2%) for depression, 7.7% (95% CI: 6.5% - 8.9%) for anxiety and 5.7% (95% CI: 4.6% - 6.7%) for the co-occurrence of both disorders. For all three outcomes, prevalence was significantly higher among females and in rural areas. Only depression increased with age. Preliminary analyses showed that female sex, living in a rural area, and living without a partner were associated with the three outcomes (Odds Ratios from 1.59 to 3.27; p<0.01). In-depth results regarding correlates of depression, anxiety and the co-occurrence of both will be presented.Conclusion:The prevalence of depression and anxiety was high among Central African older people. Evidence on the epidemiology of these common psychiatric symptoms are of importance for care management and also emphasize the need to maintain and/or strengthen social support around older people in the region.
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McCabe, Rosemarie, and Stefan Priebe. "Explanatory models of illness in schizophrenia: Comparison of four ethnic groups." British Journal of Psychiatry 185, no. 1 (July 2004): 25–30. http://dx.doi.org/10.1192/bjp.185.1.25.
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BackgroundExplanatory models of illness may differ between ethnic groups and influence treatment satisfaction and compliance.AimsTo compare explanatory models among people with schizophrenia from four cultural backgrounds and explore their relationship with clinical and psychological characteristics.MethodExplanatory models, insight, treatment compliance, health locus of control, quality of life, treatment satisfaction, therapeutic relationships and symptomatology were assessed in UK Whites and Bangladeshis, African-Caribbeans and West Africans.ResultsWhen biological and supernatural causes of illness were compared, Whites cited biological causes more frequently than the three non-White groups, who cited supernatural causes more frequently. When biological and social causes were compared, Whites cited biological causes more frequently than African-Caribbeans and Bangladeshis, who cited social causes more frequently. A biological explanatory model was related to enhanced treatment satisfaction and therapeutic relationships but not treatment compliance.ConclusionsExplanatory models of illness contribute to patient satisfaction with treatment and relationships with clinicians.
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Michael, Paul K. "Racism, Vulnerability, and the Youth Struggle in Africa." Dialogue and Universalism 31, no. 1 (2021): 105–18. http://dx.doi.org/10.5840/du20213117.
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Because youths are particularly vulnerable to social problems, philosophers since Plato to date have continued to show interest in developing, empowering, and protecting the youths. African youths are particularly far more than ordinarily vulnerable to various social problems including racism especially from outside the continent, mainly because of the shortfall in youth development and empowerment strategies in most African countries. Consequently, young people are pulled to countries with resources and infrastructures that provide them with opportunities to enlarge their capabilities and improve their quality of life, where they are also faced with discriminatory, prejudicial, and antagonistic treatments simply because of their skin colour. So, one way to look at racism and reduce its effects is to examine those socio-political as well as economic structures that constitute obstacles to youth development and empowerment, and which push and expose the young in Africa to the ill-treatments emanating from racism.
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Murphy, Gwen, Valerie McCormack, Diana Menya, Blandina Mmbaga, Katherine Van Loon, Elia Mmbaga, Satish Gopal, et al. "Development of an African Esophageal Cancer Consortium." Journal of Global Oncology 3, no. 2_suppl (April 2017): 31s. http://dx.doi.org/10.1200/jgo.2017.009712.
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Abstract 44 Background: Esophageal cancer is the sixth leading cause of cancer death worldwide. It kills 400,000 people every year, most of whom live in two distinct geographic bands across central Asia and along the eastern Africa corridor that extends from Ethiopia to South Africa. In these high-risk areas, nearly all cases are esophageal squamous cell carcinoma (ESCC). Our group and others have performed many etiologic, genetic, and early detection and treatment studies of ESCC in central Asia, but this disease remains essentially unstudied in eastern Africa. Over the past few years, several groups have begun quality studies of ESCC in Africa, including case-control studies in Dar es Salaam, Tanzania (University of California, San Francisco, and Muhimbili University of Health and Allied Sciences); Eldoret, Kenya (International Agency for Research on Cancer and Moi University); Moshi, Tanzania (International Agency for Research on Cancer and Kilimanjaro Clinical Research Institute); Bomet, Kenya (National Cancer Institute and Tenwek Hospital); and Lilongwe, Malawi (National Cancer Institute and the UNC-Malawi Project). In November 2015, these groups met and decided to create the African Esophageal Cancer Consortium. The goals of the consortium are to raise awareness of the importance of ESCC in Africa, to coordinate etiologic and molecular studies of ESCC in high-risk populations, and to facilitate provision of therapeutic training and equipment aimed to improve survival and quality of life. Methods: The first coordinated activity was to standardize questionnaires so that data can later be compared and combined. The consortium has embraced mobile health technologies through development of an mHealth app for real-time data capture on a phone or tablet and to collect harmonized data from the outset, increase efficiency, eliminate transcription mistakes, and allow real-time quality control and supervision of field activities from any location. Results: The consortium held its second annual meeting in September 2016. At this meeting, the five member sites affirmed their commitment to the consortium and the first study coordinator was named. Conclusion: Case-control studies in Moshi, Bomet, and Lilongwe are using the mobile app. A case-control study in Dar es Salaam is complete, with results pending. Coordinated genome-wide association and genomic studies are planned, with collection of biospecimens from multiple sites. The consortium is actively working with partners in China to provide affordable stents in Africa for palliative ESCC treatment as well as to secure training to safely and effectively place stents. Annual meetings will continue to follow-up on progress and develop new initiatives. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.
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Rosenfeld, Dana, and Jane Anderson. "‘The own’ and ‘the wise’ as social support for older people living with HIV in the United Kingdom." Ageing and Society 40, no. 1 (August 2, 2018): 188–204. http://dx.doi.org/10.1017/s0144686x18000909.
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AbstractAs the HIV population ages, how the ageing and HIV experiences intersect to shape the lives of older people living with HIV (PLWH) becomes an increasingly pressing question. This multi-method study investigated social support, mental health and quality of life among 100 older PLWH in the United Kingdom. Drawing on data from three focus groups and 74 life-history interviews with older (aged 50+) White men who have sex with men (MSM), and Black African and White heterosexual men and women, living with HIV, we explore participants’ distinctions between, evaluations of and access to sources of social support. Participants distinguished between support from the HIV-negative (Goffman's ‘the own’) and experientially based support from other PLWH (Goffman's ‘the wise’), and viewed the former, while valuable, as needing to be supplemented by the latter. Furthermore, access to experientially based support varied across participant groups, whose communities had different histories with HIV/AIDS and thus different degrees of knowledge about HIV and avenues for connecting to other PLWH. Thus, social support among older PLWH cannot be neatly divided into ‘formal’ and ‘informal’ domains, or fully appreciated by applying traditional social support measures, including, in the context of health conditions, ‘peer support’ created through formal service organisations. Rather, older PLWH's own distinctions and evaluations better illuminate the complexities of social support in the context of ageing with HIV.
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Amalu, Uche C. "Food Security: Sustainable Food Production in Sub-Saharan Africa." Outlook on Agriculture 31, no. 3 (September 2002): 177–85. http://dx.doi.org/10.5367/000000002101294029.
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Falling world grain stocks, rising grain prices and the poor economic situation of Africa have, since 1995, made food security a major issue. Structural adjustment programmes, the crushing burden of debt, the collapse of commodity prices and mismanagement of national economies have rendered African people even poorer in terms of per capita income and quality of life than they were in the first decade after the attainment of independence. Yet Africa is rich in many ways — for example, in virgin land for agriculture and in mineral resources, including energy. It is rich above all in its people and their determined spirit to face all disasters, natural and man-made. In line with this spirit, Africa is moving ahead on a new consensus that food security through enhanced agricultural production is the continent's most fundamental development issue. Although the economic plans of successive African governments have stressed the goal of food self-sufficiency, the food sector has received little investment or political priority. Africa continues to rely on food aid and food imports, which consume a large part of its meagre export earnings. The increasingly limited capacity to purchase food abroad and the bitter experience of depending on emergency aid are honing a clear determination that Africa must marshal the resources to grow its own food and so release the creative energies of its people to contribute fully to their own development and well-being. Top priority should be given to food security during this process, as no country can consider itself free until it has the wherewithal to provide for the basic needs of its people.
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Marume, Martin, Susan De Klerk, and Lee-Ann Jacobs-Nzuzi Khuabi. "Rehabilitation following flexor tendon injury to the hand in African countries: a study protocol for a scoping review." BMJ Open 11, no. 4 (April 2021): e045260. http://dx.doi.org/10.1136/bmjopen-2020-045260.
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Quality of life is enhanced by engagement in meaningful activities and participation using our hands. In African countries, people rely predominantly on the use of their hands to engage in economic productive activities, including agricultural, fishing, mining and construction, that are largely performed by machines in high-income contexts. Anecdotal evidence suggests a high incidence of flexor tendon injuries that are managed using protocols that were adopted from high-income countries and implemented without considering contextual differences. African therapists use discretion in selecting protocols thereby presenting inconsistency in tendon management. This result in challenges with ascertaining the most effective protocol, factors that influence protocols and the extent of evidence about flexor tendon rehabilitation in Africa. Therefore, this scoping review aims to provide evidence currently available on the rehabilitation of flexor tendons in African countries. This will synthesise the advantages and disadvantages of the current protocols and make proposals that are contextually relevant and cost-effective for rehabilitation of tendon injuries.Methods and analysisThe research will follow the scoping review methodological framework developed by Arksey and O’Malley (2005). The search strategy was developed and will be used to retrieve articles from eight databases. Further literature will be searched in the bibliography of the identified eligible articles. Grey literature will be searched in scientifically reliable websites, organisations and other sources. Articles will be reviewed by two independent researchers and opinion will be sought from a third reviewer when disagreement prevails on the inclusion quality of an article. All relevant articles that meet the criteria will be analysed using Weft QDA.Ethics and disseminationThe scoping review paper will be discussed with local therapists. Thereafter, findings will be published in the year 2021 and sent to rehabilitation associations in respective African countries.
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Wadley, Antonia L., Duncan Mitchell, and Peter R. Kamerman. "Resilience does not explain the dissociation between chronic pain and physical activity in South Africans living with HIV." PeerJ 4 (September 13, 2016): e2464. http://dx.doi.org/10.7717/peerj.2464.
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Pain burden is high in people living with HIV (PLWH), but the effect of this pain on functionality is equivocal. Resilience, the ability to cope with adversity, may promote adaptation to pain, so we hypothesised that higher resilience would correlate with less pain-related impairment of activity. We recruited 197 black South African PLWH, 99 with chronic pain (CP) and 98 patients without. We measured pain intensity and interference using the Brief Pain Inventory, and resilience using the Resilience Scale. Participants were generally highly resilient. Greater resilience correlated with better health-related quality of life, but not with pain intensity or interference. We also measured physical activity objectively, by actigraphy, in a subset of patients (37 with chronic pain and 31 without chronic pain), who wore accelerometers for two weeks. There was no difference in duration or intensity of activity between those with and without pain, and activity was not associated with resilience. In this sample, pain was not associated with altered physical activity. Resilience did not explain differences in pain intensity or pain interference but was associated with improved quality of life. Financial stresses and the fear of HIV stigma may have driven patients to conceal pain and to suppress its expected impairment of activity.
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Wadley, Antonia L., Stella Iacovides, Johanna Roche, Karine Scheuermaier, W. D. Francois Venter, Alinda G. Vos, and Samanta T. Lalla-Edward. "Working nights and lower leisure-time physical activity associate with chronic pain in Southern African long-distance truck drivers: A cross-sectional study." PLOS ONE 15, no. 12 (December 3, 2020): e0243366. http://dx.doi.org/10.1371/journal.pone.0243366.
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Background In South Africa, the trucking industry employs over 70,000 people and the prevalence of chronic pain in this occupational group was reported at 10%. We investigated factors associated with chronic pain in truck drivers including mental health, physical activity, and sleep, as no study has done so. Methods Southern African male, long-distance truck drivers were recruited at truck stops in Gauteng and Free State Provinces, South Africa (n = 614). Chronic pain was defined as pain present for at least the last three months. Depressive symptoms were assessed with the Patient Health Questionnaire-9, post-traumatic stress disorder with the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), exposure to traumatic events with the Life Events Checklist-5 (LEC-5) and daytime sleepiness with the Epworth Sleepiness Scale. Sleep quality was measured on a four-point Likert scale. Leisure-time physical activity was measured using the Godin-Shephard leisure-time physical activity questionnaire. Associations between these factors, demographic factors and chronic pain were investigated. Results Multivariate analysis showed that working ≥ 2 nights/week (OR = 2.68, 95% CI = 1.55–4.68) was associated with chronic pain and physical activity was protective (OR = 0.97, 95% CI 0.95–0.98). In an exploratory analysis, greater depressive symptoms (p = 0.004), daytime sleepiness (p = 0.01) and worse sleep quality (p = 0.001) was associated with working ≥ 2 nights/week. Lower leisure-time physical activity was associated with worse sleep quality (p = 0.006), but not daytime sleepiness or depressive symptoms (p>0.05). Conclusions There is a clear relationship between working nights and activity levels, and chronic pain, sleep quality, and depression in truck drivers.
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Isobell, Deborah, Sandy Lazarus, Shahnaaz Suffla, and Mohamed Seedat. "Research translation through participatory research: The case of two community-based projects in low-income African settings." Action Research 14, no. 4 (July 24, 2016): 393–411. http://dx.doi.org/10.1177/1476750315626779.
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In the context of a call for public health research to address social challenges and transform communities and society, research translation has increasingly become an imperative in South Africa. Research translation seeks to improve real-world settings and enhance quality of life by applying research-generated knowledge. These goals are shared by proponents of participatory action research (PAR). However, the way in which research is pursued constitutes a major focus for PAR, where the paradigmatic position influences how we relate to knowledge and people, and whether and how we achieve the goals concerned. This article contrasts the meta-theoretical positioning of PAR with that of research translation as it is pursued within public health circles, and then argues how PAR both challenge and optimise the espoused goals of research translation through its accent on co-learning, knowledge co-construction, social action and the dialectic between research and action. We offer two African-centred examples of community-engaged research focusing on violence prevention, and safety and peace promotion to illustrate how the participatory mechanisms of empowerment and agency, knowledge co-construction and knowledge sharing foster research translation. Attention to power dynamics, exemplified through researcher reflexivity is emphasised as a key challenge for researchers wishing to address public health challenges.
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Wang, Chao, Run Pu, Bishwajit Ghose, and Shangfeng Tang. "Chronic Musculoskeletal Pain, Self-Reported Health and Quality of Life among Older Populations in South Africa and Uganda." International Journal of Environmental Research and Public Health 15, no. 12 (December 10, 2018): 2806. http://dx.doi.org/10.3390/ijerph15122806.
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Chronic musculoskeletal pain (CMP) is a serious health concern especially among the elderly population and has significant bearing on health and quality of life. Not much is known about the relationship between chronic pain with self-reported health and quality of life among older populations in low-resource settings. Based on sub-national data from South Africa and Uganda, the present study aimed to explore whether the older population living with CMP report health and quality of life differently compared to those with no CMP complaints. This study was based on cross-sectional data on 1495 South African and Ugandan men and women collected from the SAGE Well-Being of Older People Study. Outcome variables were self-reported physical and mental health and quality of life (QoL). Mental health was assessed by self-reported depressive symptoms during the last 12 months. CMP was assessed by self-reported generalised pain as well as back pain. Multivariable logistic regression models were used to measure the association between health and QoL with CMP by adjusting for potential demographic and environmental confounders. The prevalence of poor self-rated health (61.2%, 95% CI = 51.7, 70.0), depression (37.2%, 95% CI = 34.8, 39.6) and QoL (80.5%, 95% CI = 70.8, 87.5) was considerably high in the study population. Mild/moderate and Severe/extreme generalised pain were reported respectively by 34.5% (95% CI = 28.9, 40.5) and 15.7% (95% CI = 12.2, 19.9) of the respondents, while back pain was reported by 53.3% (95% CI = 45.8, 60.4). The prevalence of both types was significantly higher among women than in men (p < 0.001). In the multivariate analysis, both generalised pain and back pain significantly predicted poor health, depression and QoL, however, it varied between the two different populations. Back pain was associated with higher odds of poor self-rated health [OR = 1.813, 95% CI = 1.308, 2.512], depression [1.640, 95% CI = 1.425, 3.964] and poor QoL [1.505, 95% CI = 1.028, 2.202] in South Africa, but not in Uganda. Compared to having no generalised pain, having Mild/Moderate [OR = 2.309, 95% CI = 1.219, 7.438] and Severe/Extreme [OR = 2.271, 95% CI = 1.447, 4.143] generalised pain was associated with significantly higher odds of poor self-rated health in South Africa. An overwhelmingly high proportion of the sample population reported poor health, quality of life and depression. Among older individuals, health interventions that address CMP may help promote subjective health and quality and life and improve psychological health.
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Bekele, Tsegaye, Evan J. Collins, Robert G. Maunder, Sandra Gardner, Sergio Rueda, Jason Globerman, Thao Lan Le, et al. "Childhood Adversities and Physical and Mental Health Outcomes in Adults Living with HIV: Findings from the Ontario HIV Treatment Network Cohort Study." AIDS Research and Treatment 2018 (2018): 1–17. http://dx.doi.org/10.1155/2018/2187232.
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We sought to estimate the prevalence of childhood adversity and examine its relationship with health outcomes among people living with HIV. Study participants included 1409 adults living with HIV and receiving care in Toronto, Canada. Data on childhood adversity, health behaviors, HIV outcome measures, depression, and health-related quality of life (HRQOL) were collected through face-to-face interviews and medical records. Statistical analyses included multivariable linear and logistic regression modeling. The prevalence of any childhood adversity was 71% (individual types ranged from 11% to 44%) and higher prevalence was associated with younger age, Indigenous or African/Caribbean/Black ethnicity, lower socioeconomic status, and higher rates of cigarette smoking and nonmedicinal drug use. Greater number of childhood adversities was associated with greater odds of depression and decreasing mental HRQOL. HIV care providers need to screen for childhood adversities and address childhood trauma within the context of HIV care.
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Bopape, Mamare A., Tebogo M. Mothiba, and Hilde Bastiaens. "What Are the Experiences and Training Needs of Home-Based Carers in Dealing With Diabetes in a Rural Village in South Africa? An Explorative Study." Global Journal of Health Science 11, no. 3 (February 21, 2019): 52. http://dx.doi.org/10.5539/gjhs.v11n3p52.
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Type 2 Diabetes Mellitus is a difficult chronic condition associated with morbidity, mortality and loss of quality of life. In Sub-Saharan African countries, HBC (Home-Based Carers) play an important role in the care of people diagnosed with chronic illnesses like diabetes. However, home-based carers seem to lack knowledge to care of people with diabetes because they have not been not formally trained. The aim of this study is to explore and describe the practices, knowledge and learning needs of Home-Based Carers (HBCs) of people with diabetes. A qualitative explorative approach was taken, holding interviews with 15 HBCs at the 4 clinics in the Ga-Dikgale village. The purposive sampling method was used to select participants for this study. Four themes are described: activities performed by HBCs during the care of diabetes patients, existing structures and sources of information for HBCs on the management of diabetic patients, challenges experienced by HBCs during the provision of care to diabetes patients and the learning needs of HBCs, based on how they want their training to be organised. HBCs execute various activities during the care of PWD (patients with diabetes) including providing nutritional advice, medication support, helping with household chores, accompanying patients to healthcare services and dressing their wounds. However, they lack knowledge of issues related to the care of PWD, which makes their role very difficult and challenging.
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Atakere, Darlingtina. "DETERMINANTS OF GENERAL WELL-BEING IN BLACK MALES WITH CHRONIC ILLNESS." Innovation in Aging 3, Supplement_1 (November 2019): S394. http://dx.doi.org/10.1093/geroni/igz038.1451.
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Abstract Over the last decades, considerable attention has been directed towards examining the well-being of people living with chronic illness. The presence of one or more chronic illnesses challenges their quality of life and general well-being, thus, impacting their abilities to function physically, psychologically, and socially. I investigated reports of general well-being in Black males with chronic illness(es) in a sample of N=242 participants. The males were aged 35–63 and identified as Black/African American males. The participants responded to items assessing general well-being; ethnic identity; self-esteem; active coping; the presence of chronic illness(es); and additional demographic, social and ecological characteristics. Analyses of responses indicated that marital status, ethnic identity, self-esteem are significant determinants of general well-being in Black males with chronic illness(es). Data further showed active coping to be negatively correlated with well-being. I discuss the implications of results for the understanding of health outcomes among this marginalized population.
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De Boni, Liesl, Veerle Msimang, Alex De Voux, and John Frean. "Trends in the prevalence of microscopically-confirmed schistosomiasis in the South African public health sector, 2011–2018." PLOS Neglected Tropical Diseases 15, no. 9 (September 16, 2021): e0009669. http://dx.doi.org/10.1371/journal.pntd.0009669.
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Background Schistosomiasis, also known as bilharzia, is a chronic parasitic blood fluke infection acquired through contact with contaminated surface water. The illness may be mild or can cause significant morbidity with potentially serious complications. Children and those living in rural areas with limited access to piped water and services for healthcare are the most commonly infected. To address the prevalence of the disease in parts of South Africa (SA) effective national control measures are planned, but have not yet been implemented. This study aimed to estimate the prevalence and trends of public sector laboratory-confirmed schistosomiasis cases in SA over an eight-year (2011–2018) period, to inform future control measures. Methodology & principal findings This is a descriptive analysis of secondary data from the National Health Laboratory Service (NHLS). The study included all records of patients for whom microscopic examination detected Schistosoma species eggs in urine or stool specimens from January 2011 to December 2018. Crude estimates of the prevalence were calculated using national census mid-year provincial population estimates as denominators, and simple linear regression was used to analyse prevalence trends. A test rate ratio was developed to describe variations in testing volumes among different groups and to adjust prevalence estimates for testing variations. A total number of 135 627 schistosomiasis cases was analysed with the highest prevalence observed among males and individuals aged 5–19 years. We describe ongoing endemicity in the Eastern Cape Province, and indicate important differences in the testing between population groups. Conclusion While there was no overall change in the prevalence of schistosomiasis during the analysis period, an average of 36 people per 100 000 was infected annually. As such, this represents an opportunity to control the disease and improve quality of life of affected people. Laboratory-based surveillance is a useful method for reporting occurrence and evaluating future intervention programs where resources to implement active surveillance are limited.
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Horsten, D. "The Role Played by the South African Human Rights Commission's Economic and Social Rights Reports in Good Governance in South Africa." Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad 9, no. 2 (July 10, 2017): 176. http://dx.doi.org/10.17159/1727-3781/2006/v9i2a2821.
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The preamble of the Constitution of South Africa, 1996 (the Constitution) contains the commitment to, amongst other things, establish a society based on democratic values, social justice and fundamental human rights, lay the foundations for a democratic and open society in which government is based on the will of the people and every citizen is equally protected by law and improve the quality of life of all citizens and free the potential of each person. One of the methods used to achieve these objectives is the inclusion of enforceable socio-economic rights in the Chapter 2 Bill of Rights. Despite numerous debates surrounding the issue of enforceability of socioeconomic rights, it has become evident that these rights are indeed enforceable. Not only does section 7(2) of the Constitution place the state under an obligation to respect, protect, promote and fulfil all rights in the Bill of Rights, including socio-economic rights, but the Constitutional Court has in various decisions passed judgment on issues relating to socio-economic rights, underpinning the fact that these rights are indeed enforceable. The fact that socio-economic rights have been included in the Bill of Rights and are enforceable is, however, not sufficient to achieve the aims set out in the preamble. In order for these rights to be of any value to the people they seek to protect, they need to be implemented. One of the ways in which the implementation of these rights is monitored is by means of the South African Human Rights Commission's annual Economic and Social Rights Reports. The aim of this contribution is to assess these reports and to establish the degree to which they contribute to good governance in South Africa with reference to, inter alia, the constitutional mandate of the South African Human Rights Commission, the reporting procedure and the evaluation of reports.
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Gomez, A., J. Lindblom, V. Qiu, A. Cederlund, A. Borg, S. Emamikia, Y. Enman, J. Lampa, and I. Parodis. "POS0101 ADVERSE HEALTH-RELATED QUALITY OF LIFE OUTCOME DESPITE ADEQUATE CLINICAL RESPONSE TO TREATMENT IN SYSTEMIC LUPUS ERYTHEMATOSUS." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 260.2–261. http://dx.doi.org/10.1136/annrheumdis-2021-eular.1472.
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Background:Despite improvements in medical care that have contributed to prolonged life expectancy for people living with systemic lupus erythematosus (SLE) over the past decades, they still suffer from substantial diminutions of health-related quality of life (HRQoL) compared with the general population and with other chronic diseases.Some studies have demonstrated that conventional synthetic and biological disease-modifying agents contribute to improvements in SLE patients’ HRQoL, and responders to treatment have been shown to report greater improvements than non-responders. Although these observations are clinically relevant, improvement following a therapeutic intervention does not necessarily signify that the individual has achieved a satisfactory health state perception. In rheumatoid arthritis, significant pain and severe fatigue persist in a substantial proportion of patients who achieve a good clinical response to treatment or remission. This paradoxical observation has not been thoroughly explored in SLE.Objectives:To determine the prevalence of adverse HRQoL outcomes in patients with SLE who achieved an adequate clinical response after a 52-week long period on standard therapy plus belimumab or placebo, within the frame of two phase III clinical trials. We further aimed to compare frequencies of adverse HRQoL outcomes across different age categories and ethnic groups, and sought to identify contributing factors.Methods:We included patients who met the primary endpoint of the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials (N=760/1684), i.e. attainment of the SLE Responder Index 4 at week 52. Accordingly, evaluation of adverse HRQoL outcomes was based on patient reports at week 52 from treatment initiation, using the Medical Outcomes Study Short Form 36 (SF-36) health survey and the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-Fatigue) scale. Adverse HRQoL outcomes were defined as (i) SF-36 scale scores ≤ the 5th percentile derived from age- and sex-matched US population-based norms from the SF-36 health survey user manual; and (ii) FACIT-Fatigue scores <30.Pearson’s chi-square or Fisher’s exact tests were used to investigate associations between dichotomous variables. Comparisons of continuous data between SLE patients and age- and sex-matched norms were performed using the Wilcoxon signed-rank test. Multivariable logistic regression models were created in order to assess independence and priority of potential factors associated with adverse HRQoL outcomes.Results:We found clinically important diminutions of HRQoL in SLE patients compared with matched norms and high frequencies of adverse HRQoL outcomes, the highest in SF-36 general health (29.1%), followed by FACIT-Fatigue (25.8%) and SF-36 physical functioning (25.4%). Overall, frequencies were higher with increasing age. Black/African American and White/Caucasian patients reported higher frequencies than Asians and Indigenous Americans, while Hispanics experienced adverse HRQoL less frequently than non-Hispanics. Increasing organ damage was associated with adverse physical but not mental HRQoL outcomes; disease activity showed no impact. In multivariable logistic regression analysis, addition of belimumab to standard therapy was associated with lower frequencies of adverse SF-36 physical functioning (OR: 0.59; 95% CI: 0.39–0.91; P=0.016) and FACIT-F (OR: 0.53; 95% CI: 0.34–0.81; P=0.004).Conclusion:Substantial proportions of SLE patients reported adverse HRQoL outcomes despite adequate clinical response to treatment, especially in physical aspects. Particularly high proportions were seen within Black/African American and White/Caucasian patients. Add-on belimumab may be protective against adverse physical functioning and severe fatigue. Our results corroborate that HRQoL diminutions constitute a substantial burden in patients with SLE, and highlight the limitations of current therapeutic strategies.Acknowledgements:The authors would like to thank GlaxoSmithKline (Uxbridge, UK) for sharing the data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials with the Clinical Study Data Request (CSDR) consortium, Dimitris Ladakis, Joaquin Matilla and Martin Pehr for contributing to the management of data, as well as all participating patients.Disclosure of Interests:Alvaro Gomez: None declared, Julius Lindblom: None declared, Victor Qiu: None declared, Arvid Cederlund: None declared, Alexander Borg: None declared, Sharzad Emamikia: None declared, Yvonne Enman: None declared, Jon Lampa: None declared, Ioannis Parodis Grant/research support from: Research funding and/or honoraria from Amgen, Elli Lilly and Company, Gilead Sciences, GlaxoSmithKline and Novartis.
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Demissie, Mekdes, Charlotte Hanlon, Rahel Birhane, Lauren Ng, Girmay Medhin, and Abebaw Fekadu. "Psychological interventions for bipolar disorder in low- and middle-income countries: systematic review." BJPsych Open 4, no. 5 (August 30, 2018): 375–84. http://dx.doi.org/10.1192/bjo.2018.46.
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BackgroundAdjunctive psychological interventions for bipolar disorder have demonstrated better efficacy in preventing or delaying relapse and improving outcomes compared with pharmacotherapy alone.AimsTo evaluate the efficacy of psychological interventions for bipolar disorder in low- and middle-income countries.MethodA systematic review was conducted using PubMed, PsycINFO, Medline, EMBASE, Cochrane database for systematic review, Cochrane central register of controlled trials, Latin America and Caribbean Center on Health Science Literature and African Journals Online databases with no restriction of language or year of publication. Methodological heterogeneity of studies precluded meta-analysis.ResultsA total of 18 adjunctive studies were identified: psychoeducation (n = 14), family intervention (n = 1), group cognitive–behavioural therapy (CBT) (n = 2) and group mindfulness-based cognitive therapy (MBCT) (n = 1). In total, 16 of the 18 studies were from upper-middle-income countries and none from low-income countries. All used mental health specialists or experienced therapists to deliver the intervention. Most of the studies have moderately high risk of bias. Psychoeducation improved treatment adherence, knowledge of and attitudes towards bipolar disorder and quality of life, and led to decreased relapse rates and hospital admissions. Family psychoeducation prevented relapse, decreased hospital admissions and improved medication adherence. CBT reduced both depressive and manic symptoms. MBCT reduced emotional dysregulation.ConclusionsAdjunctive psychological interventions alongside pharmacotherapy appear to improve the clinical outcome and quality of life of people with bipolar disorder in middle-income countries. Further studies are required to investigate contextual adaptation and the role of non-specialists in the provision of psychological interventions to ensure scalability and the efficacy of these interventions in low-income country settings.Declaration of interestNone.
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Attfield, Robin. "Africa and Climate Change." Utafiti 14, no. 2 (March 4, 2020): 281–94. http://dx.doi.org/10.1163/26836408-14010016.
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Abstract Africa is affected by climate change in multiple ways. Like other continents, its coastline is in danger of being flooded, and its islands are in danger of being inundated. Many people are forced by climate change to migrate, and this increases the flows of refugees moving both north towards the Mediterranean and south towards the Cape, seeking a viable homeland. It is in the interest of African countries to develop in ways that are climate-friendly. More electricity needs to be generated to enhance people’s quality of life, but this should be generated in environmentally friendly ways. Large schemes of tree-planting are also needed, to restore the forests of areas where they have been lost in civil conflicts (as in central and northern Ethiopia) and at the same time to sequestrate some of the carbon dioxide of the atmosphere. As well as mitigation, collaborative efforts are needed in the field of adaptation, so as to limit the impacts of climate change. Developing countries should assist such measures, but they should be adopted whether or not such assistance materialises.
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Mokhele, Khotso. "Using Astronomy to shape a country's science and technology landscape." Proceedings of the International Astronomical Union 10, H16 (August 2012): 539. http://dx.doi.org/10.1017/s1743921314011983.
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AbstractThere is data abundant to show a positive correlation between a nation's investment in science, engineering and technology and the economic prosperity of that nation. Yet, there remain many countries in the world, particularly in developing countries, where little, if any, serious investment in science, engineering and technology is evident. Even in these countries, policy documents speak positively about the positive correlation between investment in science, engineering and technology and national development and prosperity. Unfortunately these positive policy statements rarely get converted into real investment. When the National Research Foundation was founded in Post-Apartheid South Africa it set out to “. . .contribute to the improvement of the quality of life of all people. . .” and its inspiring vision was to achieve “A prosperous South Africa and African continent steeped in a knowledge culture, free of widespread diseases and poverty, and proud contributors to the well-being of humanity." This organisation, with its altruistic vision, succeeded in convincing the emerging government to invest in and support the construction of the Southern African Large Telescope as one of its flagship projects. This decision was subsequently followed by a high level national decision to leverage South Africa's geographical advantage to host major global astronomy facilities such as the Square Kilometer Array. This presentation highlighted the reasons for such decisions and how we went about motivating government organs that investing in astronomy would contribute to addressing societal challenges by stimulating the science and technology landscape.
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Da Silva, Ariana Kelly Leandra Silva, Lorena Madrigal, and Hilton Pereira Da Silva. "Relationships among genomic ancestry, clinical manifestations, socioeconomic status, and skin color of people with sickle cell disease in the State of Pará, Amazonia, Brazil." Antropologia Portuguesa, no. 37 (December 11, 2020): 159–76. http://dx.doi.org/10.14195/2182-7982_37_7.
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In Brazil about 3500 children are born annually with Sickle Cell Disease (SCD). In the State of Pará, Amazonia, the prevalence is 1%. This article analyzes the Genomic Ancestry (GA) of patients attending the Regional Blood Center in the capital, Belém, in relation to sex, age, clinical manifestations, income, racism, and skin color. Samples were collected from 60 patients (11− 46 years, 34 of them female), and each individual was analyzed for 61 Ancestry Informative Markers (AIM). Semi-structured interviews were conducted to assess socioeconomic status (SES), self-declared color, perception of racism, and symptoms of SCD. From the 55 participants with conclusive DNA samples, 58.2% presented European, 21.8% Amerindian and 20% African DNA. From all the 60 participants, 86.6% self-classified as black or brown, 61.92% were living in poverty and 72% suffered some form of racism due to SCD and/or their skin color. There was an inverse correlation between wage and number of symptoms in all groups. European ancestry and being female was correlated with a greater number of symptoms. In Pará, SCD involves vulnerabilities such as poverty, severe clinical manifestations without treatment, and effects of racism. These results can be useful to develop public policies and to improve quality of life of people with SCD in Brazil and in other countries with heterogeneous populations.
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Dzinamarira, Tafadzwa, Gashema Pierre, Itai Chitungo, Michael Habtu, and Rosemary Okova. "A Scoping Review on Nutrition Challenges Among People Living With HIV/AIDS in Sub-Saharan Africa." Global Journal of Health Science 11, no. 12 (October 9, 2019): 109. http://dx.doi.org/10.5539/gjhs.v11n12p109.
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The connection between under-nutrition and HIV is bidirectional. It affects the quality of life, as well as the survival of affected people. While this is the case, there are various nutritional challenges, which are faced by people living with HIV/AIDS (PLWH), and which hamper the fight against the scourge. This study therefore sought to map literature on the nutritional challenges among PLWH in sub-Saharan Africa and guide future research in nutritional management to improve health outcomes for PLWH. A systematic search was done from the following sources: PubMed, the Cochrane Database of Systematic Reviews, EBSCOhost (CINAHL and Academic Search Complete), Web of Science, and Google Scholar. In addition, information was obtained both from unpublished studies, which included book chapters, reference lists, theses and conference papers. Eleven (11) studies met the inclusion criteria, and were used for data extraction. The studies were based in different countries, which form part of the Sub Saharan Africa. One of the studies was carried out in Senegal, two studies were carried out in various West African countries, one study was carried out in Burkina Faso; one study was carried out in Ethiopia and one of the studies was carried out in different countries forming part of the Sub Saharan Africa. Two of the studies were carried out in Zambia, one in Zimbabwe, one in Cameroon, and one in Ghana. Most of the studies established the main nutrition challenge facing PLWH to be food insecurity. Based on the findings of the study, it can be concluded that some of the main nutrition challenges include food insecurity, lack of nutritional support among PLWH, late detection of HIV, huge cost of treating severe acute malnutrition, and lack of feeding supplementations.
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Mazonson, Peter, Theoren Loo, Jeff Berko, Oluwatoyin Adeyemi, Alan Oglesby, Frank Spinelli, and Andrew Zolopa. "943. Older Gay Black Men Living with HIV Report Higher Quality of Life than Older Gay White Men, Despite Facing Additional Burdens." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S504. http://dx.doi.org/10.1093/ofid/ofaa439.1129.
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Abstract Background Improving quality of life (QoL) is an important goal of care for people living with HIV (PLWH). This analysis uses data from the Aging with Dignity, Health, Optimism and Community (ADHOC) online registry to identify the different challenges faced by older white/Caucasian (“white”) and black/African American (“black”) gay or bisexual men living with HIV, and to assess differences in total QoL between the two groups. Methods QoL was measured using the PozQoL, a validated instrument for PLWH. The PozQoL assesses QoL across four domains: health concerns, psychological, social, and functional wellbeing. Total QoL was determined by combining domain scores for a total score. Student’s t-tests and chi-squared tests were used to identify disparities between black and white men. Factors with p< 0.05 were used as control variables in a multivariable linear regression model where PozQoL total score was the dependent variable. Results In the ADHOC database, 91% (n=612) of respondents were white men (WM) and 9% (n=59) were black men (BM). Both BM and WM had a median age of 59 years, and had a similar number of comorbidities (7.9 vs 9.2 respectively, p=0.12). Compared to WM, BM were more likely to be single (74% vs 51%, p< 0.001), less likely to have an income greater than $50,000 (25% vs 56%, p< 0.001), less likely to have a college degree or more (42% vs 69%, p=0.034), and less likely to be virally suppressed (87% vs 96%, p=0.001). Even after controlling for these differences in the multivariable model, BM had significantly higher total QoL than WM (Table 1). Conclusion In this analysis, there were substantial differences between older BM and WM living with HIV. After controlling for sociodemographic and clinical challenges, BM still reported higher QoL than WM. Programs designed to improve QoL for older gay and bisexual BM and WM living with HIV should take into consideration the unique strengths and challenges faced by each group. Disclosures Peter Mazonson, MD, MBA, ViiV Healthcare (Grant/Research Support) Theoren Loo, MS, BS, ViiV Healthcare (Grant/Research Support) Jeff Berko, MPH, BS, ViiV Healthcare (Grant/Research Support) Oluwatoyin Adeyemi, MD, ViiV Healthcare (Grant/Research Support) Alan Oglesby, MPH, ViiV Healthcare (Employee) Frank Spinelli, MD, ViiV Healthcare (Employee) Andrew Zolopa, MD, ViiV Healthcare (Employee)
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Viáfara-López, Carlos Augusto, Glenda Palacios-Quejada, and Alexander Banguera-Obregón. "Ethnic-racial inequity in health insurance in Colombia: a cross-sectional study." Revista Panamericana de Salud Pública 45 (July 1, 2021): 1. http://dx.doi.org/10.26633/rpsp.2021.77.
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Objective. Characterize the relationship between ethnic-racial inequity and type of health insurance in Colombia. Methods. Cross-sectional study based on data from the 2019 Quality of Life Survey. We analyzed the type of health insurance (contributory, subsidized, or none) and its relationship to ethnic-racial status and predisposing variables (sex, age, marital status), demographic variables (area and region of residence), and socioeconomic variables (education, type of employment, income, and unmet basic needs) through simple and multivariate regression analyses. The association between ethnic-racial status and type of health insurance was estimated using odds ratios (OR) and their 95% confidence intervals, through a multinomial logistic model. Results. A statistically significant association was found between ethnic-racial status and type of health insurance. In comparison with the contributory system, the probabilities of being a member of the subsidized system were 1.8 and 1.4 times greater in the indigenous population (OR x 1.891; 95%CI: 1.600-2.236) and people of African descent (OR = 1.415; 95%CI: 1.236-1.620), respectively (p <0.01) than in the population group that did not identify as belonging to one of those ethnic-racial groups. Conclusions. There is an association between ethnic-racial status and type of insurance in the contributory and subsidized health systems in Colombia. Ethnic-racial status is a structural component of inequity in access to health services and heightens the disadvantages of people and population groups with low socioeconomic status.
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Short, Erica E., Cyril Caminade, and Bolaji N. Thomas. "Climate Change Contribution to the Emergence or Re-Emergence of Parasitic Diseases." Infectious Diseases: Research and Treatment 10 (January 1, 2017): 117863361773229. http://dx.doi.org/10.1177/1178633617732296.
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The connection between our environment and parasitic diseases may not always be straightforward, but it exists nonetheless. This article highlights how climate as a component of our environment, or more specifically climate change, has the capability to drive parasitic disease incidence and prevalence worldwide. There are both direct and indirect implications of climate change on the scope and distribution of parasitic organisms and their associated vectors and host species. We aim to encompass a large body of literature to demonstrate how a changing climate will perpetuate, or perhaps exacerbate, public health issues and economic stagnation due to parasitic diseases. The diseases examined include those caused by ingested protozoa and soil helminths, malaria, lymphatic filariasis, Chagas disease, human African trypanosomiasis, leishmaniasis, babesiosis, schistosomiasis, and echinococcus, as well as parasites affecting livestock. It is our goal to impress on the scientific community the magnitude a changing climate can have on public health in relation to parasitic disease burden. Once impending climate changes are now upon us, and as we see these events unfold, it is critical to create management plans that will protect the health and quality of life of the people living in the communities that will be significantly affected.
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Pandya, Devesh M., Sukeshi Patel, Norma S. Ketchum, Brad H. Pollock, and Swaminathan Padmanabhan. "A Cancer Survivorship Study of Perceptions Among Leukemia Patients In the Acute, Extended, and Permanent Survival Phases." Blood 116, no. 21 (November 19, 2010): 1517. http://dx.doi.org/10.1182/blood.v116.21.1517.1517.
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Abstract Abstract 1517 Background: There are three phases of cancer survivorship: acute, extended, and permanent survival phases. The acute survival phase (ASP) begins with diagnosis of the disease and is dominated by diagnostic and therapeutic efforts. Extended survival phase (ESP) occurs when a patient goes into remission or has completed treatment. The permanent survival phase (PSP) is equated with cure. While fear and anxiety are known elements of the phases of cancer survivorship, other perceptions of patients during these phases are not well known. While there has been a large focus on survivorship in pediatrics, as well as solid tumor malignancies, this has been an understudied area in adults with leukemia. Previous work by our group had focused on the ASP in solid tumors, as well as perceptions of breast cancer patients in the ESP (Pandya et.al, AACR, 2007; Abstract 3423). This IRB-approved retrospective pilot project examined perceptions and beliefs among patients with leukemia in the ASP, ESP, and PSP. Methods: Fifty-five adult patients from our NCI-designated cancer center were individually interviewed by one interviewer. Questions were taken from the People Living With Cancer website, the National Comprehensive Cancer Network, and the National Research Council. These 57 questions were beta tested in multiple iterations. Subjects were asked about multiple areas of survivorship including their social support system, satisfaction and compliance with treatment, and satisfaction and trust of their primary care physician, nursing staff, and hematologist. Other topics covered included their distress level (0-10), quality of life, and also their perceived efficiency of diagnosis and treatment. Results: Demographics of the 55 patients are ALL-10, AML-9, CLL-23, and CML-13; females-23 and males-32; Hispanics-55%, Caucasians-36%, and African-Americans-9%; ASP-22, ESP-21, and PSP-12. Overall, 45% of the patients did not feel their life was normal and 51% feared recurrence with 39% reporting anxiety about their leukemia. AML patients experienced the most physical, family, emotional, and spiritual problems (78%, 33%, 56%, and 22%). In addition, 56% of AML patients also reported requesting more assistance with psychological well-being compared to ALL (10%), CLL (17%), and CML (1%) patients, (p-value 0.045). Finally, AML patients had the highest distress level with a mean score of 5.8 (SD 1.7), compared to ALL (1.8), CLL (3.2), and CML (5.1), (p-value < 0.001). Among all the phases of survivorship, the ASP had the highest distress level (mean-4.8) and the worst quality of life (mean-2.3). The ASP patients had the most treatment for depression (38%). In the PSP, 100% reported satisfaction with their treatment, survivorship care, compliance, being informed, sense of control, high self esteem, relationship with family and friends, sense of gain for surviving, and satisfaction with care for physical, social, and spiritual well-being, (p-value 0.026). When comparing races, African Americans and Hispanics (40% and 37%) were unable to cope with finances, compared to Caucasians (5%), (p-value 0.016). Fear of recurrence was highest in Hispanics (67%), compared to African Americans (40%) and Caucasians (30%), (p-value 0.031). African Americans reported requiring more assistance with social and spiritual well-being (40% for each). Hispanics (40%) experienced problems with housing, insurance, work, transportation, and child care, as compared to African Americans (20%) and Caucasians (10%), (p-value 0.047). Overall, leukemia patients had a lower average distress score of 3.8 versus breast cancer and solid tumor patients (4.5 and 5.2). Leukemia patients were satisfied with medical care with regards to their physical (95%), psychological (87%), social (82%), and spiritual (87%) well-being versus solid tumor malignancies (67%, 57%, 43%, and 23%). Treatment for depression was lower for leukemia patients (24%), compared to breast cancer (46%) and solid tumor (27%) patients. Conclusions: This pilot study addresses the perceptions and beliefs of leukemia survivors. While patients are satisfied in many areas in the PSP, there is still a need to further investigate various aspects of quality of life during the ASP and ESP, particularly in AML and minority patients. Future prospective studies are warranted that identify and overcome barriers to optimal cancer survivorship care. Disclosures: No relevant conflicts of interest to declare.
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Kwak, Jung, Heehyul Moon, and Soonhee Roh. "The Role of Health, Social Network, and Race in Advance Care Planning Among Medicare Beneficiaries." Innovation in Aging 4, Supplement_1 (December 1, 2020): 69–70. http://dx.doi.org/10.1093/geroni/igaa057.227.
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Abstract Advance care planning (ACP) is linked with high-quality end-of-life outcomes. However, ACP engagement level among older adults varies significantly by demographic, social, and health characteristics. In this study, we sought to identify characteristics associated with informal and formal ACP, in order to inform development of targeted education and outreach efforts that are tailored to diverse groups of older adults. The data came from a nationally representative study of Medicare beneficiaries living in communities, the National Health and Aging Trends Study (Round 8, N= 5,547). Multivariable logistic regressions were conducted to identify individual characteristics (i.e., race/ethnicity, age, gender, income, functional disability, cognitive function, perceived health, and numbers of people in social networks) associated with ACP engagement. Rates of informal ACP (talking to someone), and formal ACP, completing a healthcare power of attorney (HPOA) and a living will (LW), were 56%, 60.5%, and 56% accordingly. Logistic regression showed that individuals who were married or had a larger social network, and had higher functional impairment and health needs were significantly more likely to engage in both informal and formal ACP. However, individuals with memory problems (only informal ACP) and African Americans and Hispanics were significantly less likely to engage in both informal and formal ACP. African Americans without dementia were more likely to have completed HPOA compared with Whites. Findings suggest an important role of social network, and functional and cognitive health in ACP with implications for developing targeted outreach efforts in faith-based or social group settings, and healthcare settings.
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Laubscher, Cornelius V., Marilize C. Burger, Maria M. Conradie, Magda Conradie, and Jacobus D. Jordaan. "Prevalence of Sarcopenia in Older South African Patients Following Surgery for Fragility Fractures of the Hip." Geriatric Orthopaedic Surgery & Rehabilitation 11 (January 1, 2020): 215145932097156. http://dx.doi.org/10.1177/2151459320971560.
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Introduction: Geriatric patients with a fragility fracture of the hip (FFH) are especially prone to sarcopenia with poor functional outcomes and quality of life. We assessed the prevalence of sarcopenia in older South African patients with FFH. Risk factors for sarcopenia were also investigated. Materials and Methods: From August 1 to November 30, 2018, all older patients with FFH were invited to participate. Sarcopenia was diagnosed based on the revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Handgrip strength (HGS) and muscle strength were assessed. Muscle quantity was determined by dual-energy X-ray absorptiometry. Demographic information was collected, and 25-hydroxyvitamin D (25[OH]D) status was determined. Results: Of the 100 hip fracture cases, 65 were enrolled, and 52% (34/65) were sarcopenic (women: 62%; men: 38%). HGS accurately identified sarcopenia (sensitivity and specificity: 100%). Patients >80 years of age had a prevalence of sarcopenia twice (18/21 [83%]) that of younger patients (18/44 [36%]). Women with sarcopenia were smaller than those without (weight: p < 0.001; height: p < 0.001; body mass index: p = 0.018). Low 25(OH)D was almost universally present, with median 25(OH)D levels significantly lower in the patients with sarcopenia (27 nmol/L [interquartile range {IQR}: 20–39] vs. 40 nmol/L [IQR: 29–53]). Several risk factors, including advanced age; female sex; a smaller body size, especially among women; limited physical activity; and low 25(OH)D levels, were identified. Discussion: The accuracy of HGS testing in this cohort underscores EWGSOP2’s recommendation that muscle strength is key to sarcopenia. Further study and follow-up are required to determine the clinical relevance of sarcopenia among FFH patients. Conclusion: The prevalence of sarcopenia in our FFH population is high. Sarcopenia is associated with poor patient outcomes following surgical intervention. Orthopaedic surgeons should therefore be cognizant of the presentation and associated risk of sarcopenia as our patient populations age.
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Adeyeye, Samuel Ayofemi Olalekan. "The role of food processing and appropriate storage technologies in ensuring food security and food availability in Africa." Nutrition & Food Science 47, no. 1 (February 13, 2017): 122–39. http://dx.doi.org/10.1108/nfs-03-2016-0037.
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Purpose This paper aims to review scientific contributions that are essential to reduce the challenges to food security in Africa through food processing and appropriate storage technologies. Design/methodology/approach Several literature studies on the role of food processing and appropriate storage technologies in ensuring food security and food availability in Africa were critically reviewed. Findings The study revealed that the world faces multiple challenges to food security including under nutrition and overconsumption, rising food prices, population growth, rapid diet transitions, threats to agricultural production, inefficient production practices and supply chains and declining investment in food system research. Many people lack adequate amounts of foods that are rich in the nutrients needed for a healthy and productive life. According to FAO, 1996, chronic undernutrition affects 43 per cent of the Africa’s population or some 215 million people in sub-Saharan Africa. Food security is highly instrumental to the economic growth and sustainability of any country. The use of simple but effective on- and off-farm storage facilities and agro-processing technology should be promoted to add value to products and increase their shelf-life. The Strategic Grain Reserve Scheme should be modernized, strengthened and upgraded to a National Food Reserve Program, which will enable it to handle all staples and essential food products. This will help in attainment of national food security goal. It is also crucial to promote and develop agro-processing in the various African countries for the evolution of virile agro-allied industries and rural micro-enterprises. Research limitations/implications The paper reviewed the role of food processing and appropriate food storage technologies in ensuring food security and availability in Africa. There are insufficient data and information on adoption of new food processing and appropriate storage technologies in Africa. Although, there have been some instances where the introduction of modern techniques has resulted in products rejection by consumers. Practical implications The paper helps in reviewing food situation in Africa and how to make food available for the people and Africa food secured. Social implications This paper revealed strategies that could be used to improve food security and ensuring food availability in Africa. Originality/value This review paper is of value to policymakers, government agencies responsible for food quality control and assurance and consumers to make food available and affordable for the people.
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Pomohaibo, Valentyn Mychailovych. "Philosophy of life in successful community." Filosofiya osvity. Philosophy of Education 24, no. 1 (December 4, 2019): 128–41. http://dx.doi.org/10.31874/2309-1606-2019-24-1-128-141.
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Historical experience and scientific researches witness that both an individual’s life success and a country’s prosperity and the living standard of population depend not on the quality of education itself, but on its effectiveness. The effectiveness of education, in turn, is determined by a social productivity of science, which can be presented elementarily by such a simple indicator as a number of Nobel laureates. The USA holds the leading place among countries in this area. Thus, the United States is the country that can maximally ensure human development, and most importantly – a realization of human natural gifts and an acquisition of appropriate material welfare. This is evidenced not only by the high level of science development, but also by the phenomenon of a success of a number of immigrant communities compared with the US European population. The most successful ethnic groups in the United States are Jews, Indians, Chinese, Nigerians, Cubans, Iranians and Lebanese. Particularly impressive is the success of the Nigerians and Cubans against a background of comparatively small achievements of the African and Latin Americans. It has been found that all most successful ethnic groups in the USA have three mental traits: a superiority complex, an insecurity, and impulse control. The superiority complex lies in deep inner confidence in an uniqueness of your community compared to others. This confidence can be based on religion, majestic history and culture, origin, and so on. Insecurity means anxiety uncertainty in its significance in society, concern about a lack of results of its activities. Key sources of insecurity are scorn by other communities, fear and parents’ pressure. A scorn by the people of a strange country and its own indignation in this regard may be the most powerful incentive for growth. The second source of the insecurity is fear of being unable to survive in a strange country, which can lead to despair, paralysis of will, capitulation, even shame. But it can also cause a completely different reaction – an urge to rise, earn money, reach power, either to become successful here, or to have same means to escape. The third and most common source of the sense of threat in successful immigrant communities is the pressure from parents to children to be succeed. Parents bring up children's to conviction that success, foremost in learning, is a responsibility of family honor, as well as protection from an uncertain and hostile world. Impulse control means an ability to withstand various temptations, especially the temptation to relinquish difficulty and challenge a difficult task rather than to perform it. No human society can exist without control of impulses. However, it must be remembered that individual control of impulses is just a futile austerity. Success is only possible as a result of combining all three principles – a conviction of superiority, a sense of threat, and an impulse control. Philosophy of a successful life is an extremely effective means of achieving a high social status, if it is important for you. However, it should be used only to succeed. After this it is necessary to get rid of success philosophy, because in the future it can cause a pathological drive to extremes. The experience of bringing up children in the successful communities of America will undoubtedly be useful in the current reforming of Ukrainian education.
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Elwell-Sutton, T., N. Folb, A. Clark, L. R. Fairall, C. Lund, and M. O. Bachmann. "Socioeconomic position and depression in South African adults with long-term health conditions: a longitudinal study of causal pathways." Epidemiology and Psychiatric Sciences 28, no. 2 (August 14, 2017): 199–209. http://dx.doi.org/10.1017/s2045796017000427.
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Aims.There is convincing evidence that lower socioeconomic position is associated with increased risk of mental disorders. However, the mechanisms involved are not well understood. This study aims to elucidate the causal pathways between socioeconomic position and depression symptoms in South African adults. Two possible causal theories are examined: social causation, which suggests that poor socioeconomic conditions cause mental ill health; and social drift, which suggests that those with poor mental health are more likely to drift into poor socioeconomic circumstances.Methods.The study used longitudinal and cross-sectional observational data on 3904 adults, from a randomised trial carried out in 38 primary health care clinics between 2011 and 2012. Structural equation models and counterfactual mediation analyses were used to examine causal pathways in two directions. First, we examined social causation pathways, with language (a proxy for racial or ethnic category) being treated as an exposure, while education, unemployment, income and depression were treated as sequential mediators and outcomes. Second, social drift was explored with depression treated as a potential influence on health-related quality of life, job loss and, finally, income.Results.The results suggest that the effects of language on depression at baseline, and on changes in depression during follow-up, were mediated through education and income but not through unemployment. Adverse effects of unemployment and job loss on depression appeared to be mostly mediated through income. The effect of depression on decreasing income appeared to be mediated by job loss.Conclusions.These results suggest that both social causation and social selection processes operate concurrently. This raises the possibility that people could get trapped in a vicious cycle in which poor socioeconomic conditions lead to depression, which, in turn, can cause further damage to their economic prospects. This study also suggests that modifiable factors such as income, employment and treatable depression are suitable targets for intervention in the short to medium term, while in the longer term reducing inequalities in education will be necessary to address the deeply entrenched inequalities in South Africa.
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Onyemelukwe, Ndubuisi H., Chidiebere E. Irolewe, Catherine O. Ogbechie, and Abosede O. Ogunnaike. "Literary cum Philoso-Religious Periscope on the Nature of Man." International Journal of English Linguistics 7, no. 6 (September 27, 2017): 88. http://dx.doi.org/10.5539/ijel.v7n6p88.
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The self-evident truth that man is a mystery to himself generates justifiable intellectual curiosity. Giving expression to such curiosity would help to further unravel the mysterious nature of man by means of philoso-religious investigations into the personality of some purposively selected major characters in the literary works of prominent African and non-African writers. Consequently, this study undertakes to investigate some creative works of world-acclaimed fame. Purposively selected for the study in this regard include Profs. Chinua Achebe and Isidore Okpewho’s fictions, Prof. Ola Rotimi’s The gods Are not to Blame, George Orwell’s narratives, Ngugi Wa Thiongo and Micere Githae Mugo’s The Trial of Dedan Kimathi, Marie Correli’s The Sorrows of Satan and Cheik Hamidou Kane’s The Ambiguous Adventure. These classics are selected, because besides being philoso-religiously oriented, their geographical settings cut across the world to validate the findings of the study. The objective of the investigation focused on the selected works is to help man understand himself now more than previously ever, especially in relation to the will of God, his creator. This objective is pursuant to the expectation that achieving it would significantly improve the quality of life on earth, and by extension, man’s eternal destiny. The theoretical premise which drives the investigation of man and his nature in the novels used for the study conceptualises man in relation to ethics and the metaphysical world. It, therefore, provides appreciable insights into man’s identity profile which distinguishes between the created man as an enemy of God and the redeemed man as a friend of God. Relying on some scientific basis, the theoretical framework establishes that God is an undeniable reality, concluding, therefore, that it translates to stark ignorance or gross senselessness not to know Him. The analysis done as part of the study confirms its hypothesis, namely, that literature is a mirror of life which is largely a reflection of the natures of the created man rather than those of the redeemed man. The confirmation of this hypothesis proves that humanity is farther away from God than she is close to Him. In other words, the final destiny of mankind, hereafter, is largely threatened. The pragmatics of this worrisome major finding is that the near-countable redeemed people of God in this generation, especially the clergy, should and must commit themselves to intensified effective creative evangelisation to forestall evil from overtaking the world. Positive response to this clarion call by the redeemed people of God found in all authentic religious sects is imperative, else, evil will eventually overtake the world and provoke God’s devastating wrath on humanity.
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Mashola, Mokgadi Kholofelo, Elzette Korkie, and Diphale Joyce Mothabeng. "Pain and its impact on functioning and disability in manual wheelchair users with spinal cord injury: a protocol for a mixed-methods study." BMJ Open 11, no. 1 (January 2021): e044152. http://dx.doi.org/10.1136/bmjopen-2020-044152.
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IntroductionApproximately 80% of people with spinal cord injury experience clinically significant chronic pain. Pain (whether musculoskeletal or neuropathic) is consistently rated as one of the most difficult problems to manage and negatively affects the individual’s physical, psychological and social functioning and increases the risk of pain medication misuse and poor mental health. The aim of this study is to therefore determine the presence of pain and its impact on functioning and disability as well as to develop a framework for self-management of pain for South African manual wheelchair users with spinal cord injury.Methods and analysisCommunity-dwelling participants with spinal cord injury will be invited to participate in this three-phase study. Phase 1 will use a quantitative, correlational design to determine factors related to pain such as pectoralis minor length, scapular dyskinesis, wheelchair functioning, physical quality of life, community reintegration and pain medication misuse. Demographic determinants of pain such as age, gender, type of occupation, completeness of injury and neurological level of injury will also be investigated. Participants with pain identified in phase 1 will be invited to partake in a qualitative descriptive and contextually designed phase 2 to explore their lived experience of pain through in-depth interviews. The results of phases 1 and 2 will then be used with the assistance from experts to develop a framework for self-management of pain using a modified Delphi study. Data analysis will include descriptive and inferential statistics (quantitative data) and thematic content analysis (qualitative data).Ethics and disseminationApproval for this study is granted by the Faculty of Health Sciences Research Ethics Committee of the University of the Pretoria (approval number 125/2018). This study is registered with the South African National Health Research Database (reference GP201806005). This study’s findings will be shared in academic conferences and published in scientific peer-reviewed journals.
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Burlutskaya, A. V., A. V. Statova, and E. V. Mamyan. "Structure and organisation of palliative care for children in Krasnodar Krai." Kuban Scientific Medical Bulletin 27, no. 2 (April 12, 2020): 29–37. http://dx.doi.org/10.25207/1608-6228-2020-27-2-29-37.
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Palliative care is aimed at enhancing the quality of life of patients living with life-threatening conditions and their families. According to the World Health Organization, about 40 million people require palliative care every year. Out of these people, 78% reside in low- and middle-income countries. 89% of children requiring palliative care are from low- and middle-income countries, with half of these children living on the African continent. Such a widespread prevalence and need for palliative care is expected to grow due to the increasing number of chronic non-communicable diseases, and the provision of palliative care at early stages reduces the frequency of unnecessary hospitalisations and the use of medical services.Aim. To assess the structure and organisation of palliative care for children in Krasnodar Krai.Material and methods. The study was conducted on the basis of medical institutions located in Krasnodar and other cities in Krasnodar Krai (Apsheron, Vyselkovsky, Gelendzhik, Kavkazsky, Kushchevsky districts, Leningradsky region, Seversky and Tuapse districts), which provide palliative care for children aged from 3 months to 18 years. Along with inpatient services, outpatient forms of palliative care for children, such as long-term artificial respiration for incurable patients, were analysed. Statistical methods of analysis were not used due to the descriptive character of the research.Results. 28 palliative care beds for children were open in Krasnodar Krai over the period from 2013 to 2018. The number of visiting nurse brigades comprised 13. An analysis of the provision of palliative care in accordance with No. 985 form “Data on patients receiving palliative care” and the report of the palliative care structure as of September 1, 2018 showed that 193 children needed round-the-clock inpatient care. Out of these children, 71.5% and 21.2% suffered from CNS and cancer conditions, respectively, while 7.3% were referred to the ‘other diseases’ group. 250 patients were treated in the offices of palliative care, including 94.4% of neurological patients, 2.8% of cancer patients and 2.8% of children with other pathologies. At home, 14 incurable patients received long-term artificial respiration, 78.6% of whom were children with hereditary neuromuscular diseases, 7.1% with congenital malformations of the central nervous system, 7.1% with lysosomal storage disease and 7.2% with Pompe disease.Conclusion. Palliative care is one of the priority branches of medicine in the Russian Federation. The problem of providing palliative care for children is of particular significance due to the growing number of patients with life-threatening and terminal conditions.
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Thiamwong, Ladda, and Norma E. Conner. "EXPERIENCES AND FACILITATORS OF FALLS PREVENTION AMONG ETHNICALLY DIVERSE OLDER ADULTS: A QUALITATIVE STUDY." Innovation in Aging 3, Supplement_1 (November 2019): S854. http://dx.doi.org/10.1093/geroni/igz038.3142.
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Abstract Background: Falls increase as people age and decrease the quality of life. Even though fall interventions have received great attention, fall incidence rates have still arisen. In order for older adults to reap the benefits of evidence-based fall interventions, a challenge of implementation in the real world and right context must be met. Understanding experiences, facilitators, and barriers of fall prevention among four major ethnic groups in the Unites States could be extremely valuable. Objective: The aim of this study was to describe experiences and highlight facilitators and barriers on fall and fear of falling interventions among ethnically diverse community-dwelling older adults. Methods: Four ethnically specified (African American, Asian, Hispanic and Non-Hispanic White) focus groups were conducted. A total of 28 older adults and four family caregivers were interviewed. Interviews covered experiences on falls and fear of falling, attitudes, factors, consequences, risk assessment, and interventions. Data were organized and analyzed with the NViVo software. Results: Falls related experiences and behaviors were multifaceted and varied. Three themes related to falls experiences and behaviors were identified, 1) falls prevention versus fear of falling amplification; 2) role identity, culture and family considerations; and 3) take care of you, take care of me. Facilitators of fall prevention were integration of individual learning within a group meeting, providing appropriate assistive devices and promoting environmental safety. Barriers were inconsistent fall risk assessments, low fall risk awareness and acknowledgment, and balance and visual impairment.