168 research outputs found
From madrasah to museum : a biography of the Islamic manuscripts of Cape Town
No full textThis paper focuses on the Islamic manuscripts of Cape Town, locally referred to as kietaabs, written by Muslims predominantly in the 19th century, in jawi (Arabic-Malay) and Arabic-Afrikaans. Inspired by the idea of a 'biography' of the archive and 'the social life of things', the study traces the life of the kietaabs, from their creation and original use, to their role in contemporary South African society, as objects of heritage and identity. It approaches the kietaabs as objects, emphasizing their movements, status and use, rather than their content
Identifying COPD in primary care: targeting patients at the highest risk
No full textAim: To select and internally validate candidate variables for a risk prediction algorithm to detect chronic obstructive pulmonary disease (COPD) in primary care.
Background: COPD is vastly under-diagnosed in primary care and a variety of case finding and screening tools have been proposed to help identify patients with undiagnosed disease. Risk prediction algorithms have been developed for a variety of diseases but the development and use of such models for identification of COPD in the UK is currently limited. We used routine primary care data to identify and internally validate candidate variables for inclusion in a risk prediction model for COPD in primary care.
Method: We performed a literature search to identify potential risk factors associated with COPD. We then extracted data on 17,719 patients with an incident diagnosis of COPD (from 1st January 1990 to 31st March 2006) and 35,944 age-, sex-, and practice-matched controls from the General Practice Research Database and randomised them in a 2:1 ratio to form derivation and validation samples, respectively. The prevalence of a variety of clinical risk factors in the derivation sample (recorded at least 60 days prior to the diagnosis of COPD or equivalent matched time point for controls) was summarised. The unadjusted association between COPD and these risk factors was assessed using fixed effects conditional logistic regression. Candidate predictors were initially scoped from the literature search and then selected for a combined model based on the difference in prevalence between cases and controls, clinical face validity, and the size and statistical significance of their unadjusted odds ratios (ORs≥1.5 with p<0.05). The adjusted ORs were then estimated from a random intercept model. This model was used to formulate a risk prediction algorithm and was tested on the validation sample to assess its accuracy as measured by the area under the receiver operator characteristic curve (AUC or c-statistic) and calibration slope. Analyses were performed using Stata version 10.1.
Results: The mean age in the derivation sample was 69.7 years (SD 11.0) and 51.8% were male.Smoking status, salbutamol prescriptions and dyspnoea were the strongest predictors of COPD. Altogether nine variables were included in the combined risk prediction model including symptoms of wheeze and cough, previous diagnosis of asthma and lower respiratory tract infections (LRTI), and prescriptions of prednisolone and antibiotics for a chest infection. When tested on the validation sample this risk prediction algorithm had an AUC of 0.875 (95% CI 0.87 to 0.88). A cutpoint of 0.3 yielded a sensitivity of 86.6% and specificity of 70.1%. The algorithm performed good estimates against risk group deciles with a calibration slope of 0.98 (95% CI 0.87 to 1.10).
Conclusions: A risk prediction algorithm that includes smoking status, history of asthma and LRTI, symptoms of dyspnoea, wheeze and cough and prescriptions of salbutamol, antibiotics for respiratory infections and prednisolone appears to be highly predictive of incident COPD in primary care. This model, combined with age and sex, will be further developed and externally validated in a large screening trial for COPD in primary care (Birmingham Lung Improvement Studies, TargetCOPD). An externally validated risk prediction algorithm with sufficient sensitivity and specificity could be used to identify patients in primary care who might benefit from spirometry testing to detect COPD
نسخہ خطی شمائل حسنیہ میں منشی غلام حسن شہید ملتانیؒ کےآثارکا تعارف: INTRODUCTION TO THE WORKS OF MUNSHI GHULAM HASSAN SHAHEED MULTANI IN THE MANUSCRIPT “SHAMIL-E-HASSANIA’’
No full textThe book “Shamil-e-Hassania’’ was authored by Molvi Nzam-u-Din Rang puri (Mercy be Upon Him) in which he has pen downed the glorious presentment, sayings and persona of his beloved spiritual master “Munshi Ghulam Hassan Shaheed Multani (Mercy be Upon Him)” –The book is comprised of four chapters and Rukan Doam end note. In the third chapter, he has briefed about written work of Hazrat Khawaja Munshi Ghulam Hassan Shaheed Multani. He discussed the books with name from page 18 to page 21. The objective of this book was not only to give tribute to his beloved spiritual master, but also to establish a way forward for ultimate truth seekers in this mortal world. This book serves as a beacon for strayed and remedy for ignorance.Different sufi saints of Chisti family until Hazrat Niam ud Din aolia (Mercy be Upon Him ) and finally to Hazrat Khawaja Hafiz Muhammad Jamalullah Chishti Nizami (Mercy be upon him) And Munshi Ghulam Hassan Shaheed Multani. In Shamil-e-Hassania Munshi Ghulam Hassan Shaheed Multani (Mercy be upon him) have been discussed. In the end note, his sescendants and their caliphs have been discussed in detail. At many places in this account, author has supported the secrets of Toheed, and Honors of Sufism in the light of Quran and Hadith, Moreover, the use of mystic poetry has further glorified the comprehensiveness of the book
Case finding for COPD in primary care: a qualitative study of the views of health professionals
No full textShamil Haroon, Rachel E Jordan, David A Fitzmaurice, Peymane AdabSchool of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UKBackground: Chronic obstructive pulmonary disease (COPD) is common but largely underdiagnosed. Case-finding initiatives have been evaluated in primary care, but few studies have explored the views of service providers on implementing them in practice.Aim: To explore the views of primary health care providers on case finding for COPD.Methods: A total of 20 semi-structured interviews were conducted from March 2014 to September 2014 among general practitioners, nurses, and managers from practices participating in a large COPD case-finding trial based in primary care in the West Midlands, UK. Participants’ views were sought to explore perceived benefits, harms, barriers, and facilitators to implementing COPD case finding in practice. Interviews were transcribed and analyzed using the framework method.Results: Participants felt that case finding improves patient care but also acknowledged potential harms to providers (increase in workload) and to patients (overdiagnosis). Insufficient resources, poor knowledge of COPD, and limited access to diagnostic services were viewed as barriers to diagnosis, while provision of community respiratory services, including COPD specialist nurses, and support from secondary care were thought to be facilitators. Participants also expressed a need for more education on COPD for both patients and clinicians.Conclusion: Care providers believe that early detection of COPD improves patient care but also has accompanying harms. Barriers to diagnosing COPD, such as insufficient expertise in primary care and limited access to diagnostic services in the community, should be explored and addressed. The knowledge and attitudes of the public about COPD and its symptoms should also be investigated to inform future education and awareness-raising strategies.Keywords: chronic obstructive pulmonary disease, primary care, diagnosis, qualitative researc
Case finding for chronic obstructive pulmonary disease (COPD) in primary care: finding the optimal approach
No full textChronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality but widely underdiagnosed. This thesis explores methods to improve case finding for COPD in primary care. It includes two systematic reviews- the first evaluated the diagnostic accuracy of screening tests and showed that handheld flow meters are more accurate than the COPD Diagnostic Questionnaire. The second evaluated the comparative effectiveness of different case finding strategies and found that inviting symptomatic ever smokers for a screening assessment may be more efficient than inviting all ever smokers directly for diagnostic spirometry. The thesis then reports the development and external validation of two risk prediction models for COPD using data from electronic health records and a cluster randomised controlled trial. These models can be used to assess the risk of undiagnosed COPD to help target patients for case finding and can potentially be integrated with clinical information systems. Finally, primary care providers were interviewed to explore their views on case finding for COPD, including potential benefits and harms, as well as barriers and facilitators. This suggests that more training and support for community respiratory services may be needed in order to improve the timely diagnosis of COP
To the Issue of the Imam Shamil's Campaign to Kabarda in 1846 year
Get PDFThe article analyzes the reasons, the course and the results of the march of the detachments led by
Imam Shamil to the territory controlled by Kabardian princes Anorovs and naib Nur Ali to the vicinity of the
Daryal canyon in April 1846. The social processes in the region launched in the Central Caucasus region in
the 1820s by commander of the Separate Caucasian Corps A.P. Ermolov is also paid attention in addition to
the military-tactical aspect.
The social nature of the ruling groups in Kabarda (princes Anzorovs and other aristocratic families)
and the leaders of the movement for jihad in Chechnya and Dagestan (Imam Shamil and most of his naibs) is
considered. The author comes to the conclusion that both the class distinctions and the basic characteristics
of the social structure of Kabarda on the one hand, and of Chechnya and Upland-Dagestan, on the other,
caused insuperable subject contradictions. The armed confrontation of the mountain people with Russia
played a key role in shaping the prerequisites for Imam Shamil's efforts to unite with the Kabardian rulers,
and also extend his influence to the mountain communities of the ghalghai and kists that are close to the
Chechens. This attempt to unite the mountain peoples united and firm hand of the imam under the banners
of Islam was not successful. The lack of mass support for the movement headed by Shamil from the side of
ordinary Kabardians and Vainakh societies Aki and Tsori put Shamil and his naib in front of the prospect of
being surrounded by Russian troops. Only the skillful tactical decisions of the mountain commanders and the
relative passivity of the Russian command saved Shamil from the catastrophe. All this is understood on the
basis of a wide range of materials, including unpublished archival sources
Delay and completion of tuberculosis treatment:a cross-sectional study in the West Midlands, UK
No full textBACKGROUND: TB remains a significant problem in the UK with the West Midlands having the highest incidence after London. Treatment is usually for a minimum of 6 months and requires a high level of compliance. We investigated potential determinants of delays and completion of treatment for tuberculosis (TB) in the West Midlands, UK.METHODS: We used data on 4840 patients with TB in the West Midlands from the Enhanced Tuberculosis Surveillance database from 1 January 2005 to 1 October 2010. We used regression models to investigate the cross-sectional association between sociodemographic and clinical risk factors and the timeliness and completion of TB treatment.RESULTS: Patients with TB waited 82 days on average from symptom onset to treatment initiation. Female patients spent 6% longer time than males before receiving treatment [95% confidence interval (CI): 1.2-11.6%, P = 0.015]. Asian/Asian British patients were 11 times more likely to complete treatment than White patients (adjusted odds ratio: 11.4, 95% CI: 1.31-100.3, P = 0.028).CONCLUSIONS: Females in the West Midlands took longer time to receive TB treatment than males, representing a health inequality that could be addressed through gender-sensitive awareness raising programmes. White patients were less likely to complete treatment than Asian/Asian British patients; additional support is needed in this group.</p
Defeating Apartheid: Cuba in Southern Africa / HSRC Seminar 21st November
No full textInvitation HSRC Seminar Series, in partnership with the Institute for Humanities in Africa, UCT, the Wits History Workshop, IFAS and NIHSS Defeating Apartheid: Cuba in Southern Africa Presenters: Presenter: Prof. Piero Gleijeses, School of Advanced International Studies, Johns Hopkins University and author of Visions of Freedom: Havana, Washington, Pretoria and the Struggle for Southern Africa 1976-1991 Chair: Associate Professor Shamil Jeppie, UCT Moderator: Prof. John Stanfield, DGSD, HSRC ..
Clinical characteristics of patients newly diagnosed with COPD by the fixed ratio and lower limit of normal criteria: a cross-sectional analysis of the TargetCOPD trial
No full textMartin R Miller,1 Shamil Haroon,1 Rachel E Jordan,1 Alice J Sitch,1 Andrew P Dickens,1 Alexandra Enocson,1 David A Fitzmaurice,2 Peymané Adab1 1Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK; 2Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK Background: Consensus on the definition of airflow obstruction to diagnose COPD remains unresolved.Methods: We undertook systematic case finding for COPD in primary care using the fixed ratio (FR) criterion (forced expiratory volume in 1 s/forced vital capacity [FEV1/FVC] <0.7) for defining airflow obstruction and also using the lower limit of normal (LLN). We then compared the clinical characteristics of those identified by the 2 criteria.Results: A total of 3,721 individuals reporting respiratory symptoms were invited for spirometry. A total of 2,607 attended (mean age 60.4 years, 52.8% male, 29.8% current smokers) and 32.6% had airflow obstruction by FR (“FR+”) and 20.2% by LLN (“LLN+”). Compared with the LLN+/FR+ group, the LLN–/FR+ group (12.4%) was significantly older, had higher FEV1 and FEV1/FVC, lower COPD assessment test scores, and less cough, sputum, and wheeze, but was significantly more likely to report a diagnosis of heart disease (14.2% versus 6.9%, p<0.001). Compared with the LLN+/FR+ group, the LLN–/FR– group was younger, had a higher body mass index, fewer pack-years, a lower prevalence of respiratory symptoms except for dyspnea, and lower FVC and higher FEV1. The probability of known heart disease was significantly lower in the LLN+/FR+ group compared with those with preserved lung function (LLN–/FR–) (adjusted odds ratio 0.62, 95% CI: 0.43–0.90) but this was not seen in the LLN–/FR+ group (adjusted odds ratio 0.90, 95% CI: 0.63–1.29).Conclusion: In symptomatic individuals, defining airflow obstruction by FR instead of LLN identifies a significant number of individuals who have less respiratory and more cardiac clinical characteristics. Keywords: lower limit of normal, diagnostic criteria, primary car
Defeating Apartheid: Cuba in Southern Africa / HSRC Seminar 21st November
No full textInvitation HSRC Seminar Series, in partnership with the Institute for Humanities in Africa, UCT, the Wits History Workshop, IFAS and NIHSS Defeating Apartheid: Cuba in Southern Africa Presenters: Presenter: Prof. Piero Gleijeses, School of Advanced International Studies, Johns Hopkins University and author of Visions of Freedom: Havana, Washington, Pretoria and the Struggle for Southern Africa 1976-1991 Chair: Associate Professor Shamil Jeppie, UCT Moderator: Prof. John Stanfield, DGSD, HSRC ..
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