Walter Sisulu University
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African Oral Literature and the Humanities: Challenges and Prospects
Get PDFThis paper examines the origin, evolution and emergence of folklore (oral literature) as an academic discipline in Africa and its place in the humanities. It draws attention to the richness of indigenous knowledge contained in oral literature and demonstrates how the ethical and moral gap in the existing educational system can be filled by the moral precepts embedded in oral literature. The paper argues that African oral literature has not received the attention it deserves among other disciplines of the humanities in institutions of higher learning in Africa. It concludes that any discussion on African literature will be incomplete, and indeed irrelevant, if it does not equally give adequate attention to the oral literature of the African people. As a result, a new curriculum and pedagogy must be designed to give pride of place to folklore and oral literature as the best repository of our cultural norms and values especially in African tertiary institutions
How good are our guidelines? Four years of experience with the SAMJ’s AGREE II review of submitted clinical practice guidelines
Get PDFThe South African Medical Journal (SAMJ) is an established source of clinical practice guidelines (CPGs) serving the local healthcare community. CPGs link professional societies and clinicians by guiding best practice through the collation and interpretation of the best available evidence. Not only are CPGs important in standardising the quality of patient care, but they also assist with medicine selection and resource allocation decisions, adjudicating medicolegal claims, and promoting equity by influencing medicine access and health system organisation.[1] In 2014, the SAMJ appointed an editorial subcommittee to review CPGs submitted for publication.[2] This was in response to several concerns, including the global shift in CPG quality requirements, the potential effect of poor-quality CPGs on healthcare quality and cost, and the challenges South African (SA) CPG developers face in meeting new standards. This editorial reflects on the SAMJ CPG review subcommittee’s experience over the past 4 years and describes the value of more robust CPG development
Practice intentions at entry to and exit from medical schools aspiring to social accountability: findings from the Training for Health Equity Network Graduate Outcome Study
Get PDFBackground: Understanding the impact of selection and medical education on practice intentions and eventual practice is an essential component of training a fit-for-purpose health workforce distributed according to population need. Existing evidence comes largely from high-income settings and neglects contextual factors. This paper describes the practice intentions of entry and exit cohorts of medical students across low and high income settings and the correlation of student characteristics with these intentions. Methods: The Training for Health Equity Network (THEnet) Graduate Outcome Study (GOS) is an international prospective cohort study tracking learners throughout training and ten years into practice as part of the longitudinal impact assessment described in THEnet’s Evaluation Framework. THEnet is an international community of practice of twelve medical schools with a social accountability mandate. Data presented here include cross-sectional entry and exit data obtained from different cohorts of medical students involving eight medical schools in six countries and five continents. Binary logistic regression was used to create adjusted odds ratios for associations with practice intent. Results: Findings from 3346 learners from eight THEnet medical schools in 6 countries collected between 2012 and 2016 are presented. A high proportion of study respondents at these schools come from rural and disadvantaged backgrounds and these respondents are more likely than others to express an intention to work in underserved locations after graduation at both entry and exit from medical school. After adjusting for confounding factors, rural and low income background and regional location of medical school were the most important predictors of intent to practice in a rural location. For schools in the Philippines and Africa, intention to emigrate was more likely for respondents from high income and urban backgrounds
Deriving an optimal threshold of waist circumference for detecting cardiometabolic risk in sub-Saharan Africa
Get PDFBACKGROUND: Waist circumference (WC) thresholds derived from western populations continue to be used in sub-Saharan Africa (SSA) despite increasing evidence of ethnic variation in the association between adiposity and cardiometabolic disease and availability of data from African populations. We aimed to derive a SSA-specific optimal WC cut-point for identifying individuals at increased cardiometabolic risk. METHODS: We used individual level cross-sectional data on 24 181 participants aged ⩾15 years from 17 studies conducted between 1990 and 2014 in eight countries in SSA. Receiver operating characteristic curves were used to derive optimal WC cutpoints for detecting the presence of at least two components of metabolic syndrome (MS), excluding WC. RESULTS: The optimal WC cut-point was 81.2 cm (95% CI 78.5–83.8 cm) and 81.0 cm (95% CI 79.2–82.8 cm) for men and women, respectively, with comparable accuracy in men and women. Sensitivity was higher in women (64%, 95% CI 63–65) than in men (53%, 95% CI 51–55), and increased with the prevalence of obesity. Having WC above the derived cut-point was associated with a twofold probability of having at least two components of MS (age-adjusted odds ratio 2.6, 95% CI 2.4–2.9, for men and 2.2, 95% CI 2.0–2.3, for women). CONCLUSION: The optimal WC cut-point for identifying men at increased cardiometabolic risk is lower (⩾81.2 cm) than current guidelines (⩾94.0 cm) recommend, and similar to that in women in SSA. Prospective studies are needed to confirm these cut-points based on cardiometabolic outcomes
Predictors of consent to cell line creation and immortalisation in a South African schizophrenia genomics study
Get PDFPotential latitudinal variation in orodigestive tract cancers in Africa
Get PDFBackground. Previous studies have alluded to a causal relationship between pathological entities and geographical variations, but there is a paucity of studies from Africa discussing the effect of latitudinal variation on orodigestive cancers in this region. It seems plausible that the burden of orodigestive cancer would differ as a result of variations in diet, cultural habits, climate and environmental conditions down the length of Africa. Objectives. To analyse regional variations in prevalence, incidence and mortality data in the global cancer statistics database (GLOBOCAN 2012) curated by the World Health Organization and the International Agency for Research on Cancer. Basic descriptive statistical tools were used to depict regional variations in cancer morbidity and mortality. Methods. Data on 13 African countries between longitude 20⁰ and 30⁰ east and latitude 35⁰ north and 35⁰ south were examined for variation in age-standardised orodigestive cancer prevalence, incidence and mortality. Possible regional causes for orodigestive tract cancer development were investigated. Data on lip and oral cavity, oesophageal, gastric, colorectal, liver, gallbladder and pancreatic cancers in the 13 countries were compared. Results. Our empirical findings from this preliminary study support the notion that the incidence and prevalence of orodigestive cancers vary within Africa. This effect may be due to environmental, economic, political and possibly genetic factors. Conclusions. Considering the heterogeneity of the above factors across Africa, disbursement of funding for cancer research and therapy in Africa should be focused in terms of regional variations to make best use of the fiscal allocation by African governments, non-governmental organisations and international agencies
Diurnal variation of steroid hormones and their reference intervals using mass spectrometric analysis
Get PDFPerspectives about the execution of police powers and functions in the republic of Zimbabwe
Get PDFThis study was conducted to explore views about the execution of powers and functions of the police in the light of related challenges. This study made use of data from a total of 83 adult participants (a survey involving 73 individuals, and 10 in-depth interviews), including males and females of diverse occupational backgrounds from Bindura and Mount Darwin policing districts in Zimbabwe. A closed-ended, mostly Likert-scale-based questionnaire was used to collect data about the prevalent forms of police abuse of powers and functions, while an in-depth interview guide was provided to harvest information qualitatively. Findings reveal that police officers abuse their powers through unlawful arrests, arbitrary search and seizure, excessive use of force, unlawful methods of investigation, and ill treatment of detainees. Though not as prevalent as other forms of abuse, malicious criminal prosecution and partisan policing were also cited.K EYWOR DS: powers, abuse, function, police, Zimbabw
Cloud computing adoption: Strategies for Sub-Saharan Africa SMEs for enhancing competitiveness
Get PDFSmall and medium-sized enterprises (SMEs) need to design and implement strategies for adopting new technologies as a competitive tool for maintaining their competitive advantage and cloud computing is at its peak. Since its emergence, there has been a surge in the adoption of cloud computing with research into its adoption primarily concentrated on bigger firms. However, a major characteristic of cloud computing is the anticipated possibilities it holds for SMEs. This paper primarily explores cloud computing adoption strategies for SMEs operating in Sub-Saharan Africa. Using a mixed method approach, a sample of 261 respondents and 11 SMEs was respectively used for the quantitative and qualitative stages of the research. The results reveal that, even though SMEs have their unique expectations for adopting cloud computing, they were of the consensus that elements of an adoption strategy should include adoption goals, a roadmap, and considerations. The paper makes specific recommendations to SMEs to develop adoption strategies that meet their specific needs if they expect cloud computing to play a stronger role to support more strategic initiatives to grow their businesses and improve customer experience
Point-of-care and lung ultrasound incorporated in daily practice
Get PDFPoint-of-care ultrasound (POCUS) is a fast-growing clinical utility and is becoming an essential clinical skill for all practitioners attending to critically ill patients. Ultrasound equipment is now smaller, more affordable and readily available in clinical work areas. POCUS is performed by a non-cardiologist physician at the patient’s bedside as an adjunct to the physical examination. It is easily taught, non-invasive and allows for real-time clinical information. Bedside use of ultrasound imaging aids with rapid diagnosis of severe and life-threatening pathological conditions. It can be repeated, may change clinical management, and impact on patient outcome. POCUS has a broad clinical use, including, but not limited to, focused assessed transthoracic echocardiography (FATE), lung ultrasound imaging, extended focused assessment with sonography for trauma (e-FAST), vascular access and regional blocks. It may also be extended to detect endotracheal intubation and the estimation of intracranial pressure. Assessment of cardiac pathology by POCUS, performed by a novice examiner, has been shown to compare with the gold standard of an expert. Training is paramount. The physician should know his limitations and always relate the information back to the clinical scenario and context. By incorporating POCUS as part of our armamentarium and into our daily medical practice, we might see it reach its full clinical potential, optimising patient care and improving patient outcomes