7 research outputs found
<i>Ubuntu</i> and the body: A perspective from theological anthropology as embodied sensing
No full textThe author asks whether the notion of ubuntu truly exists within contemporary South African society and how the experiencing of South Africans� embodiment can be connected to ubuntu � especially amongst black people. The notion of ubuntu is briefly explored within law and theology. The author has recently proposed a model for a contemporary theological anthropology as �embodied sensing� which functions within the intimate relationship of the lived body, experiencing in a concrete life-world, language, and the �more than�. It is from this perspective that the notion of ubuntu is explored.</p
Book Reviews
No full textBook Review 1Book Title: Drugs in Old Age: New Perspectives. British Medical Bulletin. Vol. 46Book Authors: M.J. Denham & C.F. George (Eds.)Pp. 299. Edinburgh: Churchill Livingstone. 1990.Book Review 2Book Title: Bile and Bile-duct Abnormalities. Pathophysiology, Diagnosis and ManagementBook Authors: G.N.J. Tytgat & K. Huibregrse (Eds.)Stuttgart: Georg Theme Verlag. 1989.Book Review 3Book Title: Radiology of Syndromes, Metabolic Disorders, and Skeletal Dysplasias. 3rd ed Book Authors: Hooshang Taybi & Ralph S. Lachman (Eds.)Chicago: Year Book Publishers. 1990Book Review 4Book Title: Manual of Epidemiology for District Health ManagementBook Authors: J.P. Vaughan & R.J. Morrow (Eds.)Pp. viii + 198. Illustrated. Geneva: WHO. 1989.Book Review 5Book Title: Intra-uterine Growth Retardation. Nestle Nutrition Workshop Series. Vol. 18Book Author: Jacques Senterre (Ed.)Pp. xvi + 300. Illustrated. New York: Raven Press. 198
Dental morphology and variation across holocene Khoesan people of Southern Africa
No full textIncludes bibliographical references.Dental analyses of the Holocene Khoesan populations of southern Africa can provide insight into the biological evolution of an anthropologically important people. There have been many studies of dental variation in Holocene populations of Europe and the Americas, but few of African populations. Despite the Khoesan being the focus of much osteological research over the last two decades, their dental morphology is understudied and we know little about their dental evolution. Here, I assess the metric and non-metric dental morphology and variation of Holocene Khoesan individuals across southern Africa (N=487). Due to the fragmentary nature of many archaeological skeletons, most previous work on Khoesan osteology has focused on the second half of the Holocene, because more recent skeletons tend to be better preserved. There are, however, relatively abundant and well-preserved dental remains from the early Holocene. These are studied in detail for the first time in this dissertation, adding to our understanding of the emergence of Holocene Khoesan dentition and providing insight into phenotypic (and presumably genetic) continuity in this region. In addition to examining similarities/differences among the Khoesan through space and time, comparisons are made between the teeth of Khoesan and those of Holocene archaeological skeletons from East Africa (Kenya) to provide a broader context for interpreting the Khoesan dentition. Comparisons are also made between Holocene Khoesan and Mid-Late Pleistocene teeth from southern Africa in order to provide insights into dental relationships deeper in time. There are six aims of this thesis: (1) to construct the population's dental map and with it, (2) evaluate the significance of Khoesan Late mid-Holocene body size fluctuations and (3) assess the question of population continuity or replacement ca. 2000 BP with the introduction of herding in South Africa, (4) to explore possible geographic differences among Khoesan dentitions (5) to investigate temporal differences within the Holocene, and also to compare Holocene and earlier hunter-gatherers to assess population continuity/discontinuity, and (6) to evaluate the position of Khoesan dentition in a global context. Up to 52 non-metric traits were scored using the Arizona State University Dental Anthropology System. To test for significant relationships between groups through time, chi-square statistics were employed on dichotomised data and the mean measure of divergence was assessed in order to identify phenetic similarities and dissimilarities between regions. Additionally, MANOVAs and Principal Components Analysis were used to investigate size and shape variation. Metric analyses demonstrate minor size/shape variation between temporal and regional groups. Increased metric variation is observed during the Late Holocene, coinciding with fluctuations in body size documented in previous studies. Although some differences in trait frequencies are observed during the Late Holocene, there is little variation in qualitative traits throughout the Khoesan sample. This suggests that the minor differences observed result from intrinsic factors such as geographic variation, rather than gene flow from outlying areas. Teeth from the Mid-Late Pleistocene demonstrate a degree of phenetic affinity to Holocene Khoesan dentition. Finally, the Khoesan dentition is significantly different from global dental complexes, as exemplified by a suite of twelve core Khoesan traits that distinguish Khoesan teeth from other dental patterns (including Afridonty). Taken together, these results support hypotheses of morphological and genetic continuity in southern African populations during the Holocene, with some evidence for continuity deeper in time. In addition, these results place the Khoesan dentition at the margins of the range of human dental variation and call into question the fit of this dental map into current sub-Saharan African dental models
Determinants of recovery from post-COVID-19 dyspnoea: analysis of UK prospective cohorts of hospitalised COVID-19 patients and community-based controls
No full textBackground
The risk factors for recovery from COVID-19 dyspnoea are poorly understood. We investigated determinants of recovery from dyspnoea in adults with COVID-19 and compared these to determinants of recovery from non-COVID-19 dyspnoea.
Methods
We used data from two prospective cohort studies: PHOSP-COVID (patients hospitalised between March 2020 and April 2021 with COVID-19) and COVIDENCE UK (community cohort studied over the same time period). PHOSP-COVID data were collected during hospitalisation and at 5-month and 1-year follow-up visits. COVIDENCE UK data were obtained through baseline and monthly online questionnaires. Dyspnoea was measured in both cohorts with the Medical Research Council Dyspnoea Scale. We used multivariable logistic regression to identify determinants associated with a reduction in dyspnoea between 5-month and 1-year follow-up.
Findings
We included 990 PHOSP-COVID and 3309 COVIDENCE UK participants. We observed higher odds of improvement between 5-month and 1-year follow-up among PHOSP-COVID participants who were younger (odds ratio 1.02 per year, 95% CI 1.01–1.03), male (1.54, 1.16–2.04), neither obese nor severely obese (1.82, 1.06–3.13 and 4.19, 2.14–8.19, respectively), had no pre-existing anxiety or depression (1.56, 1.09–2.22) or cardiovascular disease (1.33, 1.00–1.79), and shorter hospital admission (1.01 per day, 1.00–1.02). Similar associations were found in those recovering from non-COVID-19 dyspnoea, excluding age (and length of hospital admission).
Interpretation
Factors associated with dyspnoea recovery at 1-year post-discharge among patients hospitalised with COVID-19 were similar to those among community controls without COVID-19.
Funding
PHOSP-COVID is supported by a grant from the MRC-UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19. The views expressed in the publication are those of the author(s) and not necessarily those of the National Health Service (NHS), the NIHR or the Department of Health and Social Care.
COVIDENCE UK is supported by the UK Research and Innovation, the National Institute for Health Research, and Barts Charity. The views expressed are those of the authors and not necessarily those of the funders
A study of fund administrators' job performance in a financial institution
No full textBibliography: leaves 119-140
Prevalence of physical frailty, including risk factors, up to 1 year after hospitalisation for COVID-19 in the UK: a multicentre, longitudinal cohort studyResearch in context
No full textSummary: Background: The scale of COVID-19 and its well documented long-term sequelae support a need to understand long-term outcomes including frailty. Methods: This prospective cohort study recruited adults who had survived hospitalisation with clinically diagnosed COVID-19 across 35 sites in the UK (PHOSP-COVID). The burden of frailty was objectively measured using Fried's Frailty Phenotype (FFP). The primary outcome was the prevalence of each FFP group—robust (no FFP criteria), pre-frail (one or two FFP criteria) and frail (three or more FFP criteria)—at 5 months and 1 year after discharge from hospital. For inclusion in the primary analysis, participants required complete outcome data for three of the five FFP criteria. Longitudinal changes across frailty domains are reported at 5 months and 1 year post-hospitalisation, along with risk factors for frailty status. Patient-perceived recovery and health-related quality of life (HRQoL) were retrospectively rated for pre-COVID-19 and prospectively rated at the 5 month and 1 year visits. This study is registered with ISRCTN, number ISRCTN10980107. Findings: Between March 5, 2020, and March 31, 2021, 2419 participants were enrolled with FFP data. Mean age was 57.9 (SD 12.6) years, 933 (38.6%) were female, and 429 (17.7%) had received invasive mechanical ventilation. 1785 had measures at both timepoints, of which 240 (13.4%), 1138 (63.8%) and 407 (22.8%) were frail, pre-frail and robust, respectively, at 5 months compared with 123 (6.9%), 1046 (58.6%) and 616 (34.5%) at 1 year. Factors associated with pre-frailty or frailty were invasive mechanical ventilation, older age, female sex, and greater social deprivation. Frail participants had a larger reduction in HRQoL compared with before their COVID-19 illness and were less likely to describe themselves as recovered. Interpretation: Physical frailty and pre-frailty are common following hospitalisation with COVID-19. Improvement in frailty was seen between 5 and 12 months although two-thirds of the population remained pre-frail or frail. This suggests comprehensive assessment and interventions targeting pre-frailty and frailty beyond the initial illness are required. Funding: UK Research and Innovation and National Institute for Health Research
Effects of sleep disturbance on dyspnoea and impaired lung function following hospital admission due to COVID-19 in the UK: a prospective multicentre cohort study
No full textBackground:
Sleep disturbance is common following hospital admission both for COVID-19 and other causes. The clinical associations of this for recovery after hospital admission are poorly understood despite sleep disturbance contributing to morbidity in other scenarios. We aimed to investigate the prevalence and nature of sleep disturbance after discharge following hospital admission for COVID-19 and to assess whether this was associated with dyspnoea.
Methods:
CircCOVID was a prospective multicentre cohort substudy designed to investigate the effects of circadian disruption and sleep disturbance on recovery after COVID-19 in a cohort of participants aged 18 years or older, admitted to hospital for COVID-19 in the UK, and discharged between March, 2020, and October, 2021. Participants were recruited from the Post-hospitalisation COVID-19 study (PHOSP-COVID). Follow-up data were collected at two timepoints: an early time point 2–7 months after hospital discharge and a later time point 10–14 months after hospital discharge. Sleep quality was assessed subjectively using the Pittsburgh Sleep Quality Index questionnaire and a numerical rating scale. Sleep quality was also assessed with an accelerometer worn on the wrist (actigraphy) for 14 days. Participants were also clinically phenotyped, including assessment of symptoms (ie, anxiety [Generalised Anxiety Disorder 7-item scale questionnaire], muscle function [SARC-F questionnaire], dyspnoea [Dyspnoea-12 questionnaire] and measurement of lung function), at the early timepoint after discharge. Actigraphy results were also compared to a matched UK Biobank cohort (non-hospitalised individuals and recently hospitalised individuals). Multivariable linear regression was used to define associations of sleep disturbance with the primary outcome of breathlessness and the other clinical symptoms. PHOSP-COVID is registered on the ISRCTN Registry (ISRCTN10980107).
Findings:
2320 of 2468 participants in the PHOSP-COVID study attended an early timepoint research visit a median of 5 months (IQR 4–6) following discharge from 83 hospitals in the UK. Data for sleep quality were assessed by subjective measures (the Pittsburgh Sleep Quality Index questionnaire and the numerical rating scale) for 638 participants at the early time point. Sleep quality was also assessed using device-based measures (actigraphy) a median of 7 months (IQR 5–8 months) after discharge from hospital for 729 participants. After discharge from hospital, the majority (396 [62%] of 638) of participants who had been admitted to hospital for COVID-19 reported poor sleep quality in response to the Pittsburgh Sleep Quality Index questionnaire. A comparable proportion (338 [53%] of 638) of participants felt their sleep quality had deteriorated following discharge after COVID-19 admission, as assessed by the numerical rating scale. Device-based measurements were compared to an age-matched, sex-matched, BMI-matched, and time from discharge-matched UK Biobank cohort who had recently been admitted to hospital. Compared to the recently hospitalised matched UK Biobank cohort, participants in our study slept on average 65 min (95% CI 59 to 71) longer, had a lower sleep regularity index (–19%; 95% CI –20 to –16), and a lower sleep efficiency (3·83 percentage points; 95% CI 3·40 to 4·26). Similar results were obtained when comparisons were made with the non-hospitalised UK Biobank cohort. Overall sleep quality (unadjusted effect estimate 3·94; 95% CI 2·78 to 5·10), deterioration in sleep quality following hospital admission (3·00; 1·82 to 4·28), and sleep regularity (4·38; 2·10 to 6·65) were associated with higher dyspnoea scores. Poor sleep quality, deterioration in sleep quality, and sleep regularity were also associated with impaired lung function, as assessed by forced vital capacity. Depending on the sleep metric, anxiety mediated 18–39% of the effect of sleep disturbance on dyspnoea, while muscle weakness mediated 27–41% of this effect.
Interpretation:
Sleep disturbance following hospital admission for COVID-19 is associated with dyspnoea, anxiety, and muscle weakness. Due to the association with multiple symptoms, targeting sleep disturbance might be beneficial in treating the post-COVID-19 condition.
Funding:
UK Research and Innovation, National Institute for Health Research, and Engineering and Physical Sciences Research Council
